LIQUID DETERGENTS PODS POSE RISK TO CHILDRENS EYE HEALTH

Liquid laundry and dishwasher detergent pods are an emerging source of chemical exposure in children. When squeezed or bitten into, these pods can burst and send detergent into the mouth, nose, and eyes. A new report published in the current issue of the Journal of the American Association for Pediatric Ophthalmology and Strabismus (AAPOS) cautions that these products should be kept away from children because the bursting detergent pods can cause significant corneal injury.

Detergent pods may offer a simpler way to do laundry, but they represent a source of potential danger when in the hands of a young child. Available in the European market for over a decade and first introduced to the American market in 2010, liquid detergent pods are brightly colored, which makes them attractive to young children who mistake them for toys.

Michael E. Gray, MD, and Constance E. West, MD, from the Abrahamson Pediatric Eye Institute at Cincinnati Children’s Hospital Medical Center, began tracking ocular injuries from detergent pods after noticing an increase in patients over the course of several months beginning in 2012. Ten children, all under 4 years of age, were treated for eye injuries stemming from burst detergent pods. Over the same time frame, 21 other children were seen in the emergency room for injuries caused by ingestion of the detergent contained in the pods.

For the children with eye injuries, two cases involved the child biting down on the pod, seven cases resulted from children squeezing the pod in their hands, and in the last case, the cause was unknown. All ten children with eye injuries presented with significantly bloodshot eyes, although no limbal ischemia or clinically significant conjunctival chemosis was found. Corneal abrasions were found in all of the cases, with defect sizes ranging from 3 mm in diameter to a nearly complete corneal epithelial defect. In addition, three children also had mild periorbital edema or erythema ipsilateral to the corneal abrasion.

During ophthalmologic examination, the ocular surface pH was measured and found to be neutral in all cases, but as study co-author Dr. Gray, Pediatric Ophthalmologist and Assistant Professor, Division of Pediatric Ophthalmology at Cincinnati Children’s and UC Department of Ophthalmology, points out, the pH levels among different brands can vary. “Alkaline injury should also be suspected in association with the ocular cases. However, reported pH from Material Safety Data Sheets (MSDS) of different brands of pods is variable. The pH of some brand name pods is close to neutral (6.8 – 7.6), whereas other brands are considerably alkaline (8.0 – 11.0).”

The report also explains that because these pods are designed to be concentrated, they often contain higher levels of surfactants than traditional detergent, making them more likely to cause injury when they are ingested or when the chemicals enter the eye.

In the study, all affected subjects were treated with irrigation and topical antibiotic ointment. The recovery period for the children averaged just under four days, and none of the patients experienced additional complications or relapse.

While makers of these detergent pods have made changes to packaging to try to keep children out, not all brands adhere to the same safety standards. “Manufacturers have taken steps to prevent such injuries, such as warning labels and container lid safety features,” states Dr. West, Pediatric Ophthalmologist and Associate Professor, Cincinnati Children’s and UC Department of Ophthalmology. “These safety features are not always present, however, particularly with off-brand or generic laundry pods that might be sold at discount stores.”

As convenient as detergent pods may be, families with young children need to take safety precautions. As Dr. Gray concludes, “This consecutive case series highlights the risk of ocular injuries from laundry detergent pods in the United States. Parents or caregivers must be aware of the potential for ocular injury from these pods and prevent access to these chemicals by young children.”

Cataract Clouds of the eye

Cataract

EYES - Cataract

Clouds of the eye

In olden days, aged people who suffered fromcataract led the rest of their life being blind. Now, in the anti-ageing era (?), everyone should thank scientific development in surgical manipulation for lighting up the vision and thus one’s life. Cataract is one of the most common complaints of vision problems of people over 50 years of age. Nowadays it is also the commonest surgery among aged persons with the maximum results.

Cataract is the disease of the lens in the eyes, where the clear lens loses its transparency and focusing quality due to ageing or disease or trauma. Cataract is a cloudy opaque area forming in the lens, involving the centre or periphery in one eye or both eyes. Cataract in aged persons is due to the ageing process and usually occurs in both eyes.

