Stye : External Hordeolum

An External hordeolum
Sty



is an acute small staphylococcal abscess of a lash follicle and its associated gland of Zeis or moll.

Signs:
Tender Inflamed swelling in the lid Margin, which points anteriorly thought the skin.
More than one lesion may be present and occasionally minute abscess may involve the entire lid margin.
In severe case a mild preseptal cellulitis may be present.

Treatment:
No treatment is required in most cases because styes frequently resove spontaneously or discharge anteriorly
Hot compresses
Epilation
Systemic Antibiotics may be necessary.

Conjunctivitis

Conjunctivitis is an inflammation or infection of the conjunctiva, the thin transparent layer of tissue that lines the inner surface of the eyelid and covers the white part of the eye. Conjunctivitis, often called “pink eye,” is a common eye disease, especially in children. It may affect one or both eyes. Some forms of conjunctivitis can be highly contagious and easily spread in schools and at home. While conjunctivitis is usually a minor eye infection, sometimes it can develop into a more serious problem.

Conjunctivitis may be caused by a viral or bacterial infection. It can also occur due to an allergic reaction to irritants in the air like pollen and smoke, chlorine in swimming pools, and ingredients in cosmetics or other products that come in contact with the eyes. Sexually transmitted diseases like Chlamydia and gonorrhea are less common causes of conjunctivitis.

symptoms:

* A gritty feeling in one or both eyes
* Itching or burning sensation in one or both eyes
* Excessive tearing
* Discharge coming from one or both eyes
* Swollen eyelids
* Pink discoloration to the whites of one or both eyes
* Increased sensitivity to light

What causes conjunctivitis?
Allergic Conjunctivitis occurs more commonly among people who already have seasonal allergies.

Allergic Conjunctivitis occurs more commonly among people who already have seasonal allergies.

The cause of conjunctivitis varies depending on the offending agent. There are three main categories of conjunctivitis: allergic, infectious and chemical:
Allergic Conjunctivitis

* Allergic Conjunctivitis occurs more commonly among people who already have seasonal allergies. At some point they come into contact with a substance that triggers an allergic reaction in their eyes.

* Giant Papillary Conjunctivitis is a type of allergic conjunctivitis caused by the chronic presence of a foreign body in the eye. This condition occurs predominantly with people who wear hard or rigid contact lenses, wear soft contact lenses that are not replaced frequently, have an exposed suture on the surface or the eye, or have a glass eye.

Infectious Conjunctivitis

* Bacterial Conjunctivitis is an infection most often caused by staphylococcal or streptococcal bacteria from your own skin or respiratory system. Infection can also occur by transmittal from insects, physical contact with other people, poor hygiene (touching the eye with unclean hands), or by use of contaminated eye makeup and facial lotions.

* Viral Conjunctivitis is most commonly caused by contagious viruses associated with the common cold. The primary means of contracting this is through exposure to coughing or sneezing by persons with upper respiratory tract infections. It can also occur as the virus spreads along the body’s own mucous membranes connecting lungs, throat, nose, tear ducts, and conjunctiva.

* Ophthalmia Neonatorum is a severe form of bacterial conjunctivitis that occurs in newborn babies. This is a serious condition that could lead to permanent eye damage unless it is treated immediately. Ophthalmia neonatorum occurs when an infant is exposed to Chlamydia or gonorrhea while passing through the birth canal.

Chemical Conjunctivitis

Chemical Conjunctivitis can be caused by irritants like air pollution, chlorine in swimming pools, and exposure to noxious chemicals.

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How is conjunctivitis diagnosed?
Comprehensive Eye Exam

Conjunctivitis can be diagnosed through a comprehensive eye examination.

Conjunctivitis can be diagnosed through a comprehensive eye examination. Testing, with special emphasis on evaluation of the conjunctiva and surrounding tissues, may include:

* Patient history to determine the symptoms the patient is experiencing, when the symptoms began, and the presence of any general health or environmental conditions that may be contributing to the problem.

* Visual acuity measurements to determine the extent to which vision may be affected.

