Most common eye diseases

There is a wide variety of eye diseases in the world. Younger people turn to the eye doctor most often with complaints about dry eyes, eye inflammations and optical defects. Older people tend to have problems with cataract, glaucoma and macular degeneration in addition.

In order to raise the awareness of patients, we are glad to share information about the most common eye diseases.

Inflammation of the mucous membrane

Inflammation of the mucous membrane is a very common eye problem. Patients complain that eyes are itching, red and watery, there is eye discharge. The inflammation appears suddenly and disturbs our everyday life. Nearly 70% of the inflammations in adults are caused by viruses. Therefore there is no adequate treatment for such inflammations but it helps to place cold compresses on your eyelids and using moisurizing eye drops.
Bacterial mucous membrane inflammation occurs nearly 30% of the cases and these are treated with eye drops with antibiotics.
Children’s mucous membrane inflammations are mostly caused by bacteria, eyes are normally very red and have discharge. Eye drops with antibiotics help.
If patients have complaints that refer to inflammation, it is a good idea to first visit the family physician who can write a prescription for anti inflammatory eye drops. For recurrent problems, it is more expedient to turn to the eye doctor.

Eyelid inflammation

Eye doctors get often visits from patients who complain about eyelid redness, stinging and itching. These symptoms refer to eyelid margin inflammation or blepharitis. The inflammation normally occurs in case there is poor eyelid anatomy when the eyelid glands clog up and the oily secretion needed for the tear film, cannot reach the eye’s surface and it accumulates inside the eyelid thus causing discomfort. When bacteria are added, the inflammation is magnified. In case of eyelid inflammation, it helps to massage the lids that activates the work of eyelid glands. Antibiotic ointments also weaken the inflammation reaction and it often helps to take in omega-3 fatty acids that promote the work of eyelid glands. If blepharitis turns into a chronic disease, it might magnify the eyelid inflammations, for example in a form of a stye and chalazion. Then an inflamed bump is formed inside the eyelid that is painful when touching it. For treatment use eye ointments or operative care.

Cataract

Cataract is one of the most common eye diseases nowadays. A cataract is a clouding of the eye’s natural lens and as a result causes decrease in:

  • vision acuity
  • sensitivity of contrast acuity
  • seeing double contours may occur

There are different types of cataract and therefore the vision complaints also vary. Cataract is more often a problem of the older aged people for the metabolic changes that take place in the lens may change the eyes’ water content and lens size. As a rule, these are inevitable changes in the eyes’ anatomy which means that cataract cannot be prevented.

Cataract is seldom innate. It might occur during other diseases in process, it might emerge during long-term administration of medicines and also as a result of eye traumas.

Nowadays the only proved treatment of cataract is operative care.

Eye drops or other medication cannot prevent cataract from occurring. During the surgery, corneal micro-wounds are created through which the dimmed content of the lens is removed with an ultrasound device and an artificial lens is inserted. The surgery is painless as a rule, local anaesthesia is used, the process is relatively short and the surgery with one of the best results. The frequency of complications is approximately 1:10000. More common complications are eye inflammation or bruising, secondary eye diseases, corneal changes, dimming of the eye capsule. The latter one being quite a common problem and is possible to remove with a laser procedure.

Cataract surgery has been included in the Estonian Health Insurance Fund pricelist which means that the patient doesn’t need to pay for the procedure. Cataract suregeries are performed in Estonian biggest eye clinics.

Glaucoma

Glaucoma is chronic and quite a common eye disease. There are different factors that make up this disease which means that in order to be able to diagnose it, there have to occur several different forms of disease deviations. With glaucoma, the intraocular pressure has increased. Such forms of disease where the ocular pressure is normal or even low have also occurred. Intraocular pressure is normal between 10–21 mmHg. If that indicator becomes higher, you should definetely investigate the reasons. Most often the problem lies in the eyes aqueous humour drainage canals – these might get clogged for different reasons and cause the pressure gradient.

The glaucoma’s high intraocular pressure damages the optical nerve and retinal nerve fibre layer. An eye doctor can visually assess that by looking at the eye fundus. The disease in the early stages can be identified using a number of research methods – e.g. GDX, OCT, HTR studies.

When already ca 60% of nerve fibres have been damaged, also changes in the visual field emerge – vision loss, non-perception of certain areas, blind spots. In that case, the disease has already progressed into advaced phase.

When there is a rise in intraocular pressure and with the eyes structural and functional changes, the first treatment option is medicinal therapy – using eye drops that lower the eye pressure. The treatment is continuous, sometimes even lifelong.

In some cases it is possible to perform laser treatment on the eyes aqueous humour canals. If the methods described before don’t work, it is possible to perform an eye surgery that creates a drainage underneath the mucous membrane. Nowadays, there are various treatment methods.

Risk factors include:

  • Glaucoma in the family or among close relatives
  • Myopia or nearsightedness
  • Age over 50
  • Thin cornea (eyes with thin cornea have a higher intraocular pressure)
  • Very high or very low (especially nocturnal) blood pressure
  • Diseases that may cause a secondary glaucoma (cataract, diabetes, cardiovascular diseases)

We have to admit that if the glaucoma has already caused nervous damage, it is not possible to take them out or cure them. But it is possible to keep the disease under control with adequate treatment.

Macular degeneration

The macular degeneration is a metabolic older age eye disease in which case structural changes emerge in the area of the drusen, the area that gives us the sharpest vision. The retina may become thinner, pigment epithelium changes and waste products of the retinal metabolism emerge.

Risk factors include:

  • Age over 50
  • Female
  • Smoking
  • High blood pressure
  • Diabetes

The symptoms of this disease is impaired vision when looking at close or far distances. The central vision is damaged, black spot may occur before the eyes.

There are several forms of that disease. The first is a dry form in which case the structure of the drusen has changed, but there is no fluid underneath the retina and the layers. The second is a wet form in which case the pigment epithelium is damaged and because of the leakage of blood vessels, there is fluid between the retinal layers and the pigment epithelium. That creates swelling, and in addition, new blood vessels are formed that may cause haematomas in the eyes retina and vitreous body. Dry degenerative changes are currently untreatable but when changes have been identified, it is recommended to consume the vitamins and mineral complexes for the eye fundus that inhibit the progression of the disease. In case of the wet form, it is possible to carry out special eye injections that inhibit the new blood vessels from growing and lower the swelling of the eye fundus. Normally there is a need for more than one injection. Your eye doctor can assess the expedience of treatment. Nowadays there are many diagnostic means (OCT, Spectralis) that show structural changes in detail and help plan the treatment.

Vitreous body floaters

Often patients complain about seeing spots, flies or threads in their vision field. Mostly these appear suddenly and move along with the eyes when moving them. The floaters are better seen on a white background and can have various shapes. We are then dealing with intraocular tissue clusters that may have been detached from the eye structures and float freely inside the eye. From time to time these floaters appear before the vision axis and are therefore visible.

Such complaints appear among the young and the old. The older aged people may have these complaints attached to some other disease – age-related vitreous body detachment in which case a thin film membrane detaches from inside the eye and thus some pieces remain floating inside the eye.

The vitreous body floaters are generally a safe problem that doesn’t need intervention. It is assumed that these tissue clusters melt away or dissolve into smaller pieces along the years, or people just get used to having them in their vision field.

But in case you see a lot of black or red spots before your eyes that form as if a partial curtain or veil, then that is a sign to turn to your eye doctor immediately. Such symptoms may indicate retinal detachment. That is, in turn, a very serious eye disease that needs prompt surgical treatment.