Lens – Lens is a form of skin (which is developed from skin ectoderm during embryological development) which is a colourless (not white), biconvex and crystalline material situated just behind the pupil of the eye. It is made up of protein and water which is arranged as a lot of fibres in dense layers. The central part of the lens is called nucleus and the peripheral part is called cortex. Its size is about 9 mm in diameter and 4 mm in thickness. Even though it is a type of skin, it has no blood supply. Its nourishment and oxygen come from aqueous humour (optically transparent watery suspension behind the lens) and auto oxidation of lens protein (glutathione is oxidised by beta crystalline) which help in metabolism.

The lens help in convergence of the light rays which pass through them for forming the image in the retina. The lens is also very important for focusing on the object. The coagulation of the proteins in the lens due to the ageing process (loss of oxidation process) or diseases may cause cataract.

Occurrence and incidence – It occurs irrespective of race and sex, after the age of 50. Incidence is more in people with diabetes.

Types of cataract – Cataract can be classified as

Nuclear cataract – Also termed as hard cataract where opacity is in the centre of the lens i.e. it is sclerosis of the nucleus. The periphery part remains transparent. It is sometimes visualised as brown or black due to melanin deposition. This type takes a very long time to get matured.

Cortical cataract – Also termed as soft cataract where the glare is the very first complaint. This form of cataract easily gets matured in about 6 months to one year.

Triggers of cataract: Even though there are lots of thoughts about the triggers of cataract, the ultimate reason or exact cause remains unknown. Researchers have not succeeded yet in knowing the cause of cataract and mechanism of its formation. But correlation shows ageing and deficiency of vitamins and minerals can cause cloudy and opaque cataract. Cataracts tend to grow slowly, so vision gets lessened gradually which finally leads to complete loss of vision when it gets fully matured.

The main triggers are:

A) Internal factors

• Senile cataract or age-related cataract are developed due to coagulation of lens protein and defective oxidation process of lens
• Cataract due to deficiency of glutathione, beta crystalline, riboflavin and vitamin C
• Congenital cataract : In this case, cataract forms either due to infection of German measles or vitamin deficiencies during pregnancy.
• Systemic illness – Cataract incidence rate shows drastic increase in diabetic patients, due to metabolic disturbances.

B) External factors

• Trauma – Cataract can develop immediately after an eye injury or later on slowly.
• Irritants- Smoke, acid fumes, etc.
• Radiation
• Drugs – Steroidal drugs may cause cataract.

C) Infections of the eyes spreading inside involving the lens due to delayed treatment or maltreatment will also cause cataract formation

D) Genetic – It is also found to run in families.

Symptoms of cataract

• Cloudy vision – as if seeing through a fog or vision will be like washout images
• Glaring of sunlight, lamps and it is mostly noticed at the time of crossing the road and night driving
• Rainbow colours or haziness or circular ring can be seen surrounding the light.
• Needs more light for better vision, in initial period of cataract

Effects of cataract

• Losing self-confidence – depression may develop.
• Losing independent movement – achievements and self work will get disturbed.

Diagnosis can be made easily by an eye check-up. You yourself can diagnose it when you see the opaque white or grayish white thing in the pupa. Ophthalmologist diagnoses it clearly with its type and management, with the help of ophthalmoscope and slit lamp examination after dilating pupils with atropine. With Refraction Chart Test and Tonometer (which helps in analysis of eye pressure) diagnosis and its complications can be made very clear.

Regular check-up of eye, blood pressure and sugar is mostly enough for ruling out its risk factors and sometimes culture of conjunctiva discharges may be done to rule out bacterial infection.

Prevention of cataract: Since we don’t know the exact cause, prevention also seems to be difficult for us. But it is better to avoid and manage the triggering factors. So
Avoid

• Steroidal drugs which cause cataract and glaucoma
• Smoking and smoke
• Watching TV for a long time
• Working for a long time on computers.
• Long and continuous study
• Direct sunlight or high beam lights

Take

• Nutritious diet for a healthy life, especially food rich in vitamins A, B and C.
• Rest with closed eyes for a while, when you are straining more at the computer or reading.
• Plenty of fluids – water, juices to avoid dehydration and sclerosis.
• Care of the eye and protect it from infection, dust, UV lights, radiation and injury by wearing sunglasses.

Complications – Infections, glaucoma, blindness and inability to view retina for any retinal diseases especially in case of diabetic retinopathy.

