Internal eye pain: The request could not be satisfied
Computer Eye Strain: 10 Tips for Relief
By Gary Heiting, OD, and Larry K. Wan, OD
How to get relief from digital eye strain symptoms
It seems like everyone is staring at a computer screen, phone or other digital device these days. It’s causing a widespread problem called digital eye strain.
Symptoms of digital eye strain include:
Research sponsored by The Vision Council showed that 59% of people who routinely use computers and digital devices experience symptoms of digital eye strain (also known as computer eye strain or computer vision syndrome).
Here are 10 easy steps you can take to reduce your risk of eye strain and the symptoms that go along with it:
1. Get a comprehensive eye exam.
An annual comprehensive eye exam is the most important thing you can do to prevent or treat computer vision problems. During your exam, be sure to tell your eye doctor how often you use a computer and digital devices at work and at home.
Measure how far your eyes are from your screen when you sit at your computer, and bring this measurement to your exam so your eye doctor can test your eyes at that specific working distance.
SEE RELATED: How to choose an eye doctor
2. Use proper lighting.
Eye strain often is caused by excessively bright light either from outdoor sunlight coming in through a window or from harsh interior lighting.
When you use a computer, your ambient lighting should be about half as bright as that typically found in most offices.
Eliminate exterior light by closing drapes, shades or blinds. Reduce interior lighting by using fewer light bulbs or fluorescent tubes, or use lower intensity bulbs and tubes.
Also, if possible, position your computer screen so windows are to the side, instead of in front or behind it.
Many computer users find their eyes feel better if they can avoid working under overhead fluorescent lights. If possible, turn off the overhead fluorescent lights in your office and use floor lamps that provide indirect “soft white” LED lighting instead.
Sometimes switching to “full spectrum” fluorescent lighting that more closely approximates the light spectrum emitted by sunlight can be more comforting for computer work than regular fluorescent tubes. But even full spectrum lighting can cause discomfort if it’s too bright.
Try reducing the number of fluorescent tubes installed above your computer workspace if you are bothered by overhead lighting.
3. Minimize glare.
Glare from light reflecting off walls and finished surfaces, as well as reflections on your computer
screen also can cause computer eye strain. Consider installing an anti-glare screen on your display and, if possible, paint bright white walls a darker color with a matte finish.
If you wear glasses, consider buying lenses with anti-reflective (AR) coating. AR coating reduces glare by minimizing the amount of light reflecting off the front and back surfaces of your eyeglass lenses.
4. Upgrade your display.
If you have not already done so, replace your old tube-style monitor (called a cathode ray tube or CRT) with a flat-panel LED (light-emitting diode) screen with an anti-reflective surface.
Old-fashioned CRT screens can cause a noticeable “flicker” of images, which is a major cause of computer eye strain. Even if this flicker is imperceptible, it still can contribute to eye strain and fatigue during computer work.
To ease eye strain, make sure you use good lighting and sit at a proper distance from the computer screen.
Complications due to flicker are even more likely if the refresh rate of the monitor is less than 75 hertz (Hz). If you must use a CRT at work, adjust the display settings to the highest possible refresh rate.
When choosing a new flat panel display, select a screen with the highest resolution possible. Resolution is related to the “dot pitch” of the display. Generally, displays with a lower dot pitch have sharper images. Choose a display with a dot pitch of .28 mm or smaller.
Also, choose a relatively large display. For a desktop computer, select a display that has a diagonal screen size of at least 19 inches.
5. Adjust your computer display settings.
Adjusting the display settings of your computer can help reduce eye strain and fatigue. Generally, these adjustments are beneficial:
Brightness: Adjust the brightness of the display so it’s approximately the same as the brightness of your surrounding workstation. As a test, look at the white background of this Web page. If it looks like a light source, it’s too bright. If it seems dull and gray, it may be too dark.
Text size and contrast: Adjust the text size and contrast for comfort, especially when reading or composing long documents. Usually, black print on a white background is the best combination for comfort.
Color temperature: This is a technical term used to describe the spectrum of visible light emitted by a color display. Blue light is short-wavelength visible light that is associated with more eye strain than longer wavelength hues, such as orange and red. Reducing the color temperature of your display lowers the amount of blue light emitted by a color display for better long-term viewing comfort.
SEE RELATED: Blue light facts
6. Blink more often.
Blinking is very important when working at a computer; it moistens your eyes to prevent dryness and irritation.
When staring at a screen, people blink less frequently — only about one-third as often as they normally do — and many blinks performed during computer work are only partial lid closures, according to studies.
Tears coating the eye evaporate more rapidly during long non-blinking phases and this can cause dry eyes. Also, the air in many office environments is dry, which can increase how quickly your tears evaporate, placing you at greater risk for dry eye problems.
If you experience dry eye symptoms, ask your eye doctor about artificial tears for use during the day.
By the way, don’t confuse lubricating eye drops with the drops formulated to “get the red out.” The latter can indeed make your eyes look better — they contain ingredients that reduce the size of blood vessels on the surface of your eyes to “whiten” them. But they are not necessarily formulated to reduce dryness and irritation.
To reduce your risk of dry eyes during computer use, try this exercise: Every 20 minutes, blink 10 times by closing your eyes as if falling asleep (very slowly). This will help rewet your eyes.
7. Exercise your eyes.
Another cause of computer eye strain is focusing fatigue. To reduce your risk of tiring your eyes by constantly focusing on your screen, look away from your computer at least every 20 minutes and gaze at a distant object (at least 20 feet away) for at least 20 seconds.
Some eye doctors call this the “20-20-20 rule.” Looking far away relaxes the focusing muscle inside the eye to reduce fatigue.
Another exercise is to look far away at an object for 10-15 seconds, then gaze at something up close for 10-15 seconds. Then look back at the distant object. Do this 10 times. This exercise reduces the risk of your eyes’ focusing ability to “lock up” (a condition called accommodative spasm) after prolonged computer work.
Both of these exercises will reduce your risk of computer eye strain. Also, remember to blink frequently during the exercises to reduce your risk of computer-related dry eye.
8. Take frequent breaks.
To reduce your risk for computer vision syndrome and neck, back and shoulder pain, take frequent screen breaks during your work day (at least one 10-minute break every hour).
During these breaks, stand up, move about and stretch your arms, legs, back, neck and
shoulders to reduce tension and muscle fatigue.
9. Modify your workstation.
If you need to look back and forth between a printed page and your
computer screen, place the written pages on a copy stand adjacent to your screen.
Light the copy stand properly. You may want to use a desk lamp, but make sure it doesn’t shine into
your eyes or onto your computer screen.
Poor posture also contributes to computer vision syndrome. Adjust your workstation and chair to the correct height so your feet rest comfortably on the floor.
Position your computer screen so it’s 20 to 24 inches from your eyes. The center of your screen should be about 10 to 15 degrees below your eyes for comfortable positioning of your head and
10. Consider computer glasses.
For the greatest comfort at your computer, you might benefit from having your eye doctor modify your eyeglasses prescription to create customized computer glasses.
This is especially true if you normally wear contact lenses, which may become dry and uncomfortable during extended screen time.
Computer glasses also are a good choice if you wear bifocals or progressive lenses, because these lenses generally are not optimal for the distance to your computer screen.
Also, you may want to consider photochromic lenses or lightly tinted lenses for computer eyewear to reduce your exposure to potentially harmful blue light emitted by digital devices. Ask your eye doctor for details and advice.
READ MORE: How computer glasses can help computer vision syndrome
Notes and References
Blink rate, blink amplitude, and tear film integrity during dynamic visual display terminal tasks. Current Eye Research. March 2011.
Computer Workstations. U.S. Department of Labor, Occupational Safety & Health Administration. Accessed on OSHA website. June 2010.
Computer Ergonomics. U.S. Centers for Disease Control and Prevention. Accessed on CDC website. June 2010.
Strategic rest breaks reduce VDT discomforts without impairing productivity, NIOSH study finds. National Institute for Occupational Safety and Health (NIOSH). Published on CDC/NIOSH website. February 2009.
