Eye Diseases
Eye disorders may be classified according to the part of the eye in which the disorders occur.
The most common disease of the eyelids is hordeolum, known commonly as a sty, which is an infection of the follicles of the eyelashes, usually caused by infection by staphylococci. Internal sties that occur inside the eyelid and not on its edge are similar infections of the lubricating Meibomian glands. Abscesses of the eyelids are sometimes the result of penetrating wounds. Several congenital defects of the eyelids occasionally occur, including coloboma, or cleft eyelid, and ptosis, a drooping of the upper lid. Among acquired defects are symblepharon, an adhesion of the inner surface of the eyelid to the eyeball, which is most frequently the result of burns. Entropion, the turning of the eyelid inward toward the cornea, and ectropion, the turning of the eyelid outward, can be caused by scars or by spasmodic muscular contractions resulting from chronic irritation. The eyelids also are subject to several diseases of the skin such as eczema and acne, and to both benign and malignant tumors. Another eye disease is infection of the conjunctiva, the mucous membranes covering the inside of the eyelids and the outside of the eyeball. See Conjunctivitis; Trachoma.
Disorders of the cornea, which may result in a loss of transparency and impaired sight, are usually the result of injury but may also occur as a secondary result of disease; for example, edema, or swelling, of the cornea sometimes accompanies glaucoma.
The choroid, or middle coat of the eyeball, contains most of the blood vessels of the eye; it is often the site of secondary infections from toxic conditions and bacterial infections such as tuberculosis and syphilis. Cancer may develop in the choroidal tissues or may be carried to the eye from malignancies elsewhere in the body. The light-sensitive retina, which lies just beneath the choroid, also is subject to the same type of infections. The cause of retrolental fibroplasia, however—a disease of premature infants that causes retinal detachment and partial blindness—is unknown. Retinal detachment may also follow cataract surgery. Laser beams are sometimes used to weld detached retinas back onto the eye. Another retinal condition, called macular degeneration, affects the central retina. Macular degeneration is a frequent cause of loss of vision in older persons. Juvenile forms of this condition also exist.
The optic nerve contains the retinal nerve fibers, which carry visual impulses to the brain. The retinal circulation is carried by the central artery and vein, which lie in the optic nerve. The sheath of the optic nerve communicates with the cerebral lymph spaces. Inflammation of that part of the optic nerve situated within the eye is known as optic neuritis, or papillitis; when inflammation occurs in the part of the optic nerve behind the eye, the disease is called retrobulbar neuritis. When the pressure in the skull is elevated, or increased in intracranial pressure, as in brain tumors, edema and swelling of the optic disk occur where the nerve enters the eyeball, a condition known as papilledema, or chocked disk.