The main diseases of the eye

- After standing in front of the computer long time, I have a feeling of irritation and sand in the eye.
- I feel my eyes tired and irritated. It is getting worse when I try to read or watch television.

• Symptoms.Many people suffer from dry eye syndrome. This problem is more common for older people, but young people may have dry eye too. Discomfort is often associated with certain activities, like standing in front of the computer screen or reading. Most people feel not only dry eye discomfort, but also fatigue, irritation or pain. The cause is the absence of the tear film (which in ordinary terms we call tears or tear liquid), which makes it impossible to keep humidity in the eyeball. This causes some minor injuries, irritation and foreign body sensation.
• Treatment. There is no cure for dry eye, but there are great chances of improvement.

Blepharitis is a chronic inflammation that affects the eyelids and eyelashes and it is one of the most common problems doctors see in their office. A frequent problem in both children and adults, blepharitis often causes redness and swelling, as well as itching and irritation of the eyelids. Among the most common causes of blepharitis are poor eyelid hygiene; excessive oil produced by the glands in the eyelid; bacterial infections; and allergic reactions.

A Chalazion is a small firm bulge in the eyelid, caused by a blocked opening or infection of the oil producing glands, located in the upper or lower eyelids. They are frequently associated with a condition called Blepharitis. Chalazia may be uncomfortable, unsightly or interfere with vision. They are initially red, swollen, and tender. In rare cases, the Chalazion may grow large enough to apply pressure on the eye, causing droopiness of the eyelid, and blurred vision.

What is keratoconus? Keratoconus is the medical term for cone-shaped cornea. Keratoconus is a condition that generally shows no symptoms until the last years of adolescence. It is a congenital “programming error” of corneal growth, resulting in a refractive defect that, as it advances, becomes increasingly difficult to correct. The cornea is normally gibbous and has a smooth surface on the front side, allowing the light to enter the lens evenly and reaching the retina. In the case of keratoconus, cornea’s structure is weakened, and gradually it is getting thinner and reaches the cone shape. Such cases are partly inherited and this disease is more common in boys.

• Symptoms. Keratoconus affects the sight gradually and its evolution stops at 40. After that, changes are generally mild and slow. In time, the sight is blurred and lesions appear, and in rare cases, an increased inflammation of cornea may cause transient pain. This inflammation, oftenly sudden, is called dropsical attack and the treatment consists in applying a lubricant and an antibacterial ointment. This disease may be perceived as serious, but it never leads to corneal perforation.
• Treatment. Initially, impaired vision can be corrected with glasses, and if the cornea changes shape too much, contact lenses are a good alternative. In advanced stages of the disease, when vision can no longer be corrected this way, corneal transplant may be used. In this case, the central part of the cornea is replaced.

Conjunctivitis is a mucous membrane similar to other mucous membranes of the human body, for example, nose and throat. The most common form of allergic symptoms of the conjuctivitis is due to hypersensitivity to substances like pollen or hay, and allergies to animals with fur or similar cases. Hypersensitivity reactions can occur to people without known previous allergies, too.

• Symptoms. Allergic reactions to conjuctivitis are usually very unpleasant, but completely harmless to eyes and sight. They may manifest as itching, redness and inflammation. Sometimes there is an abundant flowing secretion leaving sticky marks. It is usually accompanied by sensitivity to light. During these so-called toxic reactions, along with the triggering of a strong reaction to an irritating factor in the environment, a strong inflammation often develops.

Conjuctive’s role is to secrete substances to lubricate the tear film. It also has a defense function against infections, like respiratory mucous membranes. For example, during a cold, the conjuctive inflames and turns red, causing a sticky secretion just like the mucous membranes of the nose and throat. Conjunctivitis is commonly associated with cold symptoms, but it can also occur independently of the respiratory symptoms.

• Symptoms. Conjuctivitis can cause pain, burning, itching and sometimes light sensitivity. Eyes are getting red and a sticky secretion oftenly occurs, especially in the morning.
• Treatment. The most frequent cause of conjunctivitis is the viral infection. In general, the symptoms disappear in a few days without treatment, just by washing the eyes with warm water. In persistent cases, infection may have a bacterial nature, where antibiotics drops are necessary. In cases of recurrence of the disease, the presence of bacteria at the edge of the eyelid is suspected. This situation can be prevented by washing and regular cleaning of the eyelids (light massage or clearing) with a clean tissue and warm water. In many cases it is difficult to determine whether that person suffers from some form of allergy with manifestation at the conjuctive level. If there are no other allergic symptoms, determining any other triggering factors is almost impossible. If one of the main symptoms is itching and the appearance of conjuctivitis suggests hypersensitivity, eye drops against allergic symptoms may be recommended.

