Sympathetic Ophthalmitis

Sympathetic Ophthalmitis - this is a rare inflammatory response of the normal eye
following trauma to the other eye. The injured eye is referred to as the "exciting eye",
the undamaged eye as the "sympathizing eye". The aetiology is unknown but the
inflammatory reaction is thought to be the result of autoimmune processes possibly
triggered by the release of uveal pigment from the injured eye. The uveitis in the
sympathising eye may commence at any time after the first fortnight from injury. An
iridocyclitis occurs in both eyes with lacrimation, photophobia, and the presence of
keratic precipitates (K.P.).

Management:
Is primarily prophylactic entailing the removal of a "dangerous eye" when the following
indications are present:
- A badly perforated eye with no vision.
- An injured eye not settling by 14 days, and especially where K.P. are present.
- Sensitivity to light or photophobia developing in the uninjured eye.

If sympathetic ophthalmitis has developed, removal of the exciting eye is too late to
benefit the sympathetic precesses. Sometimes the exciting eye ultimately becomes
the better eye so it is not removed.

Treatment:
Prolonged immunosuppression: systemic corticosteroids or others, atropine eye drops.

What Contact Lens Wearers Should Know before the Lasik Consultation (Part 1)

Keeping your informed on various aspects of eye surgery.

It is always better to look before leaping. So read this article on
eye surgery before you claim that you know all about eye surgery.

Saying that all that is written here is all there is on eye surgery would
be an understatement. Very much more has to be learnt and propagated
bout eye surgery.

What Contact Lens Wearers Should Know before the Lasik Consultation
If you wear contact lenses there are some things you should consider
before making the decision to have Lasik surgery.

Variety is the spice of life. So we have added as much variety as possible
to this matter on eye surgery to make it’s reading relevant, and interesting!

Similarities. Both Lasik and contacts are able to correct nearsightedness,
farsightedness and, to some extent, astigmatism. Both Lasik and contacts
can eliminate the effect of minification and peripheral distortion that might
have been evident if and when you wore glasses, because both options correct
your vision right at the surface of your eye.
Coordinating matter regarding to eye surgery took a lot of time. However, with
the progress of time, we not only gathered more matter, we also learnt more
about eye surgery. (to be cont'd.)

When Enhancement Lasik Eye Surgery is Necessary

This article provides all the necessary know-how on eye surgery.

Hope is something we have put in this article on eye surgery. We hope that it provides everyone with the know-how on eye surgery.

This is the counterpart to our previous paragraph on eye surgery. Please read that paragraph to get a better understanding to this paragraph.

When Enhancement Lasik Eye Surgery is Necessary
We find great potential in eye surgery. This is the reason we have used this opportunity to let you learn the potential that lies in eye surgery.
Are you are tired of wearing glasses or contact lenses? Are you tired of scratches on your eye glasses? Does the thought of placing contacts on your eyes every morning make you cringe? Do you lose your eyeglasses? Do you have to put a chain on your glasses to avoid losing them? Do you have to “put your eyes in” to see anything? If the answer to one or more of these questions is yes, then maybe it is time you consider a new option that could reduce or completely eliminate the need for eye glasses or contact lenses. Lasik is a new technology that can surgically repair your eyes. For some it restores their eyes to 20/20 vision or better.
Lasik surgery is not for everyone, but for some it is a necessity of life. If you have had to live ten, twenty, thirty or more years fighting with eye glasses or contact lenses, then you may consider Lasik eye surgery a necessity. The thought of never having to put anything in their eye again or possibly never having to wear another pair of eye glasses is appealing to most people. Lasik surgery is the answer. To some it seems like a miracle cure. To others, it just the latest invention of technology. Either way, Lasik is a modern marvel that will change the way we all see the world.


