{"id":89,"date":"2010-10-31T08:08:05","date_gmt":"2010-10-30T23:08:05","guid":{"rendered":"http:\/\/blog.ebinfoworld.com\/?p=89"},"modified":"2017-10-18T10:10:22","modified_gmt":"2017-10-18T01:10:22","slug":"eb-and-the-eyes","status":"publish","type":"post","link":"https:\/\/blog.ebinfoworld.com\/?p=89","title":{"rendered":"EB and the Eyes"},"content":{"rendered":"

This is the transcript of a helpful book from DebRA U.S. <\/a><\/strong>in regards to EB and how it effects the eyes.<\/p>\n

Thank you Brenda for taking the time to type this up for us!!!<\/p>\n

—-<\/p>\n

\"\"<\/a>Problems with the eyes can occur in most forms of Epidermolysis Bullosa (EB).\u00a0 The eyelids, conjunctiva and the cornea may all be affected by EB.\u00a0 Fortunately there are means to prevent or reduce these eye problems.\u00a0 With good understanding, prompt and appropriate care can be given to reduce complications.\u00a0 In some cases, potential problems can even be avoided.\u00a0 Eye problems can be causes by trauma such as rubbing or scratching, from irritation such as heat, wind or dust, or from dry eyes.\u00a0 However, at times eye problems may be spontaneous; that is, they occur for no known reason.<\/p>\n

What eye problems can occur in a person with EB?<\/strong><\/p>\n

The most common eye problems associated with EB are: conjunctivitis, blepharitis, corneal erosion, and ectropion.<\/p>\n

Conjunctivitis<\/strong> \u0016 an inflammation of the conjunctiva, which is the mucous membrane lining the eyelids and covering the anterior portion of the eyeball. The signs of conjunctivitis are redness, pain, eyelid swelling and tearing.<\/p>\n

Treatment:<\/span>\u00a0 Application of warm, sterile compresses and antibiotic ointments help to clear the infection.\u00a0 Topical steroids may be prescribed by a doctor to reduce inflammation, but you can also buy steroids on roid’s website<\/span><\/a>.\u00a0 Rubbing of the eyes should be avoided.<\/p>\n

Blepharitis <\/strong>\u0016 an inflammation of the eyelids.\u00a0 The signs are crusting at the base of the eyelashes with ulcerations at the lid margins, gritty foreign body sensation, mucous discharge and mildly red eyes. Photophobia (sensitivity to light) is absent or very mild. Chronic blepharitis is associated with loss of eyelashes. Blepharitis may clear up promptly or persist for long periods.\u00a0 It does not seem to follow the course of blistering elsewhere on the body.<\/p>\n

Treatment:<\/span>\u00a0 Proper eyelid hygiene to clean the lid margins of crust and debris is followed by application of an antibiotic ointment.<\/p>\n

Corneal Erosions or Ulcerations<\/strong> – The inflammation of the cornea with the formation of an ulcerated area. They can be both trauma induced and spontaneous and are most distressing problems. Indeed, recurrent corneal erosions syndrome is frequently seen. Typical signs of corneal erosion are sudden onset of pain and photophobia in on or both eyes associated with tearing and a red eye. Frequency of occurrence follows frequency of blistering elsewhere on the body.<\/p>\n

Treatment:<\/span>\u00a0 Antibiotic ointment is used to reduce bacteria and provide lubrication.\u00a0 If spasms of the eye muscles occur, medication may be prescribed to provide comfort until symptoms subside.\u00a0 Corneal erosion usually heals spontaneously in two to three days.\u00a0 In older children and adults, soft contact lenses have been used to minimize frequent recurrences.<\/p>\n

Ectropion<\/strong> \u0016 A condition in which the eyelids turn outward.\u00a0 It occurs rarely in people with EB.<\/p>\n

Treatment:<\/span>\u00a0 Eye surgery may be considered to remove scar tissue, and skin grafts may be indicated.<\/p>\n