Supplementary breaks and stretching exercises for data entry operators: A follow-up field study. American Journal of Industrial Medicine. July 2007.
Occupational health aspects of working with video display terminals. Environmental and Occupational Medicine. 3rd ed. 1998. Philadelphia: Lippincott-Raven, pp. 1333-1344.
Page published in February 2019
Page updated in August 2021
Why Your Eyes Burn or Sting
By Amy Hellem; reviewed by Gary Heiting, OD
Why do my eyes burn?
Burning eyes can have several possible causes, ranging from simple to complex. The burning sensation can occur with or without other symptoms such as itching, eye pain, watery eyes or discharge. Frequently, burning eyes are caused by unavoidable environmental influences, such as strong winds or high pollen counts. However, similar sensations can be symptoms of a more serious eye problem that requires medical attention.
To select appropriate treatment, it’s important to first establish the cause (or causes) of your burning eyes.
Causes of burning eyes
Sometimes it’s easy to tell what’s causing an eye to burn. For example, your eyes might burn if you get chemicals in them, such as shampoo ingredients, chlorine from a swimming pool or sunscreen. Other common irritants that can make your eyes burn include makeup, skin moisturizers, soap and cleaning products.
Burning eyes can have many causes. A trip to the eye doctor is the best way to get relief.
Wearing contact lenses for long periods of time can also make your eyes burn.
Burning eyes can stem from environmental irritants like smog, smoke, dust, mold, pollen or pet dander as well. If you are allergic to any of these substances, they are even more likely to make your eyes burn. However, even “clean” air can cause your eyes to burn, especially when it’s particularly hot, cold or dry.
Although getting something in your eyes can cause them to burn, burning eyes sometimes signal a serious eye condition. For example, conditions such as ocular rosacea, dry eyes and blepharitis can cause symptoms like burning eyes.
Anything that causes inflammation can create a burning sensation in your eyes. Eye allergies, as well as bacterial and viral eye infections, can cause inflammation that leads to burning eyes. Even a common cold or the flu can cause the eyes to burn.
In rare instances, burning eyes can be a sign of a serious sight- or life-threatening condition such as uveitis or orbital cellulitis (a sudden infection of the tissues immediately surrounding the eye, resulting in pain, swelling, discomfort when moving your eyes and decreased vision; orbital cellulitis is a medical emergency that requires prompt treatment to prevent vision loss).
Often, burning eyes occur alongside other symptoms that can give your eye doctor clues about the root cause of your discomfort. For example, when burning eyes occur with itching, it may signal allergies; or if you have burning and eye discharge, this could mean an infection.
Burning eyes and COVID-19
There have been reports of COVID-19 patients with burning or stinging sensations in their eyes. One study of non-hospitalized COVID patients in Europe showed that more than 36% of people with eye-related symptoms reported burning eyes.
If eye irritation is your only symptom, however, it probably isn’t caused by COVID-19, according to the American Academy of Ophthalmology.
COVID-19 has been proven to cause pink eye in some people. A burning or stinging sensation can be a symptom of pink eye, which is also called conjunctivitis.
But this type of coronavirus infection almost always comes with other symptoms, too.
Symptoms of viral conjunctivitis can include:
This type of pink eye can affect one or both eyes.
If you notice thick and/or colored discharge, you may have bacterial conjunctivitis. This form of “pink eye” is caused by a bacteria, not a virus — that includes the coronavirus that causes COVID-19.
If you think you may have COVID-19, be sure to follow the latest CDC guidance on quarantining and seeking medical care.
SEE RELATED: Eye problems that could be related to COVID
How to get relief from burning eyes
If a household product gets in your eyes and causes burning, the first thing you should do is check the product label for specific instructions. In many cases, you will be able to safely rinse your eyes to alleviate the burning sensation.
For example, children and adults often get sunscreen in their eyes during the warmer months. Though the burning or stinging may initially be significant, rinsing the eyes gently with clean water will often provide quick relief. (See sidebar below: “What to do if you get sunscreen in your eyes.”)
If you are an allergy sufferer, your doctor may prescribe specific eye drops that can minimize the burning you might usually experience during allergy season. These drops differ from oral allergy medicines, which can sometimes cause eyes to burn by drying them out.
If you are taking an allergy medication, or any other medication that you believe is causing your eyes to burn, make sure you discuss your concerns with your doctor before discontinuing use.
Burning eyes caused by a dry eye condition can usually be relieved with frequent use of lubricating eye drops (also called artificial tears). When selecting a brand of artificial tears, consider one that is preservative-free — particularly if you plan to use the drops frequently. If your discomfort continues, let your doctor know, since there are other dry eye treatments that may be more effective and also help relieve your burning eyes.
Cool compresses gently applied over your closed eyelids can also help soothe burning eyes.
SEE ALSO: How to use eye drops without spilling
What to do if you get sunscreen in your eyes
Sunscreen is an absolute must for both children and adults to protect skin from the sun’s dangerous UV rays. But these products cause more than their fair share of burning eyes.
Getting sunscreen in your eyes at the beach is a common cause of burning eyes.
Although getting sunscreen in your eyes won’t cause any permanent damage, it can cause significant burning and eye inflammation.
If you wear contact lenses, the first thing you should do if you get sunscreen in your eyes is remove your contacts. Next, flush your eyes with a lubricating eye drop or artificial tear if you have either product handy.
It’s best to avoid rinsing your eyes with tap or bottled water. Both can harbor microorganisms that can cause serious eye infections such as Acanthamoeba keratitis. So it’s always a good idea to take a bottle of sterile eye wash liquid or artificial tears with you to the beach — whether or not you wear contact lenses.
Cold, wet compresses over closed eyes also help ease the sting of sunscreen in the eyes.
You can help the burning subside even more quickly by frequently applying preservative-free lubricating eye drops (every 20 minutes or so) until you feel better.
Also, if you wear contact lenses, consider switching to daily disposable contacts so you can immediately replace your lenses with fresh ones if you get a pair contaminated with sunscreen.
When to call a doctor
If your burning eyes are accompanied by pain or excessive light sensitivity, or if you have any eye discharge, blurred vision, eye floaters or flashes of light, double vision or other unexpected symptoms, contact your eye doctor right away for immediate attention.
Even if none of these additional symptoms occur, you should contact your eye doctor if your eyes continue to burn for more than a few days.
Page published in March 2019
Page updated in September 2021
Evaluation of the Painful Eye
1. Shields T,
A comparison of eye problems in primary care and ophthalmology practices. Fam Med.
2. Nash EA,
Patterns of emergency department visits for disorders of the eye and ocular adnexa. Arch Ophthalmol.
3. Dargin JM,
The painful eye. Emerg Med Clin North Am.
4. Azari AA,
Conjunctivitis [published correction appears in JAMA. 2014;311(1):95]. JAMA.
5. National Institute for Health and Care Excellence. Headaches in over 12s. https://www.nice.org.uk/guidance/cg150. Accessed May 3, 2015.
6. Weaver-Agostoni J.
Cluster headache. Am Fam Physician.
7. Kaye S,
Herpes simplex keratitis. Prog Retin Eye Res.
8. Lee S,
Management of preseptal and orbital cellulitis. Saudi J Ophthalmol.
9. Catron T,
Herpes zoster ophthalmicus. West J Emerg Med.
10. Wipperman JL,
Evaluation and management of corneal abrasions. Am Fam Physician.
11. Gerstenblith AT, Rabinowitz MP. The Wills Eye Manual: Office and Emergency Room Diagnosis and Treatment of Eye Disease. 6th ed. Philadelphia, Pa.: Lippincott Williams & Wilkins; 2012.
12. Walochnik J,
Twenty years of acanthamoeba diagnostics in Austria. J Eukaryot Microbiol.
13. Sambursky RP,
The prevalence of adenoviral conjunctivitis at the Wills Eye Hospital Emergency Room. Optometry.
14. Lorenzo-Morales J,
An update on Acanthamoeba keratitis: diagnosis, pathogenesis and treatment. Parasite.
