Sunday, August 14, 2011
Eye-rubbing may indicate glaucoma
Penny is a 10-year-old cocker spaniel who has had her share of ear problems.
Pat isn't sure whether Penny is having a problem now, but she is noticing a new behavior. Penny is rubbing the left side of her face on the carpet, and she's started to do it more frequently.
Pat thinks Penny is specifically rubbing her left eye. There is some redness around the eye and the eyeball. Pat first thought Penny may have gotten something on her face, but she no longer believes that to be the case.
Well, Pat, there is a problem. That's the easy part. Determining the underlying problem is the not-so-easy part.
I am going to assume that Penny is indeed rubbing her eye and not some other area close to it. So we can conclude there must be something irritating Penny's left eye or the lids around it.
There are many possibilities that can cause eye irritation. Penny may have damaged the corneal layer of the eye, causing significant discomfort. The cornea is a very specialized layer of clear cells that covers the colored portion of the eye, the iris. The pupil is behind the cornea. Damage to the cornea can come from contact with anything that can score or puncture the tissue. Foreign material in the eye is but one possibility.
Penny may have developed a conjunctivitis or inflammation of the conjunctiva. The conjunctiva is a very thin layer of tissue that covers the inside of the eyelids and eyeball itself. It can become inflamed from an allergic response or a bacterial infection or a combination of both. This list can go on, but there is one possible cause that is potentially very serious and could lead to blindness. Cocker spaniels are a high-incidence breed for this disease.
Penny may have glaucoma. Glaucoma occurs because of increased pressure within the eye. The eye is actually filled with a viscous fluid that supports its round structure. The fluid is maintained at a constant pressure through constant production within the eye and constant drainage out of the eye. If this system is disturbed, usually affecting the drainage, the pressure within the eye can increase; if left untreated, this increased pressure will destroy the retina at the back of the eye, causing blindness.
This process can be extremely painful and is considered an emergency.
In humans with acute glaucoma, the increase in pressure and corresponding discomfort can be communicated to the doctor and therapy immediately performed. Pets do not usually do this, at least early on, although Penny may have done so with her rubbing behavior.
Penny needs immediate veterinary attention. If she does have glaucoma and there is still sight present, we may be able to save her eye. If not, she will need to have treatment done to alleviate her pain. This might include removal of her nonfunctioning eye.
New gold standard in glaucoma treatment
The price of gold is going up but a clinical trial shows it may be worth it for some people with vision problems. Yale glaucoma surgeon Nils Loewen checks on his patient Ron Kortsep.
Ron recently had one of these inserted into his eye. It's called a "shunt made of gold." It's to prevent glaucoma from stealing his eyesight.
"My left eye was getting weaker, I was losing vision, peripheral vision which glaucoma tends to do, the glaucoma was getting more aggressive so we're trying some different things to bring the pressure down," Kortsep said.
Losing his eyesight would be devastating for Kortsep, who loves to travel the world and see the sights. Dr. Loewen is the first physician in the U.S. to insert a gold shunt into a patient's eye. It's part of a trial. The device reduces eye pressure by helping it drain properly.
"It all happens at the front part of the eye where the big surgeries with the drainage implants are at the very back, even back past the equator in some cases," Loewen said.
The procedure is already approved in other countries. In one picture you can make out the tiny shunt at the bottom of the eye. The shunt is made of gold and gold is really expensive, so you must be thinking these must be costly. They're actually only worth pennies apiece, but they do cost a lot because of the price of research and development to create them.
So you may be wondering why gold? It isn't like a bar of gold, it's highly purified. Scientists take out all of the copper and the body does not reject it. Dr. Loewen said this shunt could become the gold standard if approved for glaucoma patients, because results are promising and it's less invasive.
"With these smaller incisions less wound area, equals a quiet eye, equals a comfortable eye," Loewen said.
Ron recently had one of these inserted into his eye. It's called a "shunt made of gold." It's to prevent glaucoma from stealing his eyesight.
"My left eye was getting weaker, I was losing vision, peripheral vision which glaucoma tends to do, the glaucoma was getting more aggressive so we're trying some different things to bring the pressure down," Kortsep said.
