Glaucoma and it types

 

Glaucoma is a group of eye diseases in which optic nerve damage is caused due to increase in intraocular pressure inside the eye. This happens when there is an increase of fluid build-up in the front part of the eye.

In a healthy eye, aqueous humor (a clear fluid) continuously circulates in the front portion of the eye.  Eye steadily produces a small amount of aqueous humor and simultaneously equal amount of fluid flows out of the eye. This helps to maintain a constant healthy eye pressure inside the eye. If aqueous humor does not flow accurately from the eye, it results in build-up pressure over time. This increase in pressure can damage the optic nerve fibers of the eye which further can lead to glaucoma.

Glaucoma can develop in one or both eyes and is the main cause of vision loss in people at the age of 60 and above. There are several types of glaucoma.

Types of glaucoma

  1. Open-angle glaucoma
  2. Closed-angle glaucoma
  3. Congenital glaucoma
  4. Secondary glaucoma

1. Open-angle glaucoma is the most common form of glaucoma that accounts for around 90% of all glaucoma cases.In open type, the drainage angle between the cornea and the iris remains open but the trabecular meshwork remains partially blocked. This clogging of the drainage canals of the eye results in an increase of intraocular pressure. It is also called as primary or chronic glaucoma.

2. Closed-angle glaucoma is caused when there is a closed or narrow- angle between the iris and the cornea. When the drainage angle gets completely blocked, it results in a sudden rise in intraocular pressure. It is also called as acute glaucoma or narrow-angle glaucoma.

glaucoma -open and closed

3. Congenital glaucoma is a type of glaucoma that occurs in babies where there is an incomplete development of eye’s drainage canals. This is a rare condition which if not diagnosed and treated early can lead to blindness in infants and young children.

4. Secondary glaucoma is a type of glaucoma which is characterized by an identifiable cause of increased eye pressure that results in optic nerve damage and vision loss. This is referred as ‘secondary’ as it results from another eye condition or disease. For example, if a person has undergone any eye injury, then that person has more chances to develop secondary glaucoma. The most common examples of secondary glaucoma are pigmentary glaucoma, pseudoexfoliative glaucoma and neovascular glaucoma

Facilities at Rajan Eye care hospital

Rajan Eye Care Hospital is highly recommended for screening and treatment of glaucoma. For more details and appointments, visit us at www.rajaneyecare.comor contact us at: 98401 77177 / 2834 0300 / 500

 

 

 

 

How Retinopathy of prematurity (ROP) is treated?

Retinopathy of prematurity (ROP) is a disorder of developing retina that occurs in low birth weight preterm infants especially those born before 31 weeks of gestation and who weigh less than 1.25 kgs. In ROP, the blood vessels overgrow and swell in the light-sensitive areas located at the back of the eye (retina). In severe condition, these abnormal retinal vessels get extended into the vitreous that fills the center of the eye. Bleeding from these retinal vessels can scar the retina, causing partial or complete retinal detachment that potentially can lead to blindness.

Detection

All premature babies are generally at the higher risk for vision problems including ROP and therefore an eye examination screening test is recommended for every premature baby. High risk premature infants kept in the neonatal care unit are examined by a retinal specialist or pediatric ophthalmologist where they perform and screen for ROP.

Eye drops will be placed into baby’s eyes that will help to enlarge the pupil. Your ophthalmologist will use a special lens to view the retina.  Depending upon the condition of abnormal blood vessel development, the eye condition will be graded and further examinations will be conducted every one to two weeks from birth.

ROP detection-1

Treatment

Timely treatment for ROP is effective in preventing severe vision loss in premature babies. Treatment for ROP depends completely on the stage of the disease. Stage 1 and 2 requires no major treatment. It is only from stage 3 that treatment is required. The most effective treatments for ROP are laser therapy or cryotherapy.

  • Laser surgery is the most common type of ROP surgery. This surgery involves the use of small laser beams to scar the peripheral retina. This whole procedure may take 30-45 minutes for each eye.
  • Cryotherapy also known as cryosurgery uses freezing temperature to scar the peripheral retina that stops abnormal blood vessel growth.