Before you get lasik eye surgery, it is important to understand what lasik is, and then decide if it is right for you. Keep in mind that lasik is a type of surgery and there are risks involved in getting this and any other surgical procedure. Educating yourself is the best way to prepare for these risks. Do your homework. Research online and talk with your eye doctor about the procedure and the risks involved. Be sure to ask questions about recovery time, pre-op requirements, etc. Once you understand what lasik is, then it is up to you to decide if it is necessary.
The title of this composition could be rightly be eye surgery. This is because what is mentioned here is mostly about eye surgery.
Everyone’s eyes are different. They are as unique as fingerprints. It is for this reason that many security companies use retinal scans, or the scanning of the eyes, as a security measure. Your eyes are a lot harder to copy than a fingerprint is. Since no two eyes are the same, a visit to your eye doctor is necessary to begin the process of lasik surgery. Once you get an eye exam, your eye doctor will be able to tell you if you are a good candidate for lasik eye surgery.
The initial stages of this article on eye surgery proved to be difficult. However, with hard work and perseverance, we have succeeded in providing an interesting and informative article for you to read.
We had at first written a rough assignment on eye surgery. Then after a few improvisions and enhancements here and there, we have ended up with this end product.
Lasik is one of many eye surgeries, however due to the recovery time and the success rate of this surgery; it is easy to see why it the most common and the preferred eye surgery to date. In layman’s terms lasik is cutting a flap in the top layer of the eye and letting a laser reshape the eye. It is a rather simple surgery. Some doctors will let you watch a video of the surgery. This way you know what to expect during the surgery. If you still opt for the surgery, your doctor should talk with you about what to expect before, during and after the surgery. If you are ready to ditch the glasses or contact lenses, then lasik is the way to go. The goal is to repair your eyes to 20/20, however sometimes that is just not possible. Don’t let that stop you. If lasik can not completely repair your eyes, it could possibly improve them. You may be able to have lighter, thinner lenses. You may even be able to have the luxury of only having to wear glasses when you read. To some that is an improvement well worth the money. The only way to know for sure what your odds are that the surgery will be successful is to visit your eye doctor.

With the right eye doctor and reasonable expectations of lasik surgery, you should be well prepared. Lasik is not for everyone, but it may be for you. Visit your eye doctor today and find out if you are a good candidate for lasik eye surgery! You will see the world from a brand new prospective with new eyes!
A lot of effort was put in the creation of this article on eye surgery. You can repay this effort by enjoying this article.

Seven Eye Conditions that Lasik Helps to Correct

Some of the greatest points about eye surgery.

Reading is a good habit that has to be cultivated. And reading
about eye surgery is something that will help in cultivating the
reading habit.

The information available on eye surgery is infinite. There just
seems to be so much to learn about, and to write about on eye
surgery. It was at the spur of the moment that we ventured to
write something about eye surgery. Such is the amount of matter
that is available on eye surgery.

Seven Eye Conditions that Lasik Helps to Correct
Improved vision is not the only reason why many people turn
to Lasik vision correction. It is true that Lasik has become popular
for those who rely on corrective lenses everyday. But the Lasik
procedure can also help correct or improve other eye conditions.
Lasik vision correction surgery uses the latest in laser technology
to help treat several kinds of eye problems and disease.

Lasik surgery is designed to help improve the eyesight in patients
with low to moderate vision problems. Those with more severe
vision problems can also benefit from Lasik technology. While most
patients experience improved vision and never had a need for glasses
or contacts again, others may still need to use a prescription. For those
suffering from more severe forms of eye conditions, Lasik may be
recommended. There are many forms of Lasik surgery and an eye care
professional will help determine which one is right for the condition of
the patient.

The Lasik procedure has become very popular for treating eye diseases
such as glaucoma, macular degeneration, diabetic retinopathy and
presbyopia. In addition the Lasik surgery can help those with astigmatism
and myopia and hyperopia, which are all three common forms of eye
problems.

