Wednesday 29 July 2020

Chloroquine-HCQ-Plaquenil-Retinal toxicity

Chloroquine-HCQ-Plaquenil-Retinal toxicity

یہ ایک بہت ہی محفوظ اور موثر دوا ہے لیکن ، تمام دوائیوں کی طرح ، یہ بھی مضر اثرات پیدا کر سکتی ہے۔ یہ سمجھا جاتا ہے کہ کچھ لوگ جو پانچ سال سے زیادہ / یا زیادہ مقدار میں کلوروکوئن لیتے ہیں۔ ان کے ریٹینا جو آنکھ کے پچھلے حصے پر خلیوں کی ہلکی حساس پرت ہے ,کو نقصان پہنچنے کا خطرہ ہوتا ہے۔ اسے ریٹینیوپیتھی کہا جاتا ہے۔

It is a very safe and effective drug but, like all medicines, it can cause side effects. It is known that some people who take chloroquine for more than five years and/or in high doses are at increased risk of damage to their retina, the light-sensitive layer of cells at the back of the eye. This is known as retinal toxicity or retinopathy.

کلوروکوئن آپ کی آنکھوں کو متاثر کرسکتی ہے

کلوروکوئن آپ کی آنکھوں کو متاثر کرسکتی ہے

کچھ لوگوں میں ، پلاکینیل ایک ایسی حالت کا سبب بن سکتا ہے جسے کلوروکوئن ریٹینیوپیتھی کہا جاتا ہے ، جسے اکثر بیلوں کی آنکھوں کی میکولوپیتھی کہتے ہیں۔ ... جیسے جیسے یہ مرض بڑھتا ہے ، اس سے مرکزی نقطہ نظر بھی متاثر ہونا شروع ہوجاتا ہے اور زندگی بدل کے رہ جاتی ہے۔ یہ تبدیلیاں اکثر اوقات مستقل ہوتی ہیں ، لیکن کچھ معاملات میں ، نظر میں بہتری آجاتی ہے۔

Chloroquine can affect your eyes

In some people, Plaquenil can cause a condition called chloroquine retinopathy, often referred to as bulls-eye maculopathy. ... As the disease progresses, it begins to affect central vision and becomes life-altering. The changes are most often permanent, but in some cases, a vision has improved.

کلوروکوئن ریٹینوپیتھی کا سبب بن سکتی ہے

کلوروکوئن ریٹینوپیتھی کا سبب بن سکتی ہے

کلوروکوئن (ایچ سی کیو) ریٹینوپیتھی کے نتیجے میں مستقل طور پر بینائی ضائع ہوسکتی ہے۔ کلوروکوئن ریٹینوپیتھی کے ابتدائی مراحل میں ، مریض عام طور پر نظر کے تحفظ کے ساتھ غیر سنجیدہ ہوتے ہیں۔ کلوروکوئن ریٹینیوپیتھی سے عام طور پر دونوں ٓانکھوں کا پردہ بسارت متاثر ہو سکتا ہے۔ کلوروکوئن کی ابتدائی علامات مرکز نظر میں سوزش کا باعث بنتی ہے اور پردہ بسارت میں آر پی ای کی دو طرفہ دانے دار بگاڑ ہے۔

Chloroquine can cause Retinopathy

Chloroquine (HCQ) retinopathy can result in permanent vision loss. In the early stages of HCQ retinopathy, patients are usually asymptomatic with the preservation of visual acuity. Chloroquine retinopathy is caused by the build-up of the systemic drug and thus the findings are bilateral and symmetric. The early signs of chloroquine toxicity are macular edema and/or bilateral granular depigmentation of the RPE in the macula.

پردہ بسارت پرکلوروکوئن کےمضراثرات کی علامات

پردہ بسارت پرکلوروکوئن کےمضراثرات کی علامات

کلوروکوئن کے پردہ بسارت پر ہونے والے مضر اثرات کے ابتدائی مراحل میں ، زیادہ تر مریض اسیمپوٹومیٹک ہو سکتے ہیں۔ جب پہلی علامات ظاہر ہونے لگیں تو ان کی شکایات درج ذیل ہیں: پڑھنے میں پریشانی ، رنگوں کی پہچان میں کمی ،احاطہ نظر میں کالے دھبے کا نمودار ہونا۔

Symptoms of retinal toxicity?

In the early stages of HCQ retinal toxicity, most of the patients could be asymptomatic. When the first symptoms start to appear their complaints are the following: trouble with reading, diminished color vision, fine visual alteration due to the central or paracentral scotoma.

