Documentos de Académico
Documentos de Profesional
Documentos de Cultura
(CLS201)
NOTES:
• My notes are in blue.
• The order of the lecturer’s notes was rearranged slightly to reflect the order of
presentation.
• The sections without any additional notes were not discussed in class. I’m assuming we
are still responsible for them…
–GF
Always be thinking laterally with eye disorders: What else is wrong? Look for associated
disease. The eye is not separate from the rest of the body.
Pathologies/Disorders
Inherited
Infective organism
Age related
• Most children are born slightly far-sighted. Uncorrected farsightedness in children:
accommodation, associated convergence, child’s eyes turn in. “Lazy eye” can occur.
Children should be examined before age 3.
Environmental
• People from tropical countries tend to need reading glasses 4-5 years earlier. May be due to
the amount of sunlight they are exposed to.
• Flicker of old-school computer screens is not good for the eye/brain. The eye likes stable,
high contrast (books). New computer screens are better: light doesn’t flicker. This is the
Symptoms/Signs
Blurred Vision
Redness
Swelling
Pain
Discomfort
Diplopia (double vision)
Refractive Errors
Myopia
Can see close, can’t see far. Nearsighted. Optical focus of eye isn’t correct. Disorder of growth.
More common in larger eyes.
Light rays focus in front of retina, patient can see well at near but distance blurred
Corrected with concave spectacle lenses or contact lenses
Usual age of onset 8 – 20
usually stable after age 20
Causative factors: genetic, environmental? diet (if severe malnourishment)
Hyperopia
More common in smaller eyes: point of focus is behind retina.
Light rays focus behind retina when accommodation relaxed (cilliary muscle = accommodation.
As we age, we can no longer accommodate: lens becomes more dense.)
Age of onset birth after 40
Accommodation can compensate in younger patient
Far Sightedness (Near vision poorer than distance)
Eyeglasses contact lenses
If left uncorrected amblyopia and strabismus may be a result
All children should be screened for this, a chief cause of reading/learning dysfunction
Astigmatism
Refracting surface is not spherical, but egg-shaped. Pointless vision.
Very common
Cornea has a cylindrical profile (like the side of an egg)
Changes through-out life
Spectacles /contact lenses
Age of onset: 0-all
Presbyopia
This happens with every person: inability of eye to focus with age.
Normal physiological changes in crystalline lens preventing accommodation
Lens proteins coagulate = higher density --- decreased elasticity
Cannot adjust to focus at near or adjust for hyperopia
Corrected with reading glasses (convex) or multi-focal lenses
Age of onset 40-50 stable at 60
Accelerated by UV exposure (earlier onset in those from tropical climates
Amblyopia
Allergic Disorders
Atopic Dermatitis:(Excema of the eyelids), associated with asthma and hay fever
Acute allergic edema,: unilateral or bilateral puffy lids without pain
Contact dermatitis:localised erythema and crusting
Ectropian: Lower lid away from cornea, tissue dries dry eye Surgery, lubricant gels
Entropian
Lower lid turn in, lashes abrade cornea,Treat with surgery/ soft contact lens
Potential for corneal ulcer (a bad thing)
• Caveat with laser surgery: patient must have no lid disorders! Need good mucin, especially in
immediate post-operative stage. Cornea has to be kept clean and moist for proper healing.
Conjunctivitis
• When using contact lenses, FOLLOW THE RULES! Dispose of solution and lenses when
you are supposed to.
• #1 cause of conjunctivitis is allergy.
• Also called “red eye” (not “pink eye”)
Allergic - Viral – Bacterial –Toxic – Trauma
• If allergic: clear stuff will come out of the eye. Could indicate presence of toxin, foreign
body.
• If discharge is stringy, mucous-y, or possibly clear, this is viral.
• If discharge is yellow-green: this is a bacterial infection. Patients may be given antibiotics,
but this may not help at all. (not sure why…)
Corneal Ulcer
• Some benign pathologies in other parts of body limit function in the eye: more serious
consequences in the eye. Ulcer on lip? Ok. Ulcer on eye? Painful, red eyes, excessive
tearing, blurring.
• Could be due to herpes simplex infection. Have to refer for antibiotic treatment.
Corneal ulcer or abrasion characterised by a white spot on the cornea
Herpes simplex, pseudomonas, opportunistic pathogens
Painful
Eye red, excessive tearing, blurred,
Refer immediately for treatment
Often associated with soft contact lens wear or injury abrasion
• The problem isn’t the virus, but the inflammation that the body creates as a response to the
virus.
• Associated with unhygienic soft contact use.
Pingueculitis
Cataract
• Light is bent by cornea and lens.
Lens is made of proteins
Homogenous in clear lens
Random sizes in cataract
UV energy may cause proteins to “clump together”
• With age, proteins start to change and become opaque. Non-homogenous proteins in lens.
Like an egg white as it cooks: goes white and opaque.
Typical onset >65
Rarely <50
More common in sunny countries and outdoor lifestyle (UV component)
Congenital with rubella
Treat with surgical removal
Cataract surgery: Indicated when patients vision is less than they desire and cataract is the cause.
Surgery only needed when it bothers the patient.
“Ripe” is an antiquated term
No stitches (small incision through cornea) Lens is replaced with a plastic one.
20 minutes, local anaesthesia, out patient
• Possible correlation with free-radicals.
• Cornea doesn’t change with age.