Category Archives: Eye Health

Column by Dr S.S. Gill

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 – 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 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 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.

Dr S.S. Gill

Drooping Eyelid in Old Age

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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 DERMATOCHALASIS.  

A common kind of droopy eyelid seen in old age is called dermatochalasis. If you look carefully, you will find that no one is really spared from this as they age. It does happen to almost everyone to a lesser or greater degree as they move onwards into their seventies and eighties. In dermatochalasis the eyelids appear to sag with excess “baggy” skin surrounding them that contributes to the typical droopy eyelid in old age.

       Dermatochalasis will almost definitely affect a person’s appearance, making a person look “sleepy”. Droopy eyelids are generally referred to as Ptosis (pronounced “toe-sis”) which is the general term for a droopy eyelid (discussed in the last issue).

Why does it happen?

In general, a person’s skin tends to sag with age, losing it’s’ elasticity. Skin is made up of components called elastin and collagen. The COLLAGEN is a structural protein that functions by giving the skin turgor, support or form. The ELASTIN works by allowing the skin to stretch and contract to its original state. This stretching and contracting of eyelid skin occurs every time you blink your eyes. With aging there is an overall loss in amount and quality of this collagen and elastin in the eyelids, making them sag or droop. Gravity of course does not help and hastens the process of eyelid sagging along with genetics, weight changes, and exposure to the sun.

Dr S.S. Gill
Upper pic shows what dermatochalasia will look like when compared to normal (lower pic) after blepharoplasty

Dr S.S. GillSymptoms

Apart from the cosmetic appearance of a person looking tired that results from dermatochalasis, a patient may complain of some visual difficulties. These visual difficulties may present as loss of vision in the upper part of the field of vision, reading difficulties and loss of peripheral vision when driving if the sagging eyelids overhang the side of the eyes. When the vision compromise occurs, the condition should be treated. Some patients compensate unconsciously by using the muscles of the eyebrows to lift the affected eyelids up. This effort may cause frequent headaches.

Treatment

May be divided into SURGICAL and NON-SURGICAL. Surgical treatment is of course a more permanent solution to the problem.

Non-surgical options
The non-surgical options are of course great for patients who would like to address this problem but aren’t quite ready for surgery. Some of the common non-surgical options are:

The age old remedy of avoiding salty food, drinking plenty of water and getting enough sleep still holds good to this day. A good moisturizer may help in hydrating the eyelid skin to reduce the sagging effect.

Over the counter Vitamin A skin creams have also been known to give some benefit but you do not have to spend an arm and a leg to get any of those super expensive creams having the same ingredients in them.

BOTOX® injections can be injected into the eyebrows which will elevate them and therefore relax the eyebrow depressors, so that the unopposed muscles in the forehead will raise the position of the eyebrows,

Surgical option

This is the gold standard in the treatment of dermatochalasis. The surgery is called blepharoplasty.

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

(05-5455582) or email gilleyecentre@dr.com.

Drooping 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 Drooping Eyelids or Ptosis.  

Ever seen your older friends slowly begin to have droopy or sagging eyelids? Well this condition is fairly common in old age. It is called dermatochalasis and the eyelids appear to sag with excess “baggy” skin surrounding them. This is the age related cause of a droopy eyelid.

It is sometimes referred to as Ptosis (pronounced “toe-sis”) which is the general term for a droopy eyelid. There are many general causes for a droopy eyelid to occur. They are:

Drooping eyesCongenital — The child is born with drooping eyelids because of a problem in development of the eyelids. Most of these cases affect only one eye. It is important to look out for the drooping eyelid that blocks off the vision of the eye in a child. If this occurs, then surgical correction has to be done early to prevent the development of a “lazy eye” or “amblyopia”.

Local eye problems — In some cases, the eyelid starts drooping because of nerve injury due to trauma, eyelid infections and tumours within the bony cavity or eyeball socket.

Age related ptosis (Aponuerotic Ptosis) — This also may be referred to as dermatochalasis.  Due to the long-term effects of gravity and the aging, it causes the eyelid skin to sag over the eye. Both eyes are usually affected but drooping may be worse in one eye.

