Tag Archives: Ipoh Echo Eye Health

Thyroid Eye Disease

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Resident Consultant Ophthalmologist, Hospital Fatimah Ipoh
Dr S.S. Gill

Eye Health

By Dr S.S. Gill

Ipoh Echo’s EYE HEALTH series continues with Consultant Eye Surgeon Dr S.S. GILL talking to us about Thyroid Eye Disease.

The Thyroid gland is an organ that is found in the front of the neck. Thyroid hormones are released by the thyroid gland into the bloodstream as “chemical messengers” which are essential for managing the metabolism in our bodies. As with most organs in the body, when the thyroid gland functions well, it goes unnoticed but when it starts producing too much or too little hormones, it causes a lot of problems to the body. The eyes get affected when the gland becomes hyperactive. When this happens, it is termed as either Thyroid Eye Disease or Thyroid Orbitopathy, Graves’ Ophthalmopathy, Ophthalmic Graves’ Disease or Thyroid Ophthalmopathy.

Who Gets Thyroid Eye Disease?

Thankfully this is not a very common condition. In every 100,000 people, approximately 15 women and 3 men are affected by Thyroid Eye Disease. Most of the time it affects the middle age group. There is a genetic link, making those in some families to be more predisposed to suffering from Thyroid Eye Disease.

What Happens To The Eyes In Thyroid Disease?

Thyroid eye disease - S.S. GillIn Thyroid Eye Disease, the eye muscles and fat that surrounds the eyeball gets inflamed (swollen). The two eyeballs may or may not be affected equally, giving rise to the following symptoms in the eyes:

  • Eyes protrude or bulge out of its sockets – an appearance that the person is staring! Thyroid Eye disease is the most common cause of protruding eyes (proptosis).
  • More of the cornea (transparent part of the eye) and the conjunctiva (white of the eye) get exposed because the eyelids may not fully close over the eyes well enough (eyelid retraction).
  • The eyes may ache, with intermittent sharp pain when the cornea dries out especially   when the person is concentrating on something for long as in reading.
  • Some people get diplopia (double vision) because the eye muscles are unable to move properly due to the swelling of the eye muscles.
  • Blurring vision in some patients.

This may happen along with other features such as irritability or nervousness (mood disturbances), preference for cold environments, increased sweating, insomnia (sleeping difficulty), palpitations (a rapid heartbeat), tremor of the hands, weight loss, frequent bowel movements, unexplained fatigue or weakness of muscle, difficulty in conception and irregular menstruation.

How Is It Diagnosed?

If a doctor suspects that you may be having Thyroid Eye Disease, the following tests are usually done:

  • Thyroid Function Test (blood test): This will measure hormone levels in your body which includes TSH (Thyroid Stimulating Hormone), T4 which is the principal thyroid hormone and another thyroid hormone T3, plus Thyroid Stimulating Immunoglobulin Test (TSI). The other blood test that may be done is the RAIU test             (Radioactive Iodine Uptake) – which helps to evaluate the Thyroid gland and to find out the cause of increased production of thyroid hormones (hyperthyroidism).
  • Thyroid Scan – to determine the shape and size of the thyroid gland and to pick up any thyroid nodules that may be benign or cancerous.
  • MRI Scan of the Orbits – to determine the amount of proptosis (bulging forward of eyes) and the amount of inflammation of the eye muscles within the eyeball sockets.

More on Thyroid Eye Disease prognosis and treatment in the next issue.

For more information, call Gill Eye Specialist Centre at Hospital Fatimah (05-545 5582) or email gilleyecentre@dr.com.

Inflamed Eyelids

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Resident Consultant Ophthalmologist, Hospital Fatimah Ipoh
Dr S.S. Gill

Eye Health

Ipoh Echo’s EYE HEALTH series continues with Consultant Eye Surgeon Dr S.S. Gill talking to us about BLEPHARITIS, or inflammation of the eyelids.

Blepharitis, or “inflammation of the eyelids”, comes from the Greek word “blepharos”, which means “eyelid” and “itis” which means inflammation.

WHAT DOES BLEPHARITIS APPEAR LIKE?