15. Shields SR.
Managing eye disease in primary care. Part 3. When to refer for ophthalmologic care. Postgrad Med.
16. Saw SM,
Interventions for angle-closure glaucoma. Ophthalmology.
17. Jabs DA,
Guidelines for the use of immunosuppressive drugs in patients with ocular inflammatory disorders. Am J Ophthalmol.
18. Smith JM,
Predicting the need for surgical intervention in pediatric orbital cellulitis. Am J Ophthalmol.
19. Pula JH,
Current options for the treatment of optic neuritis. Clin Ophthalmol.
20. Jabs DA,
Episcleritis and scleritis. Am J Ophthalmol.
21. Dart JK.
Predisposing factors in microbial keratitis: the significance of contact lens wear. Br J Ophthalmol.
22. Schein OD.
Contact lens abrasions and the nonophthalmologist. Am J Emerg Med.
23. Yaphe J,
The predictive value of the penlight test for photophobia for serious eye pathology in general practice. Fam Pract.
24. Beck RW,
Optic Neuritis Study Group.
High- and low-risk profiles for the development of multiple sclerosis within 10 years after optic neuritis. Arch Ophthalmol.
25. Harman LE,
Uveitis: the collaborative diagnostic evaluation. Am Fam Physician.
26. Kerr NM,
Diagnostic accuracy of confrontation visual field tests. Neurology.
27. Han F,
Characteristics of visual field defects in primary angle-closure glaucoma [in Chinese]. Zhonghua Yan Ke Za Zhi.
28. Keltner JL,
Visual field profile of optic neuritis. Arch Ophthalmol.
29. Robinett DA,
The physical examination of the eye. Emerg Med Clin North Am.
30. Liesegang TJ.
Epidemiology of ocular herpes simplex. Natural history in Rochester, Minn, 1950 through 1982. Arch Ophthalmol.
31. Shaikh S,
Evaluation and management of herpes zoster ophthalmicus. Am Fam Physician.
32. Leibowitz HM.
The red eye. N Engl J Med.
33. Spector RH. The pupils. In: Walker HK, Hall WD, Hurst JW. Clinical Methods: The History, Physical, and Laboratory Examinations. Boston, Mass.: Butterworths; 1990.
34. Chong NV,
Pen torch test in patients with unilateral red eye. Br J Gen Pract.
35. Blazek P,
Objective characterization of the relative afferent pupillary defect in MS. J Neurol Sci.
36. Stanley JA,
The swinging flashlight test to detect minimal optic neuropathy. Arch Ophthalmol.
37. Harooni H,
Diagnostic yield for neuroimaging in patients with unilateral eye or facial pain. Can J Ophthalmol.
38. Cain W Jr,
Detection of anterior chamber leakage with Seidel’s test. Arch Ophthalmol.
39. Pokhrel PK,
Ocular emergencies [published correction appears in Am Fam Physician. 2008;77(7):920]. Am Fam Physician.
40. Waldman CW,
A practical approach to ocular pain for the non-ophthalmologist. Pain Manag.
41. Fiore DC,
Pain in the quiet (not red) eye. Am Fam Physician.
Pain In the Quiet (Not Red) Eye
1. Dargin JM,
The painful eye. Med Clin North Am.
2. Lee AG,
Painful ophthalmologic disorders and eye pain for the neurologist. Neurol Clin.
3. Wilson SA,
Management of corneal abrasions. Am Fam Physician.
4. De Potter P.
Ocular manifestations of cancer. Curr Opin Ophthalmol.
5. Optic Neuritis Study Group.
The clinical profile of optic neuritis: experience of the Optic Neuritis Treatment Trial. Arch Ophthalmol.
6. Graham K, Rizzo J. A review of optic neuritis. Digital Journal of Ophthalmology. http://www.djo.harvard.edu/site.php?url=/physicians/oa/390. Accessed March 19, 2010.
7. DiNubile MJ.
Septic thrombosis of the cavernous sinuses Arch Neurol.
8. Friedman DI.
The eye and headache. Ophthalmol Clin North Am.
9. Obermann M,
Update on trigeminal neuralgia. Expert Rev Neurother.
10. Friedman DI.
Headache and the eye. Curr Pain Headache Rep.
11. Flynn CA,
Should we patch corneal abrasions? A meta-analysis. J Fam Pract.
12. Pflugfelder SC.
Anti-inflammatory therapy of dry eye. Ocul Surf.
13. La Mantia L,
International Headache Society.
Tolosa-Hunt syndrome: critical literature review based on HIS 2004 criteria. Cephalgia.
14. Tyagi A,
Evidence base for the medical treatments used in cluster headache. Curr Pain Headache Rep.
15. van Vliet JA,
Intranasal sumatriptan in treatment of cluster headache: randomized placebo controlled double-blind study. Neurology.
16. Krafft RM.
Trigeminal neuralgia. Am Fam Physician.
17. Malhotra R,
Management of ocular ischaemic syndrome. Br J Ophthalmol.
18. Biousse V,
Ischemic optic neuropathy associated with internal carotid artery dissection. Arch Neurol.
19. Kawasaki A,
Giant cell arteritis: an updated review. Acta Opthalmol.
20. Ritch R,
Angle closure in younger patients. Ophthalmology.
21. Lee PP,
Longitudinal prevalence of major eye diseases. Arch Ophthal.
22. Rosenberg CA,
Narrow-angle glaucoma presenting as acute, painless visual impairment. Ann Emerg Med.
23. Kaiser PK,
Pineda R II.
A study of topical nonsteroidal anti-inflammatory drops and no pressure patching in the treatment of corneal abrasions. Corneal Abrasion Patching Study Group. Ophthalmology.
24. Turner A,
Patching for corneal abrasion. Cochrane Database Syst Rev.
25. Mejia-Novelo A,
Ocular metastases from breast carcinoma. Med Oncol.
26. Poulopoulos M,
Neurological complications with acute sphenoid sinusitis a surgical emergency? Neurocrit Care.
27. Capobianco DJ,
Diagnosis and treatment of cluster headache. Semin Neurol.
28. Cittadini E,
Effectiveness of intranasal zolmitriptan in treatment of cluster headache: a randomized, placebo-controlled, double-blind crossover study. Arch Neurol.
29. Jürgens TP,
Oxygen treatment in acute cluster headache. Curr Pain Headache Rep.
30. Aukerman G,
Management of the acute migraine headache. Am Fam Physician.
31. Prasad S,
Trigeminal neuralgia: historical notes and current concepts. Neurologist.
32. Cruz J,
Successful use of high dose mannitol treatment in patient with Glasgow coma scale scores of 3 and bilateral abnormal pupillary widening: a randomized trial. J Neurosurg.
33. Gorelick PB,
Headache in acute cerebrovascular disease. Neurology.
34. Smetana GW,
Does this patient have temporal arteritis? JAMA.
Uveitis | National Eye Institute
Uveitis treatments primarily try to eliminate inflammation, alleviate pain, prevent further tissue damage, and restore any loss of vision. Treatments depend on the type of uveitis a patient displays. Some, such as using corticosteroid eye drops and injections around the eye or inside the eye, may exclusively target the eye whereas other treatments, such immunosuppressive agents taken by mouth, may be used when the disease is occurring in both eyes, particularly in the back of both eyes.
An eye care professional will usually prescribe steroidal anti-inflammatory medication that can be taken as eye drops, swallowed as a pill, injected around or into the eye, infused into the blood intravenously, or, released into the eye via a capsule that is surgically implanted inside the eye. Long-term steroid use may produce side effects such as stomach ulcers, osteoporosis (bone thinning), diabetes, cataracts, glaucoma, cardiovascular disease, weight gain, fluid retention, and Cushing’s syndrome. Usually other agents are started if it appears that patients need moderate or high doses of oral steroids for more than 3 months.