Both these treatments laser surgery and cryotherapy are performed only on those infants who are suffering from advanced ROP “plus disease” stage III. In the later stages of ROP, other surgeries which are performed include:

  • Scleral buckle –A scleral buckle includes placing of flexible silicone band around the circumference of the eye and tightening it to create a slight depression inside of the eye. This prevents the vitreous gel from pulling on the scar tissue and allows retina to flatten back down onto the wall of the eye.
  • Vitrectomy – This procedure involves removing the vitreous gel and replacing it with a usually perfluoropropane (C3F8) or silicone oil to maintain the pressure of the eyeball. After this, the scar on the retina can be peeled back or cut away that will allow the retina to relax back against the eye wall. Vitrectomy is mainly performed at stage V.

Prevention

In infants who need treatment for ROP, the various treatment procedures work well in preventing vision loss; however, ROP can be effectively prevented by avoiding premature birth.

Facilities at Rajan Eye Care Hospital

ROP can be very worrisome for parents. To avoid any complications, the most crucial step every parent should take is to consult their eye care professional for their babies, and follow the doctor’s appointment carefully.

For more details and appointments, visit us at www.rajaneyecare.comor contact us at: 98401 77177 / 2834 0300 / 500.

Retinopathy of prematurity (ROP)

Retinopathy of prematurity (ROP) is caused due to the abnormal development of retinal blood vessels. This blinding disease occurs in infants that are born too early (premature). It is one of the common causes of vision loss in children that can lead to lifelong blindness.

Causes

Around 16 weeks of pregnancy, the eye starts to develop in an infant. The blood vessels grow toward the edges of developing retina continuously, supplying nutrients and oxygen. When a baby is grown fully, the retinal blood vessel growth is also complete. However, if the baby is born before time then there may be abnormal blood vessel growth.  When the blood vessels grow abnormally it spreads throughout the retina.

These abnormal blood vessels are sometimes so weak that it can lead to leakage, scarring of the retina and detaching from its position. This is known as retinal detachment that is the main cause of visual impairment and blindness in ROP.

ROP image-1

ROP is classified in five stages, ranging from mild (stage I) to severe (stage V):

Stage I – In this case, there is a mild abnormality in the development of blood vessel and hence mostly its gets resolved on its own.

Stage II – This includes moderately abnormal blood vessel growth. Many children who develop stage II require no treatment and it progresses into normal vision.

Stage III – In this condition, the blood vessel grows abnormally towards the center of the eye, rather than growing along the surface of the retina. Sometimes infants with stage III develops “plus disease” (blood vessel becomes enlarged and twisted), where treatment is required.

Stage IV – This involves partial detachment of retina where the abnormal blood vessels pull the retina away from the wall of the eye.

Stage V – In this condition, there is a complete detachment of retina that can lead to severe visual impairment and blindness if left untreated.

Other symptoms of severe ROP include:

  • Abnormal eye movements
  • Crossed eyes
  • Severe nearsightedness
  • White-looking pupils (leukocoria)

Risk factors

Birth weight and gestational age are the most important risk factors associated with ROP. Other factors for the development of ROP include poor weight gain, anemia, respiratory distress and overall health of an infant.

To know more about ROP, its diagnosis, and treatment, keep reading our blogs!

Facilities at Rajan Eye care hospital

Rajan Eye Care Hospital is highly recommended for screening and treatment of Retinopathy of prematurity. For more details and appointments, visit us at www.rajaneyecare.com or contact us at: 98401 77177 / 2834 0300 / 500

Chemical eye injuries –First aid information and treatment

Chemical injuries to the eye occur when eyes come in contact with chemicals such as acids, alkalis or any irritants unexpectedly. Symptoms of chemical burns may vary depending on the type of chemical and degree of burn. These symptoms may range from minor irritation, swelling and redness in the eye to serious eye injuries that may cause severe changes to the cornea.  Chemical burns to the eye can destroy all or portions of the corneal epithelium and conjunctival epithelium. Chemical burn can also lead to severe conditions such as corneal scarring, symblephara, and trichiasis. In severe conditions, chemical injuries can lead to blindness. Therefore, you have to seek medical treatment immediately before the symptoms become worse.

Until you visit your dentist, follow this first-aid to handle the situation:

First-aid suggestions for chemical burns

chem injury-1

  1. Wash your face under running water for at least 15 to 20 minutes to remove these harmful chemicals from the eyes. The longer the chemical stays in your eyes, it will cause more damage.

