Discuss Health

What is Amblyopia?

You may know it as ‘lazy eye’ and I am sure we can all remember a kid at school with an eye patch over one eye to encourage the ‘lazy eye’ to buck its ideas up.  Well the medical name for this condition is amblyopia.  It is defined as an eye condition that produces reduced vision that cannot be corrected with glasses or contact lenses and that is not due to any underlying eye disease. What is happening in fact is that for some reason, the brain is not fully acknowledging the images as the amblyopic eye sees them. Amblyopia almost invariably affects only one eye but may result in reduced vision in both eyes. An estimate is that in children under six three percent have some degree of amblyopia. 

Are Lazy Eye and Strabismus the same condition?

While it is easy for even a non-medical person  to spot a large eye turn or deviation (strabismus), amblyopia that occurs without strabismus or when it is associated with a small deviation is often missed by parents and paediatricians. Only an eye doctor (ophthalmologist) who is practised in examining young children can correctly diagnose this type of amblyopia. This is why it is so important to have early infant and pre-school eye examinations.

Due to common misconceptions or slang or colloquial terms for different eye conditions (i.e., crossed eyes or lazy eye), there is the danger that an individual may be inaccurately labelled as having a “lazy eye.”

If you think you or perhaps someone you know has a  lazy eye, it is a good idea that you try to learn more about the condition.

What causes Amblyopia?

 
Both eyes must always receive clear images and anything that interferes with clear vision in either eye during the critical development period between birth to 6 years of age can result in amblyopia developing.  Strabismus is the most common cause of amblyopia as is anisometropia (a different prescriptions in either eye), with loss or reduction of function of an eye whether due to trauma, lid droop or any other factor. If, while one eye is seeing clearly the other sees nothing more than a blur, the good eye and the brain will override the eye with the blur representing a neurological process. This inhibitory process or suppression of the eye that’s sees less well, can result in a permanent decrease in the vision in that eye that it will  not be possible to correct with glasses, lenses, or with lasik surgery.

How is Amblyopia Diagnosed?

 
As amblyopia almost always occurs in one eye only, many parents and even the child with amblyopia may be completely unaware of the condition. It is therefore very important that parents take their youngsters for an early and comprehensive visual examination.  As this does not always happen,  many children go undiagnosed until they have their eyes examined at a later age.

Diagnostic tools  for amblyopia are special visual acuity tests, which are more specialised than the letter charts currently used in schools, and by paediatricians and eye doctors. Examination with the use of  cycloplegic drops may be necessary to correctly diagnose this condition in the young.

What is the Treatment for Amblyopia?

Caught early, treatment for this condition is usually straight forward, using glasses, drops, vision therapy and sometimes an eye patch. Diagnosis and correction of amblyopia before the age of two is considered to represent the best chance of a successful outcome however, the widely held belief that a child cannot be treated successfully for amblyopia if the condition is diagnosed after the age of seven, has recently been disproved by scientific research

In conclusion, improvements in an amblyopic eye are possible at any age, but it is certainly true that early detection and treatment will always offer the best outcome. If not detected and treated early, it is possible for amblyopia to cause a permanent loss of vision along with the associated loss of the depth perception possible with a two eyed gaze. (stereopsis)

Conjunctivitis is the inflammation of the delicate surface membrane that forms a thin, transparent covering across the eye folding back and upwards inside the eyelid

What are the causes Conjunctivitis?

Conjunctivitis is generally caused by irritation or infection by may also be caused by allergens. The most common reason for a mild case of conjunctivitis, that lasts only a few days, is inflammation of the conjunctiva, which may occur alongside a viral illness like a cold or with the flu.  In these cases viral conjunctivitis is rarely serious, only causing a temporary redness, some eye watering and perhaps a mild discomfort.  There is no specific treatment for this and it is best treated with cleansing using boiled water that has been allowed to cool down. 

A more prolonged inflammation can often be seen with more serious viral cases such as with the herpes virus and this can be harder to treat, and may result in ulcers and even, in severe cases, in damage to the corneal surface of the eye.

As a general rule, if your eye redness symptoms last more than four days, and especially if they are not associated with a cold or are particularly severe you should get your eyes checked by a doctor without delay.

Newborn babies face higher risks of bacterial infection exist as they can be contracted from the normal bacteria in the mother’s birth canal, or more seriously, from a mother who has untreated sexually transmitted infection.

Bacterial infections occur in all ages, and are more likely than viral infections to present as a sticky discharge and have an element of crusting. Antibiotic cream may be prescribed it the symptoms persist longer than a few days.

What are the symptoms of conjunctivitis?

Conjunctivitis causes redness of the white of the eye and of the inside of the eyelids (the conjunctiva), and usually affects both eyes. The eyes may feel very sore, itchy, and a burning sensation may be present.  This condition can sometimes be extremely painful with bright light often seeming to make the condition worse.

If the infection is bacterial there might be yellowy/white sticky pus like discharge. This can form a crust on the eyelashes and sometimes stick the eyelids together, especially after a period of sleep.