کلوروکوئن ریٹینوپیتھی کیلئے قبل از وقت تشخیصی معائنہ

Screening for chloroquine retinopathy

قبل از وقت تشخیصی معائنے کا مقصد ریٹینوپیتھی کو روکنا کیلئے مریض کی علامات پر توجہ دینے سے پہلے اس کی ابتدائی واضح علامات کا پتہ لگانا ہے۔ تمام افراد جو کلوروکوئن کا استعمال شروع کریں انہیں ٓانکھوں کا ابتدائی معائنہ اور مطلوبہ ٹیسٹ لازمی کروانا چاہیے۔ تاہم جو لوگ پانچ سال یا اس سے زیادہ عرصے سے کلوروکوئن لے رہے ہیں انہیں ریٹینوپیتھی کیلئے سالانہ تشخیصی معائنہ لازمی کروانا چاہیے۔

تشخیصی معائنے کیلئے مطلوبہ ٹیسٹ مندرجہ ذیل ہیں

  • عینک اور عینک کے بغیر بینائی کی جانچ
  • رنگوں کی پہچان کا معائنہ
  • احاطہ نظر کی جانچ
  • او سی ٹی) بصری طبقہ نگاری )

اگرمطلوبہ ٹیسٹ میں ریٹینوپیتھی کی کوئی علامات ظاہر نہ ہو

اگر تمام ٹیسٹوں میں پردہ بسارت میں کوئی تبدیلی واضع نہ ہو تو پھر ریٹینوپیتھی کے کوئی آثار نمودار نہیں ہوتے ۔ اس طرح یہ تمام ٹیسٹ 6 ماہ بعد دوبارہ کیے جاتے ہیں تاکہ نئےٹیسٹوں میں ہونے والی تبدیلیوں کا موازنہ پرانے ٹیسٹوں سے کیا جاسکے۔ جب تک آپ کلوروکوئن لیتے رہیں تو آپ کو ہر سال تشخیصی معائنہ لازمی کرواتے رہنا چاہیے۔

Screening for chloroquine retinopathy

The aim of screening is not to prevent retinopathy but to detect the earliest definitive signs of it before a patient notices any symptoms. All people who start using chloroquine should need an initial eye exam and required tests. All individuals who have taken chloroquine for greater than 5 years should receive annual screening for retinopathy.

The screening tests are:

  1. BCVA
  2. Digital Color Vision Test
  3. Visual Field
  4. Optical Coherence Tomography (OCT)
  5. Digital Fundus Photograph

The Screening tests are performed as under

The 1st test for Chloroquine-BCVA-Visual Acuity

BCVA

Resolving power of the eye is known as Visual Acuity. Visual acuity (VA) is acuteness or clearness of vision, especially form vision, which is dependent on the sharpness of the retinal focus within the eye, the sensitivity of the nervous elements, and the interpretative faculty of the brain.

The 2nd test-Digital Color Vision Test

Digital Color Vision Test

A color vision test, also known as the Ishihara color test, measures your ability to tell the difference among colors. If you don't pass this test, you may have poor color vision, or your doctor may tell you that you're color blind.

The 3rd test-Visual Field

Visual field

A visual field test is a method of measuring an individual's entire scope of vision, that is their central and peripheral (side) vision.

The 4th Test-Optical Coherence Tomography (OCT)

Optical Coherence Tomography (OCT)

OCT is an imaging method used to generate a picture of the back of the eye, called the retina. The picture is made by precisely measuring the amount of a dim red light that reflects off the retina.

The 5th test- Digital Color vision Test

Fundus photograph

A digital fundus camera is used to take an image of the fundus — the back portion of the eye that includes the retina, macula, fovea, optic disc, and posterior pole. It helps to detect diagnosis and follow chloroquine toxicity closely.

No signs of retinopathy

If all the tests show a normal retina then there are no signs of retinopathy. The images of your retina will be kept on file and you will be invited back 6 months later for a repeat of the tests. The new images will be compared to the original ones to check for any changes. You will continue to be screened every year until you stop taking chloroquine.

Contact Our Team:

If you are looking for any of below services, please fill the form below, one of our team members will get in to provide you with full facilitation:

1- Comprehensive Primary Eye Exam/ Consultation

Consultation ::: Adult Eye Examination and Consultation
Consultation ::: Children Eye Examination Refraction Consultation
Consultation ::: Infant Eye Examination Refraction Consultation
2-Secondary Follow up Eye Examination and Consultations

Followup ::: Examination under Sedation for Kids (After Initial Consultation)
Followup ::: Dilated Fundus Examination(DFE)
Followup ::: Cycloplegic Refraction and DFE
3-Diagnostic Eye Test

Diagnostic ::: OCT
Diagnostic ::: Angio OCT
Diagnostic ::: Anterior Segment OCT
Diagnostic ::: Pachymetry
Diagnostic ::: Perimetry/Visual Fields
Diagnostic ::: Hess Chart/Digital Squint Assessment/Digital Diplopia Test
Diagnostic ::: Digital Colour vision test

Tuesday 28 July 2020

Children’s Eye Health & Safety Month

Children’s Eye Health & Safety Month

August is Children’s Eye Health & Safety Month

Is Too Much Screen Time Harming Children’s Vision?

Acuity Eye Center Lahore Pakistan and the American Academy of Ophthalmology help parents separate the facts from fiction.

