Eye Disorder
Eye Disorder
Eye Disorder
Grey line;
Where the skin joins palpebral conjunctivas.
Accessory glands
Krauses gland located in the eye lid.
Meibomian gland
Basal tear secretion is constant & under sympathetic nervous system control.
Function of tear
Refraction: to provide an optically smooth surface to the cornea.
Lubrication of the front of eye ball.
Cleansing action by washing away dust particles from the eye.
Protection from infection by secreting the enzyme lysozyme, immuno-proteins &
antimicrobial agents.
Flow of tear is affected by;
Blinking.
Capillary attraction into the puncta.
Lacrimal pump by contraction of muscle.
Gravity.
Internal Structure of eye
Eye Ball;
It is lined by 3 layers,
1. Outer protective layer
It is fibrous layer.
It consists;
A. Sclera
It is the white part of the eye.
Form outermost tissue of posterior & lateral (4/5)th aspects of eye ball.
It is continuous anteriorly with cornea.
Maintains the shape of the eye & gives attachment to extra ocular muscle of eye.
B. Cornea
It is the anterior continuation of sclera.
It is clear transparent & allow passage of light rays.
It is convex anteriorly & is involved in refraction or bending light rays to focus
them on retina.
It is highly sensitive.
2. Middle layer
It is Vascular organ.
It Consists;
A. Choroid
Lines the posterior (5/6)th of inner surface of sclera.
Highly vascularized.
Emmetropia means the light is exactly focused on the retina, not infront of it or behind it.
When the light is does not focus properly, it is called a refractive error.
Refractive errors include;
1. Myopia (Short sightedness).
2. Hyperopia or hypermetropia (Long sightedness).
3. Astigmatism (asymmetric focus).
4. Presbyopia.
5. Aphakia.
1. Myopia or short sightedness
A short sighted person has a long eyeball and the eye have excessive refracting power
(cornea and lens).
The light rays therefore come to a focus in front of the retina.
Can see near objects clearly.
Objects at a distance are blurred.
C/F = decreased distant vision.
Can be corrected by concave lens (minus), so that objects seen in the distance are focused
clearly on the retina. It bends light ray out ward.
3. Astigmatism
It is a refractive error in which the light rays are spread over a diffuse area rather than
sharply focused on the retina.
It results from unequal curvature of the cornea, causing horizontal and vertical rays to be
focused at two d/t pts on the retina, so that there is no point of focus of the light rays on
the retina.
C/F: - blurred vision, eye discomfort.
It can be hyperopic or myopic in relation to where the image falls.
4. Presbyopia
It is a form of hyperopia that occurs as a normal process of aging usually around the age
of about 45 years.
As the lens ages and becomes less elastic , it loses its refractive power and the eye no
longer has the ability to accommodate for near vision.
The light rays therefore fall behind the retina before coming to a focus.
Can be corrected by convex lens.
C/M
Mx
o Daily meticulous cleaning of the lid margins using cotton tipped applicator, with dilute
baby shampoo: 2x/day.
o Worm Compresses.
o Application of antibiotic ointment 2-3x/d.
o Dandruff RX.
o Stop using make up or change the brand used.
o Improve hygiene.
Complication
Conjunctivitis.
Trichiasis.
Entropion or ectropion of lower lid.
Corneal Ulcer.
4. Trichiasis
It is a condition in which the eye lashes grow in words & rub on the cornea.
Cause: - blepheritis
- Trauma or surgery to the lids.
Rx: - Epilation
Complication: - Corneal abrasions
- Corneal ulceration
- Corneal Opacity
- Vascularisation of cornea
5. Entropion
Turing inward of eyelids, usually lower eye lids.
Cause: - Contraction of the palpebral conjunctiva following trauma or disease to the eye lid or
conjunctiva.
MX
Enucleation of the sightless eye within 10 days of injury is usually recommended to
reduce the risk of sympathetic disease in the other eye.
Indication for enucleation
Blindness after penetrating injury.
Painful blind eyes that is unresponsive to the medical treatment.
Tumor of the eye.
Disease of the inner ear
1. Panophthalmitis
It is an inflammation of all tissue of the eye ball.
Etiology
Bacteria.
Virus.
Fungus.
E.t.c
Hx of recent intraocular operation.
Penetrating trauma.
Common in immune compromised pts, such as HIV/AIDS and diabetes.
C/M
Severe pain.
Loss of vision.
Redness of conjunctiva and underlying episclera.
Mgx
Medication (antimicrobial plus steroids)
Topical.
Subconjuctival.
Intravitreally.
Systemically, or in combination form.
Surgery
Enucleation.
Injuries to the eye
1. Trauma to the eye
A. Blunt contusion
It is bruising of the periorbital soft tissue.
C/M
Swelling and discoloration of the tissue.
Bleeding in to the tissue and structure of the eye.
Pain.
Mgx
Reducing swelling and pain by applying cold and warm compress.
Mgx
1.
C/M
Dx
Mgx
Lacrimation
Photophobia
Pain relief.
Bilateral patching with antibiotic ointment and cycloplegics.
Other eye condition
1. Glaucoma (Disorder of an aqueous Humor Circulation)
Glaucoma is a pathological rise in the intra ocular pressure that causes damage to the
various structure of the eye, especially the optic nerve.
It is the cause of blindness.
There are four types of glaucoma. These are;
1. Congenital .
2. Closed angle (acute).
3. Open angle (chronic)
4. Secondary.
Congenital glaucoma.
It is a rare condition that occurs in infant and neonates
The diameter of the cornea increase in size.
The cornea becomes edematous
Tonometry exam-increase IOP.
Pulled off: - by vitreous traction, which occurs when new blood vessels
have grow in to the vitreous.
This condition con be caused by;
DM.
Retinal hemorrhage .
Vitreous hemorrhage.
Pushed off: - A lesion behind the retina . such as choroidal tumors,
hemorrhage, choroiditis & retinopathies
Floated off :- If a tear or hole appears in the retina, subretinal fluid or
vitreous fluid enters the hole, floating the neural layer off the epithelial
layer. Rhegmatagenaus ( tear induced ) detachment - is most common
type.
In general the causes can be;
congenital malformation
Metabolic disorders
Vascular disease
Neoplasm
trauma
Degenerative changes
C/F: - History of floating or flashing lights or both. The floaters are perceived as tiny
dark spots or cobwebs.
Spreading shadow or curtain moving across the field of vision, resulting in blurred vision
& loss of visual field as the retina separates
Decreased central acuity or lass or central vision
Flashing lights (photopia).