DISORDERS AND CONDITIONS

OF
THE EYE
Claudette Anne T. Cormary

 Anatomy of Eye

Eyes

Housed in a cone of fatty tissue

Eyeball
Three layers
External fibrous layer
Middle vascular layer
Inner layer of nerve tissue

Anatomy of the Eye

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External Fibrous Layer

Sclera
white of eye
Protective & supportive outer layer

Cornea
Dense fibrous connective tissue
Must be transparent to allow light

Middle Vascular Layer

Heavily pigmented
Blood vessels

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Inner Layer
Retina
Continuous with optical nerve in rear
Ora serrata in front
Two parts
Outer part-pigmented-attached to choroid layer
Inner part is nerve tissue

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 Eyelids
Tarsal glands secrete oil to lubricate

Lacrimal glands outer edge of eye socket

Secretes tears to clean & protect

Aqueous humor between cornea & lens

Salty clear fluid

Retina
Thin membrane lining rear of eye
Contains light sensitive cells
Rods & cones
Rods are sensitive to light
120 million rods

Cones are sensitive to colors

6 million cones

Eye Disorders

CATARACT
GLAUCOMA
CORNEAL ABRASION OR ULCER
RETINAL DETACHMENTE
EYE INFECTIONS/INF;LAMMATORY
DETACHMENTS
REFRACTIVE ERRORS
EYE TRAUMA/EMERGENCIES
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CATARACT
MECHANISM
* Gradual deterioration of lens

ETIOLOGY
* familial
* old age
* congenital
* trauma
* drug toxicity (high level of steroids)
* diabetes mellitus
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 SYMPTOMS AND SIGNS

Cataracts usually form slowly and cause few symptoms until they noticeably
block light. When symptoms are present, they can include:

Vision that is cloudy, blurry, foggy, or filmy

Progressivenearsightednessin older people often called "second
sight" because although their distance vision is deteriorating, they
may no longer need reading glasses.
Changes in the way you see color because the discolored lens acts
as a filter.
Problems driving at night such as glare from oncoming headlights.
Problems with glare during the day.
Double visionwhile looking through the eye with a cataract (like a
superimposed image).
Sudden changes in glasses prescription.

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 DIAGNOSIS
* Visual examination
* pen light of slit lamp confers the presence of a
cataract
TREATMENT

Types of Cataract Surgery

There are two types of cataract surgery. In the more common type, called
phacoemulsification (phaco), the doctor makes a tiny incision in the eye and breaks up
the lens using ultrasound waves. The lens is removed, and an intraocular lens (IOL) is
put in its place. In most modern cataract surgeries the IOL eliminates the need for thick
glasses or a contact lens after surgery.

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Cataract Surgery Innovations

Recent developments in cataract surgery can correct both near and distance vision. They
minimize or eliminate the need for reading glasses after surgery. Conventional
"monofocal" lenses only correct for distance vision, meaning reading glasses are still
needed after surgery. "Toric" implants are available to correct astigmatism.

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 What to Expect After Surgery

itchy and sensitive to light.

You may be prescribed drops to aid healing and asked to wear an eye shield or glasses for
protection. I
t'll take about eight weeks for your eye to heal completely, though your vision should begin to
improve soon after surgery. You may still need glasses, at least occasionally, for distance or
reading -- as well as a new prescription after healing is complete.

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Cataract Surgery Risks

rare
The most common risks are bleeding, infection, and changes in eye pressure,
which are all treatable when caught early.
Surgery slightly raises the risk of retinal detachment, which requires
emergency treatment. Sometimes, lens tissue left after surgery and used to
support the IOL can become cloudy, even years after surgery. This "aftercataract" is easily and permanently corrected with a laser.

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 Tips to Prevent Cataracts

Things you can do that may lower your risk of
developing cataracts:
Don't smoke.
Always wear a hat or sunglasses in the sun.
Keep diabetes well controlled.
Limit alcohol consumption.

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GLAUCOMA

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What happens?

