Beware if you wake up with swollen eyes! Many diseases, especially cardiovascular diseases, can be diagnosed by the symptoms experienced in our eyes.

Stating that morning puffiness in the eyes can be a symptom of heart disease, Prof. Dr. Nur Acar Göçgil said, “During sleep, edema accumulation can occur in the eyelids at most in the body. When we wake up, we may feel swelling in our eyes. Complaints such as this swelling, which decreases later in the day, may be warnings of hidden heart disease.” Most symptoms in our eyes give us signs about other diseases in our body. Reminding that most people do not prefer to go to the doctor before experiencing a certain progression of health problems, Ophthalmologist Prof. Dr. Nur Acar Göçgil emphasized the importance of early diagnosis to prevent many diseases from diabetes to hypertension, vascular changes to clotting.

EARLY DIAGNOSIS CAN SAVE LIVES
Regular examinations increase the chances of treatment in diseases detected early and this saves lives against fatal diseases. Delay in the diagnosis of diseases such as diabetes, hypertension and heart diseases causes the disease to progress and results in the destruction of our eyes. This can result in reduced vision and even permanent vision loss.

SWELLING IN THE EYES MAY BE A SIGN OF HIDDEN HEART DISEASE
If you wake up in the morning with constantly swollen eyes, the cause of this swelling may be heart disease. During sleep, our head is at the level of the heart. During sleep, the most edema accumulation in the body can occur in the eyelids. When we wake up, we may feel swelling in our eyes. Complaints such as this swelling, which decreases later in the day, may be warnings of hidden heart disease.

DIABETES CAN BE DIAGNOSED DURING EYE EXAMINATION
Changes in vision in both eyes or one eye can also indicate diabetes and hypertension. Diabetes, which can cause significant and permanent damage to the eyes, can be diagnosed early with an ophthalmologic examination. Small vessel blockages due to diabetes and hypertension can also cause complaints such as double vision. The main cause of heart diseases is the development of arteriosclerosis. This arteriosclerosis can occur in all vessels in our body. Stiffness in the eye vessels or clot formation in the eye vessels can cause temporary visual disturbances. Disorders in the heart rhythm can also lead to consequences such as clots in the eye vessels. It is important for people with temporary vision loss to be checked for the risk of cardiovascular diseases and heart rhythm disorders. Stating that one should be aware of the symptoms experienced in the eyes, Ophthalmologist Prof. Dr. Nur Acar Göçgil listed the symptoms that may occur in the eye due to cardiovascular diseases as follows: Uncontrolled high blood pressure can cause blockages in the eye veins, causing visual impairment in the central vision or in an area. Hemorrhages in the retina and edema in the yellow spot may develop in the occluded vein area. With close follow-up and timely treatment, permanent visual damage is minimized. Treatment of the underlying systemic disease is also very important. With treatment and close follow-up, the development of new abnormal blood vessels in the retina is prevented. The severity of the disease can be determined by eye examination.

PEOPLE IN THIS GROUP ARE AT RISK OF HEART ATTACK
Especially in congenital cholesterol elevations, whitish ring formation around the iris can be seen in the eye. It is important for people in this group to have their cholesterol levels monitored in terms of the risk of heart attack and to be followed up by a specialist doctor in terms of heart health.

September 2023

Eyelid drooping, double vision, difficulty chewing and swallowing may be a sign of myasthenia gravis.

The prevalence of myasthenia gravis, which means dangerous and serious muscle weakness and prevents the transmission of messages from nerves to muscles and is rare, varies from country to country, but is approximately 20 per 100,000 people. Although there is no prevalence study in our country, it is thought that the prevalence is similar in Turkey. Prof. Dr. İhsan Şükrü Şengün, Faculty Member of Dokuz Eylül University Faculty of Medicine and Chairman of the Turkish Neurology Association Neuromuscular Diseases Working Group, shared important information about myasthenia gravis.

Prof. Dr. İhsan Şükrü Şengün said, “All voluntary striated muscles are carried by electrical impulses coming from the brain and carried to the muscles by peripheral nerves. The impulse coming from the brain to the nerve ending in the muscle causes the release of an excitatory substance called acetylcholine from the nerve ending to the gap called the nerve-muscle junction. This secreted acetylcholine then binds to acetylcholine receptors on the muscle membrane at the nerve-muscle junction, causing these channels to open and sodium ions to enter the muscle cell. The entry of sodium ions into the muscle cell leads to the generation of the electrical potential required for contraction of the muscle cell. In people with an abnormal immune system, the immune system releases antibodies that shut down, alter or destroy these acetylcholine receptors. Then there is a problem in generating the electrical potential required for muscle contraction.”