The eyelids usually appear crusted, red and swollen. The crust is yellowish-white and powdery, like the scalp of a person who suffers from dandruff. There may be varied symptoms. In most cases, the eyes become itchy, irritated and sometimes feel dry due to the disruption of the layer of tear film that is normally present in the eye. Contact lens wearers may complain of discomfort and a gritty sensation. This is often mistaken by the layman as “dry eyes”.

When blepharitis becomes chronic, there may not be much signs of inflammation such as redness but just a visible crusting on the eyelid and eyelashes. This may appear a little unsightly especially when the crusting on the eyelashes is visible. You may liken it to a skin condition except that in the case of blepharitis, it affects the eyelid margins where the eyelashes arise. Blepharitis can affect any age, both young and old.

Inflamed eyelids - dr gillWHAT CAUSES BLEPHARITIS?

When the oil glands at the eyelid margins malfunction and produces too much oil (sebaceous secretions), blepharitis can occur. At times, it may be associated with an underlying skin condition called Acne rosacea where there is already a generalised illness of the oil glands of the skin. Allergies to certain cosmetics like mascara, eyelid lotions, contact lens solutions, allergens in the air and some chemicals may also trigger blepharitis.

WHAT ARE THE COMPLICATIONS OF BLEPHARITIS?

Blepharitis usually does not cause any serious eye conditions. However, it may cause the following:

1. Stye:

    This occurs when the oil glands of the eye gets infected. A lump appears on the eyelid margin in a localised area. There may be some pus seen on the tip of the stye (appearing like a pimple about to rupture), with surrounding redness of the eyelid.

2. Chronic Conjunctivitis:

    Blepharitis may cause recurrent bouts of conjunctivitis or pink eye. If this happens, eliminating this underlying problem is essential.

3. Chalazion:

    Occurs when the oil glands of the eyelid get blocked. This is painless but appears unsightly with a lump appearing on the eyelid.

4. Cornea Ulcers:

    Due to chronic irritation by the inflamed eyelids and/or a misdirected eyelash growth, an ulcer may form on the cornea. Corneal ulcers are serious conditions.

HOW IS THIS PREVENTED AND TREATED?

Good eyelid hygiene is essential to prevent blepharitis. Frequent face washing, warm compresses over the eyelids and removal of eye makeup is important. Remove any crusting present on the eyelid margins. Cleaning the eyelids with a cotton bud soaked in a very dilute (5 parts water to) baby shampoo is helpful to control any excessive oiliness and crust. Basically, every effort must be made to keep the eyelid clean. The other alternative is to use a special over-the-counter Lid Care cleaner. Keep the eyes closed when cleaning. Be especially careful to avoid rubbing or scratching your eyes.

If you are in doubt about any eyelid problems, do seek professional help.

Do’s and Don’ts with Contact Lenses

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Resident Consultant Ophthalmologist, Hospital Fatimah Ipoh
Dr S.S. Gill

Eye Health

 Ipoh Echo’s Eye Health Series Continues with Consultant Eye Surgeon Dr S.S. Gill Talking About Contact Lens Care.

Many young people these days prefer not to wear glasses to correct short-sightedness and other refractive errors, preferring to wear contact lenses either for cosmetic or sports reasons. Regardless of the reasons, it is important to know how to look after them to avoid contact lens related problems.

There are basically two general categories of contact lenses – soft contact lenses and rigid gas permeable (RGP) contact lenses requiring different care requirements. There should be no short cuts in the care of these lenses.

Contact lensSome pointers to take note of are as follows:

1. CLEAN YOUR HANDS: This is the most basic and crucial step before you handle any contact lenses. Failure to do so can result in serious eye infections. It is mandatory to wash hands with soap and clean water, dry them with a clean dry towel, before handling contact lenses. Make sure that the soap is free from moisturizers as it may then end up in the eye, only to cause problems such as eye irritation, eye pain, redness or blurred vision.

