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Eye
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Conjunctivitis or 'red eye' is an inflammation of the membranes covering the outside of the eye, resulting in a feeling of burning or itching.
It may be caused by an allergy, for example to pollen, which is eased by preparations containing antihistamines, or sodium cromoglycate. Sodium cromoglycate is thought to stabilise mast cells which release histamine in the allergic response.
The presence of a discharge as well as redness, particularly if there is difficulty opening the eyes in the morning, suggests a bacterial infection for which a specific antibacterial agent is indicated. More severe cases should see a doctor, particularly if there is pain or sensitivity to light.
Viral conjunctivitis may be herpetic or non-herpetic; in both cases medical attention should be sought. Herpes simplex, which can affect both the eyelids and the eye, is a threat to sight so you should not self-medicate but see a doctor as soon as possible.
Blepharitis is an inflammation of the eyelids which appear reddened and thickened along the edge. Treatment in simple cases involves bathing with salt solution to remove the dandruff-like crusts.
In unresponsive cases a weak steroid ointment and/or antibiotic may be needed.

A stye is an infection of a single eyelash follicle. Treatment is by bathing with warm water; antibacterial ointments may also help. If crops of styes occur, a course of antibiotics may be needed.

Any eye condition that is not clearing up after 2-3 days of treatment, or is getting worse, should be seen by a doctor.
If there is any sudden pain or blurred vision, the patient should be referred to the doctor as quickly as possible.

Dry eye is common in the elderly and is often associated with connective tissue diseases such as arthritis.
The preparations to treat this are substitutes for tears, for use if natural tear production is inadequate.
Many eye preparations must not be used by contact lens wearers particularly those with soft lenses. Check packs for details.
Eye drops should usually be discarded within one month of opening.

EYE, FOREIGN BODY IN

What is It?
Embedding of a small speck of metal, wood, stone, sand, paint or other foreign material in the eye.
Causes
Airborne foreign material accidentally gets into the eye.
Signs and Symptoms
* Severe pain, irritation and redness in the eye.
* Foreign body visible with the naked eye (usually). Sometimes the foreign body is very small, trapped under the eyelid and invisible except with medical examination.
* Scratchy feeling with blinking.
Risk Factors
* Windy weather.
* Occupations or activity, such as carpentry or grinding in which fine particles of wood or other materials fly loose in the air.
Prevention
Wear protective eye coverings (guards or spectacles) if your occupation or hobby involves the risk of eye injury. Spectacles made of polycarbonate plastic lenses with a minimum centre thickness of 3 millimetres, and industrial strength frames are considered most protective.
Diagnosis and Treatment
General Measures
1. Don't rub the eye.
2. Keep the eye closed, if possible, until you are examined.
3. Ask someone else to drive you to the doctor's office. Don't try to drive yourself.
4. Eye examination may include staining the eye with a harmless substance (fluorescein) to outline the object and examine the eye through a magnifying lens.
5. The procedure to remove the object will be determined by its size and location within the eye.
6. An eye patch will be applied to keep the eye closed.
7. Follow-up examination should be done in 1 to 2 days.
Medication
* Antibiotic eye drops to prevent infection.
* Pain relievers may be prescribed.
* Local anesthetic eye drops.
Activity
* Resume your normal activities gradually after removal of the foreign body and the patch, if one is applied.
* Don't drive with a patch on one eye.
Diet
No special diet.
Possible Complications
* Infection, especially if the foreign body is not removed completely.
* Severe, permanent vision damage caused by penetration of deeper eye layers.
Prognosis
Most objects can be removed simply under local anesthesia in a doctor's office or emergency room.


IRITIS
What is It?
Inflammation of the iris and the ciliary muscle ( the ring of colored tissue surrounding the pupil of the eye).
Causes
Infection that spreads to the eye from other body parts.
Common causes include:
Toxoplasmosis.
Tuberculosis.
Histoplasmosis.
Syphilis.
Sarcoidosis.
Viruses (herpes simplex or zoster).
Injury to the eye.
Automimmune reaction.
Unknown in many cases.
Signs and Symptoms
Acute iritis of sudden onset:
Severe eye pain.
Sensitivity to light.
Eye redness.
Smaller pupil in the affected eye (sometimes).
Tears.
Blurred vision.
Iritis of gradual onset:
Eye pain.
Less intense sensitivity to light.
Floating spots in the field of vision.
Blurred vision.
Risk Factors
Collagen disorders.
Ulcerative colitis.
Viral, bacterial, fungal or parasitic infection.
Other eye disease.
Prevention
Cannot be prevented at present.
Diagnosis and Treatment
General Measures
Special eye exam will confirm the diagnosis ( by ophthalmologist).
Wear dark glasses even indoors until treatment is complete.
Treatment for any underlying condition.
Medication
Eye drops (mydriatics) that dilate the pupil and prevent scarring. You may need to use eye drops for a long time.
Oral cortisone drugs or cortisone eye drops to reduce inflammation.
Activity
Rest in bed until symptoms subside. Allow 1 to 2 weeks.
Diet
No special diet.
Possible Complications
Glaucoma.
Cataracts.
Permanent or partial vision loss.
Prognosis
Vision can usually be preserved with prompt treatment. Usually dependent on the underlying condition.


