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Treatment

No cure for Sjogren’s syndrome has been developed. Treatment focuses on relieving symptoms. Treatments include eye drops and lubricants, mouth lubricants, immune system suppressants, medications to increase saliva production, and surgery to prevent tears from draining. Patients have also found relief by increasing water intake and wearing protective eye glasses or goggles outdoors.

Also known as demyelinating optic neuritis, optic neuritis refers to the inflammation of the optic nerve due to the loss of or damage to a protective covering called myelin, which surrounds the optic nerve. The myelin is essential to the function of the optic nerve. A more general term, optic neuropathy, refers to nerve damage or abnormalities due to blocked blood flow, disease, or toxic exposure. Optic neuritis is a type of optic neuropathy.

Symptoms

Several vision symptoms accompany optic neuritis including blurred vision, blind spots, pain with eye movement, and reduced color vision. These symptoms typically precede a loss of vision. If left untreated, optic neuritis can lead to permanent optic nerve damage and permanent loss of visual acuity.

Causes

Although the exact cause of optic neuritis is not yet understood, optic neuritis occurs when the body’s immune system mistakenly attacks the myelin, which protects your optic nerve. The myelin is vital for the proper function of the optic nerve. When damaged, the nerve cannot efficiently transfer electric signals/information from the eyes to the brain, hindering vision.

Optic neuritis tends to occur in conjunction with several medical conditions, disorders, and diseases including multiple sclerosis (MS), neuromyelitis optica, systemic lupus erythematosus, sarcoidosis, Lyme disease, ocular herpes, syphilis, measles, mumps, and sinusitis. In addition, optic neuritis can also develop in reaction to certain medications.

Most common among women, young adults between the ages of 20 and 40 are at the greatest risk of developing optic neuritis.

Diagnosis and Treatment

Eye care professionals diagnose optic neuritis using a series of tests and evaluations including a routine eye exam, an ophthalmoscopy (to inspect the back of the eye, looking for a swollen optic nerve), pupillary light reaction test (to check for abnormal function of the pupil), and blood tests.

Patients diagnosed with optic neuritis are much more likely to develop MS. As a result, if a patient is diagnosed with optic neuritis, an MRI will often be recommended to look for further signs of nerve damage and the possible development of MS.

Optic neuritis may clear up on its own. If, however, it does not, an eye care professional will usually recommend a regimen of steroids administered both orally and intravenously to reduce inflammation and suppress the immune system.

If signs of MS are present in the patient, medications to slow the onset or development of MS will also be prescribed.

An eye occlusion is a blockage in one of the arteries or veins supplying blood to the retina and/or optic nerve. These blockages can cause severe and sudden vision loss. Contact your eye care professional immediately if you experience sudden vision loss, and follow up right away with your family doctor. Eye occlusions often signal other serious health problems requiring immediate medical attention.

Diagnosis and Treatment of Eye Occlusions

There are 4 main types of eye occlusions, categorized based on the vessels involved, their location within the eye, and the type of vision loss they cause. An eye care professional will perform a complete eye exam to determine the root problem:

• Branch Retinal Artery Occlusion or “BRAO”— Characterized by a sudden loss of peripheral vision, and occasionally central vision, from a broken clot or plaque traveling from the carotid (in the neck) artery into the branch retinal artery. Rapid treatment (within 12-24 hours of the onset of symptoms) with glaucoma medicine can help. 80% of patients with a BRAO can recover up to 20/40 in visual acuity.
• Branch retinal vein occlusion or “BRVO”— Involves distorted and diminished vision, peripheral vision loss, and blind spots in one eye. This type of occlusion usually occurs in people with diabetes or high blood pressure. Your eye care professional will diagnose the condition based on retinal bleeding along one of the retinal veins, which is detected during a fluorescein angiogram test. Laser and pharmaceutical treatments can help some patients recover a degree of their lost vision.
• Central retinal artery occlusion or “CRAO”— Manifests as painless, yet extensive and sudden vision loss in one eye and can point toward serious narrowing of the carotid artery or complications of diabetes. Immediate, full medical and eye exams are necessary to address the root cause. Vision loss is often permanent, with only a few therapies offering limited success at restoring some vision. Treatments must be implemented within a very short time frame after the onset of symptoms to have a chance of success.
• Central retinal vein occlusion or “CRVO”— Diabetes and high blood pressure are risk factors for CRVO, which can cause mild to severe vision loss. Laser and pharmaceutical treatments can stop the damage and prevent worsening vision if caught early.

Any sudden vision loss, whether painful or painless, requires immediate attention because prompt treatment offers better vision outcomes in the case of eye occlusions. Also remember to check in with your physician for diagnosis and treatment of other potentially serious eye occlusion risk factors.