Other immunosuppressive agents that are commonly used include medications such as methotrexate, mycophenolate, azathioprine, and cyclosporine. These treatments require regular blood tests to monitor for possible side effects. In some cases, biologic response modifiers (BRM), or biologics, such as, adalimumab, infliximab, daclizumab, abatacept, and rituximab are used. These drugs target specific elements of the immune system. Some of these drugs may increase the risk of having cancer.
Intermediate, posterior, and panuveitis treatments
Intermediate, posterior, and panuveitis are often treated with injections around the eye, medications given by mouth, or, in some instances, time-release capsules that are surgically implanted inside the eye. Other immunosuppressive agents may be given. A doctor must make sure a patient is not fighting an infection before proceeding with these therapies.
A recent NEI-funded study, called the Multicenter Uveitis Treatment Trial (MUST), compared the safety and effectiveness of conventional treatment for these forms of uveitis, which suppresses a patient’s entire immune system, with a new local treatment that exclusively suppressed inflammation in the affected eye. Conventionally-treated patients were initially given high doses of prednisone, a corticosteroid medication, for 1 to 4 weeks which were then reduced gradually to low doses whereas locally-treated patients had a capsule that slowly released fluocinolone, another corticosteroid medication, surgically inserted in their affected eyes. Both treatments improved vision to a similar degree, with patients gaining almost one line on an eye chart. Conventional treatment produced few side effects. In contrast, the implant produced more eye problems, such as abnormally high eye pressure, glaucoma, and cataracts. Although both treatments decreased inflammation in the eye, the implant did so faster and to a greater degree. Nevertheless, visual improvements were similar to those of patients given conventional treatment.
Causes, Symptoms, Diagnosis, and Treatment
What Is a Hyphema?
Injuries can cause bleeding in the front (or anterior chamber) of your eye, between the cornea and the iris. This bleeding is called a hyphema.
This part of your eye holds a clear liquid called aqueous humor. Folds in the back (or posterior chamber) of your eye called ciliary processes make this fluid. It then passes through your pupil into the anterior chamber.
Symptoms of a hyphema include:
- Blurry, cloudy, or blocked vision, or vision with a red tint
- Blood in the front of your eye
- Sensitivity to light
When to go to the doctor
Hyphema is a medical emergency. Call your eye doctor right away. If they’re not available, go to your local hospital’s ER.
Hyphema Causes and Risk Factors
About 70% of hyphemas happen in children, especially in males ages 10 to 20. They’re usually caused by blunt injuries from activities like:
- Industrial accidents
- Shooting BB and airsoft guns
Less common causes include:
- Eye surgery
- Unusual blood vessels on your iris
- Eye infections from a herpes virus
- Blood clotting problems
- Eye cancers
Some things that affect your blood can make you more likely to have a hyphema, such as:
- Sickle cell disease
- Von Willebrand disease
- Blood-thinning (anticoagulant) drugs
Your doctor will ask whether you’ve ever had an eye injury and what happened before the hyphema. It’s important for them to know if, for example, you were hit in the eye with a baseball or you ran into a tree branch.
The doctor will do an eye exam. This involves:
- A visual acuity test to check how well you can see. They’ll also check the pressure inside your eye (called intraocular pressure).
- Looking inside your eye with a special microscope called a slit lamp. A hyphema looks like a clot or layered blood in the front of your eye. If the anterior chamber is filled with blood, it’s called a total, black, or eight-ball hyphema. The doctor can also see if you have a microhyphema, which looks like a haze of red blood cells.
- A CT scan to look at your eye sockets and other parts of your face, if the injury is severe
- Screening for sickle cell disease or thalassemia in people of African descent
Questions to ask your doctor
- How big is the hyphema?
- Are there any signs of permanent damage?
- Are there any signs of permanent vision loss?
- How can I keep this injury from happening again?
- Should I stop taking blood-thinning medications?
- When can I get back to my regular activities?
Don’t try to treat a hyphema without talking to your eye doctor. Don’t put anything over your eye, because you may do more harm than good.
About 15% to 20% of people with a hyphema have more bleeding in 3 to 5 days.
Your body usually absorbs the blood, but your doctor will want to be sure that it’s happening like it should. If the pressure in your eye goes up or if you have more bleeding, you may need to stay in the hospital.
It’s important to follow your treatment plan. This usually includes:
- Limit eye movement. Rest in bed with the head of the bed raised as far as you can.
- Use eye drops exactly as prescribed. Your doctor will probably give you atropine to dilate (widen) your pupil and corticosteroids to prevent scarring.
- Protect your eye. Cover it with a shield to keep from injuring it more. You may also need to wear a patch over the shield to keep light out of your eye.
- Watch your medications. Don’t take any medicines with aspirin. It can lead to more bleeding. Also avoid nonsteroidal medications such as naproxen, ibuprofen, and many arthritis drugs. You can use a mild pain reliever, such as acetaminophen, but don’t take too much. You need to know if you have eye pain. It may be related to an increase in pressure. If the pain gets worse, go back to the doctor right away.
- Check your pressure. Your doctor will probably want to measure the pressure inside your eye every day for several days.
You may also get medicine to prevent vomiting, which can raise the pressure inside your eye.
Red blood cells that block the mesh inside your eye can sometimes raise the pressure. If your eye pressure goes up, your doctor might give you medicine such as a beta-blocker.
Children and older people may not be able to follow the home treatment plan. They and people who have complications could need to stay in the hospital.
Depending on your case and your other medical conditions, you might need surgery.
If you’ve been in the hospital for a hyphema, wear an eye shield for 2 weeks. You’ll need more eye exams for at least 2 to 4 weeks. Also, avoid difficult activities for at least 2 weeks.
A serious eye injury can raise your risk of glaucoma. Your doctor should check for it every year.
Other complications of a hyphema include:
- Damage to your optic nerve
- A stained cornea
- Permanent vision loss
A hyphema can happen any time you injure your eye. Wear protective goggles when you take part in a sport or activity that could lead to eye injury.
Eye pain and headaches – Latvijas Amerikas acu centrs
Is eye pain always associated only with an eye disease?
No, other diseases can also cause pain in the eye or around it.
When are other structures of the body responsible for eye pain?
The eye is a generously innervated organ whose sensation is supplied by the trigeminal nerve which is responsible for sensation to the skin of the head, upper lid, lacrimal gland, cornea and eye mucosa or conjunctiva, the root of the nose, frontal sinuses and also in a part of meninges, their outer layer and blood vessels. In case of pathology of this nerve, one of the symptoms could also be eye pain although the eye as an organ is intact.
Trigeminal nerve (V) and its branches
One of the nucleus of the trigeminal nerve is located in the neck region where it interacts with a cranial nerve XI or accessory nerve and also with nerve tracts in the upper part of the neck thus transferring neck-emerged pain to the head including the eye.
Nucleus of the trigeminal nerve (V) in the neck
Eye pain may be caused also by diseases of the optic nerve and occipital neuralgia or diseases of nerves originated from the region of the first and second cervical vertebrae.
Anatomy of the optic nerve
What diseases cause eye pain and headaches?
Migraine or disease characterised by intense headache. Symptoms of the disease can include increased sensitivity to light and sound, nausea and vomiting, dizziness, pains in the eye or behind the eye, blurred vision, changes in the visual field (floating opacities, flashing lights) etc.
Migraine is classified as two types, migraine with or without an aura. In case of migraine with an aura, there are symptoms before the migraine attack signalling an approaching attack. The attack of migraine may last from several hours up to several days and it usually has several phases. However, each patient can react differently.
There is also a retinal migraine or eye migraine when the main complaints during the attack are associated with visual disturbances, blurred vision.
Migraine and cluster headache
Cluster headaches are one of the most intensive headaches. They usually start abruptly without any warning symptoms and are characterized by episodes of pain which repeat periodically. The period of attacks usually lasts from 6 to 12 weeks and may be seasonal. During the period of attacks, pain usually occurs every day, possibly even several times per day. Duration of one episode of pain may be from 15 to 180 minutes, besides each time it starts at a specific time of the day, most frequently at night, 2 to 3 hours after falling asleep. Pain is usually tormenting, in most cases it is localised around the eye but it can radiate to the face, head, even to the neck and shoulders. Pain is unilateral and could be accompanied by redness of the eye, increased lacrimation, eyelid oedema and even dropping of the upper eyelid.