Myopia and Hyperopia: These conditions are more commonly known
as farsightedness and nearsightedness. Myopia is caused by an irregular
shaped cornea. This will cause light rays to focus in the front of the retina,
rather than on the retina. Those who are nearsighted will have good close-up
vision, but objects at a distance will be difficult to see. Hyperopia is the
opposite. Light will focus behind the retina. Those who are farsighted,
can see objects at a distance, but not close-up. These two conditions are
the most common reasons why patients choose to have a Lasik procedure.

Lasik surgery is very beneficial to patients with myopia and hyperopia.

Astigmatism: Astigmatism is a very common form of visual impairment.
This condition is caused when the eye is shaped more like an oval or
football shaped. The odd shape of the eye causes the light to focus on two
points of the retina instead of just one. Usually, those with astigmatism are
either nearsighted or farsighted as well. When Lasik is done on patients with
astigmatism, both problems can be corrected in one surgery.

If there is the slightest possibility of you not getting to understand the
matter that is written here on eye surgery, we have some advice to be
given. We have actually followed a certain pattern while writing on eye
surgery. We have used simple words and sentences to facilitate easy
understanding for the reader. We were rather indecisive on where to
stop in our writings of eye surgery. We just went on writing and writing
to give a long article.

Presbyopia: This common condition is normally cause by natural
aging. Presbyopia causes problems with focusing on objects close-up.
Usually patients that experience this difficulty are between the ages
of forty and fifty years of age. Often, this problem can be improved by
monovision, intraocular lens implants and Lasik.

Glaucoma: This common eye disease is usually characterized by
elevated pressure in the eye that causes damage to the optic nerve.
Laser glaucoma surgery can be performed using three different
techniques. These are all performed with a laser and help either
increase or decrease the pressure of fluid in the eye. The type of
glaucoma treatment a patient receives will depend on the severity
of the condition.

The more you read about eye surgery, the more you get to understand
the meaning of it. So if you read this article and other related articles,
you are sure to get the required amount of matter for yourself.

Macular Degeneration: Macular degeneration is an eye disease that
is caused by abnormal blood vessel growth in the eye. This can result in
serious vision loss if left untreated. If this disease is caught in the very
early staged, it can be treated with laser vision correction surgery. While
treatments do not reverse damage cause by the disease, it will prevent
further vision loss. With laser surgery, the laser is used to destroy new
blood vessels within the eye. Laser surgery is a very popular way to help
prevent macular degeneration from causing further vision loss.

Diabetic Retinopathy: This eye disease is a degenerative eye disease
caused by damage to blood vessels and abnormal vessel growth. Those
with diabetes are the ones that suffer from this eye disease. Those with
diabetes should always maintain good diabetic care to help prevent this
type of eye disease. Laser surgery can be used to seal the retina from
further damage that can lead to retina detachment. This kind of surgery
is performed under local anesthesia. For patients who suffer from these
kinds of eye diseases, Lasik vision correction surgery can help stop further
damage to the eye. For more serious eye conditions such as macular
degeneration, Lasik surgery can help patients keep their eyesight without
further vision loss. It is important to discuss health history with an eye
care professional to see which treatment is best for the particular kind of
eye disease.

Lasik Eye Surgery in Review

The most interesting and informative article on eye surgery.

Why do you think a eye surgery was made? Do you have an answer to this?

Well, if not, you can very well find the answer here.

Lasik Eye Surgery in Review
Isn’t it amazing how much information can be transferred through a single page?
So much stands to gain, and to lose about eye surgery through a single page.
The value of this composition is achieved if after reading it, your knowledge on eye
surgery is greatly influenced. This is how we find out that the meaning of eye surgery
has really entered you!

The results of one reading this composition is a good understanding on the topic of eye
surgery. So do go ahead and read this to learn more about eye surgery.

Lasik is the acronym used to describe Laser in Situ Keratomileusis. It is a special type
of refractive laser eye surgery that can only be performed by ophthalmologists. The surgery
is intended to help correct poor vision.