2. USE PROPER DISINFECTING SOLUTIONS: It is important to use the proper disinfecting contact lens solutions and enzymatic protein removing cleaners if you are not wearing daily disposable lenses. Never ever use tap water or any other solutions to wash or clean your lenses. Microorganisms easily contaminate the contact lenses and may lead to eye infections. Clean each contact lens carefully by gently rubbing the surface between your palm and fingers. Remember to clean your contact lens case daily too. The contact lens case will also need to be replaced every three months. Never leave the contact lens storage case in the bathroom where moisture and bacteria can settle on it.

3. MAKE-UP: All make-up should be applied after putting on the contact lenses and not before doing so. Likewise, take out your contact lenses before removing eye make-up.

4. LEARN HOW TO WEAR THEM CORRECTLY: Learning the correct method of putting on and taking off contact lenses is essential to prevent the accidental scratching of your corneas or tearing the soft contact lenses. Learn how to recognise whether the contact lenses are the correct way up by placing them on the tip of the finger before putting them on. Make sure that they are the right side up. If not, do remove them and reinsert them into the eyes.

5. DO NOT SWIM WITH CONTACT LENSES: Never ever swim with your contact lenses on. This is because there is a risk of getting an eye infection from a kind of bacteria commonly found in swimming pool water, tubs, oceans and lakes. The organism is called Acanthamoeba. Should this organism get into the eye through contaminated contact lenses, it could lead to an eye infection that is difficult to treat.

Additional pointers:

a-      Remove your contact lenses if you experience any symptoms of eye irritation, redness or eye discharge, excessive tearing, burning, blurred vision or eye pain.

b-      Remove your contact lenses if they feel uncomfortable as they may be torn.

c-      Should you have eye problems associated with contact lens wear, don’t throw them away as you may be required to bring along the lenses when you see your eye doctor as he  may wish to send them to a laboratory to identify the organisms that may be causing your eye problems.

Contact lenses when used correctly, have been a safe alternative to correct refractive errors like myopia. However, if you do not follow proper procedures, you may be unnecessarily exposing your eyes to problems. If you are in doubt about any contact lens related eye problems, do seek professional help.

For more information, call Gill Eye Specialist Centre at Hospital Fatimah (05-545 5582) or email gilleyecentre@dr.com.

Consultant Eye Surgeon Dr S.S. Gill

Subconjunctival Heamorrhage

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Resident Consultant Ophthalmologist, Hospital Fatimah Ipoh
Dr S.S. Gill

Eye Health

Ipoh Echo’s Eye Health series continues with Consultant Eye Surgeon Dr S.S. Gill talking to us about Subconjunctival Haemorrhage.

Subconjunctival Haemorrhage or subconjunctival bleeding is a condition where there is bleeding under the conjunctiva. The conjunctiva is the clear transparent layer that covers the white part of the eye (sclera). When the white of the eye has a bleed, this is called subconjunctival haemorrhage. Every other week, someone or the other walks into the consultation of an Ophthalmologist seeking treatment for this.

The appearance of such a bleed is often alarming to a person. Thankfully, it is generally a harmless condition when it occurs by itself and it is confirmed that the person has no other underlying serious conditions associated with it.

Consultant Eye Surgeon Dr S.S. GillWhat does it look like in the eye?

Subconjuntival haemorrhage or a subconjunctival bleed appears blood red and is located over the white of the eye (see adjacent picture).

It may appear in any area of the white part of the eye. It does not cause any pain but may cause some discomfort or heaviness if there is a large amount of blood collection.

Who gets subconjunctival bleeding?

Subconjunctival bleeding may occur in any age group – in adults, children or even infants. It is basically a bleed that arises from the tiny blood vessels of the conjunctiva. These tiny blood vessels are fragile and easily bleeds into the white of the eye.

What are the causes of subconjunctival bleeding?

The commonest cause is trauma of some form to the eye. This may range from too vigorous rubbing of the eyes, swimming goggles that are too tight, any direct trauma of any nature to the eye, head injuries, severe cough or sneezing, severe straining when lifting heavy objects or straining when passing stools especially when one is constipated. It may be also seen in those who do bungee jumping and in children who have been  physically abused.

