Tag Archives: Keratoconjunctivitis sicca

Eatching & tearing of Eyes (Epiphora)

Definition:

Watery eyes (epiphora) tear persistently or excessively.

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Depending on the cause, watery eyes may clear up on their own. Self-care measures at home can help treat watery eyes, particularly if caused by inflammation or dry eyes.

Causes:
Watery eyes can be due to many factors and conditions.

In infants, persistent watery eyes, often with some matter, are commonly the result of blocked tear ducts. The tear ducts don’t produce tears, but rather carry away tears, similar to how a storm drain carries away rainwater. Tears normally drain into your nose through tiny openings (puncta) in the inner part of the lids near the nose. In babies, the tear duct may not be fully open and functioning for the first several months of life.

In older adults, persistent watery eyes may occur as the aging skin of the eyelids sags away from the eyeball, allowing tears to accumulate and flow out.

Sometimes, excess tear production may cause watery eyes as well.

Allergies or viral infections (conjunctivitis), as well as any kind of inflammation, may cause watery eyes for a few days or so.

There may be some more other cause like due to different medication & other  diseases.

Do your eyes itch after you’ve been near a cat? Do they puff up or run with tears when pollen is in the air? Allergies of the eye affect about 20% of Americans each year, and are on the rise. The same inhaled airborne allergens — pollens, animal dander, dust mite feces, and mold — that trigger allergic rhinitis (the familiar sneezing, runny nose, and congestion) can lead to allergic conjunctivitis (inflammation of the conjunctiva, the lining of the eye). It’s not surprising that people with allergic rhinitis often suffer from allergic conjunctivitis as well.

About 50% of allergic conjunctivitis sufferers, who tend to be young adults, have other allergic diseases or a family history of allergies. About 80% of eye allergies are seasonal; the rest are perennial (year-round). The symptoms are itchy and red eyes, tearing, edema (swelling) of the conjunctiva or eyelid, and a mucous discharge. Although it can be uncomfortable, you can rest assured that it is not a threat to your vision.

Diagnosing allergic conjunctivitis:

Allergic conjunctivitis usually can be confirmed by your doctor based on your symptoms. Testing is not usually needed to diagnose the condition, but skin testing (the same kind that’s done for other allergic reactions) may help identify the allergens causing your symptoms.

If your symptoms don’t quickly respond to treatment, see your doctor in case you have a different condition. Dry eye, in particular, can mimic the symptoms of allergic conjunctivitis.

Treating allergic conjunctivitis:-

Avoidance is your first line of defense. If you are allergic to cats, for example, avoid them (or at least don’t touch your eyes when near one), and wash your hands immediately after touching one. If pollen is your nemesis, keep your windows closed and an air purifier or air conditioner going in pollen season. Also, don’t rub your eyes, because rubbing causes cells in the conjunctiva to release histamine and other inflammatory chemicals, which worsens symptoms. Use artificial tears (available without prescription) frequently for relief and to dilute allergens in the eye.

If your only allergy problem is allergic conjunctivitis, then medicated eye drops would be your first step. You can start with an over-the-counter product, such as ketotifen eye drops (Zaditor, Alaway). The active ingredient is an antihistamine and a mast cell stabilizer, both of which can control the immune system overreaction that leads to your symptoms. Prescription-strength products that have similar actions are also available.

Allergic conjunctivitis can also be treated with over-the-counter oral antihistamines such as loratadine (Claritin), cetirizine (Zyrtec), and fexofenadine (Allegra), or the prescription antihistamines desloratadine (Clarinex) and levocetirizine (Xyzal). These are especially useful for people that have other allergy symptoms in addition to conjunctivitis.

For allergic conjunctivitis that is very severe and doesn’t improve with other medications, there are prescription eye drops that contain corticosteroids, such as loteprednol etabonate (Alrex, Lotemax) and fluorometholone (Fluor-Op, FML Forte). However, these eye medications should only be used under the guidance of an ophthalmologist.

General  precautions  & Alternative treatment of eatching & tearing eyes:

*Remember to keep their eyes free from dust and other particles that cause a blocking of the tear ducts.

*Wash the face and eyes frequently as this will also help to keep you refreshed. Washing your eyes frequently also removes the impurities from around the area of the tear ducts, keeping them free from blockages.

*You could also keep your eyes moist with the use of some mild eye drops. This will help in reducing the itchiness and the dryness that you experience.

*If you are going outdoors, make sure to wear some protective eye wear that help to keep impurities out of the eyes, thereby avoiding any irritability of the sense organs.

