A Family Doctor's Tale - BLINDNESS

DOC I AM BLIND

Blindness is the inability to see.

The degree of blindness depends on the extent of loss of vision.

The causes of blindness are:
1.cataract


2.glaucoma
Glaucoma is due to a build-up of pressure within the eye causing damage to the  optic nerve transmitting visual information from eye to the brain.

The damage is progressive with loss of peripheral vision  followed by reduction in central vision resulting in blindness.

3.Age-related macular degeneration
Age-related Macular degeneration (AMD) is a degenerative disorder affecting the macula at the back the eye.

4.Corneal opacities are often caused by infections or damage to the cornea


5.Retinal detachment
Retinal detachment occurs with ageing and myopia (nearsightedness) may cause the retina to be pulled and  detached.

6.Trachoma and other infections of the eye often cause loss of vision

7.Accidents (such as chemical burns,fireworks or sports injuries) affects the cornea of the eye


8.Vitamin A deficiency
Vitamin A deficiency leads to decreased production of a photosensitive pigment in the rods of the eye resulting in night blindness .


Three-quarters of all blindness can be prevented or treated.

Blindness is a lack of vision.
It may also refer to a loss of vision that cannot be corrected with glasses or contact lenses.

1.Partial blindness means that there is  very limited visual ability


2.Complete blindness means a total loss of visual or light perception .

3.People with a vision worse than 20/200 are usually legally blind.

Treatment of blindness:
1.Blindness due to some causes such as infection, Vitamin A deficiency or glaucoma can be prevented through early detection and appropriate treatment.

2.Although visual loss cannot be completely restored,  medical and surgical treatment can prevent the loss from further progress and  complete blindness.

3.Because many serious forms of visual loss are painless, any forms of vision loss will need to be detected early and treated to prevent blindness.

Prevention of blindness
1.Vitamin A deficiency cna be treated with Vitamin A to prevent scarring of the eye and the ensuing blindness

2.Diabetes must be well controlled and regular eye examinations are necessary to prevent retinopathy


3.Majority of eye injuries can be prevented by using safe physical activities and proper eye protection.


4.Ensure good lighting and install handrails along stairs to prevent falling especially among the elderly.

5.Sharp corners and edges of furniture may be padded or cushioned.

6.Protective eye glasses are used to prevent insecticides and corrosive liquids from entering the eyes


7.Children should avoid toys with sharp points, shafts, spikes, rods and sharp edges to prevent eye injuries.

A Simple Guide to Cataract

 A Simple Guide to Cataract
---------------------------------------

What is a Catarct?
-------------------------------

A cataract is a clouding of the eye's natural transparent lens, which helps us to focus on the objects we see.
The lens is mostly made of water and protein.
Due to age, some of the protein may clump together and start to cloud a small area of the lens. This is a cataract, and over time, it may grow larger and cloud more of the lens, making it harder to see.


How are Cataract Classified?
-----------------------------------------


Cataracts are classified as one of three types:
1.A nuclear cataract is most commonly seen as it forms.
This cataract forms in the nucleus, the center of the lens, and is due to natural aging changes.


2.A cortical cataract, which forms in the outer lens cortex, gradually extends its spokes from the outside of the lens to the center. Many diabetics develop cortical cataracts.


3.A subcapsular cataract begins at the back of the lens. 
People with diabetes, high farsightedness, retinitis pigmentosa or those taking high doses of steroids may develop a subcapsular cataract.


How Do You Diagnose a Cataract ?
----------------------------------------------


A cataract begins slowly and at first has little effect on your vision.
There may some blurring of vision .
Light from the sun or a lamp may seem too bright or glaring.
Colors may not appear as bright as they once did.

What are the causes of Cataracts?
-------------------------------------------------



The eye's lens changes as we age, forming cataracts.
1. exposure to ultraviolet light may be a cause of cataract development, so eye specialist recommend wearing sunglasses and a wide-brimmed hat.