Underlying systemic conditions that may cause this is uncontrolled hypertension, bleeding disorders, those who may be on anti-platelet (blood-thinning medication) therapy, and also sometimes it maybe seen immediately after eye surgery, particularly Lasik.

Should you be concerned?

Subconjunctival bleeding does not cause any problems with vision and is generally a harmless condition. However, it is important to be sure that it is not associated with some underlying systemic illness of the body.

How is it treated?

If it has been confirmed that the subconjunctival bleeding is not part of a systemic illness like uncontrolled hypertension, a blood disorder, etc., then it will not require any form of treatment because it is harmless. The reason it does not require any treatment is because the body’s natural mechanisms of healing will absorb the blood collection. It usually takes a few days to a few weeks for the blood collection to clear. The smaller the bleed, the faster it  gets absorbed. Those with a large collection of blood may take longer.

Subconjunctival bleeding while harmless in most instances, should be checked out especially if it occurs spontaneously and it has occurred with no direct trauma to the eye. If you are in doubt as to the underlying cause of the bleed, do consult your local practitioner or eye doctor.

For more information, call Gill Eye Specialist Centre at Hospital Fatimah

(05-545 5582) or email gilleyecentre@dr.com.

Arcus Senilis

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Resident Consultant Ophthalmologist, Hospital Fatimah Ipoh
Dr S.S. Gill

Eye Health

Ipoh Echo’s EYE HEALTH series continues with Consultant Eye Surgeon Dr S.S. GILL talking to us about ARCUS SENILIS.

Arcus Senilis, (pronounced “ar-kus see-nil-is”) is a visible whitish-grey arc seen above and below the outer part of the cornea (clear dome shaped part of the eye). It is easily visible in some people and often mistakenly referred to as a cataract by layman. Arcus Senilis is also sometimes referred to as Corneal Arcus or Arcus Cornealis.

Eye Health – Arcus SenilisHOW DOES IT LOOK LIKE IN THE EYE?

Arcus Senilis affects the cornea of the eye. The cornea is the clear transparent dome shaped part of the eye, like the car windscreen. Arcus Senilis appears greyish or whitish over the peripheral part of the cornea. In the initial stages, it appears over the upper and lower part of the cornea. Later, this whitish-grey area on the corneal periphery eventually may become a complete ring around the cornea, making it appear as a white ring around the edge of the clear part of the eye.

WHO GETS ARCUS SENILIS?

Arcus senilis is often seen in the eyes of senior people. It’s caused by fat (lipid) deposits deep in the periphery of the normally clear cornea. Arcus senilis doesn’t affect vision but it does give the doctor a sign. Remember again, as highlighted (in previous issues of the Ipoh Echo) that our eyes are not isolated from things that are happening in our bodies including the effects of aging. It increases with age in both male and female. It however occurs more frequently in men.

WHAT ARE THE CAUSES OF ARCUS SENILIS?

Arcus Senilis is mainly an aged-related change, a sign of aging. However, it may be also seen in younger individuals. When it is seen in younger individuals, that is, those below the age of 50 years, it is important to look for dyslipidaemia (abnormal amount of lipids or fat in the blood) which is one of the risk factors for coronary heart disease. The formation of Arcus Senilis is more often seen in those having high serum LDL-cholesterol.

In other words, it is seen in aging individuals. The other link is when it occurs in younger people, that is, the association of high serum LDL-cholesterol in such individuals.

SHOULD YOU BE CONCERNED?

Arcus Senilis does not cause any problems with vision, so there is no need for any concern. You do not need to be running to see an eye doctor for this. It is a harmless condition for the eye.

The only thing that you will need to be concerned about is if you are younger than 50 years old and the Arcus Senilis is visible in your eye. In such instances, it would be wise to get a blood examination done to look for dyslipidaemia, remembering that dyslipidaemia has an association with heart disease.

CAN IT BE TREATED?

Arcus Senilis requires no treatment because it does not cause vision problems. What would need to be looked into and treated is the dyslipidaemia if this is found to be abnormal in order to avoid cardiovascular risk. Arcus Senilis is only a sign – common in aging, to be concerned of only when seen in younger individuals. There is no treatment for arcus senilis by itself. If you are in doubt whether you have such a condition, do consult your local practitioner or eye doctor.