Many correctable vision problems are caused by abnormal eye anatomy. Very few people have perfectly shaped eyes that facilitate ideal vision. Rather, most people have some degree of abnormal curvature or other anatomical irregularities that cause slight visual changes. Astigmatism is one common form of visual impairment that results from irregular anatomy.

What Is Astigmatism?

The clear front area of the eye is called the cornea, which is important for refracting light rays to direct them onto the retinal surface. Light rays pass through the cornea onto the lens. The lens is flexible, changing shape to further focus the light rays and ensure that they hit the retina. Light must bend at a particular angle to result in clear, focused vision. Any abnormalities in eye structure may cause light to be improperly focused onto the retina, preventing visual sensory cells from processing the images.

Astigmatism occurs when either the cornea or the lens is abnormally curved. It is important to note that nearly everyone has some degree of astigmatism, as ocular structures are rarely perfectly shaped. When the cornea or lens has particularly pronounced curvature, however, light rays fail to focus onto the retina. This leads to blurry vision. Unlike farsightedness or nearsightedness, astigmatism causes blurred vision at any distance. Many people have astigmatism as well as farsightedness or nearsightedness.

Diagnosis of Astigmatism

A comprehensive optometry exam checks your eye anatomy and vision for signs of astigmatism. Tests of visual acuity typically reveal some inability to clearly read letters on a distance chart. The eye care provider may also use a keratometer, a tool that measures the curvature of your cornea. By shining a bright light into your cornea and measuring its reflection, the eye doctor can assess the curvature of your cornea. Your eye care provider may also place different lenses in front of your eyes to determine if you have a refractive error and to what extent.

Treatments

Most commonly, treatment for astigmatism consists of prescription eyeglasses or contact lenses. An alternate treatment is orthokeratology, in which your eye doctor provides a series of rigid contact lenses for you to wear for relatively short periods of time. These lenses reshape your cornea, allowing you to have clear vision. Although orthokeratology does not permanently change the shape of your cornea, it may help you go without glasses or contact lenses for everyday activities. Surgery is another option for those who want a more permanent solution.

Astigmatism is very common and relatively easy to treat. If you experience any blurriness or change in vision, consult your eye doctor immediately to receive an optometric exam.

A chalazion is the medical term for a slowly developing lump on the eyelid that occurs due to an oil gland blockage. At first, the eyelid may appear to be red, tender and swollen. After several days, the chalazion will form on the eyelid, appearing as a slow growing lump. While it is initially painless and nearly impossible to detect, with steady growth, the chalazion may reach the size of pea. Chalazia are most common in adults between the ages of 30 to 50, although individuals of all ages, including children, can develop a chalazion.

Initially, chalazia can be difficult to diagnose as they are often confused with styes. A stye is also a red, swollen lump along the eyelid. However, styes are located on the edge of the eyelid or inside the eyelid’s immediate surface. They are more painful than a chalazion and typically occur closer to the eyelid’s surface. A stye is caused by an infection of the oil gland within the eyelid; a chalazion, in contrast, is caused by a blockage in the actual oil gland.

Causes and Risk Factors

Glands within the eyelids known as the meibomian glands naturally produce oil. Should a blockage within these glands occur, oil will build up inside the gland and eventually thicken, forming a lump known as a chalazion. In some cases, the gland may even break open, releasing the oil into the surrounding eyelid tissue, which causes inflammation. In some cases having a stye can also result in a chalazion. Risk factors for chalazion development include conditions associated with excessive oil production, such as seborrhea and acne rosacea. A viral infection, tuberculosis, and chronic blepharitis (inflammation of the eyelids and lashes) also increase the risk for developing a chalazion.

Diagnosis and Treatment

In some cases, a chalazion will resolve itself over the course of several weeks without the need for medical intervention. At-home remedies can speed the healing process. For example, an eye care provider may recommend the application of a warm compress to the eyelid for 10 to 15 minutes four to six times per day. Warmth from the compress can help soften the hardened oil that is blocking the gland, facilitating the healing process. Light massage on the external area of the eyelid may also help to facilitate drainage. Never attempt to squeeze or drain a chalazion by yourself. If the chalazion does not heal within one month, contact your eye doctor for additional medical care.

Stinging, irritated eyes, and blurred vision may indicate nothing more than a case of blepharitis — an unpleasant but, in most cases, relatively harmless condition. Blepharitis is a chronic eyelid inflammation caused by a variety of irritants and/or the inability to maintain proper eye lubrication. In some cases, bacterial infection may be involved. If you suffer from this annoying problem, don’t feel obliged to live with it — see your eye care professional to discover the cause of your blepharitis and get advice on how to relieve yourself of it.