Occipital neuralgia is a common type of headache. These headaches are caused by a pair of occipital nerves which arise in the neck region next to the 2nd and 3rd cervical vertebrae. Causes of pain includes tumours, trauma, infections, haemorrhages or such a systemic disease as osteoarthritis, degenerative changes in the cervical vertebrae, diabetes and gout. Occipital neuralgia may be caused also by prolonged flexion of the head. Usually pain starts in the neck and then spreads up and radiates behind the eyeball, to the back of the head, forehead and temple. Pains are sharp, pulsating, like an electric shock.
Trochleitis is inflammation of the tendon of the superior oblique muscle which causes pain above the eyeball or in the inner eye corner. Trochleitis may be caused by autoimmune connective tissue diseases, e.g. Behçet’s disease, granulomatosis with polyangiitis, lymphoma, Tolosa-Hunt syndrome and rheumatic diseases – rheumatoid arthritis, systemic lupus erythematosus or inflammation of paranasal sinuses, tumours. In case of trochleitis, pains are sustained, their intensity may vary from dull to very intense. It has been mentioned in isolated studies that trochleitis may trigger migraine if a patient has previously suffered from it.
Anatomy of trochlear nerve
LASH is a very rare type of headaches which may manifest in two ways. In the first case, the symptoms of the disease are episodic and manifest by short-term, frequent attacks of headaches accompanied by signs such as irritation of conjunctiva, lacrimation, dropping of the upper eyelid, nasal discharge. One attack lasts from 2 to 45 minutes. In the second case, LASH manifests as mild to moderate long-lasting unilateral headaches accompanied by migraine-like attacks with an even more pronounced pain syndrome. In both cases, pains could be localized also behind the eyeball.
Trigeminal neuralgia is a chronic condition affecting the trigeminal nerve, and in case of it even a mild stimulation of the face may trigger an attack of shooting pain. The attack of pains may be triggered by smiling, speaking, touching the face, drinking cold or hot drink, shaving, brushing teeth etc. Initially, the attacks may be short and mild which gradually progress both in duration and intensity. Pains are cutting and like electric shock, their reason is not fully understood.
Optic neuritis is a demyelinising inflammation of the optic nerve causing the optic nerve to lose myelin fibres which results in impaired transfer of visual information to and from the brain. This inflammation is characterized by visual impairment and pains which intensify upon eye movement. Changes in colour vision are also commonly observed. Frequently, pains are the first sign of the optic neuritis. The cause of this inflammation frequently is systemic diseases such as multiple sclerosis and neuromyelitis.
Postherpetic neuralgia occurs in 7% of patients who suffered from herpes zoster with involvement of the eye. After recovery, patients may suffer from episodic or even continuous pain for months and even years also in the area around the eye. Postherpetic neuralgia is more likely to occur in elderly patients and those whose herpes zoster started with a prodrome, symptoms which resemble a cold.
Disease of paranasal sinuses is an inflammation or oedema of tissue in those sinuses which may be a result of action of different viruses, bacteria, fungi or allergens. Inflammation causes obstruction of the sinuses which is manifested by typical symptoms – nasal discharge, tenderness in the face area including area around the eye, headaches, fever, weakness, sore throat and cough.
Irradiating pain. Eye pain can also occur in case of haemorrhagia in the frontal lobe when pain radiates to the eye, in case of damage of the posterior cranial fossa and cervicalgia or pain in the cervical part.
Even the famous philosopher Socrates who lived before our ere has said: “Just as you ought not to attempt to cure eyes without head or head without body, so you should not treat body without soul…” Although the narrow specialization in different medical fields is characteristic of medicine today it is always worth remembering that the human body is a whole entity which should be treated so.
90,000 Eye diseases in inflammatory bowel diseases
Approximately 10% of patients with inflammatory bowel disease suffer from secondary eye diseases . Most of them are treatable and do not lead to decreased vision. However, if something bothers you, it is better to see an ophthalmologist. In inflammatory bowel diseases, the following secondary eye diseases may occur:
Uveitis (inflammation of the choroid) is one of the most common ocular complications.Ludis uveitis may experience pain, blurred vision, photophobia, and redness of the eyes. These symptoms may appear gradually or suddenly. To diagnose uveitis, an ophthalmologist (a doctor who specializes in eye conditions) uses a “slit lamp” (a special microscope that allows the doctor to look at the inside of the eye). The symptoms of uveitis decrease, while the inflammation in the intestines decreases. But an ophthalmologist may prescribe special eye drops containing glucocorticosteroids to reduce inflammation.If the process is not treated in time, uveitis can lead to glaucoma (an eye disease in which intraocular pressure rises), and possibly a decrease in visual acuity.
Keratopathy is an eye disease with corneal dystrophy (malnutrition) that can also develop in some people with Crohn’s disease. As a result of this process, thickening, opacity, edema of the cornea occurs. Again, the ophthalmologist uses a slit lamp to make the diagnosis.Keratopathy causes pain and does not lead to loss of vision, therefore, usually does not require special treatment, except for the treatment of the underlying disease – inflammatory bowel disease.
Episcleritis is manifested by inflammation of the episclera (outer dense connective tissue membrane of the eye). When the small blood vessels of the biscuits become inflamed, they dilate and the eye turns red. In addition, episcleritis can also lead to pain and tenderness in the eye. For its treatment, glucocorticosteroids and vasoconstrictor drugs in drops are usually used, but there are cases of spontaneous healing with a decrease in inflammation in the intestine.
Dry eye syndrome. Vitamin A deficiency can lead to dry eyes, which is caused by a decrease in the formation of tear fluid or an increase in the evaporation of the tear film. Dry mucous membranes can subsequently lead to infection and irritation of the eyes, which is manifested by itching and burning. With severe infection, a course of antibiotics may be needed. Another possible consequence may be “night blindness” (a disorder of night and twilight vision, when a person sees well in bright light, but poorly at dusk).Artificial tear and vitamin A formulations have been shown to relieve dry eye symptoms.
Other problems. Inflammation can occur in other parts of the eye, for example, in the retina or optic nerve, although this does not occur often. The reason lies not only in the inflammatory bowel disease itself, which secondarily affects the tissues of the eye, but also in the fact that the drugs used to treat IBD have side effects. For example, prolonged use of hormones – corticosteroids – can lead to glaucoma (increased intraocular pressure) and cataracts (clouding of the lens of the eye), which leads to deterioration of vision.
Certainly not all patients with Crohn’s disease or ulcerative colitis develop eye diseases, however, you should know that regular examination by an ophthalmologist is very important. Early detection of the problem leads to successful treatment and maintenance of normal vision.
90,000 Ophthalmologists told why coronavirus is dangerous for the eyes
COVID-19 can affect the eyes and affect visual acuity, ophthalmologists say. A new type of coronavirus can cause swelling, spasms of the eye muscles, disturbances in the functioning of the optic nerve, as well as inflammation of the retina.WHO has already listed eye lesions as a common symptom of COVID-19. Gazeta.Ru tells about how to protect eyesight.
Coronavirus infection can lead to visual impairment, said Tatyana Shilova, ophthalmologist, expert of the State Duma Committee on Health Protection, to the radio station “Moscow speaking”.
“Indeed, at the moment there are studies that claim that the eyes can be the gateway for the coronavirus, and it can infect their mucous membranes.
Some sources say about 5-7% of cases of manifestation of coronavirus in the form of coronavirus conjunctivitis “,
– she said.
The medic stressed that COVID-19 is not the only infectious disease that causes vision problems. “We are well aware of the behavior of some viruses that infect not only the surface of the eye, but also its internal structures, including penetrating with the blood stream,” she explained.
