WHAT IS BLINDNESS? Blindness is loss of vision sufficient enough to result in inability to conduct normal daily living activities such as;

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4 WHAT IS BLINDNESS? Blindness is loss of vision sufficient enough to result in inability to conduct normal daily living activities such as; walking unaided cooking for yourself washing for yourself Blindness affects people of all ages e.g. young children, young adults and the elderly. In Botswana, the rate and distribution of blindness is not known. However WHO estimates blindness rate for developing countries, including Botswana to be 1% and the common cause being cataract. Most of the blind people come from rural areas, (where there are more old people than in towns). The situation at these places is worsened by the uneven distribution of trained eye care personnel and the lack of knowledge about blindness and its prevention by the general public. 2

5 CAUSES OF BLINDNESS Causes of blindness include; injuries cataract eye infection of the newborn squint/crossed eyes glaucoma These injuries can occur at home, at work, at play and during fights. Sometimes the eye lens which helps us see things clearly is cloudy, resulting from cataract. This can also be a result of injuries, diseases, drugs etc. Sexually transmitted diseases like gonorrhoea and chlymadia can cause corneal ulceration in the newborn (conjunctivitis). Squint refers to crossed eyes or eyes looking in different directions due to weakness of some eye muscles. In children this can lead to poor vision if it is not corrected in good time. 3

6 MECHANICAL INJURIES Mechanical injuries often result from either blunt or sharp objects such as a blow from a fist or knife respectively. These injuries can also be due to corneal foreign bodies. Corneal foreign bodies Injuries caused by corneal foreign bodies are usually sustained at work when grinding metallic objects without wearing effective protective goggles. Metal particles can enter the eye and stick on the cornea during this exercise. If the foreign body is small and superficial it can be removed without damaging the cornea. When it is big and deep, a big corneal scar may result which reduces the vision. Painful red tearing eyes, foreign body sensation reduced vision and a scar on the cornea. Prevention Make sure you don t let foreign bodies enter your eyes. This can be archived by wearing effective protective eye goggles when grinding metal, chopping wood, digging the soil and when cutting trees. When a foreign body enters your eyes, irrigate the eye with water, or refer to a health facility. 4

7 CORNEAL ABRASIONS This is a superficial injury to the cornea caused by objects such as; clothes getting in contact with your eyes book scratching your cornea child finger nails scratching mothers eyes Painful red eyes, tearing eyes, not seeing well etc. Prevention Make sure clothes, books and finger nails do not come in contact with your eyes. If very painful go to the nearest health facility. 5

8 PERNETRATING EYE INJURY This is when the eye is torn and the internal contents protrude or spill over. These injuries are more likely to cause blindness than corneal foreign bodies. These injuries can be caused by sharp objects such as: knives, wood, glass, pens, forks. Sign and symptoms Torn eye, contents of the eye spill over or protrude, not seeing well, pain, tearing and red eyes. Prevention Wear protective plastic goggles when working with anything that may send hard or sharp objects flying. Supervise children during play. Visit a health facility immediately if injured. 6

9 BLUNT INJURY This is a type of injury which is caused by blunt objects such as a fist, tennis ball, stone, squash ball. The injury may lead to blindness. Double vision, clouding and blurring of vision, bleeding inside the eye, swollen red eyes, sunken or protruding eye, and some bones surrounding the eye may be broken. Immediately the injury is realised, make sure you take your child to the nearest health facility. Prevention Discourage fights, and supervise children during play. Make sure your children do not play around with hard blunt objects without your supervision. 7

10 THERMAL BURNS Thermal injuries are burns to the eye caused by hot water, tea, fire steam, etc. In most cases even in severe facial burns, the eyes are often protected by the eye lids. Burnt face, burnt eyelids, not seeing well, tearing and pain. Prevention Always handle hot fluids with care. Keep hot fluids out of children s reach. If burnt, go to the nearest health facility. Severe thermal burns should be referred for treatment by trained opthalmic personnel. 8

