Eye diseases can affect many anatomical structures: cornea, iris, lens, vitreous, retina, optic nerve… These diseases can be of infectious, inflammatory, metabolic, tumor, traumatic or degenerative origin.
Let’s take a look at the most common eye disorders and the treatment adapted to each one.
The eye is equipped with a lens called “crystalline” which allows, like a camera lens, to focus images on the retina. We talk about cataracts when the lens becomes cloudy or opaque, which impairs near and far vision. In most cases, it is the aging of the eye that causes this clouding. However, other risk factors can lead to the development of cataracts:
- iabetes and other metabolic diseases;
- eye injury;
- certain drugs;
- ultraviolet rays.
The standard treatment for cataracts is surgery, which involves removing the nucleus of the clouded lens and replacing it with an artificial lens, the intraocular implant. Cataract surgery is routinely offered to patients when vision loss interferes with daily life, regardless of the severity of the clouding. Cataract surgery is performed under local anesthesia, which makes it possible even in very old people. Both eyes are never operated on at the same time.
Astigmatism manifests as blurry or distorted vision at all distances due to an abnormality in the curvature of the cornea or lens. It can occur in families where both parents suffer from refractive errors such as nearsightedness and / or hyperopia. Treatment involves wearing glasses or soft contact lenses. A cornea transplant is recommended when the astigmatism is too severe. We can also use the laser to give a more rounded shape to the cornea.
Cataracts are treated surgically. Patients notice the difference soon after the operation because light can pass through the lens again.
The retina is the membrane covering the back of the eye and it is this which captures the images to be transmitted to the brain. Diabetes can cause certain problems in this part of the eye, and cause a condition called diabetic retinopathy. In an affected person, abnormal blood vessels form and can leak fluid and fat, causing the retina to “swell”. It can also happen that small vessels invade the retina and grow like the roots of a tree. If they break, they can cause bleeding.
Hemianopsia is decrease or loss of vision in half of the visual field in one or both eyes.
Depending on the case, it can be considered unilateral or bilateral, lateral or altitudinal, homonymous or heteronymous. This vision disorder is caused by nerve damage to the optic nerve.
Retinitis pigmentosa (RP) is a degenerative genetic disease of the eye which is characterized by a gradual and gradual loss of vision, usually progressing to blindness. RP is also called rod-cone dystrophy or retinitis pigmentosa,
Age-Related Macular Degeneration (AMD)
The central part of the retina is called the macula. It is this which makes it possible to read, write, thread a needle, and perform all other precision work. When the macula is degenerated, central vision (precision vision) decreases and may even disappear. Peripheral vision is not affected, so the disease does not usually lead to total blindness and sufferers can move around on their own, but they will have to stop driving.
AMD mostly affects older people. In North America, this disease is the leading cause of loss of precision vision in people over 75 years of age.
Research on AMD has advanced tremendously over the past 5 years. It is known that cigarettes combined with certain hereditary factors increase the risk of developing the disease by 8 to 10 times.
The rounded shape of the eye is maintained by a slight pressure of the fluids secreted inside the eye: this is called intraocular pressure. If the exit of these fluids outside the eye is restricted (for one reason or another), there may be an increase in pressure. Therefore, it can interfere with the functioning of the optic nerve which carries images from the eye to the brain.
Glaucoma is a disease that causes damage to the optic nerve and loss of visual fields (anything the eye can see sideways, down and up, while staring straight ahead). The increased pressure inside the eye is often associated with this disease, but other factors increase the risk of its development:
- a family history of glaucoma;
- diabetes and vascular disease;
- great myopia.
If it is not diagnosed in time, the pressure on the nerve and the retina continues to take its toll. Without treatment, the patient risks permanent and irreversible vision loss in just a few years. The possible treatments are surgery and eye drops.
It is a serious condition of the retina which is separated from the surrounding tissues. It is usually caused by the presence of one or more holes or tears in the retina. A tear in the retina is often caused by the retraction of a transparent substance that fills the eye socket (the vitreous), and the thinning of the retina with age does not help. Retinal detachment most commonly affects people who are extremely short-sighted, those who have had cataract surgery or have suffered an eye injury. It can also be genetic.
Treatment and repair of the retina should be recommended immediately at the risk of permanent vision loss. There are several types of treatments, including surgery, laser therapy, and cryopexy (cold treatment of tears).
Refractive errors (Myopia and hyperopia)
Nearsightedness is blurred vision when looking at distant objects while hyperopia or is blurred vision when looking at objects at a close distance. The latter is two times less frequent. Both conditions are basically hereditary. Nearsightedness and farsightedness are easily treated with corrective glasses, contact lenses, and refractive surgery.
Millions of people suffer from these eye disorders. It is necessary to take care of them as soon as possible to avoid any complications. They are not necessarily detected right away, which is why it is important to have regular eye exams, especially as you get older. To preserve your visual comfort, do not neglect the protection of your eyes from external aggressions, in particular from the sun which can cause a lot of damage without realizing it.
