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DISORDERS AND CONDITIONS OF THE EYE Dr.Mohamed Medhat – Pediatric clinical pharmacy specialist Dr.Shaimaa Mahmoud - Pediatric clinical pharmacy specialist 1 Eyes • Anatomy of Eye – Housed in a cone of fatty tissue Eyeball – Three layers – External fibrous layer – Middle vascular layer – Inner sensory layer of nerve tissue. 2 Anatomy of the Eye 3 4 External Fibrous Layer • Sclera الصلبة = البياض حول العين – “white of eye’ • Protective & supportive outer layer • is the white outer coat of the eye that acts as a tough protection from injury, and provides attachment for the extraocular muscles that move the eye • Cornea القرنية – Dense fibrous connective tissue • Must be transparent to allow light • The main purpose of the cornea is to help focus light that is entering the eye 5 • Eyelids الجفون • The eyelids serve to protect the eye from foreign matter, such as dust, dirt, and other debris, as well as bright light that might damage the eye. When you blink, the eyelids also help spread tears over the surface of your eye, keeping the eye moist and comfortable 6 EYE DISORDERS • REFRACTIVE ERRORS • MUSCULAR DISORDERS • DISORDERS OF THE EYELID • DISORDERS OF THE GLOBE OF THE EYE 7 Common eye disorder 1. Dry Eye 2. Viral conjunctivitis 3. Chemical burn – minor eye irritation – loosen foreign body inside eye 8 Dry Eye Dry eyes is a common condition that occurs when your tears aren't able to provide adequate lubrication for your eye • The eye depends on the flow of tears to provide constant moisture and lubrication to maintain vision and comfort. • Tears are a combination of water, for moisture; oils, for lubrication; mucus, for even spreading; and antibodies and special proteins, for resistance to infection. • These components are secreted by special glands located around the eye(Lacrimal gland ). • When there is an imbalance in this tear system, a person may experience dry eyes. 9 Dry Eye pathophysiology Tear secretion is controlled by the lacrimal functional unit consisting of the ocular surface (cornea, conjunctiva, accessory lacrimal glands, Causes of Dry Eye dry eyes can be caused by situations that dry out the tear film This can be due to dry air from air conditioning, heat, or other environmental conditions. Other conditions that may cause dry eyes are: 1.The natural aging process, especially menopause 2.Side effects of certain drugs such as antihistamines and birth control pills 3.Diseases that affect the ability to make tears, such as rheumatoid arthritis, 4.Structural problems with the eyelids that don't allow them to close properly. 11 Tears and tear film • Function : 1.Cleaning 2.Wetting ocular surface 3.Bacteriostasis = retardation of growth of bacteria 4.Supporting the cornea (oxygen supply) 12 Treatment of Dry eye and minor eye irritation • Nonpharmacologic Therapy : • avoiding environments that increase evaporation of the tear film. • 1. avoid dry or dusty places. • 2. avoiding prolonged view of computers screens and wearing eye protection • Pharmacologic Therapy : • alleviate and control the dryness of the ocular surface by using ocular lubricants and others interventions. 1.Artificial tear drops 2. omega-3 via diet or supplement is very helpful to those suffering with dry eye. 13 3. Non medicated ointment contains white petrolatum Artificial tear drops • Lubricants that are formulated as artificial tear solutions consist of preservatives, inorganic electrolyte to achieve tonicity and maintain pH, and water-soluble polymeric systems. 14 If both drop and ointment therapy are indicated, instill the drops at least 10 minutes before the ointment so that the ointment does not become a barrier to the drops' penetrating the tear film or cornea. 1.Tilt your head back. 2.Pull your lower lid away from your eye to form a "pocket" 3.Hold the bottle upside-down with the other hand, and let a drop fall into the "pocket." 4.Don't let the tip of the bottle touch your eye or eyelid. 5.Close your eyes (don't blink) and apply light pressure to the point where your lids meet your nose. Hold for two to three minutes. Allergic Conjunctivitis • Definitions: Allergic conjunctivitis refers to eye inflammation resulting from an allergic reaction to substances like pollen or mold spores. • Sings and symptoms: 1.Red, 2.itchy, watery, 3.Burning eyes. 4.You may also wake up in the morning with puffy eyes 16 Nonpharmacologic Therapy : (1) remove or avoid the allergen, (2) limit or reduce the severity of the allergic reaction, (3) provide symptomatic relief, and (4) protect the ocular Surface. A. applying cold compresses co the eyes three to four times per day will help reduce redness and itching B. Removal or avoidance of the responsible allergen. Pharmacologic Therapy : 1. Ocular antihistamine.. 2.Oculr decongestant 3. Nonsteroidal anti-inflammatory drugs (NSAIDs) LOOSE FOREIGN SUBSTANCES IN THE EYE & Chemical burn • The goal in treating loose foreign substances in the eye is to remove the irritant by irrigating the eye. • If reflex tearing does not remove the foreign substance, the eye may need to be flushed. • Chemical bums may occur from exposure to alkali (e.g., oven cleaners), acids (e.g., battery acid or vinegar), detergents. • Pharmacologic Therapy : Ocular lrrigants: An ocular irrigating is used to clean ocular tissues while maintaining their moisture; these solutions must be physiologically balanced with respect to19 pH and osmolaliry. find out what’s brands in Saudi market Homework