Tag: Eye problems

Eye Injuries

Eye injuries can sometimes cause serious damage, especially if not managed in time. It is prudent to see an eye doctor even for seemingly trivial eye injuries, regardless of whether you perceive a decrease in vision or not. Till such time that you reach your eye doctor, this is what you should do:

Something in the Eye (Foreign body)

• Do not rub the eye
• Pull down the upper lid and blink repeatedly
• Do not use tweezers or even cotton swab/buds on the black part of the eye (Cornea)
• You may try and use a sterile cotton swab/ bud gently remove the speck from to white of the eye or lid
• Wash the eye with drinking water
• See a doctor if the speck does not wash out

Cuts/ Stabs/Jabs in the eye

• Do not rub the eye
• Do not wash the eye
• Do not try to remove any foreign body stuck in the eye, seek immediate medical attention

Chemical Exposure

• Don’t rub your eyes
• Immediately wash the eye with lots of water, for at least ten to fifteen minutes
• Do not bandage the eye
• Seek immediate medical attention

Eye Allergy

Eye allergies, called allergic conjunctivitis, result when the eyes are exposed to something that irritates them (called an allergen). Because of this, the eyelids and conjunctiva may become red, swollen and itchy, with excessive tearing. Unlike infective conjunctivitis (which maybe bacterial, or more commonly, viral) allergic conjunctivitis is not transmitted by contact with the person suffering from it.

Causes:

  • Seasonal allergies: triggered by pollen, mould spores etc
  • Perennial allergies: exposure to other environmental triggers such as dust, smoke, pet hair, make up products

Symptoms:

  • Redness of eye
    Watering/ stringy/ ropey discharge
    Swelling of conjunctiva, eyelids

Treatment:

Identifying and removing the cause of allergic conjunctivitis, whenever possible, is critical. It’s best to avoid arid, dusty environs and to protect the eyes with wrap-around sunglasses from potential exposure to allergy causing agents. A humidifier to avoid the dryness caused by air-conditioning also helps. Ice packs and cold water compresses help in reducing the discomfort due to an eye allergy. The treatment options that your doctor will chose from are listed below. These are used in various combinations depending on disease severity and duration.

Topical tear supplements: Usually preservative free eye drops that keep the eyes lubricated help with decreasing the allergen load, as well as increase patient comfort.

Antihistamine eye drops: Help by decreasing the redness and the generalised allergic response.
Mast cell stabilizers eye drops:These act in the long term providing prophylaxis against a potential allergic reaction, and are recommended for those struggling with seasonal and perennial allergies.

NSAIDS or Non steroidal anti-inflammatory agents: Help by decreasing the inflammation caused by the allergies, and ease discomfort.

Steroid eye drops: Are usually limited to the severe cases not responding to conventional therapy, and must be used under strict medical supervision because of potential side effects.
Oral antihistamines (tablets) maybe prescribed in severe cases.

Dry Eye

When the eye does not produce adequate tears, or if the quality of the tears produced is poor, or in case the tears get evaporated at a speed greater than normal, the eyes may feel gritty and tired. This is called dry eye.

The surface of the eye may get inflamed along with dryness. If left untreated, this may lead to discomfort, pain, ulceration and scarring of the cornea.

Dry eye can make working on the computer or reading uncomfortable, and can also decrease the tolerance to dry, arid environments (including airplanes, and air-conditioned spaces).

Any disease process that alters the components of tears can make them unhealthy and result in dry eye.
The symptoms of dry eye include:

• Stinging or burning of the eye
• Gritty feeling, feeling a foreign body in the eye
• Excessive tearing
• Stringy discharge from the eye
• Pain and redness
• Episodes of blurred vision which may improve on blinking
• Decreased contact lens tolerance
• Discomfort while reading, working on the computer
• General eye fatigue
Causes of dryness of the eye include:

• Diseases of the eyelids such as meibomian gland dysfunction, lagophthalmos, increased size of palpebral fissure due to thyroid disease, trauma
• Pregnancy
• Menopause, and hormone replacement therapy
• Post- LASIK.
• Following chemical and thermal burns
• Infrequent blinking
• Long-term contact lens wear
• Dry eye can be associated with disorders such as Sjögren’s syndrome, lupus, and rheumatoid arthritis.
• Exposure to pollutants and irritants
• Thyroid disease and diabetes
• Facial nerve palsy
• Side effect of some medications, including anti allergics, tranquilizers, certain blood pressure medicines, Parkinson’s medications, contraceptive pills and anti-depressants.

