Medical Questions & Answers » Eyes

Less Sleep Due to Work Shifts

medicalquestions — Fri, 24 Apr 2009 06:00:53 +0000

In my job I have to work shifts. I work two days from noon till 8 pm then have a day off, then two days from 8 pm till 4 am, then a day off, then two days from 4 am to noon, followed by another day off. This has gone on for four years, and for most of that time I have not been able to sleep properly. I can’t sleep during the day on night shift, or at night when on day shift. I’m getting irritable, lose my temper easily, can’t relax and have headaches. What should I do?
You have an atrocious job, with an employer who has no conception of the effects such irregular hours can have on an employee.
There are many jobs which require workers to be on site 24 hours a day, but rapidly rotating shifts do not give the body’s natural clock and biorhythm any chance to catch up. You are suffering from perpetual jetlag, and I am surprised that you do not have more symptoms than you have mentioned.
I suggest that you join with other employees in approaching your employer with a request for a more reasonable roster. This does not mean that you avoid night work, but you change shifts less often.
For reasons of health and employee productivity (you won’t work well if you are tired and irritable) you should spend four to six weeks on each shift, and then change to another shift. With a prolonged period on one shift, you can adjust your sleep patterns to a regular one, be it night or day.
On days off, you should try to keep roughly the same sleep times. This can interfere with your family and social life, so if there is some special function you need to alter your sleep time for, ask your doctor to prescribe a mild sleeping tablet (eg. Stillnox, Normison, Halcion) to help you get off to sleep.
Far too many shift workers are being forced to work unreasonable rosters, with rapid changes in shifts. I believe this is something that unions should be investigating, and acting to protect their workers.

I get eight hours sleep a night, but always have dark circles under my eyes, and my eyes get bloodshot in the evening. I am also very fatigued. I would appreciate your professional opinion.
Dark circles under the eye have no specific diagnostic meaning, and many people are just unlucky enough to develop them far more easily than others. If you are ill, suffering from an allergy, or under stress, they occur more readily, but it is impossible to make any diagnosis or form a reasonable opinion about a person from that symptom alone.
In your case, it may be possible to link the widely varied symptoms together. Your bloodshot eyes may also be the result of an allergy, as dust, pollutants and pollen can enter the eye during the day, and cause a reacrion in the eye to make them red, itchy and watery. They can recover overnight, as the closed eyes
prevent any more irritants from entering. Chronic fatigue may also be the result of allergy problems, so all your symptoms may be due to the one cause. Discuss this possibility further with your general practitioner.

Dealing with Cataract

medicalquestions — Thu, 25 Dec 2008 13:00:56 +0000

My father aged about 78 years underwent cataract operation in the left eye, which threw up many complications. After every few days there is liquid discharge with a feeling of sand particle irritation and slight pain, which continues for a few hours, and then subsides by itself. Doctor says that the cornea has hardened a bit, so no other operation should be carried. The normal daily medicines he is taking are Amlodeck 5 mg for hypertension, folic acid, and vitamins. He applies I LUBE drops for eyes.
Your father has a cornea swelling and breakdown which does occur sometimes following cataract surgery. It is termed as pseudophakic bulbous keratopathy where the front of the eye, or the cornea, swells and forms small fluid-filled blisters which rupture at regular intervals leading to acute discomfort. The best answer is to try a bandage contact lens over the cornea which will let it heal, and if that does not work, simply do a corneal transplant. Usually in these eyes the corneal transplant works well and the patient recovers useful vision with comfort.

Don’t Squint Your Eyes

medicalquestions — Fri, 12 Dec 2008 10:29:03 +0000

I have been operated twice for my squint. I did not have the squint at birth, it occurred at the age of two. Both the surgeries were unsuccessful and done by the same doctor. My squint is prominently visible when I’m ill. When I wear glasses (-2 power in right eye and -2.5 in left eye) my squint is reduced to a great extent. Should I consider a third surgery?
Correcting a squint is a fairly simple procedure requiring a reorientation of the ocular muscles. Unless there is a paralytic component, which cannot be handled by surgery, most squints can be fairly easily managed. You need to have your eyes evaluated on a special machine known as a Synaptophore, which is available at most large hospitals, to tell us about the muscular imbalance. Once you provide that information I can advise you further.

