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| HEALTH TRIBUNE |
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Preventable loss of vision among the elderly
Diwali crackers |
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Preventable loss of vision among the elderly
Aging causes a dramatic slowing in dark adaptation. This age-related delay in dark adaptation may also contribute to night vision problems commonly experienced by the elderly. Colour vision and contrast sensitivity are also affected by aging. The aging lens and cornea causes glare by light scattering, leading to poor vision quality especially when the pupil dilates as in the dark. The most aggravating aspect of vision in an older person seems to be the feeling that it does not work as effortlessly or as quickly as it did in younger days. They must concentrate harder and require higher levels of illumination than they formerly did in order to have the same perceptual results.
Although plain seeing in simplified situations, as in routine vision testing, is as good and as quick as ever, perceiving a complex, changing scene is more difficult and slower. Good lighting can make the difference between seeing and not seeing for older adults. We suggest that you provide lighting solutions in your homes, stairways, kitchen, living rooms, etc. Naked bulbs are worst for older eyes, producing a glare that can be disorienting and painful. Chandeliers are problematic for the same reason. It makes sense to have a place in the house to do paperwork. Light should be concentrated on the work, not towards the eyes. Adjustable lamps with shades that direct light are recommended. A good choice is a compact fluorescent light with electronic ballast that starts up without flickering. Lights should be installed over countertops and stoves. Lots of light should be provided overhead and even in the shower; better is a rectangular fluorescent lamp with an opaque cover to block glare and distribute light upward and outward. An advantage of a good fluorescent lighting is its “blue” energy, which helps older people see colours.
Aging causes laxity and downward shift of eyelid tissues and the atrophy of the orbital fat. These changes contribute to the etiology of several eyelid disorders.
The major age-related causes of blindness and visual disability include cataract (nearly 50 per cent of all blindness), glaucoma, macular degeneration and diabetic retinopathy. With the predicted increase in the number of older people worldwide, these figures may soon be 80 per cent of new cases of blindness. Cataract results from a change of transparency of the lens in the eye, which becomes opaque and impedes the light from entering the eye. This condition causes gradual loss of vision and blindness, which is largely curable.
Aging-related cataract can be treated with a relatively simple operation to remove the opaque lens. This treatment is available in all countries, but is not always accessible for those who are poor or live in remote areas in developing countries. The term glaucoma does not refer to a single condition, but to a group of diseases, which cause irreversible blindness due to optic nerve damage. Although glaucoma as such cannot be prevented, its consequences of visual loss can be avoided if the disease is detected and treated early.
Older people should have regular eye examinations, particularly those with a family history of glaucoma. Diabetes is associated with damage to the blood vessels in the retina, resulting in the loss of vision. Diabetic retinopathy is the leading cause of blindness in adults in India. After 15 years of diabetes, most people develop visual disability. Regular eye examinations and timely treatment can prevent the loss of vision in diabetic retinopathy.
Age-related macular degeneration is the most common disorder in the group of non-avoidable causes of visual loss. It involves the progressive degeneration of a very light sensitive area of the retina, and is seen in around 25 per cent of people aged 80 years and older. Although it cannot be effectively treated, the resulting visual disability can be alleviated by means of optical devices, rehabilitation and counselling. Use of ultraviolet protective glasses can decrease the incidence of cataract and macular degeneration both.
WHO has recently launched the initiative “Vision 2020: A Right to Sight” with the objective of eliminating avoidable blindness by 2020.
The writer, a senior eye specialist, is the author of “Healthy Eyes”.
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Diwali crackers
India is one of those countries where cases of burn injuries are rising. Every year thousands of people suffer from burns and one-third of these people die and many become crippled forever.
Most of these tragedies occur due to the wrong handling of fireworks. Fire-crackers are pieces of entertainment and joy and are played extensively during festivals like Diwali and Gurpurab. But sometimes these happy moments turn into those of sorrow and pain if adequate safety measures are not taken while lighting these crackers. These mishaps mostly harm the eyes, the face and the hands which in turn result in blindness, permanent disfigurement or amputation.
Fireworks fascinate everyone, especially the flower-pot crackers called “anar” and the missile crackers which explode high up in the air to glitter in the sky with colourful sparklers. Most of the burn injuries occur due to the bursting of “anar” while lighting. The so-called bombs with a short fuse also cause injury to the hands and eyes.
A common practice among young children to collect unburnt crackers next day when adults are not around and then to extract potash, to stash it over the paper and lighting the fire is often a cause of flash burns on the face.
Missile crackers, if misdirected, are very dangerous and can be the cause of a big fire if they fall on any inflammable material lying on the rooftops or in the open.
