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May 16, 2013Eye Health, Featureseye herpes, Ipoh Echo Eye Health, ipoh echo issue 166, ophthalmologist Dr S.S. The eye gets infected most commonly when an infected person touches an active sore or blister, after which he or she touches their eyes. A patient who gets infected will complain of a painful sore over the eyelid or a painful red eye with blurring in some instances especially if it infects the clear transparent part of the eye called the cornea. The eye doctor will often instil temporary stain into the affected eye (with fluorescein dye) to detect the eye infection. If the eye infection is detected early and the virus has infected the cornea (clear transparent area) superficially only, it often heals well with no problems.
Floaters are deposits of different sizes and shapes within the eye’s vitreous humour which is normally transparent. The common type of floater is due to changes in the vitreous humour, its natural ageing process.
This vitreous debris casts shadows on the retina, and it is the shadow that is visible to you. Other serious causes of floaters, blood in vitreous, pigment in vitreous. Painless, temporary visual disturbances (flashes, blind spots, visual distortions) that can affect one or both eyes.
Involuntary spasms of the eyelid muscles most common causes: fatigue, stress, caffeine, nutritional imbalance, magnesium deficiency, dry eyes, allergies, eye strain. The Herpes Simplex Virus, known as HSV, is occasionally responsible for the development of herpes of the eye, with epithelial keratitis being the most common variation.
Herpes keratitis is the most common of the eye herpes and also goes by the name herpetic epithelial keratitis – it affects the cornea on the top superficial layer of the surface of the cornea, and since this layer is called the epithelium the adjective epithelial is applied to it. Eye herpes, or ocular herpes as it’s sometimes called, normally comes from type 1 herpes – the cold sore type – but on rare occasions it can come from type 2 herpes which affects the genital area and is far more serious.
Whilst herpes cold sores can be treated by oneself without resort to a visit to the doctor, any kind of eye herpes needs to be brought to the attention of therapeutic optometrist or an ophthalmologist for urgent attention.
Great care needs to be taken by the eye-care professional in determining which variation is present as treatments are specific and an inappropriate treatment can lead to aggravation. A past symptom is the occurrence at some time or other of type 1 herpes – cold sores on the lips. Eye pain, sensitivity to light, blurred vision and “pink eye” are regular symptoms with excessive tearing being an additional discomfort. Diagnosis requires careful examination with a microscope specific for eyes called a biomicroscope.  This is not a diagnosis that a general practitioner can make and it is certainly not something that you would go to the pharmacist for over the counter drops. Millions of people have a dormant herpes virus inside them from being unintentionally infected by family members kissing them as a young child on the lips. Fortunately less than 1% of those people will ever have an episode of general herpes, and then less than 1% of those will suffer from epithelial keratitis. As mentioned earlier, care is needed in accurately identifying the particular epithelial keratitis as treatment is specific.
An antiviral topical ointment (Zovirax) or alternatively eye drops should be applied – not to eradicate the virus entirely but to slow its growth until nature takes its course and the infection clears up – a sound way to do things! It’s important then that the full course of treatment is followed – many eye-care specialists complain that patients do not do this, thinking that their condition has cleared up when this is simply not the case. Dr Jim Kokkinakis (Optometrist) graduated in 1983 from the Optometry School University of NSW. He has a specialist clinical practice in the Sydney CBD with interests in Eye Strain, Computer Vision problems, Treatment of Eye Diseases and complex Contact lens Fittings. Please tell me where you are located as this requires a second opinion as soon as possible.
TweetThe eye is a highly sensitive organ to light, pressure and other sensations like itching and pain. It is important understand certain terms when discussing and assessing any disease of the eye. Iritis is inflammation of the iris, the front part of the middle layer of the eye, which is the pigmented part of the eye that is responsible for the variation in eye color among people. Neuritis is the inflammation of the nerve and in relation to the eye, optic neuritis is inflammation of the optic nerve. The cornea and conjunctivata of the eye are prone to injury and infections as it makes direct contact with the environment when the eyelids are open. Contact lens keratitis – inflammation of the cornea due to irritation by contact lens which may be non-infectious (sterile) or infectious.
Herpes simplex keratitis which is also viral in nature and caused by the herpes simplex virus (HSV).
Fungal infections are uncommon but more likely seen in immunocompromised patients (HIV-positive particularly). Photokeratitis which is also known as welder’s keratitis or UV keratitis, is induced by exposure to very bright light, either articifical or natural (sunlight). Corneal ulceration is seen with severe mechanical or chemical trauma, long term inflammation particularly in infections that are left untreated and persistent inflammation of the eyelids (blepharitis). Scleritis, which is the inflammation of the whites of the eye, may be seen along with conjunctivitis or keratitis. Iritis rarely arises on its own but may be associated with scleritis or the other parts that make up the middle layer of the eye (uvea) including the choroid and ciliary body. Blepharitis is inflammation of the eyelids and may also involve the eyes, particularly the conjunctiva, cornea and sclera. Inverted eyelid (entropion) where the eyelid is turned inside and rubs against the cornea thereby causing corneal abrasion. Everted eyelid (ectropion) where the eyelid is turned outwards and exposes the eye to air thereby leading to dry eyes. It is important to understand the different parts of the eye when considering pain emanating from this area. To the inner side (medial) is the nose (nasal cavity) and the ethmoid and sphenoid sinuses. Above the eye lies the frontal sinus as well as the brain and meninges housed within the cranial cavity. The skull itself has many superficial muscles which may also be responsible for pain in and around the eye.