Myasthenia gravis — This is a disease that can affect the whole body causing progressive muscle weakness.  The eyelids as well as facial muscles including the legs, arms and other parts of the body may be affected. This condition will require a thorough assessment and treatment by a physician or neurologist. A test called Tensilon test where a drug called edrophonium chloride is injected into a vein in order to diagnose this condition.

Nerve problems — Any nerve damage due to a stroke, aneurysm of blood vessel in the brain and brain tumour may cause a droopy eyelid. Nerve damage due to longstanding diabetes mellitus may also cause a droopy eyelid.

Tumours — There is also a condition called Horner’s Syndrome where a cancerous tumour at the top part of the lungs results in one half of the face losing the ability to sweat along with a drooping eyelid.

Strokes  —  Any nerve damage due to a stroke, aneurysm of blood vessel in the brain and brain tumour may cause a droopy eyelid. Nerve damage due to long-term diabetes can also cause a droopy eyelid.

Drooping eyesWhen the drooping eyelids cover a person’s vision causing a vision disturbance, the person usually ends up COMPENSATING UNCONSCIOUSLY BY USING THE MUSCLES OF THE EYEBROWS TO LIFT THE AFFECTED EYELIDS UP (see pic on the left). The person may also end up unconsciously tilting the chin up or tilting the head back as a method of seeing through the lower part of the eye. All this may cause the person to have headaches and even neck problems in the long run. Whatever the cause of a drooping eyelid may be, if you are unsure of the cause, get it checked out by a doctor.

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

Dr S.S. Gill - opthalmologist

World Glaucoma Week 2013

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

Eye Health

Dr S.S. Gill - opthalmologist

In conjunction with the recent World Glaucoma Week 2013, Ipoh Echo talks to  Consultant Eye Surgeon Dr. S.S. Gill about this “SILENT THIEF OF SIGHT”.

World Glaucoma Week 2013 - 2What is Glaucoma?

Glaucoma is a group of eye diseases that result in progressive damage of the optic nerve (the “main cable” that carries visual information from the eye to the brain). If glaucoma is not treated, it permanently damages vision in the affected eye(s) and results in blindness. It is often, but not always, associated with increased pressure of the fluid in the eye (aqueous humour).

Glaucoma has been nicknamed the “silent thief of sight” because the vision loss normally occurs gradually over a long period of time without significant symptoms until you eventually lose significant vision. In other words, it means that one will only notice poor vision when the disease is serious and the damage to the optic nerve is advanced.

Dr S.S. Gill - opthalmologistWorldwide, glaucoma is the second leading cause of blindness after cataracts. Glaucoma affects one in 200 people aged fifty and younger, and one in 10 over the age of eighty. As many as 6 million people are blind in both eyes from glaucoma today. Most of these people were once unaware they had this disease until they lost significant vision in one or both eyes.

One reason why a person may not realise that he or she is losing vision is because the vision loss involves the peripheral part of a person’s vision. This peripheral vision loss is the reason why it goes unnoticed by the patient until the very late stage when the central vision starts being affected. Rarely, in some patients there may be symptoms of slight eye discomfort, mild headache and haloes around lights.

Any person who is 40 years and above should go for glaucoma screening. More so, if you have a family history of glaucoma and have never been screened for glaucoma yourself, you should go for an eye check as soon as you can. Don’t wait for vision problems before you do. It may be too late.

For more information, call  05-5455582  at  Hospital Fatimah  or  email  gilleyecentre@dr.com.

The Twitching Eyelid (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 Twitching Eyelid.

Most eyelid twitches are MINOR and not dangerous. Thankfully, they also do not last for very long although sometimes that may rarely last for a few months. The MORE SERIOUS or problematic form of eyelid twitching is called blepharospasm or hemifacial spasm. Here, Dr Gill speaks to us more about the other causes of eyelid twitching.

