DOCSLIB.ORG

Shining a Light on This Essential Dry Eye Disease Segment

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Shining a Light on This Essential Dry Eye Disease Segment WOMEN AND DRY EYE Shining a Light on This Essential Dry Eye Disease Segment Sponsored by 101516_akorn__rp_jA.indd 1 9/22/16 1:41 PM WOMEN AND Marguerite McDonald, MD, FACS (Moderator) DRY EYE NYU School of Medicine, Ophthalmic Consultants of Long Island New York, New York Shining a Light on This Essential Dry Eye Disease Segment esearch in recent years has found that as many Etty Bitton, OD, MSc, FAAO Ras 78.5 million Americans may suffer from dry eye Université de Montréal disease (DED), with nearly twice the number of Montreal, Quebec, Canada females ages 50 years or older reportedly suffering from the disease than males in the same age bracket.1,2,3 In the clinical realm, not only do women report DED symptoms with a higher frequency, but they also cite the severity and impact on their daily lives to be great- er. A 2013 study found that women spent signifi cantly more money per month on dry eye therapies, and Whitney Hauser, OD expressed greater dissatisfaction with treatment side Signal Ophthalmic Consulting effects and time to amelioration than their male coun- Memphis, Tennessee terparts.4 As the “healthcare gatekeepers” for their families (as described by one group of researchers), women’s personal satisfaction with available ocular care services is mission critical.5 If not promptly diagnosed, DED and its systematic Paul M. Karpecki, OD, FAAO effects on female patients’ ocular and vision health is Kentucky Eye Institute, further amplifi ed. According to the Mayo Clinic, dry eye Lexington, Kentucky complications include greater risk of eye infection and Gaddie Eye Centers, Louisville, ocular surface damage, which can lead to infl ammation, Kentucky corneal surface abrasion and ulcers, and vision prob- lems if left unaddressed.6 Beyond the physical consequences of DED is the re- sulting degradation in life quality, reported to be acutely experienced by female patients due to the inability of these patients to perform many everyday activities.6 Terrence P. O’Brien, MD This in turn heightens the risk of psychosomatic disor- Bascom Palmer Eye Institute ders, such as depression, stress and anxiety.7,8 In se- Palm Beach Gardens, Florida vere DED cases, patient utility assessment scores are, somewhat shockingly, comparable to those of acute angina and dialysis patients.9,10 This diverse panel of luminaries sheds light on the truth about today’s experience for female dry eye disease patients, and provides recommendations for diagnosing, treating and managing this unique—and essential—segment of DED sufferers. – Marguerite McDonald, MD, FACS 2 REVIEW OF OPHTHALMOLOGY • OCTOBER 2016 101516_akorn__rp_jA.indd 2 9/22/16 1:41 PM The Face of Dry Eye What Are the Symptoms of Dry Eye? Disease Dry eye symptoms may include any of the following: Dr. McDonald: Are the dry eye • Stinging or burning of the eye disease statistics cited earlier • A sandy or gritty feeling as if something is in the eye estimating nearly double the • Episodes of excess tears following very dry eye periods number of women than men, • A stringy discharge from the eye representative of what you are • Pain and redness of the eye 2,3 seeing in your practice? • Episodes of blurred vision Dr. Karpecki: This does rep- • Heavy eyelids resent the majority of patients • Inability to cry when emotionally stressed that I see. In fact, the ratio is • Discomfort with contact lenses at least 2:1 women to men in • Decreased tolerance for reading, working on the computer or any activity that patients over age 50—or, age requires sustained visual attention 44, in my estimate. I’m also • Eye fatigue noticing a clear hormonal component with DED since the National Eye Institute. What are the symptoms of dry eye? Available at: https://nei.nih.gov/health/dryeye/dryeye (last preponderance of these patients accessed May 1, 2016). are perimenopausal. If you look at the 2014 Beaver Dam understand that dry eye and maintain the integrity of the Offspring Study as evidence, ocular surface diseases tend to ocular surface. This includes the incidence of dry eye in the be progressive. In fact, many the cornea—the fi rst interface patient population under age eye care providers have begun for clear vision as well as the 40 was relatively equal between to view these diseases with an conjunctiva. When the cornea men and women.11 approach similar to glaucoma.12 is not kept adequately lubri- Dr. Bitton: We, too, fi nd this Severe DED cases can lead cated it will progress to severe to be the core demographic of to irreversible ocular surface dryness, which will eventually dry eyes patients—especially damage when not under proper deteriorate vision. Even tran- post-menopausal women. management, and similar to sient blur throughout the day Dr. O’Brien: The data high- glaucoma, dry