Treatment of dry eye is an ongoing process. In case the underlying cause can be identified, it is treated while providing supportive therapy to ensure symptomatic relief.

Usually, your eye doctor will prescribe tear supplements (eye drops and gels) to keep you comfortable, the nature and frequency of which will be determined by disease severity. Preservative free tear supplements work best for dry eye.

Cyclosporine, an anti-inflammatory medication, is the only prescription drug available to treat dry eye. It is known to increase basic tear production, and reduce symptoms.

Your doctor may offer to insert punctal plugs into your eyes. These are small plugs that are inserted into the punctum of the eye, the drainage holes in your eyelid, that connect the eyes to your nose and throat. These plugs are made of silicone or collagen, are reversible, and do not cause any discomfort following insertion.

In some patients supplements or dietary sources (such as tuna fish) of omega-3 fatty acids may decrease symptoms of irritation.

Other supportive measures which may help you be more comfortable include:

• Wearing glasses or sunglasses (wrap around)
• Using a humidifier indoors
• Decreasing screen time
• Avoiding contact lens use
• Remembering to blink

Lasik

LASIK or “laser in situ keratomileusis.”   uses a specially designed laser to reshape the cornea, so your vision can be restored to normal without using spectacles. LASIK is an outpatient procedure, and generally takes 10 to 15 minutes for each eye. LASIK can be used to treat nearsightedness (myopia), farsightedness (hypermetropia) and also astigmatism.

In case you are interested in getting a surgery to get rid of your glasses, you can discuss the possibility of LASIK with your eye doctor, who will determine if the surgery is appropriate for you.

Contraindications for LASIK:

  • Age less than 18 years
  • Change in eyeglass or contact lens prescription in the past 12 months.
  • Thin cornea, keratoconus
  • Pregnancy and breastfeeding

Relative contraindications:

  • Certain diseases like chronic autoimmune disease (lupus, rheumatoid arthritis) , uncontrolled diabetes
  • Contact sports such as boxing, martial arts, wrestling
  • Previous eye inflammation, such as uveitis or iritis,  herpes s

Glaucoma

Severe dry eye

Cataract

Cataract is a part of the natural ageing process, but can affect any age group, including newborns. A clouding of the natural lens of the eye due to degenerative changes results in a blurring of vision.

The main signs and symptoms of cataract include:

  • Cloudy or blurred vision.
  • Decreased vision, especially at night
  • Sensitivity to light and glare.
  • Seeing “halos” around lights, especially around incandescent bulbs and car headlights.
  • Frequent changes in eyeglass.
  • Fading or yellowing of colours.
  • Double vision or “ghosting” of images.

The treatment for cataract is surgical, and is recommended based on the density of the cataract and its impact on daily activities of the patient.

In case both eyes are affected, your doctor will usually choose to operate the worse eye first, operating on the second after a gap of a few weeks.

The different types of cataract surgery are day care procedures, under local anaesthesia, and are usually elective i.e. you get to choose when you want to get the surgery done.

Cataract Surgery

Phacoemulsification uses ultrasound vibrations to break up the cloudy lens, so that it can be sucked out through a small cut in the eye. The incision heals on its own and does not require any eye patch or stitches. A foldable, artificial lens (intraocular lens, IOL) can be inserted through the same incision.

Phacoemulsification with a still smaller incision (1.8mm as compared to standard phacoemulsification incision of 2.2mm) is called Microincision Cataract Surgery (MICS).

This technique is associated with fewer complications such as astigmatism (irregular curvature of the cornea needing glasses for correction) and results in a much faster healing.

In case you do not want to wear glasses for reading following cataract surgery, your surgeon might offer you a multifocal lens. You may also be given the option of monovision, where one eye is corrected for distance, and the other for near work.