Since prevention is the best medicine, lighting of crackers should be done in an open space, and children should be made to play fireworks under the strict supervision of adults. A bucket of water and sand should always be kept handy. No flower-pot cracker or any other explosive-type should be lighted while being held in hand.
The “anar” should be lighted with a sparkler rather than a candle or a match stick. Keep the face and the body away from the direction of the firing of the cracker. No fire-cracker should be held in the other hand or kept in the pockets lest it catches fire. Children should be made to understand that the crackers are explosives and not toys.
Burns sustained due to fire-crackers can be superficial or deep. Once burn occur, do not panic. If clothes have caught fire, instead of running, smother out the fire and remove the loose clothing. The rule is to stop, drop and roll and try to extinguish fire with whatever is available like water, blanket, etc. Pour tap water to cool the burnt part. If burns are extensive, try not to use cold water or ice as it may result into hypothermia. Water decreases the duration of the contact of heat and kills temperature. Keeping the affected part dipped in water for longer than a few minutes will increase the incidence of blistering of the skin. To numb the pain, give a suitable pain-killer or get an injection for the purpose from the nearest doctor. Never apply butter, toothpaste, grease, oil,
“chasni”, etc, as they are messy and painful to remove when wounds have to be managed.
Treatment of burns require meticulous care which includes their daily cleansing and reapplication of antibiotic creams. It is a myth that burnt parts heal faster if kept open. Exposed burns tend to take a longer time to heal because of contamination.
Once burns occur, take proper medicines to relieve pain and prevent infection. If rightly managed, superofficial burns take one to three weeks’ time to heal and leave no scars. Only deep burns take longer than one month to heal and will always leave behind a scar.
Though management of burns is a costly and difficult affair, the majority of the fire incidents are preventable. Moreover, it is always better to be on the safer side than to feel sorry later on. With a little care and caution, we can prevent the festivities from turning into moments of sorrow and despair.
The writer is Head Plastic Surgery and Burns Unit, Dayanand Medical College and Hospital, Ludhiana.
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Homoeopathy & you
Medically speaking, slow metabolism is one of the main causes for cold intolerance. Some people (often very slender women) do not tolerate cold environments simply because they have minimal body fat and are unable to keep warm. General poor health, faulty diet and medical conditions such as anorexia nervosa, hypothyroidism, AIDS and other chronic illness can also lead to intolerance.
Be it the lack of warmth in the body or symptoms that sensitive individuals develop, homoeopathic medicines such as Silicea, Calcarea Carb offer a big promise in their treatments. Personally, I would rank Silicea ahead of other medicines in treating cold intolerance. Silicea is an invaluable constitutional remedy, and is indicated in the over-sensitive, imperfectly nourished (generally), not for want of food, but because of imperfect assimilation. There are very high levels of cold intolerance. Nothing makes the Silicea patient feel warm and take cold easily, especially from uncovering the head or the feet.
The main indication for Silicea is that no matter how hard the patient tries, feet don’t seem to get warm and also there is an increased cold intolerance on the head. Least exposure seems to bring on a severe headache, only to be relieved by warm applications. Chronic conditions — sinusitis, cold, asthma, bronchitis and cough caused in such oversensitive individuals — are effectively treated with Silicea. Calcarea Carb is very useful in constitutions where metabolism seems to slow down; it is indicated in cold intolerance associated with hypothyroidism and one of the main indications for the use of Calcarea Carb is constant sensation of cold damp feet.
Please note that the conditions mentioned above are chronic and can best be treated with help of an experienced homoeopath.
The writer is a Chandigarh-based homoeopath.
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SYDNEY: ALT 711, a drug developed by Australian researchers a few years ago, can help protect vulnerable diabetics from developing terminal kidney and heart “injuries.
The drug, designed to interfere with the attachment of glucose to the kidneys and heart, has shown positive results during recent animal testing. —
ANI |
As the eye ages, certain changes occur that can be attributed to solely the aging process. The quality of vision worsens due to reasons independent of aging eye diseases. While there are many changes of significance in the healthy eye, the most functionally important changes seem to be a reduction in the pupil size and the loss of accommodation or focusing capability. For visually guided tasks on which performance varies with illumination, an older person requires extra lighting. 
You dread winters! Because cold makes life hell for you — runny nose, sneezes, headache, stuffed-up feeling, and that cold damp feeling in the feet. Your defences are also too high, with a muffler wrapped around your head all day long, layers of woolens, more than a pair of warm socks, still nothing seems to keep you warm and if you thought that’s only the way to beat out your sensitivity, believe me you are totally wrong. Homoeopathy may just be the right choice for you. A well-directed homoeopathic treatment can actually help reduce and cure your sensitivity towards cold and disorders associated with it. In homoeopathy we call it a “chilly constitution” and certain specific medicines are there for it.