2.Other types of radiation such as from TV or PC monitors may also be causes.
Airline pilots may be exposed to cosmic radiation.


3.People with diabetes are at risk for developing a cataract.
The same goes for users of steroids and diuretics.


4.Other risk factors include cigarette smoke, air pollution and heavy alcohol consumption


What is the treatment of Cataract?
------------------------------------------------


Symptomatic treatment:
When symptoms begin to appear, you may be able to improve your vision for a while using new glasses, strong bifocals, magnification, appropriate lighting or other visual aids.

Some eye care practitioners believe that a diet high in antioxidants, such as beta-carotene (vitamin A), selenium and vitamins C may slow down cataract development.


Eye drops such as Catalin and Quinax has been prescribed to slow down the development of cataract.


Surgical treatment:
An intraocular lens (IOL) is implanted in the eye in place of the patient's clouded natural lens.
During surgery, the surgeon will remove your clouded lens, and in most cases replace it with a clear, plastic intraocular lens (IOL).


What is the prognosis of Cataract?
-------------------------------------------------


Cataract surgery is very successful in restoring vision.

How do you Prevent Cataract?
----------------------------------------

The most important prevention for cataracts is to avoid direct sun rays and other forms of radiation from TV or PC monitors, polluted air and smoking.

A Simple Guide to Cytomegalovirus

A Simple Guide to Cytomegalovirus
-----------------------------------

What is Cytomegalovirus?
---------------------------

Cytomegalovirus is an acute viral disease of all ages which can be transmitted to the fetus before birth.

It affects people at all ages but seldom causes any symptoms in adults.


What are the causes of Cytomegalovirus?
----------------------------------------

Cytomegalovirus is a virus of the herpes group characterised by its ability to stay dormant in the body over a long period.

It is transmited in body fluid (urine, saliva ,blood, semen, tears and breast milk)


What are Signs and symptoms of Cytomegalovirus?
---------------------------------------------

Adult and children Cytomegalovirus infection do not normally give rise to symptoms except for mild fever and a mononucleosis-like illness.

Congenital Cytomegalovirus infections presents itself at birth:

1.Microcephaly

2.Hepatosplenomegaly with jaundice

3.Hearing impairment

4.Blindness

5.Chorioretinitis

6.Hemolytic anemia with petechiae

7.Seizures

8.Respiratory distress


How is the diagnosis of Cytomegalovirus made?
------------------------------------------

1.blood tests for igG or igM for Cytomegalovirus are positive within 3 weeks of birth

2.Usually appears normal at birth

3.Ultrasound during pregnancy to dentify any brain abnormalities .

4.Saliva , urine may be taken to test if there is presence of the Cytomegalovirus.


What are the complications of Cytomegalovirus?
-----------------------------------------------

1.Respiratory distress

2.Mental retardation

3.Hemolytic anemia

4.Blindness

5.Deafness


What is the treatment of Cytomegalovirus?
--------------------------------------------------

There is no effective treatment of Cytomegalovirus at the present moment.

A antiviral drug ganciclovir which is used to treat AIDS may help babies with Cytomegalovirus infection.

A vacine is also being developed for prevention.


What is the prognosis of Cytomegalovirus ?
------------------------------------------

Prognosis for congenital Cytomegalovirus infection is poor.

Adult Cytomegalovirus infection do not have any problem.


What are the Preventive measures taken for Cytomegalovirus ?
------------------------------------------------------------------

There is no vaccine at the present moment for Cytomegalovirus.

Transmission of Cytomegalovirus infection is always preventable because it is transmitted through body fluid from hand,nose and mouth of a suseceptible person.

People who interacts with children and pregnant mothers shuold practice good safe hygiene methods such as washing of hand and wearing of clothes when changing diapers.

Pregnant women are also advised to practice safe hygiene methods and to seek advice in the presence of a mononucleosis-like illness.

