WHAT YOU DIDN’T KNOW ABOUT INSTILLING EYE DROPS

"Oh please! How hard caninstilling eye drop possibly be?" 

Most definitely at one time or the other, we must have used an eye drop and we either applied it ourselves or got someone else to do it, hence we ask the above question.  I will tell you the story which inspired this piece and I am sure it will make you see the importance.

I saw a patient some time ago with swollen red eye. She had used an eye drop but got no improvement, rather it was getting worse. After examination, it was found that she had bacterial conjunctivitis and the eye drop she had used was actually the right eye drop. 

Further questioning revealed that she had used a needle (non-sterile) to open the eye drop.
This little action rendered that eye drop ineffective and this is because microorganisms from the needle contaminated the eye drop and introduced more microorganisms into the eye aggravating the infection.

This is just one of the many things you probably never knew about using eye drops. 

Did you know that…….?

To open your eye drop for the first time, just press the cap tightly then open. This punctures a hole in the tip of the dropper. However, if this does not work, use a new needle (new syringe needle) to puncture a hole on the tip.

Drops should always be put inside the lower eyelid and not on the cornea (the transparent tissue covering the dark part of the eye).

You should not touch the tip of the bottle with your fingers, or let it touch your eye during instillation to prevent contamination.

In cases where the eye drop is a suspension, you should shake the bottle before use.

Some (but not all) eye drops need to be stored in the fridge. Always ask your doctor about the mode of storage.

Contact lenses should be removed before instilling eye drops except for re-wetting drops. This is because some eye drops contain substances that are absorbed by the contact lens, which can cause adverse reactions in the eye.

10 simple steps in instilling eye drop

• Wash your hands thoroughly with soap and water.
• Wipe your eyes with a clean tissue to clear any residual discharge (in cases of infection)
• Tilt your head backwards, pull your lower lid downwards to form a pocket and look upwards.
• Hold the dropper or bottle with your other hand above the eye and gently squeeze one drop into the pocket made by the lower eyelid. Take care not touch the eye or eyelashes with the tip of the bottle. This is to prevent microorganisms from the eye from getting into the eye drop and contaminating it.
• Close your eye for 2 to 3 minutes and tip your head down as though looking at the floor. Do not to blink or squeeze your eyelids.                                          
• Place a finger on the tip of the eye close to the nose (tear duct) and apply gentle pressure. This reduces the amount of the drug that gets into the tear duct; reducing systemic absorption.
• Wipe away any excess liquid with a clean tissue.

• If you have more than one drop to put in, or are using more than one type of eye drop, wait about ten minutes before putting the next drop in. This is to ensure that the second drop does not wash away the first.
• Replace and tighten the cap on the dropper bottle. Do not wipe or rinse the dropper tip.
• Wash your hands once again, to remove any medication.

Instilling eye drops is truly not difficult but there are some little ‘dos’ and 'don’ts' associated with its use as you have seen above.

If you did ask that initial question, -‘Oh please! How hard can instilling eye drop possibly be?’ 

I hope you had an interesting read and have picked up a few new tips on the proper use of eye drops.

WHAT COULD BE RESPONSIBLE FOR MY HEADACHE?

Many people are still in the state of confusion on how to find a solution to their persistent headaches. Some have tried several drugs, going from one doctor to another just to have a minute rest from the hammering headache which has become part of their daily living. Since drugs could not solve their problems, they have come to a conclusion that headache is inevitable. 

Alas! Have you been told that your eyes might be the source of this inevitable headache? You may wonder, “what is the relationship between headaches and my eyes?” Well, refractive errors in the eye can lead to eye strain, which in turn causes headache. 

Refractive errors include astigmatism, hyperopia (farsightedness) and myopia (near sightedness).

Astigmatism:  It is caused by an abnormal curvature of the eyeball or the refracting surfaces in the eye. This makes objects up close and/or at a distance to appear blurry. The individual is forced to strain the eyes to make the images sharper, leading to headaches.

Headaches due to astigmatism is very common. Usually this refractive error can be corrected with glasses or contact lenses relieving the individual of the headaches.

Hyperopia: This is usually caused by the axis of the eyeball being too short. The headaches associated with this refractive error are also the result of too much strain being placed on the eyes from an attempt to correct for some imbalance, especially when engaging in some form of near work such as reading, beading, pinging, etc. Eyeglasses and contact lenses are a relatively easy way to correct for the condition and to eliminate the headaches that are associated with this refractive error. 

Myopia: It is caused by the eyeball being too long, or the cornea being too steeply curved. The strain on the eyes from this refractive error especially when trying to see distant objects causes headaches. Eyeglasses and contact lenses are effective at both correcting the vision and eliminating headaches.