As children spend more time tethered to screens, there is increasing concern about potential harm to their visual development. Ophthalmologists – physicians who specialize in medical and surgical eye care – are seeing a marked increase in children with dry eye and eye strain from too much screen time. But does digital eyestrain cause lasting damage? Should your child use reading glasses or computer glasses? As you send your kids back to school this month for more time with screens and books, Acuity Eye Center Lahore Pakistan and the American Academy of Ophthalmology is arming parents with the facts, so they can make informed choices about their children’s eye health.

It’s a fact that there is a world-wide epidemic of myopia, also known as nearsightedness. Since 1971, the incidence of nearsightedness in the US nearly doubled, to 42 percent. In Asia, up to 90 percent of teenagers and adults are nearsighted. Clearly, something is going on. But scientists can’t agree on exactly what.

A new study appearing in Ophthalmology, the journal of the American Academy of Ophthalmology, offers further evidence that at least part of the worldwide increase in nearsightedness has to do with near work activities; not just screens but also traditional books. And, that spending time outdoors—especially in early childhood—can slow the progression of nearsightedness. It remains unclear whether the rise in nearsightedness is due to focusing on phones all the time, or to light interacting with our circadian rhythms to influence eye growth or none of the above.

Digital Strain

While scientists look for a definitive answer, there is no doubt that most computer users experience digital eyestrain. Kids are no different from adults when it comes to digital eyestrain. They can experience dry eye, eye strain, headaches, and blurry vision, too. While symptoms are typically temporary, they may be frequent and persistent.

But this doesn’t mean they need a prescription for computer glasses or that they have developed an eye condition of middle-age that requires reading glasses, as some suggest. It also doesn’t mean that blue light coming from computer screens is damaging their eyes. It means they need to take more frequent breaks. This is because we don’t blink as often while using computers and other digital devices. Extended reading, writing, or other intensive near work can also cause eye strain. Ophthalmologists recommend taking a 20-second break from near work every 20 minutes.

Tips to help protect your child’s eyes from computer eyestrain

Here are 10 tips to help protect your child’s eyes from computer eyestrain:

  • Set a kitchen timer or a smart device timer to remind them.
  • Alternate reading an e-book with a real book and encourage kids to look up and out the window every two chapters.
20-20-20 Rule
  • After completing a level in a video game, look out the window for 20 seconds.
  • Pre-mark books with a paperclip every few chapters to remind your child to look up. On an e-book, use the “bookmark” function for the same effect.
  • Avoid using a computer outside or in brightly lit areas, as the glare on the screen can create strain.
  • Adjust the brightness and contrast of your computer screen so that it feels comfortable to you.
  • Use good posture when using a computer and when reading.
Encourage your child to hold digital media farther away, 18 to 24 inches is ideal.
  • Encourage your child to hold digital media farther away, 18 to 24 inches is ideal.
  • Create a distraction that causes your child to look up every now and then.
  • Remind them to blink when watching a screen.

“I prefer to teach kids better habits, instead of supplying them a crutch like reading glasses to enable them to consume even more media,” said K. David Epley, M.D., clinical spokesperson for the American Academy of Ophthalmology. “If you run too far and your legs start hurting, you stop. Likewise, if you’ve been reading too long or watching videos too long, and your eyes start hurting, you should stop.”

Here is the message from our lead consultant Professor Dr. Zia Ul Mazhry,

"Your child’s vision is critical and even more critical is protecting it during everyday activities. Eye injuries occur most commonly during outdoor sports or athletic. The parents and guardian need to pay close attention as a caregiver. If the kids are left alone, will often opt to not wear protective eyewear when playing sports, let alone a helmet, due to a number of reasons. Therefore, it’s up to you to ensure your child’s eyes and vision are kept safe."

About the American Academy of Ophthalmology

The American Academy of Ophthalmology is the world’s largest association of eye physicians and surgeons. A global community of 32,000 medical doctors, we protect sight and empower lives by setting the standards for ophthalmic education and advocating for our patients and the public. We innovate to advance our profession and to ensure the delivery of the highest-quality eye care. Our EyeSmart® program provides the public with the most trusted information about eye health. For more information, visit aao.org.

Contact Our Team:

If you are looking for any of below services, please fill the form below, one of our team members will get in to provide you with full facilitation:

1– Comprehensive Primary Eye Exam/ Consultation

Consultation ::: Adult Eye Examination and Consultation

Consultation ::: Children Eye Examination Refraction Consultation

Consultation ::: Infant Eye Examination Refraction Consultation

2-Secondary Follow up Eye Examination and Consultations

Followup ::: Examination under Sedation for Kids (After Initial Consultation)

Followup ::: Dilated Fundus Examination(DFE)

Followup ::: Cycloplegic Refraction and DFE

3-Diagnostic Eye Test

Diagnostic ::: OCT

Diagnostic ::: Angio OCT

Diagnostic ::: Anterior Segment OCT

Diagnostic ::: Pachymetry

Diagnostic ::: Perimetry / Visual Fields

Diagnostic ::: Hess Chart/Digital Squint Assessment/Digital Diplopia Test

Diagnostic ::: Digital Colour vision test