The HEALTH : July 2018 | Page 9

JULY , 2018 | The HEALTH issue : eye 09
JULY , 2018 | The HEALTH issue : eye 09
Dr Manoharan Shunmugam .
affects both eyes but may be asymmetrical . Blood vessels damaged from diabetic retinopathy can cause vision loss in two ways :
• Fragile , abnormal blood vessels can develop ( this is called proliferative retinopathy ) and leak blood into the retina . At first , there may only be a few specks of blood , or spots , “ floating ” in your vision .
• Hemorrhage ( bleeding ) tends to happen more than once , often during sleep . Sometimes , without treatment , the spots clear . However , bleeding can recur and cause severely blurred vision . If left untreated , proliferative retinopathy can cause severe vision loss and even blindness .
Proliferative retinopathy if not treated on time can lead to serious conditions such as ( tractional ) retinal detachments whereby abnormal blood vessels start pulling the retina off resulting in permanent vision loss .
Fluid can leak into the center of the macula , the part of the eye where sharp , straight-ahead vision occurs . The fluid makes the macula swell and blurring of vision . This condition is called macular oedema . It can occur at any stage of diabetic retinopathy , although it is more likely to occur as the disease progresses . Half of the people with proliferative retinopathy also have macular edema .
CREDIT : IMAGE COURTESY OF NIH NATIONAL EYE INSTITUTE
Vesicular eruptions caused by herpes zoster seen around the skin of the eyes .

Corneal ulcer

Sleeping in contact lenses identified among causes
Pantai Hospital Kuala Lumpur Consultant Ophthalmologist , Dr K . Sivamalar explained that conditions like high blood pressure , diabetes and common flu are triggers that are capable of waking up the dormant virus thus causing a flare up around the eye . The herpes zoster virus type 1 will also cause drops of vesicular eruptions around the skin of the eyes .
“ The virus ’ s effects can extend to the cornea causing scar formation . The cornea has five layers and the infection can go from the top layer to the bottom
Dr K . Sivamalar .
layer . Infection in the top layer will observe mild scarring however , if the infection goes to the bottom layer , it can cause more pain and in deeper layers will result in uveitis infection and inflammatory problems in the retina .”
The risks for developing blindness is noted to increase as well .
Another branch of the eight herpes viruses , Herpes Zoster virus type 2 is a usual result of chickenpox that remains dormant in the trigeminal ganglia which can flare up and as a result , can be disfiguring . Commonly observed , the presence of the virus comes up as a lot of crux and crusty vesicles containing pus . Another common observation would be rashes on the tip of the nose , called herpes zoster ophthalmicus .
Symptoms
Fevers , sprouts of vesicles , tearing , glares , photophobia and pain are symptoms to keep an eye on . This virus however , affects only one eye .
Get yourself treated
Antivirus is usually administered , however this too depends on the extent of the infection and location of the tissues that is involved in the eye .
ANTAI Hospital Kuala

P

Lumpur Ophthalmologist and Vitreoretinal surgeon Dr Manoharan Shunmugam described a corneal ulcer as an erosion or open sore in the outer layer of the cornea .
“ It is often the result of a localised infection , similar to an abscess . It can be caused by a variety of things including viruses , bacteria or fungi . Sometimes it can also be a result of some types of underlying illnesses which either cause very severe dryness or auto-immune ulcers .
Things that may put you at increased risk of a corneal ulcer include :
• Foreign bodies in the eye
• Contact-lens overuse ( this includes sleeping in contact lenses )
• Scratches ( abrasions ) on the eye surface
• Severely dry eyes
• Severe allergic eye disease
• Eyelids that do not close all the way , such as with Bell ’ s palsy
• Various inflammatory disorders
Symptoms
“ A swollen eyelid , redness , pain or
discomfort in the eye , pain when looking into bright light , watering eyes , blurred eyesight and a white patch seen on the cornea are common symptoms .”
“ Examination and tests includes visual acuity , slit-lamp ( microscope ) examination with fluorescein dye , swab of the eye or scrapings from the cornea to look for bacteria ,” he said .
Treatment
“ Eye drops and sometimes tablets are common treatment . However , severe ulcers can sometimes lead to scarring and if this happens to be in the centre of the cornea it can permanently affect your vision . Sometimes the only way of getting rid of the scar is to perform a corneal transplant .”
“ The ophthalmologist would also advice against eye make-up , prolonged period of contact lens use , to wear sunglasses or protective glasses and intensive eye drops .
Corneal ulcers can be prevented by paying close attention to cleanliness while handling contact lenses , not wearing them overnight or swimming in them .
gland openings and the lid may have associated notches , styes and Meibomian gland cysts . Tear film instability is often present , and can be identified by staining the tear film with a yellow dye called fluorescein . Inflammation and loss of the corneal surface skin cells ( the epithelium ) may also be seen on fluorescein staining .”
Treatment would include cleaning your eyelids twice a day , and eventually
Excess oil droplets form on the edge of your eyelid .
The edge of the eyelid becomes inflamed and crusty with flakes .
CREDIT : REPRODUCED FROM PATIENT PICTURES : OPHTHALMOLOGY , HEALTH PRESS , OXFORD 2001 . ILLUSTRATED BY DEE MCLEAN .
two or three times a week to prevent blepharitis from returning .
“ Artificial tear drops to treat dry eye symptoms and tear film instability , antibiotic eye-drops and ointments to treat acute infection if present , flaxseed oil supplements , mild steroid eye drops to treat any associated corneal and conjunctival inflammation and antibiotics ,” he said .

How to clean your eyelids ?

Wash your hands .

1

Soak a flannel / washcloth in warm water .

2 Close your eyes and gently press the flannel against them for three to five minutes . This will help to soften any hardened oil secretions . Massage your eyelids using forefinger .

3 Move in a downward motion for the upper eyelid and an upward motion for the lower eyelid . Add two drops of medicated baby

4 shampoo into a small cup of boiled then cooled water ( about 50 ml ). Soak a cotton bud in the water . Then , gently rub the cotton bud along the edge of the lower lid as it helps to tilt the lid outward using a finger from your other hand . The upper lid is more difficult to clean . It is best done with the eyelid closed and pulled slightly over the lower lid to ensure that you don ’ t poke yourself in the eye . Put in ointment / drops after you ’ ve finished .

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