How you can prevent these common eye infections

Phillip Kavuma became blind after suffering from glaucoma, a treatable eye condition. It started two years ago, when he developed pain in the eyes. He could not see clearly. But he did not pay attention to the changes hoping that his eyes would stabilise after some time. That did not happen.

“I felt like I had an object in my eyes and everything looked blurred. Sometimes, my eyes would itch. That is when I decided to go to the hospital,” he says. At the eye clinic at Mulago National Referral Hospital, Kavuma was diagnosed with glaucoma.
The disease had already affected his eyes, leaving him blind. Now waiting to undergo surgery, Kavuma wishes he had sought treatment as soon as the itching started.

Like Kavuma, Mary Grace Akello, a nurse says she started experiencing eye problems in 2011. “I went to see a doctor who said I was suffering from an allergic reaction. My eyes became red and swollen,” she says.

Akello was given steroids to improve the symptoms, but instead her eyes continued to itch and pain.
“When I returned to the doctor, he aised me to visit the eye clinic at Mulago. It was there that I was diagnosed with glaucoma,” she says.

Akello spent seven months with the condition and in August 2011, she underwent surgery to correct her vision. A month later, the second surgery was carried out.

“The pain reduced although I now have to avoid exposing my eyes to too much light. I regularly use eye drops that help me to maintain my intraocular pressure,” she says.

Expert take
Dr Angella Nakandi Lwanga, a consultant ophthalmologist (eye specialist) at Mulago National Referral Hospital, says glaucoma is a condition in which a lot of pressure is inserted on the eyes, which leads to pain, frontal headache and blurry vision.
The pressure on the eyes stretches the retina and kills eye nerves. When a person has glaucoma, doctors say the peripheral (side) vision is usually the first to be impaired.

Dr Lwanga says glaucoma can be diagnosed by undergoing an eye pressure checkup to determine several things including sensitivity of the side vision, the point where glaucoma strikes first.

She recommends immediate medical attention for this kind of infection to be managed, because once the optical nerve is affected, glaucoma cannot be treated, leading to blindness. According to Dr Lwanga, the eyes contain a fluid called aqueous humour, which clean the eyes and keep them healthy.

In normal eyes, the fluid flows at a rate of 10 to 21millimetres of mercury. However, when a person’s eyes are affected by glaucoma, the flow is disrupted, occurring at 22 millimetres of mercury.

Joy Letiru, a nurse at the eye clinic notes that about 50 patients visit the facility every day for various eye-related diseases.

She says the common diseases recorded at the facility include eye injuries, conjunctivitis, glaucoma, and corneal ulcers.

Conjunctivitis, like corneal ulcer can be caused by a virus, bacteria, fungi, or allergies. And in each case, the symptoms present differently.

When caused by allergies, conjunctivitis presents with severe itching of the eyes, while painful eyes that are light-sensitive are caused by a virus. Discharge from the eyes, as well as sticky eyes could indicate conjunctivitis that is caused by a bacteria.

Another common eye condition that affects many people is cataracts. According to Sight Savers Uganda, approximately 300,000 people in the country have developed visual impairment as a result of cataracts, representing about 50 per cent of all eye-related infections.

Dr Grace Ssali, a paediatrician ophthalmologist at Mulago hospital, says cataracts result from the clouding of the lens of the eye, which prevent the passage of light. The condition creates a white round shape in the middle of the eyeball.

Dr Ssali says some children are born with the disease, in which case surgery is the recommended treatment. However, cataracts is also common in old age. Other causes of the condition include eye injuries and inflammation.

Caused by chlyamadia trachomatis and transmitted by houseflies from one person to another, trachoma can result in blindness if not treated early.

Dr Ssali explains that blindness caused by trachoma occurs after repeated episodes of infection. The disease is common in women and children. “This is a disease of poverty and affects people in areas where water and sanitation facilities are not adequate,” notes Dr Ssali.

However, trachoma can be easily prevented if people adhere to simple cost effective interventions such as observing proper hygiene, ensuring good waste disposal such as proper use of pit latrines.

According to a survey by Sight Savers Uganda, trachoma is prevalent in about 40 districts, mostly in north and north eastern Uganda. The survey also reveals that about seven million people are at risk of infection, while 700,000 children below the age of 10 have the disease.

Red eyes
Dr Ssali says red eyes are caused by viral infections that spread from one person to another, through close contact.
The main symptoms of red eyes include itching and pain. However, Dr Ssali says red eyes can be managed by observing proper eye hygiene and taking antibiotics.

Refractive errors
These can be classified into long and short sight conditions. Refractive errors can be genetic and the most effective ways to manage it is through regular eye check-up or wearing corrective glasses. However, if not treated early enough, the condition can result in visual impairment.

Corneal ulcers
Corneal ulcer is a wound on the corneal of the eye. Letiru explains that in healthy eyes, the corneal is supposed to be smooth. But when there is a break in the passage of light, it becomes an ulcer.

The ulcer is caused by infections that result from bacteria, virus or fungi. Dust, frequent scratching of the eyes with dirty hands or smoke can exacerbate the problem.

Common symptoms for corneal ulcers include pain and teary discharge. Sometimes, however, corneal ulcers can be mistaken for cataracts, and if the disease becomes aanced, doctors recommend removal of the affected eye.

Age-related macular degeneration (AMD)
This condition affects older people, and involves the loss of the person’s central field of vision. Globally, AMD ranks third as a cause of blindness after cataract and glaucoma. The main risk factor is ageing.

Other risk factors may include the use of tobacco, genetic tendencies and consumption of a non-balanced diet

Another ignored eye problem is squints. According to Dr Ssali, this can be corrected as long as a person visits a health facility on time. Treatment usually involves using glasses or eye surgery. Squints can result from cataract or a refractive error. They can also be genetic or can be acquired later in life.

Dr Lwanga says early diagnosis is crucial in managing all forms of eye conditions or infections. Therefore, any person who experiences an itching or pain in the eyes should seek treatment as soon as possible.

Easy ways to keep eyes healthy
Ruth Nakalembe, a clinical officer in charge of eye diseases at Mulago National Referral Hospital, says people can keep their eyes free from infections through the following measures.
•Routine eye check-up. This can be done once a year to ensure that the eyes have no underlying infections. This is because some symptoms may present when the infection is already in the aanced stages.
•Avoiding self-medication. According to Nakalembe, people should avoid administering self-medication without first consulting a doctor, as this could make the condition worse, or a person may end up treating an infection with the wrong medication. She also discourages the use of herbal medicine to treat any eye infection.
•Use of protective gear such as sun glasses and goggles, especially when engaging in activities such as welding or spending long hours working under the sun is recommended.
•If a child has an eye problem, they should be supported and taken to the hospital as soon as possible. Nakalembe says this can potentially save them from blindness or chronic eye conditions in the future.
•Diet also plays a crucial role in the wellbeing of a person’s eyesight. Health workers encourage people to eat nutrient-rich foods such as vegetables, fruits and iron. Young children and expectant mothers are particularly encouraged to eat these foods to boost their eyesight.
•Parents are also encouraged to take their children for routine immunisation, especially against measles, a disease that destroys a child’s immune system, increasing their risk of blindness.
• People should read in bright light conditions and avoid watching television when the lights are off.

The outlook
Globally, the World Health Organisation (WHO) estimates about 314m people worldwide live with impaired vision and blindness. Most cases of impaired vision are due to uncorrected refracted errors, which could have been prevented if people sought treatment early enough.
In Uganda, about seven million people are at risk of infection from trachoma, a common eye disease that can easily be prevented.

SOURCE: Daily Monitor

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