Strabismus

Strabismus is characterized by a deviation of eyes (one or two) from the central axis. Eyes thus look in different directions. The view can’t be focused on a certain subject. More often strabismus develops at two – three-year-old children when joint work of both eyes is formed.

Strabismus can result from inflammatory or tumoral lesions of eye muscles, injuries and infections of brain, wrong compensation of visual impairments, congenital diseases and birth trauma, the excessive exercises and mental stresses.

There is a concomitant and paralytic strabismus. In case of concomitant left and right eyes squint in turn, size of their deviation from the central axis is identical. Paralytic strabismus arises at injury of oculomotor muscles or disease of optic nerve. One eye (not affected) squints. Sick eye when examining a subject badly moves, not affected eye moves on the increased angle.

Strabismus can meet be convergent (the eye moves to the nose that is usually combined with hyperopia); divergent with eye deviation to the temple (more often it is combined with myopia); vertical when the eye deviates down or up.

The patient is disturbed by doubling in eyes, headache and giddiness. He sees a flat image instead of 3D, in the squinting eye visual acuity goes down.

Treatment of strabismus is begun as soon as possible, illness does not pass independently. Begin with correction of disturbances of vision. To the child puts on glasses which should be worn till strabismus symptoms decrease.

The surgery is shown at paralytic strabismus or at non-effective conservative treatment of concomitant strabismus.

Conjunctivitis

Conjunctivitis is an inflammation of conjunctiva, the mucosa covering front area of eyeball (up to cornea) and internal surface of blepharons.

The conjunctivitis can arise at bacterial or viral infection, and funguses lesion. If the person rubs eyes with dirty arms or swims in muddy reservoir, infection is very probable. Viruses can get into eyes also through blood (flu, measles, chicken pox).

The allergic conjunctivitis arises at irritation of sensitive organism with flower pollen or other substance.

Conjunctivitis can be caused with ultra-violet radiation. Non-observance of rules of handling with contact lenses, frigorism, eyestrain, vitamin deficiency belongs to other causes of disease.

The acute conjunctivitis arises suddenly, proceeds roughly. Fine vascular vessels extend and burst, eye reddens, eyelids swell; there is a discharge (slimy or purulent). The patient is disturbed by pains, burning sensation in the eye as if there is sand in it. Tears, sometimes pus flow, light sensitivity increases. Quite often from one eye illness passes to the second.

The chronic conjunctivitis develops gradually, torpid and usually affects at once both eyes. It is caused with long smoke, dust, chemicals effect. Also the disease arises at vitamins deficiency, chronic nose lesions. The chronic conjunctivitis is characterized by itch, burning sensation, photophobia, and fatigue of eyes.

At pus discharge eyelids stick together. For softening of sticky substance e eye should be washed out with warm infusion of chamomile (two teaspoons are infused with boiling water, brew 5 minutes). It is not necessary to apply bandage on eye.

Coloboma

Coloboma is a congenital or acquired defect of one of eye parts, its deformation, partial or total absence. Depending on place of damage there is an iris, choroid, lens, ciliary body, optic nerve, upper or lower eyelid coloboma. The illness symptomatology also depends on it.

An iris coloboma is shown by “dazzle”. It is not blindness. The patient keeps his vision, however the ability of the eye to limit the quantity of light is broken. Mesh glasses or darkened contact lenses transparent in the center are applied for treatment. At significant defects the iris is sutured.

In case of coloboma of ciliary body accommodation is broken. The patient complains of the complicated perception of close located objects.

At coloboma of ciliary body the vascular cover is damaged. It breaks retina supply. The part of retina doesn’t perceive the image, there is a site missing. The coloboma of optic nerve is clinically similar to choroid coloboma. Both diseases are still considerably not curable.

The lens coloboma is similar to astigmatism on symptoms, some areas of lens have various light refraction. Significant coloboma of lens is cured with replacement by the artificial lens.

At a coloboma of blepharon vision remains unchanged. Weakening of cornea humidification with lacrimal liquid is possible. The patient complains also of essential cosmetic defect. The coloboma of blepharon is eliminated by means of surgery.

Cataract

Cataract is a lenticular opacity. Lens is a natural lens refracting light beams. It is located in the interval between crystalline humor of eye and iris. The lens of young people is transparent, elastic, well changes its shape under the influence of the muscles stretching it.

In the presence of a cataract the lens grows turbid partially or completely, the small part of light beams gets to an eye, image sharpness decreases. As years go by the illness progresses, vision worsens. Without well-timed treatment the cataract causes blindness. The main method of diagnostics of cataract is an examination of an eye grounds.

The cataract is met in patients of any age. There is a congenital cataract, radial, traumatic, medicinal, caused by the general diseases (avitaminosis, diabetes mellitus), illnesses of eyes (glaucoma, severe short-sightedness), smoking, poisonings (naphthalene, mercury, thallium, and ergot). But the most widespread is an age-related cataract (senile) developing after 50 years.