Blepharitis may take one of two forms, anterior (toward the front of the eyelid, where the eyelashes begin) and posterior (on the inner edge of the lid). You may even have both types of blepharitis at the same time. Anterior blepharitis often occurs when dandruff flakes, allergens, or bacteria irritate the eyelid and eyelashes. Posterior blepharitis is the result of a failure on the part of tiny glands within the eyelid, known as meibomian glands, to produce sufficient lubrication between the eyelid and the cornea of the eye.

Typical symptoms of blepharitis include the formation of crusts along the eyelids, eye pain, redness, oozing, abnormal tear formation, irregularities in the arrangement of your eyelashes, and a tendency for the eyelids to stick together.

Getting Relief from Blepharitis

The good news is that most cases of blepharitis are more annoying than dangerous. While extreme cases may require medical treatment to prevent possible damage to the cornea, your eye care professional can recommend several simple home care practices you can adopt to keep this recurring problem at bay. These may include warm compresses, commercial eyelid cleansers, anti-dandruff shampoos, and artificial tears.

You may also be advised to stop wearing contact lenses or using eyeliner and eye shadow, since these practices can make people more prone to blepharitis. (Since blepharitis attacks tend to come and go, you may want to keep a pair of eyeglasses handy so you can continue to see clearly while treating the condition.) Even a massage of the outer eyelids can help relieve the condition.

No one enjoys the prospect of a chronic eye condition, but once you learn how to control your blepharitis instead of simply suffering with it, you will feel better both physically and emotionally. Contact your eye care professional for personal help and advice on this common yet irritating problem.

If you suffer from Bell’s palsy, a paralysis of one side of the face caused by nerve inflammation, you may lose control over your eyelids. This eyelid paralysis can create problems for the sensitive cornea that protects the eye’s lens and helps focus light waves into clear images. Fortunately, an experienced eye care professional can recommend measures to soothe and protect the afflicted eye.

Understanding Bell’s Palsy

What causes this form of paralysis, which strikes so suddenly that many sufferers think they’ve had a stroke? While doctors are not entirely certain, it would appear that the herpes or shingles virus can produce a bout of Bell’s palsy, along with viral meningitis or a facial injury.

Bell’s palsy occurs when the seventh cranial nerve, which relays motor commands and sensation to one side of the face, becomes impinged or inflamed. The pressure on the nerve stops the flow of information, causing severe weakness or total paralysis to the muscles on that side of the face — including the muscles that control the upper and lower eyelids. As a result, you may experience an outward drooping of the lower lid, while the upper lid may refuse to close without assistance.

While the nerve paralysis that causes Bell’s palsy may have no direct effect on your vision, it can cause serious eye issues indirectly. The inability to shut your eye, not even while sleeping, causes the cornea to dry out and develop dry eye syndrome. This is not unlike the dryness that occurs in computer users who forget to blink regularly. Lengthy periods of dehydration can lead to a painful condition called exposure keratitis.

Saving Your Eye from Pain and Irritation

Various medical treatments, including steroids and anti-viral drugs, can help you rebound from Bell’s palsy to regain total or near-total muscle control. In the meantime, however, you must take steps to protect your affected eye from dehydration. Hourly use of artificial tears, which are easily obtained over the counter, can help soothe and protect the cornea during the daytime. Your eye care professional may recommend you apply tape or a patch to keep the eyelid shut at night. In some cases, a special external weight may be prescribed. Ask your eye care professional to advise you on keeping your eye safe and healthy.

Ocular rosacea, an inflammation of the eye and/or eyelid, occurs in conjunction with rosacea of the skin. A chronic inflammatory condition, rosacea primarily affects the face, cheeks, forehead, and chest area. When rosacea affects the eyes and/or eyelids, the condition is known as ocular rosacea.

Ocular Rosacea Symptoms

Ocular rosacea primarily occurs in conjunction with rosacea of the skin, appearing either before, after, or at the same time as a skin flare up, but ocular rosacea can also develop independently. Symptoms of ocular rosacea include itchy, dry, burning, or stinging eyes; red or swollen eyelids; frequent sties; excessive tearing; eye redness (erythema); visible blood vessels on the whites of the eye; sensitivity to light; blurred vision; and the feeling of having something caught in the eye. Individuals with rosacea often do not realize they are also experiencing ocular rosacea, as eye symptoms are not always as severe as skin symptoms.

Who is at Risk?

Individuals with fair skin, a family history of rosacea, or who are prone to blushing or flushing are at a higher risk of developing rosacea. Among those who develop ocular rosacea, most are women between the ages of 30 and 60 or undergoing menopause.

