Eyes And Ears

We often suffer from various problems related to our eyes and ears, but infection and inflammation (occasionally due to allergy) are certainly most common. In effect, the problems may involve several parts of our eye, especially the iris and conjunctiva (the flimsy membrane that wraps the front portion of the eyes and also forms the lining of the eyelids). On the other hand, compared to the inner ear, the external and middle part of the ear are more vulnerable to infections.

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Our eyes are also susceptible to a severe disorder called glaucoma, wherein the intraocular pressure or fluid pressure inside the eye increases and it may in due course lead to blindness. In addition, people suffering from high blood pressure (hypertension) and diabetes may suffer from an eye disorder called retinopathy (an ailment related to the retina). This problem may be cured through treatment in the primary stages.

The disorder of the ear may include cerumen (wherein there is an accumulation of wax in the external part of the ear) and other problems related to the balancing mechanism of the body.

Medicaments for glaucoma

For the uninitiated, glaucoma is a disorder of the eye where several conditions result in an abnormal increase of the pressure of the fluid inside the eye. When this occurs, the blood vessels that supply to the optic nerve (nerve connecting the brain to the eye) are compressed, which may result in a permanent damage to the nerve and also cause permanent blindness.

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Open-angle glaucoma or chronic glaucoma is the most widespread form of this eye disorder. When this occurs, the drainage of the fluid from the eye is reduced, which, in turn, causes the fluid pressure within the eye to increase gradually. In open-glaucoma, the sufferer may experience gradual loss of vision in the peripheral field. As it takes several months, sometimes even many years, to develop, the problem may not be noticed of felt in the initial stages.

On the other hand, a person suffers from closed-angle glaucoma, which is also known as acute glaucoma, when the iris blocks the fluid drainage from the eye all of a sudden. In this case, the pressure of the fluid inside the eye builds up abruptly and blurs the vision in the eye affected by the condition. The affected eye turns red and sore, which occurs together with headaches and, occasional vomiting. Before the main attack, often there is a mild warning. These warning attacks include seeing halos around a light source and it occurs some weeks or months before the major attack.

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Aged people and those suffering from hyperopia (farsightedness) are especially vulnerable to acute glaucoma. People with this condition will experience a sudden narrowing of the angle of their vision, which may occur after an injury or as a side effect of specific medications, such as anti-cholinergic drugs.

Treatment of both glaucoma types is done using medicines. Some of the medications used in treating glaucoma include beta blockers, miotics, and specific diuretics like osmotics and carbonic anhydrase inhibitors.

The medicines that are used for treating glaucoma work in many different ways to diminish the fluid pressure inside the affected eye. A group of drugs called miotics augment the fluid drainage from the eye. Ophthalmologists treat chronic or open glaucoma by enhancing the drainage of aqueous humor in the eye via the trabecular meshwork, a channel that drains the fluid from the eyes. Acute or closed glaucoma is treated using miotics, which have a constricting effect on the iris, pulling it away from the channel draining the aqueous humor, thereby facilitating the flow of the fluid normally. On the other hand, carbonic anhydrase inhibitors and beta blockers act on the eye cells that produce aqueous humor with the aim of diminishing the drainage of aqueous humor.

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Medicines that are used for treating acute or closed-angle glaucoma work rapidly to alleviate pain as well as other symptoms just within some hours. On the contrary, the benefits of the medicines used for treating chronic or open-angle glaucoma may not be felt right away because, in this case, treatment with medicaments only helps to arrest the vision from deteriorating further.

It is likely that people who are using miotic eye drops will experience darkening of their vision and, at the same time, find it difficult to see in darkness. They may also experience an increase in short-sightedness or myopia. A number of miotic medications may also be responsible for the redness and irritation of the eyes. On the other hand, the routine side effects of using beta blocker eye drops are very few, but they may be risky for some people. Usually, the use of acetazolamide results in thirst as well as more frequent urination. This drug may also cause nausea and general depression in many people.

Generally, miotics are considered to be safe for use by everyone. However, in case our body absorbs beta blockers, they may have an adverse effect on the heart, lungs as well as circulation. This is the main reason why physicians are very cautious while prescribing these beta blockers to people suffering from asthma or having specific disorders related to the circulatory system. In a number of instances, physicians advise such people to abstain from using these drugs under any situation.

However, it is possible to regulate the amount of the drug that is absorbed by the body. You can reduce its absorption by being careful while applying the beta blocker eye drops. Generally, physicians do not prescribe acetazolamide for treatments that go on for prolonged periods, as it has niggling side effects, which may include itchiness of the hands as well as feet. In some cases, use of acetazolamide may even contribute to kidney stone formation and, in rare instances it may damage the kidneys too. Therefore, this medication is generally not prescribed for people who are already suffering from any kind of kidney disorder.