* Evaluation of the conjunctiva and external eye tissue using bright light and magnification.

* Evaluation of the inner structures of the eye to ensure that no other tissues are affected by the condition.

* Supplemental testing may include taking cultures or smears of conjunctival tissue, particularly in cases of chronic conjunctivitis or when the condition is not responding to treatment.

Using the information obtained from these tests, your optometrist can determine if you have conjunctivitis and advise you on treatment options.

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How is conjunctivitis treated?

Treatment of conjunctivitis is directed at three main goals:

1. To increase patient comfort.
2. To reduce or lessen the course of the infection or inflammation.
3. To prevent the spread of the infection in contagious forms of conjunctivitis.

The appropriate treatment for conjunctivitis depends on its cause:

* Allergic conjunctivitis – The first step should be to remove or avoid the irritant, if possible. Cool compresses and artificial tears sometimes relieve discomfort in mild cases. In more severe cases, non-steroidal anti-inflammatory medications and antihistamines may be prescribed. Cases of persistent allergic conjunctivitis may also require topical steroid eye drops.

* Bacterial conjunctivitis – This type of conjunctivitis is usually treated with antibiotic eye drops or ointments. Improvement can occur after three or four days of treatment, but the entire course of antibiotics needs to be used to prevent recurrence.

* Viral Conjunctivitis – There are no available drops or ointments to eradicate the virus for this type of conjunctivitis. Antibiotics will not cure a viral infection. Like a common cold, the virus just has to run its course, which may take up to two or three weeks in some cases. The symptoms can often be relieved with cool compresses and artificial tear solutions. For the worst cases, topical steroid drops may be prescribed to reduce the discomfort from inflammation, but do not shorten the course of the infection. Some doctors may perform an ophthalmic iodine eye wash in the office in hopes of shortening the course of the infection. This newer treatment has not been well studied yet, therefore no conclusive evidence of the success exists.

* Chemical Conjunctivitis – Treatment for chemical conjunctivitis requires careful flushing of the eyes with saline and may require topical steroids. The more acute chemical injuries are medical emergencies, particularly alkali burns, which can lead to severe scarring, intraocular damage or even loss of the eye.

Contact Lens Wearers
Contact lens wearers may need to discontinue wearing their lenses while the conjunctivitis is active.

Contact lens wearers may need to discontinue wearing their lenses while the conjunctivitis is active.

Contact lens wearers may need to discontinue wearing their lenses while the condition is active. Your doctor can advise you on the need for temporary restrictions on contact lens wear.

If the conjunctivitis developed due to wearing contact lenses, your eye doctor may recommend that you switch to a different type of contact lens or disinfection solution. Your optometrist might need to alter your contact lense prescription to a type of lens that you replace more frequently to prevent the conjunctivitis from recurring.
Self-care

Practicing good hygiene is the best way to control the spread of conjunctivitis. Once an infection has been diagnosed, follow these steps:

* Don't touch your eyes with your hands.
* Wash your hands thoroughly and frequently.
* Change your towel and washcloth daily, and don't share them with others.
* Discard eye cosmetics, particularly mascara.
* Don't use anyone else's eye cosmetics or personal eye-care items.
* Follow your eye doctor's instructions on proper contact lens care.

You can soothe the discomfort of viral or bacterial conjunctivitis by applying warm compresses to your affected eye or eyes. To make a compress, soak a clean cloth in warm water and wring it out before applying it gently to your closed eyelids.

For allergic conjunctivitis, avoid rubbing your eyes. Instead of warm compresses, use cool compresses to soothe your eyes. Over the counter eye drops are available. Antihistamine eye drops should help to alleviate the symptoms, and lubricating eye drops help to rinse the allergen off of the surface of the eye.

See your doctor of optometry when you experience conjunctivitis to help diagnose the cause and the proper course of action.