The World Health Organization has also listed eye lesions as a common symptom of COVID-19 infection.At the same time, an ophthalmologist and professor at Oxford University Robert McLaren told the BBC that a recent study in Wuhan, China, showed that local patients with coronavirus also developed vision problems, expressed in swelling and discharge from the eyes. …
“These symptoms are not just external manifestations, they can seriously affect visual acuity, and affected people may even be advised not to drive vehicles,” he said.
Ophthalmologist Natalya Ivankovskaya explained to Gazeta.Ru that the mucous membrane of the eye is indeed a favorable environment for the coronavirus. “The fact is that the pH (a measure of acidity, – Gazeta.Ru) of the new type of coronavirus coincides with the pH of a tear, so if the virus gets into the eyes, it lingers in them – they, in turn, begin to practically“ melt ” , as happens, for example, with herpes, ”the doctor said.
She added that because of this, PCR tests (a method for diagnosing infections based on the study of the patient’s genetic material – “Newspaper.Ru “) can be taken directly from the mucous membrane of the eye.
“COVID-19 aims at the target organs, if someone has weak kidneys, it hits the kidneys, if the vessels are weak, strokes begin. The same is true here – if there were problems with the eyes, then as a result the infection will result in an eye pathology. “,
– the doctor noted.
According to Tatyana Shilova, coronavirus infection can be expressed in redness of the eyes, photophobia, lacrimation and cramps – this is caused by damage to the retina, choroid, and optic nerve virus.In addition, the patient may complain of blurred vision and various spots and sparks in front of the eyes, the specialist said.
Ivankovskaya, in turn, reported that the most common ophthalmological manifestations of COVID-19 are conjunctivitis and blepharitis (a pathology that affects the eyelids and causes inflammation on their edges, – Gazeta.Ru).
“Because of the coronavirus, inflammation begins, and almost any inflammation leads to visual impairment. This happens for various reasons. For example, an infection can cause swelling, a change in the structure of the tear fluid and a spasm of the eye muscles, ”explained the ophthalmologist.However, she stressed that in this case, visual acuity can be restored.
Changes in COVID-19 can also occur in the fundus, ophthalmologist Tatyana Anfalova told Gazeta.Ru – however, their connection with coronavirus has not yet been scientifically established. “Coronavirus infection is not yet sufficiently studied to draw any precise conclusions, but vigilance should be in any case,” said the doctor.
At the same time, Tatyana Shilova drew attention to the fact that not only the coronavirus itself has a negative effect on the eyes, but also some drugs that treat this infection, in particular, we are talking about the antimalarial hydroxychloroquine, the trials of which were previously suspended by the WHO due to its toxicity.
“It causes changes in the center of the retina, that is, it impairs visual acuity, accommodation (the ability to see at different distances, -” Gazeta.Ru “), photophobia may appear, with prolonged use – retinopathy (damage to the inner lining of the eye, -” Gazeta. Ru “)”, – said the doctor.
According to Tatyana Anfalova, the use of hydroxychloroquine has always been under the supervision of an ophthalmologist. “Typically, this drug gave a delayed lesion several months after continuous use,” – said the medic.
At the same time, Sofia Ermakova, an ophthalmologist at the Research Institute of Eye Diseases, told Gazeta.Ru that such an effect of hydroxychloroquine is a rare phenomenon. “Also, in addition to this remedy, antiviral drugs and antibiotics are used in the treatment of patients with coronavirus, but, as we know, they definitely do not negatively affect vision,” she added.
If a person has already contracted a coronavirus infection, you can protect your eyes from damage by contacting a competent ophthalmologist, Natalya Ivankovskaya believes.
“A professional will prescribe the correct individual treatment, see what is more in the eye – viruses or bacteria”,
– she explained. The doctor added that in most such cases, antibacterial, anti-inflammatory and local immunity-enhancing therapy will be used.
To protect the eyes of people already sick with COVID-19, you need proper nutrition and quitting smoking, Tatyana Anfalova is convinced. “It is necessary to devote time to self-diagnostics of vision: to check the eyes one by one.If you detect a decrease in vision, spots before the eyes, distortion of lines, narrowing of the visual fields, immediately consult a doctor, “the doctor said in a conversation with Gazeta.Ru.
In addition, for prophylaxis, ophthalmologists advise wearing not only masks and gloves, but also glasses in public places. “After all, if the virus got into the eye, it means that it also got into the whole body, because there is a terminal vascular branch in the eye, and the infection quickly spreads through the bloodstream throughout the body,” concluded Ivankovskaya.
90,000 symptoms and treatment, causes of
Varieties and signs of the inflammatory process of the eyelids
The types of inflammation depend on the causes of its occurrence. Let’s take a closer look:
With this type of infection, meibomitis occurs, that is, the release of pus from the sebaceous gland. Barley, as a rule, can have one focus of development, and can simultaneously affect the upper and lower eyelids, in which case Staphylococcus aureus acts as an infection.Signs of eyelid inflammation are as follows: swelling, redness, swelling, and pus. In the advanced stage of inflammation of the eyelid of the eye, severe pain is possible.
Abscess of the eyelid
This is the formation of a cavity in the eyelid filled with pus. Predisposing factors may be previously transferred infectious diseases, parallel processes of nasal inflammation. Symptoms are similar to those of barley – swelling, redness, pain, and severe itching.
Herpes is a viral disease that causes herpes inflammation of the eyelid.A feature of the virus is the symptoms – watery bubbles with liquid. As the virus develops, the bubbles burst and small ulcers form in their place.
The most common cause of inflammation of the eyelid of the eye, namely the edges of the eyelid. Blepharitis as an infection occurs due to a weak immune system, chronic diseases, or concurrent inflammatory processes. So an elementary disregard for hygiene standards can develop into an infectious disease.The main symptoms of blepharitis are severe itching and burning, redness, painful sensations and purulent discharge.
Treatment of inflammation of the eyelids
Treatment of an infection depends on the symptoms, stage and type of infection. So you can highlight the method of treating symptoms and mandatory hygiene procedures. It is also best to use drugs, drops or ointments containing antibiotics or antiviral drugs that localize pathogens and effectively destroy them.
In addition to drugs, it is necessary to observe basic hygiene measures. It often seems that inflammation can be easily cured, of course this is so, but only the treatment is recommended by a specialist
SarcoidosisUK – Sarcoidosis and The Eye
2) Inflammation of the lacrimal gland
This type of eye inflammation is rare.
- dry eyes
- itchy, burning eyes
- Irritation when reading and using screens
- Overproduction of tears due to cold, draft and wind
Treatment: Administration of artificial tears or ointment.
3) Inflammation of the conjunctiva
Small bulges (follicles) form on the white of the eye or on the inside of the eyelids. This type of eye inflammation is rare.
- disfigurement of the eye
- pain, feeling of pressure around the eyes
- redness (severe inflammation)
Treatment: Anti-inflammatory eye drops.
4) Deterioration of the optic nerve
Deterioration of the optic nerve is rare and is almost always associated with an inflammatory disease of the nervous system.Consultation with a neuro-ophthalmologist is recommended.
- blurred / dull / segmented vision (e.g. lower / upper field is blind)
- Reduced color vision
- pain around the eye or orbit
Treatment: Corticosteroids in tablet form or by infusion.
Neurosarcoidosis and eye
Neurosarcoidosis may affect normal eye function. It is sometimes confused with sarcoidosis of the eye.For more information on how neurosarcoidosis can affect the eyes, see the SarcoidosisUK Patient Fact Sheet. Sarcoidosis and the nervous system .
Complications of Uveitis
In rare cases of sarcoidosis, additional complications surrounding the eye may occur:
Cataracts and Glaucoma : Due to eye inflammation and long-term corticosteroid treatment, the lens may become opaque (cataract) and intraocular pressure may increase (glaucoma).Glaucoma is treated with eye drops and may require surgery in extreme cases. The cataract lens can be replaced with an artificial lens.
Macular edema Prolonged uveitis causes retinal edema, which can kill light-sensitive cells. This can cause permanent eye damage in patients with sarcoidosis and uveitis. Treatment may include corticosteroid injections, pills, or other immunotherapy such as biologics.