Development
Dr. Jose Barraquer created a procedure that was the first step toward the
development of Lasik in 1970. At this time, he created a microkeratome, which was
used to change the shape of the cornea and to cut the thin corneal flaps.
This procedure was called keratomileusis.

In 1990, Dr. Lucio Buratto of Italy and Dr. Ioannis Pallikaris of Greece developed
Lasik surgery as it is known today. This was accomplished by combining
Dr. Barraquer’s technique with photorefractive keratectomy, or PRK. PRK is a
form of laser eye surgery that permanently changes the shape of the anterior central
cornea by burning off a small amount of eye tissue from the corneal stroma. Today,
this procedure alone is not preferred because it takes longer for patients to recover
from surgery and is more painful than Lasik.

The combination approach, however, was shown to have a lower number of complications
and to be more precise in correcting vision. Dr. Stephen Slade and Dr. Stephen Brint first
performed the procedure in the United States in 1991. That same year, German doctors
Thomas Neuhann and Tobias Nuehann completed the first automated Lasik surgery in Munich.

Pre-Surgery
Before beginning Lasik surgery, the surface of the corneas must first be
examined using a computer controlled scanning device. This serves to determine
the exact shape of the cornea. Low power lasers are then used to create a topographic
map of the surface of the cornea. This allows the surgeon to also determine the degree
of astigmatism, if any, as well as other irregularities that might be present in the cornea's
shape.

This information helps the surgeon determine how much corneal tissue needs
to be removed, and from where. Generally, the patient is also prescribed antibiotics
beforehand. This helps to minimize the risk of developing an infection after the
procedure is completed. In addition, Lasik patients who wear contact lenses are
encouraged to stop wearing the contacts for days, or even weeks, prior to the
surgery. This is because the cornea needs to absorb oxygen in order to fully function.
Low-oxygen permeable contact lenses reduce the ability of the cornea to absorb oxygen.
This can result in blood vessels growing into the cornea in a process called corneal
neovascularization. This condition can cause an increase in the inflammation of the area
and lead to a longer healing time. It can also cause additional discomfort during surgery.
So after reading what we have mentioned here on eye surgery, it is up to you to provide
your verdict as to what exactly it is that you find fascinating here.

Now while reading about eye surgery, don’t you feel that you never knew so much
existed about eye surgery? So much matter you never knew existed.

The Procedure
The patient remains awake and fully functional throughout the entire procedure.
Usually, a mild sedative is used, along with anesthetic eye drops. The surgeon
will then use lasers to make all of the necessary incisions. As this takes place,
the computer system keeps track of the patient's eye position at a rate of 4,000
times per second. In this way, it can redirect laser pulses to maintain precise
placement of the laser. Using a blade or a femtosecond laser, the surgeon cuts
a flap in the cornea, but leaves a hinge on one end. The flap of corneal lining is
pulled back to uncover the stroma, which is the middle portion of the cornea.
Using an excimer laser, the surgeon reconfigures the corneal stroma by effectively
vaporizing tissue. This procedure does not, however, damage the adjacent
stroma.

Post Surgery
Lasik surgery does have potential complications, though these are fairly
uncommon.

Some potential complications include: dry eyes, halos or starbursts around
light sources, over or under correction, sensitivity to light, double vision, wrinkles
in the debris under the induced astigmatism, and epithelium erosion.

Many of the potential complications occur as a result of the flap detaching from
the rest of the cornea. For this reason, most doctors recommend going home to
sleep after the surgery, as this will decrease the likelihood that it will become
detached completely. In addition, it is possible to develop an infection under the
corneal flap.

Lasik eye surgery is an innovative procedure that utilizes cutting edge technology.
But, care should be taken to learn all of the potential risks, both short term and long
term, associated with the procedure before having it done.
These few words bring the ending of this beautiful article on eye surgery. The next
time there is more to write on eye surgery it is sure to be found here!

TRACHOMA

Trachoma

A chronic, bilateral infectious, cicatrizing, keratoconjunctivitis.