 

 It is important to know that there are other eye problems which can cause headache. Headaches caused by refractive errors are majorly felt towards the front of the head.

You are therefore advised to see an eye doctor if you have a persistent headache for proper diagnosis.

VALENTINE SPECIAL

Valentines day, a day to love, a time to show that special person how much they mean to you.

There was a man who had such a person. He had that day all planned out.  He ordered a cake and had it sent to her office.  He sent numerous text messages expressing his feelings.

Later that evening he took her to a prestigious restaurant that had a romantic setting.

The meal was tantalizing and the wine was exquisite. While they were having desert, the man gently took hold of both hands, looking intensely and said. “Look into my eyes, tell me what you see”. The beautiful lady moved closer to him, starred intently into his eyes and replied.  “Oh! You have an encroaching pterygium. Can I book you for surgery in my clinic?”

Hilarious! I guess that’s what you get for dating an eye doctor.

On a serious note. What is an “encroaching pterygium”?

According to Millidot’s dictionary of optometry and visual science, a pterygium is a triangular fold of bulbar conjunctiva in the interpalpebra fissure, with its apex advancing progressively towards the cornea, usually from the nasal side.

I hope that’s not too technical. All its saying is that a pterygium is an abnormal mass of tissue arising from the conjunctiva of the inner corner of the eye.  It is common among people in warm, dry climates and/or people who are on the long term, exposed to outdoor elements or smoky/dusty environments.

It is benign but sometimes may become red and inflamed.  When it advances onto the cornea, it is then said to be encroaching.

Management

UV – blocking spectacles are advised due to the apparent link with exposure to the environment.  Patents are advised to avoid smoky or dusty areas as much as possible.

Ocular lubricants can also be used to reduce the feeling of dryness in some instances.

In cases where the encroaching pterygium is significant i.e. blocking the visual axis and/or cosmetically unacceptable, surgical excision is advised.

DIABETIC RETINOPATHY: EVERYBODY'S BUSINESS

 

Diabetes is on the increase worldwide, due mainly to the rise in the number of people with type 2 diabetes. Diabetes increases the risk of a range of eye diseases, including cataract (diabetic cataract), but the main cause of blindness associated with diabetes is diabetic retinopathy (DR).

Diabetic Retinopathy (DR) is the name given to the changes in the retina, which occur over a period of time in diabetics. The retina is the back part of the eye where objects form images and it is made up of cells, which are sensitive to light.

 

THINGS EVERY DIABETES PATIENT SHOULD KNOW

 

Diabetes will eventually affect the blood vessels in the eyes. This is called diabetic retinopathy, and it can lead to visual impairment and blindness.

By controlling your blood sugar and blood pressure, you can reduce the damage diabetes can cause in your eyes.

Diabetic retinopathy in most people has no symptoms - you cannot tell if you have it. Only an examination of the back of the eyes (by your eye doctor) can detect it, and you should be examined every year.

Diabetic retinopathy is treatable if it is found in the early stages.
 

If you attend all your screening or clinic appointments and have treatment when recommended, it is unlikely you will go blind.

 
If you do not attend diabetic eye screening or eye clinic appointments, your diabetic retinopathy can become very advanced and will affect your vision. If left untreated, you may go blind.

Modern treatments with laser and drug are very effective in stopping vision loss. Unfortunately, treatment cannot restore vision that has already been lost.

A family history of diabetes definitely indicates one should check even more frequently as early detection means better prognosis.

 

EYE HYGIENE

EYE HYGIENE

Hygiene is the maintenance of healthful practices, or proper care for the body, keeping it clean and healthy allowing you to look and feel your best. 

Good hygiene should naturally be extended to the eye since the eye is the window through which the mind sees. Healthy eyes must be maintained for preservation of good vision.  No one is ever comfortable looking into a swollen, red and pus-filled eyes (except a doctor examining the eye). 

REASONS FOR EYE HYGIENE

Proper eye hygiene is necessary to prevent bacteria, dirt and foreign particles on the face from getting into the eye. It also prevents transfer of infection either from person to person or from one eye to another. Good eye hygiene helps to prevent against infections such as blepharitis (inflammation of the eyelid), conjunctivitis (inflammation of the conjunctiva), meibomianitis (inflammation of the meibomian/oil gland) etc.

WHAT TO DO

Taking the following measures could help one avoid these uncomfortable conditions.

Wash your hands always especially before touching your eyes. Your hands come into contact with a lot of things during the course of the day and minute organisms and dirt attach to the hands. We are very quick to rub our eyes with our hands and if these organisms get into the eyes, it could lead to an infection or irritation. Therefore, try as much as possible to keep your hands clean at all times. 

‘Clean hands’ is thus the first step to healthy eyes.

