Eye

                             "WORLD EYE SIGHT DAY 13TH OCTOBER."

In last few years, new tools have been developed from microsurgery, lasers, diagnostic equipment's, nano emulsifications and robotic cataract surgery. Not only these tool help  in precise diagnosis of various eye ailments and near perfect treatment outcomes, they also help in the early rehabilitation of the patient with minimum discomfort and lowest rate of complications.

Taking care of eyes and preventing blindness due to serious eye ailments. In the last few years , due to impact of excessasive screen time, there has been spurt in patients and children coming with a decrease in vision due to refractive error, dry eyes, and computer vision syndrome. 

Introduction

• It is advised  to take regular breaks when they are in front of screens.
• Remember 20-20-20 rule? Look away from the screen every 20 minute by focusing on some thing 20 feet away for at least 20 seconds.
• Also blinking often helps in lubricating the eyes naturally.

If you are feeling pain in the eyes or your vision is becoming blurred, you need to get a comprehensive eye examination soon. This can be due to various conditions like cataract, glaucoma or retinal ailments that require immediate attention. An annual eye examination is a must if you are suffering from diabetes or taking BP medications. Children going to schools, and those who have long screening hours should also get periodical examination done. 

Advance treatment include the use of new technologies such as Femotolaser assisted cataract surgery with use of advance intraocular lenses like extended dept of focus or multi focal intra ocular lenses that can help the patient to get rid of  glasses even at the extremes of age. As these are one time surgeries, the best tech and the implants should be chosen after a comprehensive eye examination.

Eye Problems

Various etiological factor for eye disorders  :

According to Ayurveda-

• Exposure to cold water
•  Exposure to cold immediately after exposure to heat
• Alteration in sleep pattern
• Constant watching of distant objects
• Tensions
• Anger
• Excessive crying
• Trauma
• Consuming sour preparation in excess.
• Controlling essential urges.
• Increasing the amount of (Sudation).
• Exposure to gasses or fumes.

Squints

A transitory squint in newborn babies is common and does not need any treatment. Children with a fold of skin  between the  eye and nose (epicanthic fold) or with a wide bridges of the nose and increased distance between the two pupils may  falsely appear to have a squint. However, a true squint must be  attended  to immediately or it may lead to permanent blindness.  An eye specialist should be consulted and his advice followed. Sometimes, the child just needs glasses. At times a squint may follow a serious head injury or a tumor of the eye.. Some times surgical correction is required.

Refractive Error Needing Glasses

Every child should be subjected  to an eye check up  before joining school to ascertain if he has a squint or needs glasses.

Infections of the eye

Watering in the eye in the new born without sticky eyes or pus like discharge from the eye is usually due to blockage of the tear duct connecting the eye to the nose.  This is not due to any infection and generally stops spontaneously before the child is 6 months old. If you notice a pus like discharge from the eye, your doctor will teach you how to massage the area between the eye and the nose and advice some eye drops to be put after cleaning the eye with warm water. If watering persist after 6 months, an eye specialist should be seen. He may submit the child  to a minor procedure to open the tear duct. This is quite effective.

Redness of the eye or sticky discharge  from the eye could  be due to a bacterial or viral infection. If the redness is accompanied with severe itching in the eye, the cause could be an allergy. Do not use an antibiotic or cortisone eye drops without consulting a doctor.

In a newborn with conjunctivitis, antibiotic eye ointment can be used, but make sure that  it does not contain any corticosteroids.. If not indicated, medicine containing cortisone can be harmful. In persistent cases your doctor may send an eye swab to the laboratory to ascertain the causative organism and prescribe an antibiotic by mouth.

In rare case, tuberculosis can manifest in the eye as 'phlyctenular conjunctivitis'. In this condition, a pimple like spot is seen on the outer side of cornea. Thin blood vessels are seen radiating from this spot. Further investigations are needed to confirm this.

If conjunctivitis suddenly starts affecting a large number of people in the community, it is mostly due to viral infection of the eye. It is highly infectious and may be prevented by immediate hand washing after touching a patient and by keeping a separate hand towels. Antibiotic are of no use because of the  viral origin. If the redness persist, see a doctor who may prescribe antibiotic eye drop or an ointment if required. The antibiotic should only be put in the affected eye every hour or two while the child is awake. This is advised because the medicine is quickly washed out with the watering of the eye. Unaffected members of the family should not use the medicine.

Eye Injuries

The commonest injury to the eye is caused by a small foreign body, like a grain of sand getting stuck to the conjunctiva, covering the white of the eye or the lids. Wash the eye with plenty of water. If it does not come out, take a wick made from cotton, moisten it and clean the speck  from the conjunctiva. If you cannot see it and the eye is irritated and watering profusely, the speck may be stuck under the upper eyelid. To turn this lid up, ask the child to look down, put a matchstick (or use the finger of one hand) over the lid. Catch the eye lashes of the upper lid  with your thumb and index finger and quickly turn the lid up over the stick. The foreign substance is generally seen on the upper lid below the eyelashes. Remove it with moist cotton or the corner of the clean piece of cloth.

If some chemical has gone into the eye keep washing the eye with water till you see a doctor.

If the eye has been punched and the child cannot see (ignore a transitory loss of vision after an injury), see the doctor as soon as possible. If the child's vision is not affected, put an eye ointment into the eye, ask a child to gently close the eye  and put a thick pack of gauze on it  and keep it in place with leucoplast or a bandage till you see your doctor.

If the foreign substance is over the cornea (the cornea covers the pupil and the colored portion of the eye called the iris). Do not try to remove it your self. Let the doctor handle it.

Problems of Eyelids

 A boil like painful swelling near the eye lid is due to a stye (hordeolum). There may be more than one stye. Hot water fomentation thrice a day  with application of antibiotic of an antibiotic eye ointment  after the fomentation clears the infection. The use of an ointment  must be continued for  another 3-4 days even after the stye subsides.

A stye should be differentiated  from a chalazion  that results in a firm  non painful swelling  in the lid.It can disappears on its own. but may require simple surgery.

Sometimes the margins of the eyelid presents with persistent itchy scales that sticks together during sleep. The eyelid should be gently cleaned with warm water and the scales removed. Then apply an antibiotic eye ointment. This condition, called blephritis tends to recur. Occasionally, local application of corticosteroids is needed.

Congenital Ptosis

This condition refers to drooping of the upper eyelid, and could be familial. It needs surgical correction. Mild ptosis is operated upon before the child joins  regular school. Ptosis that inter fears with vision should be corrected earlier as per the advice  of an eye specialist.

Night Blindness

Inability to see properly in the dark may be the first indication of Vitamin A deficiency. It is easily cured by a diet  rich in vitamin A, and the use of vitamin A. If ignored, it can lead to severe damage  to the eye and permanent blindness. Prevention is possible by  breastfeeding the baby (preferably for 2 years) and giving him dark green leafy vegetables and red or yellow fruits and vegetables.Some of these children may also have associated roundworm infestation that should be treated as well.

Television

Should children be allowed to watch T.V?

Whether we like it or not, television has come to stay. Also some of  the programs on sports, travel, music, and science are quite educative. In fact, good educational programmes may have a positive effect. Keeping this in mind, I suggest that you stick to intelligent rationed viewing for yourself as well as for your child.

Diet 

• Amla Pacifies Tridosha, pacifies blood , cures indigestion, leucoderma and dysentery.