Eyes Issues

medicalquestions — Sun, 07 Dec 2008 08:47:56 +0000

I’ve noticed that when I move my eyes around, some black web like figures appear are increasing and affecting my vision. There are also wrinkles in the corners of the white parts of both eyes. Sometimes I also have pain in my right eye or both eyes. This is not often. These days both my eyes are getting dry, itchy and achy. I’m not using spectacles. My vision is 6/6, 6/6. Will the floaters lead to color blindness?
Floaters are small specks or clouds that move in your field of vision. They are better seen against a plain background, like a blank wall or the sky. Floaters are actually tiny clumps of gel or cells in the vitreous, the clear jelly-like fluid that fills the inside of your eye. They may look like specks, strands, webs or other shapes, but what you are actually seeing, are the shadows of the floaters cast on the retina, the light-sensitive part of the eye. Because they are inside your eye, they move with your eyes when you try to see them. They are usually harmless, and never cause color blindness, but flashes of light may indicate a problem. These flashes occur more often in older people as the vitreous humor thickens and tugs on the light-sensitive retina. They may be a warning sign of a detached retina. Best is to ignore the floaters. Alternatively, an iodine based eye drop does help in some patients. If they worry you a lot, they can be surgically removed. The wrinkles in the side of your eye could be due to dryness or a Vitamin A deficiency.

I am 74. I had a cataract surgery 1.5 years ago in my right eye. Now the vision has become blurred. I am advised this is common and it needs treatment with a YAG LASER. Kindly tell me about this procedure. Is it safe?
When a cataract surgery is done nowadays, a part of the natural lens, the thin posterior capsule is left behind to stabilize the intraocular implant put in. It thickens in time, and needs a YAG laser to open it. This takes only seconds to do and is usually safe.

Be Cautious for your Eyes

medicalquestions — Mon, 01 Dec 2008 06:57:38 +0000

I am a computer student. I recently underwent a successful LASIK surgery, and the doctors assured me that there won’t be any problem of weak vision upto the age of 35-40. But I am pursuing computers that requires me to sit for long hours. And as a student I need to read a lot. I am worried whether under such conditions, I will gain develop weak eyesight and advice some simple exercises that can be performed to reduce eye strain.
It is a standard requirement for individuals who have myopia, to restrict all intense close vision activity to before 9 p.m. Try also to take 10-minute breaks after every 40 minutes of reading or computer work. Use the period to focus on distant objects. This will give your eyes enough time to relax. However genetics also plays a role here, and if you are going to put stress on your eyes, a small number could return, for which you will need to do another LASIK later or correct with lenses.

Eyesight : Spectacles

medicalquestions — Thu, 19 Jun 2008 06:00:08 +0000

Alternatives to spectacles: There are four main options available to overcome the disadvantages of spectacles:
Contact Lenses
These are small polymer lenses, which are placed directly over the cornea. They are of two main types — soft and semi soft. Soft contact lenses are pliable and therefore very comfortable, but require utmost meticulous care and maintenance. Infections and allergy (GPC : giant papillary conjunctivitis) are the likely complications. Semi soft lenses (or Rigid Gas Permeable) are rigid and thus, initially, slightly uncomfortable to wear, but they do not require too much care. Complications like infection and allergy are uncommon with these lenses. However, in the Indian context infection, GPC, mishandling, dust and pollution associated conjunctivitis continue to be major causes of contact lens intolerance. Patient compliance is generally not satisfactory relating to the lens care and maintenance schedules.
• High degree of astigmatism cannot be corrected by contact lenses.
• Extended wear lenses are not suitable for Indian conditions.
• Hard lenses are obsolete and should not be used as they prevent oxygen supply to the cornea.
Refractive Kartotomy (RK)?
This is an operation where 4 to 8 (rarely 16) incisions are made on the cornea using a diamond knife. This results in flattening of the complications caused by RK.
Excimer LASER (PRK) technique
Using a computer controlled LASER (mostly Argon Fluoride 193 nm) the surface of the cornea can be reshaped imparting a predetermined curvature. This leads to correction of both myopia and hypermetropia, and also moderate amount of astigmatism, the procedure is short and simple and being computer controlled is highly accurate. The patients suitable for PRK are the ones above 18 years of age, with refractive error between 1 to 6 D and whose error has been stable for the last 1 year. There should not be any other complicating factor or disease in the eye. PRK, although a little expensive, is relatively safe in comparison to RK. The complications are postoperative pain (due to removal of epithelium during surgery), prolonged healing time and need to use steroids, slight corneal haze and late regression of the effect seen in some patients. It is not useful for high refractive errors and high astigmatism.
LASIK is an acronym for Laser Assisted In-situ Keratomileusis.
It combines all the advantages of the above procedures and virtually eliminates all their disadvantages. In LASIK an ultra-thin flap/ layer of cornea is raised using an automated cutting device called the microkeratome, and then Excimer laser is delivered to reshape the corneal stroma (inner layer of cornea) into desired curvature. The flap is repositioned back where it self seals without any stitches.

