Tag Archives: ophthalmologist Dr S.S. GILL

Thyroid Eye Disease

Share
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 [email protected].

Colour Blindness

Share
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 Colour Blindness or Colour Deficiency.

So many of us take the ability of seeing colours for granted. Every year, 17 year olds undergo colour vision assessment as part of their drivers’ licence test. A fraction of these teenagers are shocked when they find out that they have colour blindness (better called Colour Deficiency). What does colour deficiency mean?

HOW THE EYE FUNCTIONS

The eye is a very sophisticated camera! Inside the eyeball, right at the back of the eye is the layer of the retina where all the nerve cells are. These nerve cells comprise of special cells called Rods and Cones. The Rods have no colour vision function except that they are very sensitive to light and help in our night vision.

On the other hand, the cells responsible for picking up the colour that we see are the Cone Cells. Among these Cone Cells, there are varying degrees of pigment present. Depending on the pigment present in the Cone Cells, they help react to different colours. Some of them respond and pick-up the longer wavelength light like the red colours and some of them respond to the shorter wavelength light like that of blue colours.

CAUSES OF COLOUR DEFICIENCY

Although there are many conditions that can result in Colour Blindness, for most people who suffer from this, it is mainly of genetic cause. This just means that they are born with Colour Blindness. When we say it is genetic, it means that the Colour Blindness has been passed down in the genes from the parents.

In our genes, there are the X and Y chromosomes. The gene which is responsible for Colour Blindness is carried on the X chromosome and so more men suffer from Colour Blindness than women. Women are usually only the carriers but do not normally have Colour Blindness. Worldwide it is estimated that there are some 250 million people who are colour blind to a lesser or greater extent.

Colour blindnessTYPES OF COLOUR DEFICIENCY

Colour Deficiency may be mild, moderate or severe. Also, depending on the amount of pigment deficient, it may be divided into:

Red-Green Colour Deficiency – Is the most common type where the reds and greens appear similar (adjacent picture is a simulation of how it would appear)

Blue-Yellow Colour Deficiency – These are less common. Most of the time they also have some concomitant red-green deficiency too.

TREATMENT

There has been on-going research in the area of gene therapy for the treatment of Colour Deficiency. Animal studies for this have shown promise where the introduction of a gene (opsin gene) has given the animals colour vision that they did not have before treatment.

In the USA, special kind of spectacles have been developed which are purplish in colour that are able to help those with the most common form of Colour Blindness. These glasses filter out certain wavelengths of light that disturb the perception of colour vision. They are not without trouble though because some things disappear from vision when these glasses are worn in some instances. If you are unsure of whether you have colour deficiency or not, do not hesitate to get your eyes checked.

 

For more information, call Gill Eye Specialist Centre at Hospital Fatimah (05-545 5582) or email [email protected].

Do’s and Don’ts with Contact Lenses

Share
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 [email protected].

Conjunctival Naevus

Share
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 CONJUNCTIVAL NAEVUS.

Every now and then, there are patients who come in complaining of some patches of brown or grey on the white (conjunctiva) of their eyes. Well, most often than not, it will probably be a conjunctival naevus. Conjunctival naevus is a pigmented growth or lesion similar to a mole on your skin. It may be referred to as a “freckle in the eye.”

The word “naevus” has its origins from Latin. The Oxford dictionary defines it as a birthmark or a mole. Medically, a naevus may be found in the eye usually in the clear front white of your eye (conjunctiva), around the colored part of the eye (iris), or underneath the retina (nerve at the back of the eye). If the naevus is at the back portion of the eye (retina), it is called a choroidal naevus.

Conjunctival NaevusHOW DOES IT LOOK LIKE IN THE EYE?

Conjunctival naevus appears as a dark brown to black patch in the white of the eye (conjunctiva). The size of the patch may range from a small, barely noticeable patch, to a large patch that may cover a noticeable portion of the white of the eye (see adjacent picture).

