Medicines Used to treat Eye Diseases

Glaucoma
 
Glaucoma is a condition in which the tension inside the eyeball is raised causing damage to the innermost layer of eye i.e. retina.

Major risk factors for the development of glaucomatous optic nerve damage include the level of intra-ocular pressure, increasing age, black race, and a family history of glaucoma. Broadly it can be classified into various types, of which POAG (primary open angle glaucoma) is an acquired condition, with onset typically after age 40. It affects both eyes but often asymmetrically. In early and even moderate stages, the patient is usually asymptomatic. Abnormalities of the visual field occur. In more advanced stages, the patient may become aware of an enlarging scotoma (defect in visual field) particularly when it encroaches on fixation. If left untreated, vision may be lost. Angle-closure glaucoma can be devastating. Bilateral blindness can result in 2 to 3 days from onset. The patient has severe pain in eye associated with redness, watering. Glaucoma can be treated with long-term medication or surgically.

Commonly used drugs for chronic open angle glaucoma are Timolol meleate 0.5%, Betaxolol 0.5% (Batapress, Optipress), Levobunolol 0.1 % (Betagan), Brimonidin eye drop 0.2% (Alghagan) or Latanoprost eye drop 0.005% (Xalatan) used once a day. Pilocarpine 2% and for Acute glaucoma (narrow angle type) 3-4 times a day provides quick relief and reduction of eye-pressure. Surgical iridectomy (removing a piece of iris) or laser iridotomy (cutting a hole in iris) provide drainage pathway to the eye fluid so pressure decreases.

Injuries

Injury to eye can be due to roadside accidents, bums or foreign bodies.

Roadside Accidents: The eyes are generally well protected by the bony structure surrounding them. A large blunt object can only damage the eyelids. A black eye (black area below or on side of the eye), which commonly occurs during roadside accidents, is due to blood beneath the thin skin of the eyelids and is usually associated with swelling. The vision may be unaffected. Cold compresses for 10 minutes every hour for a day will reduce the swelling. If the injury is severe or the vision is affected, the doctor should be consulted.

Burns: Chemical substances bum the eye and require thorough washing with water. No time should be wasted in finding a neutralizing agent for the chemical substance. The most effective method is to plunge the entire face into a container of water and then open the eye under Water. Heat burn requires treatment similar to chemical burns. Bandaging or closing both the eyes will prevent the movement of eyeballs and reduce pain. No lotion should be used for washing the eyes.

Foreign Bodies: Dirt or dust in the eye may cause sensation of a foreign body being in the eye. It may come out by washing the eyes. If not, it should be removed by a physician.

Vitamin-A Deficiency

Vitamin-A deficiency most commonly affects the eyes, the clinical condition being xerophthalmia and kratomalacia. Xerophthalmia denotes the entire spectrum of ocular abnormalities arising from vitamin A deficiency. These include night blindness, retinopathy, conjunctival and corneal xerosis (dryness), corneal ulceration and softening. The eye instead of looking clear appears muddy and wrinkled. It becomes dry, hazy (like ground grass) and unwettable. There may be grayish, triangular, foamy, rough and raised patches on the eye (Bitot's spots). These are present in both the eyes. It may progress to ulcer in the eyes. Severe deficiency of vitamin A may cause keratomalacia (softening of a part or the entire eyeball). The process is rapid one. It is a grave medical emergency and if not treated promptly, may lead to necrosis and perforation of the eye ball resulting in blindness. It is often associated with protein energy malnutrition.

Treatment: The symptoms of vitamin A deficiency can be prevented by adequate nutrition contained in the food mentioned above. A shortcut has been suggested by National Institute of Nutrition, Hyderabad, which consists of the administration of 200,000 IU (66,000 ug) of vitamin A every six months to pre school children who are unlikely to have adequate nutrition. Excess of vitamin A may produce toxic effects. Commonly available preparations such as AQUASOL-A contains 50,000 IU of vitamin A.

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