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Glaucoma: what is happening

Either:
the drain
blocks here

Or poor
blood supply
here

Damages the optic

nerve..looks caved
in, called cupped

Characteristic pattern to loss of visual field

Rim of optic nerve
becomes thinner as disc
caves in and becomes
more cupped

Types of glaucoma

Congenital
Secondary
Juvenile
open angle*
Angle-closure*
Many different
types

Who gets glaucoma?

You are at an increased risk of glaucoma if you:

Are of African-American, Irish, Russian, Japanese, Hispanic, Inuit, or
Scandinavian descent
Are over age 40
Have a family history of glaucoma
Have poor vision
Have diabetes
Take certain steroid medications, such as prednisone
Have had trauma to the eye or eyes

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S/Sx

"sneak thief of vision.

If you have any of the following symptoms, seek immediate medical care:
Seeing halos around lights
Vision loss
Redness in the eye
Eye that looks hazy (particularly in infants)
Nausea or vomiting
Pain in the eye
Narrowing of vision (tunnel vision)

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Dx/Treatment
Glaucoma can be treated with eye drops,
pills, laser surgery, traditional surgery or a
combination of these methods. The goal of
any treatment is to prevent loss of vision,
as vision loss from glaucoma is
irreversible.The good news is that
glaucoma can be managed if detected
early, and that with medical and/or
surgical treatment, most people with
glaucoma will not lose their sight.
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Corneal Abrasion
Acornealabrasionisascratchonthe
eye'scornea.

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Causes of Corneal
Many situations can cause a corneal
Abrasion?
abrasion, including:
Being poked in the eye, for instance by
a fingernail, plant, ormakeupbrush
Dirt, sand, sawdust, ash, or some
other foreign matter blowing into your
eye and getting caught under the
eyelid
Chemical burns

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 Aggressively rubbing your eye

Poor fitting or dirtycontact lenses
Certain types of eye infections
Not protecting the eyes during
surgery while under general
anesthesia; if your eyes are not
closed during surgery, the cornea
can dry out, making it more prone
to corneal abrasion.
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Symptoms of Corneal Abrasion

Feeling like you have sand or grit

in your eyeEye pain, especially
when opening or closing your
eyeTearing and
rednessSensitivity to lightBlurred
visionor loss of vision
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Corneal Abrasion Treatment

Antibioticeyedropsorointment
Painmedication

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Retinal Detachment

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What happens?
Theretinalpigmentepithelium(RPE)isalayer
ofsupportcellsthatlinesthebackoftheeye.It
isnormallyattachedtothesensoryretinalayer.
Inretinaldetachmentcausedbyaretinaltear,
thesensoryretinaispulledawayfromtheRPE
becausefluidbuildsupbetweenthetwolayers.
Partoralloftheretinacomesoff(detaches
from)thebackoftheeye.
Blurredandlostvisioncanoccur.
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Retinal detachment means that the retinaa thin

layer of nerve tissue at the back of your eyehas
detached, or pulled away. This can lead to vision loss
and blindness, but surgery can often restore good
vision.
A retina can detach as a result of aging, an eye
injury, inflammation, or some diseases such as
diabetes. But many times there is no obvious cause.

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Retinal Detachment - Cause

Tearsorholesintheretina.
TractionontheretinaTractiononthe
retina.
Fluidbuildupundertheretina.

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Retinal Detachment - What

Increases Your Risk

Afamilyhistoryofretinaldetachment.
Previousretinaldetachmentintheother
eye.
Latticedegeneration,aninherited
conditioninwhichpartsoftheretina
becomeverythinandareeasilytorn.
Ageolderthan50.
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Nearsightedness(myopia).
Surgeryforcataracts.
Bluntinjuryorblowtothehead.
Injurytotheeye.
Diabetes,whichcanleadto
proliferativediabeticretinopathy.
Othereyedisordersoreyetumors.

