DEPARTMENT OF COUNSELLING

1. DEPARTMENT OF COUNSELLING Corneal Opacity

2. What is 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

3. Treatment • 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

4. Should explain the advice of the doctor whether it istabtooing, 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 Role of the counsellor

5. Injuries • 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

6. Role of the counsellor • 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

7. 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

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

9. Symptoms • Redness • Discharge • Discomfort • Irritation

10. Treatment • 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

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

12. 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

13. Corneal Dystrophies 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

14. Symptoms • Progressive loss of vision and pain

15. 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

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

17. 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

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

19. 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

20. Cornea Plano • It is a hereditary condition where the cornea is flat and causes defective vision

21. Symptoms • Defective vision

22. Investigations • Corneal topography for example orbs can

23. Treatment • Glasses, contact lens or in severe cases may require corneal transplantation

24. 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

25. THANK YOU