Sense organs; Sight Pathologies Flashcards
Blepharitis
- Inflammation of the eyelid margin
Pathophysiology:
* Can be acute or chronic.
* Most commonly in adults
Aetiology: Causes/triggers
* Often associated with Staphylococcus aureus infection or dermatitis
Main signs and symptoms:
* Red eyelid margins
* Sore, gritty eyes, scales and flakes
* Eyelids may stick together, often worse in morning
* Itching and burning
* Loss of eyelashes
* Can black sebaceous glands & cause recurrent styes
Allopathic treatment:
* Eyelid hygiene. Clean with a cotton bud
* Warm compress (apply to closed eyes for 5-10 mins)
* Topical antibiotics
* Avoid contact lens use until resolved
Alternative treatment:
* Omega-3 fatty acids found in fish oils may improve tear quality (boosting immune function)
* Treat topically using anti-inflammatory & anti-microbial herbs
* Nutritional support for inflammation / infection
* Homeopathy
* Colloidal silver, calendula, lid massage
Stye
- Inflammation of sebaceous glands of eyelid
Aetiology:
* Usually a bacterial infection (Staphylococcus)
* Risk factors: Diabetes mellitus and Chronic blepharitis
Main signs and symptoms:
* Red, swollen and / or painful infection of sebaceous glands of eyelid
* Usually affects the upper lid
Allopathic treatment:
* Usually none necessary
* Typically will burst and the pus will drain, hot compresses 3-4 x day eases pain/ aids pus removal
* Antibiotic ointment if the stye doesn’t resolve
Alternative treatment:
* Treat topically using anti-inflammatory, demulcent and anti-bacterial herbs
* Nutritional support for inflammation / infection
* Homeopathy, colloidal silver, calendula eyewash
Complications:
* Cyst formation can damage the cornea
Conjuntivitis
- A highly contagious inflammation of the conjunctiva
Aetiology:
* Viral
* Bacterial
* Often linked to allergies
Main signs and symptoms:
* Red eye, irritated / uncomfortable, watery / purulent discharge
* Photophobia suggests corneal (deeper involvement)
Allopathic treatment:
* Eye bath with salt water or eye cleansing solution.
* Antibiotic eye drops or oral antibiotics rarely
Alternative treatment:
* Treat topically using anti-inflammatory, demulcent and anti-bacterial herbs
* Homeopathy
* Colloidal silver, calendula bath
Uveitis
- Inflammation of any part of the uvea (iris, ciliary body, choroid)
Aetiology:
* Autoimmune disease (increased with HLA-B27 e.g. Ankylosing spondylitis (AS)
* Trauma to the eye (includes contact lenses)
* Viral infection (e.g. herpes), fungal or parasitic
Main signs and symptoms:
* Progressive unilateral red eye with pain, blurred vision and photophobia
* Visual acuity reduced in affected eye.
* Watery discharge
Allopathic treatment:
* Antibiotics, cortisone depending on the cause
Alternative treatment:
* Treat topically using anti-inflammatory and anti-bacterial herbs
* Nutritional support for inflammation / infection
* Homeopathy
Corneal Ulcer
- An ulcer (open sore) that develops in the cornea
Aetiology:
* Bacterial (e.g. gonorrhoea)
* Viral (e.g. herpes simplex)
* Fungal infection
* Trauma (e.g. contact lens)
* Spread from blepharitis
Main signs and symptoms:
* Pain
* Reduced vision
* Photophobia
* Discharge
Allopathic treatment:
* Medical emergency – possible loss of sight
* Antibiotics, antifungal or antiviral drugs
* Keratoplasty (corneal transplant)
Other notes:
* Rare due to extensive ocular defense mechanism
Strabismus
(Squint)
- Mis-alignment of the eyes, which means the retinal image is not in corresponding areas of both eyes
- Esotropia = inward squint
- Exotropia = outward squint
Aetiology:
* Genetic (family history of squint)
* Damage to nerves supplying extra-occular muscles (e.g. stroke, brain tumour, trauma)
Allopathic treatment:
* Glasses to correct visual problems and patching the normal eye (forces the brain to use the affected eye)
* Surgery to tighten muscles around the eye
Cataracts
- Cataracts describes the opacity of the lens (structure of the lens (connective tissue) becomes disorganized (stretched / squashed together), and as a result can refract light in different quantities)
Aetiology:
* Age related deterioration of lens
* Congenital
* Diabetes mellitus
* Smoking