CAUSES OF A CONJUNCTIVAL NAEVUS

A conjunctival naevus (pigmented growth) is produced by pigment cells called melanocytes. These are the same pigment cells which contribute to the colour of our skin, hair and eyes. These melanocyte cells are usually distributed evenly in the eyes, but when they form a cluster, it results in the formation of a conjunctival naevus.

SHOULD YOU BE CONCERNED?

Conjunctival naevus, although benign, should be periodically assessed with photographs taken at every check-up. This is to ensure that if it should ever start growing in size, it should be removed surgically. Sometimes there may be changes in colour and when this happens it should also be removed. This is because there is a small risk of the growth turning malignant and becoming a melanoma (cancerous). Thankfully, the risk of this happening is very low.

HOW IS IT TREATED?

There are no eye drops or medication available to treat conjunctival naevus. The only option for treatment is surgical removal.

Surgical excision is always done mainly for two reasons:

Cosmetic reasons – this is the commonest reason especially in cases where the growth is very dark or large, and appears unsightly to the patient.

Malignant (cancerous) transformation – this is the other reason that a conjunctival naevus growth is removed, that is, if it undergoes malignant transformation. In such instances, surgical removal is mandatory.

If you are in doubt about any pigmented lesions around the eye, do seek professional help.

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

(05-545 5582) or email [email protected].

Gill

Consultant Eye Surgeon Dr S.S. Gill

Subconjunctival Heamorrhage

Share
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 [email protected].

Arcus Senilis

Share
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 [email protected].

Signs of Eye Problems – Part 2

Share
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 [email protected]

The Warning Signs of Eye Problems

Share
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 [email protected].

Corneal Ulcers

Share
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 [email protected]

Corneal Abrasions – Part 2

Share
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 scratch injury to the clear part of the eye or cornea is common in both kids and adults. It usually occurs when some sand or dust enters the eye. In the last issue, Dr. Gill talked about the causes and symptoms of corneal abrasions. In this issue, he speaks more about treatment and prevention methods.

TREATMENT

Tired Boy Rubbing EyesCorneal abrasions usually begin with a sensation that something foreign has entered the eye. Should this happen to you or your child, ensure that you DO NOT RUB THE EYE.

Some immediate steps that you can take are as follows:

FLUSH OUT THE EYE: Place clean water or saline into a little round cup and place it over your eye to wash out the foreign body. Most of the time, this will solve the problem.

GET YOUR CHILD TO BLINK HIS EYE: If the child is tearing profusely, this is good as the tears itself will often wash off the offending agent.

IF YOU NOTICE SOMETHING STUCK TO THE CORNEA: Do not attempt to remove this by yourself as this may lead to further damage to the cornea by way of an infection or at worse, a corneal ulcer. Seek professional help in this case so that the foreign body can be removed without damage to the eye or introducing unnecessary infection.

If you have a simple antibiotic eye drop (without steroid) at home, you can instil them in the eye. Then pad the eye to keep it from blinking, as blinking may cause more pain especially to a child. This will help make it more comfortable for the patient while waiting to be seen by the doctor.

After removal of the foreign particle, there may be a gritty or scratchy feeling in the affected eye for a day or two depending on whether the abrasion is large or small. You will often be given antibiotic eye drops along with some analgesics if you are unable to tolerate the pain. Sometimes, your doctor may prescribe a sedative for a restful night’s sleep especially if the discomfort is very troubling.

PREVENTION

If you are a contact lens wearer, do not wear your contact lenses until the corneal abrasion has healed well. Your eye doctor will advise you when you will be able to resume wearing them.

Do wear eye safety goggles whenever you work with tools or drills, participate in high speed sports activities such as squash, badminton or hockey, handle any chemicals, or when working in a garden surrounded by thorny bushes and shrubs.

Prevention is better than cure. It is best to avoid getting injured instead of trying to get well after an injury.

Corneal abrasions only cause trouble if they get secondarily infected and end up as corneal ulcerations which can lead to blindness if not treated early. 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 [email protected].