Common eye problems:

The who have got treatment from the hospitals of GHS were ground that 22% having cataract in their eye, 19% patients with diseases in cornea, 33% patients with diseases in Refraction, 06% Orbit, 01% Neuro, 01% glaucoma,01%Retina, 02% peadritics diseases and rest of them having other eye diseases 15% .

Let see what the diseases are.

Cataract:

At Grameen GC Eye hospitals 22 % patients have cataract their eye. There are many types of cataract were found. But all the identified cataract patients were not advised for surgery. Only 7% of total patients ware advised for surgery. It was found that one patients having more than one eye diseases and the average ratio of eye disease is 1: 1.7.

 

Among the patients who were identified for cataract 51% was female and 49 % was male. The age break up of patients is 0-15 years 01% , 16-40 years old was are 04%, 41-50 years old patients was 11%, 51-60 years old patients was 31%, 61-70 years old patients was 34%,71-80 years old patients was 15%. Above 80 years old patients was 4%.

 

 

Cataract formation is not associated with "signals" such as pain, redness or tearing. The common symptoms are:

 

A cataract is a clouding that develops in the crystalline lens of the eye or in its envelope, varying in degree from slight to complete opacity and obstructing the passage of light.

• Cataract is not a new growth or a film over the eye. In most cases, it is just part of the aging process.
• It is not contagious

There are many types of cataracts. The most common type of cataract is Senile Cataract, comprising 80 percent of the total cataracts. It occurs in patients above the age of 50. Cataracts in children are Congenital Cataract. That can be caused by infection of the mother during pregnancy, or they may be hereditary. Eye injuries may cause cataracts in patients of any age is called as Traumatic Cataract. Eye diseases, like glaucoma, iritis, eye tumours, and diabetes may cause Secondary Cataract. Drug-induced Cataract is prolonged treatment with steroid drugs, either for local (e.g., allergic conjunctivitis) or systemic diseases (e.g., asthma) may lead to cataract formation.
Treatment
Cataract cannot be cured by medicines or spectacles. Removal of the clouded lens through surgery is the only treatment. Small Incision of Cataract Surgery and Phaco are the modern technique of cataract surgery.
SICS
After administering a local anesthesia, a 10 mm incision is made in the eye. The clouded lens is removed and replaced by an IOL and the incision is then closed with sutures. The entire procedure takes only 15 minutes.

Phaco
After giving a local anesthesia, a 5mm incision is made in the eye. The cataract lens is broken into small pieces by a machine with ultrasonic waves and removed with a needle. A specially prepared IOL is inserted into the eye and the wound heals without sutures.

Advantages of Phaco

• Early surgery can be done, so that patient need not wait for the cataract to mature
• Small Incision
• No sutures and no need of suture removal.
• No irritation, no watering
• Early return to work
• No need to continue drops for a long time
• No need for hospital stay, Even if the patient stays, it is only for a short time
• Only one post-operative visit
• Stable refraction after one month

The ophthalmic surgeon decides whether the patient can undergo phaco or not.

Refractive error

GHS Eye hospitals have find out.. types of patients who have different types of refractive error. Among total patients 33% patients have refractive error their eye. It should be mentioned that one patients having more than one eye diseases and the average ratio of eye disease is 1 : 1.7.

Among the patients who were identified for refractive error 49% was female and 51% was male. The age break up of patients is 0-15 years 05% , 16-40 years old was are 31%, 41-50 years old patients was 31%, 51-60 years old patients was 21%, 61-70 years old patients was 8%,71-80 years old patients was 3%. Above 80 years old patients was 1%.The mentioned percentage dose not reflects the picture of total population. The people who are aware and suffering from intolerable condition of eye disease, they are only come in the hospitals.In normal vision, light rays from an object focus on the retina (emmetropia). Alternatively, in the presence of a refractive error, the light rays get focused in front or behind the retina causing blurred vision. Under normal conditions, as the eye ball grows in size from infancy to adulthood, there will be a corresponding change in curvature of cornea and the lens enabling the eye to remain emmetropic, at all ages.