Fatigue: A lack of sleep, whether due to stress or other reasons, can trigger eyelid spasms. A good night’s rest may not only affect your mood the next day, but also your eyes. Sleep is a way to rejuvenate and refresh not only your body but also your eyes, “recharging” them for the day ahead. When you don’t get sufficient sleep, your eyes will feel tired, just like how the rest of your body may feel, says Dr Gill.

We spend about one-third of our entire lifetime sleeping. This is not wasted time because from the moment we slip into sleep, a whole cascade of events take place involving the brain, eyes, immune function, hormones, skin, respiratory system and digestive system. Inadequate sleep results in fatigue that can only be replaced by the natural process of getting the hours of sleep you have been deprived of. There is no other way to solving this!

gillDry eyes: Dry eyes are very common among postmenopausal women, the elderly, those who spend hours at the computer, those who are on medication such as antihistamines and antidepressants and also among those who wear contact lenses for long hours. Should you start getting an eyelid twitch, it’s best to see your eye doctor for a dry eye evaluation, because many treatments are now available.

Eye allergies: People who suffer from eye allergies with symptoms of itchy and watery eyes may have twitching eyelids too. This is because histamine is released into the eyelid tissues and this results in twitching of the eyelids. If you self-medicate with antihistamine eye drops, do be careful because this can cause some dry eyes too. Remember, dry eyes can be an underlying cause for eyelid twitching! So, it would be best to seek professional advice should you suffer from this.

Nutritional imbalances: Nutritional deficiencies like magnesium deficiency can trigger spasms of the eyelid. Having a balanced diet and eating healthy will definitely help.

Remedies for eye twitching

The first thing to do is to identify the underlying cause or trigger factor for the eyelid twitching. If it is excessive caffeine, then it’s time to take it easy on those cups of coffee. If it is stress, do find ways to de-stress from time to time. If it is dry eyes, then lubricant eye drops will often help. These can be purchased over the counter quite easily. If it is because of lack of sleep, then there is no easy way out but to get that sleep that you lack!

For the more serious blepharospasm and hemifacial spasms, you would need to see the ophthalmologist or neurologist. Medication like anxiolytics (anti-stress medication) may help some patients. If this does not help, then BOTOX (botulinum toxin) injections into the muscles surrounding the eyes (periorbital area) may help. This relaxes the muscles for several months. The BOTOX injection does not last forever and so may need to be repeated at three to six months intervals. This form of treatment has proven to be successful in most cases.

As a last resort, and only if absolutely necessary, a neurosurgical procedure may be done to relieve pressure on the nerve. This is only performed as a final measure if other forms of treatment do not help, as this type of surgery runs a risk of serious complications.

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

The Twitching Eyelid

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

Ipoh Echo’s Eye Health Series Continues with Consultant Eye Surgeon Dr S.S. Gill talking to us about The Twitching Eyelid.

Twitching of the eyelid is a term for spasms of the eyelid muscles that occurs involuntarily. This is an annoying problem when it happens. Twitching of the eyelids and eyelid spasms are quite common. Most of the time, only the lower eyelid is involved and that too, commonly in one eye only. However, sometimes the upper eyelid may also be involved.

Most eyelid twitches are MINOR and not dangerous. Thankfully, they also do not last for very long although sometimes they may, though rare, last for a few months. The good thing is that eyelid spasms are often so subtle that people around us do not even notice that someone has an eyelid twitch.

The MORE SERIOUS or problematic form of eyelid twitching is called blepharospasm or hemifacial spasm. Thankfully, these serious forms of twitching occur less often. When they do occur, they may warrant further testing and investigation.

dr gillSome of the possible causes for eyelid twitching are as follows:

  • Stress induced
  • Caffeine intake
  • Alcohol consumption
  • Eye fatigue
  • Nutritional deficiencies
  • General fatigue

Identifying the cause for the eyelid twitching helps us to handle the treatment. Often it is just a matter of setting something right. The more serious varieties of twitching however may be a part of a nerve condition and may need to be investigated.

Stress

Mankind is now living in possibly the most stressful era of all time. We are often reminded that “life is not a bed of roses”. The stresses of everyday life with regards to job stress, health conditions and emotional issues are common problems that one may have to face.

