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DISORDERS AND CONDITIONS

OF
THE EYE
Claudette Anne T. Cormary

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• 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

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Anatomy of the Eye

11/1/2011

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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 4 .

Middle Vascular Layer • Heavily pigmented • Blood vessels 11/1/2011 5 .

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 11/1/2011 6 .

• 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 7 .

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

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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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they may no longer need reading glasses. Sudden changes in glasses prescription. or filmy Progressive nearsightedness in older people often called "second sight" because although their distance vision is deteriorating. When symptoms are present. Double vision while looking through the eye with a cataract (like a superimposed image).• SYMPTOMS AND SIGNS • Cataracts usually form slowly and cause few symptoms until they noticeably block light. blurry. • • • • • 12 . Problems driving at night such as glare from oncoming headlights. Problems with glare during the day. Changes in the way you see color because the discolored lens acts as a filter. they can include: • • Vision that is cloudy. foggy.

and an intraocular lens (IOL) is put in its place. the doctor makes a tiny incision in the eye and breaks up the lens using ultrasound waves.• 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 most modern cataract surgeries the IOL eliminates the need for thick glasses or a contact lens after surgery. 13 . In the more common type. The lens is removed. called phacoemulsification (phaco).

meaning reading glasses are still needed after surgery. They minimize or eliminate the need for reading glasses after surgery. 14 . "Toric" implants are available to correct astigmatism. Conventional "monofocal" lenses only correct for distance vision.Cataract Surgery Innovations Recent developments in cataract surgery can correct both near and distance vision.

I t'll take about eight weeks for your eye to heal completely. at least occasionally.as well as a new prescription after healing is complete. though your vision should begin to improve soon after surgery. 15 . for distance or reading -. You may be prescribed drops to aid healing and asked to wear an eye shield or glasses for protection.• What to Expect After Surgery • • • itchy and sensitive to light. You may still need glasses.

which requires emergency treatment. which are all treatable when caught early. infection. 16 . lens tissue left after surgery and used to support the IOL can become cloudy. even years after surgery. and changes in eye pressure. This "aftercataract" is easily and permanently corrected with a laser. Surgery slightly raises the risk of retinal detachment.Cataract Surgery Risks • • • rare The most common risks are bleeding. Sometimes.

• Limit alcohol consumption.• Tips to Prevent Cataracts • Things you can do that may lower your risk of developing cataracts: • Don't smoke. 17 . • Keep diabetes well controlled. • Always wear a hat or sunglasses in the sun.

GLAUCOMA 18 .

What happens? 11/1/2011 19 .

looks ‘caved in’.Glaucoma: what is happening Either: the drain blocks here Or poor blood supply here Damages the optic nerve.. 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 .

Inuit. such as prednisone Have had trauma to the eye or eyes 23 . Japanese. Hispanic. or Scandinavian descent Are over age 40 Have a family history of glaucoma Have poor vision Have diabetes Take certain steroid medications. Russian.Who gets glaucoma? • • • • • • • • You are at an increased risk of glaucoma if you: Are of African-American. Irish.

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) 24 .“ If you have any of the following symptoms.S/Sx • • • • • • • • • "sneak thief of vision.

most people with glaucoma will not lose their sight. traditional surgery or a combination of these methods. laser surgery. as vision loss from glaucoma is irreversible. The goal of any treatment is to prevent loss of vision. and that with medical and/or surgical treatment. pills. 11/1/2011 25 . The good news is that glaucoma can be managed if detected early.Dx/Treatment • Glaucoma can be treated with eye drops.

Corneal Abrasion • A corneal abrasion is a scratch on the  eye's cornea.  26 .

or some other foreign matter blowing into your eye and getting caught under the eyelid • Chemical burns 27 . sawdust. ash. plant. for instance by a fingernail. or makeupbrush • Dirt.Causes of Corneal • Many situations can cause a corneal Abrasion? abrasion. sand. including: • Being poked in the eye.

28 . the cornea can dry out.• Aggressively rubbing your eye • Poor fitting or dirty contact lenses • Certain types of eye infections • Not protecting the eyes during surgery while under general anesthesia. if your eyes are not closed during surgery. making it more prone to corneal abrasion.

especially when opening or closing your eyeTearing and rednessSensitivity to lightBlurred  vision or loss of vision 29 .Symptoms of Corneal Abrasion • Feeling like you have sand or grit in your eyeEye pain.

