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DEPARTMENT:. SHALAKYA DEPARTMENT. COMPILATION TOPIC:. NIGHT BLINDNESS. COMPILED BY:. INTERN DIVYA DEEPAK SHARMA. NIGHT BLINDNESS ( Nyctalopia ). Defination:. It means poor vision in feeble illumination, so that a person cannot move freely in such

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  1. DEPARTMENT: SHALAKYA DEPARTMENT COMPILATION TOPIC: NIGHT BLINDNESS COMPILED BY: INTERN DIVYA DEEPAK SHARMA

  2. NIGHT BLINDNESS ( Nyctalopia ) Defination: It means poor vision in feeble illumination, so that a person cannot move freely in such an illumination and collides with objects.

  3. CAUSES OF NIGHT BLINDNESS A } Congenital and heridiatory conditions: Congenital and herediatory night blindness with other abnormalities in the retina as in Oguchi's diseases, usually occuring in Japan. B } DISEASES OF THE EYE: 1. Retinitis pigmentosa or pigmentary degeneration of the retina. 2. Peripheral Chorio-retinitis. 3. Myopic degenerative changes in the periphery of the retina. 4.Chronic simple glaucoma with marlied contraction of the visual field. 5. Retinal detachment

  4. C } SYSTEMIC DISEASES 1. Vitamin A deficiency. 2. Pathological changes in the liver . eg: cirrhosis of liver and occasionally in Jaundice. The night blindness is mainly due to the damage to the rods cells or due to deficient regeneration of visual pupil. It can be detected by an instrument known as ADPHOMETER.

  5. DISORDERS 1.RETINITIS PIGMENTOSE. It is a primary pigmentary degeneration of the retina. It is a Chronic progressive degeneration of all the layers of the retina with proliferation of retinal pigment occuring usually in young and there is a heridiatory tendency FUNDUS PICTURE: (a) Black pigment spot like bone corpuscles along the blood vessel mainly in the equitorial region. (b) Yellow waxy appearance of the optic disc. (c) Retinal arteries markedly narrow. SYMPTOMS: (a) Night blindness. (b) Later on dimness of vision.

  6. 2. MYOPIC DEGENERATIVE CHANGES. FUNDUS PICTURE: (a) Myopic cresent either on temporal side of the optic disc or surrounding the disc. (b) Chorio-retinal atrophy at the periphery. (c) Atrophic patches in the macula with secleroir of choroidal vessels. (d) Ectaria of the sclera at the posterior pole. SYMPTOMS: (a) Reduced vision acuity for the distance. (b) Black spots floating in front of the eye due to vitreous opacities. TREATMENT OF MYOPIA: (a) It is corrected by prescribing concave spherical glasses. (b) Contact lens is an ideal substitute in high myopia. (c) Surgery like radial keratotomy. There is practically no treatment for pathological changes seen in the progressive myopia.

  7. 3. CHRONIC SIMPLE GLAUCOMA {Primary wide angle glaucoma} SIGNS: (a) Eye remains quite with a clear cornea. (b) On late stage,the cornea is slightly hazy and pupil reaction may become sluggish. (c) Rise in intra occular tension:It varies between 30-40 mm of Hg. (d) cupping of the optic disc. (e) Defects in the vision field. SYMPTOMS: (a) Symptoms are nil in early stages. (b) Mild headache and eyeache occur but they are not severe. (c) Presbyopic glasses require frequent charge due to accomodative weakness. (d) Gradual dimness of central vision is noted at a later stage. (e) In later stage, there may be night blindness.

  8. TREATMENT { MEDICINAL } : (a) Treatment by miotic-Pilocarpine 2% drops, 2-3 times a day. Eserine sulph 0.5% to 1% solution may be combined with Pilocarpine. (b) Timolol 0.25% to 0.5% twice daily, Pilocarpin. (c) Treatment by carbonic anhydrase inhibitor i.e. Dimox. OPERATIVE TREATMENT: (a) Trabeculectomy operation. (b) Iridencleris operation:

  9. 4. RETINAL DETACHMENT CLINICAL SIGNS: By ophthalmoscope, the detached retina is seen to be raised,bluish in apperance and thrown into folds.A hole or a tear in the retina may be visible. SYMPTOMS: The field of vision corresponding to the area detached becomes defective. Thus if there is detachment of the upper temporal retina of the right eye, the lower nasal field for the right eye becomes defective. TREATMENT: Sealing the retinal hole or tear by application of diathamy points on the sclera around the break in the retina. This is followed by drainage of the subretinal fluid by puncturing the sclera opposite to the hole. This is applicable when the detachment is due to a hole or a tear in the retina.

