29-Mar-16

Common Eye Disease

Unit 3 1) Conjunctivitis
2) Trachoma
Ocular Eye Diseases & Primary Eye 3) Corneal Ulcer
Care 4) Eye Opacity
5) Irises
6) Cataract
7) Glaucoma
Krunal H.Parmar 8) Squint
Lecturer, Biomedical Department 9) Systemic disorders
A.V.Parekh Technical Institute, Rajkot 10) Retinal detachment

Conjunctivitis (Pink Eye)

• Conjunctivitis is the inflammation of thin, clear covering of the

white of the eye (sclera) & the inside of the eye lids
(conjunctivita)
• Conjunctivita is the transparent, it contains blood vessels that
overlay the sclera of the eye.

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Normal Eye Vs Conjunctivitis
Types of Conjunctivitis
• Viral Conjunctivitis
• Allergic Conjunctivitis
• Bacterial Conjunctivitis
• Chlamydial Conjunctivitis
• Chemical or Irritant Conjunctivitis
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Common Symptoms of Conjunctivitis
• Eye becomes pink or reddish
• There may also be pain, burning, itchiness
• Watering of the eye
• The affected eye may have increased tears or be “stuck shut”
in the morning.
• Swelling of the white part of the eye may also occur
• Conjunctivitis can affect one or both eyes
Viral Conjunctivitis
Causes:
• Viral conjunctivitis can be caused by Virus (Adenovirus usually
infect the respiratory tract) & is often associated with
common cold
• Highly contagious (can spread rapidly between people)
Symptoms:
• Eye becomes reddish and watery discharge
• Eyelids & even the conjunctivita on the white of the eye may
swell, creating a glassy appearance
• Eyes are uncomfortable
• Patient usually describing a sensation of an object in the eye
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Bacterial Conjunctivitis

Causes:
• Bacterial Conjunctivitis is an infection caused by bacteria such
as Staphylococci, Streptococci or Haemophilus
• These organisms may comes from patient’s own skin, upper
respiratory tract or caught from another person with
conjunctivitis
Symptoms:
• It affects both eyes
• Eyes usually feels gritty & irritated with sticky yellow or
greenish yellow discharge
• Eyelids may stuck together, particularly in the morning &
there may be discharge or crusting on the eye lashes.

Allergic Conjunctivitis

Cause:
• Allergic conjunctivitis is common in people who have other
types of allergic diseases, such as hay fever, asthma & eczema.
• Allergic Conjunctivitis is often caused by antigens like pollen,
dust mites or cosmetics.

Symptoms:
• Intense itching of the eyes
• Intermittent red eyes & stringy discharge

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Chlamydial Conjunctivitis

Cause:
• It is caused by an organism called Chlamydial Trachomatis

Symptoms:
• Red eyes & sticky discharge in one or sometimes in both eyes
• Swollen eye lids
• Cornea may also involved in this condition

Chemical or Irritant Conjunctivitis

Cause:
• It can be caused by chemicals in swimming pool or smoke.
• It can also be due to either acidic or alkali substance getting in
the eye

Symptoms:
• Show primarily marked redness

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Trachoma Symptoms:

• Trachoma is the form of conjunctivitis • Eye redness

• Trachoma is contagious bacterial infection which affects the
conjunctival covering of the eye, the cornea & the eyelids.
Cause:
• It is caused by bacteria Chlamydia Trachomatis, Serotypes A,B
&C
• It may also caused by unclean water supply, some parasitic
bacteria & poor sanitation
• Purulent drainage from the eye
• Eye irritation or pain
• Poor vision or Visual loss
• Photophobia (Sensitivity to light)
• Inverted eyelids (entropion)
• Inverted eyelashes (trichiasis)

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Corneal Ulcer Symptoms:

• Corneal ulcer is an open sore in the cornea. It is often caused • Blurry or Hazy vision
by infection.
• Eye that appears red or bloodshot
Causes:
• Itching & discharge
• Corneal ulcers are most commonly caused by infection with
bacteria, viruses, fungi or a parasite • Very painful & watery eyes
• Foreign bodies in the eye • White patch on the cornea
• Scratches on the eye surface
• Severely dry eyes
• Severe allergic eye diseases
• Various inflammatory eye disorders
• Wearing contact lenses, especially soft contacts that are left in
overnight may cause a corneal ulcer

Eye Opacity Symptoms:

• Eye opacity is quality of lacking transparency. • Vision decrease or loss

• Pain in the eye or feeling like something in the eye
Corneal Opacity: • Eye redness, excessive tearing
• Corneal opacity is disorder of the cornea. • Blurred vision
• Corneal opacity occurs when the cornea becomes scarred. • Irritation
This stops light from passing through the cornea to the retina • Milky or cloudy area on the cornea
and may cause the cornea to appear white or clouded over. • Eye discharge

Causes:
• Infection, injury or swelling of the eye

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Cataract
• Cataract is the medical condition in which the lens of the eye
becomes progressively opaque, resulting in blurred vision.
Symptoms:
• Vision that is cloudy, blurry, foggy, or filmy
• Progressive nearsightedness in 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 vision while looking through the eye with a cataract
(like a superimposed image).
• Sudden changes in glasses prescription.
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Causes:
• It occurs when there is buildup of protein in the lens that
makes it cloudy
• This prevents light from passing clearly through the lens,
causing some loss of vision
Types of Cataract:
• Age-related cataracts: As the name suggests, this type of
cataract develops as a result of aging.
• Congenital cataracts: Babies are sometimes born with
cataracts as a result of an infection, injury, or poor
development before they were born, or they may develop
during childhood.
• Secondary cataracts: These develop as a result of other
medical conditions, like diabetes, or exposure to toxic
substances, certain drugs (such as corticosteroids or
diuretics), ultraviolet light, or radiation.
• Traumatic cataracts: These form after injury to the eye.
Glaucoma
• Glaucoma is the condition of increased pressure within the
eye ball, resulting in damage to optic nerves causing gradual
loss of sight.
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• There is a small space in front of the eye called the “Anterior

chamber”. Clear liquid flows in and out of the anterior
chamber, this fluid nourishes and bathes nearby tissues.