*Rose water is an excellent remedy to soothe dryness or burning sensations that are experienced in the eyes. Washing out the eyes in a capful of rose water will provide instantaneous relief.

*There are occasions where the optical nerve of the eyes and the muscles around the eyes have been strained, leading to dryness and itching, followed by a continuous flow of secretions. In order to relax the eyes and the relevant muscles, place slices of cucumber over the eyelids while you rest your eyes. The cooling effect of the cucumber slices will provide a great deal of relief to your tired eyes.

*On certain occasions, a warm compress, made by dipping a piece of towel into warm water and pressing it gently over the eyes will provide relief from symptoms of itching and continuous flow of tears.

Disclaimer: This information is not meant to be a substitute for professional medical advise or help. It is always best to consult with a Physician about serious health concerns. This information is in no way intended to diagnose or prescribe remedies.This is purely for educational purpose.
Resources:
Harvard Medical School healthbeat@mail.health.harvard.edu via nf163.n-email.net
http://www.home-remedies-for-you.com/askquestion/83237/causes-of-itchy-eyes-what-could-be-the-root-of-itc.html
http://www.mayoclinic.org/symptoms/watery-eyes/basics/causes/SYM-20050821

The Amazing Nutrient that Lowers Your Blood Pressure

Research has recently found that vitamin D has a protective effect against arterial stiffness and impaired blood vessel relaxation.

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Study participants with reduced levels of vitamin D had increased arterial stiffness and vascular function impairment. However, among those whose vitamin D levels were normalized over a six month period, vascular health improved and blood pressure measurements declined.

Science Newsline Reports:

“The results add to evidence that lack of vitamin D can lead to impaired vascular health, contributing to high blood pressure and the risk of cardiovascular disease.”

In related news, researchers have also found that high level of vitamin D could be protective against the development of early age-related macular degeneration (AMD), a leading cause of vision loss in adults.

In women younger than 75, those who had 25-hydroxyvitamin D concentrations lower than 38 nanomoles per liter were more likely to have age-related macular degeneration than women with concentrations greater than 38 nanomoles per liter.

Resources:
*Science Newsline April 4, 2011
*Archives of Ophthalmology April 2011; 129(4): 481-489
*MSNBC April 27, 2011
*Science Daily March 21, 2011
*Journal of General Internal Medicine April 21, 2011 [Epub ahead of print]
*Diabetes Care May 2011;34(5):1133-8
*Journal of General Internal Medicine March 15, 2011 [Epub ahead of print]

Posted By Dr. Mercola | April 30 2011

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Blepharospasm

Definition:
Benign essential blepharospasm (BEB) is a progressive neurological disorder characterized by involuntary muscle contractions and spasms of the eyelid muscles. It is a form of dystonia, a movement disorder in which muscle contractions cause sustained eyelid closure, twitching or repetitive movements. BEB begins gradually with increased frequency of eye blinking often associated with eye irritation.

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Benign means the condition is not life threatening. Essential indicates that the cause is unknown, but fatigue, stress, or an irritant are possible contributing factors. Symptoms sometimes last for a few days then disappear without treatment, but in most cases the twitching is chronic and persistent, causing lifelong challenges. The symptoms are often severe enough to result in functional blindness. The person’s eyelids feel like they are clamping shut and will not open without great effort. Patients have normal eyes, but for periods of time are effectively blind due to their inability to open their eyelids.

Although strides have recently been made in early diagnosis, blepharospasm is often initially mis-diagnosed as allergies or “dry eye syndrome“. It is a fairly rare disease, affecting only one in every 20,000 people in the United States.


Symptoms:

*Excessive blinking and spasming of the eyes, usually characterized by uncontrollable eyelid closure of durations longer than the typical blink reflex, sometimes lasting minutes or even hours.
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*Uncontrollable contractions or twitches of the eye muscles and surrounding facial area. Some sufferers have twitching symptoms that radiate into the nose, face and sometimes, the neck area.

*Dryness of the eyes

*Sensitivity to the sun and bright light

click to see the picture
Causes:

Some causes of blepharospasm have been identified; however, the causes of many cases of blepharospasm remain unknown, although some educated guesses are being made. Some blepharospasm patients have a history of dry eyes and/or light sensitivity, but others report no previous eye problems before onset of initial symptoms.

Some drugs can induce blepharospasm, such as those used to treat Parkinson’s disease, as well as sensitivity to hormone treatments, including estrogen-replacement therapy for women going through menopause. Blepharospasm can also be a symptom of acute withdrawal from benzodiazepine dependence. In addition to blepharospasm being a benzodiazepine withdrawal symptom, prolonged use of benzodiazepines can induce blepharospasm and is a known risk factor for the development of blepharospasm.

