Leading ophthalmic care providers including Dr. Agarwal’s Eye Hospital, LV Prasad Eye Institute, Sankara Eye Hospitals are all concerned over growing eye and vision problems with hepatitis. These hospitals are convinced that only immunisation for hepatitis can stall ocular infections like retinal vasculitis, uveitis and third nerve palsy reported among infected patients. Side effects ensuing from Interferon drug prescribed to treat hepatitis is also seen to affect eyesight.
Immunisation can prevent the onset of hepatitis. It is not only important that the public should be inoculated but also hospital staff dealing with hepatitis infected patients is also vaccinated, Dr. Ashray Nayak, consultant Vitreo Retinal Surgeon, Dr. Agarwal’s Eye Hospital told Pharmabiz.
In India, typically retinal vasculitis followed by uveitis and third nerve palsy are commonly diagnosed among hepatitis infected patients. Ophthalmologists are challenged to treat these conditions where medication is limited, pointed out experts from Sankara Eye Hospitals and Narayana Nethralaya.
Safe injections and blood transfusions can prevent the spread of hepatitis B and C, while hygienic, clean food and water can reduce the risk of hepatitis A and E infection. “But mandating immunisation across the population and specially for doctors, nurses and paramedics among other patient care assistants is much wanted, added ophtha specialists.
While retinal vasculitis reduces the blood flow and oxygen to the retinal tissues, uveitis is an inflammation are caused by circulation of antibodies and antigens brought about by the hepatitis infection.
According to WHO, hepatitis which is preventable and treatable accounts for more fatalities than HIV and malaria together, and is second only to tuberculosis deaths among communicable diseases in the South East Asian region.
“In India hepatitis is increasing. There is need for immediate and urgent action to arrest the spread of hepatitis which is possible only with mass and mandatory immunisation of the Indian population,” said Dr. Naik.
Treatment options for retinal vasculitisis are a combination of oral- topical medications followed by laser therapy. For uveitis, an inflammation affecting the front portion of the eye, requires both oral and topical drugs. Third nerve palsy causing temporary paralysis of the third cranial nerve that controls eye muscle movement is difficult to treat, he said.
Moreover retinal vasculitis, uveitis and third nerve palsy can be treated only by retina surgeons. Currently, India has around 3,000 retina surgeons. Although we do not see a shortage in the metros but the peripheral areas where hepatitis is on the rise has a paucity of retina surgeons, said Dr. Naik.
At Bengaluru’s six Dr. Agarwal’s Hospitals have only one retina surgeon. Although all the ocular conditions in hepatitis patients can be diagnosed by ophthalmologists at primary health centres, administering laser therapy is only by retina surgeons. The specialization of retina surgery is offered only by a handful of centres including LV Prasad, Aravind Eye Care, Sankara and Maulana Azad Medical College.