Treatment – There is no specific medicine available for cataract. Recently, most doctors prescribe antioxidants only as a general drug for old age problems, including cataract. The main four antioxidants are beta carotene, vitamins C and E, and the mineral selenium. Antioxidants are present naturally and mostly in grape seeds, corns, turmeric, garlic, sesame seeds, ginger, plums, ginseng, holy basil, olive oil, etc. Antioxidants have proved in scientific research that they can retard or postpone many aspects of the ageing process. But it is only a general drug and not a cure giving drug.

So allopathic treatment mainly depends on surgical manipulations or extraction of the opaque lens and replacing it with a new clear artificial lens i.e. an intraocular lens (IOL). Cataract surgery with IOL is the permanent solution for opaque lens and refraction errors. There is no hard and fast rule for operation so you can take your own relaxed time for operation.

There are different types of surgeries like:

• Intra capsular cataract surgery – here the lens with capsule is removed – rarely done
• Extra capsular cataract surgery with implantation of rigid intraocular lens – here the back part of the capsule is left undisturbed.
• Phaco-emulsification i.e. Micro incisional surgery has the advantages of shorter hospital stay and fewer complications. Phaco-surgery is the most common procedure in developed countries. Here lens is emulsified using laser and a foldable silicon lens is inserted through the minute incision.

Now cataract surgery is very safe and effective, when performed without any risk factors like hypertension, diabetes, glaucoma and eye disorders. Rarely complications occur with pain, redness, swelling due to infection or pressure in eyeballs.

Homoeopathic approach – Betterment is important and not the system or the doctor. In case of cataract diagnosed early, surgeons usually wait till the cataract matures, so that it can be removed easily. Until then, the patient has to suffer with the complaint and its effects and complications.

But in Homeopathy, if you are diagnosed earlier itself as having cataract, you can get started with Homeopathic Cineraria Maritima Succus eye drops, so that you will never go to the surgeon’s table for cataract surgery. Prevention is better than cure – Homeopathy is advantageous over other systems of medicine with this saying in the case of cataract since it proves the ability to prevent and control the progress of cataract.

The earlier you treat, the better your chance of complete recovery or otherwise stopping the progress of the maturation of cataract. Cataract is a structural damage, so reversing cataracts is tough, yet it can be done over time with patience.

If later, when the cataract gets mature, the best way out is surgery and not drops or any medications. If the patient’s health is not fit for surgery, then they can be somewhat (10-20 per cent) benefited with this Cineraria Maritima Succus eye drops. Also, cataract needs to be removed only if it affects the vision so much that it interferes with your day-to-day activities. You can postpone it for any vacation period or your leisure period.

Recent treatment proves no other eye drops can treat or cure cataract other than CMS eye drops. Cataract can be treated in the early stages itself with this eye drops. Early treatment gives the best results. Cineraria Eye Drops – Cineraria Maritima Succus is the only most effective Homeopathic remedy which can increase eye vitality power. It has been used for a long time and proved its efficacy in treating all types of cataracts.

Recently, the Central Council of Research in Homeopathy – CCRH – Government of India, has claimed that Cineraria Maritima Succus surely prevents cataract formation. So, any patient diagnosed with cataract in the early stages by an ophthalmologist, can simply use Cineraria Maritima Succus eye drops twice daily for 6 months to 1 year. They will never let their eyes to be touched by a surgeon’s knife.

Homeopathic Medicines should be taken under the advice and diagnosis of a qualified Homeopath.

for new hope

Dr. S. Chidambaranathan, BHMS, MD (Homeo)

Laxmi Homeo Clinic

24 E. New Mahalipatti Road

Madurai, TN 625 001

India

Tel:  +91-452-233-8833 | +91-984-319-1011 (Mob)

Fax: +91-452-233-0196

E-mail:  drcheena@yahoo.com

www.drcheena.com / www.drcheena.in

(Disclaimer: The contents of this column are for informational purpose only. The content is not intended to be a substitute for professional healthcare advice, diagnosis, or treatment. Always seek the advice of healthcare professional for any health problem or medical condition.)

TINY NEEDLES OFFER POTENTIAL NEW TREATMENT FOR TWO MAJOR EYE DISEASES

Needles almost too small to be seen with the unaided eye could be the basis for new treatment options for two of the world’s leading eye diseases: glaucoma and corneal neovascularization.