  10. THIS IS HOW A SCEAN APPEARS FOR A PERSON SUFFERING FROM NIGHT BLINDNESS.

  11. SHLESHMA VIDAGDHA DRISHTI REFERENCE: (Su.7.A) According to Sushrut, vitiated kapha takes shelter in Drishti thus making the vision Shweta. So due to this the patient sees everything shweta. If this vitiated kapha spreads to the 3 patals then it leads to loss of vision at night. During day time, the kapha starts liquifying due to the heat of the sun. So the person is able to see the objects to some extent in the day time. Aacharya Vagbhata gives another opinion for the same and named it as USHNA VIDAGDHA DRISHTI.

  12. USHNA VIDAGDHA DRISHTI REFERENCE: (Ashtang Hriday.12.A) In extreme hot climate, if a person immediately takes bath in cold water, then all the 3 doshas along with rakt get vitiated. Due to ushma of rakt it moves upwards to shira pradesh and takes shelter in the netra. Due to this, the person feels burning sensation and heat in the eyes and the Shukla bhaag of the eye gets dirty. Due to this the patient can't see properly in the day time and can't see at night time. This is called USHNA VIDAGDHA DRISHTI.

  13. NAKULANDHYA Due to the accumalation of the vitiated doshas in the drishti and the eyes of the patient shine as the eyes of the nevla is called as NAKULANDHYA. In the day time the person sees the objects in various colours but he is not able to see at night.

  14. TREATMENT FOR NIGHT BLINDNESS Treatment for night blindness will depend upon its cause. Treatment may be as simple as a new prescription for your eyeglasses or switching glaucoma medications. This occurs normally due to vitamin A deficiency so it can be overcome by giving vit.A rich diet. Netra Tarpana: This treatment aims to provide optimum rejuvenation to eyes. Dough of Urad (black gram) is put around the eye ball in such a way that a dam like appearance is seen. Then herbal healing ghee (clarified butter oil) is put in this groove to lubricate eye and surrounding areas which will be kept warm for 30 – 35 minutes. This provides improved vision with beautiful eyes and strengthening of eye tissues.

  15. Grut used for snehan are: TRIVRUT GHRUT & TILVAK GHRUT. ANJAN: Harenuka anjan. Gomaanas anjan. Manasheela anjan. Ajmoda anjan. Yakrut Pleeha anjan.

  16. DAY BLINDNESS { Hemerolopia } DEFINATION: It means that vision is poor in bright light but better in dim light. In dim light, the pupil dilates and so the peripheral retina is used for vision. CAUSES: (a) Pathological changes in the macula. (b) Central opacity of cornea or lens. (c) Congenital conditions when it is usually associated with total colour blindness.

  17. PITTA VIDAGDH DRISHTI Aacharya Sushruta says that vitiatedand increased pitta takes shelter in the eye. The drishti mandal of the patient becomes yellowish in colour. The patient sees all the things in yellow colour. In this disease, the doshas take shelter in tritiya patal. Due to this the patient cannot see during the day time. But the patient can see things during night time. Because at night due to increase in the sheet guna, the pitta subsides and the person sees the things during night.

  18. TREATMENT FOR DAY BLINDNESS. > No treatment for achromatopsia symptom > Palliative and functional treatment for stroke > Occupational therapy - mobility aids > Speech pathology - speech therapy, swallowing therapy > Aspirin or other anti-platelet medications > Thrombolysis (drugs to break up clot) > Drugs for underlying conditions such as hypertension and diabetes

  19. TREATMENT FOR PITTA VIDAGDHA DRISHTI One should give : NASYA SHEKA ANJAN PUTPAK TARPAN GHRUT USED FOR TARPAN Triphala siddhghrut Lodhra siddhaghrut

  20. ANJAN > Rasanjan > Kashmirandanjan > Saindhav anjan > Karpur anjan

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