When to See a Doctor

Individuals who experience any discomfort or symptoms of rosacea around their eyes or eyelids should visit an eye care professional at once. Patients who have been diagnosed with skin rosacea should visit an eye care professional periodically to rule out the possibility of ocular rosacea. If left untreated, ocular rosacea can lead to further medical complications such as blepharitis or chronic dry eyes, which can permanently damage the cornea and lead to vision loss.

Diagnosis and Treatment

An eye care professional diagnoses ocular rosacea simply by reviewing symptoms, looking over medical history, and examining the patient’s eyes and eyelids. As the exact cause of ocular rosacea is not yet understood, no cure exists. The symptoms, however, can be managed with oral antibiotics and regular cleaning of eyelids with a prescription solution. Sometimes an eye care professional might recommend artificial tears.

Eye care professionals also recommend patients with ocular rosacea make a few lifestyle adjustments, as certain activities have been shown to aggravate the condition. Activities that may aggravate ocular rosacea include consuming hot or spicy foods and beverages, drinking alcohol, undergoing both physical and emotional stress, getting too much sunlight, taking drugs which dilate the blood vessels like blood pressure medication, and exposing the skin to extreme cold or hot temperatures.

Seeing a spot or a flash of light in your field of vision is more than an inconvenience. It could be the first signs of a detached retina. A retina becomes detached when separated from underlying layers of support tissue. Detached retinas will lead to a permanent loss of vision if they are not quickly corrected.

Detached Retina Symptoms

Once the retina pulls away from surrounding supportive tissue, spots, floaters, and flashes of light start appearing. Additional symptoms crop up as detachment worsens, including blurry vision or shadows descending over the eye. These symptoms can either occur gradually or suddenly depending on the speed of detachment.

No pain is associated with these symptoms. If they occur, it is important to visit your eye doctor immediately. They can diagnose if you are suffering from a detached retina and take steps to help you regain your vision before it becomes permanently lost.

Detached Retina Causes

Eye or facial injuries are common causes for detached retinas. Athletes who get struck in the face or poked in the eye are usually most at risk for this method of retinal detachment.

Detached retinas can also result in cases of extreme nearsightedness. Nearsighted people have longer eyeballs and thinner retinas that are more prone to tearing or detaching. Sometimes, fluid movement or new blood vessels growing under the retina can also pull it away from surrounding tissue.

Cataract surgery, eye tumors, and diseases, such diabetes and sickle cell disease, can all lead to detached retinas. In extremely rare cases, retinal detachment can develop as a complication following LASIK surgery.

Detached Retina Treatments

Surgery is the only option for repairing a detached retina. It must receive immediate attention from an ophthalmologist who has received training to perform this surgery. Surgical reattachment doesn’t always work. Success depends on the location, cause, and extent of the detachment.

Surgical options for a detachment include:

Scleral Buckling Surgery – a small silicone or plastic band is attached to the outside of the eye. It compresses the eye inward and lets it reattach to the interior wall of the eye.

Vitrectomy – clear fluid is removed from the posterior chamber of the eye and replaced with clear silicone oil to push the retina back onto the supporting tissue.

Pneumatic Retinopexy – a small gas bubble is injected into the vitreous body to push the retina back onto the supporting tissue.

The cornea is present as a clear tissue that is located at the front of the eye. A corneal ulcer occurs when there is a sore in the layer of the cornea. Symptoms of this include redness, drainage, visual disturbances, sensitivity to light, itching and discomfort.

Causes and Effects of Corneal Ulcers

The most common cause of a corneal ulcer is infection. This can occur following damage to the eye. Other possible causes include fungi, eye dryness, a scratch in the eye, an inflammatory disorder, allergic eye disorders, and viruses.

Contact lens wearers are especially prone to corneal ulcers, especially if they wear their contacts while sleeping or while swimming.

Changes in vision may take place after a corneal ulcer has healed. It can also cause long term damage to the vision and even a loss of the eye itself. In some cases a corneal transplant may even be necessary. This is why it is important to seek treatment as soon as possible after noticing any symptoms.

Treatment of Corneal Ulcers

After examination of the eye, the eye care professional will determine what type of treatment is needed. If the corneal ulcer was caused by bacteria the doctor will likely prescribe a topical antibiotic for the eye. Culture of the eye drainage may be taken for further examination. If the doctor suspects a fungal infection topical anti-fungal medication may be needed. If the corneal ulcer is severe, oral agents may also be prescribed.