For more information, call Gill Eye Specialist Centre at Hospital Fatimah (05-545 5582) or email gilleyecentre@dr.com.

Signs of Eye Problems – Part 2

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Resident Consultant Ophthalmologist, Hospital Fatimah Ipoh
Dr S.S. Gill

Eye Health

Ipoh Echo’s EYE HEALTH series continues with Consultant Eye Surgeon Dr S.S. GILL talking to us about THE WARNING SIGNS OF EYE PROBLEMS – PART 2.

Our eyes are not isolated from medical problems like diabetes and hypertension, and also other factors like the effects of aging, the harmful rays of the sun, smoke and dust around us.

Warning Signs

There are some symptoms and signs that may indicate prompt treatment  be required. In most cases, you should see your eye doctor immediately if you experience some of the following:

 

See fingersDouble vision or ‘ghost’ images

Double vision is also called diplopia. This symptom may be caused from eye conditions ranging from minor to serious. In most cases, any sudden onset of double vision cannot be taken lightly. This is because it may be a signal of an underlying condition such as a stroke.

The other conditions that may cause double vision are brain tumours, nerve paralysis, brain swelling and abnormal brain vessels impinging on some part of the brain. Sometimes a person may need to be referred to neurologist or neurosurgeon depending on the kind of stroke that occurs.

Remember that if you have a sudden onset of double vision, see your eye doctor or general practitioner immediately. Quick treatment is invaluable in these cases.

Irritated eyes with redness and a scratchy feeling

Often this is as a result of dry eyes. It is not really an eye emergency but if left untreated may affect the eyesight of the individual affected. The symptoms of dry eyes may at times be very  severe, Dry Eye Syndrome is also known as keratoconjunctivitis sicca (quite a mouthful). It is a condition due to the changes in the quantity or quality of the tears. Dry eye normally occurs as irritated eyes.

Dry eyes may affect vision because it disturbs the tear film layer on the cornea that is  essential for good vision. Our tears help bend the light on its way to the back of your eye (the retina) so that you can see nice and sharp images. Consult your eye general practitioner for advice about remedies, which may include over-the-counter or prescription eye drops.

Blurred Vision with Eye Pain, Nausea and/or Vomiting:

These vision changes may be due to an acute glaucoma. Since there may be associated symptoms like vomiting and nausea, the glaucoma may sometimes be missed and passed on as gastroenteritis. The patient may end up seeing their Physician only to be picked up as a glaucoma suspect to be sent to the ophthalmologist. Keep a lookout for this if you have a family history of glaucoma.

Sudden Brief Loss of Vision

You may be experiencing a condition called Amaurosis Fugax. The name  is derived from the Greek word amaurosis meaning ‘dark’, and the Latin word fugax meaning ‘fleeting’ – referring to a transient loss of vision in one or both eyes. It may be a symptom of Central and Branch Retinal Artery occlusion and must not be taken lightly.

These are only some of the warning signs. Never hesitate to seek professional help if you experience any unusual eye symptoms that you are unsure of.

For more information, call Gill Eye Specialist Centre at Hospital Fatimah (05-545 5582) or email gilleyecentre@dr.com

The Warning Signs of Eye Problems

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Resident Consultant Ophthalmologist, Hospital Fatimah Ipoh
Dr S.S. Gill

Eye Health

Ipoh Echo’s EYE HEALTH series continues with Consultant Eye Surgeon Dr S.S. GILL talking to us about THE WARNING SIGNS OF EYE PROBLEMS.

Many people ask me why is it that their eyes are just not same like they were before. Well, the answer is simple. It’s because our eyes are not isolated from medical problems (diabetes, hypertension & other conditions), from the effects of aging or even from the environment that we live in with all the sun exposure, smoke and dust around us. Eye problems may occur at any age but they are often more common in old age. It is important to be wary of the warning signals that something is going wrong with your eyes and to take proper action should that occur. In many cases, such as diabetic eye disease, eye strokes or acute angle closure glaucoma, quick intervention is important to avoid permanent vision loss.