Ask a Doctor Online Now!Eye strain, from looking at a computer screen and reading for too long, does not cause eye pain as such although there is soreness. Orbital cellulitis is inflammation of the fat surrounding the eyeball and often extending to neighboring structures including the eye, forehead (eyebrows), cheek and eyelids. This infectious condition is mostly isolated to the eyeball but can involve surrounding tissue like the eyelids and skin of the forehead and even cheek. Ask a Doctor Online Now!Please note that any information or feedback on this website is not intended to replace a consultation with a health care professional and will not constitute a medical diagnosis.
Many patients today come to our offices with numerous questions about their eyes, and how they can care for them. Age-Related Macular Degeneration (AMD, ARMD) (MAK-yu-lur) - Group of conditions that include deterioration of the macula, resulting in loss of sharp central vision. Blepharitis (blef-uh-RI-tus) - Inflammation of the eyelids, usually with redness, swelling, and itching.
Cataract - Opacity or cloudiness of the crystalline lens, which may prevent a clear image from forming on the retina. Corneal Ulcer - Corneal Ulcers usually occur after trauma to the cornea by a foreign body, also including contact lenses. Diabetic Retinopathy (ret-in-AHP-uh-thee) - Spectrum of retinal changes accompanying long-standing diabetes mellitus. Floaters - Particles that float in the vitreous and cast shadows on the retina; seen as spots, cobwebs, spiders, etc. Glaucoma (glaw-KOH-muh) - Group of diseases characterized by increased intraocular pressure resulting in damage to the optic nerve and retinal nerve fibers. Macular Pucker - Macular Pucker is when a cellophane-like membrane forms over the macula of the eye. Allergies - Eye allergies are usually associated with other allergic conditions, particularly hay fever and dermatitis. Dry Eye - When a patient does not naturally produce enough tears to keep the eye comfortable, this condition is known as Dry Eye Syndrome, or DES. Fuch's Dystrophy - Fuchs' dystrophy, also known as Fuchs' endothelial dystrophy, is a slowly progressing corneal disease that usually affects both eyes, and is slightly more common in women than in men.
Map-Dot-Fingerprint Dystrophy (MDF) - Map-Dot-Fingerprint dystrophy is a corneal disorder that is characterized by recurrent erosions of the epithelium, the skin like covering of the cornea. Ocular Herpes - The recurring eye infection of the cornea, which can potentially threaten sight, is most commonly caused by the herpes simplex eye disease known as HSV type 1.
It may be transmitted by the infected person into his or her own eye or from one person to another.
The infected portion gets stained and is able to be picked up when special blue cobalt light is shone into the affected eye. However, if the cornea is involved more deeply, the infection may lead to scarring of the cornea, loss of vision and sometimes even blindness.
Can cover only nasal sclera or temporal sclera or both.Usually a painless, harmless condition with spontaneous recovery within 7-10 days. There are a number of herpes eye variations depending on where in the eye the herpes itself decides to initiate its inflammatory action.
All of these symptoms are indications of other eye diseases and infections, particularly conjunctivitis, so an accurate diagnosis for epithelial keratitis is often fraught with difficulty.
It is essential in such cases that the services of an eye-care specialist such as an optometrist are sought early as loss of vision might be a long term outcome. After treatment (pred forte) she continued to suffer from keratitis and it has become a chronic condition.
Since it is exposed to the environment and lacks the protection of skin, apart from the eyelids, the eyes are prone to injury and diseases. Due to its close relationship with the underling uvea (middle layer of the eye comprising the choroid, ciliary body and iris), it may be associated with inflammations in these areas. It is commonly caused by infections, toxicity associated with substances used during intraocular surgery, an artifical lens, foreign bodies, trauma or spread of cancer (metastasis).
It usually arises at the base of the eyelid where oil glands (sebaceous glands) occur with the hair follicles (eyelashes). The eye is housed in the bony area of the skull known as the orbit, or simply as the socket. To the outer side (lateral) lies the large temporal muscles which play a role in chewing (mastication). Herpes zoster opthalmicus (HZO) is caused by the varicella zoster virus which is also responsible for chickenpox and shingles.
Our staff is dedicated to providing the highest level of eye care, and is fully trained in all aspects of eye care. Surgical removal of the lens may be necessary if visual loss becomes significant, with lost optical power replaced with an intraocular lens, contact lens, or aphakic spectacles. Corneal Ulcers may also occur without trauma to the cornea like dry eye syndrome or lid disease which can allow bacteria or fungi to enter into the cornea and cause infection and inflammation. Macular Pucker is typically a slow-progressing problem that affects the patient's central vision, causing blurring and distortion. In this condition a patients eyes feel dry or may even have a burning or stinging sensation.