eye disease can can impact daily activities, in- lighted are also consistent with permanently impair goblet cells, cluding computer use, reading, my experiences in clinical prac- limbal stem cell and lacrimal driving, etc. Keeping the tear tice, where women are nearly glands, potentially impacting a fi lm stable and uniform using two times as likely to have dry patient’s visual function if left a product such as TheraTears® eye disease as men. unaddressed. Dry Eye Therapy Lubricant Dr. Hauser: Agreed. DED is a Eye Drops will provide a clear Consequences of chronic, progressive condition. refractive surface, and lubricate Neglecting Dry Eye Just like any other disease that the corneal surface for unwav- Dr. McDonald: Can you talk goes unmanaged, the associated ering vision throughout the day. about the systemic impacts of signs and symptoms—such as leaving dry eye disease untreat- fl uctuating vision, redness and Symptom Presentation ed and how this can negatively irritation—only worsen with in the Female Patient impact on a woman’s ocular time. Dr. McDonald: Do men and health and overall well-being? Dr. Bitton: The tear fi lm has women with dry eye typically Dr. O’Brien: We have come to many roles, one of which is to present with different symp- toms/complaints? Dr. Karpecki: In my experi- ence, women are more likely to seek clinical help at an earlier stage of DED; thus, symptoms such as transient blur, burning, dryness and irritation are more common. Men tend to wait until advanced stages to come to my offi ce, and then frequent- Patient reports fl uctuating vision at the end of the day, chronic redness and transient ly complain of blurred vision, irritation. Photos: Whitney Hauser, OD which, upon investigation, has 3 REVIEW OF OPHTHALMOLOGY • OCTOBER 2016 101516_akorn__rp_jA.indd 3 9/22/16 1:41 PM Expert DED Management Protocol: Dry Eye Summit The 2014 Dry Eye Summit put forth basic management recommendations for dry eye disease that include the following protocol: 1. For all patients: • Ocular lubrication • Lid hygiene • Nutrition (includes oral nutraceuticals and dietary interventions) 2. Topical anti-infl ammatories when necessary Improving The Screening, Diagnosis, And Treatment of Dry Eye Disease: Expert Recommendations From The 2014 Dry Eye Summit. Available at: https://www.reviewofoptometry.com/ CMSDocuments/2015/6/0615_BioSciencei.pdf (last accessed May 23, 2016). progressed beyond transient where their discomfort occurs, only do women report to us blur from an unstable tear fi lm along with a list of medications DED symptoms with a higher to signifi cant SPK [superfi cial that they’ve used in the past. frequency, but they also cite the punctate keratitis] and epi- They are very open about how severity and impact on their thelial desiccation. They may DED is affecting them, beyond daily lives to be greater. exhibit redness, photophobia the physical manifestations. and even ocular neuropathic Dr. Hauser: I have also found A Comprehensive nociceptor hyperactivity and female patients to be more Approach to Diagnosis pain, which are very diffi cult to forthcoming about their ocular Dr. McDonald: Please walk treat.13 symptoms and general well-be- us through your diagnostic Dr. Bitton: I haven’t noticed ing. Many offer a narrative that approach when female patients differences insofar as the provides me with a keener sense arrive at your practice with actual symptoms that men and of the physical and emotional DED symptoms and how this women mention, but I have impact that DED is having in strategy might differ for a male observed distinctions in the their lives. patient. way they communicate the in- Dr. O’Brien: We have tracked Dr. Hauser: A case history is formation. Female patients are gender-specifi c reporting dif- always a critical component more descriptive, verbally and ferences with regard to DED of any clinical exam, but it’s otherwise; many will come in that may impact management especially important for female with a detailed log of when and and patient satisfaction. Not patients who report dry eye The Tear Film’s Critical Role The 2007 International Dry Eye WorkShop (DEWS) report, putting forth a new defi nition of dry eye disease (DED) from an earlier defi nition presented at the 1995 National Eye Institute Industry Dry Eye Workshop, highlights the critical role the tear fi lm plays relative to dry eye disease:1 Dry eye is a multifactorial disease of the tears and ocular surface that results in symptoms of discom- fort, visual disturbance, and tear fi lm instability, with potential damage to the ocular surface. It is accompanied by increased osmolarity of the tear fi lm and infl ammation of the ocular surface. In deciding upon its phrasing, the committee agreed that the updated language needed to refl ect new knowledge about the roles of tear hyperosmolarity and ocular surface infl ammation in dry eye, along with dry eye’s impact on visual function.