Seasonal hyperacute panuveitis (SHAPU) In Nepal

Seasonal hyperacute panuveitis (SHAPU), characterized by an unusual form of unilateral severe hyper acute diffused intraocular inflammation, is one of the mysterious eye diseases of which the definite cause and treatment remains yet to be tound out. In this study, a total of six cases were included. Aqueous and vitreous samples were subjected to direct microscopy and culture (bacterial or fungal). Of the six cases included, two yielded Streptococcus pneumoniae and one Acinetobactor sp. on culture. All three culture positive samples showed pus cells in direct microscopic examination (gram stain). All cases were subjected to vitrectomy and intravitreal antibiotic and steroid injection, along with oral antibiotics and steroid. Five cases were also treated with antiviral agent. After treatment four cases showed reversal of hypotony and three cases recovered some vision.

Moths have been reported to increase the prevalence of this disease. Complications can be as devastating as blindness.

Read NMJ journal Article...Read

Computer Eye Strain: Tips to relieve

Computer Eye Strain: 10 Steps for Relief

1. Get a computer eye exam.

2. Use proper lighting.

3. Minimize glare.

4. Upgrade your display.

5. Adjust the brightness and contrast of your computer screen

6. Blink more often.

7. Exercise your eyes.

8. Take frequent breaks.

9. Modify your workstation.

10. Consider computer eyewear.

Top 10 causes of Blindness

Causes of blindness and visual impairment

In spite of the progress made in surgical techniques in many countries during the last ten years, cataract (47.9%) remains the leading cause of visual impairment in all areas of the world, except for developed countries.
Other main causes of visual impairment in 2002 are
glaucoma (12.3%),
age-related macular degeneration (AMD) (8.7%),
corneal opacities (5.1%),
diabetic retinopathy (4.8%),
childhood blindness (3.9%),
trachoma (3.6%), and
onchocerciasis (0.8%).

The causes of avoidable visual impairment world wide are all the above except for AMD. In the least-developed countries, and in particular Sub-Saharan Africa, the causes of avoidable blindness are primarily, cataract (50%), glaucoma (15%), corneal opacities (10%), trachoma (6.8%), childhood blindness (5.3%) and onchocerciasis (4%).

Sudden Visual Loss or Blindness

Sudden Visual Loss

Etiology:
transient visual obscuration, TVO, papilledema, increased intracranial pressure, amaurosis fugax, monocular blindness, partial blindness, total blindness, transient monocular visual loss, TMVL, transient monocular blindness, TMB, transient bilateral visual loss, TBVL, ocular infarction, ischemic damage to the eye, internal carotid artery disease, ICA disease, angle-closure glaucoma, central retinal artery occlusion, CRAO, branch retinal artery occlusion, BRAO, ischemia of the optic nerve, anterior ischemic optic neuropathy, AION, ruptured globe, sudden visual loss, decreased vision, nonarteric anterior ischemic optic neuropathy, NAION, migraine, scintillating scotoma, intraocular foreign body, cardiac disease, stenotic vascular disease, carotid or vertebral artery atherosclerotic disease, fibromuscular dysplasia, arteritis, carotid artery dissection, vertebral artery dissection, platelet-containing emboli, hypercoagulable states, antiphospholipid syndrome, anemia

Preventable Blindness

Causes:

Cataract

Corneal diseases

retinal pathology

glaucoma

trachoma

Injuries

Cataract: A waterfall that curtains your sight

What is a cataract?
When cataracts are mentioned, people often think of a film that grows on their eyes causing them to see double or blurred images. However, a cataract does not form on the eye, but rather within the eye.
Eye without a cataract
Eye with a cataract
A cataract is a clouding of the natural lens, the part of the eye responsible for focusing light and producing clear, sharp images. The lens is contained in a sealed bag or capsule. As old cells die they become trapped within the capsule. Over time, the cells accumulate causing the lens to cloud, making images look blurred or fuzzy. For most people, cataracts are a natural result of aging.
In fact, they are the leading cause of visual loss among adults 55 and older. Eye injuries, certain medications, and diseases such as diabetes and alcoholism have also been known to cause cataracts.