Corneal Abrasion Treatment • Antibiotic eye drops or ointment •  Painmedication 30 .

Retinal Detachment 31 .

  the sensory retina is pulled away from the RPE  because fluid builds up between the two layers. 32 . • In retinal detachment caused by a retinal tear. • Blurred and lost vision can occur.What happens? • The retinal pigment epithelium (RPE) is a layer  of support cells that lines the back of the eye.  Part or all of the retina comes off (detaches  from) the back of the eye. It  is normally attached to the sensory retina layer.

inflammation. or some diseases such as diabetes. or pulled away. an eye injury. But many times there is no obvious cause.Retinal detachment means that the retina—a thin layer of nerve tissue at the back of your eye—has detached. A retina can detach as a result of aging. This can lead to vision loss and blindness. 33 . but surgery can often restore good vision.

34 .  • Traction on the retinaTraction on the  retina. • Fluid buildup under the retina.Cause • Tears or holes in the retina.Retinal Detachment .

What Increases Your Risk • A family history of retinal detachment. • Age older than 50. 35 .Retinal Detachment . • Previous retinal detachment in the other  eye. an inherited  condition in which parts of the retina  become very thin and are easily torn. • Lattice degeneration.

Diabetes. Injury to the eye.  Surgery for cataracts. Blunt injury or blow to the head. 36 .• • • • • Nearsightedness (myopia). which can lead to  proliferative diabetic retinopathy. • Other eye disorders or eye tumors.

Retinal Detachment .When To Call a Doctor • Flashes of lights/ floaters • Migraine headaches • Exams/test: •  routine eye exams  37 .

  pneumatic retinopexy. 38 .Treatment • Surgery: • Almost all retinal detachments can be  repaired with scleral buckle surgery. or vitrectomy.

Eye Health Uveitis • What Are theand Symptoms of Uveitis? • • • • • Eye redness and irritation Blurred vision Eye pain Increased sensitivity to light Floating spots before the eyes 39 .

• What Causes Uveitis? • There are four types of uveitis: • Iritis  • Cyclitis • Retinitis • Choroiditis 40 .

 Antibiotics are used in  patients with infectious uveitis. 41 .• How Is Uveitis Treated? • For uveitis not caused by an  infection. your eye specialist may  prescribe eye drops containing  steroids to reduce swelling and drugs  to relieve pain. Dark  glasses will help with light sensitivity.

• Complications of uveitis may include  glaucoma. and vision loss. cataracts. 42 . fluid within the  retina. Early diagnosis  and treatment by an eye specialist is  critical. abnormal growth  of blood vessels in the eyes that  interfere with vision.

Iritis • Iritis Causes: • Iritis may be a consequence of trauma  (traumatic iritis) or nontraumatic causes: • Blunt trauma to the eye can cause traumatic  inflammation of the iris. 43 .

44 .  tuberculosis.• Nontraumatic iritis is frequently associated  with certain diseases. • Infectious causes may include Lyme disease.inflammatory bowel disease. such as  ankylosing spondylitis.toxoplasmosis. Reiter syndrome. and  herpes simplex and herpes zosterviruses.  sarcoidosis. no cause for iritis  is found. • In a large number of cases. syphilis. and  psoriasis.

• Iritis Symptoms: • Pain in the eye or brow region • Worsened eye pain when exposed to bright  light • Reddened eye. especially adjacent to the iris • Small or funny shaped pupil • Blurred vision • Headache 45 .

When to Seek Medical Care for Iritis Eye pain. including pain associated  with bright light • Blurred vision • Redness in the eye. especially near  the iris 46 .

• Iritis Exams and Tests • Iritis Treatment at Home • Drugs to Treat Iritis 47 .

Allergy Conjunctivitis (Pink Eye) 48 .

What Are the Symptoms of Allergic Pink Eye? • Symptoms of allergic pink eye include: • Redness in the white of the eye or inner  eyelid • Increased amount of tears • Itchy eyes • Blurred vision • Swelling of the eyelid • Crusty eyes 49 .

How Is Allergic Pink Eye Treated? • • • •  Ocular (topical) decongestants Ocular (topical) antihistamines Ocular (topical) steroids Ocular (topical) mast cell stabilizers  (such as Cromolyn) • Immunotherapy 50 .