Prevention of Corneal Ulcers

The best way to avoid suffering from a corneal ulcer is protection of the eye. When doing any type of work or activity that would put yourself at risk for damage to the eye you should wear some type of mask, safety glasses, or goggles. If you are prone to dry eyes you can administer lubricating eye drops as needed. Contact lens wearers need to take proper care of the lenses in cleaning them and storing them. Contact lenses should never be worn while sleeping or swimming. Most importantly, proper hand washing is a must to avoid transmitting bacteria to the eye. This is the first line of defense in protecting your health.

Conjunctivitis, also known as pink eye, is a common eye problem that can afflict children and adults alike. It is highly contagious and spreads quickly in environments like classrooms or offices filled with multiple people in close proximity to one another. The good news is that conjunctivitis is easily treated and can be prevented.

Conjunctivitis Symptoms

Conjunctivitis gets the nickname pink eye because it gives the affected eye a shade of pink. Symptoms of pink eye vary depending on which of three types of pink eye you have contracted. One or both eyes can be affected by these symptoms.

Viral conjunctivitis produces watery and itchy eyes and causes sensitivity to light. It can be spread through coughing and sneezing.

Bacterial conjunctivitis creates a yellow-green discharge in the corner of the eye. It can cause your eyelids to stick together while you are sleeping. This type of pink eye is spread through direct contact with infected hands or objects.

Allergic conjunctivitis leads to watery, burning and itchy eyes. Other associated symptoms include a runny nose, stuffiness, and light sensitivity. Both eyes are affected by it, but this form of pink eye is not contagious.

Conjunctivitis Causes

Causes behind a case of conjunctivitis vary based on which type you have contracted. Some types of conjunctivitis are more dangerous to the long-term health of your eyes than others.

Viral conjunctivitis is caused by a virus. It is a contagious form of pink eye, but typically clears up on its own within a few days. Allergic conjunctivitis is usually connected with allergies, so it typically flares up when exposed to seasonal irritants like pollen or everyday irritants like dust or pet dander.

Bacterial conjunctivitis is the most dangerous type of pink eye. It results from a bacterial infection. If left untreated by an eye care professional, the bacteria can cause serious damage to the affected eye.

Conjunctivitis Treatments

Treatments for conjunctivitis vary based on the type afflicting your eyes. Viral conjunctivitis does not usually require medical treatment. A cold wet washcloth is often enough to relieve symptoms. Allergy medications can be effective in reducing or preventing bouts of allergic conjunctivitis. Bacterial conjunctivitis can only be treated through applying antibiotic eye drops or ointments prescribed by your eye care professional.

If you wear contact lenses, switch to eyeglasses until your eye care provider has performed an eye exam to determine which type of conjunctivitis is affecting your eyes.

Acanthamoeba keratitis is a relatively rare type of eye infection, but it can become quite serious. If left untreated, Acanthamoeba eventually leads to vision loss, requiring a corneal transplant to restore sight. Understanding how to prevent this infection is key.

What Is Acanthamoeba Keratitis?

Acanthamoeba is a type of microscopic, single-celled organism known as an amoeba. Acanthamoeba live in all sorts of water sources. These parasites exist in tap water, natural bodies of water, wells, hot tubs, sewage, and can survive in the moisture in soil. When an Acanthamoeba infects the translucent, outer layer of the eye (the cornea), Acanthamoeba keratitis results.

Symptoms of Acanthamoeba Keratitis

The symptoms of Acanthamoeba keratitis include eye pain, redness, sensitivity to light, blurred vision, excessive tearing, and the sensation that something is stuck in one’s eye. These symptoms reflect those of more common eye infections like pink eye, and as a result the infection can be misdiagnosed.

If you experience any of these symptoms, it is important to see an eye care professional right away, as Acanthamoeba keratitis and other eye infections can lead to permanent loss of vision if not addressed immediately.

Who Is at Risk of Contracting Acanthamoeba Keratitis?

Individuals who wear contact lenses are substantially more likely to become infected with Acanthamoeba keratitis. Improperly cleaned and disinfected contact lenses, wearing contact lenses while swimming, bathing, showering, or hot tubbing also increase the risk.

Precautions against Acanthamoeba Keratitis

One can take several precautions against becoming infected with Acanthamoeba keratitis, such as always taking proper care of contact lenses, which includes cleaning and rubbing them after each use with a brand of contact solution recommended by an eye care professional. Disinfecting a contact lens case while not in use may also prevent infection. It is also recommended that contact wearers avoid wearing contact lenses while swimming, showering, or participating in any water-related activity. If a patient chooses to wear contact lenses in the water, airtight swimming goggles should be worn, and lenses should be removed for cleaning immediately after.