The stresses of life have often been identified as underlying causes for various health problems ranging from constipation, depression, hypertension, menstrual irregularities, decreased immunity and even precipitating heart attacks that may lead to death. We all react to stress differently. The response to stress may result in a major illness as mentioned above or just a simple annoying eyelid twitch. If the cause for the eyelid twitch has been identified as stress-induced, then concerted efforts should be taken to address it, the scope of which is beyond this article.

Caffeine

Caffeine is a psychoactive stimulant drug. Caffeine was first discovered by a German chemist, Friedrich Ferdinand in 1819. Caffeine is found not only in coffee but also in some leaves, beans and fruits of some plants. Believe it or not, it can actually act as a natural pesticide that kills some insects that feed on the caffeine-containing plants.

Caffeine is a stimulant (central nervous system or CNS stimulant) that restores alertness and postpones drowsiness. It enhances the effect of the stress we experience. Additionally, caffeine also increases blood pressure and so caffeine and stress do work synergistically in a negative sense. If you do have an annoying eyelid twitch, it would be worth a try cutting back on caffeinated drinks such as coffee, tea, soft drinks and energy drinks. The problem often is that too many of us are in some sense “addicted” to caffeine and claim to not be able to function without that morning cup of coffee! More on Eyelid Twitch in the next issue of the Ipoh Echo.

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

Dr S.S. Gill

Medication Affecting The Eyes (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 More On Medication That Can Affect The Eyes.

Taking medication for a particular illness or ailment may be necessary for some of us at some point in our lives. Some medication can result in side effects including eye-related side effects, some more serious than others. It all depends on the type of medication and the duration of use. In this second part, Dr Gill speaks to us more about some medication that may cause eye side effects.

Amitriptyline

Amitriptyline is an effective tri-cyclic antidepressant. Patients who are on this medication may experience dry eyes. It has an effect on accommodation of the eyes, resulting in difficulty with near reading and sometimes distant vision too. This medication may also have a risk for causing a type of glaucoma called “Angle Closure Glaucoma”, particularly in persons who are at risk for this kind of glaucoma. Thankfully, most people who suffer from glaucoma have “open angle” glaucoma, and not the angle closure glaucoma variety. Open angle glaucoma patients should experience no problems when taking this medication.

Dr S.S. GillCorticosteroids

Corticosteroids is a common and effective medication that is often used to treat a variety of illnesses ranging from  arthritis, digestive problems, bronchial asthma, certain skin diseases, and even some eye conditions, as well as used for hormone replacement therapy (HRT). This may be given orally, injected, inhaled, given as eye drops or applied directly to affected areas of skin.

Long-term use of such steroid medication may result in early cataracts in some patients. Topical and oral corticosteroids have also been found to cause glaucoma. People who are taking corticosteroids for extended periods should have their eyes checked from time to time.

Accutane

This is a medication used to treat acne (pimples). It is known to cause dryness of mucous membranes in our body and also the eyes. When someone develops dry eye symptoms, they may complain of redness, a burning sensation, and even blurred vision at times. Often, a simple prescription of lubricant eye drops or artificial tears and ointments may help.

Accutane may also lead to temporary visual disturbances and trouble with night vision for some people. When starting on Accutane, your doctor will often inform you about these potential side-effects. Do inform your doctor should you have any of these symptoms.

Minocycline

This drug is also used to treat acne and another skin condition called rosacea. It is similar to the oral antibiotic called tetracycline. It may cause a side effect resulting in a blue-grey or brownish pigmentation of the white of the eye (sclera). This pigmentation may be more in areas exposed to sunlight. The good thing is that discontinuation of this drug reverses the pigmentation that it causes.

In conclusion, every medication may have side effects but the decision on whether you need it is BEST DECIDED by your physician after weighing the benefits against the side effects. Also, NOT every person will develop side-effects! Always keep a tab of all medication that you may be taking. Should you need to see various doctors for various ailments, you must inform them of all the medication you are taking. This will avoid unnecessary problems with drug interactions.

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