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Retinal Detachment - When To

Call
a Doctor
Flashes
of lights/ floaters
Migraine headaches
Exams/test:
routine eye exams
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Treatment
Surgery:
Almostallretinaldetachmentscanbe
repairedwithscleralbucklesurgery,
pneumaticretinopexy,orvitrectomy.

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Eye
Health
Uveitis
What
Are theand
Symptoms
of Uveitis?

Eyerednessandirritation
Blurredvision
Eyepain
Increasedsensitivitytolight
Floatingspotsbeforetheeyes

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 What Causes Uveitis?

Therearefourtypesofuveitis:
Iritis
Cyclitis
Retinitis
Choroiditis

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 How Is Uveitis Treated?

Foruveitisnotcausedbyan
infection,youreyespecialistmay
prescribeeyedropscontaining
steroidstoreduceswellinganddrugs
torelievepain.Antibioticsareusedin
patientswithinfectiousuveitis.Dark
glasseswillhelpwithlightsensitivity.

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 Complicationsofuveitismayinclude
glaucoma,cataracts,abnormalgrowth
ofbloodvesselsintheeyesthat
interferewithvision,fluidwithinthe
retina,andvisionloss.Earlydiagnosis
andtreatmentbyaneyespecialistis
critical.

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Iritis
IritisCauses:
Iritismaybeaconsequenceoftrauma
(traumaticiritis)ornontraumaticcauses:
Blunttraumatotheeyecancausetraumatic
inflammationoftheiris.

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 Nontraumaticiritisisfrequentlyassociated
withcertaindiseases,suchas
ankylosingspondylitis,Reitersyndrome,
sarcoidosis,inflammatoryboweldisease,and
psoriasis.
InfectiouscausesmayincludeLymedisease,
tuberculosis,toxoplasmosis,syphilis,and
herpessimplexandherpeszosterviruses.
Inalargenumberofcases,nocauseforiritis
isfound.

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 Iritis Symptoms:
Painintheeyeorbrowregion
Worsenedeyepainwhenexposedtobright
light
Reddenedeye,especiallyadjacenttotheiris
Smallorfunnyshapedpupil
Blurredvision
Headache

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When to Seek Medical Care for Iritis

Eyepain,includingpainassociated
withbrightlight
Blurredvision
Rednessintheeye,especiallynear
theiris

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 Iritis Exams and Tests

Iritis Treatment at Home
Drugs to Treat Iritis

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Allergy Conjunctivitis (Pink Eye)

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What Are the Symptoms of

Allergic
Pink
Eye?
Symptomsofallergicpinkeyeinclude:
Rednessinthewhiteoftheeyeorinner
eyelid
Increasedamountoftears
Itchyeyes
Blurredvision
Swellingoftheeyelid
Crustyeyes
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How Is Allergic Pink Eye Treated?

Ocular(topical)decongestants
Ocular(topical)antihistamines
Ocular(topical)steroids
Ocular(topical)mastcellstabilizers
(suchasCromolyn)
Immunotherapy

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Other Tips for Allergic Pink Eye

Don'ttouchorrubtheaffectedeye(s).
Washyourhandsoftenwithsoapandwarmwater.
Washyourbedlinens,pillowcases,andtowelsinhot
wateranddetergenttoreduceallergens.
Avoidwearingeyemakeup.
Don'tshareeyemakeupwithanyoneelse.
Neverwearanotherperson'scontactlens.

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 Wearglassesinsteadofcontactlenses
toreduceirritation.
Washyourhandsbeforeapplyingthe
eyedropsorointmenttoyoureyeor
yourchild'seye.
Donotuseeyedropsthatwereusedin
aninfectedeyeinanon-infectedeye.

