Many Nigerians live with challenges of eye diseases, some of which are self-induced. Principal Optometrist with the Health and Human Services Secretariat, Federal Capital Territory Administration, Dr Okonokhua Ozy, provides insight into the causes, types, prevention and treatment of prevalent eye diseases in this interview with MARCUS FATUNMOLE, Excerpts:
What are the causes of eye diseases?
Eye diseases are many and varied. If we are going to look at the causes of eye diseases, we need to identify the particular eye disease we want to be talking about. For instance, cataract is one of the disease conditions that affect the eye. Cataract is a senile disease principally, which means it happens to people who are old. But we also have some other types of cataract that may come up as a result of secondary condition – may be the use of drugs like steroids – which can predispose one to have cataract. Also, excessive exposure to sunray can hasten cataract.
Can you elaborate more on other forms of eye diseases and their causes?
There are diseases that affect the front of the eye; there are some diseases that affect the back of the eye. There are some diseases that affect the way you see. If we start with the diseases that affect the front of the eye, maybe we start with the simple one such as conjunctivitis; that is the one we call Apollo. Conjunctivitis affects the front of the eye, principally. It only affects the vision a little bit. It is viral in nature – it is caused by a virus. This virus is self-eliminated; meaning that it can die by itself, even when you don’t treat it. It is just that the secondary effect of the virus is what we normally have. It makes the bacteria to grow more in the eye once it is there. That is a simple example of disease of the eye that affects the front of the eye.
There are diseases that affect the eyelids; that make the eyelid swollen. This, at times, can result in a boil; people often have different interpretation to this. There are diseases that affect the back of the eye. These are different types of retinopathy diseases that we have inside the eye. There is also another one we call glaucoma. Glaucoma is one of the leading causes of blindness, globally. The unfortunate aspect of glaucoma is that it does not give the patient any sign. It is only the doctor that can detect the presence of glaucoma in the patient’s eye. We call it the ‘silence thief of sight’ because the patient does not know that he or she has glaucoma, except a test is done in the clinic.
Glaucoma does not have a particular cause but there are predisposing factors that make a patient more prone to having glaucoma. One of such predisposing factors is short-sightedness. A patient who is short-sighted is most likely to develop glaucoma, especially if the short-sightedness is high. We have also found that it is more common in blacks than it is in whites. It also tends to run in the family. These are some of the things we want to associate with glaucoma, which is one of the things that happen at the back of the eye. Then, there are other visual defects or impairments. We have short-sightedness, long-sightedness, astigmatism etc. These are conditions that prevent a patient from seeing clearly whether at far or near. Some affect the lid, some affect the cornea, and there are some that affect the whole part of the eye.
Is it possible for a child to be born blind?
Yes. In that case, it is a congenital blindness; that means it was as a result of defects in the development while the child was in the womb. It is very possible that a child can be born blind. You will check the history of the pregnancy of that particular child. There must have been some problems that took place when being conceived in the womb. It is just like a child coming out deformed. It is possible that the eye can be deformed just like the leg, ear or the head can all be deformed.
What are the treatments for eye disease?
Apollo for instance, I am liberally using the word Apollo here, doesn’t need any treatment. But, the bacterial infection that comes in because of the presence of that virus is what you need to treat. Like any viral infection like flu, in seven days, it goes whether you treat it or not. But, it makes room for other bacteria to grow. It is that bacterial infection that we need to treat. That is the way of treating Apollo. Other disease conditions like glaucoma as I mentioned before, cannot be treated. Glaucoma is only managed. You only manage the symptoms of glaucoma, you don’t treat it.
As for cataract, the treatment for cataract is surgical intervention. There is no other means of treating cataract for now except to remove the opaque lens from the eyes and replace it with intraocular lens. For other conditions like visual impairments that I mentioned earlier, shortvision or long-vision, those ones we treat primarily with the use of glasses, contact lenses; depending on the patient’s choice.
There have been instances where persons assumed to be blind regained their sight through free operations by well-meaning Nigerians and government. Don’t you think we need more of these free surgeries, especially from government?
Yes, the government is trying the best it could. Also, a lot of professional bodies are doing as much as they can. I know for instance of the Ophthalmological Society of Nigeria, the Nigeria Ophthalmic Association, the Ophthalmic Nurses Association of Nigeria among others have come together at various points in time to see how they can put resources together to provide free services for persons who are in need of these services. Those with cataract for instance, I am aware that often times, they organize this free cataract surgeries for some categories of people. A lot of them fail to turn up. You know that surgery is not something you can compel somebody to do. Surgery is something that you provide for somebody who is motivated for it. Since some of them benefit from the condition that they are in, which is the blindness and the benefit they derive is that they go along the streets begging for cheap money. They are not highly motivated to go for surgeries. Those who are highly motivated to go for surgery, they usually benefit from such medical intervention that is provided.
What would you describe as the effect of people gluing their eyes on computers and television screens today?
First and foremost, the computer screen or monitor emits a kind of ray that induces strain on the ocular muscles. The tendency is that when somebody is on the computer screen for a long period of time, their eyes can get fatigued faster than somebody who is in the larger field looking at distance object. The computer screen is a source of ocular strain which in turns is referred to as a headache for the person. That is one thing we have been able to identify the computer screen for. To a smaller degree, the handsets, the palm top, the Ipad and all that smaller devices also emit this type of ray which induce strain on the ocular muscles. That is as far as it goes for those devices. But, that is not to say that these devices are of no benefit. It is the long term use and duration of time you spend on the system that predisposes you to this type of strain. Simple thing to do is that if you stay on the computer screen for like 20 to 30 minutes, just look away from the screen for a minute or two so that you can allow that eye to recover itself from whatever strain its under.
What is your opinion on people who use glasses that are not recommended?
It is a very dangerous trend when you just walk to the market and you pick up a pair of glasses that is not recommended; you are going to do more damage to your eye. It is like buying drugs not prescribed. Glasses are meant to be prescribed after a test has been done by the relevant professionals. But, what you find is that somebody just wakes up one day and goes to pick a pair of glasses at the roadside and starts using. You may be using a magnifier that will in the long run damage your eye. So, the best thing is to avoid such glasses and first and foremost go to a registered and recognized, licensed eye care provider preferably an optometrist who is trained in that specialty to do for you a refraction. It is after that refraction has been done that you can now pick up your prescription which you are now aware of. If for instance I know that I am using a certain prescription, and I see it at the roadside, nothing stops me from buying it. But, make sure you’ve done a test before you go to pick up any prescription from anywhere. In that way, you will not run the risk of damaging your eyes in the long run