Load more

Recommended publications
  • Scleral Faqs
    www.scleralcenter.com SCLERAL FAQS CONTACT US: Office: 501 E. Palm Valley Blvd. WHY ARE SCLERAL LENSES SO Round Rock, TX 78664 COMFORTABLE? Website: www.scleralcenter.com Scleral lenses vault over the cornea and rest on Phone: 512.248.2424 the white portion of the eye (sclera), which is less sensitive. They fit under the eyelid, resulting in comfort & stability. JAVIER R. ZAMORA, OD Dr. Zamora is the co-founder of Advanced Eye Care & Surgery and has been fitting specialty contact lenses since 1998. He is a graduate of the University of Texas at Austin and the University of Houston College of Optometry. FIRM LENSES LARGER LENSES Sharp Vision Comfort & Stability DEBBIE A. ZAMORA, OD Dr. Zamora is the co- founder of Advanced Eye WHY DO SCLERAL LENSES OFFER Care & Surgery and has SUPERIOR VISION? been fitting specialty contact lenses since They are manufactured in Gas Permeable (GP) 2001. She is a graduate HOW material which provides a smooth optical surface of Tulane University and the University of Houston and excellent vision even if your cornea has an College of Optometry. SCLERAL LENSES irregular shape. Scleral lenses treat astigmatism and are available with bifocal options. CAN HELP YOU DEBRA A. WARE, OD WHAT IS THE ‘LIQUID BANDAGE’ Dr. Ware has been fitting EFFECT? specialty contact lenses since 1998. She is Scleral lenses provide extra moisture for healthy a graduate of Baylor eyes, as well as for patients with severe dry eyes. University and the The space between your eye and the back of the University of Houston scleral lens acts as a fluid reservoir that provides College of Optometry.
    [Show full text]
  • Dry Eye in Patient with Clinical History of Chronic Blepharitis and Chalaziosis Edited by Dr
    year 10 num b e r 2 4 e y e d o c t o r m a r ch- a p r i l 2018 CLINICAL CASES OF LUCIO BURATTO Dry eye in patient with clinical history of chronic blepharitis and chalaziosis edited by Dr. Maria Luisa Verbelli, Dr.Alessia Bottoni Observation and 1 anamnesis Arrives at our observation at CIOS, Italian Center for Dry Eye at CAMO, a 56-year-old patient with blepharitis, redness, ocular burning and abundant mucous secretion present in both eyes. Furthermore, an enlarged lymph node is seen in the right laterocervical site. At ocular anamnesis the patient reports chronic blepharitis from the juvenile age, multiple chalazion in both eyes, an operation for right Fig. 1 Handpiece for the application of the pulsed light of the Eye-Light instrument upper eyelid chalaziosis in 2006 (4 upper eyelid chalazion , 3 in the lower); negative anamnesis for these pathologies in the family. The patient is shortsighted since adolescence, has not had any other eye operations and has no ocular allergies. The general anamnesis does not report major systemic diseases or medication intake. On objective examination of the anterior segment we find bilaterally: reduced lacrimal meniscus, posterior blepharitis, obstruction of all the Meibomian glands of the upper and lower eyelids, conjunctival hyperemia with dry spots, transparent cornea, transparent crystalline. The no contact tonometry is 15 mmHg in RE, 16 mmHg in LE. The OCT of the macula does not show changes in both eyes. The BUT is 4.9 seconds in RE, and 15.6 seconds in LE.