The microneedles, ranging in length from 400 to 700 microns, could provide a new way to deliver drugs to specific areas within the eye relevant to these diseases. By targeting the drugs only to specific parts of the eye instead of the entire eye, researchers hope to increase effectiveness, limit side effects, and reduce the amount of drug needed.

For glaucoma, which affects about 2.2 million people in the United States and is the second leading cause of blindness worldwide, the goal is to develop time-release drugs that could replace daily administration of eye drops. A painless microneedle injection made once every three to six months – potentially during regular office visits – could improve treatment outcomes by providing consistent dosages, overcoming patient compliance issues.

In the second disease, corneal neovascularization, corneal injury results in the growth of unwanted blood vessels that impair vision. To treat it, the researchers developed solid microneedles for delivering a dry drug compound that stops the vessel growth.

“The power of microneedles for treating eye conditions is the ability to target delivery of the drug within the eye,” said Mark Prausnitz, a Regents’ professor in the School of Chemical and Biomolecular Engineering at the Georgia Institute of Technology. “We are developing different microneedle-based systems that can put the drug precisely into the part of the eye where it’s needed. In many cases, we hope to couple that delivery with a controlled-release formulation that would allow one application to treat a condition for weeks or months.”

The research, which was supported by the National Eye Institute of the National Institutes of Health (NIH), was reported November 13 in the journal Investigative Ophthalmology & Visual Science. The research was done using animal models, and could become the first treatment technique to use microneedles for delivering drugs to treat diseases in the front of the eye.

Glaucoma results from elevated pressure inside the eye that can be treated by reducing production of the aqueous humor fluid in the eye, increasing flow of the fluid from the eye, or both. Glaucoma is now controlled by the use of eye drops, which must be applied daily. Studies show that as few as 56 percent of glaucoma patients follow the therapy protocol.

The microneedle therapy would inject drugs into space between two layers of the eye near the ciliary body, which produces the aqueous humor. The drug is retained near the injection side because it is formulated for increased viscosity. In studies with an animal model, the researchers were able to reduce intraocular pressure through the injections, showing that their drug got to the proper location in the eye.

Because the injection narrowly targets delivery of the drug, researchers were able to bring about a pressure reduction by using just one percent of the amount of drug required to produce a similar decline with eye drops. The research team, which also included Georgia Tech postdoctoral fellow Yoo Chun Kim and Emory University Emeritus Professor of Ophthalmology Henry Edelhauser, hopes to produce a time-release version of the drug that could be injected to provide therapy lasting for months.

“The ultimate goal for us would be for glaucoma patients visiting the doctor to get an injection that would last for the next six months, until the next time the patient needed to see the doctor,” said Prausnitz. “If we can do away with the need for patients to use eye drops, we could potentially have better control of intraocular pressure and better treatment of glaucoma.”

To treat corneal neovascularization, the researchers took a different approach, coating solid microneedles with an antibody-based drug that prevents the growth of blood vessels. They inserted the coated needles near the point of an injury, keeping them in place for approximately one minute until the drug dissolved into the cornea.

In an animal model, placement of the drug halted the growth of unwanted blood vessels for about two weeks after a single application. In addition to the researchers already mentioned, the corneal neovascularization research included Emory University Professor of Ophthalmology Hans Grossniklaus.

While the research reported in the journal did not include time-release versions of the drugs, a parallel project is evaluating potential formulations that would provide that feature.

Eye injections with hypodermic needles much larger than the microneedles are routinely used to administer compounds into the center of eye. These injections are well tolerated, and Prausnitz expects the use of microneedles would also not cause significant side effects.

“Increasingly, eye drops are not able to deliver drugs where they need to go, so injections into the eye are becoming more common,” said Edelhauser. “But hypodermic needles were not designed for the eye and are not optimal for targeting drugs within the eye.”

In contrast to the larger hypodermic needles, the microneedles are tailored to penetrate the eye only as far as needed to deliver the drugs to internal spaces within the layers of the eye. For the glaucoma drug, for instance, the needle is only about half a millimeter long, which is long enough to penetrate through the sclera, the outer layer of the eye, to the supraciliary space.

Both potential treatments would require additional animal testing before human trials could begin.