A Simple Guide to Corneal Ulcer

A Simple Guide to Corneal Ulcer
----------------------------------------------------

What is Corneal ulcer?
---------------------------------------

Corneal ulcer is a inflammatory disease of the surface of the cornea which causes local destruction of the superficial layer of the cornea resulting in ulcers.

Corneal ulcers can be infectious(due to infection) or non infectious(due to injury or autoimmune disease)


Who is affected by corneal ulcer?
---------------------------------------------------

Corneal ulcers may be present more frequently in patients with :
Vitamin A deficiency

autoimmune disease

neurological disorders like facial palsy

What is the Cause of corneal ulcer?
-----------------------------------------------------

The causes of Corneal ulcers can divided into 2 type:
Infections:
1. Bacterial infection such as Streptococci, Staphhylococci, pneumococci, pseudomonas

2. Viral infections such as herpes simplex, herpes zoster,

3. Fungal infection

Non-infection:
1.Injury due to hard contact lens, abrasions from trauma, accidental scratch

2.autoimmune disease

3.Systemic disease

What are the Symptoms and signs of corneal ulcer?
-----------------------------------------------------------

Symptoms varies from mild to severe:

1.Severe pain in the eye or around the eye and eyebrow especially with infectious causes. Non-infectious causes may not give rise to pain.

2.Red eye - increased blood flow through inflamed eye shows up the blood vessels

3.Tearing -excess tears from inflammation

4.Discharge -may be pus discharge from eyes especially in the morning

5.Light sensitivity - sensitive to bright lights

Signs:

1.White spot on the cornea, that depending on the severity of the ulcer, may not be visible with the naked eye

2.increased dilated blood vessels present due to inflammation


How do you make the Diagnosis of corneal ulcer?
------------------------------------------------------------

The presence of a corneal ulcer can be seen using a slit lamp microscope.
Sometimes a dye fluorescein may be dropped into the eye making it more visible and easier to detect.

What investigation are necessary in Corneal ulcer?
-----------------------------------------------------

If the patient is suspected to have infection(pus discharge from the eyes), a tissue culture of the corneal cells(gently scraped from the ulcer) may be necessary to determine the type of micro-organism infecting the eye.


What are the complications of corneal ulcer?
---------------------------------------------------

The complication is always the risk of :

1.Severe infection of the eye especially with pseudomonas infection causing infection of the anterior chamber of the eye and then spreading to the rest of eye resulting in loss of an eye.

2.Scarring of the corneal ulcer resulting in partial loss of vision

What is the treatment of corneal ulcer?
---------------------------------------------------

Treatment depends on the type of corneal ulcer:

Infection:
1.Bacterial infection requires more intense treatment with oral antibiotics and antibiotic eye drops (given every 15 minutes)

2.Viral infections are usually treated with acyclovir tablets orally and acyclovir eye cream

3.Fungal infections are less common but are usually treated with antifungal medicine and eye drops.

In all infection cases, corticosteroid medications are not given.
Painkillers such as paracetamol can be given for pain

Non-infection:
1.Corticosteroid eye drops are usually given to reduce the inflammation

2.Antibiotic are also given to prevent infections of the ulcer.

In all cases the eye should be covered with eye pad until the epithelium of the ulcer heals about 10-14 days.

What is the prognosis of corneal ulcer?
-----------------------------------------

The prognosis depends on the severity of the disease

Most cases can be healed if detected early.

There may be minimum scarring of the cornea with possible loss of some vision.

Rarely the eye may be lost if there is severe infection and no treatment.


What are preventive measures in corneal ulcer?
-----------------------------------------------------

1. A nutritious diet with vitamin supplements can strengthen the body resistance against illness.

2.Avoid the use of infected contact lens lotion

3.A soft lens are more prone to eye infection. Always wash the hands before using any contact lens.

4.Avoid rubbing the eyes with dirty hands or tissues

5.A healthy lifestyle with less stress and mild exercise is always good for the body.