When the body attacks the eye!

We all know that the air we breathe and the soil we walk on are full of micro organisms like bacteria, virus and fungii.  Though we are surrounded by micro organisms we seldom fall sick. This is because our immune system fights off bacterial and viral infections. Immune system  is a complex network of specialized cells and organs that work together to defend the body against attacks by foreign invaders, such as bacteria and viruses. The immune system can be classified as innate immune system & acquired immune system. The innate  immune system  is more primitive and it employs types of white blood cells called granulocytes and monocytes to destroy harmful substances. The acquired immune system is the part of the immune system that develops as a person grows. It employs antibodies and specialized white blood cells to fight harmful substances.

The body forms antibodies to fight bacteria and virus attacks. Each time a new bacteria or virus attacks us  our body forms a specific antibody to counter it. Sometimes these antibodies mistake our body parts for micro organisms and it starts attacking the body by mistake. This is called auto immune disorders.

Autoimmune diseases can occur in the eyes. When the white outer cover of the eye is attacked by our own antibodies we develop a painful condition called scleritis. When the inner coat of the eye called uvea is attacked the condition is called uveitis.

Uveitis usually presents with redness in the eyes and hence can be mistaken for conjunctivitis or madras eye. As opposed to conjunctivitis delayed treatment can cause permanent blindness.  Uveitis is estimated to be responsible for approximately 10% of the blindness in the United States. The main differentiating factor between uveitis and conjunctivitis is pain which is usually always present in uveitis but is absent in conjunctivitis.

Uveitis can be caused by autoimmune disorders such as rheumatoid arthritis or ankylosing spondylitis, infection, or exposure to toxins. However, in many cases the cause is unknown.

Uveitis can be associated with any of the following:

·         AIDS

·         Ankylosing spondylitis

·         Herpes zoster infection

·         Injury

·         Psoriasis

·         Rheumatoid arthritis

·         Sarcoidosis

·         Syphilis

·         Toxoplasmosis

·         Tuberculosis

Symptoms

·         Blurred vision

·         Dark, floating spots in the vision

·         Eye pain

·         Redness of the eye

·         Sensitivity to light

Treatment

·         Dark glasses to lessen photophobia

·         Eye drops that dilate the pupil to relieve pain

·         Steroid eye drops

·         Uveitis treatment depends on the underlying cause but almost always includes steroids taken by mouth. Additional specialists in infectious disease or autoimmunity may be needed for such diseases as syphilis, tuberculosis, AIDS, sarcoidosis, or Behcet syndrome.

·         If the uveitis is caused by a body-wide infection, treatment may involve antibiotics and powerful anti-inflammatory medicines called corticosteroids.

Expectations (prognosis)

With proper treatment, most attacks of anterior uveitis go away in a few days to weeks. However, relapses are common.

Inflammation related to posterior uveitis may last from months to years and may cause permanent vision damage, even with treatment.

Key Words

Antibody – A special protein produced by the body’s immune system that recognizes and helps fight infectious agents and other foreign substances that invade the body.

Antigen – A foreign substance that triggers the production of antibodies when it is introduced into the body.

Autoimmune disease – A disease that results when the immune system mistakenly attacks the body’s own tissues.

Corticosteroids – Potent anti-inflammatory hormones that are made naturally in the body or synthetically (man-made) for use as drugs. They are also called glucocorticoids. The most commonly prescribed drug of this type is prednisone.

Immunosuppressive drugs – Drugs that suppress the immune response and can be used to treat autoimmune disease. Unfortunately, because these drugs also suppress normal immunity, they leave the body at risk for infection.

Inflammation – A reaction of body tissues to injury or disease, typically marked by five signs: swelling, redness, heat, pain, and loss of function.

Eye Safety During Deepavali Fireworks

Each Deepavali, thousands of people are injured from using consumer fireworks. Of the thousands of fireworks-related injuries each year, nearly half are head-related injuries, with nearly 30 percent of these injuries to the eyes. One-fourth of fireworks eye injuries result in permanent vision loss or blindness.

“Too many Deepavali celebrations are ruined because a child has to be rushed to the emergency room after a fireworks accident,” says Prof. Dr. Suseela Prabhakaran.  

Children are the most common victims of firework accidents, with those 15 years old or younger accounting for half of all fireworks eye injuries. For children under the age of five, seemingly innocent sparklers account for one-third of all fireworks injuries. Sparklers can burn at nearly 2,000 degrees Fahrenheit, which is hot enough to cause a third-degree burn.

“Among the most serious injuries are abrupt trauma to the eye from bottle rockets,” according to Prof. Dr. Suseela Prabhakaran. The rockets fly erratically, often injuring bystanders. Injuries from bottle rockets can include eyelid lacerations, corneal abrasions, traumatic cataract, retinal detachment, optic nerve damage, rupture of the eyeball, eye muscle damage and complete blindness.

For a safe and healthy Deepavali celebration, Divya Prabha Eye Hospital urges observance of the following tips:

• Never let children play with fireworks of any type.
• View fireworks from a safe distance: at least 500 feet away for best viewing.
• Respect safety barriers set up to allow pyrotechnicians to do their jobs safely.
• Leave the lighting of fireworks to trained professionals.
• Follow directives given by event ushers or public safety personnel.
• If you find unexploded fireworks remains, do not touch them. Immediately contact your local fire or police departments.
• If you get an eye injury from fireworks, seek medical help immediately

Heart Burn Due to Gastro Oesophageal Reflux Disease: GERD

 GERD is a recurrent and chronic disease for which long-term medical therapy is usually effective. It is important to recognize that chronic reflux does not resolve itself. There is not yet a cure for GERD. Long-term and appropriate treatment is necessary.