Diagnosis and Treatment

The Acanthamoeba keratitis infection is often mistaken for more common eye conditions, and usually not properly diagnosed until after the failed use of antibiotics. Once diagnosed, Acanthamoeba keratitis can be fairly difficult to cure, but is treated with topical anti-microbial agents. If symptoms persist, a corneal transplant might be necessary for the patient to achieve a full recovery.

Most people classified as blind still retain some ability to see. They often have significantly impaired vision but can discern light, shapes, or other figures. Low vision refers to a class of visual impairment that cannot be corrected by glasses or contact lenses. A number of conditions may cause low vision, and actual visual abilities may vary by individual. A thorough assessment by an eye care provider can help you determine the severity of your visual impairment and identify potential avenues for treatment.

What Is Considered Low Vision?

A person is typically considered “legally blind” if he or she has vision that cannot be corrected to better than 20/200. The World Health Organization defines low vision by degree of impairment. Someone whose best corrected vision (in his or her best eye) is 20/70 to 20/160 has moderate low vision; vision in the 20/200 to 20/400 range is considered severe low vision; from 20/500 to 20/1,000 is profound low vision; and less than 20/1,000 is near total blindness. Only if someone cannot discern any light is he or she considered to be totally blind.

So what does this mean for you? If you have a visual condition that prevents your visual abilities to be fully corrected to near 20/20, you may have low vision. Significant loss of visual field, such as the inability to see in peripheral areas, is also considered low vision.

Causes of Low Vision

Low vision does not refer to a single etiology of vision loss. Rather, it is a cluster of conditions that significantly impair visual abilities. Common causes of low vision include macular degeneration, diabetic retinopathy, retinal detachment, cataracts, or glaucoma. Many of these conditions are associated with aging, and older adults are more likely to experience low vision. However, traumatic brain injury, eye injuries, and some genetic conditions can cause low vision at any age.

Diagnosis and Treatment

A thorough optometry exam is the best way to diagnose low vision. Your eye care provider will test your visual acuity, visual fields, and ability to detect color and contrast. Although by definition, low vision cannot be corrected by prescription glasses or surgery, some therapeutic options can help you continue activities of daily living. Magnifying devices, using large-print materials, and increasing contrast may facilitate everyday activities. Other aids, such as books-on-tape or talking watches may also be helpful. Discuss your visual impairment with your optometrist to come up with a plan to improve your quality of life despite low vision.

Color blindness, also known as color vision deficiency, occurs when an individual cannot distinguish between certain colors like red and green or, less commonly, blue and yellow.

Cause of Color Blindness

Light-sensitive tissue, the retina, lines the back of the eye and consists of two types of light distinguishing cells: rods and cones. While rods detect or see light and dark, cones are responsible for detecting color and sending the information to the brain for processing. Your eye has three types of cones; one for perceiving red, another for blue, and third for green. In a healthy eye, the cones work together to facilitate your ability to see a broad range of colors. When one or more type of cone functions abnormally, color deficiency occurs.

Color Blindness Symptoms

Depending on which cones are affected, the symptoms of color blindness range from mild to severe. Mild color blindness is defined as difficulty distinguishing colors in low light, and severe color blindness can leave someone seeing only a range of grey tones. Symptoms of color blindness include having difficulty seeing colors or their brightness, and the inability to distinguish between different colors. People with color blindness most frequently have a hard time telling the difference between red and green or blue and yellow.

Risk Factors for Color Blindness

Most individuals with color deficiency are born with it. Congenital color blindness is usually inherited as a genetic trait passed down from mother to son. Males are much more likely than females to inherit color deficiency, experiencing color blindness from birth.

Color blindness, however, can develop as the result of disease, medical conditions, trauma, or as a side effect of medication. Conditions that may lead to color blindness include macular degeneration, glaucoma, Parkinson’s disease, Alzheimer’s disease, leukemia, sickle cell anemia, and alcoholism. Color blindness which develops later in life as the result of a condition is known as acquired color deficiency.

Diagnosis and Treatment

An eye care professional diagnoses color blindness with a simple test. The patient is shown diagrams comprised of differently colored dots. Color blind individuals will not be able to distinguish shapes or numbers hidden among the dots in a different color.

While there is no cure for congenital color blindness, special lenses for glasses or contacts have been developed to help color deficient individuals distinguish between colors. Acquired color blindness can sometimes be treated by addressing the underlying cause.

Nystagmus is a vision condition characterized by repetitive, uncontrolled eye movements. These involuntary eye movements may be side-to-side, up and down, or in a circular pattern, which hinders the eyes’ ability to focus on a steady object. Individuals with nystagmus may hold their heads in unusual positions or nod their heads in an effort to compensate for these vision obstructions. Nystagmus that develops in childhood is typically inherited; if this condition develops later in life, it may be due to an accident injury. In some cases, however, the exact cause for nystagmus is not fully known.