Macula lutea is located exactly in the center of the retina, the only place where the vision is very clear. When examining the retina, this area appears yellow. The functions of the photosensitive cells, which are concentrated in this area, may be affected by various diseases. The most common diseases are caused by aging. Causal relationships are unclear, but poor blood circulation and metabolic problems seem to have an important role. Only in exceptional cases, disease progression may be affected by changing lifestyles. Macular degeneration due to the age is the most common cause of vision problems in adults in the Western world.

• How do we recognize changes in the macular degeneration due to age?In most cases, the image of the object is splitted, with pieces missing; the object may appear as seen through fog or it is not visible. Problems are most easily observed when reading or conducting activities in small distance. The area around the observed object, called peripheral, is perceived more clearly. The changes of macula lutea do not cause blindness. But it will gradually decrease the ability to read, although this is not a quick process. In cases where the orientation vision decreases, this is probably due to other conditions, an evaluation by an ophthalmologist being required.
• How do we treat changes in age related macular degeneration? Unfortunately, there is no treatment to relieve symptoms. If the perceptions of objects composed of straight lines (the door, the frame of a picture, etc.) appear sudden broken lines, it could be a sign that a new inflammation occurred near the macula lutea. This requires examination by an ophthalmologist. In exceptional cases, inflammation can be reduced with laser treatment. This may be a way to slow vision loss.
  Photodynamic therapy. In some types of changes due to age, one can successfully use the so-called photodynamic therapy. This method is new, but available in known eye clinics.
  Medical Optics.In cases of gradual decrease of vision in both eyes, it is recommended to use optical medical devices and counseling is also offered.

As we age, the vitreous body, formed by a liquid with gel consistency, tends to shrink and may eventually separate from the inside surface of the eye. This may cause small bleeding which appear like red spots. The shrinking process occurs naturally as a consequence of aging, but it especially manifests in people with myopia and those who have had cataract surgery or inflammation inside the eye. Within the vitreous body, small clots or fibers may be formed in the same way.

• Symptoms. Affected persons see dots, lines, circles or spots that “float” in front of their eyes. What one sees are the projected shadows of the affected cells or tissue on the retina. They can be seen more easily when we look to a uniform surface, like the sky or the wall.
• Treatment. Posterior segment detachment of the vitreous body is not a disease in itself and it cannot be treated, but if there are new sudden “spots”, it could be a sign of a more serious problem. The vitreous body that shrinks and detaches from the posterior wall of the eyeball can damage the retina and may lead to its separation. If you start seeing more “spots”, “lightning”, you suffer from partial loss of vision or reduced vision, and you should go to your doctor as soon as possible. If you see such “spots” when you read or you move your eyes, try to look up and then down to make clots to travel. In general, the symptoms disappear on their own in time.

A retinal detachment occurs when the retina’s layers separate. Any portion of the retina that is detached cannot send visual signals to the brain. If left untreated, retinal detachment can cause devastating damage to an individual’s vision. Retinal detachment is considered an ocular emergency that requires immediate medical attention.

Small specks or clouds moving in your field of vision are called floaters. Most floaters are not dangerous and are caused by tiny pieces of tissue inside of the eye. When light hits these pieces of tissue it creates shadows on the retina, that appear to float across your field of vision. It may appear that these specks are on the front surface of your eye, but they are actually inside. In most cases floaters are no cause for alarm and no treatment is necessary, however a sudden increase in new floaters may indicate a problem and an eye examination is recommended if this occurs.

A subconjunctival hemorrhage occurs when a small blood vessel under the conjunctiva breaks and bleeds. It may occur spontaneously or from coughing, heavy lifting, or vomiting. In some cases, it may develop following eye surgery or trauma. A subconjunctival hemorrhage tends to be more common among those with diabetes and hypertension.