 

chem injury-32.  Use your fingers to keep your eyelids open apart however, make sure that you wash your hands thoroughly first

 

 

chem injury-2

3. If you are wearing contact lenses, immediately remove them

 

 

 

 

However these are general precautions to be taken, but you have to seek medical help immediately to avoid further complications.

Diagnosis of chemical burns to the eye includes:

Depending on the type of chemical, your doctor will carry out the following:

  • Irrigation – Your ophthalmologist will rinse your eyes by flushing water or saline over your eyes that will help to reduce the risk of further injuries and long-term damage.
  • Different structures of the eye will be assessed to check the extent of damage and the location of theburn. Certain diagnostic tests such as fluorescein evaluation test will be carried out using a special dye that color damaged or dead tissues and viewed under ultraviolet light.
  • Full- eye examination – Eye examination using an eye chart will be carried out to determine how well you can see.

Treatment for chemical burns

Treatment depends completely on the chemical substance and the severity of the injury.Topical antibiotics may be given in the form of eye drops or ointment to reduce the risk of infection. The most important part of treatment is the application of lubricating  drops and ointment that are given in early stages along with antibiotic drops.Lubricants are applied on the surface of the eye to avoid the eyelids from sticking to the cornea. And in the case when the pain is severe, systemic pain relieving medication will be given.

If there is a major alkali or acid burn, you may require immediate admission to the hospital where you may have to undergo surgery.

Other eye safety suggestions

  1. Know your chemicals and choose safer products – Avoid using hazardous chemicals at home and workplace. Always check chemical labels and replace toxic chemicals with less toxic chemicals ones.
  2. Keep safety equipment ready–Safety goggles and glasses should be used while handling hazardous chemicals to avoid such situations.

(Note: Consider every eye injury as potential emergencies and therefore never hesitate to visit your doctor immediately.)

Facilities at Rajan Eye care hospital

For more details and appointments, visit us at www.rajaneyecare.com or contact us at: 9840177177/ 2834 0300 / 500

 

 

 

 

 

 

 

 

 

Chemical injuries of the eye

Most of the chemical injuries of the eye occur at work; however some can also take place at home while carrying out daily household work. Many students may also experience chemical injuries of the eye while handling volatile chemicals, concentrated acids and organic compounds in laboratories. These injuries can be dangerous and needs treatment immediately.

Chemical injuries to the eye can be divided broadly into three groups:

  1. Alkali burns
  2. Acid burns
  3. Irritants

 

  1. Alkali burns

Alkali burns are the most dangerous ones, as more damage is caused by higher pH chemicals. These alkali chemicals penetrate the surface of the eye where they can affect both external structures (such as the cornea) and the internal structures (such as lens) of the eye.

The example of chemical alkali substance includes hydroxides of ammonia, magnesium, potassium hydroxide, lye and lime. You have to be very careful while handling some of the household items as most of them contains these alkali chemicals. Such household products include various cleaning products that contain ammonia, drain cleaners contains lye and cement contain lime.

  1. Acid burns

Acid burns also lead to an eye injury, but they are usually less severe than alkali burns. This is because of their low pH and therefore, they do not penetrate so easily like alkaline substances. However, there are exceptions like hydrofluoric acid burns which are as dangerous as alkali chemical burns.

Common examples of acids that can cause eye burns are hydrochloric acid, sulphuric acid, acetic acid, nitric acid and chromic acid. House hold items that contain these acids are vinegar, nail polish remover (acetic acid), glass polish (hydrofluoric acid) etc. Therefore, you have to be very careful while handling such items which can lead to acid burns to your eye.

  1. Irritants

Irritants are substances that have neutral pH and they usually cause more irritation and discomfort to the eye, more than damage. Most of the household detergents belong to the irritant category.

Chemical eye burns symptoms

The symptoms of chemical injuries to the eye depend upon the type of chemical splashed into the eye. However the common symptoms include:

  • Pain
  • Redness
  • Irritation
  • Swelling of the eyelid
  • Inability to open eye
  • Excessive tearing
  • Blurry vision

In severe injury to the eye, it can lead to various complications such as corneal perforation, corneal ulcer, cataracts and glaucoma.

chem injury eye

Fig 1: An eye that sustained a chemical injury

To know more about diagnosis and treatment of the eye burns due to any chemical injury, please keep reading our blogs!

Facilities at Rajan Eye care hospital

For more details and appointments, visit us at www.rajaneyecare.com or contact us at: 9840177177/ 2834 0300 / 500