The disease occurs under living conditions with poor hygiene;
especially where there is little washing, dirt, and flies, so that
the infection is passed from eye to eye (ocular transmission).
A second type of trachoma infects the epithelium of the genital
tract and may be transmitted venerially.

Causative organism - Chlamydia Trachomatis.

Three clinical stages are-
1. The stage of infiltration - a simple conjunctivitis without any
macroscopic differentiating features. The onset may be acute
after an incubation period of about five days. If there is a secon-
dary infection, oedema of the lid, and discharges, are prominent.

2. Stage of active inflammation with diagnostic appearance of
papillae and follicles especially involving the upper tarsal plate.
A vascular and cellular infiltration of the corneal epithelium
(pannus) characteristically spreads from the upper arc of the
limbus.

3. Stage of scarring - scars lead to shrinkage of the conjunctiva
and particularly of th eupper eye lid (entropion). Time factor varies
from months to few years. As a reservoir of infection persists in the
community, reinfections and exacerbations are common.

Complications:
- conjunctival scarring and shrinkage
- corneal scarring
- entropion of lid margins causing trichiasis, corneal ulceration and
further scarring
- ptosis
- xerosis
- blindness

Treatment: should be both medical and social (if possible)
medications - Sulphonomides (Septrim, Bactrim) or tetracycline
orally, and tetracycline eye ointment topically.

Environmental improvement will reduce the rate of transmission and
re-infection.

Attempts should be made to improve personal hygiene and sanitation.

UVEITIS

Uveitis - inflammation of the uveal tract may be due to:-

(a) Autoimmune reactions: for most cases of iritis and cyclitis, no cause
is found, but the inflammation is considered to be a complex, immune
response.

(b) Infections from micro-organisms which reach the iris by: -
- Associated with local viral infections - herpes simplex, herpes zoster
ophthalmicus.
- Penetrating wounds of the eyeball.
- Post-operative, especially cataract extraction (early) or via thin, filtering
blebs (late).
- General infection - syphilis, gonorrhea, tuberculosis (very rare).

(c) Associated with some types of arthritis e.g. juvenile rheumatoid arthritis
(Still's disease), ankylosing spondylitis.

(d) Toxins or poisonous substances derived from septic foci elsewhere in the
body e.g. teeth, tonsils, sinuses, chest. These causes are subject to
much dispute and doubt.

KERATOCONUS (Conical Cornea)

Keratoconus - a form of corneal dystrophy affecting the central part
of the cornea. It is usually bilateral though frequently one eye is more
involved than the other. The chief symptom is decreased visual acuity
for far and near caused by marked astigmatism which is usually irre-
gular. Placido's disc can be used to demonstrate the distortion of the
corneal reflection. Glasses may be used to correct the astigmatism
when it is mild. Contact lenses provide a regular anterior curvature to
improve vision. A corneal graft may be necessary when vision cannot
be corrected adequately by glasses or contact lenses, but glasses or
contact lenses are often necessary to correct vision after grafting.

ALLERGIC CONJUNCTIVITIS

Allergic Conjunctivitis

Very varied allergens can give rise to superficial conjunctival reactions.
Allergens such as dust, pollens, cosmetics and eye drops can be
responsible. Spring and summer outbreaks are most common from
pollens. A diagnostic feature is itch, especially near the medial canthi.

Treatment
Topical vasoconstrictor and antihistamine eye drops (antistine-provine),
oral antihistamines, desensitisation.

(a) Spring Catarrh (Vernal Conjunctivitis) - a bilateral chronic allergic
condition is more common in hot climates. It begins in pre-pubertal years;
boys are more commonly affected. The major complaint is itching, worse
in hot weather. Two areas predominantly affected, usually of different inten-
sity: - Palpebral - the upper tarsus is pale pink, thickened and contains
irregular swellings - "cobblestones".

Limbal - a pink, vascularised swelling close to the limbus in the palpebral
aperture.