Losing his eyesight would be devastating for Kortsep, who loves to travel the world and see the sights. Dr. Loewen is the first physician in the U.S. to insert a gold shunt into a patient's eye. It's part of a trial. The device reduces eye pressure by helping it drain properly.
"It all happens at the front part of the eye where the big surgeries with the drainage implants are at the very back, even back past the equator in some cases," Loewen said.
The procedure is already approved in other countries. In one picture you can make out the tiny shunt at the bottom of the eye. The shunt is made of gold and gold is really expensive, so you must be thinking these must be costly. They're actually only worth pennies apiece, but they do cost a lot because of the price of research and development to create them.
So you may be wondering why gold? It isn't like a bar of gold, it's highly purified. Scientists take out all of the copper and the body does not reject it. Dr. Loewen said this shunt could become the gold standard if approved for glaucoma patients, because results are promising and it's less invasive.
"With these smaller incisions less wound area, equals a quiet eye, equals a comfortable eye," Loewen said.
Wednesday, May 4, 2011
Glaucoma risks on rise
The silent killer of sight, glaucoma, is on the rise among the poor people as they are unable to afford surgery or prolonged medication expenses.
Half the population that forms the serpentine queue at the government eye hospital is likely to slip into blindness due to this problem as the disease can be cured only if detected early or would result in the patient losing vision, say doctors.
“Every month, we get as many as 150 new cases of glaucoma, but are able to conduct only 8-10 surgeries. Most of the patients are too poor to afford the drugs for treatment, which is out of reach even for the middle class,” says a doctor at the hospital.
While medicines are a more popular mode of treatment for the disease in western countries, surgeries, despite their complications, are the best option for people here,” explains Dr. Krishnaraj, an ophthalmologist, pointing out that 10 to 15 per cent of patients are not even aware that they are suffering from the disease.
As the cost of eye drops begins from `200 and above depending on the treatment many people do not have enough money to procure it as a long term medical solution.
The progress of glaucoma that affects the optic nerve, causing irreversible vision loss, can be arrested if detected early.
Half the population that forms the serpentine queue at the government eye hospital is likely to slip into blindness due to this problem as the disease can be cured only if detected early or would result in the patient losing vision, say doctors.
“Every month, we get as many as 150 new cases of glaucoma, but are able to conduct only 8-10 surgeries. Most of the patients are too poor to afford the drugs for treatment, which is out of reach even for the middle class,” says a doctor at the hospital.
While medicines are a more popular mode of treatment for the disease in western countries, surgeries, despite their complications, are the best option for people here,” explains Dr. Krishnaraj, an ophthalmologist, pointing out that 10 to 15 per cent of patients are not even aware that they are suffering from the disease.
As the cost of eye drops begins from `200 and above depending on the treatment many people do not have enough money to procure it as a long term medical solution.
The progress of glaucoma that affects the optic nerve, causing irreversible vision loss, can be arrested if detected early.
Steroid Can Cause Glaucoma
CHANDIGARH: When 25-year-old Raman was detected with glaucoma (a disease of retina that usually afflicts the elderly), ophthalmologists were surprised. After seeing his case history, it was found that to cure conjunctivitis, he overused steroids without a doctor's advice, which caused glaucoma. Of 60 to 70 cases of seasonal conjunctivitis (also known as pink eye) coming daily to city government hospitals, one-fourth show glaucoma and eye ulcers ' which eventually can cause loss of vision ' due to overuse of steroids on self-medication. Dr SK Arya, department of ophthalmology at GMCH-32, said, ''We are getting 30 to 40 patients daily and half of them are new cases. Also, most of these are severe cases that have turned into glaucoma due to steroid overuse.''
''Pollen and dust are the common causes of pink eye. On an average, 30 to 40 cases come to our out patient department daily,'' said Dr Jagat Ram, eye specialist at advanced eye centre, PG
''Pollen and dust are the common causes of pink eye. On an average, 30 to 40 cases come to our out patient department daily,'' said Dr Jagat Ram, eye specialist at advanced eye centre, PG
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