Watch Video: 8 minutes

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GLAUCOMA: Facts

Glaucoma Facts and Stats

Glaucoma is a very misunderstood disease. Often, people don’t realize the severity or who is affected. We hope the following information is helpful to you.
Four Key Facts About Glaucoma.
Glaucoma is a leading cause of blindness
Glaucoma can cause blindness if it is left untreated. And unfortunately approximately 10% of people with glaucoma who receive proper treatment still experience loss of vision.
There is no cure (yet) for glaucoma
Glaucoma is not curable, and vision lost cannot be regained. With medication and/or surgery, it is possible to halt further loss of vision. Since glaucoma is a chronic condition, it must be monitored for life.

Diagnosis is the first step to preserving your vision.

Everyone is at risk for glaucomaEveryone is at risk for glaucoma from babies to senior citizens. Yes, older people are at a higher risk for glaucoma but babies can be born with glaucoma (approximately 1 out of every 10,000 babies born in the United States).
Young adults can get glaucoma, too. African-Americans in particular are susceptible at a younger age.
There may be no symptoms to warn youWith open angle glaucoma, the most common form, there are virtually no symptoms. Usually, no pain is associated with increased eye pressure.
Vision loss begins with peripheral or side vision. You may compensate for this unconsciously by turning your head to the side, and may not notice anything until significant vision is lost. The best way to protect your sight from glaucoma is to get tested. If you have glaucoma, treatment can begin immediately.
Some Statistics About GlaucomaSources are listed at the bottom of this page.
It is estimated that over 3 million Americans have glaucoma but only half of those know they have it. (1)
Approximately 120,000 are blind from glaucoma, accounting for 9% to 12% of all cases of blindness in the U.S. (2)
About 2% of the population ages 40-50 and 8% over 70 have elevated IOP.
Glaucoma is the second leading cause of blindness in the world, according to the World Health Organization.
Glaucoma is the leading cause of blindness among African-Americans. (2)
Glaucoma is 6 to 8 times more common in African-Americans than Caucasians. (3)
African-Americans ages 45-65 are 14 to 17 times more likely to go blind from glaucoma than Caucasians with glaucoma in the same age group.
The most common form, Open Angle Glaucoma, accounts for 19% of all blindness among African-Americans compared to 6% in Caucasians. (4)
Other high-risk groups include: people over 60, family members of those already diagnosed, diabetics, and people who are severely nearsighted.
Estimates put the total number of suspected cases of glaucoma at around 65 million worldwide. (5)
Public Awareness and AttitudesA survey done for GRF by ICR, Inc. in Media, PA, found that:
74% of over 1,000 people interviewed said they have their eyes examined at least every two years. 61% of those (less than half of all adult Americans) are receiving a dilated eye exam (the best and most effective way to detect glaucoma). 16.1% of African-Americans were unfamiliar with glaucoma. 8.8% of Caucasians do not know anything about glaucoma. A Research To Prevent Blindness Survey found that:
Blindness ranked third (after cancer and heart disease) as people’s major fear. 20% of people knew that glaucoma was related to elevated pressure within the eye. Most of them mistakenly thought people could tell if they had glaucoma due to symptoms, or that it was easily cured, or that it did not lead to blindness. 50% had heard of glaucoma, but weren’t sure what it was. 30% had never heard of glaucoma.


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Diagnostic Tests

Early detection, through regular and complete eye exams, is the key to protecting your vision from damage caused by glaucoma.
It is important to have your eyes examined regularly. Your eyes should be tested at:
ages 35 and 40
age 40 to age 60, get tested every two to four years
after age 60, every one to two years
Anyone with high risk factors, should be tested every year or two after age 35.

Four Common Tests for Glaucoma
Regular glaucoma check-ups include two routine eye tests: tonometry and ophthalmoscopy.
1.Tonometry
Ttest he tonometry measures the inner pressure of the eye. Usually drops are used to numb the eye. Then the doctor or technician will use a special device that measures the eye’s pressure.

2.Ophthalmoscopy
Ophthalmoscopy is used to examine the inside of the eye, especially the optic nerve. In a darkened room, the doctor will magnify your eye by using an ophthalmoscope (an instrument with a small light on the end). This helps the doctor look at the shape and color of the optic nerve.
If the pressure in the eye is not in the normal range, or if the optic nerve looks unusual, then one or two special glaucoma tests will be done. These two tests are called perimetry and gonioscopy.
Perimetry
The perimetry test is also called a visual field test. During this test, you will be asked to look straight ahead and then indicate when a moving light passes your peripheral (or side) vision. This helps draw a “map” of your vision.