    [Show full text]
  • Albinism Terminology
    Albinism Terminology Oculocutaneous Albinism (OCA): Oculocutaneous (pronounced ock-you-low-kew- TAIN-ee-us) Albinism is an inherited genetic condition characterized by the lack of or diminished pigment in the hair, skin, and eyes. Implications of this condition include eye and skin sensitivities to light and visual impairment. Ocular Albinism (OA): Ocular Albinism is an inherited genetic condition, diagnosed predominantly in males, characterized by the lack of pigment in the eyes. Implications of this condition include eye sensitivities to light and visual impairment. Hermansky Pudlak Syndrome (HPS): Hermansky-Pudlak Syndrome is a type of albinism which includes a bleeding tendency and lung disease. HPS may also include inflammatory bowel disease or kidney disease. The severity of these problems varies much from person to person, and the condition can be difficult to diagnose with traditional blood tests Chediak Higashi Syndrome: Chediak Higashi Syndrome is a type of albinism in which the immune system is affected. Illnesses and infections are common from infancy and can be severe. Issues also arise with blood clotting and severe bleeding. Melanin: Melanin is pigment found in a group of cells called melanocytes in most organisms. In albinism, the production of melanin is impaired or completely lacking. Nystagmus: Nystagmus is an involuntary movement of the eyes in either a vertical, horizontal, pendular, or circular pattern caused by a problem with the visual pathway from the eye to the brain. As a result, both eyes are unable to hold steady on objects being viewed. Nystagmus may be accompanied by unusual head positions and head nodding in an attempt to compensate for the condition.
    [Show full text]
  • Scleral Lenses and Eye Health
    Scleral Lenses and Eye Health Anatomy and Function of the Human Eye How Scleral Lenses Interact with the Ocular Surface Just as the skin protects the human body, the ocular surface protects the human Scleral lenses are large-diameter lenses designed to vault the cornea and rest on the conjunctival tissue sitting on eye. The ocular surface is made up of the cornea, the conjunctiva, the tear film, top of the sclera. The space between the back surface of the lens and the cornea acts as a fluid reservoir. Scleral and the glands that produce tears, oils, and mucus in the tear film. lenses can range in size from 13mm to 19mm, although larger diameter lenses may be designed for patients with more severe eye conditions. Due to their size, scleral lenses consist SCLERA: The sclera is the white outer wall of the eye. It is SCLERAL LENS made of collagen fibers that are arranged for strength rather of at least two zones: than transmission of light. OPTIC ZONE The optic zone vaults over the cornea CORNEA: The cornea is the front center portion of the outer Cross section of FLUID RESERVOIR wall of the eye. It is made of collagen fibers that are arranged in the eye shows The haptic zone rests on the conjunctiva such a way so that the cornea is clear. The cornea bends light the cornea, overlying the sclera as it enters the eye so that the light is focused on the retina. conjunctiva, and sclera as CORNEA The cornea has a protective surface layer called the epithelium.
    [Show full text]
  • Partial Albinism (Heterochromia Irides) in Black Angus Cattle
    Partial Albinism (Heterochromia irides) in Black Angus Cattle C. A. Strasia, Ph.D.1 2 J. L. Johnson, D. V.M., Ph.D.3 D. Cole, D. V.M.4 H. W. Leipold, D.M.V., Ph.D.5 Introduction Various types of albinism have been reported in many Pathological changes in ocular anomalies of incomplete breeds of cattle throughout the world.4 We describe in this albino cattle showed iridal heterochromia grossly. paper a new coat and eye color defect (partial albinism, Histopathological findings of irides showed only the heterochromia irides) in purebred Black Angus cattle. In posterior layer fairly pigmented and usually no pigment in addition, the results of a breeding trial using a homozygous the stroma nor the anterior layer. The ciliary body showed affected bull on normal Hereford cows are reported. reduced amount of pigmentation and absence of corpora Albinism has been described in a number of breeds of nigra. Choroid lacked pigmentation. The Retina showed cattle.1,3-8,12,16,17 An albino herd from Holstein parentage disorganization. Fundus anomalies included colobomata of was described and no pigment was evident in the skin, eyes, varying sizes at the ventral aspect of the optic disc and the horns, and hooves; in addition, the cattle exhibited photo­ tapetum fibrosum was hypoplastic.12 In albino humans, the phobia. A heifer of black pied parentage exhibited a fundus is depigmented and the choroidal vessels stand out complete lack of pigment in the skin, iris and hair; however, strikingly. Nystagmus, head nodding and impaired vision at sexual maturity some pigment was present and referred to also may occur.