Best Sunglasses for Eyes

medicalquestions — Sun, 01 Jun 2008 06:00:49 +0000

Question: What are the best sunglasses to buy?
There are a very wide range of sunglasses on the market, but very few manufacturers give any information about the characteristics of the lenses, and most people buy for appearance rather than effectiveness.
A good pair of sunglasses should be large enough to prevent glare from entering the eye from around the edges. They should absorb all the ultraviolet (UV) and infra-red radiation frequencies, as these are totally unnecessary for vision, but may be harmful to the eye itself. The total light transmission of the sunglass lenses should be reduced to below 40%, but some go as low as 15%. Polarized lenses, which reduce reflected glare markedly, are also better than non-polarized ones. The actual color of the lens makes little difference, but the variable shaded lenses are better avoided, as they do not give adequate protection from reflected glare.
Excess sun on the eyes will aggravate cataracts, and can cause an overgrowth of tissue on the white of the eye called a pterygium. It is just as sensible to protect your eyes with good sunglasses as it is to protect your skin with a good sun screen lotion.

Cataract Operation

medicalquestions — Sun, 01 Jun 2008 06:00:32 +0000

Question: My GP said that I have a cataract and It will need an operation. Is this the best treatment for a cataract?
Behind the pupil in your eye is the lens. This is transparent and able to change its shape with the aid of tiny muscles attached to its edge. The change in shape enables it to focus on objects near and far.
A cataract is the clouding over of this lens. Once the vision has deteriorated sufficiently to cause significant sight impairment in both eyes, the worst eye will be operated upon, because this is the only way of treating a cataract. There are no medications or drops that will help. The operation is technically difficult, but can be completed in half an hour and is often done under local anesthetic. The cloudy lens is removed, and a new clear plastic lens is inserted. This new lens is not mobile, and cannot change shape, thus spectacles are normally required for close work, and sometimes distant vision as well.

Question: What is the best time to have a cataract operation? When it is only slightly annoying, or should I wait until later?
A cataract is the slow clouding of the lens in the eye, until it becomes like frosted glass, and impossible to see through.
There is no urgency about having a cataract operation until your sight has deteriorated to the point where glasses are unable to compensate for the clouding of the lens. Usually one eye deteriorates faster than the other, and when reading, driving or other skills become difficult, the worst eye will be operated upon. Only very rarely are both eyes done at once.
Once the bad eye has recovered, the other eye will be treated, and most patients find a dramatic improvement in their sight. One of the most common comments by patients after a cataract operation is that they find colors far brighter and more vibrant. The slow progression of the cataract over many years has had the same effect as slowly turning down the color control on a television to give a very washed-out effect.

Pterygium in the eyes

medicalquestions — Sun, 01 Jun 2008 06:00:22 +0000

Question: I would appreciate your opinion on the cause of a pterygium in the eyes. Some say it is glare, others sand or other foreign matter in the eyes. How is this condition caused, and how do you prevent it?
A pterygium is a fleshy overgrowth of the white part of the eye (cornea) that grows across the colored part of the eye (iris). They develop very slowly over many years, but once they are half way across the iris, they should be removed in a simple operation to avoid growth across the pupil and blindness.
Pterygium are very common in Australia, but more so in the north than the south, as they are caused by recurrent mild sunburn to the cornea. The irritated tissue overgrows, and spreads across the eye. Farmers, sailors, drivers, outdoor workers and sports people are most prone to pterygium as glare and sun exposure are the prime cause. The problem can be prevented by wearing good quality (polarized) sun glasses.
A pterygium may become irritated, red and itchy at times. Simple drops available from chemists will ease this problem. Once present they will remain until removed surgically. There are no drops that will make them go away.

Question: My mother is having a vitrectomy. What sort of operation is this?
The eye contains a clear jelly-like substance called the vitreous. If this becomes discolored, the vision in that eye will be remarkably reduced, possibly to the point of blindness.
The most common cause of discoloration of the vitreous is bleeding into the eyeball. This can occur in high blood pressure, diabetes and injury. In the last few years, a very delicate operation has been devised in which the blood-stained vitreous can be removed from the eye and a new artificial substance substituted, allowing normal vision again. It is performed under a general anaesthetic by an ophthalmologist (eye doctor) who has had specialist training in this procedure.

Squint in eyes

medicalquestions — Sat, 31 May 2008 06:01:40 +0000

Question: The doctor is concerned about my grand-daughter’s squint. What is a squint, and is it serious?
A squint (or strabismus, to give it its correct medical name), occurs when the two eyes do not align equally when looking at a distant object. One eye appears to be looking in one direction, while the other is looking in a different direction. This is quite normal when looking at something very close, as both eyes turn in to look at it.
If a child does have a significant squint, the brain will gradually suppress the sight in one eye, to avoid double vision. The affected eye may never learn to see again, resulting in the child becoming blind in that eye. The correction of a squint at an early age is therefore vital. Treatment usually involves prescribing special spectacles to correct the problem. If the squint is more severe, the good eye will be covered for a period every day, as well as using the glasses. This strengthens the vision in the poor eye and prevents blindness in that eye. In marked degrees of squint, it is necessary to operate on the tiny muscles that control eye movement to shorten those that are not pulling the eye around far enough.