associated with backache, osteoporosis most
commonly causes the disease. There is no effusion or synovial
thickening. Crepitus is present.
Rheumatoid arthritis involves the peripheral
joints too in association with the knee and ankle. Early morning
stiffness with relief of pain as day advances is characteristic
of rheumatoid arthritis. There is synovial thickening and
effusion and minimal local tenderness. A classical doughy
feeling is elicited. There is atrophy of muscles around the
joints of the interossei. Deformities in rheumatoid arthritis
as mentioned early are typical, when the knee and ankle are
alone involved in rheumatoid in rheu- matoid arthritis.
Rest in Cases of osteoporosis, adequate mobilisation
and change of occupation as in drivers with cervical spondylosis
are simple but important guidelines.
THIS LECTURE LASTED FOR TWO HOURS DIVIDED
INTO TWO SESSIONS OF ONE HOUR EACH. FOUR CASES OF OSTEOARTHRITIS-KNEE,
TWO CASES RHEUMATOID ARTHRITIS AND ONE CASE EACH OF OSTEOPOROSIS
AND CERVICAL SPONDYLOSIS WERE DEMONSTRATED.
Visual handicap is the major physical sensory
deficit in the elderly. Cataract, glaucoma, diabetic and hypertensive
retinopathy, macular degeneration, corneal degeneration, refractive
errors, dacryocystitis and conjunctivitis are some of the
common diseases in the old. Arcus senilis is a normal physiological
change in this age group. Early intervention prevents blindness,
hence early referral is absolutely essential.
Any lenticular opacity is called cataract.
Development of cataract is a physiological process in senility.
Factors like working in welding, manufacture of gun-powder,
genetic predisposition and constant exposure to ultraviolet
rays (sunlight) influence the onset of cataract formation.
There occurs gradual painless loss of vision. Depending upon
the progress of opacity, cataract formation is divided into
four stages viz. (i) early (ii) immature (iii) mature and
(iv) hypermature. A white opacity in the pupillary area denotes
cataract. In cases of immature cataract, the iris throws a
shadow which can be well visualized. Absence of iris shadow
signifies a mature cataractous lens. In the hypermature stage,
calcified spots are seen in the anterior chamber as a result
of which intraocular pressure shoots up. Emergency removal
of the cataract is then indicated.ln cases of immature cataract,
glasses would suffice. Early surgery can be done for immature
cataract-surgical intervention depends upon the visual needs
and acuity. If defective vision interferes with the occupation
of the person, surgery can be done. Mature cataract always
demands surgery. Expulsive haemorrhage is a complication that
can be met with during surgery. Post-operatively infections
as panophthalmitis, iridocyclitis and endophthalmitis may
occur. Iridocyclitis can be cured in few days.