When one of these fails to happen, refractive error occurs:

• The eye ball being larger or smaller than the normal size
• The corneal curvature being flatter or steeper than usual
• Increase or decrease in the power of the lens

These refractive errors can be classified as myopia (near sightedness) and hypermetopia (far sightedness)

 

 

 

 

 

 

 

 

 

 

 

 

Myopia

Myopia or nearsightedness is a defect of the eye in which the person is able to see near objects clearly but distant objects appear blurred.

 

Hypermetropia

Just opposite to myopia if the eyeball is short or the cornea is flat the patient is unable to see objects especially for near. Hypermetropia is often confused with Presbyopia which is a defect usually appears at the age of 40 years due to a loss of accommodation of the lens causing a similar problem of not being able to see near objects. These Refractive errors usually become stable by the age of 18 years.

Astigmatism

Astigmatism causes difficulties in seeing fine detail. In some cases vertical lines and objects such as walls may appear to the patient to be leaning over like the Tower of Pisa. Astigmatism can be often corrected by glasses with a lens that has different radii of curvature in different planes (a cylindrical lens), contact lenses, or refractive surgery.

Treatment for the above conditions

• Corrective spectacle is the best option available. Though children may initially refuse to accept glasses, they will become fond of them once they realize they can see better with them on.
• The power of the glasses may change depending on the growth of the eye ball. An eye check-up and change of glasses if necessary, has to be done once in 6 months for children less than 5 years of age and once a year thereafter. Making a child wear glasses regularly is the duty and responsibility of the parents.
• Failure to wear glasses in childhood when needed will retard the development of vision in that eye.
• Children older than 15 years can use contact lenses if they don't want spectacles.

Failure to correct the refractive errors and the eventual low vision may hamper the academic activities of the child. So an ophthalmic consultation is essential in children, especially with symptoms of refractive errors. Finally, there is no relationship between nutritional deficiency and the occurrence of refractive error. So loading these children with Vitamin A will not help them. Sometime this may lead on to other complications.

Glaucoma

Glaucoma has been nicknamed the "silent thief of sight" because the loss of vision normally occurs gradually over a long period of time and is often only recognized when the disease is quite advanced. Once lost, this damaged visual field cannot be recovered. Worldwide, it is the second leading cause of blindness. At Grameen GC Eye hospitals, 01% patients have Glaucoma in their eyes. Among the patients who were identified for Glaucoma 50 % was female and 50 % was male.

The age break up of patients is 0-15 years 01% , 16-40 years old was are 04%, 41-50 years old patients was 11%, 51-60 years old patients was 31%, 61-70 years old patients was 34%,71-80 years old patients was 15%. Above 80 years old patients was 4%.

Glaucoma is a condition wherein the pressure of fluid within the eye (hydrostatic pressures within the eye) gradually increases to a level not tolerated by the sensitive tissues of the eye. The optic nerve, which is similar to a cable wire carrying visual images to the brain, is the portion of the eye susceptible to damage from glaucoma. Such damage is irreparable and visual loss due to glaucoma is irreversible.

In most cases of glaucoma, the patient is not aware of the gradual loss of sight until vision is significantly impaired.

However, if glaucoma progresses without adequate treatment, the following symptoms may occur in some individuals:

• Pain around the eyes when coming out from darkness (e.g., as soon as the person comes out of a cinema hall)
• Colored halo rings seen around light bulbs especially in the mornings and nights
• Frequent change of reading glasses, headaches, pain and redness of the eyes
• Reduced vision in dim illumination and during nights
• Gradual decrease of side vision with progression of glaucoma
• Blurring of vision

Treatment
The loss of vision due to glaucoma is irreversible. However, appropriate treatment and regular follow-up can preserve residual vision.
Earlier diagnosis has better chances of arresting visual impairment.