    [Show full text]
  • Wavelength of Light and Photophobia in Inherited Retinal Dystrophy
    www.nature.com/scientificreports OPEN Wavelength of light and photophobia in inherited retinal dystrophy Yuki Otsuka1, Akio Oishi1,2*, Manabu Miyata1, Maho Oishi1, Tomoko Hasegawa1, Shogo Numa1, Hanako Ohashi Ikeda1 & Akitaka Tsujikawa1 Inherited retinal dystrophy (IRD) patients often experience photophobia. However, its mechanism has not been elucidated. This study aimed to investigate the main wavelength of light causing photophobia in IRD and diference among patients with diferent phenotypes. Forty-seven retinitis pigmentosa (RP) and 22 cone-rod dystrophy (CRD) patients were prospectively recruited. We designed two tinted glasses: short wavelength fltering (SWF) glasses and middle wavelength fltering (MWF) glasses. We classifed photophobia into three types: (A) white out, (B) bright glare, and (C) ocular pain. Patients were asked to assign scores between one (not at all) and fve (totally applicable) for each symptom with and without glasses. In patients with RP, photophobia was better relieved with SWF glasses {“white out” (p < 0.01) and “ocular pain” (p = 0.013)}. In CRD patients, there was no signifcant diference in the improvement wearing two glasses (p = 0.247–1.0). All RP patients who preferred MWF glasses had Bull’s eye maculopathy. Meanwhile, only 15% of patients who preferred SWF glasses had the fnding (p < 0.001). Photophobia is primarily caused by short wavelength light in many patients with IRD. However, the wavelength responsible for photophobia vary depending on the disease and probably vary according to the pathological condition. Inherited retinal degenerations (IRDs) represent a diverse group of diseases characterized by progressive photo- receptor cell death that can lead to blindness 1.
    [Show full text]
  • Frequency and Risk Factors of Symptomatic Dry Eye Disease at Tertiary Care Eye Hospital, Karachi
    Biostatistics and Biometrics Open Access Journal ISSN: 2573-2633 Research Article Biostat Biometrics Open Acc J Faisal’s Issue - January 2018 Copyright © All rights are reserved by Muhammad Faisal Fahim DOI: 10.19080/BBOAJ.2018.04.555639 Frequency and Risk Factors of Symptomatic Dry Eye Disease at Tertiary Care Eye Hospital, Karachi Shaheerah Gul1, Adil Salim Jafri1, Muhammad Faisal Fahim2* 1Department of Ophthalmology, Al-Ibrahim Eye Hospital, Pakistan 2Department of Research & Development, Al-Ibrahim Eye Hospital, Pakistan Submission: November 27, 2017; Published: January 19, 2018 *Corresponding author: Muhammad Faisal Fahim, M.Sc (Statistics), Statistician, Research & Development Department, Al-Ibrahim Eye Hospital, Isra postgraduate Institute of Ophthalmology, Karachi, Pakistan, Tel: ; Email: Abstract Objective: To determine frequency and risk factors of symptomatic dry eye disease at tertiary care eye hospital, Karachi. Material & Methods: This was a descriptive cross sectional study carried out at Al-Ibrahim Eye Hospital, Isra postgraduate Institute of Oph- thalmology, Karachi from March to October 2016. Non-Probability purposive sampling technique was used for data collection. Inclusion criteria give consent. Symptoms of dry eye were assessed using Tear breakup test (TBUT) test. SPSS version 20.0 was used to analyze data. were patients aged ≥ 21 years and on the basis of dry eye symptoms. Exclusion criteria were other systemic eye disease and those who did not Results: A total of 100 patients 65 female and 35 male were diagnosed with dry eye syndrome. The age group of 21-30 years having the high- est frequency of 34 patients, whereas after the 50 years of age the frequency of patients decreases to 21.