3.Gonioscopy
Gonioscopy is a painless eye test that checks if the angle where the iris meets the cornea is open or closed, showing if either open angle or closed angle glaucoma is present.
Optic Nerve Computer Imaging
In recent years three new techniques of optic nerve imaging have become widely available. These are scanning laser polarimetry (GDx), confocal laser ophthalmoscopy (Heidelberg Retinal Tomography or HRT II), and optical coherence tomography (OCT).
The GDx machine does not actually image the optic nerve but rather it measures the thickness of the nerve fiber layer on the retinal surface just before the fibers pass over the optic nerve margin to form the optic nerve. The HRT II scans the retinal surface and optic nerve with a laser. It then constructs a topographic (3-D) image of the optic nerve including a contour outline of the optic cup. The nerve fiber layer thickness is also measured. The OCT instrument utilizes a technique called optical coherence tomography which creates images by use of special beams of light. The OCT machine can create a contour map of the optic nerve, optic cup and measure the retinal nerve fiber thickness. Over time all three of these machines can detect loss of optic nerve fibers.

4.Your intraocular eye pressure

(IOP) is important to determining your risk for glaucoma. If you have high IOP, careful management of your eye pressure with medications can help prevent vision loss. Recent discoveries about the cornea, the clear part of the eye’s protective covering, are showing that corneal thickness is an important factor in accurately diagnosing eye pressure. In response to these findings, the Glaucoma Research Foundation has put together this brief guide to help you understand how your corneal thickness affects your risk for glaucoma, and what you can do to make sure your diagnosis is accurate.
Corneal Thickness
In 2002, the five-year report of the Ocular Hypertension Study (OHTS) was released. The study’s goal was to determine if early intervention with pressure lowering medications could reduce the number of ocular hypertensive (OHT) patients that develop glaucoma. During the study, a critical discovery was made regarding corneal thickness and its role in intraocular eye pressure and glaucoma development.

Why is Corneal Thickness Important?
Corneal thickness is important because it can mask an accurate reading of eye pressure, causing doctors to treat you for a condition that may not really exist or to treat you unnecessarily when are normal. Actual IOP may be underestimated in patients with thinner CCT, and overestimated in patients with thicker CCT. This may be important to your diagnosis; some people originally diagnosed with normal tension glaucoma may in fact be more accurately treated as having regular glaucoma; others diagnosed with ocular hypertension may be better treated as normal based on accurate CCT measurement. In light of this discovery, it is important to have your eyes checked regularly and to make sure your doctor takes your CCT into account for diagnosis.
A Thin Cornea—The Danger of Misreading Eye Pressure
Many times, patients with thin corneas (less than 555 µm) show artificially low IOP readings. This is dangerous because if your actual IOP is higher than your reading shows, you may be at risk for developing glaucoma and your doctor may not know it. Left untreated, high IOP can lead to glaucoma and vision loss. It is important that your doctor have an accurate IOP reading to diagnose your risk and decide upon a treatment plan.
A Thicker Cornea May Mean Less Reason to Worry About Glaucoma
Those patients with thicker CCT may show a higher reading of IOP than actually exists. This means their eye pressure is lower than thought, a lower IOP means that risk for developing glaucoma is lowered. However, it is still important to have regular eye exams to monitor eye pressure and stay aware of changes.
Pachymetry—A Simple Test to Determine Corneal Thickness
A pachymetry test is a simple, quick, painless test to measure the thickness of your cornea. With this measurement, your doctor can better understand your IOP reading, and develop a treatment plan that is right for your condition. The procedure takes only about a minute to measure both eyes.
Related Articles
What is Glaucoma?
Are You at Risk For Glaucoma?
Anatomy of the Eye
Glaucoma Facts and Stats
The Importance of Corneal Thickness