Medications

For most people with glaucoma, regular use of medications will control the increased fluid pressure. However, in some, drugs may stop working after a period of time. In these situations, the ophthalmologist can help by adding or changing medications or by choosing another type of treatment: laser or surgical methods. Periodical eye examinations are therefore essential to ensure that the medications are working.

Laser

In some type of glaucoma, called angle closure glaucoma, laser treatment is the primary form of reducing the eye pressure. This is a simple out-patient procedure, which uses a strong beam of light to relieve the fluid pressure.
In open angle type glaucoma, laser treatment is applied only if various medications fail to control the fluid pressure. Medications need to be continued regularly even after laser treatment. Laser treatment has very minimal complications, but its effect in reducing the eye pressure may wear off over time.


Surgery

In some persons with glaucoma, medical or laser treatment is insufficient to arrest glaucoma and surgery is indicated. But this treatment option has its risks and limitations and is reserved as the treatment of last resort. Even after surgical treatment, individuals with glaucoma should continue periodical check-ups by an ophthalmologist and additional medications may be required indefinitely to control eye pressures.

Retina

The eye is like a camera with a lens in front and a film (retina) at the back. The retina is located approximately two centimeters behind your pupil. It is shaped like a small cup. The retina converts the ocular image into a signal that is sent to the brain. The central part of the retina, called the macula, is used for straight-ahead vision and what is in your direct line of sight.

A healthy macula is crucial for tasks involving fine vision such as reading, recognizing faces and distinguishing things. The area surrounding the macula helps in mobility and in seeing from the 'corner' of the eye, though it is not useful for fine work. The retina is connected to the brain by the optic nerve. Blood is supplied to the retina and the optic nerve by blood vessels that maintain the health of these tissues. In front of the retina is the vitreous cavity, which is filled with a gel-like substance, called the vitreous.

Diseases of the retina, the vitreous, and the optic nerve can cause serious vision problems. Fortunately, most of them can now be managed satisfactorily with modern methods of diagnosis and treatment.

Retina diseases

The eye is like a camera with a lens in front and a film (retina) at the back. The retina is located approximately two centimeters behind your pupil. It is shaped like a small cup. The retina converts the ocular image into a signal that is sent to the brain. The central part of the retina, called the macula, is used for straight-ahead vision and what is in your direct line of sight. A healthy macula is crucial for tasks involving fine vision such as reading, recognizing faces and distinguishing things. The area surrounding the macula helps in mobility and in seeing from the 'corner' of the eye, though it is not useful for fine work. The retina is connected to the brain by the optic nerve. Blood is supplied to the retina and the optic nerve by blood vessels that maintain the health of these tissues. In front of the retina is the vitreous cavity, which is filled with a gel-like substance, called the vitreous. Diseases of the retina, the vitreous, and the optic nerve can cause serious vision problems. Fortunately, most of them can now be managed satisfactorily with modern methods of diagnosis and treatment.

Pediatrics diseases

At GHS hospitals 11 % patients is under 15 years old. After investigation of their eyes 19 diseases were found among them 73% refractive error, in the refractive error 81% were myopic which they have acquired from the parents.

Orbital Diseases

 

Orbital diseases may be vascular, thyroid-related (Graves' disease), infectious, inflammatory, or neoplastic. Cavernous sinus thrombosis causes many of the same symptoms and signs as orbital diseases. Drooping of the upper eyelid (ptosis) is a common problem dealt by this Department. If the lid droop is very severe especially in young children, it can even lead to lazy eye (amblyopia). Hence correction of the condition is essential for functional and cosmetic improvement. Orbit is the bony cavity enclosing the eye. The orbit can be the seat of tumors that cause protrusion of the eyeball (proptosis). The lacrimal system drains tears into the nose and could be the site of chronic infection (dacryocystitis). These and several other diseases are managed by a group of dedicated full time Consultants. Around 1000 surgeries are performed every year in this Department.

Percentage of Major Eye other diseases