• If a patient has glaucoma, the fluid does not drain properly

• It drains too slowly out of the eye

• This leads to fluid build up and pressure inside the eye rises.

• Unless this pressure is brought down & controlled, the optic

nerve & other parts of the eye may become damaged, leading
to loss of vision.

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Glaucoma

Closed Low Tension Pigmentary

Open Angle
Angle Glaucoma Glaucoma

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Squint (Strabismus)

• Squint is a condition in which eyes are not aligned correctly.

• Any one of the eye will either turn upwards (Hypertropia),

inwards (Esotropia), outwards (Exotropia) or downwards
(Hypotropia).

• The perfect cause for squint eye is yet to be known. Some

infants have squint eye right from their birth (Congenital),
while some may develop it sometime later (Acquired).

Causes:

• The primary reasons that cause acquired squint occur due to

attempts made to overcome refractive errors.
• There problems include:
• Myopia: Reduction in the ability to view distant objects
• Hyperopia: Reduction in the ability to view close objects
• Astigmatism: Cornea gets unevenly curved causing blurred
vision
In some rare cases, squint eye may also be caused due to:
• Childhood ailments like measles
• Genetic conditions like cerebral palsy or Down’s syndrome
• Hydrocephalus which is caused due to fluid build-up in brain
• Some issues that affect retina

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Sign & Symptoms:

Treatment

• Double vision
• Wearing eye glasses
• Strain on eyes
• Eye exercises or injections
• Headaches
• Squint eye surgery
• Jittery vision
• Fatigue when reading
• Inability to read comfortably
• Loss of depth perception
• Impaired vision

Blindness in Children

• Blindness in children can be defined as a visual acuity of less

than 3/60 in the eye with better vision of child under 16 year
of age.

• This means, generally that child cannot see something three

feet away that another child can see sixty feet away.

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Causes: • There are many causes of childhood blindness.

• Blindness may be due to
• Genetic mutations
WHO Classification
of Causes of • Birth defects
Childhood • Premature birth
Blindness
• Nutritional deficiencies
• Infections
• Injuries & other causes
• Severe Retinopathy of Prematurity (ROP)
Anatomical Aetiological
Classification Classification • Cataracts & refractive errors are also causes of blindness in
children.

Anatomical Classification of Causes of Childhood Blindness Aetiological classification of causes of Childhood blindness

• Whole globe (e.g. ano/micro phthalmos) • Hereditary (at conception), e.g. genetic , chromosoma
• Cornea (e.g. corneal scarring, Keratoconus) abnormalities)
• Lens (e.g. cataract, aphakia)
• Uvea (e.g. aniridia) • Intrauterine (during pregnancy, e.g. rubella)
• Retina (e.g. retinal dystrophies)
• Optic Nerve (e.g. atrophy) • Perinatal (e.g. retinopathy of prematurity, birth
• Glaucoma injury, neonatal conjunctivitis/ ophthalmic
• Conditions where the eye appears normal (e.g. refractive neonatorum)
errors, cortical blindness, amblyopia)
• Childhood (e.g. measles, trauma with vitamin A deficiency)
• Unknown/ Cannot be determined

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Role of Ophthalmic Assistant in Primary
Care
Original Duty Chart for Ophthalmic Assistant
• Train staff at peripheral level in eye-care
• Treat the patients for eye ailments
• Test vision and prescribe glasses
• Assist Mobile Units in conducting eye-care camps
• Survey the community for early detection of eye defects
• Organize community education.
Role & Responsibility at Primary Level
• Screening and identification of eye diseases at Primary level:
• Treatment/ Medical intervention at Primary level (PHC) of the
following common eye diseases
• Usage of following medications a) Mydratics b) Cycloplegics
drugs for refraction c) Topical anaesthetics for diagnostics d)
Basic antibiotics, pain killers, antihistaminics, antialergics
• Refraction & prescription of spectacles
• Dispensing of spectacles
• Identify, initiate primary medical treatment (as per the
protocol) and refer to an Ophthalmologist immediately in the
following emergency cases: a) Chemical burns b) Perforating
injuries of eyeball or lids c) Corneal infections d) Gluocoma
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Modified duty chart of Ophthalmic Assistants
• Test vision and prescribe glasses
• Assist Medical Officer PHC in providing primary eye-care
including treatment for trachoma, conjunctivitis and
associated infections
• Assist Mobile Unit in conducting eye-care camps.
• Survey the community for early detection of eye defects.
• Organize community eye-care education activities.
• Train staff at peripheral level.
• Minor surgical procedures a) Epilation for Trichiasis b)
Superficial foreign body removal
• Enucleating of the eye in cornea donation after proper
training
• Follow up of post operative cases
• Health education and training at Primary level: For all Primary
level functionaries and Volunteers
• Organization and management at Primary level a)
Documentation b) Counseling c) Screening camps d) School
eye health e) Health education sessions f) Coordination with
other departments (ICDS, social justice, primary health) g)
Tele-ophthalmology h) Epidemics
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