Hemifacial myokymia and its Management

Hemifacial myokymia is an uncommon involuntary movement, its a disorder of muscles supplied by facial nerve and characterized by sudden movement under the skin.
Involuntary vermiform movement (twitches) of affected muscles are characteristic features.
Involved muscles are orbicular oris and orbicularis oculi

Management:
Mecobalamine (vitamin B12) nutritional supplement. alongside topical antihitamine for orbicularis twitches, or oral antihistamine for recalcitrant cases.
Injection Botulinum toxin (BTX)
But we often need to differentiate it from Pathological blepharospasm.

By exercise:
Exercises related to stress relaxation if stress will release it can help in controlling twiching Some sort of psychotherapy
Surgery:
MVD microvascular decompression surgery to treat the symptoms caused by compression of nerve due to vein or artery

Why your eyesight get worse

When you visit your eye doctor for follow up after some months and you find there that your eyesight is getting worse.

Ways that worse your eyesight:

1) Not wearing glasses:
when you not wear the prescribed glasses that will worse your eyesight. Without glasses your eyes will use alot of a power to focus something thats the way that your eyes always use a power to focus something will effect you eyesight. childrens before age of 12 must have to wear the glasses. if they have not weared the glasses after the age of 12 they will lost eyesight permanently (Amblyopia also known as lazy eye). How to remove your glasses

2) Excessive uses of computer\Mobiles:
Today's life about every one is busy with their Compiter\Mobile. focusing at screen for several hours at a time can irritates and put a real stain on eyes. eye problem cause by a screen is called COMPUTER VISION SYNDROME. About 50-90% of computer using peoples feels starting symptoms that cause your eyesight worse.

3) Excessive Near work:
Children's who spend almost 100% of their time indoor for reading or other purposes and getting very little sunlight expoure will effect eye growth and development. Excessive reading and very little exposure to sunlight worse your eyesight.Improve eyesight by eating foods

4) Reading in dim light:
Reading at close distance things in dim light can put a stain on your eyes and your eyes need power to read or focus the reading material effects your eyes. but it won't cause lasting vision.

 5) Age:
your eyes change as you age. some eye problems that cause worse your aeyesight :presbyopia presbyopia is a condition in which the lens become hard and inflexible with age. And Presbyopia starts at about age of 40. Presbyopia making difficult focusing at near normally.

An Optometrist's own story about his eye problem

by Dr Hashim Ali Khan B.SOpt, FAAO

I was in my office , seeing patients. Mmm, its story of five days back. The cold last days of November 2012 (the 1st and last November of the year.

Before I had finished with my patients, rather there were atleast 4 patients with 8 attendants in my waiting room area, I felt my Left eye was very painful. Something was irritating my eye. I rubbed my eye wildly I went to the washroom, washed my eye and came out, but pain and irritation were beyond the limits of my tolerance. I just ran to the room of GP to look at my eye and he indeed looked said “O Doctor, how an eye doctor can have an eye problem? (I wish if we people may never had eye problem. It’s nothing I then again ran to another one person. He everted my lid but the pain of lid eversion was more than that I actually had (I thought by that moment, is lid eversion really that much painful?) I told him I feel like having a lash in my upper fornix. He although said I didn’t see anything sir, but I can make a power wash (was without a LEMON MAX :). He washed; I kept tearing, sneezing and all those painful. The wash actually was unsuccessful as he didn’t use any detergent. Unfortunately, I didn’t have any eye doctor other than me. I self everted my lid and couldn’t see anything inside.
I excused all patients and requested them to come back next day, asked the driver to start my Car, instilled a drop of local aanesthetic and made a call to one of my Favorite Eye Doctor. This was the first time in history my driver took so long to reach the place (atleast I felt). My Eye Doctor (an Optometric colleague of mine) everted my lid again inside my car (lid eversion isn’t really painful or even it doesn’t cause discomfort, believe me). He pulled out that nuisance lash with some mucus which I suppose had arrived there for bad romance with that vagabond lash. I kissed my doctor’s hands went back to home and started to instill antibiotic eye drops qid to cover inflammation of my conjuctiva and to prevent any possible infection.
Next morning, I had some lid edema and forign body sensation. Being an astute clinician I examined my palpebral conjuctiva using a mirror and saw something (Follicles or papillae?) I assumed them to be papillae and considered it an allergic reaction and continued same medication with the addition of antiallergic eye drops b.i.d.Two days passed and my symptoms were on the rise. I saw my doc again he diagnose them papillae and I started taking oral Levocetirizine along with aforementioned drops. Aaaahhhh my bad luck. Nothing worked. Things kept on worsening. The oral levocetirizine, however, made me dizzy and sleepy all those days.
I saw another eye doctor (ophthalmologist) who confirmed the Diagnosis of my original doc. Now three docs (I, optom and an ophth) had the same opinion the Allergic conjuctivitis but we all were wrong.
Two days back I developed periauricular lymphadenopathy and same symptoms and lesions in fellow eye as well. So what actually I had was chlamydial conjuctivitis(my own DX). Those grape bunches inside were large follicles. I missed because I can't see my eye on slit lamp and my optometric colleague examined me all times on any Klatsch. My Ophthalmologist colleague however looked my eyes through Slit lamp (Another Painful experience. I’ll not let do any Dilated Fundus biomicroscopy on myself 😛 )
I’m on Azithromycin (bactizith) 1 gram stat. ill repeat after a week to get back my eye’s prurient look