    [Show full text]
  • Blepharitis Last Revised in October 2015
    Menu Sign in (https://accounts.nice.org.uk/signin) Search... Blepharitis Last revised in October 2015 Changes Back to top Last revised in October 2015 October 2015 — reviewed. A literature search was conducted in October 2015 to identify evidence­ based guidelines, UK policy, systematic reviews, and key randomized controlled trials published since the last revision of the topic. No changes to clinical recommendations have been made. Previous changes Back to top September 2012 — reviewed. A literature search was conducted in September 2012 to identify evidence­based guidelines, UK policy, systematic reviews, and key RCTs published since the last revision of the topic. No changes to clinical recommendations have been made. April 2011 — minor update. Change to recommendation regarding need for additional contraception during or after a course of tetracycline ­ additional contraception is no longer required when using antibiotics that are not enzyme inducers with combined hormonal methods for durations of 3 weeks or less [FSRH, 2011 (/blepharitis#!references/­315093)]. Issued in June 2011. March 2011 — topic structure revised to ensure consistency across CKS topics — no changes to clinical recommendations have been made. September 2010 — minor update. Hydromoor® (hypromellose 0.3% preservative­free single dose eye drops) have been included. Issued in September 2010. March 2010 — minor update. Lubri­Tears® eye ointment has been discontinued. Prescription removed. Issued in March 2010. December 2007 to May 2008 — converted from CKS guidance to CKS topic structure. The evidence­ base has been reviewed in detail, and recommendations are more clearly justified and transparently linked to the supporting evidence. The clinical scenario structure has been reviewed.
    [Show full text]
  • 29 Yo White Female
    5/21/2014 29 yo white female CC: Decreased VA OD X few days Women of Vision Present Are We PMHx: 5 months pregnant at Risk for Vision Morbidity MODERATOR BVA: 20/30 OD 20/20 OS Pupils: (-) APD Louise Sclafani O.D. Louise A. Sclafani, OD, FAAO CF: FTFC OD/OS Co-instructors: Jill Autry, OD, Melissa Associate Professor Barnett, OD, Susan Cotter, OD, Diana University of Chicago Hospital Shechtman, OD GOALS It’s a BOY… • Our panel will take on this challenge and discuss this population as it relates to the following conditions optic neuritisOCT Women at Risk: Retinal Issues Fetus maculopathy??? evaluation, AMDnutritional controversy, psychosocial issuesmanagement options with strabismus, ocular concerns for common Diana Shechtman, OD systemic pharmaceuticals, safety issues with [[email protected]] ophthalmic drugs, and the hormonal influence Associate Professor of Optometry at on ocular surface disease NOVA Southeastern University College of Optometry Courtesy of Dr. M Rafieetary CASE PRESENTATION SUMMARY So why would’t ICSC (idiopathic central serous chorioretinopathy) WE (female gender) be stressed out? Serous macular detachment due to RBR breakdown • As ODs we need to place a higher priority on those individuals at increased risk for vision- threatening ocular disease. It has been estimated that the female gender represents 23 of all visually compromised individuals due to inherent risk factors and lack of access to healthcare. Diana Shechtman OD FAAO 1 5/21/2014 Hyperpermeability at RPE site is associated with choroidal Which of the following drugs in Not associated CSR in women circulation disruption/vascular congenstion with ICSC? Quillen et al.
    [Show full text]
  • What Is Hermansky-Pudlak Syndrome?
    American Thoracic Society PATIENT EDUCATION | INFORMATION SERIES What is Hermansky-Pudlak Syndrome? Hermansky-Pudlak Syndrome (HPS) is a rare inherited disease, named after two doctors in Czechoslovakia who, in 1959, recognized similar health conditions in two unrelated adults. Since the discovery of HPS, the condition has occurred all over the world but is most often seen in Puerto Rico. The most common health conditions with HPS are albinism, the tendency to Journal of Hematology bleed easily, and pulmonary fibrosis. A Figure 1. Normal platelet with dense bodies growing number of gene mutations have visualized by electron microscopy. been identified causing HPS (including numbers HPS1 to HPS10). What is albinism? Albinism is an inherited condition in which CLIP AND COPY AND CLIP reduced pigmentation (coloring) is present in the body. As a result, people with albinism are often fair-skinned with light hair. However, skin, hair, and eye color may vary, as some people with albinism may have dark brown hair and green or hazel/brown eyes. Journal of Hematology People with albinism all have low vision and Figure 2. Patient’s platelet with virtually absent dense bodies visualized by electron microscopy. varying degrees of nystagmus. All people who have HPS have albinism, but not all circulate in the blood stream and help the people with albinism have HPS. blood to clot. HPS patients have normal Skin problems—The reduction of numbers of platelets, but they are not pigmentation in the skin from albinism made correctly and do not function well, so results in an increased chance of developing the blood does not clot properly.
