By N R Galloway,SpringerLink (Online service)
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Extra resources for Common eye diseases and their management
Think of the “short-sighted” old man who cannot see to read without glasses and, at the same time, the “short-sighted” young lady who cannot see clearly in the distance. The term “short sight” is used in these instances unwittingly by the layman to mean two different situations; either it can mean presbyopia (caused by diminished focusing power with ageing, as in the case of the old man) or it can mean myopia (caused by a larger eyeball, as in the case of the young lady). Leaving aside presbyopia for the time being, we need to realise that the myopic person has physically larger than normal eyes, with an anteroposterior diameter of more than 24 mm, and, by contrast, the hypermetropic (or longsighted person) person has smaller than usual eyes, with an anteroposterior diameter of less than 24 mm.
A local antibiotic can be applied to the lid margins twice daily with good effect in many, but not all, cases. In severe cases with ulceration of the lid margin, it might be necessary to consider prescribing a systemic antibiotic, preferably after identifying the causative organism by taking a swab from the eyelids. Local steroids when combined with a local antibiotic are very effective treatment, but the prescriber must be aware of the dangers of using steroids on the eye and long-term treatment with steroids should be avoided.
The retained secretions of the gland set up a granulating reaction and the cyst itself might become infected. The patient might complain of soreness and swelling of the eyelid, which subsides, leaving a pea-sized swelling that remains for many months and sometimes swells up again. During the stage of acute infection, the best treatment is local heat, preferably in the form of steam. This produces considerable relief and is preferable to the use of systemic or local antibiotics. Antibiotics might be required if the patient has several recurrences or if there are signs and symptoms of septicaemia.