Dr Khan is a consultative optometrist and specializes in retinal disorders. He speaks frequently to many Optometric groups. Also, he provides consultation to numerous optometrists across the country. He is founding Editor in chief of Pakistan's first peer reviewed optometric journal "Inside Optometry" Optometry in Pakistan

Headache due to eye problems

Is your headache is due to eyes problems,  “When was your last eye checkup?”

A routine eye exam can turn up a variety of issues that may be causing headaches. In some cases staring at the computer screen too long, or working on overly bright or dim light may be the culprit. Adjusting workplace lighting, or remembering to take a break every 20 minutes for 20 seconds or so to give your eyes a rest can remedy those problems.

Some common eye conditions that may result in headaches if untreated. They are: 

1)Myopia:

Myopia, also known as short-sightedness, is a condition of the eye where light focuses in front of, instead of on, the retin. This causes distant objects to be blurry while close objects appear normal. 

2)Hyperopia:

Hyperopia, also known as long-sightedness is a condition of the eye in which light is focused behind, instead of on, the retina. This causes close objects to be blurry, while far objects may appear normal.

3)Astigmatism:

Assitgmatism is due to change of curvature of corena or lens or shape of eyeball. When the cornea has an irregular shape, it is called corneal astigmatism. When the shape of the lens is distorted, you have lenticular astigmatism. Due to result of either type of astigmatism, your vision for both near and far objects appears blurry. It's almost like when travelling you see the earth is too low or too high than the nornal.

4)Presbyopia:

Presbyopia is condition in which the lens become hard and inflexible with age, making difficult to focus normally. presbyopia normally starts after the age of 38 or above.Improve your eyesight by eating foods

If you feeling headache for years and not improving with any medicines visit your eye doctor. Headache due to the above is improve with using glasses. if already you are using the glasses the visit your eye doctor for changing the glasses number. with glasses you will see clear and feel headache free.How to get rid of glasses naturally

Other conditions that causes Headache:

1)Convergence Insufficiency:

Convergence insufficiency or convergence disorder is a sensory and neuromuscular anomaly of the binocular eyes system, in which the ability of eyes to turn together at same time is effected. e.g when you start reading a book you see double words instead of single word and you start feeling frustration and just want to quite reading. 

Convergence insufficiency is improve by simply starting a pencil pushup excercise just for a hour a day for two weeks.

2)Glaucoma and Cataract: 

In glaucoma your intra ocular pressure (IOP) is raised and you feel headache and eyepain. 

When the lens start opacity with age your vision starts to decrease and feeling headache

when you feeling headache and not improving with any medicine visit your eye doctor for eye checkup.

Events

World optometry day on 23rd march

World Diabetic Retinopathy day on 14th november

World Sight day on every second thursday of october

What is an optometrist??

An optometrist is an eye doctor who has earned the Doctor of Optometry (OD) degree or Bsc (hons) in optometry.Optometrists examine eyes for both vision and health problems, and correct refractive errors (myopia, hypermetropia and presbyopia) by prescribing eyeglases and contact lenses. Some optometrists also provide low vision care and vision theraphy.

Being a regulated profession, an optometrist's scope of practice may differ depending on location. Thus, disorders or diseases detected outside the treatment scope of optometry are referred out to relevant medical professionals for proper care, more commonly to ophthalmologists. Optometrists typically work closely together with other eye care professional such as ophthalmologists and opticians to deliver quality and efficient eyecare to the general public.

A story about an optometris

Contact me

Optometrist.2012@yahoo.com