Types of Nystagmus

Forms of nystagmus include congenital nystagmus and acquired nystagmus. Congenital typically develops between two and three months of age. Eyes appear to move in a horizontal swing fashion. Congenital nystagmus is associated with conditions like undeveloped optic nerves, albinism, congenital cataracts, and the congenital absences of the iris.

Acquired nystagmus generally occurs in adulthood. While the cause is typically not know, this condition may be triggered by central nervous system issues due to alcohol or drug toxicity, stroke, multiple sclerosis, or a blow to the head.

Diagnosis and Treatment

A comprehensive eye exam is necessary to diagnose nystagmus. An eye care professional will first study a patient’s history to determine whether environmental factors, general health problems, or medications could be causing any of the symptoms the patient is experiencing. Next, visual acuity measurements will be taken to assess the extent to which vision has been compromised. These tests will help determine the appropriate refractive lens necessary to compensate for nearsightedness, farsightedness, or astigmatism. Finally, tests will be done to determine how the eyes work together to move in unison and focus on a single object.

While there is no “cure” for nystagmus, treatment options are available to help correct other vision problems that may be associated with this condition. Depending on the type of nystagmus, it is also possible that the condition will spontaneously correct itself. In extremely rare cases, surgery may be performed to alter the position of the muscles that move the eye. However, lifestyle changes such as using large-print books, increased lighting, and magnifying devices are generally the preferred treatment methods.

The condition known as a macular hole refers to a tiny break in the macula that results in blurry or distorted vision. To fully understand the condition, one must understand eye anatomy. The macula is a spot located in the center of the retina (the back portion of the eye). Located where light comes to a focused point in the eye, the macula is the portion of the eye most concentrated with color detecting cones and responsible for seeing clear color vision. The rest of the retina is covered with photosensitive rods, which detect darkness, light, or movement.

Symptoms

Macular hole development usually occurs gradually. As a result, the first symptoms include slight distortions of vision. For example, straight lines might appear wavy or you might have difficulty reading or recognizing faces. A sudden loss of vision in one eye usually follows these early symptoms.

Causes

A gel-like substance called vitreous fills most of the eye’s interior. Millions of fibers attach the vitreous to the retina, holding it in place and maintaining the eye’s round shape. Vitreous begins to shrink with age, and pull away from the retina, leaving pockets of space which become filled with fluid. Normally, this process occurs with no adverse effects. However, if the vitreous shrinks and the fibers are firmly attached, it can tear the retina. The fluid which then fills the void space can seep through the retina and pool on the macula, distorting and blurring vision.

Since most cases of macular holes develop as the result of age, individuals over the age of 60 are at the highest risk. Macular holes, however, can also develop due to injury, severe nearsightedness (myopia), retinal detachment, or macular pucker.

Diagnosis and Treatment

If left untreated, a macular hole can worsen over time, leading to permanent vision loss. If you notice any unusual eye symptoms, you should seek treatment with an eye care professional right away.

The most common treatment for a macular hole is a surgical procedure called a vitrectomy, and is performed by a retinal specialist. In this procedure vitreous gel and fibers are removed from the middle of the eye to prevent further tearing of the retina. A mixture of air and gas is then inserted into the space once filled with vitreous, putting pressure on the macular hole and allowing it to heal.

As we age, our eyes—like the rest of our bodies—begin to lose flexibility and strength. When this happens to the lens of the eye and its surrounding muscles, your lens will become stiff. This makes it harder to see close objects clearly because the eyes can’t focus properly. It’s a natural part of aging that typically begins around age 40. Presbyopia can be corrected easily with eyeglasses or contact lenses from an optometry clinic.

Is Presbyopia the Same as Farsightedness?

No. Farsightedness is caused by distortions in the shape of the eyeball. Presbyopia occurs when your lens becomes stiff.

What Are the Symptoms of Presbyopia?

• A need to hold things at arm’s length to read them
• Blurry vision when reading things at a normal distance
• Fatigue or headaches after doing work at a close distance

How Is Presbyopia Diagnosed?

Your eye care provider will conduct a thorough eye exam and check for presbyopia.

How Is Presbyopia Treated?

To help correct the symptoms, your eye care provider may advise you to use aids such as:

• Prescription eyeglasses
• Contact lenses
• Reading glasses
• Progressive lenses
• Bifocals

Most commonly, bifocals or progressive lenses are recommended. The top portion of the eyeglass lenses correct vision at long distances, and the bottom portion helps you see clearly up close. Bifocals have a distinct edge between the two prescriptions, but progressive lenses have a graduated transition between the areas.