11 ULTRAVIOLET RADIATION Ultraviolet radiation is a rare cause of injury to the eyes caused by direct looking at bright lights such as the sun, welding lights, or by living in very hot climates. Growth in the eye can be removed by an operation. Painful eyes after looking at bright light can be treated with eye drops. Swollen eyelids, not seeing well, pain especially after exposure to arc light, whitish yellow patch on the transparent surface of the eye, development of a reddish growth on the eye surface. (pterygium). Prevention Wear protective goggles when welding or exposed to other bright lights. Do not look directly at the sun when there is an eclipse. Wear sun glasses when ever involved in outdoor activities on sunny days. 9 1

12 CATARACT Inside the eye there is a lens, which helps us see things clearly. The lense is normally clear, when it is cloudy then one has cataract. Cataract is also caused by old age, injuries, repeated eye diseases, general conditions such as diabetes, some drugs and heredity (seen in children). Poor eye sight, difficulty in driving at night, seeing double. Things may appear yellow when seen through a cataract. Squint in a long standing vision. The only treatment for cataract is an operation to remove the cloudy lense. There are no medicines or tablets to remove the cataract. 10

13 CATARACT TREATMENT Will one see normally after the operation? Removing the cloudy lense will not on its own restore good sight. For one to see well an artificial lense is inserted into the eye (intraocular lens implant or IOL) contact lenses and spectacles can also be used. Intraocular lens implant This is the best method and it gives the best results. The power of the lens implant will determine whether one will wear spectacles or not. In Botswana, implants are fast replacing spectacles (cataract glasses) Spectacles After the operation, a patient wears thick spectacles (cataract glasses). These makes objects look bigger. Spectacles need care as they scratch easily. One should 11 clean spectacles with clean water and soap, rinse and dry them with soft cloth. Contact lenses These are the next best choice after intraocular implants. These lenses need more special care than cataract lenses, including daily cleaning to avoid infections and build up of dirt on the surface. Some patients develop allergic reactions to either the contact lenses or the cleaning solution. Notes to remember There are many causes of poor vision, not all the white patches on the eyes are cataracts. Succesful operation depends on the health of the eye and that of the patient.

14 EYE INFECTIONS OF THE NEWBORN Conjunctivitis is caused by sexually transmitted infections such as gonorrhoea chlamydia. The infection occurs in infants under 30 days old. The infection is contracted in the birth canal during delivery. If not treated, the condition may lead to the development of a wound on the eye (corneal ulceration). These include; swollen eye lids, pus or discharges (sticky eyes), swelling of the membrane of the eye (conjuntiva), painful eyes and wound in the eye (corneal ulceration) Prevention Importance of antenatal clinics, treatment of mother with sexually transmitted infections,such as gonorrhoea and chlamydia. Instillation of chloramphenicol or Tetracychine eye oitment to all newborn babies. Take the child to the nearest health facility for treatment with antibiotics. 12

15 SQUINT Squint eyes are caused by congenital abnormalities, a person can be born with squint. Trauma and fractures of the bony wall of the eye as a result of a blow from a fist, stone etc. Diseases of the muscle such as paralysis of the eye muscles. Eyes not looking straight. Reduced sight. Treament Immediately you notice these signs, take the child to the hospital. An operation to straighten the eyes can be done by an eye doctor. Squint referes to crossed eyes or eyes looking in different directions due to weakness of some eye muscles. 13

16 GLAUCOMA This is an inherited disease caused by blockage of the channels that drain water from the eye. This leads to high pressure in the eye. The high pressure kills the nerves that is required for sight leading to blindness. Glaucoma leads to gradual painless loss of vision. Sometimes there may be dull eye pain.there may also be coloured rings around lights. Eye drops are used to reduce the pressure in the eye. If this fails an eye operation to drain the water can be performed by an eye doctor. Prevention All adults 40 years and above, with close relatives suffering from glaucoma, should have yearly eye checks. If treatment is started early, then blindness can be prevented. 14