- stringy mucoid conjunctival discharge contains eosinophils.
- corneal ulcer may occur, especially from rubbing by the rough upper lid.

Treatment consists of local instillation of minimal amounts of corticosteroids,
or sodium cromoglycate 2% (Opticrom) eye drops, to suppress the hypersen-
sitivity. The condition tends to disappear with time, but may continue for
several years.

(b) Giant Papillary Conjunctivitis - a complication of soft lenses, chronic sensi-
tivity, resembles spring catarrh; change or stop lenses, poor response to medi-
cations.

(c) Drug Sensitivity - to the topical application of atropine and similar alkaloids,
antibiotics, adrenaline and similar substances e.g. phenylephrine, antivirals
(I.D.U.), miotics. It is prone to occur with prolonged administration especially
where there is chronic or recurrent disease, but some drugs can cause sensiti-
vity quickly e.g. Neomycin.

It occurs more readily with a seborrhoeic background. When sensitivity occurs
the drugs cannot be used again even after an interval so the use of ocular topical
medications must be viewed very circumspectly.

Onset of drug sensitivity may be acute or gradual, with lacrimation redness,
chemosis and a watery discharge. The skin becomes red, hot and dry. Some
toxic drugs such as the antivirals and powerful miotics can cause scarring sub-
conjunctivally and closure of the lacrimal canaliculi.

Treatment - cease administration of the drug. Topical corticosteroids usually
expedite resolution.

Adrenaline administered repeatedly as eyedrops as for the treatment of glaucoma,
leads to the deposits of black spots in the conjunctiva, especially of the lower
fornix. These are harmless, but may be mistaken for foreign bodies.

(d) Phlyctenular Keratoconjunctivitis

Appears as a small gray, elevated lesion at the limbus. It is considered a delayed
hypersensitivity to bacterial protein, particularly tuberculoprotein.

ECTROPION

Ectropion - the lid margin is everted so that it fails to be in contact
with the surface of the eye. The bulbar and the palpebral conjunctiva
are exposed. The exposed tarsal conjunctiva becomes red, thick,
rough and of unpleasant cosmetic appearance. Eversion of the lower
lacrimal punctum produces epiphora.

Causes may be:
Senile - laxity and lengthening of thelid margin, its ligaments and the
supporting orbicularis.

Skin shrinkage from years of exposure to sunlight.

Scarring of the lower eyelid following trauma, burns, severe inflammation
or neoplastic diseases, or excess removal of skin by surgery.

Bell's palsy - or other paralysis of CVII - loss of support by the paralysed
orbicularis.

Treatment:
Plastic surgery

TRICHIASIS

TRICHIASIS - turning inwards of the eyelashes toward the globe producing
irritation of the cornea and the conjunctiva with the risk of corneal ulceration.

Causes:
Scars - from acute or chronic infections (stye, trachoma)
Burns - especially from lime or hot metals.
Conjunctival shrinkage - pemphigus, trachoma, symblelpharons.
Senile entropion

Treatment:
Epilation of the lashes or destruction of the hair follicles by electrolysis or
cryotherapy. If many are involved, reconstruction of the lid margin may be
necessary.

PTERYGIUM

Pterygium - wing shaped plaque of vascular connective tissue
covered by epithelium which extends from the conjunctiva onto
the cornea in the region exposed between the lids (palpebral
aperture). It is usually on the nasal side of the limbus, but it is
never on the upper or lower margins of the cornea. The cause
is exposure to sunlight, aggravated by wind and dust.

Symptoms
- Disfigurement
- Recurrent irritaion or soreness
- Reduction of visual acuity due to astigmatism or corneal opacity.

Treatment
Reduce sunglare by sunglasses and hats - consistent use will
stop many pterygia from growing. If the pterygium is enlarging
and encroaching on the pupillary area, it should be removed
surgically and followed by Beta radiation therapy.

HYPHEMA

Hyphaema - blood in the anterior chamber.