Treatment options include lifestyle modifications, medications, surgery, or a combination of methods. Over-the-counter preparations provide only temporary symptom relief. They do not prevent recurrence of symptoms or allow an injured esophagus to heal. They should not be taken regularly as a substitute for prescription medicines – they may be hiding a more serious condition. If needed regularly, for more than two weeks, consult a physician for a diagnosis and appropriate treatment.

While diet does not cause GERD, reflux and its most frequent complaint of heartburn can be aggravated by foods.

 Common foods that can worsen reflux symptoms include

1. citrus fruits
2. chocolate
3. drinks with caffeine or alcohol
4. fatty and fried foods
5. garlic and onions
6. mint flavorings
7. spicy foods
8. tomato-based foods, like spaghetti sauce, salsa, chili, and pizza

Lifestyle Changes

1. If you smoke, stop.
2. Avoid foods and beverages that worsen symptoms.
3. Lose weight if needed.
4. Eat small, frequent meals.
5. Wear loose-fitting clothes.
6. Avoid lying down for 3 hours after a meal.
7. Raise the head of your bed 6 to 8 inches by securing wood blocks under the bedposts. Just using extra pillows will not help.

Tip: Don't lie down within 3 hours of eating. That's when acid production is at its peak, so plan early dinners and avoid bedtime snacks.


How to eat

How is perhaps more important than what you eat. A large meal will empty slowly from the stomach and exert pressure on the LES. A snack at bedtime is well positioned to reflux when you lie down. It is best to eat early in the evening so that the meal is digested at bedtime. You might try having the main meal at noon and a lighter one at dinnertime. All meals should be eaten in relaxed stress-free surroundings. Trips to the kitchen to fetch food or the performance of other tasks such as minding children should be suspended during, and for a time after, eating. Smaller meals and an upright, relaxed posture should help minimize reflux.

What you eat

Certain foods compromise the sphincter's ability to prevent reflux, and are best avoided before lying down or exertion. These differ from person to person. Many person find that fats, onions, and chocolate as particularly troublesome. Alcohol often provokes heartburn, by compromising the LES, irritating the esophagus, and by stimulating stomach acid production. Common beverages such as coffee (both caffeinated and decaffeinated), tea, cola, tomato juice, and citrus juice may aggravate symptoms by irritating the esophagus or stimulating stomach acid production.[3] Certain other foods may bother some people; upon their discovery a period of avoidance or reduction may be of benefit.

Tip: Experiment to find what does and does not work best for you. Start by reducing fatty foods, onions, and chocolate.

Some oral medications such as potassium supplements or the antibiotic tetracycline will burn if allowed to rest in the esophagus. To be safe, one should always swallow medication in the upright position and wash it down with lots of water.


Other factors
Being overweight can promote reflux. Excess abdominal fat puts pressure on the stomach and the loss of even a moderate amount of weight makes many people feel better.

Proton pump inhibitors (PPIs)
Proton pump inhibitors (PPIs) limit acid secretion in the stomach. They allow rapid resolution of symptoms and healing of the esophagus in 80-90% of patients. The drug is also useful in managing stricture, one of the more serious complications of GERD.

Even after symptoms are brought under control, the underlying disease remains present. It is possible that a person may need to take a medication for the rest of their life to manage GERD. Long-term use of medication – whether prescription or nonprescription – should be under the direction and supervision of a physician. Side effects are rare; nonetheless, any drug can potentially have adverse effects.

Why Divya Prabha!

Divya Prabha Eye Hospital was founded in 1998 by Prof. Dr. Suseela Prabhakaran and is now an established centre of excellence for people requiring rapid access to ophthalmic treatment. While we offer a wide array of ophthalmic treatments, the Hospital is renowned for being a leading centre for cataract surgery in Kerala. We only do cataract one way, the way we would want it done for our own family members, many of whom we already have. We plan and perform your procedure using the best customized plans with the safest technology available anywhere worldwide to help you achieve your personal best vision.

You might get a discounted fee at some center, but only by agreeing to lesser technology, less surgeon involvement, and much less follow up care. And more importantly, in most cases, your surgeon won’t be the one doing your evaluation, the single most important step to accuracy in treatment!

Evidence shows that if you choose a hospital in which you feel comfortable and confident, you're likely to improve both the result of your treatment and your experience while you're in hospital. You should learn as much as you can about available technologies and about your surgeon in whom you place your trust to take care of your precious sight.

There are many reasons for you to prefer Divya Prabha Eye Hospital. Here are only a few examples of why discerning patients choose Divya Prabha Eye Hospital.

 As a surgeon owned and managed hospital, we are deeply invested in our patient's futures and are unrelenting in our vision to deliver the highest levels of clinical care, innovation and patient satisfaction.

 You will have a very high degree of access to your surgeon. Your surgeon will be intimately involved with your post operative care unlike in the other environments where volume demands require that operating surgeons are almost always operating.

 Our cataract success rates are are higher than the national UK average. Our cataract complication rates are significantly lower than the national average for NHS in UK .

 Previous surveys have shown 1 in 350 cases of endophthalmitis (a serious infection in the eye following surgery) within the NHS in UK; there have been no cases in Divya Prabha Eye Hospital.

 Waiting times with prior appointment is fifteen minutes

 Clinical results comparable to UK and USA

Apart from cataract surgery, we offer a comprehensive range of treatments for eye conditions and are continually introducing new services bringing best practice from around the world.

Divya Prabha Eye Hospital's mission is to make people happy by restoring vision. We will strive to provide a single high standard of eye care consistent with our tradition of excellence. The hospital is dedicated to the protection, preservation and restoration of vision. For children, who have a world to discover and explore, and for adults, who desire to live independently and with dignity, at any age.