Eyelid drooping and double vision are common
Prof. Dr. Şengün stated that in the majority of patients, the disease starts with these two complaints and over time, complaints related to other muscles appear. “In some patients, other muscles are not affected and only eye-related complaints remain. In this case, the disease is called ocular myasthenia. In some patients, the functions of bulbar muscles such as chewing, swallowing, speaking and breathing are affected. These patients may have difficulty chewing, especially at dinner, difficulty swallowing, and food may escape into the windpipe while swallowing. In addition to symptoms such as slurred speech and slurring of words during prolonged speech, there are complaints of difficulty in breathing with fatigue. These complaints may occur individually in one patient or as a combination of all of them. Then we talk about bulbar myasthenia. If myasthenia gravis affects the muscles of the arms and legs, generalized muscle weakness occurs with physical work. This type of myasthenia gravis is called generalized myasthenia. Although myasthenia gravis can be in the form of ocular only, bulbar only or generalized myasthenia, it usually appears as a combination of these clinical manifestations,” said Prof. Dr. Şengün.

Patients should consult a neurologist
Prof. Dr. Şengün mentioned “Since myasthenia gravis is a nerve-muscle junction disease, patients with complaints such as droopy eyelids, double vision, swallowing and speech disorders, and weakness during physical activities should consult a neurology judge. The most basic factor in diagnosing myasthenia is the clinical complaints of the patient. The crucial point here is that these complaints occur with fatigue and decrease or disappear with rest. People who use computers intensively in their work are prone to eyelid drooping and double vision because they are constantly looking at the screen. On the other hand, people who have to talk all the time to teach a lesson, such as teachers, are more likely to experience slurred speech in the afternoon. When myasthenia gravis is suspected in a patient who applies to a neurologist with these complaints, fatigue tests as well as ice tests are methods that can be easily applied for definitive diagnosis.”

There are effective treatments
Prof. Dr. İhsan Şükrü Şengün said about the treatment of myasthenia gravis: “First of all, treatment that prevents the breakdown of the chemical called aceticoline secreted into the nerve-muscle junction is started. The main treatment is immunosuppressive treatments to suppress the overactive immune system. However, not all patients may respond fully to these treatments and sometimes intervening infections may disrupt the patient’s prognosis. For patients who do not respond to immunosuppressive treatments, we now have highly effective new treatments that we can easily apply.”

Underlining that some treatments, supplements and substances can worsen myasthenia gravis, Prof. Dr. Şengün stated that botulinum toxin (botox) application, which has been widely used in the fields of aesthetics and weight loss in recent years, can have fatal consequences in myasthenia gravis patients, as well as muscle relaxants and magnesium taken as supplements and some antibiotics can cause myasthenic worsening, so patients should not take a treatment without consulting their doctor. Explaining that myasthenia gravis is now a disease that is easily managed thanks to new diagnostic methods and treatments, Prof. Dr. İhsan Şükrü Şengün said: “Today, the increase in awareness about diseases through social media enables many patients to be diagnosed earlier and start treatment. Especially myasthenia gravis, which used to be a very feared disease because it can impair respiratory function, has now become a more easily managed disease thanks to today’s diagnostic methods and new treatments.”

Pay attention to these warnings
Stating that myasthenia gravis is different from other diseases with some features, Prof. Dr. İhsan Şükrü Şengün explained that especially heat causes worsening of myasthenic complaints. For this reason, it is unfavorable for patients with myasthenia gravis to enter very hot environments such as baths or saunas, Prof. Dr. Şengün said, “In addition, another issue that affects especially female patients is menstrual periods. Myasthenic complaints may worsen during menstrual periods. It is important for patients to be aware of this situation in order to understand that the deterioration in complaints is not a real clinical deterioration or myasthenic crisis. Another issue is that all types of infections worsen myasthenic complaints. For this reason, it is important to avoid infections as much as possible and to be vaccinated for infections that are common in seasonal returns.”

August 2023

Summer, aside from the heat, makes many of us happy. But it also threatens our eyes. Sea, pool, sun and allergic conditions that increase with summer negatively affect our eye health.

Sea, sand, sun… This trio means summer and of course it also means vacation. If you want to have a trouble-free summer, you should pay special attention to your eye health because many dangers await your eyes during the summer months. In summer, external factors cause some eye diseases to occur and some to increase in severity. Faculty Member of Acıbadem University Faculty of Medicine, Department of Ophthalmology and Acıbadem Hospital Ophthalmology Specialist Prof. Dr. Özgül Altıntaş said, “Some summer risks are also watching children from sun rays to the sea, pool and beach, from the garden to green areas. Allergic reactions, sun exposure, flies, sand and dust in the eyes, exposure to insufficiently cleaned or chemical-rich pool water, and many other summer hazards can cause significant problems in children’s eyes. For this reason, some rules should be observed in terms of eye health in children in summer. Otherwise, some simple mistakes can cause permanent eye damage in the future.” Prof. Dr. Özgül Altıntaş explained the factors that threaten children’s eyes in summer and ways of protection, and gave important warnings and suggestions.