Patient with cataract feels a flicker of strips and spots behind the eyes, photophobia, doubling vision. There are difficulties when reading, doing fine work. The pupil in process of “maturing” of a cataract from black becomes white.

Cataract is treated by means of ultrasound destruction with the subsequent implantation of artificial lens to the place of lens. Local drop anesthesia is well tolerated by patients, it doesn’t overload heart.

It is impossible to postpone the operation. At neglected cataract the inflated lens occupies a significant part of front eye chamber, breaking the liquid outflow because of what a severe complication – secondary glaucoma develops.

Torsion Of Blepharon

Torsion of blepharon (entropy) is a disease at which the free edge of eyelid is wrapped inside together with eyelashes. Eyelashes contact to a conjunctiva and cornea of the eye, causing irritation and reddening. The patient feels pain when blinking, burning sensation and itch, feeling of foreign body in the eye, vision deterioration. There is a photophobia, lacrimation, in severe cases cornea opacification. More often entropion occurs on the lower eyelid as its cartilage which is responsible for the shape is twice smaller than the cartilage of upper eyelid.

The torsion of blepharon is met in elderly people more often. The muscles holding a blepharon weaken with age, the skin stretches and droops. Senile entropion strikes only a lower eyelid, it is shown at the same time on both eyes, becoming more expressed over time.

The congenital torsion of blepharon is caused by genetic disorders of eyeball structure (small size) and eye muscles.

The cicatrix entropion develops because of injuries or burns of the eyes leading to formation of cicatrices. The surgery of “face lifting” which is very popular now can become the cause.

The paralytic torsion of blepharon arises because of paralysis of a eye circular muscle (because of trauma or tumor).

The mechanical torsion of blepharon appears as a complication of tumors when tumor cells invade a blepharon.

The most effective way of treatment of torsion of blepharon is surgical. Various operations are performed: applying of the sutures pulling off a blepharon, excision of narrow skin strip, dissection of eye circular muscle.

Temporarily the condition of the patient can be facilitated with emplastrum which is pasted so that it pulls off the blepharon down. It is possible to cure a small torsion of blepharon completely by means of emplastrum. Soft contact lenses prevent cornea scratching with eyelashes.

Hyperopia

Hyperopia is a disturbance of vision at which person sees well remote subjects, and closely located- poorly. In the 15th century when book printing appeared, this visual impairment became the reason of glasses invention. Concave lenses for the mope-eyed were invented a century later.

Little children and aged people beyond 40 may be far-sighted. Because of age weakening of lens ability to change the form presbyopia comes. For normal vision the subject image should be focused on retina. The point of the ideal image at a hyperopia is moved further and is behind a retina. As a result, the person sees a vague image.

The shorting of eyeball or bad refractivity of optical system is the cause of the wrong focusing.

The main implications of hyperopia: increased fatigue of eyes when examining close subjects, poor eyesight nearby, burning sensation in eyes, headaches. If to ignore hyperopia, complications:  strabismus, conjunctivitis, amblyopia or lazy eye is possible (eye seems healthy, but poorly sees, it is impossible to correct problem with glasses or lenses). At advance of hyperopia the outflow of intraocular liquid is broken and glaucoma develops.

There are three main methods of hyperopia correcting – glasses wearing, contact lenses, surgical correction. Children with hyperopia should start use lenses or glasses as soon as possible, to wear them permanently. The elder child becomes the more extended is eyeball and vision is normalizes.

Glasses or lens are required for adults for reading and fine work. At strong degree of hyperopia glasses for near and far vision are separately prescribed.

Glaucoma

Glaucoma is a chronic illness at which ocular tension increases. If not to decrease it in time, the optic nerve perishes and there is an irreversible blindness. Glaucoma develops imperceptibly, but can lead to full loss of vision.

Generally people beyond 40 years old suffer from glaucoma, but young people are also not secured against it (juvenile glaucoma), there is also a congenital glaucoma. The ocular tension increases at disturbance of intraocular liquid circulation.

Primary glaucoma is met more often than other forms. It appears in people seeming healthy without obvious reasons. From risk factors it should be noted: myopia, heredity, hypotension, diabetes mellitus, age beyond 60 years, illnesses of thyroid gland.

Secondary glaucoma is a consequence of previous disease of eyes. Inflammatory diseases of eyes, shift of lens, cataract, concussions, burns and eye injuries, surgeries, tumors of eyes may be the cause.

Congenital glaucoma is caused by anomalies of embryo development.

There are benign eye hypertensions – non-glaucoma rising of ocular tension. Optic nerve is not affected at it. The hypertensions of eye are caused by local or general diseases, intoxications, endocrine disturbances, reception of high doses of hormones.