KERATITIS
What is It?
Infection or inflammation of the cornea (the center portion of the eye that surrounds the pupil).
Causes
Bacterial, viral or fungal infections. The most common is herpes simplex virus, Type I.
Drying of the eye caused by an eyelid disorder or insufficient tear formation.
Foreign object in the eye.
Contact lenses over-use.
Intense light, such as from welding arcs or the reflection of intense sunlight from snow or water. (Symptoms may not appear for 24 hours after exposure).
Vitamin A deficiency.
Allergy to eye cosmetics, air pollution, airborne particles (pollen, dust, mold, or yeast) and other allergens.
Signs and Symptoms
Eye pain.
Photophobia (sensitivity to light).
Foreign body sensation.
Tears.
Blurred vision.
Risk Factors
Poor nutrition, especially insufficient vitamin A.
Contact lens wearers.
Illness that has lowered resistance.
Crowded or unsanitary living conditions.
Viral infections elsewhere in the body, especially cold sores or genital herpes.
Prevention
Wear protective glasses, if your work involves eye hazards.
Eat a well-balanced diet that contains sufficient vitamin A or take multiple-vitamin supplements containing vitamin A.
Diagnosis and Treatment
General Measures
Special eye exam confirms keratitis. A vision test may also be performed.
Discontinue use of contact lenses until infection clears.
Treatment usually involves eye medication.
A temporary eye patch is often necessary. It may limit your ability to take care of yourself.
Surgery to replace the cornea (severe cases only).
Medication
Antibiotic or anti-viral eye drops and ointments.
Don't treat any eye inflammation without medical advice.
Don't use non-prescription eye drops containing topical corticosteroids. These may worsen the condition or cause eyeball perforation.
Activity
Eye patching will restrict activity. Resume your normal activities gradually.
Diet
No special diet.
Possible Complications
Glaucoma.
Ulceration of the cornea.
Permanent scarring in the eye.
Vision loss.
Prognosis
Depends on the cause. With early treatment, most types of keratitis are curable.


CHALAZION
What is It?
Chronic inflammation of the meibomian gland in the eyelid.
Meibomian glands are found in the eyelid, and serve to lubricate the lid margins.
Causes
Blockage of a duct leading to the surface of the eyelid from the meibomian gland. The blockage may be due to infection (usually staphylococcal) around the duct opening.
Signs and Symptoms
* Painful focal tenderness of one eyelid.
* Mild redness of the white of the eye (conjuctivitis).
Associated Conditions
Skin conditions such as acne rosacea or seborrheic dermatitis.
Prevention
* If you have a tendency to get chalazions, wash eyelash area daily with water and baby shampoo applied with a cotton swab.
* At the first sign of eye irritation, apply warm compresses several times a day.
Diagnosis and Treatment
General Measures
* Use warm-water soaks to reduce inflammation and hasten healing. Apply soaks for 20 minutes, then rest at least 1 hour. Repeat as often as needed.
* If the chalazion does not heal spontaneously in 6 weeks, surgical removal under local anesthesia in the doctor's office may be a recommended treatment.
Medication
* Topical antibiotic ointments or creams, such as erythromycin or bacitracin may be prescribed. Apply a thin layer of medication to the lid edges 3 or 4 times daily. A heavy layer wastes medicine and is no more beneficial than a thin layer.
* Antibiotic eye drops to prevent the spread of infection to other parts of the eye. Oral antibiotics or antibiotic injections usually are not needed.
Activity
No restrictions.
Diet
No special diet.
Possible Complications
None expected.
Prognosis
A chalazion may heal spontaneously. If not, it is usually curable with surgical removal.


CORNEAL ABRASION AND ULCER
What is It?
Ulceration or sore in the thin transparent layer of the colored part of the eye (cornea).
Causes
1. Injury to the cornea or the embedding in the cornea of a foreign body, such as a small piece of steel, sand or glass. A bacterial infection, usually pneumococcal, streptococcal or staphylococcal, may follow the injury.
2. Ill-fitting or prolonged use of contact lenses.
3. Infection by the virus, herpes simplex, that produces cold sores on the mouth.
4. Infections of the eyelids and conjuctiva.
5. Defective closure of the lid.
Signs and Symptoms
1. Eye pain, usually severe.
2. Redness in the white of the eye.
3. Tearing.
4. Sensitivity to bright light.
5. Eyelid spasm.
6. Blurred vision.
7. Discharge from the eye.
Risk Factors
* Recent infection or eye injury.
* Smoking or other environmental eye irritants.
* Contact lenses.
Prevention
* Wash hands frequently.
* Avoid injury. Wear safety goggles to protect eyes when exposed to flying wood shavings or splinters, or metal or stone bits.
* Don't touch your eyes if you have cold sores.
* Handle contact lenses properly.
* Don't wear contact lenses overnight.
Diagnosis and Treatment
General Measures
* Diagnostic tests include an eye examination, sometimes a visual acuity test, a laboratory culture study of corneal scraping.
* Treatment will involve removing any foreign body, patching of the eye, and medications for the eye.
Medication
* Antibiotic eye drops, ointments or oral antibiotics for bacterial infections.
* Medication for viral and fungus infections.
* For minor pain, you may use non-prescription drugs such as acetaminophen.
Activity
After treatment, resume normal activity as soon as possible.
Diet
No special diet.
Possible Complications
Neglected corneal ulcers may penetrate the cornea, allowing infection to enter the eyeball. This can cause permanent vision loss.
Prognosis
* A corneal ulcer is a serious eye problem. It is usually curable in 2 to 3 weeks if treated.
* If scars from previous corneal ulcers impair vision significantly, a corneal transplant (grafting a new cornea onto the eye) may make vision nearly normal.
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Much time, effort and thought has gone into the design and production. The publishers, authors, reviewers and consultants have used their best efforts to provide accurate information. The authors, reviewers and consultants hereby disclaim all responsibility for any loss suffered by any person, and for all errors or omissions in this material.