OPTHALMOLOGY

Preventive Ophthalmology
Dra. Valdez
1st Shifting
July 24,2008
S.M.V.

PREVENTIVE OPHTHALMOLOGY favor NEARSIGHTED eye; the farsighted eye will be

“lazy” and will eventually become blind, though it is
Much of the responsibility for preventive straightly aligned.
ophthalmology of non-traumatic ocular diseases rest The best way to prevent ambylopia is to test the eye
with General Practitioner, Pediatrician and Internist, but or visual acuity of pre-school children. Even the
the Ophthalmologist has a major role as disseminator Pediatrician can start testing in the clinics.
of necessary information. Meanwhile, the non-eye doctor
must be aware of eye problems that can be treated OCULAR INFECTIONS
before visual lost has occurred, if detected earlier. Very
important problems fitting into this category are: In view of its exposure to the environment, the intact
• Glaucoma eye is remarkably resistant to infections; but once the
• Strabismus epithelium of the cornea is breached, opportunistic
• Complications of systemic diseases (TB, organisms can penetrate and damage the cornea.
diabetes, syphilis, leprosy, etc.)
Prevention of the damage of the corneal epithelium
It is indeed a tragedy to find undetected advanced is indisputably the key to prevention of corneal infection.
ocular diseases in a patient receiving regular medical
treatment for another illness. Massive inoculations may come from:
• Dacryocystitis
PREVENTION OF SEVERE UNDIAGNOSED • Blepharitis
GLAUCOMA • Contaminated contact lens

Chronic Open Angle Glaucoma Accidental epithelial injury may result from:
It does not cause pain in the early stages but can 1. Exposure during coma states – lid retraction
ultimately lead to blindness. Here, the central vision can present.
be good, but the peripheral vision may be already 2. UV while welding or skiing.
constricted. 3. Dessication associated with exopthalmus, facial
nerve palsy, ectropion of the lower lid (burn).
For the diagnosis, visual field exam and optic disc
exam is very necessary. Tonometry can be helpful when Temporary protection in such cases, can help save
doing P.E. for patients >20 years old. the eye – eye patching, tarsorraphy, frequent eye drops,
artificial tears, soft contact lenses.
PREVENTION OF AMBYLOPIA
PENETRATING INJURY
AMBYLOPIA is diminished visual acuity in one eye
in the absence of organic eye disease. Retained Foreign Body – use of protection shield or
eye glasses
Central vision develops from 6-7 y.o.; if visions has • Fireworks, powerdrills
not developed by then, there will be no chance for it to • Chemicals (fertilizing crops)
develop later.
Most intraocular infections come from:
Two abnormalities that will prevent a child from 1. Contaminated solutions
acquiring binocular vision are: 2. Lid margin infections
• Strabismus 3. Chemical conjunctivitis
• Anisometropia (in the absence of eye diseases) 4. Prolonged surgery
5. Surgeon’s URTI
Esotropia or Exotropia, in a young child causes
double vision. The child quickly learns to suppress Vitamin A Deficiency
images in the deviating eye and learns to see normal in May result to XEROPHTHALMIA and KERATOMALACIA
the other eye. Correction either by surgery or eye (S/Sx: night blindedness, lack of luster in corneal
glasses should be properly advised. epithelium, Bitot’s spots)

Anisometropia Early prevention to prevent corneal perforation.

Young children are more concerned with perception
of NEAR object than with distant ones. If one eye is PREVENTION OF VISUAL LOSS DUE TO DRUGS
nearsighted and the other is farsighted, the child will

MARY YVETTE ALLAIN TINA RALPH SHERYL BART HEINRICH PIPOY KC JAM CECILLE DENESSE VINCE HOOPS CES XTIAN LAINEY RIZ KIX EZRA GOLDIE BUFF MONA AM MAAN ADI KC
PENG KARLA ALPHE AARON KYTH ANNE EISA KRING CANDY ISAY MARCO JOSHUA FARS RAIN JASSIE MIKA SHAR ERIKA MAQUI VIKI JOAN PREI KATE BAM AMS HANNAH MEMAY PAU
RACHE ESTHER JOEL GLENN TONI
 OPHTHALMOLOGY
Preventive Ophthalmology
Page 2 of 2
All drugs can cause adverse reactions. Ophthalmic
eye solution should be properly labeled and packaged. Early prevention can be done. Immunization of the
On the first visit, all drugs previously used should be mother may lessen the transmission to the offspring
brought to prevent duplication and possible overdosage.
Certain eye solutions have such frequently occurring and The combined efforts of the different specialties
damaging side effects. especially OB, internists, and ophthalmologists may
reduce ocular infections or abnormalities of the
1. Atropine (use to dilate pupils) offspring.
- may precipitate glaucoma
- prolonged use may lead to
conjunctivitis, allergic eczema of eyelids
2. Anti-glaucoma drugs PREVENTION OF IATROGENIC OCULAR INFECTIONS
- stenosis of puncta
- shrinkage of conjunctiva Ophthalmologists may have been clearly implicated
3. Corticosteroids in the transmission of infectious eye diseases. Handling
of infected patients can be transmitted to the rest of the
- used locally or drops or ointments; may patients seen that day.
depress local defense mechanisms of 1. Proper personal hygiene
precipitating corneal ulcerations, often 2. Sterilization of instruments (including penlight,
FUNGAL. tonometer, cotton buds, etc.)
3. Prevent use of contaminated eye solutions.
Prolonged use may:
1. Worsen herpetic keratitis and other corneal PREVENTION OF RADIATION INJURY
infection
2. Lead to open angle glaucoma UV Radiation – may produce superficial epithelial
3. Posterior polar cataract keratitis (S/Sx: pain, redness, photophobia)
4. Worsen HSV and varicella-zoster corneal
infections Prevention: use of protective UV filter
5. Fungal endophthalmitis after cataract surgery
Solar Retinopathy – edema of the retina
Many drugs used systematically may produce: - atrophy of tissues; producing a macular hole
1. Keratopathy eventually, permanent central scotoma
2. Retrobulbar neuritis
3. Retinopathy Prevention: use of negative filter
4. Steven-Johnson syndrome
Pterygium – results from UV exposure and dessicated
It is therefore the duty of the Ophthalmologist to wind
detect early ocular changes and to inform other
specialist so they can substitute medications. Prevention: use sungalsses
PREVENTION OF GENETIC DISEASES

Until recently, prevention of genetic diseases

received little attention. Now, there are Genetic Centers
or Counseling Centers. Persons concerned with genetic
disorders or history that affects the eye has been
recognized; transmissions are very well considered.
Patients with history of DM, retinitis pigmentosa,
retinoblastoma, consanguineous mating,
neurofibromatosis, etc. need counseling to prevent
disasters to the offsprings.

Prenatal diagnosis can be made through amniotic

fluid exam.

PREVENTION OF CONGENITAL INFECTIONS

Viral diseases of the mother may be transmitted to

the fetus causing ocular anomalies the offspring, like:
1. Infectious glaucoma
2. Cataract
3. Uveal tract Coloboma