Some Warning Signs

There are some symptoms and signs that may indicate a medical emergency. In most cases, you should see your eye doctor immediately if you experience:

Eye Health - Warning signs of eye problemsRed Painful Eye with Blurring Vision

This is often a sign of an acute glaucoma (angle-closure variety) attack. There may be nausea and vomiting with a throbbing headache as well. Left untreated, this condition may result in permanent irreversible blindness. Seek treatment early should this happen. This condition may sometimes be mistaken for acute gastroenteritis (food poisoning) because of the symptom of nausea and vomiting. Seek quick treatment for this.

Blur Wavy Vision in the Centre Part of Vision

This may be an early sign of macular degeneration (AMD). It is a disease that destroys your sharp, central vision. The macular is the central part of the retina where all the fine vision takes place. When the macular is affected, the vision appears distorted, lines appearing crooked or wavy and in the late stages, the vision may be lost centrally. In recent years, there has been medication available for treatment of this condition. The sooner treatment is instituted the better.

Vision Blurring in part of your Field of Vision

If the vision loss appears like a curtain falling or like water rising from the floor, then this may be a signal of a detaching retina. The retina is a layer of nerve tissue in the back of your eye. This layer receives the images that you see and transmits it to the brain. When this retina (nerve layer) gets detached in some portion, then the vision gets lost in the corresponding part of the field of vision. The detachment is sometimes preceded by a sudden shower of floaters.

Blurred Vision with Halos around Lights

These vision changes may be due to glaucoma when there is a higher than normal eye pressure. Watch out for these subtle symptoms that may occur with a mild headache or mild eye discomfort. Be especially on the lookout for this symptom if you are already a diagnosed glaucoma patient or have a family history of glaucoma.

Sudden Blurring and/or Floaters in Diabetic Patients

In diabetics, this may be a sign of bleeding in the eye because of diabetic eye disease. It is best for diabetics to get their eyes checked regularly and not have to wait for eye symptoms such as this before seeking eye treatment. By looking into a diabetic’s eye, the eye doctor is able to obtain valuable information about the general diabetic condition which is helpful for the physician who is managing your diabetes. Regular eye exams are important if you are diabetic, regardless of whether you have blurring vision or not.

These are only some of the warning signs. Never hesitate to seek professional help if you experience any unusual eye symptoms that you are unsure of.

For more information, call Gill Eye Specialist Centre at Hospital Fatimah (05-545 5582) or email gilleyecentre@dr.com.

Corneal Ulcers

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Resident Consultant Ophthalmologist, Hospital Fatimah Ipoh
Dr S.S. Gill

Eye Health

Ipoh Echo’s EYE HEALTH series continues with Consultant Eye Surgeon Dr S.S. GILL talking to us about CORNEAL ULCERS.

In the previous issue of the Ipoh Echo, Dr Gill talked about corneal abrasions. In this issue, he speaks about corneal ulcers. When a corneal abrasion gets INFECTED, it results in a corneal ulcer formation. Corneal ulcers are serious eye infections that may even result in blindness.

corneal ulcerSYMPTOMS OF CORNEAL ULCER

The affected eye will be red and often painful. The pain may be quite severe as the cornea is a sensitive part of the eye. In most corneal ulcers, there will be a yellow discharge from the affected eye although in some instances, there may only be a mild eye discharge.

Corneal ulcers may often be visible when the affected eye is viewed in the mirror. The affected eye will often have a whitish or yellow spot seen on the clear cornea of the eye (see adjacent pic). You may also have blurred vision but in some cases when the ulcer is not in the centre but at the peripheral of the cornea, there may be no blurred vision.

WHO ARE PREDISPOSED TO CORNEAL ULCERS

Corneal ulcers are basically infections in the clear dome-shaped transparent outermost part of the eye. You can liken this part of the eye to the windscreen of your car. When this clear part gets infected, it is serious because it is an area of the body that does not have blood vessels to bring in the infection fighting white blood cells.

Trauma: A trauma to the cornea of the eye due to a scratch by a foreign body entering the eye is all it takes for ulcers to occur. The moment there is a breach in the cornea, organisms invade the broken epithelium resulting in a corneal ulcer. Disorders that cause dry eyes can leave your eye without the germ-fighting protection of tears and cause ulcers.

