Paed ophthal treatment
Paed ophthal treatment
This refers to a blockage in the drain that drains tears from the eye. A tear duct obstruction is usually present at birth and causes copious tears, discharge, and crusting on the eye surface.
What Is a Tear Duct Obstruction?
Tears are regularly produced by glands within the eyelids. After lubricating the eye, tears usually flow into two small holes ("puncta") on the inner corners of the upper and lower eyelids. The tears then drain into the back of the nose through the tear duct (also known as the nasolacrimal duct). This is why we often have a runny nose when we cry! Infants with a nasolacrimal duct obstruction often have a blockage at the most distant end of the duct, just before it empties into the nose.
Approximately six percent of all infants are born with a nasolacrimal duct obstruction (tear duct blockage) affecting one or both eyes. Fortunately, at least 90% of these obstructions will clear without treatment within the first year of life.
What are the Signs of a Tear Duct Obstruction?
Because there is nowhere for the tears to drain, they accumulate on the eye's surface and frequently overflow over the eyelashes, lids, and cheek. When a blockage occurs, bacteria in the tears have nowhere to drain. These bacteria grow within the tear duct and produce a pus-like discharge from the inner corner of the eye and on the lashes, which is commonly seen when the kid awakens.
Treatment
As the majority of tear duct obstructions will resolve without any intervention by age twelve months, conservative measures are usually recommended. The typical treatment protocol includes:
Tear duct massage (as demonstrated by the doctor) three times each day if any signs of a tear duct obstruction are evident.
Antibiotic eye drops three times daily as needed after the massage. These eye drops should be used only when a yellow or green pus-like discharge is present throughout the day. The eye drops should be discontinued if only a white mucus-like discharge or no discharge is present.
Probing
If the signs of the tear duct obstruction persist by the first birthday.
A probing of the nasolacrimal duct is a surgical procedure performed to relieve the obstruction for any of the following reasons:
If the pus-like discharge persists despite use of the antibiotic eye drops and massage.
If a more serious infection of the tear duct (“dacryocystitis”) or infection of the skin over the tear duct occurs as a result of the obstruction. This delicate procedure is safely performed when your child is motionless. This is best achieved with a brief “mask” anesthesia at a hospital outpatient surgical facility.
If it still persisits after probing, it is tried again or otherwise the child needs major procedure like Dacryocystorhinostomy with or without silicon intubation for relief.
PTOSIS (DROOPING OF EYELIDS)
Eyelid ptosis refers to the drooping of one or both eyelids and is caused by weakness of the muscle responsible for raising the eyelid, damage to the nerves that control those muscles, or laxity of the skin of the upper eyelids. The eyelid droop may be barely noticeable, or in severe cases, the lid can descend over the entire pupil. Drooping eyelids can occur in both children and adults and can be caused by the normal aging process, a congenital abnormality (present before birth), or the result of an injury or disease. Drooping eyelid occurs most often due to aging.
PTOSIS (DROOPING OF EYELIDS)
Eyelid ptosis refers to the drooping of one or both eyelids and is caused by weakness of the muscle responsible for raising the eyelid, damage to the nerves that control those muscles, or laxity of the skin of the upper eyelids. The eyelid droop may be barely noticeable, or in severe cases, the lid can descend over the entire pupil. Drooping eyelids can occur in both children and adults and can be caused by the normal aging process, a congenital abnormality (present before birth), or the result of an injury or disease. Drooping eyelid occurs most often due to aging.
What Causes Ptosis?
Eyelid ptosis occurs when the muscle that usually raises the eyelid is not strong enough to do so. It can affect one eye or both eyes and is more common in the aging or elderly, as muscles in the eyelids may begin to deteriorate. One can, however, be born with ptosis, as it is hereditary. Ptosis may be caused by damage/trauma to the muscle that raises the eyelid, or damage to the nerve which controls this muscle. Such damage could be a sign or symptom of an underlying disease such as diabetes mellitus, a brain tumor, and diseases that may cause weakness in muscles or nerve damage, such as myasthenia gravis.
PTOSIS (DROOPING OF EYELIDS)
Eyelid ptosis refers to the drooping of one or both eyelids and is caused by weakness of the muscle responsible for raising the eyelid, damage to the nerves that control those muscles, or laxity of the skin of the upper eyelids. The eyelid droop may be barely noticeable, or in severe cases, the lid can descend over the entire pupil. Drooping eyelids can occur in both children and adults and can be caused by the normal aging process, a congenital abnormality (present before birth), or the result of an injury or disease. Drooping eyelid occurs most often due to aging.
What Causes Ptosis?
Eyelid ptosis occurs when the muscle that usually raises the eyelid is not strong enough to do so. It can affect one eye or both eyes and is more common in the aging or elderly, as muscles in the eyelids may begin to deteriorate. One can, however, be born with ptosis, as it is hereditary. Ptosis may be caused by damage/trauma to the muscle that raises the eyelid, or damage to the nerve which controls this muscle. Such damage could be a sign or symptom of an underlying disease such as diabetes mellitus, a brain tumor, and diseases that may cause weakness in muscles or nerve damage, such as myasthenia gravis.
What are the symptoms & signs of ptosis?
Depending on how severely the lid droops, people with ptosis may have difficulty seeing or closing the eye completely. People have been known to tilt their heads back to try to see under the lid or raise their eyebrows repeatedly to try to lift the eyelids. The degree of droopiness varies from one person to the next.
Ptosis Treatment
Ptosis does not usually improve with time, and nearly always requires corrective upper eyelid surgery. In most cases, surgery is performed to strengthen or tighten the levator muscle and lift the eyelid. If the levator muscle is especially weak, the lid and eyebrow may be lifted. Eyelid ptosis treatment can usually be performed with local anesthesia except with young children. The surgery helps them to look cosmetically good and avoids the development of a lazy eye which cannot be rectified if detected at a later age.
BOTOX
Botulinum toxin more commonly known as Botox is a drug being used for cosmetic purposes, which was first used to manage squinting of eyes. It is being used to manage different types of squints, particularly beneficial in paralytic cases where double vision is quite troublesome. Botox injection is a 5-minute procedure done in an Outpatient clinic under topical anesthesia. Some patients may have discomfort. There are minimal side effects if any, and are temporary. Botox starts working within 3-7 days. The effect of the injection lasts for 4-6 months and then has to be repeated.
We also administer Botox in our clinic for conditions like Essential Blepharosapam, forehead wrinkles, crow’s feet, etc.