Loss of the pupillary reflex to direct light stimulation and conservation of the pupillary constriction which accompanies the convergence of the eyeballs and the accommodation of the lens. Specifically, Argyll Robertson pupils don’t constrict in response to light but do constrict to focus on a nearby object.
Technically, this is not a disease or disorder, but part of the natural aging process that begins at age 40. Presbyopia is characterized by the loss of the natural ability of the eyes to see objects near the lenses. The older we get, the more it becomes accentuated, because the lenses of the eye lose their flexibility. Presbyopia is not treated, but vision can easily be corrected with bifocals, prescription contact lenses. Wearing sunglasses outside is also recommended.
Strabismus is a misalignment of both eyes.
Normally the two eyes fix the same image, the brain then receives two identical images and models them in only one three-dimensional one. When the two eyes are not aligned, two different images are sent to the brain.
For a young child, the brain ignores the image of the unaligned eye and sees only the image of the other eye, the one that is centered, the one that sees the sharpest. The child then loses visual acuity.
Adults who develop strabismus often have double vision because the brain is able to receive images from each eye but cannot overlay them.
There are several solutions to treat strabismus: first, in children, rehabilitation of amblypia should be performed. In certain specific cases, an operation may be carried out. In children, surgery should not be considered for 4-5 years.
In children, when the optical correction does not completely correct the strabismus, an operation may be offered. Likewise, in adults, in the absence of spontaneous recovery from diplopia, surgery will be recommended.
In all cases, operations to correct strabismus are performed by acting on the oculomotor muscles (this is either to strengthen or weaken them in order to refocus the eyes). These operations are performed under general anesthesia, in an outpatient department. They last between 30 and 45 minutes. They do not leave scars on the skin (the surgeon goes directly through the conjunctiva). The intervention often requires a 7-day work stoppage and an interruption in sports activities for 3 to 4 weeks.
Anti-inflammatory and healing treatment is prescribed postoperatively, usually for a period of one month. The final result is obtained in one to three months. Sometimes a second surgery may be necessary to get the desired result.
There are two types of eye cancer, the frequencies of which are fortunately rare: retinoblastoma and choroidal melanoma.
The first is a malignant tumor of the retina usually appearing before the age of 5, affecting one or both eyes. The origin of the disease is genetic and the incidence is between 1 / 15,000 and 1 / 20,000 births. The two most revealing symptoms are strabismus (crossed eyes) and the appearance of a white reflection on the pupil (in certain directions of gaze, under certain lighting).
Thanks to recent discoveries, laser, cryotherapy (frostbite), chemotherapy and / or radiotherapy can be used to treat this cancer and thus save the eye. However, enucleation (removal of the eye) is still used if the retinoblastoma is particularly advanced.
Choroidal melanoma manifests itself in adults (the average age at diagnosis is 56 years). It is even less common than retinoblastoma: there are around 500 new cases per year in France (around 1 in 100,000). 3 This melanoma mostly develops in light-colored eyes and sun exposure appears to be a risk factor (as with melanoma of the skin). Although it does not seem to be an inherited disease, familial cases can be seen, as well as associations with skin melanoma in the same family. Unlike retinoblastoma, it is very rare for both eyes to be affected. Melanoma often metastasizes to the liver. The treatment methods are the same for both types of cancer.
Amblyopia is the decrease in vision in one eye during a very young age. The vision of each eye is stimulated from birth, every time the newborn opens his eyes.
In children, in a proportion of 4 to 7%, the path which leads the vision from one eye to the brain is not adequately stimulated. The most well-known cause of this disorder is strabismus, which affects around 2% of the population.1 The other most common cause is when one eye sends a clear message to the brain while the other eye is not in use because that it does not convey a good image to the brain. This happens when one eye is much more myopic (too long eye) or hyperopic (too short eye) compared to the other.
Fortunately, amblyopia can be treated. Treatment usually involves stimulating the visual development of the impaired eye by putting an eye patch on the developing one. If treatment is started when the child is young, it is often completely successful.
The retina, which lines the back of the eye, contains nerve cells that receive light. They translate it into electrical signals that travel to the brain via the optic nerve. There are many types of retinal diseases.
When the cells degenerate or no longer function, blind areas of the visual field appear.
Many pathologies can affect this area of the eye: AMD, diabetic retinopathy, retinitis pigmentosa…
A very widespread phenomenon, floaters are small opacities of varying shapes and densities that bathe in the liquid inside the eye (a bit like the dregs in a bottle of wine). From certain angles, the shadow cast by the floaters is superimposed on the viewed objects, giving the impression of seeing “dots”, “threads”, or even spiders.