Inflamed blood vessels In posterior uveitis and panuveitis, blood vessels may become inflamed or granulomas (edema) in the deep choroid may develop. In severe cases, small blood vessels in the retina may leak or close, causing bleeding and swelling.This can lead to oxygen deficiency and create new, weak blood vessels. They bleed easily. Retinal laser treatment can treat new blood vessels.
Eye problems are common in sarcoidosis. It is important to identify eye diseases at an early stage. Proper monitoring and timely treatment can often prevent permanent damage. Sarcoidosis patients should contact an optometrist or a good optometrist at least once a year to check for any complications.
90,000 Glaucoma. Signs and causes.
Glaucoma is a severe eye pathology that often leads to blindness and visual disability.
The term “glaucoma” unites a group of diseases with characteristic features:
- constant or periodic increase in intraocular pressure (IOP) above the tolerant (individually tolerated) level
- development of specific optic nerve atrophy
- typical defects of the visual field, followed by a decrease and central vision
Progression of glaucoma leads to degeneration of retinal ganglion cells.
These are neurons of the central nervous system, body cells of which are located in the inner retina, and axons in the optic nerve. Degeneration of these nerves results in the characteristic appearance of the optic disc and loss of vision.
Glaucoma affects more than 70 million people worldwide, with about 10% suffering from bilateral blindness, making it the leading cause of irreversible blindness in the world. This disease has a significant negative impact on the psychological, social and emotional state of patients.
Glaucoma can remain asymptomatic for a long time.
Population surveys show that only 10% to 50% of people with glaucoma know that they suffer from this pathology.
Glaucoma can be divided into 2 types:
About 80% of cases are open-angle glaucoma; however, angle-closure glaucoma is more likely to result in severe vision loss. Open-angle and closed-angle glaucoma may be the primary disease.
Secondary glaucoma can result from trauma, certain medications (corticosteroids), inflammation, swelling, or conditions such as pigment dispersion or pseudoexfoliation.
Types of glaucoma
Primary open-angle glaucoma
The most common type of glaucoma. It develops as a result of an imbalance between production and the outflow of intraocular fluid. As a result, eye pressure builds up and begins to damage the optic nerve. This type of glaucoma is painless and does not cause vision changes at first.
Some people may have optic nerves that are sensitive to normal eye pressure. This means that they are at a higher risk of developing glaucoma than usual.In such cases, normal pressure glaucoma develops. Regular eye exams are important for detecting early signs of damage to their optic nerve.
Angle-closure glaucoma (or “narrow-angle glaucoma”)
This type of glaucoma develops in eyes where the iris is very close to the angle of the anterior chamber, i.e. to the drainage system. Thus, when the pupil dilates, the iris can block the drainage of the intraocular fluid. Think of it like a piece of paper sliding over a sink drain.When the drainage angle is completely blocked, ocular pressure builds up very quickly. This is called an acute attack of glaucoma. This is a truly urgent condition that requires the immediate intervention of an ophthalmologist. Otherwise, there is a high likelihood of significant loss of vision and blindness.
Signs of an acute attack of angle-closure glaucoma:
- vision suddenly blurry
- severe eye pain
- severe headache
- rainbow rings or halos around lights
Many people with angle-closure glaucoma develop slowly.This is called chronic angle-closure glaucoma. The asymptomatic course leads to the fact that often patients turn to an ophthalmologist when an attack of angle-closure glaucoma occurs.
Risk factors that should prompt you to visit an ophthalmologist for glaucoma
- over 40 years old
- a relative has glaucoma
- Use of topical or systemic steroids
- high intraocular pressure
The importance of an appropriate ophthalmologic examination of the eye cannot be overstated in relation to the early detection of glaucoma.The loss of retinal ganglion cells causes a progressive deterioration in visual fields that usually begins in the middle periphery and can progress centripetally until only the central or peripheral visual island remains. The presence of characteristic visual field defects can confirm the diagnosis, but up to 30-50% of retinal ganglion cells may be lost before the defects are detected by standard visual field testing.
Therefore, the diagnosis of glaucoma includes:
- determination of visual acuity
- perimetry (examination of visual fields)
- biomicroscopy of the anterior and posterior parts of the eye with an assessment of the features of the anatomy of the eye and the state of the optic nerve
- gonioscopy (assessment of the state of the drainage system of the eye) and ultrasound biomicroscopy.However, these research methods are contact and cause discomfort to the patient. They were replaced by:
- Pentacam (non-contact method of examination, allowing to evaluate the anatomy of the anterior segment)
- Optical coherence tomography of the anterior and posterior segments of the eye. To date, the most highly specific method for diagnosing and assessing the progression of glaucoma
The main goal in the treatment of glaucoma is to reduce intraocular pressure to those individual values at which the progression of degeneration of retinal ganglion cells will be stopped.Treatment includes conservative, laser and surgical methods.
The choice of treatment method depends on the type of glaucoma, the level of intraocular pressure, the effectiveness of conservative therapy.
Ten Tips for Patients
1. Catch this silent thief before you lose your sight. If you have risk factors for glaucoma, you should see your ophthalmologist regularly. This increases the likelihood of detecting the disease in the early stages and prescribing timely treatment.It is equally important to take your glaucoma medication as recommended by your doctor.
2. Taking steroids? Tell your ophthalmologist. Taking steroids for a long period of time or at high doses can increase intraocular pressure, especially if you have glaucoma.
3. Eat well to preserve your eyesight. Eat lots of green vegetables and colored fruits and berries every day. They contain vitamins and minerals that protect your eyes. In fact, research shows that foods that are good for the eyes are better than vitamins at preventing glaucoma.
4. Exercise … but careful. Intense exercise that raises your heart rate can also increase your intraocular pressure. But brisk walking and regular exercise at a moderate pace can lower intraocular pressure and improve overall health.
5. Protect your eyes from injury. Eye damage can lead to glaucoma. Always wear safety glasses when playing sports or doing hazardous work in the home or yard.
6. Avoid head down position. If you have glaucoma or are at high risk for the disease, do not keep your head low for long periods of time. Placing your head down can significantly increase your intraocular pressure. Some people with severe glaucoma may need to avoid certain yoga postures. Ask your doctor if you need to avoid the head-down position in your workouts.
7. Sleep in the correct position. If you have glaucoma, stay awake with a pillow or arm.People with obstructive sleep apnea are also at risk of glaucoma. If you snore heavily or stop breathing during the night, see a specialist.
8. Protect your eyes from sunlight. There is some evidence that the sun’s ultraviolet rays can cause glaucoma. Wear quality polarized glasses and a hat when outdoors.
9. Monitor the condition of the oral cavity. Recent research has linked gum disease to damage to the optic nerve in glaucoma.Brush your teeth every day and visit your dentist regularly.
10. Tell the ophthalmologist about antihypertensive drugs. If your blood pressure drops too low while you sleep, it can worsen the progression of glaucoma. If you are taking blood pressure medications at night or if you have symptoms of low blood pressure (such as feeling dizzy), tell your ophthalmologist and physician / cardiologist. Do not change your blood pressure medications yourself.
Conjunctivitis | Institut de la Màcula
Conjunctivitis is an inflammation of the conjunctiva, the mucous membrane that covers the inner movable part of the eyelids that covers the front of the eyeball. It is caused by viruses, bacteria or allergies.
The patient develops redness, photophobia, palpebral inflammation, lacrimation, and depending on the cause of the disease, ocular discharge in the bacterial form, enlarged lymph glands in the viral form and inflammation of the eyelid margin with irritation or allergic form.The duration can vary between 1 and 3 weeks, although if conjunctivitis is severe, the illness may last longer.
Conjunctivitis can be transmitted very easily, therefore it is very important to follow the rules of hygiene, after touching an infected eye, be sure to wash your hands.
Treat both eyes with sterile saline.
It is necessary to contact a specialist who will prescribe the appropriate treatment in each case.
Spring conjunctivitis is an allergic process that affects the eyes, most common at this time of year. Allergens such as pollen often trigger or worsen the symptoms of conjunctivitis.
