ARAVIND EYE CARE SYSTEM Aravind Eye Hospital & Postgraduate Institute of Ophthalmology ARAVIND EYE CARE SYSTEM Aravind Eye Hospital & Postgraduate Institute of Ophthalmology DEPARTMENT OF COUNSELLING Corneal Opacity

 The clear cornea becomes white following scarring. The causes can be congenital or acquired from a healed ulcer.  It can result in visual loss and can be cosmetically disfiguring Picture of corneal opacity What is corneal opacity?

 Penetrating keratoplasty is a surgery where the opaque cornea of the patient is transplanted with the clear cornea from the eye of the deceased individual to provide vision for the patient  It can be done if the scar is not very long standing Picture of PKP Treatment

Role of the counsellor  Should explain the advice of the doctor whether it is tabtooing, cosmetic contact lenses or penetrating keratoplasty  The need for regular follow up and proper complained with treatment for a long duration, especially after PKP also has to be stressed  The chances for graft rejection after PKP and the necessity for glass for good vision after surgery also should be explained

  There are ocular emergencies which can vary in severity from mild damage to potentially blinding conditions   The cause can be chemical or mechanical   They affect any age group especially children and working adults’   They can have severe pain, glare and loss of vision Injuries

 Stressing the necessity for urgent treatment  Reassuring and insisting the need for proper follow up and compliance with medication  The possibility of searing and its management will also have to be explained  Counselling on protective measures and care to prevent such recurrent episodes Role of the counsellor

 Advising to take protective Helmet’s and glasses for working adults  Advise not to give sharp things to children  Advise to follow the crackers user prevention

Contagious, infective condition of the conjunctiva (white part of the eye) Picture of the conjunctivitis Conjuntivitis (Red Eye)

 Redness  Discharge  Discomfort  Irritation Symptoms

 Usually there is no visual loss and it is treated with eye drops mostly antibiotic drops and ointment  Rarely the cornea can be involved in viral conjunctivitis and EKC (Epidemic Kerato Conjunctivitis and causes defective vision Treatment

 Allergy to dust  Contact lens or pollen  Animal donator and is a non contagious type of conjunctivitis, but causes lot of Itching and discomfort Allergic Type

Role of the counsellor  Have to explain that symptoms can be relieved by eye drops but the condition tends to be recurrent and needs prolonged treatment  Stress should be laid on misuse or overuse of the steroid eye drops which can result in visual loss due to cataract or glaucoma  Should stress personnel hygiene like frequent washing of hands and not touching the eyes  Keeping their face towels, cosmetics, soaps etc separately

What is Corneal Dystrophies?  Hereditary, affecting the cornea from within, without any external source of affliction  Cause defective vision in some which may require keratoplasty eg. FUCHs and CHED (congenital hereditary endothelial dystrophies) macular, granular and lattice – stromal dystrophies Corneal Dystrophies

Symptoms  Progressive loss of vision and pain

Investigations  Detailed anterior segment (including pupils of both eyes) and posterior segment evaluation  Urine sugar, blood pressure and relevant investigations for general anesthesia if surgery is planned

Treatment  Glasses or contact lenses at the initial with relevant eye drops for example hyperosmotics and lubricants  Surgery (PKP, Lamellor, Keratoplasty)

Role of the counsellor  To explain the hereditary nature of the disease and get the siblings examined for the same  To stress that it can be transmitted to future generations

Corneal shape disorders Keratoconus & Cornea plano  These conditions cause defective vision due to abnormal shape of the cornea

Keratoconus  The cornea bulges forward due to an integral weakness in its structure  Causes could be eye rubbing, hereditary causes systemic diseases or unknown causes  Results in defective vision, which can be corrected by glass, contact lens or in severe cases may require corneal transplantation Picture of keratoconus

Cornea Plano  It is a hereditary condition where the cornea is flat and causes defective vision

Symptoms  Defective vision

Investigations  Corneal topography for example orbs can

Treatment  Glasses, contact lens or in severe cases may require corneal transplantation

Role of counsellor  To explain the chance of progression and to avoid eye rubbing  To stress on the necessity of periodical review to rule out progression and to assess the present condition and give the appropriate management