Surgery and Healing in the Developing World - Dartmouth-Hitchcock

Ophthalmology
Figure 4. A tonometer.
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Loss of Vision
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Cataracts
Cataracts are diagnosed easily, blurred vision being the predominant symptom.
Most cases will need nothing more than close monitoring. If debilitating, surgery (if
available) is the treatment of choice. Blood glucose should be measure in any patient
presenting with cataracts to exclude diabetes mellitus as a cause.
Temporal Arteritis
Temporal arteritis causes sudden painless loss of vision, usually accompanied by
tender scalp arteries and jaw claudication. An ESR of greater than 40 is also usually
seen.
Prompt corticosteroid therapy may help save the other eye. Initial doses of 40-60
mg daily should be continued until remission of disease activity when doses can be
gradually reduced to 7.5-10 mg daily. Relapse is common if treatment is discontinued
within three years.