Swelling, itching and a thin, watery discharge are the sign of an infection by allergen.

Who might be affected by conjunctivitis?

Children are particularly vulnerable, although conjunctivitis occurs at all ages, when the causes will vary.

What treatment is there for conjunctivitis?

If you think you might have conjunctivitis, you will have to see your doctor to confirm it.

With newborn babies, and very young children, simply cleaning the eyes gently might help the condition settle down.

Viral conjunctivitis usually lasts for a few days only and it is rare to experience any complications.

In most cases, the infection will clear up within a week without any need for specific treatment. Antibiotics have little effect on this type of infection so are less often recommended these days. Sometimes a more severe conjunctivitis does develop that includes involvement of the cornea (the area of that forms a cover over the iris and pupil). This type of conjunctivitis, that is caused by Herpes virus infection in adults, may last for several weeks and might need more intensive treatment with antibiotics and steroids, and frequent follow-up by an ophthalmologist (eye specialist.)

Allergic conjunctivitis is usually managed with anti-inflammatory eye drops. Here, regularly and gently bathing the eye and lashes with cool previously boiled water might be of benefit.

Most simple viral or bacterial conjunctival infections in an otherwise healthy person whose immune system is working well will resolve without treatment, but always be aware that if you have prolonged or severe symptoms you must see your doctor to make sure of the diagnosis.

I used to work in a hospital, in administration in an Oncology department.   As I read one after another of the patient’s notes by the end of the first week I was convinced that I had everything from skin cancer to cancer of the pancreas.  It is said that medical students are the same.  Being made aware of diseases and conditions that they had no prior knowledge of could make them worried by every little twinge or headache they had, and attribute it to some dread disease.  But joking aside there are some symptoms that should never be ignored and should always send you beating a path to your doctor’s door. 

Among symptoms that always need checking out are:

• Chest pains

• Abdominal discomfort
• Any unexplained bleeding 

Those may seem pretty obvious but there are other symptoms that are not so obvious but that also need to be checked out by your doctor.  These include any unexplained weight loss. Experiencing weight loss of 5% over the period of a month or a 10% weight loss from six to 12 months could be a warning of conditions such as

• hypothyroidism (an overactive thyroid)

• depression or othre mental illness
• some liver diseases
• cancers
• malabsorption

A persistent fever should always be taken seriously. Any fever of over 100 f (37.8c) degrees should be investigated if it persists for more than a week. Fever can be an indication of  underlying infection and  is also sometimes a presenting symptom for some cancers and other medical conditions. Any fever that causes violent chills (rigors) or which is greater than 103f (39.0c) needs immediate medical attention.

Shortness of breath. A persistent feeling of being short of breath on exertion can be a gradual hardly noticed symptom that can often be explained away easily, (you’re tired, are recovering from a cold, affected by pollen) However it is always best to take this type of symptom seriously, if it persists for any length of time see your doctor and of course any incidences of severe wheezing or gasping for air should be considered a medical emergency. Causes for breathlessness and wheezing are many and may include

• asthma
• heart problems
• anxiety
• panic attacks
• embolus (blood clot) in the lungs

Unexplained changes in bowel habits. Any change in bowel habits Might indicate an infection, either bacterial or viral, hepatitis, possible inflammatory bowel disease (IBS) or even colon cancer. You need to see the doctor is you have any of the following:

• severe diarrhoea that lasts for more than two days
• chronic diarrhoea that lasts for a week or more
• constipation lasting two weeks or more.
• unexplained and urgent need to have a bowel movement
• diarrhoea that contains traces or frank blood
• black stools or stools that appear tarry
• white stools

Finally symptoms that demonstrate any alteration in mental status. Unexplained changes in thinking, behaviour or demeanour may be due to:

• infection
• head injury
• stroke
• low blood sugar,
• side effects of medications.

In this area, immediate medical help should be summoned if any of the following symptoms are present:

• sudden confused thinking 
• gradual confused thinking
• disorientation  or panic
• sudden unexplained aggressive behaviour
• hallucinations in someone who has no previous history of this.

While it is important to keep an eye on your health and to know your body so that you recognise when things are not right, it is also important to keep things in perspective.  After all there is a fine line between being self-aware and becoming a hypochondriac, (one obsessed with his own health).   Just making sure that all is well and that any symptoms you have are checked out should ensure that you keep healthy and ensure that you get prompt treatment for any condition or disease that you do develop.   Remember that the earlier a disease is identified the better the chances of a good recovery for you.

GENEVA – The World Health Organization says more than 85 million children under 5 in west and central Africa will be vaccinated against polio.

The agency says the massive vaccination campaign in 19 countries by U.N. agencies and the Red Cross will start March 6. It will involve more than 400,000 volunteers and health workers. It is largely funded by Rotary International.

WHO says a 2008 polio outbreak in Nigeria spread throughout western Africa up to Mauritania. It says previous vaccination programs failed to stop the outbreak.

Polio is spread when unvaccinated people come into contact with the feces of those with the virus, often through water. It usually causes paralysis, muscular atrophy, deformation and sometimes death.