Summer allergens
Dust and pollen, which are more abundant in the air in summer, trigger allergies, often causing bloodshot, itchy and watery eyes in children. Eye allergy is an overreaction to a substance / food / pollen / house mite etc. due to the body’s immune system being sensitive to it. Itching, bloodshot and watery eyes. Sensitivity to light develops. Eyelids may swell. The best way to prevent allergies is to identify the cause of allergy and avoid it as much as possible. It is not possible to avoid every allergen. A wide-brimmed hat and sunglasses should be worn outdoors to protect against flying pollen and dust. Cold compresses can be applied to relieve the child and reduce the need for edema and itching. The type and duration of treatment is determined by the ophthalmologist according to the severity of the allergy. Otherwise, the child’s comfort of life will decrease. Rubbing and scratching the eyes causes the need for itching in the eyes to increase. Increased hand-eye contact is an important reason for the formation and proliferation of eye infections. Therefore, we should avoid rubbing our eyes and wash our hands frequently.

Getting ‘something’ in the eye!
During the summer months when children spend more time outdoors, foreign objects such as sand, dust, flies or grass can get into their eyes. Sometimes their own eyelashes can also get into their eyes. In these cases, children’s eyes bleed, watery, sensitive to light and need increased rubbing. This risk increases at beaches and rural areas. When a foreign body gets into the eyes, if we can see the foreign body, we can wash the eyes with a tear drop and float the foreign body with liquid to get it out. In this case, old drops left at home should not be used. However, if we cannot see it and the child’s complaints persist, the foreign body may be lodged in the inner part of the lids or lodged in the surface of the eye. We should definitely see an ophthalmologist. Because as the eyelid moves, the foreign body can scratch the transparent layer (cornea), causing infection and permanent damage. The ophthalmologist should remove the foreign body under a microscope if necessary and organize the necessary treatment. If it is not a foreign body but a chemical substance, the best thing to do is to wash the eye with clean water if there are no tears and to consult an ophthalmologist as soon as possible.

Solar radiation
Prolonged exposure to ultraviolet light can result in cataracts and retinal diseases in children. For this reason, children should stay away from the sun’s rays as much as possible during the hours when the sun reaches the earth vertically, especially between 10:00 and 16:00. In early infancy, the use of wide-brimmed hats in the shade of trees and the protection provided by the canopy of strollers will be sufficient. It is also a great risk for eye health for your child to look directly at the sun, either with the naked eye or with sunglasses. Therefore, when your child does this, explain why and make sure he/she understands that this is not the right thing to do.

Attractive but poor quality sunglasses
Sunglasses that children are attracted to because of their colors or because they are decorated with cartoon heroes can cause serious, permanent eye damage if they do not have UV protection. From the age of 2, children can start wearing sunglasses with 100 percent UV protection and Solar class 2 and 3. Be sure to see the certificate. The frame of the sunglasses should be made of flexible material, the lenses should be made of polycarbonate material that does not break easily and lenses that do not crack. Even if they are made of a material that does not break easily, it does not mean that they will never break. It would be appropriate to remove them in active environments, when playing in crowds with other children. It should also be suitable for the face shape of the growing child, it should be light, it should not put pressure on the nose, the temple should be long and should not disturb the ear.

Entering the sea and pool without glasses
Eye Diseases Specialist Prof. Dr. Özgül Altıntaş said, “Pool chlorine and sea salt can cause redness or irritation in the eyes. For this reason, it is important for eye health that children wear swimming goggles when entering the sea and pool. However, if water gets into the eyes or if it is not possible to have your child wear swimming goggles, it is necessary to wash the face and eyes with clean water after getting out of the water.”

Impact to the eye during sports/games
In the summer months, there are many outdoor sports for older children. During these sports, they can be hit in the eyes by balls, elbows, hands and nails, so they should always be careful. Such direct trauma can cause serious eye injury, corneal scratches, retinal tears, intraocular bleeding and edema. An insignificant blow, even if not noticed at the time, can lead to blindness in the future. Precautions should be taken according to the sport practiced. Swimmers should use swimming goggles to protect themselves from conjunctivitis and wash their eyes after leaving the pool. In tennis, both UV-protective and impact-resistant glasses should be used. Wearing protective impact-resistant sports goggles in close contact sports is useful to reduce these risks. However, these glasses are not absolutely unbreakable. It would be more appropriate not to use them in very close sports.

Klima
The simplest precaution is to moisturize our eyes more often by blinking more often, as tears can evaporate more than normal in sunny or air-conditioned environments in summer, causing drying, stinging, burning and even damage to the eye surface. You can also use an air humidifier in an air-conditioned environment. If the problem persists despite these, you can use artificial tear drops in consultation with an ophthalmologist, but if they are not enough, more intensive treatment may be required.

July 2023