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Blepharitis
Blepharitis is the medical
term for inflammation of the
eyelids. The word
"blepharitis" is derived from
the Greek word blepharos,
which means "eyelid,"

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Symptoms of Blepharitis

Feelinglikesomethingisinyoureye
Burningoftheeye
Sensitivitytolight
Redandswolleneyesoreyelids
Blurryvision
Dryeyes
Crustingoftheeyelashes
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Treatment
goodeyelidhygieneandaregular
cleaningroutinecancontrolblepharitis.
frequentscalpandfacewashing,using
warmcompressestosoaktheeyelids,
anddoingeyelidscrubs.
Thesinglemostimportanttreatment
principleisadailyroutineoflidmargin
hygiene.
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 Thefollowingisatypicallidmargin
hygieneroutine:

Softenlidmargindebrisandoils:Applyawarmwetcompressto
thelids,suchasawashclothwithhotwater,forfiveto10
minutestwotofourtimesaday.Tokeepthecompresseswarm
foralongerperiodoftime,youmayplaceasmallhotwater
bottleoverthecompress.Usingacleanwashclothforeach
cleansingisimportant.
Mechanicallyremovelidmargindebris:Afterusingthe
compresses,cleantheeyelidswithacottonapplicatorstick
soakedina4to1mixtureofwaterandbabyshampoooran
over-the-counterlid-cleansingproduct.Gentlyandrepeatedly
rubalongthelidmarginswhiletheeyesareclosed.Becareful
toavoidrubbingorscratchingyoureyes.

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 Limitorstopusingeyemakeup,asitsusewillmakelid
hygienemoredifficult.
Ifyouwearcontactlenses,youmayhavetotemporarily
discontinuewearingthemduringtreatment.
Othertreatmentdependsonthespecifictypeofblepharitis.
Thekeytotreatingmosttypesofblepharitisiskeepingthe
lidscleanandfreeofcrusts.
Dandruffshampooisastandardrecommendation.
Antibioticssuch
asdoxycycline,tetracycline,azithromycinorerythromycinm
aybeprescribedtopicallyorsystemically.

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STY
Asty(alsospelledstye)isaninfectionof
theoilglandatthebaseofaneyelash.It
appearsasared,raisedpimpleonthe
edgeoftheeyelid.Symptomsofasty
arepain,tenderness,redness,and
swellingwithasmallpustule.The
eyeballitselfmayfeelirritatedorasif
somethingisscratchingitduetothe
swellingoftheeyelid.
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 Treatmentforastyincludeswarm
compressesappliedtotheaffected
areafor10minutes,uptosixtimes
daily.Ifthestycomestoaheadand
releasespus,itshouldbecleaned
gentlywithsoapandwater.This
ruptureusuallyleadstothestygoing
away.Ifthestyisverylarge,painful,or
affectsyourvision,seeyourdoctor.

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 Therearetwodistincttypesofstyes:
hordeolumandchalazion.Eachhas
differentcausesandtreatments.

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1.Ahordeolumisablockageofoneof
thesweatglandsfoundintheskinof
thelidandbaseoftheeyelashes,or
oneofthesmallsebaceousglands
foundatthebaseoftheeyelashes.
Sebaceousglandssecretesebum,a
waxy,oilymaterial.

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 Treatmentofhordeolum:
Anoninfectedhordeolumwillresolveon
itsown.
Warmcompressesmayhelpsoftenthe
materialinthegland,easingthe
drainageofthegland'scontents.
Squeezingorcuttingthehordeolumcancausethe
skintobecomescarred.

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2.Achalazionisablockageofameibomian
gland,whichisaspecialsebaceousgland
uniquetotheeyelids.Theseglandsforma
singlerowineachlid,withthebodyofthe
glandlocatedinsidetheeyelid,andthe
openinglocatedattherimofthelid,posterior
tothelashes.Theysecreteanoilymaterial
ontothesurfaceoftheeye,preventingthe
waterlayeroftearsfromevaporatingtoo
rapidlyfromtheeye'ssurfacebetweenblinks.
Therefore,poorlyfunctioningmeibomian
glandscanleadtodryeyesymptoms.
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 Treatment:
Anoninfectedchalazionsimilarlywill
resolveonitsown,thoughoveramuch
longerperiodoftime.
Themostconservativetreatmentis
applicationoffrequentwarmcompresses.
Steroids
thechalazioncanbeincisedanddrained.

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