Blepharospasm may also come from abnormal functioning of the brain basal ganglia. Simultaneous dry eye and dystonias such as Meige’s syndrome have been observed. Blepharospasms can be caused by concussions in some rare cases, when a blow to the back of the head damages the basal ganglia.

Blepharospasm often occurs out of the blue for no specific reason. Rarely, it can run in families.

Diagnosis:
The diagnosis of blepharospasm depends on recognition of its characteristic features by an expert, such as a neurologist or ophthalmologist. There are no medical tests for proving the diagnosis, but some tests may be conducted to rule out other possible problems. These may include tests for allergies or dry eyes or scans of the brain.


Treatment:

*Drug therapy: Drug therapy for blepharospasm has proved generally unpredictable and short-termed. Finding an effective regimen for any patient usually requires trial and error over time. In some cases a dietary supplement of magnesium chloride has been found effective.

*Botulinum toxin injections (Botox is a widely known example) have been used to induce localized, partial paralysis. Among most sufferers, botolinum toxin injection is the preferred treatment method.[3] Injections are generally administered every three months, with variations based on patient response and usually give almost immediate relief (though for some it may take more than a week) of symptoms from the muscle spasms. Most patients can resume a relatively normal life with regular Botulinum toxin treatments. A minority of sufferers develop minimal or no result from Botox injections and have to find other treatments. For some, Botulinum toxin diminishes in its effectiveness after many years of use. An observed side effect in a minority of patients is ptosis or eyelid droop. Attempts to inject in locations that minimize ptosis can result in diminished ability to control spasms.

*Surgery: Patients that do not respond well to medication or botulinum toxin injection are candidates for surgical therapy. The most effective surgical treatment has been protractor myectomy, the removal of muscles responsible for eyelid closure.

*Dark glasses are often worn because of sunlight sensitivity, as well as to hide the eyes from others.

*Stress management and support groups can help sufferers deal with the disease and prevent social isolation.

Prognosis:

With botulinum toxin treatment most individuals with BEB have substantial relief of symptoms. Although some may experience side effects such as drooping eyelids, blurred or double vision, and eye dryness, these side effects are usually only temporary.

Researches:
The NINDS supports a broad program of research on disorders of the nervous system, including BEB. Much of this research is aimed at increasing understanding of these disorders and finding ways to prevent, treat, and cure them.

Disclaimer: This information is not meant to be a substitute for professional medical advise or help. It is always best to consult with a Physician about serious health concerns. This information is in no way intended to diagnose or prescribe remedies.This is purely for educational purpose.

Resources:
http://en.wikipedia.org/wiki/Blepharospasm
http://www.ninds.nih.gov/disorders/blepharospasm/blepharospasm.htm
http://www.bbc.co.uk/health/physical_health/conditions/blepharospasm1.shtml
http://www.nature.com/eye/journal/v18/n3/fig_tab/6700624f1.html
http://microbewiki.kenyon.edu/index.php/File:Botwoman.jpg
http://rarediseasesnetwork.epi.usf.edu/dystonia/patients/learnmore/craniofacial/

http://www.graphicshunt.com/health/images/blepharospasm-608.htm

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Lagophthalmos

Synonym(s): Hare’s eye

[G. lagos, hare + ophthalmos, eye]

Definition:
Lagophthalmos is defined as the inability to close the eyelids completely. A condition in which a complete closure of the eyelids over the eyeball is difficult or impossible.

Blinking covers the eye with a thin layer of tear fluid, thereby promoting a moist environment necessary for the cells of the exterior part of the eye. The tears also flush out foreign bodies and wash them away. This is crucial to maintain lubrication and proper eye health. If this process is impaired, as in lagophthalmos, the eye can suffer abrasions and infections. Lagopthalmos leads to corneal drying and ulceration.

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Nocturnal lagophthalmos is the inability to close the eyelids during sleep. Lagophthalmos is associated with exposure keratopathy, poor sleep, and persistent exposure-related symptoms.

Detection:There are a variety of causes of lagophthalmos, grouped as proptosis/eye exposure etiologies and palpebral insufficiency etiologies. Although obvious lagophthalmos is usually detected, it is sometimes difficult to recognize obscure lagophthalmos, due either to eyelash obstruction or overhang of the upper lid anterior and inferior to the most superior portion of the lower lid in a closed position. A novel classification system and illustrations of obvious and obscure lagophthalmos for detection.

