Not all red eyes are mucormycosis and not all diabetic patients will get affected by the fungus and therefore there was nothing to panic about, according to doctors at the Aravind Eye Hospital, Madurai.
“I see a lot of patients with a sense of fear psychosis when they get a red eye. Even well controlled diabetic patients are unduly and unnecessarily worried. We have to allay their anxiety too,” said Venkatesh Prajna, chief, Department of Medical Education at Aravind Eye Hospitals.
The combination of COVID-19 in an uncontrolled diabetic environment, accentuated by indiscriminate use of oral steroids is causing a resurgence of mucormycosis, which is curable.
Strict control of diabetes is required. Even post-recovery from COVID-19, patients should continue to wear masks, he said. The ophthalmologist pointed out that mucor is a type of fungus widely present in the environment – soil, leaves, compost and animal dung. “Most people come in contact with microscopic fungal spores every day. Hence, it is impossible to completely avoid coming in contact with mucormycetes,” he said.
“As long as the immune system is functioning normally, our system can take care of this,” he said. However, for people who have weakened immune systems, breathing in mucormycetes can cause an infection in lungs or sinuses which can spread to other parts of the body,” Dr Prajna cautioned.
It mainly affects people who have uncontrolled chronic health problems or take medicines that lower the body’s ability to fight germs and sickness. “Whenever a patient shows symptoms of mucormycosis, we usually suspect they are very immunocompromised patients. We used to see around seven cases per year earlier, but in the COVID-19 situation, we are seeing the same number in a month or even more,” he added.
In many cases, he said, the first culprit was very high uncontrolled diabetes and this has to be really emphasised. In addition, COVID-19, apart from causing altered immunity, itself can alter the metabolism and shoot the blood sugar up.
“So, if a patient is already an uncontrolled diabetic, then it is a double whammy”, he added. “Oral steroids are definitely a life saver in certain phases of COVID-19 treatment. However, if it is used indiscriminately, then steroids can also push up diabetes,” he noted.
He said disposable masks should be disposed of after four to six hours of use, which means, one would have to use at least two to three masks a day.
He said that any slackness to screen properly for mucor may affect organs such as the nose and paranasal sinuses. It can also invade the orbit, which causes swelling around the eyeball. When it hits the brain, it may turn fatal, Dr Prajna underlined.
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