Facial Paralysis: Any condition like Bell’s palsy can predispose a patient to corneal ulcers. This is because the patient is not able to close the eyelid completely thus exposing the cornea which become damaged due to dryness. The dry areas of the cornea are more  vulnerable to corneal ulcer formation.

Chemical Injuries: Any injury to the eye by caustic chemicals may severely damage the cornea and increase the risk of corneal ulceration.

Contact Lens Wearers: Those who wear contact lenses have an increased risk of corneal ulcers. This is especially so if the contact lens wearers cut corners and do not adhere to proper cleaning, handling and disinfection of their contact lenses including the contact lens storage case. Additionally, soft contact lenses have a high water content making it easy for bacteria to get absorbed into the contact lens.

Extended-Wear Soft Contact Lenses:

These are contact lenses that are worn for several days without removal at night. Individuals using this type of contact lenses are exposed to a ten-fold risk of corneal ulcer formation. If the lenses are not cleaned properly and there is bacteria underneath the lens, then these bacteria may multiply and get into the cornea should there be a small breach in the corneal surface. This is more so if the contact lenses have tiny scratches at the edges that may cause micro-abrasions and finally end up as corneal ulcers if they get infected.

Should you develop a red eye with discharge and blurring vision, do not ignore it but do seek professional eye treatment promptly.

For more information, call Gill Eye Specialist Centre at Hospital Fatimah (05-545 5582) or email gilleyecentre@dr.com.

Corneal Abrasions

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Resident Consultant Ophthalmologist, Hospital Fatimah Ipoh
Dr S.S. Gill

Eye Health

Ipoh Echo’s EYE HEALTH series continues with Consultant Eye Surgeon Dr S.S. GILL talking to us about CORNEAL ABRASIONS.

A corneal abrasion is a scratch injury to the cornea. The cornea is the clear dome-shaped transparent, outermost part of the eye. You can liken this part of the eye to the windscreen of your car. Injuries to this part of the eye occur commonly in both kids and adults. It usually occurs when some sand or dust enters the eye.

What are the causes?

The eye has natural barriers like the eyelashes to prevent particles or foreign bodies from entering the eyes. When a foreign particle enters the eye, the eye responds by producing a flood of tears to try and wash away the foreign particles.

The problem comes about when the foreign object remains in the eye and is in contact with the cornea in such a way that it scratches, cuts, or damages the surface. This is made worse when the person rubs the eye in an effort to get it out – which most often happens in kids! You can envision this simple action of rubbing the eye to have an effect of sandpaper on the cornea because of the trapped particle underneath the eyelid rubbing against the surface of the cornea.

Many things can enter the eye to damage or scratch the cornea. These include sand particles, dust, ceiling board flakes, wood shavings, insects, sparks from a fire, cooking oil pieces of paper or the edge of a sheet of paper and even a person’s own fingernails! Other things that may damage the cornea are chemicals, poor handling of contact lenses and eye make-up or facial cleansers used when a woman goes for a facial treatment.

Symptoms

Firstly, this will almost certainly be painful. Secondly, because of the way in which the cornea functions, it often causes vision disturbances. Often there will be a stinging or burning in the eye along with blurry vision in the affected eye.

Some of the other symptoms include the following:

  • Photophobia: the eye is hypersensitive to light.
  • Hyperaemia: the eye is bloodshot or red.
  • Lacrimation: tearing or watering from the eye is usually excessive and persistent.
  • Foreign body sensation in the eye: a sensation of a something stuck in the eye.
  • Eyelid oedema: swelling of the eyelids may occur.

How is it diagnosed?

Well, the history of something getting into the eye is quite classical. Should you or your child be exposed to something like this, DO NOT RUB THE EYE but flush the eye out with tap water or sterile normal saline if you have some of this at home. It is best to seek professional help if you are unsure of whether or not the foreign particle has come out of the eye or not, more so if you still have symptoms.

