Transcript Corneal opacity

DEPARTMENT OF COUNSELLING
Corneal Opacity
ARAVIND EYE CARE SYSTEM
Aravind Eye Hospital
& Postgraduate Institute of Ophthalmology
What is corneal opacity?
 The clear cornea becomes white
following scarring. The causes can be
congenital or acquired from a healed
ulcer.
 It can result in visual loss and can be
cosmetically disfiguring
Picture of corneal opacity
Treatment
 Penetrating keratoplasty is a surgery where the
opaque cornea of the patient is transplanted
with the clear cornea from the eye of the
deceased individual to provide vision for the
patient
 It can be done if the scar is not very long
standing
Picture of PKP
Role of the counsellor
 Should explain the advice of the doctor whether it is
tabtooing, cosmetic contact lenses or penetrating
keratoplasty
 The need for regular follow up and proper
complained with treatment for a long duration,
especially after PKP also has to be stressed
 The chances for graft rejection after PKP and the
necessity for glass for good vision after surgery also
should be explained
Injuries
 There are ocular emergencies which can vary in
severity from mild damage to potentially blinding
conditions
 The cause can be chemical or mechanical
 They affect any age group especially children and
working adults’
 They can have severe pain, glare and loss of vision
Role of the counsellor

Stressing the necessity for urgent treatment

Reassuring and insisting the need for proper
follow up and compliance with medication

The possibility of searing and its management
will also have to be explained

Counselling on protective measures and care
to prevent such recurrent episodes
 Advising to take protective Helmet’s and
glasses for working adults
 Advise not to give sharp things to
children
 Advise to follow the crackers user
prevention
Conjuntivitis (Red Eye)
Contagious, infective condition of the
conjunctiva (white part of the eye)
Picture of the conjunctivitis
Symptoms
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Redness
Discharge
Discomfort
Irritation
Treatment
 Usually there is no visual loss and it is
treated with eye drops mostly antibiotic
drops and ointment
 Rarely the cornea can be involved in viral
conjunctivitis and EKC (Epidemic Kerato
Conjunctivitis and causes defective vision
Allergic Type
 Allergy to dust
 Contact lens or pollen
 Animal donator and is a non
contagious type of conjunctivitis, but
causes lot of Itching and discomfort
Role of the counsellor
 Have to explain that symptoms can be relieved by eye
drops but the condition tends to be recurrent and needs
prolonged treatment
 Stress should be laid on misuse or overuse of the steroid
eye drops which can result in visual loss due to cataract or
glaucoma
 Should stress personnel hygiene like frequent washing of
hands and not touching the eyes
 Keeping their face towels, cosmetics, soaps etc separately
Corneal Dystrophies
What is Corneal Dystrophies?
 Hereditary, affecting the cornea from within, without
any external source of affliction
 Cause defective vision in some which may require
keratoplasty
eg. FUCHs and CHED (congenital hereditary
endothelial dystrophies) macular, granular and lattice
– stromal dystrophies
Symptoms
 Progressive loss of vision and pain
Investigations
 Detailed anterior segment (including
pupils of both eyes) and posterior
segment evaluation
 Urine sugar, blood pressure and relevant
investigations for general anesthesia if
surgery is planned
Treatment
 Glasses or contact lenses at the initial with
relevant eye drops for example hyperosmotics
and lubricants
 Surgery (PKP, Lamellor, Keratoplasty)
Role of the counsellor
 To explain the hereditary nature of the
disease and get the siblings examined for
the same
 To stress that it can be transmitted to
future generations
Corneal shape disorders
Keratoconus & Cornea plano
 These conditions cause defective
vision due to abnormal shape of the
cornea
Keratoconus
 The cornea bulges forward due to an integral
weakness in its structure
 Causes could be eye rubbing, hereditary
causes systemic diseases or unknown causes
 Results in defective vision, which can be
corrected by glass, contact lens or in severe
cases may require corneal transplantation
Picture of keratoconus
Cornea Plano
 It is a hereditary condition where the
cornea is flat and causes defective
vision
Symptoms
 Defective vision
Investigations
 Corneal topography for
example orbs can
Treatment
 Glasses, contact lens or in severe
cases may require corneal
transplantation
Role of counsellor
 To explain the chance of progression and
to avoid eye rubbing
 To stress on the necessity of periodical
review to rule out progression and to
assess the present condition and give the
appropriate management