If there are few of them, myodesopsies are harmless. On the other hand, if their number increases and is accompanied by flashes of light, an examination of the fundus of the eye must be very quickly carried out by an ophthalmologist to detect other much more serious problems.
Scleritis is a severe and sometimes necrotizing inflammation that threatens vision involving the deep episclera and the sclera. Symptoms are moderate to severe pain, redness of the eye, tearing and photophobia.
Diseases of the sclera are primarily inflammations, which are seldom caused by local infection, but by systemic autoimmune diseases (e.g. rheumatism ) or gout, and more rarely by infectious diseases (syphilis, borreliosis, herpes zoster). This is especially true for deep scleritis (as opposed to episcleritis).
In jaundice (icterus), scleric terus (yellowing of the sclera) occurs first when the total bilirubin in the serum rises> 2 mg / dl (or> 34 µmol / l), then the skin and mucous membrane also turn yellow. In addition, injuries to the sclera play an important role in ophthalmology.
Scleritis is a severe and sometimes necrotizing inflammation that threatens vision.
Symptoms include deep pain; photophobia and lacrimation; and focal or diffuse redness of the eye.
Diagnosis is clinical and by slit lamp examination.
Most patients require systemic corticosteroids and / or systemic immunosuppressants, prescribed in consultation by a rheumatologist.
A scleral graft may be indicated if there is a risk of perforation.
Nonsteroidal anti-inflammatory drugs are sufficient in mild cases of scleritis. However, usually systemic corticosteroid therapy (eg, prednisone 1 to 2 mg / kg orally once / day for 7 days, then tapered off and stopped on day 10) is the initial treatment. If the inflammation recurs, a prolonged oral corticosteroid regimen, also starting with prednisone 1 to 2 mg / kg orally once / day or an intravenous bolus corticosteroid, such as methylprednisolone 1000 mg / day day IV for 3 days, may be considered. In case of insufficient response or intolerance to systemic corticosteroid therapy or if the patient has necrotizing scleritis and connective tissue disease, systemic immunosuppressive therapy with cyclophosphamide or methotrexate or mycophenolate mofetil or biological agents (e.g. ., rituximab, adalimumab) is indicated, but only after advice from a rheumatologist. A scleral graft may be indicated if there is a risk of perforation.
Eye infections: conjunctivitis, stye and others…
Eye infections are common, but usually mild, and there are medications available to treat them.
Conjunctivitis (Pink Eye)
It is an infection usually caused by a virus or bacteria, but conjunctivitis can also be the result of an allergy. It is characterized by infection of the conjunctiva, a transparent membrane covering the inside of the eyelids as well as part of the eyeball.
Conjunctivitis can be recognized by the redness of the eye, the itching sensation as well as the thicker secretions that can make it difficult to open the eye when you wake up.
Usually, conjunctivitis goes away within a few days and is not serious. However, the virus or bacteria involved can also infect the other eye. It is therefore very important to use different eye drop bottles for each eye, to wash your hands often and not to rub the infected eye, as this could contaminate those around you.
Keratitis is an infection that can be caused by a virus, bacteria or even a fungus (in the latter case, the disease is often favored by wearing contact lenses). It is manifested by erosions or ulcerations of the cornea, which affects the eyesight and makes it cloudy. The eye becomes red, painful and sensitive to light, as with conjunctivitis. However, keratitis takes longer to heal, and it is best to see an eye doctor for this infection. He will prescribe products to accelerate healing and at the same time prevent the opacification of the cornea. Otherwise, vision could be permanently impaired.
This infection develops in the follicle of an eyelash and manifests as a small red swollen ball. Treatment consists of the application of an antibiotic ointment and warm moist compresses, which promote the ripening of the stye. Once the stye has burst, healing usually takes place on its own.
Red eyes usually are caused by allergy, eye fatigue, over-wearing contact lenses or common eye infections such as pink eye (conjunctivitis).
Redness of the eye is most often due to dilation or rupture of the small blood vessels that supply the eye. They can be caused by a multitude of factors and conditions, ranging from simple irritation to more serious eye diseases, which constitute emergencies.
The chalazion (Eyelid Cyst)
The eyes contain glands called “meibomian glands” which produce the oily part of tears. Chalazion is a usually painless cyst caused by blockage of these glands. It is treated with eye drops or antibiotic and / or anti-inflammatory ointments, or it may be removed surgically.
On the eyelids, the sebaceous glands produce a lubricating material called sebum. When it is increased in production, bacteria normally present on the skin can cause an infection such as blepharitis, which is manifested by redness of the mobile eyelid. It is accompanied by the formation of crusts, especially in the morning. Usually it does not cause vision loss, but causes a lot of discomfort to the eye.
Have a complete eye exam and don’t wait until you have a problem with one of the eye diseases.
Information: Cleverly Smart is not a substitute for a doctor. Always consult a doctor to treat your health condition.