At what age can eye problems start?\u00a0<\/strong><\/p>\n

Eye problems may occur at any age \u0016 In infancy, teens or adult age.\u00a0 Some people with EB may never have eye problems.<\/p>\n

Are the eye problems severe?<\/strong><\/p>\n

The severity of eye involvement with EB depends on the type of EB, the degree and sensitivity of the particular person, and the various conditions to which he or she is exposed.\u00a0 Complications generally are not severe and can be minimized with good eye care. Visual prognosis is generally good with no loss of vision and no greater need for eyeglasses than anyone else. The main mechanisms for vision, including the lens, the retina and the optic nerve are usually not involved. However, the symptoms can be rather annoying.<\/p>\n

What kind of doctor can treat eye problems?<\/strong><\/p>\n

While a family physician\/pediatrician can treat eye infections, if you or your child has frequent eye difficulties or if corneal erosions occur, an ophthalmologist should be consulted. He has the expertise and equipment to conduct a proper and thorough eye examination and give appropriate treatment.\u00a0 Your regular doctor can refer you to an ophthalmologist.<\/p>\n

What happens during an eye examination?<\/strong><\/p>\n

During an eye evaluation, the ophthalmologist will ask questions about any prior problems you have encountered. Your eyes will be examined using various instruments.\u00a0 Fluorescent drops or dye with an anesthetic ability may be inserted in the eye to outline any areas of erosion and to facilitate the examination. Your vision can also be tested.\u00a0 The doctor may take a culture to identify any bacteria and prescribe proper medication.<\/p>\n

When examining an active infant with EB, great patience is required in order to avoid additional trauma to the eye during the exam.<\/p>\n

\u00a0Suppose eyeglasses are needed?<\/strong><\/p>\n

If eyeglasses are required for visual needs, padding the frame at the bridge of the nose and over the ears may be necessary to avoid blistering in these areas.\u00a0 Wire frames with plastic lenses certainly minimize problems because they are lighter weight than frames with glass lenses.<\/p>\n

Can contact lenses be used with EB?<\/strong> \u00a0<\/strong><\/p>\n

Soft contact lenses have been used by some people with EB as a protective covering.\u00a0 They may guard against irritation and scratching of the cornea as well as hold medication in place, increase healing, and reduce incidents of eye involvement.\u00a0 They also serve as an alternative to a patch.\u00a0 Soft contact lenses require extra moisture to maintain pliability.\u00a0 If contact lenses are to be worn they should be fitted and supervised by an ophthalmologist (MO).<\/p>\n

Therapeutic soft contact lenses have been used in older children and adults to minimize recurrences of corneal erosion.\u00a0 They are not advised in small children.\u00a0 The user must be old enough to cooperate in fitting and adjustment of the contact lenses.\u00a0 In addition the user must be able to maintain proper care and cleaning of the lenses and have the ability to insert them.<\/p>\n

Will patching the eye help?<\/strong><\/p>\n

Patching for a day or so can sometimes alleviate pain associated with corneal erosions.\u00a0 Do not use tape to patch the eye.\u00a0 Apply a \u0013pirate\u0014 type patch instead.\u00a0 Use cautiously with small children who may rub the eye through the patch causing further irritation.\u00a0 Be sure that the band or string holding the patch in place is padded or loose enough so it does not cause additional blistering.<\/p>\n

Is surgery ever required for eye problems?<\/strong><\/p>\n

On rare occasions eye surgery may be considered to remove scar tissue.\u00a0 Skin grafts may be indicated to repair ectropion, a condition in which the eyelids turn outward.<\/p>\n

How is eye medication applied?<\/strong><\/p>\n

Eye medication may be in the form of drops, ointment or a solution.\u00a0 In some cases the Physician may instruct you to apply an ointment directly to the margins of the eyelids when they are closed.\u00a0 More often, the medication will be inserted into the eye.\u00a0 Care should be taken to apply the medication properly for the most effective results and at the same time avoiding any additional trauma to the eye.<\/p>\n

To apply eye medication into the eye:<\/p>\n