51 . • Never wear another person's contact lens. and towels in hot  water and detergent to reduce allergens. • Wash your bed linens.Other Tips for Allergic Pink Eye • Don't touch or rub the affected eye(s). • Avoid wearing eye makeup. • Don't share eye makeup with anyone else. pillowcases. • Wash your hands often with soap and warm water.

• Do not use eye drops that were used in  an infected eye in a non-infected eye. 52 .• Wear glasses instead of contact lenses  to reduce irritation. • Wash your hands before applying the  eye drops or ointment to your eye or  your child's eye.

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

Symptoms of Blepharitis • • • • • • • Feeling like something is in your eye Burning of the eye Sensitivity to light Red and swollen eyes or eyelids Blurry vision Dry eyes Crusting of the eyelashes 54 .

  and doing eyelid scrubs. using  warm compresses to soak the eyelids.Treatment • good eyelid hygiene and a regular  cleaning routine can control blepharitis. •  frequent scalp and face washing.  55 . • The single most important treatment  principle is a daily routine of lid margin  hygiene.

 clean the eyelids with a cotton applicator stick  soaked in a 4 to 1 mixture of water and baby shampoo or an  over-the-counter lid-cleansing product. for five to 10  minutes two to four times a day. you may place a small hot water  bottle over the compress. 56 . Gently and repeatedly  rub along the lid margins while the eyes are closed. Be careful  to avoid rubbing or scratching your eyes. • Mechanically remove lid margin debris: After using the  compresses. such as a washcloth with hot water. To keep the compresses warm  for a longer period of time. Using a clean washcloth for each  cleansing is important.• The following is a typical lid margin  hygiene routine: • Soften lid margin debris and oils: Apply a warm wet compress to  the lids.

• Limit or stop using eye makeup. 57 . as its use will make lid  hygiene more difficult. • Dandruff shampoo is a standard recommendation. you may have to temporarily  discontinue wearing them during treatment. • Antibiotics such  as doxycycline. • If you wear contact lenses. tetracycline.  The key to treating most types of blepharitis is keeping the  lids clean and free of crusts. • Other treatment depends on the specific type of blepharitis. azithromycin or erythromycinm ay be prescribed topically or systemically.

 and  swelling with a small pustule. raised pimple on the  edge of the eyelid.  58 . redness. The  eyeball itself may feel irritated or as if  something is scratching it due to the  swelling of the eyelid. tenderness.STY • A sty (also spelled stye) is an infection of  the oil gland at the base of an eyelash. Symptoms of a sty  are pain. It  appears as a red.

 painful. If the sty is very large. see your doctor. If the sty comes to a head and  releases pus. or  affects your vision. up to six times  daily.  59 . it should be cleaned  gently with soap and water. This  rupture usually leads to the sty going  away.• Treatment for a sty includes warm  compresses applied to the affected  area for 10 minutes.

 Each has  different causes and treatments.• There are two distinct types of styes:  hordeolum and chalazion. 60 .

 or  one of the small sebaceous glands  found at the base of the eyelashes. A hordeolum is a blockage of one of  the sweat glands found in the skin of  the lid and base of the eyelashes.  Sebaceous glands secrete sebum.1. oily material. 61 . a  waxy.

  Squeezing or cutting the hordeolum can cause the  skin to become scarred.  • Warm compresses may help soften the  material in the gland. easing the  drainage of the gland's contents.• Treatment  of hordeolum: • A noninfected hordeolum will resolve on  its own. 62 .

63 . A chalazion is a blockage of a meibomian  gland. which is a special sebaceous gland  unique to the eyelids. preventing the  water layer of tears from evaporating too  rapidly from the eye's surface between blinks. They secrete an oily material  onto the surface of the eye. poorly functioning meibomian  glands can lead to dry eye symptoms.  Therefore. with the body of the  gland located inside the eyelid. and the  opening located at the rim of the lid. posterior  to the lashes. These glands form a  single row in each lid.2.

• The most conservative treatment is  application of frequent warm compresses. though over a much  longer period of time.• Treatment: • A noninfected chalazion similarly will  resolve on its own.  64 .  • Steroids • the chalazion can be incised and drained.