Causes:
The inability to provide function to the eyelid is typically secondary to a previous or ongoing condition, surgery, or event. This paralysis is usually isolated to just one side of the face. Lagophthalmos and facial paralysis are typically diagnosed due to:

*Bell’s Palsy
*Trauma
*Neurosurgery
*Bacterial infection
*Cerebral vascular accidents (strokes)

Pathophysiology
Lagophtalmos can arise from a malfunction of the Facial nerve. Lagopthalmos can also occur in comatose patients having a decrease in orbicularis tone, in patients having palsy of the facial nerve (7th cranial nerve), and in people with severe skin disorders such as ichthyosis.

Risk Factors:
Your eyelids play a crucial role in protecting and providing nourishment to your eyes. When blinking or eyelid closure function is lost, the health of your eyes can be at risk. Many experts have noted several complications associated with lagophthalmos:

*Severe dry eye and discomfort
*Corneal ulceration (damage to the cornea-the clear tissue covering the front of your eye)
*Decrease or loss of vision
*Unsatisfactory appearance

Diagnosis:

A diagnosis can usually be made with a focused history and slit lamp examination. Treatment is multipronged and may include minor procedures or ocular surgery to correct the lid malposition; natural, topical or oral agents; and punctal plugs to manage ocular surface effects. Correct and timely diagnosis allows greater opportunity for relief of patient suffering and prevention of severe ocular surface pathology, as well as educated planning for future ocular surgical procedures.

Treatment:
Today, lagopthalmos is most likely to arise after an inexperienced or unwise cosmetic/plastic surgeon performs an overenthusiastic upper blepharoplasty, which is an operation performed to remove excessive skin overlying the upper eyelid (suprapalpebral hooding) that often occurs with aging. This can appreciably improve the patient’s appearance, and make the patient look younger. If, however, excessive skin is removed, the appearance is unnatural and “lagopthalmos” is one of the signs of such excessive skin removal.

It all begins with your diagnosis of your condition by your ophthalmologist. Typically, if your paralysis is expected to last less than six months, your doctor will recommend the use of drops and ointments throughout the day to help maintain a well-nourished eye.

If your paralysis is deemed permanent or persists without improvement, your surgeon may want to perform surgery to control the paralysis and provide a more natural function to your eyelid. The most common surgical procedure involves the placement of a small, pure-gold eyelid weight into your eyelid. This procedure very simple and is typically performed under local anesthesia in an outpatient setting.

How Does The Gold Eyelid Weight Work?

It’s very simple. The appropriate implant ‘weight’ will be selected your physician. When implanted into your lid margin, the weight will essentially allow earth’s gravity to gently pull your eye closed when your muscles relax. However, this will not affect your ability to open your eye…. when you tense the muscle, your eyelid will open normally.

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Is Gold A Safe Material?
Each weight is made from 99.99% gold (pure gold). Pure gold is an excellent material because it is biologically stable and inert. Because the gold will never break down, your surgeon can always remove it if deemed necessary. Gold has been used for decades for the treatment of lagophthalmos and is recognized by experts as an extremely safe and effective device material. If you have a known sensitivity or allergy to gold, notify your physician before surgery.

What Happens During Surgery? How Is The Gold Weight Implanted?
Gold eyelid weight surgery is usually performed under local anesthesia in an outpatient setting. Previous to the day of the surgery, your physician will have selected the appropriate gold weight size for your specific needs.

During the procedure, your physician will first make a small incision in your eyelid, just above your eyelashes. This incision will allow your physician to create a small pocket inside your lid for the gold implant to rest. The weight will be secured to your lid with sutures. Each weight contains small channels or grooves to house the sutures below the surface of the implant. The incision is closed with sutures. A protective pad will be applied to cover your eyelid.

What Happens After Surgery? What Should I Expect Regarding The Function And Appearance Of My Eyelid?

As always, your condition and progress will be closely monitored by your physician. Following the removal of your eye protection, you should be able to experience normal blinking and eyelid closure function.

Like any surgery, the incision will take time to heal. If you experience significant discomfort or swelling around the incision, contact your physician immediately.

Any questions or concerns you have about your surgery can best be answered by your surgeon. You can best insure the best outcome for your procedure by carefully following your surgeon’s instructions.

Disclaimer: This information is not meant to be a substitute for professional medical advise or help. It is always best to consult with a Physician about serious health concerns. This information is in no way intended to diagnose or prescribe remedies.This is purely for educational purpose.

Resources:
http://en.wikipedia.org/wiki/Lagophthalmos
http://www.iopinc.com/patient_link/lagophthalmos.asp
http://www.drugs.com/dict/lagophthalmos.html
http://www.ncbi.nlm.nih.gov/pubmed/16671223