At glaucoma the liquid circuit in a sick eye is broken, it accumulates and pressure starts growing in the eye. The eyeball presses on opening into orbit of an optic nerve, blasting it. The patient sees worse. If the optic nerve perishes, the patient completely loses his sight. At glaucoma there is a sudden loss of sight because of an acute attack.

Myopia

Myopia (myopia) is a widespread visual impairment. The person sees well close located subjects, poorly located in distance. Every third person has short-sightedness. Usually illness appears in children of 7-15 years, then is aggravated or remains at the former level.

Myopia is usually aggravated with:

- weakening of eye muscles;

- excessive load on eyes;

- genetic predisposition;

- injuries at labors;

- brain injuries.

In people with normal vision the image is focused on retina. In mope-eyed persons the point of the ideal image is in front of it, and the picture reaches the retina as indistinct. It occurs at diffraction disorder in lens or at elongation of eyeball. At frequent and sustain stress eye muscles stretch the eyeball, its length persistently enlarges.

The mope-eyed person has headaches, the patient quickly gets tired. Peeling of retina is serious complication of myopia. Vision thus sharply decreases, up to a total blindness.

There are three main ways of myopia correction: glasses wearing, contact lenses, surgeries (the advanced method is laser). Lenses and glasses need to be changed regularly therefore it is necessary to visit the oculist.

Surgical treatment is the only way to correct vision and to prevent complications at myopia. The serious progressing myopia requires the prescription of vitamins and medicines stimulating feeding of eye retina.

For myopia prophylaxis it is important to follow rules of hygiene (sufficient lighting, correct position when reading), have a rest in time, to carry out the exercises training eye muscles.

Nictitating spasm

Nictitating spasm is uncontrollable contraction of muscle surrounding the eye. Outwardly it looks as a strong closing of blepharons. The nictitating spasm is followed by an edema of blepharons, lacrimation. There is a vicious circle: the spasm generates consequences causing intensification of spasm.

At first person feels a rapid blinking which can’t be controlled (clonic blepharospasm). Usually at first only one eye is affected. In time spasm extends on both eyes.

In young people the nictitating spasm can arise without obvious causes and quickly disappears. The hysterical bilateral nictitating spasm appears suddenly at hysteria (usually at young women) and disappears in some hours. At this kind of nictitating spasm “pressing points” in places of an trigeminal nerve branches outlet are revealed. The nictitating spasm stops when pressing on them.

Frequently in 2-3 years a nictitating spasm becomes persistent. It is shown as closing eyes tight (tonic blepharospasm) that leads to problems in everyday life.

The nictitating spasm leads to stresses and depressions. In many cases in time the spasm extends on all facial muscles.

Often the nictitating spasm stops at activity of mouth muscles (smoking, sucking of candies, nibbling sunflower seeds). Alcohol and, emotional activation can take spasm off. Sometimes closing of one or both eyes helps. Practically it is always possible to find position of eyes in which the nictitating spasm stops. Usually this is extreme abduction to sideways. The nictitating spasm decreases in a sitting position and lying.

The strong provoker of nictitating spasm is a sunlight therefore wearing of dark glasses and work performance at the semi closed blepharons is recommended to the patient.

 

Blepharitis

Blepharitis is a chronic inflammation of eyelids edges. The reasons of blepharitis are various. Demodex can strike eyelids edges. In 80% of people demodex lives on skin, in sebaceous glands, follicles of hair. When immunity weakens because of overwork, frigorism or infection demodex is activated, quickly breeds on skin of blepharons causing a demodex blepharitis.

There is an allergic blepharitis in people to a hyper sensibility to some allergens (flower pollen, cosmetics). Usually it is complicated by a conjunctiva inflammation (mucosa of eyes). The blepharitis sometimes accompanies diabetes and diseases of the digestive system; it quite often arises in the far-sighted people who do not wear glasses. Muscles of eyes strain, get tired, the person rubs eyes with arms and infects eyes.

The disease begins of reddening and swelling of blepharons skin, itches, eyelashes fall out. It is dangerous if eyelashes start growing in cornea direction and scratch it. Eyes quickly get tired, water, sensitive to irritants. At severe course of blepharitis on the blepharon edge crusts are formed; after its falling off bleeding ulcers are revealed. The tissue cicatrizes, in some places is thickened, eyelashes grow incorrectly.

It is important to reveal and eliminate the blepharitis cause. Thorough hygiene of blepharons is necessary. The discharge and crusts delete with wet cotton lotion. Rough crusts at first are softened with wet lotion. Then the ointment containing an antibiotic and corticosteroid hormone is applied on eyelid edge. At conjunctivitis eye drops with antibiotics are instilled (gentamycin is preferable). If the blepharitis is caused by demodex, it is important before going to bed to grease eyelids edges with ointment; it breaks vital activity of demodex.