Published in "Panorama"
When the Eyes Speak !!!
Yes, when the eyes talk, they may not have the nicest of things to say to you! It’s the time of the year when we’re back to the grinding wheel after a month or more of leisure and luxury. In fact, the vacation period may have been more hectic for many of us. All the more reason we need to have our physical selves overhauled to keep our mental state alive and alert till the next break. In this sense, eye care perhaps, takes the front seat since it’s one of those sensitive organs, quick to be affected with environmental changes. Also, these may often be linked to other health problems an individual may already be having.
Many of us may not even be aware that handling heavy baggage while traveling may actually worsen the eye pressure or glaucoma we already have! For that matter did we dream of a link between arthritis and eye problems? Or that a valvular heart disease could actually lead to sudden blindness? Or prolonged medication for TB, arthritis, asthma and other ailments could result in eye problems?
It is imperative, says Dr.Azim, Specialist Eye Surgeon, Prime Medical Centre, Dubai, “that certain categories of people, particularly, should consult their eye specialist after returning from vacation or prolonged travel since these are the times when their routine with respect to diet, exercise and lifestyle is disturbed; also scope for pollution is greater. All these factors could trigger changes in their health status.”
So who are the people requiring eye checkup after returning from vacation? Of course, on the one hand, any one with visible eye symptoms like conjunctivitis and lid infections should consult a doctor to determine the correct nature of the condition, says Dr.Azim. “People are exposed to different environment whereby changes in temperature, dust getting into the eyes while traveling, could cause conjunctivitis which may be infective or non-infective. Conjunctivitis is the inflammation of the thin transparent skin making up the white of the eye. When organisms like bacteria, virus insult it, it could become infectious leading to symptoms like redness, itching and irritation of the eye, sticky lids and in severe cases, discharge from the eyes. On the other hand, allergy due to dust and pollen may also present as itching, redness, watering of the eyes with a gritty feeling – the non-infective conjunctivitis.”
Conjunctivitis, often referred to as the Madras Eye or Bombay Eye, can happen to anyone, visiting any place; the infective kind can spread from person to person through a mere handshake! Dr.Azim explains: “This happens through eye droplets which spray out each time a person blinks. If the person affected with infectious conjunctivitis rubs his eyes and then gives handshake to a fellow being who in turn fingers his eyes with the same hand, he can contract the condition! Similarly using handkerchiefs used by the infected person may spread the condition. This type of conjunctivitis comes in a season, usually comes in one eye and spreads to the other, is contagious, short-lasting and may come back again, not necessarily caused by the same organism.”
The non-infective, allergic conjunctivitis generally runs in the families, is chronic in nature, usually affects both eyes simultaneously and “comes and goes on its own” in the words of the patients. Dust from playgrounds, while traveling, chalk dust, pollen and other allergens may trigger the condition.
Dr.Azim emphasizes the importance of identifying the type of conjunctivitis for purposes of treatment. “While antibiotics are prescribed for the infective conjunctivitis, they have no role to play in the non-infective type. Similarly treatment is with steroids in very severe cases of allergic conjunctivitis, but should not be given in infective conjunctivitis – neither topically into the eyes, nor orally. While using antibiotic topical applications for the non-infective condition may do no harm, using steroids for the infective conjunctivitis could actually result in flaring up of the condition!”
What is the connection between travel and lid infection? There are a host of objects we handle while on the move, beginning with cab handles and baggage trolleys at airports, which are some of the most contaminated objects. Children cannot be kept away from gardens, parks and playing with mud and sand. When on sight-seeing spree, you are most likely in a moving vehicle from dawn to dusk, affording yourself little time to maintain good sense of hygiene by repeated washing of hands and face with water. Chances of infection are thus high. Rubbing lids with unclean hands during travel can cause lid soreness, swelling, itching and sticky lids. They should be treated properly, else they may lead to scaring in later stages, cautions Dr.Azim.
Contact lens wearers have their own set of problems. “It’s better for these people to use glasses when they are traveling by train, or traveling to dry, dusty atmosphere,” opines Dr.Azim. “These people should be particularly careful not to go swimming or take a dip in temple ponds, et al with their contact lenses on since they can get infected with fungus. In fact, people have gone blind in this manner!”
