Tag: Eye problems

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.

Diabetes and the Eye

Diabetes not only affects the lifestyle of suffering people, it also puts the patient on higher risk of blindness. If blood sugar remains consistently high, over time it can affect all organs of the body, the eye is no exception. Diabetes can increase the risk for several eye diseases in the individual: eye cataracts, glaucoma and diabetic retinopathy.

Both type 1 and type 2 diabetes can cause major problems for the eyes by increasing the risk and severity of eye diseases, with diabetic retinopathy being the most common. The retina is the light sensitive part of the eye, and its innermost layer. The image of what you see is formed on the retina, and transmitted to the brain by the nerve of the eye, called the optic nerve. In Diabetic Retinopathy, the blood vessels in the retina of the eye may become fragile and leak blood and other proteins.

In later stages, abnormal new blood vessels grow on the surface of the retina. If the fluid leaks into the centre of eye it can lead to macular edema, which is the swelling of the macular area of the retina that is responsible for sharp central vision. Due to which one may have blurry vision. Most people with non proliferative retinopathy have no symptoms.

Diabetic retinopathy has four stages:

1. Mild Non-proliferative Retinopathy. This is characterised by weakening of the blood vessels, which develop small areas of balloon-like swelling in the retina’s tiny blood vessels called microaneurysms.

2. Moderate Non-proliferative Retinopathy. As the disease progresses, some blood vessels that nourish the retina get blocked resulting in blood vessels leaking protein into the retina.

3. Severe Non-proliferative Retinopathy. Many more blood vessels are blocked, depriving the retina of blood and oxygen. These areas of the retina send signals to the body to grow new blood vessels.

4. Proliferative Retinopathy. New blood vessels form in the retina, and these are abnormal and fragile. They grow on the surface the retina and along the surface of the vitreous gel. These abnormal vessels may leak blood, resulting in severe vision loss and even blindness.

Diabetes can affect eyes in a number of ways. The unusual changes in blood sugar levels resulting from diabetes can affect the lens inside the eye, especially when diabetes is uncontrolled. This can result in blurring of vision which comes and goes over the day, depending on your blood sugar levels. Control of blood sugar can stabilise the vision.

Prolonged deranged blood sugars can lead to a clouding of the lens of the eye, this is called a cataract. Cataract is a result of ageing, but the process becomes faster in diabetics.

Diabetes also increases the risk of glaucoma in a patient (see glaucoma).

The major problem with diabetic eye diseases is that they remain undiagnosed until the late stages, since they are asymptomatic at onset.

Therefore it’s important for those with diabetes to get a comprehensive dilated eye exam at least once a year. Those already diagnosed with diabetic retinopathy may need more frequent eye exams.

The following measures reduce the risk of developing diabetic eye conditions and decrease chances of progression of disease:
• Control blood sugar levels
• Control blood pressure
• Keep your cholesterol levels in check
• Be fit, maintain a healthy lifestyle and weight and give up smoking
• Be regular with medications and doctors appointments

There are a variety of medical and surgical options for glaucoma and diabetic retinopathy, while cataract is primarily a surgical disease. With early detection, proper treatment can be administered by an eye care professional to help control the effects of diabetic eye diseases and prevent blindness.