* Steroids (breaks down proteins in connective tissue)
Main signs and symptoms:
* Gradual painless loss of vision
* Diplopia (double vision)
Allopathic treatment:
* Surgery
Other notes:
* Cataracts are the leading cause of blindness in the world
Age-Related Macular Degeneration
(AMD)
- Age-related macular degeneration (AMD) describes the aging changes that occur in the central areas of the retina (macula)
- AMD is a progressive chronic disease that is also a leading cause of vision loss worldwide
Aetiology:
* Occurs in people aged 55 years and older
* Advancing age is the most significant risk factor
* Also smoking, cardiovascular disease and family
Main signs and symptoms:
* Reduced visual acuity, particularly difficulty with near vision
* Gradual (& progressive) loss of central vision
Diagnosis/investigations:
* Using Ophthalmoscopy
* Can be assisted with the use of an Amsler grid - patients are asked to look into the grid. Patients with AMD may describe observing a distorted image of the grid (in the central visual field)
Muscae Volitantes
(Floaters)
- Opacities floating in the field of vision
Pathophysiology:
* Small, dark, shadowy shapes (can look like spots, thread-like strands, or squiggly lines)
* They move with eye movements and seemingly dart away when trying to look at them directly
* Visible because of the shadows they create on the retina
Aetiology:
* Usually shrinkage of the vitreous humour causing collagen to become fibrils which present as a floater (age)
* Vitreous haemorrhage with haemorrhaging in diabetic retinopathy
Retinal Detachment
- Separation of the neurosensory layer of the retina from the pigmented epithelium
Pathophysiology:
* Results in accumulation of sub-retinal fluid in the potential space (vitreous seeps in)
Aetiology:
* Most common in middle-aged and elderly
* Often cause unknown
* Severe trauma to head can cause it
Main signs and symptoms:
* Presents as floaters in vision, flashing lights, curtains descending over vision
Allopathic treatment:
* Ocular emergency – usually requires surgery.
* If minor retinal break can use laser
Complications:
* Can result in blindness or visual impairment
Glaucoma
- Increased intracoluar pressure caused by inadequate drainage.
(Intraocular pressure (IOP) should be 10-21mmHg. >40 = significant damage caused) - Glaucoma causes compression of the retina and optic nerve
Aetiology:
* Can be congenital or acquired (uveitis, intraocular haemorrhage, Diabetes mellitus)
* Obstruction of the canal of Schlemm (exit route for fluid from the eyeball)
* Smoking will moderately increase pressure
Main signs and symptoms:
Acute Glaucoma:
* Mild: Pain / pressure in the eyes and haloes around lights, relieved by sleep (drainage improved)
* Severe: Rapid deterioration of vision, intense eye pain, redness and watering of the eye, sensitivity to bright light, nausea and vomiting.
Chronic Glaucoma: Often no symptoms until permanent damage has occurred
* Late symptoms: Loss of peripheral vision, blurring of objects directly in front of the person. Loss of night vision
Allopathic treatment:
* Eye drops / tablets to reduce fluid production (reduces eye pressure)
* Laser or surgical treatment if this is ineffective
Alternative treatment:
* Treat allergies (shown to increase eye pressure), vitamin C, magnesium, fish oils and chromium (reduce severity / intraocular pressure)
Complications:
* Damage to the optic nerve and retina leads to permanent blindness
Other notes:
Prevention:
* Healthy vitamin C levels
* Recommended check every 2 years after the age of 40. Optician examines the optic disc, measure pressure in the eye
Diabetic Retinopathy
- Diabetic retinopathy is a progressive, potentially sight-threatening disease of the retinal microvasculature
Pathophysiology:
* Microvascular damage occurs, which includes branches of the retinal artery, causing neovascularisation (new vessel formation in an attempt to re-vascularise)
* The vessel walls become physically weak and leaky, leading to micro-aneurysms, oedema and haemorrhaging
Aetiology:
* Diabetic nephropathy occurs as a result of chronic hyperglycaemia
Main signs and symptoms:
* May retain normal sight, or present as a decline in vision and floaters (if haemorrhages)