Medicaments affecting the pupil

Ophthalmologists widely use various eye drops that affect the pupil - a tiny spherical opening in the middle of the iris (the pigmented portion of the eye), which allows light to enter the eye. The size of the pupil changes continually in order to adjust to the different intensities of light. When the light is bright, the pupil contracts and becomes quite small while it dilates when the light is dim or faint.

There are two main types of medicated eye drops that work on the pupil - one, mydriatics, eye drops that helps to enlarge the pupil when the light is bright; and, two, miotics, eye drops that help the pupil to constrict when the light is poor.

Two different sets of muscles present in the iris controls the size of the pupil. These muscles are known as the radial muscle and the circular muscle. Both these muscle sets are regulated by a different autonomic nervous system branch. While the sympathetic nervous system regulates the radial muscle, the circular muscle is controlled by the parasympathetic nervous system.

Particular miotic and mydriatic drugs work on dissimilar autonomic nervous system branches and they make the pupil to dilate or constrict, subject to the medication type used. Often the use of miotic medications hinders the night vision and may even result in temporary myopia (short-sight). On the other hand, use of mydriatic drugs, particularly the long-acting ones, harms one's aptitude to focus his/ her eyes for many hours at a stretch. This, in turn, especially hinders one's close activities, for instance, reading. People using these medications may also feel uncomfortable when the light is very bright.

Generally, it has been seen that use of eye drops do not cause too many and very serious side effects. However, use of sympathomimetic mydriatics may possibly cause the blood pressure to rise and, therefore, people suffering from high blood pressure (hypertension) and/ or heart diseases should use them with great caution. On the other hand, using miotics may cause eye irritation. However, they generally do not cause any generalized side effects.

Medicaments for ear disorders

There are a number of medications to treat ear disorders. Infection as well as inflammation of the external as well as the middle ear are most widespread ear problems, which can be treated using medicines. The medicines used to treat inflammation of the ear are subject to the cause of the problem and the site affected.

Inflammation of the outer ear

Several factors may be responsible for inflammation of otitis externa (wherein the external ear canal becomes inflamed), for example fungal or bacterial infection and/ or eczema. The hazards of such infections are more when one goes for swimming in polluted water, gets build-up of wax inside the ear, and/ or scratches or pokes the ear too often.

While the symptoms related to otitis externa may differ, generally the condition is accompanied with pain (acute in case of a boil inside the ear canal), itching, tenderness and perhaps a little impaired hearing. There will also be some kind of discharges in case there is a bacterial or fungal infection inside the ear canal.

In order to treat this condition (inflammation in the outer ear), you may use a weak corticosteroid as an ear drop. However, you are advised not to use the ear drop if you have an ear infection. In addition, you may also use an aluminum acetate solution in the form of ear drops or put some of this solution on small gauze and place it inside the external ear canal. This practice will help you to get respite from the problem in a couple of days. However, it is not advisable to use corticosteroids for a prolonged period, as doing so may diminish the ear's ability to resist infections.

In case you are suffering from inflamed outer ear as well as infection, it is likely that your physician will prescribe ear drops that have antibiotics and a weak corticosteroid. Using this medication will help to provide relief from inflammation soon. Generally, physicians prescribe an amalgamation of antibiotics - most commonly used antibiotic include framycetin, polymyxin B or neomycin. These antibiotics help to enhance the treatment and neutralize an assortment of bacteria. However, under normal circumstances, these antibiotics are not recommended for prolonged use, because using them for an extended period of time may aggravate the skin that forms the lining of the ear canal. At times, when any antibiotic administered in the form of an ear drop fails to resolve the problem, your physician may prescribe another antibiotic that is to be taken orally.

Infection of the middle ear

Another ear disorder is known as otitis media (inflammation of the middle ear). This is a very painful condition, which often causes hearing loss. This problem is widespread in small children, as the microbes responsible for the infection are able to spread freely and fast from the throat or nose to the middle ear through the Eustachian tube, also referred to as the auditory canal.

Compared to bacterial infections, viral infections are less serious and they generally get cured on their own. When the middle ear is infected by bacteria, it usually results in the swelling of the Eustachian tube, which may also be blocked causing hearing loss. Such blockages are extremely dangerous as they not only lead to accumulation of pus inside the ear, but also put a strain on the eardrum, often perforating it.

In such conditions, physicians sometimes recommend the use of an antihistamine or decongestant to lessen the inflammation inside the Eustachian tube, thereby allowing the drainage of the accumulated pus from the middle ear. In addition, physicians usually also prescribe an oral antibiotic to treat the infection.

As is well known, antibiotics do not have any effect on viral infections. Nevertheless, as it is difficult to ascertain the nature of infection (whether a bacterial or viral infection) inside the middle ear, an antibiotic may be prescribed by your physician as a preventative measure.

At the same time, your physician may prescribe an analgesic - acetaminophen, with a view to alleviate pain. He or she may even recommend a prolonged treatment with antibiotics in case the infection continues or is recurring.


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