Ocular Surface Disorders
1. Dry Eye Syndrome
‘Dry eye' is a condition characterized by an unstable tear film causing irritation and discomfort in the eye. This is because of either decreased quantity of tears or their increased evaporation from the eye. The symptoms are non-specific and can range from a tired or itching eye to diminished vision in severe cases. Normally tears get drained out of eye through small openings in the lids called punctum. These can be blocked with “punctual plugs” to reduce the tear drainage and evaporation and keep the eye moist and well lubricated.
Clinical examination along with specific tests can help diagnose the condition of dry eyes. A detailed examination is done to assess the severity of the problem and other complications. The treatment includes use of preservative-free artificial tears, topical immunosuppresive medication and autologous serum.
Dry eyes can sometimes be a manifestation of an underlying systemic disease like rheumatoid arthritis. Such patients are jointly treated by the ophthalmologist and rheumatologist.
2. Conjunctivitis
The term conjunctivitis refers to a group of diseases that cause redness, swelling, itching or burning of the conjunctiva, the protective membrane lining the eyelids and the sclera (white of the eye). The patient may also have discharge and watering. It is essentially an inflammation of the conjunctiva.
Acute infective conjunctivitis may be due to various microorganisms. The commonest organisms are various bacteria and viruses. Bacterial conjunctivitis usually requires treatment in the form of antibiotic eye-drops. Viral conjunctivitis usually does not require medication and the body’s defence mechanisms will clear the infection. Cold compresses will provide relief.
3. Limbal Stem cell deficiency
Patients suffering from ocular surface problems due to damaged limbal stem cells in the eye may benefit from limbal stem cell transplantation. This procedure helps to provide a stable ocular surface. Limbal cells can be harvested from the fellow eye or may be taken from cadaveric donor eyes.
4. Corneal Dystrophies
Corneal dystrophies are inherited conditions, usually bilateral, in which the cornea loses its normal transparency due to opacity in the cornea.
Dystrophies can cause a decrease in vision as well as symptoms of irritation, watering.
Dystrophies can be of many types. However, some of the traits shared by most dystrophies are:-
- They are usually inherited.
- They usually affect both the eyes .
- They are not caused by outside factors, such as injury or diet.
- Most cases can progress gradually.
- Most cases usually begin in one of the five corneal layers and may later spread to nearby layers.
- Most of them do not affect other parts of the body, nor are they related to diseases affecting other parts of the eye or body.
- They can occur in otherwise totally healthy people, male or female.
Some of the most common corneal dystrophies include Fuchs' dystrophy, keratoconus, lattice dystrophy, map-dot-fingerprint dystrophy and Macular Corneal Dystrophy
5. Pterygium
A pterygium is a triangular-shaped tissue growth over the cornea varying in color from yellowish-white to redish, on the nasal side of the cornea. It may occasionally become red. pterygium usually stop growing after a certain point but may sometimes continue to grow and advance toward the center of the eye.
The exact cause of pterygium is not known. However, it has been observed that people who have spent a significant time outdoors have a higher incidence of pterygium. Ultraviolet (UV) light is, therefore, believed to be a factor responsible for the formation of pterygium. Wearing protective sunglasses and/or hats with brims may reduce the risk of their formation.
It is a benign condition and often causes no harm other than being a cosmetic blemish. Lubricants can reduce the redness and provide relief from the chronic irritation. Surgery can remove the pterygium. However, it should be noted that, pterygium are notorious for recurrences and the recurrences are usually even more aggressive.
