ARAVIND EYE CARE SYSTEMAravind Eye Hospital

& Postgraduate Institute of Ophthalmology

ARAVIND EYE CARE SYSTEMAravind Eye Hospital

& Postgraduate Institute of Ophthalmology

DEPARTMENT OF COUNSELLINGDEPARTMENT OF COUNSELLING

Corneal OpacityCorneal Opacity

The clear cornea becomes white The clear cornea becomes white following scarring. The causes can be following scarring. The causes can be congenital or acquired from a healed congenital or acquired from a healed ulcer.ulcer.

It can result in visual loss and can be It can result in visual loss and can be cosmetically disfiguringcosmetically disfiguring

Picture of corneal opacityPicture of corneal opacity

What is corneal opacity?What is corneal opacity?

Penetrating keratoplasty is a surgery where the Penetrating keratoplasty is a surgery where the opaque cornea of the patient is transplanted opaque cornea of the patient is transplanted with the clear cornea from the eye of the with the clear cornea from the eye of the deceased individual to provide vision for the deceased individual to provide vision for the patientpatient

It can be done if the scar is not very long It can be done if the scar is not very long standingstanding

Picture of PKPPicture of PKP

TreatmentTreatment

Role of the counsellorRole of the counsellor Should explain the advice of the doctor whether it isShould explain the advice of the doctor whether it is

tabtooing, cosmetic contact lenses or penetrating tabtooing, cosmetic contact lenses or penetrating keratoplastykeratoplasty

The need for regular follow up and proper The need for regular follow up and proper complained with treatment for a long duration, complained with treatment for a long duration, especially after PKP also has to be stressedespecially after PKP also has to be stressed

The chances for graft rejection after PKP and the The chances for graft rejection after PKP and the necessity for glass for good vision after surgery also necessity for glass for good vision after surgery also should be explainedshould be explained

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

InjuriesInjuries

Stressing the necessity for urgent treatmentStressing the necessity for urgent treatment

Reassuring and insisting the need for proper Reassuring and insisting the need for proper follow up and compliance with medicationfollow up and compliance with medication

The possibility of searing and its management The possibility of searing and its management will also have to be explainedwill also have to be explained

Counselling on protective measures and care Counselling on protective measures and care to prevent such recurrent episodesto prevent such recurrent episodes

Role of the counsellorRole of the counsellor

Advising to take protective Helmet’s and Advising to take protective Helmet’s and glasses for working adultsglasses for working adults

Advise not to give sharp things to Advise not to give sharp things to childrenchildren

Advise to follow the crackers user Advise to follow the crackers user preventionprevention

Contagious, infective condition of the Contagious, infective condition of the conjunctiva (white part of the eye)conjunctiva (white part of the eye)

Picture of the conjunctivitisPicture of the conjunctivitis

Conjuntivitis (Red Eye)Conjuntivitis (Red Eye)

RednessRedness DischargeDischarge DiscomfortDiscomfort IrritationIrritation

SymptomsSymptoms

Usually there is no visual loss and it is Usually there is no visual loss and it is treated with eye drops mostly antibiotic treated with eye drops mostly antibiotic drops and ointmentdrops and ointment

Rarely the cornea can be involved in viral Rarely the cornea can be involved in viral conjunctivitis and EKC (Epidemic Kerato conjunctivitis and EKC (Epidemic Kerato Conjunctivitis and causes defective visionConjunctivitis and causes defective vision

TreatmentTreatment

Allergy to dustAllergy to dust

Contact lens or pollenContact lens or pollen

Animal donator and is a non Animal donator and is a non contagious type of conjunctivitis, but contagious type of conjunctivitis, but causes lot of Itching and discomfortcauses lot of Itching and discomfort

Allergic TypeAllergic Type

Role of the counsellorRole of the counsellor Have to explain that symptoms can be relieved by eye Have to explain that symptoms can be relieved by eye

drops but the condition tends to be recurrent and needs drops but the condition tends to be recurrent and needs prolonged treatmentprolonged treatment

Stress should be laid on misuse or overuse of the steroid Stress should be laid on misuse or overuse of the steroid eye drops which can result in visual loss due to cataract or eye drops which can result in visual loss due to cataract or glaucomaglaucoma

Should stress personnel hygiene like frequent washing of Should stress personnel hygiene like frequent washing of hands and not touching the eyeshands and not touching the eyes

Keeping their face towels, cosmetics, soaps etc separatelyKeeping their face towels, cosmetics, soaps etc separately

What is Corneal Dystrophies?What is Corneal Dystrophies? Hereditary, affecting the cornea from within, without Hereditary, affecting the cornea from within, without

any external source of afflictionany external source of affliction

Cause defective vision in some which may require Cause defective vision in some which may require keratoplastykeratoplasty

eg. FUCHs and CHED (congenital hereditary eg. FUCHs and CHED (congenital hereditary endothelial dystrophies) macular, granular and lattice endothelial dystrophies) macular, granular and lattice – stromal dystrophies– stromal dystrophies

Corneal DystrophiesCorneal Dystrophies

SymptomsSymptoms

Progressive loss of vision and painProgressive loss of vision and pain

InvestigationsInvestigations Detailed anterior segment (including Detailed anterior segment (including

pupils of both eyes) and posterior pupils of both eyes) and posterior segment evaluationsegment evaluation

Urine sugar, blood pressure and relevant Urine sugar, blood pressure and relevant investigations for general anesthesia if investigations for general anesthesia if surgery is plannedsurgery is planned

TreatmentTreatment Glasses or contact lenses at the initial with Glasses or contact lenses at the initial with

relevant eye drops for example hyperosmotics relevant eye drops for example hyperosmotics and lubricantsand lubricants

Surgery (PKP, Lamellor, Keratoplasty)Surgery (PKP, Lamellor, Keratoplasty)

Role of the counsellorRole of the counsellor To explain the hereditary nature of the To explain the hereditary nature of the

disease and get the siblings examined for disease and get the siblings examined for the samethe same

To stress that it can be transmitted to To stress that it can be transmitted to future generationsfuture generations

Corneal shape disordersCorneal shape disorders

Keratoconus & Cornea planoKeratoconus & Cornea plano These conditions cause defective These conditions cause defective

vision due to abnormal shape of the vision due to abnormal shape of the corneacornea

KeratoconusKeratoconus The cornea bulges forward due to an integral The cornea bulges forward due to an integral

weakness in its structureweakness in its structure Causes could be eye rubbing, hereditary Causes could be eye rubbing, hereditary

causes systemic diseases or unknown causescauses systemic diseases or unknown causes Results in defective vision, which can be Results in defective vision, which can be

corrected by glass, contact lens or in severe corrected by glass, contact lens or in severe cases may require corneal transplantationcases may require corneal transplantation

Picture of keratoconusPicture of keratoconus

Cornea PlanoCornea Plano

It is a hereditary condition where the It is a hereditary condition where the cornea is flat and causes defective cornea is flat and causes defective visionvision

SymptomsSymptoms

Defective visionDefective vision

InvestigationsInvestigations

Corneal topography for Corneal topography for example orbs canexample orbs can

TreatmentTreatment

Glasses, contact lens or in severe Glasses, contact lens or in severe cases may require corneal cases may require corneal transplantationtransplantation

Role of counsellorRole of counsellor To explain the chance of progression and To explain the chance of progression and

to avoid eye rubbingto avoid eye rubbing

To stress on the necessity of periodical To stress on the necessity of periodical review to rule out progression and to review to rule out progression and to assess the present condition and give the assess the present condition and give the appropriate managementappropriate management