Eye Disorders

Eye Disorders

Introduction

·        The eye is a highly specialized organ of vision that converts light into neural signals, enabling us to perceive the world.

·        Due to its delicate structure and constant exposure to environmental factors (dust, light, infections, trauma), the eye is susceptible to various disorders.

·        Eye diseases can affect the cornea, lens, retina, conjunctiva, optic nerve, or intraocular pressure, leading to impaired vision or even blindness if untreated.

·        Disorders may be congenital, acquired, infectious, degenerative, or refractive in nature.

·        Early diagnosis and treatment are critical in preventing permanent damage.

Glaucoma

  • Definition: A group of eye conditions characterized by increased intraocular pressure (IOP) due to impaired drainage of aqueous humor, leading to optic nerve damage and progressive loss of vision.
  • Types:
    • Open-angle glaucoma (chronic): Gradual blockage of drainage canals; painless, progressive vision loss.
    • Angle-closure glaucoma (acute): Sudden blockage of drainage angle; medical emergency with severe pain.
  • Causes/Risk factors:
    • Age > 40 years
    • Family history
    • Diabetes, hypertension
    • Eye trauma, steroid use
  • Symptoms:
    • Open-angle: Gradual peripheral vision loss ("tunnel vision").
    • Acute: Severe eye pain, headache, nausea, blurred vision, halos around lights, red eye.
  • Complications: Irreversible blindness if untreated.
  • Diagnosis:
  • Treatment:
  • Prevention/Control: Regular eye checkups after 40, especially for high-risk individuals.

Trachoma

  • Definition: A chronic infectious eye disease caused by Chlamydia trachomatis, leading to conjunctival scarring and blindness.
  • Epidemiology: Endemic in poor hygiene areas; major cause of preventable blindness worldwide.
  • Pathogenesis: Recurrent infection → chronic inflammation → conjunctival scarring → eyelid deformity (entropion) → eyelashes rub cornea → corneal opacity.
  • Symptoms:
    • Redness, tearing, discharge
    • Photophobia, pain
    • Rough inner eyelids with follicles
    • In later stages: entropion, trichiasis, corneal opacity.
  • Diagnosis: Clinical exam, conjunctival swab for Chlamydia.
  • Treatment:
    • Antibiotics: Oral azithromycin (preferred), topical tetracycline.
    • Surgery for entropion/trichiasis (SAFE strategy: Surgery, Antibiotics, Facial cleanliness, Environmental improvement).
  • Prevention: Improved sanitation, mass treatment programs, hygiene education.

Cataract

  • Definition: Opacification/clouding of the lens of the eye causing progressive, painless loss of vision.
  • Types:
    • Senile cataract: Age-related degeneration (most common).
    • Congenital cataract: Present at birth (due to intrauterine infections like rubella).
    • Secondary cataract: Due to diabetes, trauma, steroids, radiation.
  • Causes/Risk factors:
    • Aging
    • Diabetes mellitus
    • Prolonged corticosteroid use
    • Eye injuries
    • UV light exposure
  • Symptoms:
    • Blurred, cloudy vision
    • Glare and halos around lights
    • Reduced night vision
    • Fading of colors
  • Diagnosis: Slit-lamp examination.
  • Treatment:
  • Prevention: UV protection, control of diabetes, avoiding long-term steroid abuse.

Inflammations of the Eye

Eye structures may undergo inflammation due to infection, trauma, or autoimmune reactions.

  • Types:
    • Conjunctivitis (Pink Eye):
      • Inflammation of conjunctiva, caused by bacteria (Staph, Strep), viruses (Adenovirus), or allergy.
      • Symptoms: Redness, itching, tearing, discharge (purulent in bacterial).
      • Treatment: Antibiotic/antiviral drops, antihistamines for allergy.
    • Keratitis: Inflammation of cornea → pain, photophobia, corneal ulcer; caused by bacteria, viruses (Herpes simplex).
    • Uveitis: Inflammation of uveal tract (iris, ciliary body, choroid). Causes: autoimmune, TB, syphilis. Symptoms: pain, blurred vision, photophobia.
    • Blepharitis: Inflammation of eyelid margin → itching, redness, crusting.
  • Treatment (general): Antibiotics, antivirals, corticosteroid drops (under medical guidance), lubrication, removal of irritants.

Myopia (Nearsightedness)

  • Definition: A refractive error where parallel light rays focus in front of the retina due to an elongated eyeball or increased corneal curvature.
  • Causes:
    • Genetic predisposition
    • Excessive near work (reading, screen time)
    • Elongation of eyeball
  • Symptoms:
    • Blurred distance vision, clear near vision
    • Eye strain, headache
  • Diagnosis: Refraction test.
  • Treatment:
    • Concave (minus) lenses in glasses/contact lenses
    • Refractive surgery (LASIK, PRK, SMILE).
  • Prevention: Outdoor activities in childhood, reduced screen time, proper lighting.

Hypermetropia (Farsightedness)

  • Definition: A refractive error where light focuses behind the retina due to short eyeball or flattened cornea.
  • Causes: Congenital (small eyeball), aging changes, weak lens curvature.
  • Symptoms:
    • Blurred near vision, clear distance vision
    • Eye strain during reading, headache
  • Diagnosis: Refraction test.
  • Treatment:
    • Convex (plus) lenses
    • Corrective refractive surgery in adults.

Presbyopia

  • Definition: Age-related loss of accommodation of the lens, leading to difficulty in near vision, usually after age 40.
  • Cause: Reduced elasticity of lens + weakened ciliary muscle function.
  • Symptoms:
    • Difficulty in reading small print at normal distance
    • Need to hold books farther away (“long arm syndrome”)
    • Eye strain, headache while reading
  • Treatment:
    • Bifocal or progressive lenses
    • Contact lenses with multifocal correction
    • Surgical lens replacement in advanced cases.

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