The blood may fill part or the whole of the anterior chamber.
Bleeding is caused by rupture of iris or ciliary vessels. It
usually ceases quickly.

The danger is not the primary hemorrhage, but possible
secondary hemorrhage. Unless large, the primary hemorrhage
usually absorbs within 24 to 48 hours but may recur.

Treatment:
Admit to hospital
Rest in bed and sedate
Both eyes covered to provide maximum rest to the eyes.

Complications:
Secondary hemorrhage from a broken vessel may occur from the third
to fifth day following injury. Its onset is indicated by sudden pain in the
eye.

If the anterior chamber fills totally with blood (total hyphema) the outflow
channels are likely to block, causing severe secondary glaucoma. The
high intra-ocular pressure not only damages the intra-ocular structures
(iris, retina, lens, optic nerve) but blood constituents are driven into the
cornea through the damaged endothelium (blood staining of the cornea).
Most of such eyes become useless.

Management:
Reduce intra-ocular pressure - Diamox, oral Glycerol, I.V. Mannitol
sometimes surgical removal of blood clot or degradation products.

CHALAZION (Meibomian Cyst)

Chalazion (Meibomian Cyst) - is an enlarged tarsal gland which results from
accumulation of its sebaceous products because of blockage of the tarsal duct.

There is a gradual painless swelling of the gland deep in the eyelid. It may become
secondarily infected and give rise to an acute suppurative inflammation.

Treatment is by hot forments and antibiotic eyedrops until the acute stage
subsides, then excision or curettage via the conjunctival surface.

BLEPHARITIS

BLEPHARITIS - an inflammation of the lid margin that may be acute or chronic
Seborrhoea commonly predisposes to local infections.

Signs & Symptoms:
Red rimmed lids with scales, crusts and even ulcerations.
Eye lashes are matted by cellular debris and exudate.

Treatment:
Directed mainly towards correcting the seborrhoeic condition, and maintaining the
lid margins as free as possible from discharge or scales. Elimination of secondary
infection by the use of an appropriate antibiotic may be necessary, but antibiotic
treatment should not be prolonged.

HORDEOLUM (STYE)

HORDEOLUM (STYE) - is an acute suppurative inflammation of the follicle of
an eyelash or its associated glands of Zeis or Moll, usually by staphylococci.
The initial symptom is tenderness of the lid that may become marked as the
suppuration progresses. The affected lid margin becomes swollen, red and
tense, with the production of a yellow "head" at the base of the affected
eyelash. It may be associated with a blepharitis.

Treatment:
- hot compresses (hot spoon bathing) hasten resolution of the lesion.
- epilate the eyelash to allow drainage.
- local antibiotics.
- test urine for sugar if recurrences occur.
- systemic antibiotics are rarely necessary.

BELL'S PALSY

Bell's Palsy - facial paralysis without evidence of other disease or injury.

Paralysis occurs suddenly or gradually over a period of 24 to 48 hours.
The etiology is uncertain, but may be due to a virus. Inability to close
the eyelids may be partial or complete.

Dangers - lack of blinking leads to corneal dryness (exposure), potential
corneal ulceration with secondary infection, hypopyon or endophthalmitis.
Other symptoms:
(1) epiphora - excess tears from corneal irritation and weakness of lacrimal
pump.
(2) discomfort to pain
(3) difficulty to mastication - food collects on that side of mouth.

Treatment - spontaneous recovery is usual, taking a few weeks to months
but some residual weakness or muscle twitching is common.

* protect the cornea - artificial tears to wet the cornea.
* glasses with side shield, swimming goggles at night.
* strap eyelids together, especially for sleep.
* physiotherapy - muscle stimulation
* forced blinking - if Bell's phenomenon present - elevates the eye under
the upper eyelid and moistens the cornea.
* tarsorrhaphy - medial or lateral.

Other Causes of facial palsy:
* traumatic
* inflammatory
* neoplastic
* nerve pressure