All diseases which affect blood vessels, affect the eye because it is an organ richly supplied with blood vessels, all of them very fine and delicate. Patients suffering from diabetics, hypertension, high cholesterol, glaucoma, arthritis, valvular heart condition, retinal diseases, those under medication for various chronic ailments, must have an eye checkup after returning from vacation.
Dr.Azim explains, “The minor bloods vessels which are invariably the first to get affect in most cases, may get blocked, not delivering sufficient blood to the eyes, leading to eye tissues getting damaged. At the other end, they may deliver too much fluid to the eye, causing them to swell up. In people with valvular heart disease, calcium deposits which get thrown into the blood stream may block a major blood vessel going to the eye. The vision can get impaired, leading to an emergency wherein the patient can become blind. And this can happen any time in people having valvular heart problems, especially if the valve starts beating irregularly. Such patients require to visit their cardiologist and eye specialist every year.”
General Precautions to be taken to prevent eye problems
1. On returning from a holiday if you notice your eyes are red, don’t self-medicate on the belief that it is because of heat. A heat boil will generally come down in a day or two. If the redness persists beyond this time, seek out medical assistance.
2. All red eyes may not be conjunctivitis, or the non-infectious kinds. So do not self-medicate thinking it is conjunctivitis; it could worsen the condition. There are a few other conditions which can mimic the symptoms of conjunctivitis. One is iridocyclitis which is inflammation of the layers between the eyes. The treatment for this condition is entirely different from that of conjunctivitis and if not treated on time, it can lead to cataract and even blindness later in life. Acute Angular Closure Glaucoma is another conditions presenting with red eyes and severe pain, temporary dull vision which may lead to blindness if not treated as a medical emergency.
3. Even one single sulfa tablet could cause severe allergic eye reactions in some people, even leading to blindness. Hence do not self-medicate or buy medicines over the counter (OTC).
4. An eye specialist will check for medicine allergy, and other health conditions before prescribing the drug and its dosage. A pharmacist is not a qualified eye specialist to prescribe drugs; do not seek information from him on the medication that can be used.
5. Two individuals having a red eye may not be having the same problem. Do not use medicines prescribed for another individual with similar symptoms.
6. Do not treat yourself with medication that was prescribed to you some months back for an eye condition which may or may not have been similar. The problem now may be different, warranting a totally different spectrum of medicines.
7. Follow the prescribed dosage schedule. The specialist has his own reasons for specifying the period of treatment. Keep to this regimen and don’t discontinue medication midway because the problem seems to have disappeared. Over- and under-medication can bring on their own set of problems.
8. Once a topical application has been opened, do not use the same after one month since chances of contamination are there.
9. Never put eye drops or ointment on your own; chances of hurting the eye with the nozzle or dropper is always there.
10. An eye drop ideally should be put keeping the nozzle 4-5 cm away from the eye. Ensure that the person applying the drops or ointment has washed and wipes his hands before and after putting the drops, to prevent infection to both parties.
11. Always have the drops applied in a lying down posture and keep the eyes closed for 5 minutes to allow the medicine to start working.
12. Prescriptions given for certain eye and other health conditions may work differently in different environmental situations. Hence it’s necessary to consult the concerned specialist before and after travel to ensure the medication is tailor-made to suit your condition in that particular environment. This is particularly important for people moving residence.
13. Eye care of children returning from vacation is important, especially if they are wearing glasses or contact lenses. Contact lenses should be washed in solutions prescribed, not with bottled or mineral water. Contacts need to be checked to see if they are infection free after returning from holidays.
14. Never use any of the home remedies INTO the eyes. External application on the brow, lid may be fine but, strictly AVOID putting these into the eyes.
15. Eye checkup is not simply about prescribing or changing glasses and looking for eye power. A proper eye check includes evaluation of the cornea, retina, eye pressure and seeing the status of your lens. If problems in any of these areas are caught early, further damage can be arrested with appropriate treatment.
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