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- Glaucoma.
- Goitre.
- Gout.
- Gum Disease.
Glaucoma
Glaucoma is a condition where the fluid pressure within the eye (known as the intraocular pressure) increases.
If the intraocular pressure remains too high for too long, this will result in damage to the optic nerve, loss
of vision and eventually blindness. Glaucoma usually occurs in both eyes, but often first begins in one eye only.
Symptoms:
Often, there are no symptoms in the initial stage for Glaucoma. However, do take note if the following occurs:
- Eye or facial pain.
- Red eyes.
- Tearing.
- Sensitivity to light.
- An enlarged cornea.
- Dilated pupils.
- Cloudy vision with coloured halos appearing around lights.
- Frequent changes of eyeglasses, none of which is satisfactory.
- Inability to adjust the eyes to darkened rooms, such as theatres.
- Gradual loss of peripheral vision.
- Headaches.
Treatment:
Treatment involves normalising both the in-flow and drainage of fluid (the aqueous humor) in the eye,
to restore the normal balance of inner-eye pressure. Both medical and surgical approaches have high
rates of success in treating glaucoma.
Chronic glaucoma is managed with eye drops containing epinephrine or pilocarpine to help increase fluid
drainage but may have side effects such as headaches and blurred vision, as in the case of pilocarpine.
Use of epinephrine may cause excessively red, teary eyes and in rare cases aggravate heart problems.
If chronic glaucoma does not respond to medication, or the side effects of medication are too much to
tolerate, surgery may be recommended. There are two methods - trabeculoplasty and trabeculectomy.
Trabeculoplasty is a procedure where 50 to 100 small laser burns are made at the drainage angle
where the iris and cornea meet, increasing the outflow rate of aqueous fluid.
Trabeculectomy is a procedure to create an artificial channel for fluid outflow. This procedure
is used for advanced cases of glaucoma where the inner-eye pressure is high or where the optic nerve
is damaged.
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Goitre
Goitre is the enlargement of the thyroid gland, which is located at the base of the neck. It is not
necessarily due to inflammation or cancer.
Symptoms:
Symptoms include:
- Thyroid gland becomes enlarged. Size ranges from a small nodule to a massive enlargement.
- Breathing is difficult; wheezing sounds due to compression of the trachea.
- Swallowing is difficult due to compression of the esophagus.
- Dizziness when the arms are raised above the head.
- Neck veins become distended.
Treatmentv:
If the goitre is small and causes a slight increase in thyroid hormone production, treatment may not
be necessary. If the goitre continues to grow and causes excessive thyroid hormone production, insufficient
thyroid hormone production or discomfort, treatment may be necessary.
Oral supplements of iodide or a synthetic hormone (levothyroxine) are used to treat goitre and shrink the
thyroid gland to its normal size. The entire thyroid gland may have to be surgically removed if the goitre has
a lot of internal scar tissue, refuses to shrink, causes discomfort, causes overproduction of thyroid hormone,
or becomes cancerous.
Goitre problem is almost eradicated in Bhutan.
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Gout
Gout is a type of arthritis caused by uric acid. Uric acid is a waste product formed from the breakdown of
certain proteins (called purines). It is normally removed from the body by the kidneys. In gout, uric acid
builds up and forms crystals which are deposited inside the joints. Gout is more common in men, especially
between the ages of 30 and 60.
Which joints are affected?
The base of the big toe is usually affected. The big toe becomes red, hot, swollen and very painful. The pain
may last for days to weeks if not treated. Attacks may recur at intervals of weeks or months. Gout can also
affect other joints like the ankle, knee, wrist and fingers.
What is the Treatment?
Gout is a curable disease, but if left untreated, it can cause kidney stones, which may lead to kidney damage.
Rest, Heat/Cold Treatment and Medication:
During an attack of gout, bed rest is important. A hot compress or ice pack to the affected joint can relieve the pain.
Your doctor will prescribe medicines to reduce the pain and inflammation. Other drugs can also be given to reduce the uric
acid level in the body.
Diet:
Avoid eating food high in purines, especially organ meats (see chart). Drink plenty of water and avoid taking alcohol.
Avoid eating:
- organ meats like liver, kidney, brain.
- small fish (like ikan bilis, sardines) and fish roe.
- meat extracts, yeast extracts (like Marmite) and stock cubes.
- seafood like crab, cockles, prawns, scallops.
Eat less:
- asparagus, cauliflower, mushrooms and spinach.
- peanuts, dhal, beans and peas.
- chiku and custard apple.
- wholegrain breads and cereal.
- soyabean products like beancurd.
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Gum Disease
Gum disease is an infection of the gums, supporting tissues and bone which hold the teeth in the mouth.
It is a common oral condition which affects many people. If left uncontrolled, it can eventually lead to
tooth loss.
What factors can lead to a higher risk of Gum Disease?
Smoking, uncontrolled diabetes, pregnancy and long term use of certain medications (eg. epileptic medication)
may increase one's risk of gum disease.
What causes Gum Disease?
The main cause of gum disease is a build-up of dental plaque Dental plaque is a soft, sticky film of
bacteria, saliva and food debris which forms on our teeth. If dental plaque is not removed, dental plaque will
harden to form tartar. Tartar may form above and below the gum margins. This further increases your risk of
developing gum disease.Tartar cannot be removed with tooth brushing. You need a dentist to help you remove it.
Regular brushing and flossing will prevent the formation of tartar.
What are the common types of Gum Disease?
The most common type of gum disease is Gingivitis. Gingivitis is reversible if detected early.
It can be managed with good oral hygiene practices at home and with professional care. If untreated, the disease
may worsen to affect the bone supporting the teeth. This may result in tooth loss.
How would I know if I have Gum Disease?
In its initial stages, gum disease is usually painless and you may not even know that you have it.
The first signs of gum disease are:
- reddened gums.
- gums that bleed easily on gentle brushing.
- swollen, puffy gums.
- bad breath.
As the disease progresses, you may experience:
- receding gums.
- teeth which look longer.
- loose teeth.
- spaces between the teeth.
How can Gum Disease be prevented?
Gum disease may be a common condition but it can be prevented by following these simple tips:
- Brush your teeth at least twice a day - once in the morning and once at night before sleeping.
- Floss your teeth at least once a day.
- Visit your dentist at least once a year.
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