Itching is the main symptom of the disease. In addition, redness of the eyes, tearing, palpebral inflammation, secretion, eye pain, and in more severe cases, photophobia and blurred images may appear.
May be combined with upper respiratory tract infections: allergic rhinitis, and pharyngitis.
Environmental control is very important for patients prone to vernal allergic conjunctivitis. It is necessary to identify the allergen and try to avoid contact with it. If contact with the allergen does occur, it is necessary to rinse the eyes with saline to remove the irritating particles and to minimize the contact time of the allergen with the eye.
Research is needed to determine allergens. Thus, in the future, you can resort to vaccination.
For allergic conjunctivitis, topical antihistamines are prescribed. In the case of a general allergic reaction, oral antihistamines are prescribed. For the most severe forms, topical corticosteroids are prescribed.
In some cases, intravenous administration of corticosteroids is necessary.
In any case, it is necessary to consult an ophthalmologist as soon as possible to assess the degree of the disease, the severity of the pathology and the appointment of adequate treatment.
Dr. Paula Verdaguer, M.D. PhD
COMB license number: 40.737
Specialist in Corneal Treatment, Refractive Surgery and Cataract
90,000 Open-angle glaucoma: causes, symptoms, treatment
Open-angle glaucoma is a progressive chronic eye disease characterized by increased intraocular pressure, which gradually leads to damage to the optic nerve, disability and blindness.
Under the term “primary open-angle glaucoma” several clinical forms of the disease are grouped. All of them are united by the deterioration of the outflow of aqueous humor, the presence of an open angle of the anterior chamber, increased ophthalmotonus, pathological excavation (deepening) of the optic nerve head and characteristic disturbances in the visual fields.
According to the WHO, today there are more than 70 million people in the world suffering from this disease.
Open-angle glaucoma is in second place among eye pathologies leading to irreversible loss of vision, therefore, the study of the causes, identification of early symptoms, treatment and prevention of this disease is a priority in scientific and practical ophthalmology.
For a long time, open glaucoma is asymptomatic, and the first signs appear only when at least 40% of the optic nerve fibers are destroyed, which cannot be restored.
Causes of open-angle glaucoma
Normally, a balance is maintained between production and the removal of aqueous humor in the eye structures. The disease develops gradually as dystrophic changes in the drainage system progress. With impaired circulation of aqueous humor, intraocular pressure rises rapidly, which causes compression of blood vessels, as a result of which the fibers of the optic nerve do not receive oxygen and nutrients.Ischemia, hypoxia and compression of the optic nerve head cause the death of nerve fibers through which impulses enter the brain. Irreversible blindness sets in.
Risk factors affecting the onset and progression of glaucoma are divided into general and local.
Common factors include:
- Age over 60 years.
- Heredity aggravated by glaucoma.
- Endocrine pathologies: diabetes mellitus, hypothyroidism, diencephalic syndrome.
Local risk factors:
- Changes in the eye due to myopia or early age-related hyperopia.
- Dystrophy of the iris
- Lyspersis pigment syndrome
- Pseudoexfoliative syndrome.
Identification of risk factors, causes, characteristic symptoms of open-angle glaucoma is of great importance for the appointment of adequate treatment in each individual case.
Symptoms of open-angle glaucoma
In the early stages of open-angle glaucoma, symptoms are mild and usually do not bother patients, which explains the late visit to an ophthalmologist.
- Feeling of discomfort in the eyes.
- Pain in the region of the eyebrows.
- Increased lacrimation.
- Eyes cut and redness.
- Deterioration of vision at night.
- Blurred vision, the appearance of a “grid” before the eyes.
- The appearance of iridescent halos when looking at bright light
Open-angle glaucoma has 4 stages in its development:
Initial – there is no pronounced symptomatology. The diagnosis reveals increased intraocular pressure, the appearance of a depression (excavation) in the center of the optic nerve head, a slight change in the field of vision.
Developed, in which there is a significant narrowing of the visual field from the nasal side.Ocular hypertension causes severe pain (dull, pressing) in the eyeball area. At this stage, a decrease in visual acuity occurs.
Far-reaching – the visual defect is getting worse. There is a concentric decrease in the field of view in one or more segments. Excavation of the optic nerve disc increases. As a result, patients have only the so-called “tube” vision, when they look through a narrow tube, as it were.
Terminal stage is characterized by complete loss of vision in one or both eyes.In rare cases, areas of visibility in the temporal sector and light perception are preserved.
Since glaucoma in the initial stages is asymptomatic, to detect it even in the absence of patient complaints, an annual consultation with an ophthalmologist is required in people over 40 years of age.
Diagnosis of glaucoma is a comprehensive study that includes:
Tonometry – determination of intraocular pressure indicators.
Determination of visual acuity.
Perimetry – check of visual fields.
Optical coherence tomography, which allows you to study the structure of the visual apparatus: the retina, cornea, components of the anterior chamber and the state of the optic nerve.
Pachymetry – a method for assessing the thickness of the cornea (contact, non-contact)
Biomicroscopy of the eye media – slit lamp examination.
Gonioscopy of the eye to assess the internal drainage system of the eye.
Treatment of open-angle glaucoma
Basic methods of treatment;
- conservative – medication;
The goals of drug treatment for primary open-angle glaucoma are to reduce intraocular pressure, improve blood supply to the optic nerve, and normalize metabolic processes in the structures of the eye.
Decrease in intraocular pressure leads to a decrease in the progression of primary open-angle glaucoma.
The main condition for the successful treatment of open-angle glaucoma is the constant daily instillation of drugs into the eyes, as recommended by an ophthalmologist, to reduce the severity of symptoms.
Treatment begins with first-line drug monotherapy.
The first line drugs include prostaglandins F-2a, which reduce intraocular pressure by increasing the outflow of aqueous humor: Xalatan, Travatan, Prolatan.
In case of ineffectiveness or poor tolerance by the patient, the drug is replaced with a drug from another pharmacological group or a combination therapy is switched over.
Cholinomimetics (“Pilocarpine”, “Carbacholine”, “Fosfakol”) by narrowing the pupil and contraction of the ciliary muscle expand the cracks of the trabecular network – as a result, the outflow of aqueous humor improves.
Appointment of β-blockers: “Timolol”, “Betoptik”, “Proxodol” leads to a decrease in the production of aqueous humor.
Carbonic anhydrase inhibitors (Azopt, Trusopt) also reduce the production of eye fluid.
In addition, vascular therapy is used to improve blood supply and metabolic processes.
The results of the achieved hypotensive effect are periodically checked by an ophthalmologist – the condition of the optic nerve disc and the preservation of visual functions are assessed.
Indications for surgical treatment in open-angle glaucoma are:
- Progression of the disease against the background of ineffectiveness of other methods of treatment.
- Inability to use alternative methods of therapy: non-compliance by the patient with the doctor’s instructions, severe side effects.
- Maintaining a high level of intraocular pressure, which cannot be corrected by conservative methods.
The aim of glaucoma surgery is to normalize hydrodynamics – the formation of additional artificial ways for the outflow of aqueous humor.
Several types of surgical intervention for glaucoma have been developed:
- Penetrating – trabeculectomy and its modifications create new or correct existing pathways for fluid outflow.
- Cyclodestructive, which contribute to the suppression of the production of intraocular fluid.
- Installation of implants (artificial drains, valves) causes a distinct hypotensive effect and allows you to control the level of intraocular pressure, which slows down the progression of glaucomatous optic neuropathy.
Laser treatment of glaucoma consists in restoring the outflow of aqueous humor along natural pathways.
In the clinic of family ophthalmology of Professor Trubilin for the treatment of open-angle glaucoma, the technique of non-penetrating deep sclerectomy is used. This is a gentle method without opening the eyeball, all manipulations are performed within the drainage system.
In deep stages of glaucoma, a micro-shunt is installed, which is implanted under the sclera.All these techniques have been modernized by Professor Trubilin and are effective and safe.