    [Show full text]
  • Common Eye Conditions
    COMMON EYE CONDITIONS AMBLYOPIA Reduced acuity because of non-use of eye or extreme difference in acuities. Eye may be patched or surgery to correct. NYSTAGMUS - Cause unknown Involuntary rhythmic side-to-side, up-and-down, or circular (oscillating), eye movement that may be faster in one direction than the other (may be more marked in one eye than the other), reduced acuity due to inability to fixate. STRABISMUS - Defects of eye muscle Eyes are not aligned correctly, images may not fuse, brain may suppress one image resulting in permanent acuity reduction in eye where image is suppressed. ALBINISM – Hereditary – congenital (may involve all or part of body – non-progressive) Lack of pigment in eye, decreased acuity, nystagmus, strabismus, photophobia, visual fields variable, retina and macular involvement. ANIRIDIA – Hereditary Underdeveloped or absent iris. Decreased acuity, photophobia, nystagmus, cataracts, under developed retina. Visual fields normal unless glaucoma develops. CATARACTS – Congenital, hereditary, traumatic, disease, or age related (normal part of aging process) Lens opacity (chemical change in lens protein), decreased visual acuity, nystagmus, photophobia (light sensitivity). DIABETIC RETINOPATHY – Pathologic Retinal changes, proliferative – growth of abnormal new blood vessels, hemorrhage, fluctuating visual acuity, loss of color vision, field loss, retinal detachment, total blindness. GLAUCOMA (Congenital or adult) – “SNEAK THIEF OF SIGHT” hereditary, traumatic, surgery High intraocular pressure (above 20-21 mm of mercury) – (in children often accompanied by hazy corneas and large eyes), often due to obstructions that prevent fluid drainage, resulting in damage to optic nerve. Excessive tearing, photophobia, uncontrolled blinking, decreased acuity, constricted fields. HEMIANOPSIA – (Half-vision) optic pathway malfunction pathologic or trauma (brain injury, stroke or tumor) Macular vision may or may not be affected.
    [Show full text]
  • Ocular Complications of Obstructive Sleep Apnea
    Journal of Clinical Medicine Review Ocular Complications of Obstructive Sleep Apnea Pei-Kang Liu 1,2,3,4 , Tzu-Yu Chiu 1,2 , Nan-Kai Wang 4 , Sarah R. Levi 4 and Ming-Ju Tsai 5,6,7,8,* 1 Department of Ophthalmology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 807, Taiwan; [email protected] (P.-K.L.); [email protected] (T.-Y.C.) 2 School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan 3 Institute of Biomedical Sciences, National Sun Yat-sen University, Kaohsiung 804, Taiwan 4 Department of Ophthalmology, Edward S. Harkness Eye Institute, Columbia University, New York, NY 10032, USA; [email protected] (N.-K.W.); [email protected] (S.R.L.) 5 Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 807, Taiwan 6 Sleep Disorders Center, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 807, Taiwan 7 Department of Respiratory Care, College of Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan 8 Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan * Correspondence: [email protected]; Tel.: +886-7-3121101 (ext. 5601) Abstract: Obstructive sleep apnea (OSA), the most common form of sleep-disordered breathing, is characterized by repetitive episodes of paused breathing during sleep, which in turn induces transient nocturnal hypoxia and hypercapnia. The high prevalence of OSA and its associated health consequences place a heavy burden on the healthcare system. In particular, the consequent episodic oxygenic desaturation/reoxygenation series and arousals from sleep in patients with OSA have the potential to trigger oxidative stress, elevated systemic inflammatory responses, and autonomic Citation: Liu, P.-K.; Chiu, T.-Y.; dysfunction with sympathetic activation.
    [Show full text]