Herpes simplex virus is the cause of herpes labialis, sometimes causing the appearance of small skin ulcers. In almost 90% of adults, this virus is spread via some nerves. The mechanism of infection is unknown, but it probably occurs in association with a cold or other minor infection. In most people, the virus is latent and does not cause any symptoms. It is unclear why the remaining 10% of carriers show symptoms. Factors that seem to trigger the activation of herpes virus could be extreme temperatures, intense sun exposure, physical and emotional stress, general health problems and the existence of injuries.

• Symptoms. Herpetic virus can cause damage to the cornea. A typical lesion is the formation of “branches”, easily noticeable by the ophtalmologist when applying coloured eye drops. Cornea is very sensitive to pain and any lesion produces a severe pain. In addition, it enhances lacrimation, light sensitivity and sometimes blurred vision and swollen eyelids are noted. Infection is not highly contagious, but strict hand hygiene is recommended.
• Treatment. The treatment consists in applying antiviral eye ointments. If inflammation progresses to the pupil, eye drops are sometimes indicated for pupil dilation. The acute phase may worsen the problem if incorrectly cortisone-based drops are used. If sensitivity to light persists, wearing an eye bandage is required. Acute infection can heal in 1-4 weeks, but treatment can sometimes take longer. The deeper the infection progresses into the cornea, the greater the risk of a permanent lesion. A lesion located in the center of the cornea can affect vision. People who have had a herpes infection in the cornea have a 25% risk of another infection in the next two years. It is very important that treatment be initiated as soon as possible, to reduce the risk of permanent injury.

Cornea, the anterior portion of the eyeball, should act normally as a clean glass with refractive properties of light, having a right protruding shape. Cornea is one of the most sensitive organs of the body to pain.

• Symptoms. The viral infection of cornea, often simultaneous to a cold, results in emerging of small scattered gray dots and injuries to the cornea surface. This leads to a somewhat blurred vision, pain, light sensitivity and tearing. Infection can spread to other people via unwashed hands. Therefore, it is recommended strict compliance of hand hygiene.
• Treatment. There is no effective treatment against this viral infection. In some cases, one can use an ointment with lubricating properties (eventually with an antibacterial ingredient to prevent secondary bacterial infections), to relieve the symptoms. In general, the infection heals itself. Vision may be permanently affected, but very rarely. However, there are cases when healing occurs very slowly, and an excessive inflammatory response of the immune system it is suspected. Corneal healing can be accelerated by using eye drops based on cortisone. The disadvantage of this treatment is that it should be sustained over a longer period of time, sometimes even months. Sometimes the temporary problems due to contact lenses make it difficult to distinguish viral infections. In general, you can apply the same treatment for viral infections, accompanied of course by stopping wearing contact lenses. In exceptional cases, a herpes infection (herpes simplex virus type 1) may be confused with nonspecific viral infection of the cornea. If you suspect the presence of the herpes virus, it is recommended to use a specific antiherpetic eye ointment. See also corneal infection with herpes simplex virus. Nu există un tratament eficace împotriva infecţiei virale ca atare. În unele cazuri, se poate utiliza un unguent cu proprietăţi lubrifiante (eventual cu un ingredient antibacterian, pentru a preveni infecţiile bacteriene secundare), pentru ameliorarea simptomelor. În general, infecţia se vindecă de la sine. Vederea poate fi afectată permanent, însă în cazuri foarte rare. Cu toate acestea, există cazuri în care vindecarea se produce foarte încet, iar atunci se suspectează existenţa unui răspuns antiinflamator excesiv al sistemului imunitar al organismului. Vindecarea corneei se poate accelera prin utilizarea picăturilor oculare pe bază de cortizon. Dezavantajul acestui tratament este că trebuie susţinut pe o perioadă lungă de timp, uneori de ordinul lunilor de zile. Uneori, problemele temporare datorate lentilelor de contact sunt greu de diferenţiat de infecţiile virale. În general, se poate aplica acelaşi tratament ca şi pentru infecţiile virale, însoţit desigur de întreruperea purtării lentilelor de contact. În cazuri excepţionale, o infecţie cu virusul herpetic (virusul herpes simplex de tip 1) se poate confunda cu infecţia virală nespecifică a corneei. Dacă se suspectează prezenţa virusului herpetic, se recomandă utilizarea unui unguent ocular antiherpetic specific. Vezi şi Infecţia corneei cu virusul herpes simplex.

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