Keep your fingernails short and neat. This prevents dirt and bacteria from gathering underneath the nails and entering the eye on contact.

Use a clean handkerchief or clean tissue to clean your eyes. This is even better than using your hands especially when you cannot readily wash them.

Clean your eyelid and eyelashes. Dip cotton buds in warm water containing few drops of mild baby shampoo and use this to clean your eyelid margin and lashes. This can be done once a week. Sterilised eye cleaning pads can also be used. The aim of cleaning the eyelids is to remove the debris of dead skin cells and bacteria that can gather on the eyelids.
 

Do not rub your eyes if they itch. Rubbing your eyes can often make them more itchy and painful. Instead, keep blinking and allow your tears to dislodge and wash away any irritants. You could also wash your hands, wash out your eyes with clean tap water or sterile eye irrigating solution, and wipe your eyes gently with a clean towel or tissue.

Wash your face daily. Wash your face with mild soap preferably morning and night.

Clean off makeup. Ladies! This is especially important for healthy sexy eyes.  If you wear light eye makeup, you can easily remove it by washing your face and your eyelids with a gentle soap or cleanser. As you wash your face, simply wash the area of your eyelids -with eyes closed- with your fingertips to help remove eye makeup residue. Do this at bedtime and also in the morning. Avoid using creamy soap bars or creamy cleansers as they can block delicate meibomian gland openings. 

However, if you wear heavy eye makeup, you may need to use a light make up removal products. Do not use baby oil or Vaseline.  After this, wash your face as earlier explained. Also, when taking off your makeup always move the cotton pad inward toward your nose. If you rub in the other direction the lower lid can be pulled away slightly creating a pocket where debris can get in.

Use sunglasses while outdoors. If you don't normally wear glasses, you can put on sunglasses to keep dust, dirt or other objects away from your eyes when outdoors. Appropriate sunglasses will also protect everyone's eyes from harmful ultraviolet rays.

In conclusion, if you pride yourself as a clean person, then take the extra step and give your eyes the care they need. Remember ‘Prevention is better and cheaper than cure’.

DOCTOR, PLEASE HELP, MY EYE IS TWITCHING!

This was the alarming cry of one my innocent patients who has been undergoing a critical condition of eye twitching. She told me that her left eyelid had been twitching for several weeks, and it was driving her crazy. The twitching has become noticeable to people around her and she now wants a solution.

To find a solution for twitching eyes, the first step is to determine the underlying cause of this annoying problem called “myokymia” .These rippling muscle contractions in an eyelid can be triggered by several conditions.

Almost all sudden-onset eyelid twitching is benign, meaning the condition is not serious or not a sign of a medical problem. However, this kind of eye twitching can also be hard to treat. The only option for making the twitch stop is to figure out, and deal with the cause.

Some of the common causes of eye twitching include:

Stress: While under stress, our bodies react in different ways. Eye twitching can be one sign of stress, especially when it is related to vision problems such as eye strain. Reducing the cause of the stress can help make the twitching stop.

Tiredness: A lack of sleep, whether because of stress or some other reason, can trigger eyelid spasms. Catching up on your sleep can help.

Eye strain: Vision-related stress can occur if, for instance, you need glasses or a change of glasses. Your eyes, without appropriate optical correction, may be working too hard, triggering eyelid twitching.

Computer eye strain from overuse of computers, tablets and smartphones is also a very common cause of vision-related stress.
If your eyelid twitching is persistent and very annoying you should have an eye exam, because you may need vision correction. If you spend a lot of time on the computer, you also should consider talking to your eye doctor about special computer eyeglasses.

Dry eyes: More than half of the older population experience dry eyes, due to aging. Dry eyes also are very common for people who use computers, take certain medications (antihistamines, antidepressants, etc.), wear contact lenses and consume caffeine and/or alcohol.

Caffeine and alcohol: Many experts believe that too much caffeine and/or alcohol can trigger eye twitches. If your caffeine, coffee and/or alcohol intake has increased, cutting back is worth a try.

Nutritional imbalances: Some reports indicate that a lack of certain nutritional substances, such as magnesium, can trigger eyelid spasms. Although these reports lack scientific evidence, I can't rule this out as a possible cause of eyelid twitching. If you suspect a nutritional deficiency may be affecting you, however, I suggest talking this over with your family doctor for expert advice rather than randomly buying over-the-counter nutritional products.

More serious forms of eyelid twitching are caused by neurological conditions such as blepharospasm or hemifacial spasm. These conditions are much less common and should be diagnosed and treated by an eye doctor.

In conclusion, eye twitching, is pretty common. Usually only the bottom lid of one eye is involved, but the top eyelid also can twitch. Most eye twitches come and go, although they can last for weeks or even months.

If your eye twitches persistently,  see your eye doctor.