Ophthalmologist Dr S.S. Gill
Corneal Abrasions

Your GP will look for any particles still present in the affected eye. Often, the doctor will flush out the eye with normal saline solution in an attempt to flush minute particles that may not be so easily visible with a torchlight examination. If the cornea is extensively abraded, often the GP will refer the patient to the eye doctor.

The eye doctor will be able to determine if the particle is still there and also determine the extent of the corneal abrasion. Often, the eye doctor will confirm the presence of the corneal abrasion by instilling a special stain called fluorescein into the eye. Then, using cobalt blue filtered light, any corneal abrasion will light up a bright green fluorescent colour – to reveal the extent of the corneal abrasion. (See adjacent picture)

How serious is this?

Corneal abrasions if treated properly heal completely and do not cause any trouble. Corneal abrasions only cause trouble if they get secondarily infected and end up as corneal ulcerations that may even lead to blindness. Rarely, corneal abrasions do not heal well and the layer of epithelium (outer layer of cornea) refuses to close up permanently, resulting in frequent breakdown known as persistent corneal epithelial defects. Should you suffer from any symptoms that are prolonged, do seek professional eye treatment.

For more information, call Gill Eye Specialist Centre at Hospital Fatimah (05-545 5582) or email gilleyecentre@dr.com.

Eye Herpes

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Resident Consultant Ophthalmologist, Hospital Fatimah Ipoh
Dr S.S. Gill

EYE HEALTH

Ipoh Echo’s EYE HEALTH series continues with Consultant Eye Surgeon Dr S.S. GILL talking to us about EYE HERPES.

Eye Herpes is a viral infection of the eye caused by the Herpes Simplex Virus (HSV). It is more appropriately called Ocular Herpes or Herpes Keratitis. It is a common infection and it is estimated that about 400 to 500 thousand individuals get infected in the U.S.A. alone annually.  There are two kinds of herpes simplex viruses.

Eye herpes 1Types

It can be divided into:

Type I Herpes – most common type. It mainly infects the face/lips and results in the “cold sore” formation.

Type II Herpes – less common. This is the sexually transmitted variety. The primary infection is in the genitals.

The eye can be infected by both types of herpes. However, most of the time it is the Type I variety that infects the eye. The Type I variety of herpes is very contagious. It can be by skin contact with someone who has the virus. It is estimated that almost 90% of the population would have suffered from the Type I variety during childhood.

How the Eye Gets Infected

The eye gets infected most commonly when an infected person touches an active sore or blister, after which he or she touches their eyes. It may be transmitted by the infected person into his or her own eye or from one person to another.

Symptoms

A patient who gets infected will complain of a painful sore over the eyelid or a painful red eye with blurring in some instances especially if it infects the clear transparent part of the eye called the cornea. A person may also start to have a watery eye or have some excessive mucus secretions. In severe cases, it may also infect the inside of the eyeball although this is not as common as the former. There may be a hypersensitivity to light too.

Triggers or a Herpes Simplex Eye Infection

After the first infection, the virus remains dormant or inactive for months or even years until such time there may be an exposure to some trigger factor such as the following:

  • a prolonged illness or an injury
  • steroid consumption for another illness
  • usage of steroid eye drops (without supervision)
  • a high fever (unrelated to the eye)
  • prolonged exposure to cold winds
  • stress
  • menstruation in some women
  • a weak immune system
  • those receiving chemotherapy or radiotherapy for a malignancy.

Eye herpes 2How is It Diagnosed

The eye doctor will often instil temporary stain into the affected eye (with fluorescein dye) to detect the eye infection. The infected portion gets stained and is able to be picked up when special blue cobalt light is shone into the affected eye. (See adjacent pic)

How Serious is This?    

If the eye infection is detected early and the virus has infected the cornea (clear transparent area) superficially only, it often heals well with no problems. However, if the cornea is involved more deeply, the infection may lead to scarring of the cornea, loss of vision and sometimes even blindness. So if you have any eye infection that you are unsure of, or it is prolonged, do seek professional eye treatment.

For more information, call Gill Eye Specialist Centre at Hospital Fatimah (05-5455582) or email gilleyecentre@dr.com.