Early signs of Fuchs' dystrophy can be seen in people in their 30s and 40s; the disease rarely affects vision until people reach their 50s and 60s. Herpes Zoster commonly attacks the nerves around the eye, especially the nerve that supplies the upper eyelid and forehead.
The reason for the problems associated with Map-Dot-Fingerprint dystrophy are caused by an abnormal Bowman's membrane, which is the layer of the cornea just beneath the outer epithelium. In severe cases, it may also infect the inside of the eyeball although this is not as common as the former.
So if you have any eye infection that you are unsure of, or it is prolonged, do seek professional eye treatment.
Ocular migraine followed by one-sided HA’s referred to migraine with aura and the visual disturbance is referred to as an aura rather than ocular migraine.


It is now 8 months since her initial diagnosis and the opthalmologist has now told us that the condition, which initially was considered post viral keratitis has now changed, and has become herpetic. Its location and closeness to several other highly sensitive structures may also be a factor to consider when investigating eye pain. Vasculitis which is systemic inflammation of blood vessels may also be a cause of scleritis.
It can be acute or chronic and may be due to physical trauma, infections, cancer or autoimmune diseases that are not normally associated with inflammation of the eye.
One of the most prominent causes of eye pain associated with the internal structures is that of raised intraocular pressure (high eye pressure).
Optic neuritis is more commonly due to autoimmune diseases like multiple sclerosis and neuromyelitis optica. This area may be prone to various skin diseases, infections, allergies and non-infectious inflammatory conditions. It has become extremely common these days due to the widespread use of computers and has been termed computer vision syndrome. The infection may cause severe pain, produce corneal discharge, reduce visual clarity and perhaps even erode the cornea. May advance to proliferative retinopathy, which includes the growth of abnormal new blood vessels (neovascularization) and fibrous tissue. The burning or stinging sensation a patient may experience is due to an insufficient amount, or poor quality of tears being produced by the eye.
Fuchs' dystrophy occurs when endothelial cells gradually deteriorate over time without apparent reason. If the virus affects the nerves that connect directly to the eyeball, serious eye problems may occur, including corneal ulcers, inflammation and sometimes glaucoma. Generally, the infection occurs after the cornea has been injured or penetrated, allowing bacteria or fungi to enter and the deeper the infection, the more severe its symptoms and complications.
The abnormally tight attachment of the Bowman's membrane to the epithelium result in a falling away of the epithelium layer. The infections response to treatment may also vary depending upon which of the several different strains of the HSV type 1 infection caused the initial outbreak. A Pterygium commonly begins to grow at the inner corner of the eye and with time can grow over and across the cornea. In these cases, the pain may not be emanating from the eye or eyeball itself but referred from surrounding areas.
Any condition affecting the cornea or its neighboring parts like the anterior chamber of the eye which is filled with the clear watery aqueous humor, the iris and its peripheral attachment known as the ciliary body can induce pain.
The outermost part of the sclera, known as the episclera, may be inflamed and this is known as episcleritis.
It may lead to glaucoma and patients with a specific type of glaucoma known as angle-closure glaucoma are more likely to experience pain particularly in acute cases. Other causes may not be specific for the optic nerve and involve other parts of the eye or socket. Orbital cellulitis is a very dangerous condition and should be considered a medical emergency.
We hope that this may answer some of your questions and help clear up some misconceptions about the eye. Generally, the deeper the corneal infection is within the eye, then more severe the patient's symptoms and complications may be.
Dry Eye Syndrome can be caused by a lack of blinking, use of some allergy medicines; can be due to aging, smoking, and even a dry or cold environment. As more endothelial cells deteriorate over the years, the endothelium begins to pump less and less water out of the stroma. When this occurs, the patient usually experiences severe eye pain, light sensitivity, and reduced vision.
The disease usually begins on the surface of the cornea, where the eye will turn red, become uncomfortable, and sensitive to light. It is estimated that almost 90% of the population would have suffered from the Type I variety during childhood. Other signs and symptoms, ocular (eye) or non-ocular, may therefore provide a clue to the possible. It arises with infections like herpes zoster, syphilis and tuberculosis or non-infectious disorders like rheumatoid arthritis or Sjogren’s syndrome.
This includes infections, drugs, radiation and systemic autoimmune conditions like vasculitis or systemic lupus erythematosus (SLE). Infections such as keratitis, though relatively infrequent, are the most serious complication of patients who are contact lens wearers. For patients who use a computer for long periods of time, it is suggested that the patient make a conscious effort to blink a few times per minute while focusing on the computer screen. The disease may even cause permanent scarring of the cornea and inflammation inside the eye in advanced cases.
These days with the widespread use of contact lens, the cornea is even more at risk of injury and infections. Also, chronic ulcers which can be difficult to heal may also develop on the cornea due to the HSV type 1 infection. Eventually, the epithelium also begins to hold water, resulting in pain and severe visual impairment. Even though this disease may occur in one eye, it is unusual for the disease to spread to the other eye. Epithelial swelling will damage vision by changing the normal curvature of the patient's cornea. By changing the normal curvature of the cornea a sight-impairing haze will appear in the tissue.



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