Over time, if your presbyopia continues to change your vision, then you may need to update your eyewear periodically to maintain clear vision.

If you prefer a more permanent treatment, ask your eye care provider if you’re a good candidate for conductive keratoplasty. In this procedure, precise radio waves reshape your cornea to improve your vision of nearby items.

As a sign of natural and healthy aging, presbyopia can be annoying, but it’s easy to address. Whether you prefer glasses, contact lenses or surgery, talk with your eye care provider to find out which options are best for you.

Bell’s Palsy And Your Vision

In addition to temporarily paralyzing the muscles in your face, Bell’s palsy may also cause some distressing changes to your eyes. Fortunately, your ophthalmologist offers treatments that will improve your comfort and protect your eyesight.

What Is Bell’s Palsy?

Bell’s palsy happens when a nerve that controls facial muscles becomes inflamed. The inflammation weakens the muscles that control your eyelid or prevents them from moving. Doctors believe that Bell’s palsy could be caused by viruses responsible for a variety of illnesses, including chickenpox, cold sores, shingles, mumps, German measles, the flu, genital herpes, pneumonia, or hand-foot-and-mouth disease.

Symptoms of Bell’s palsy can include:

• Facial sagging on one side of your face
• Drooping mouth
• Lopsided smile
• Inability to raise your eyebrows
• Headache
• Loss of feeling on the affected side of the face
• Drooling
• Loss of taste
• Difficulty eating or drinking
• Trouble pronouncing some sounds
• Stiff neck
• Fever
• Sensitivity to noise

Bell’s Palsy and Dry Eye

Bell’s palsy may make it difficult or impossible to blink or close your eye and could also cause your lower eyelid to droop. As a result, your eye may become too dry and you might experience:

• A stinging or burning sensation in your eye
• Redness
• Light sensitivity
• A feeling that something is stuck in your eye
• Stringy mucus

A dry eye is more than just an annoyance. In fact, dry eye increases your risk of developing a corneal ulcer, a painful sore on your cornea. The cornea, the clear, rounded tissue over your pupil and iris, bends the light rays that enter your eyes and keeps germs, dirt, dust, and debris from entering your eyes. If the ulcer scars your eye, your vision could be affected. Keeping your eye moist will reduce your risk of an ulcer.

Watery Eyes Can Be a Problem If You Have Bell’s Palsy

A watery eye is one of the more annoying symptoms of Bell’s palsy. Excessive tearing can be related to:

• Dry Eye. When your eye becomes too dry, your tear glands go into overdrive and flood your eyes with tears.
• Weakness or Paralysis of the Orbicularis Oculi Muscle. This muscle makes it possible to close your eyes and also helps move tears from your eyes to the nasolacrimal duct system. Tears constantly drain through the ducts into your nose. When the orbicularis oculi muscle is paralyzed or weak, tears build up in your eye instead of draining.

How Are Eye Problems Treated?

Your ophthalmologist can recommend several treatments and strategies that will make you more comfortable, including:

• Lubricating Eye Drops and Ointments. Eye drops will keep your eye comfortably moist during the day. During the night, the ointment may be a better option, as it keeps your eye lubricated longer than drops.
• Patching the Eye. Sleeping can be difficult when you can’t close one eye. Patching the eye may make it easier to sleep and also keep your eye from drying out when you sleep. Before you put the patch on, you’ll apply drops or ointment.
• Medications. Corticosteroids decrease nerve inflammation and may help speed your recovery from Bell’s palsy. Anti-viral medication can also be helpful if your symptoms are severe, according to UpToDate.

If you develop a corneal ulcer, your ophthalmologist can prescribe pain medication. They may also give you antibiotic, antifungal, or antiviral eye drops. In most cases, corneal ulcers heal without causing scarring. If a scar does form, you may need a corneal transplant if the scar interferes with your vision.

Are you struggling with eye issues due to Bell’s palsy? Contact our office to schedule an appointment with an ophthalmologist.

Sources:

All About Vision, Bell’s Palsy: Symptoms, Risks, Diagnosis and Treatment, 1/22

UpToDate: Patient Education: Bell’s Palsy (Beyond the Basics)

Korean Journal of Ophthalmology: Ophthalmologic Clinical Features of Facial Nerve Palsy Patients, 2/1/19

National Institute of Neurological Disorders and Stroke: Bell’s Palsy Fact Sheet

How Age-Related Macular Degeneration (AMD) Affects Your Driving

Vision changes due to macular degeneration may make you wonder if it’s safe to get behind the wheel. Although you will most likely need to give up driving if you have severe vision loss, driving may still be possible if you’re in the early stages of the disease.

Wet Vs. Dry AMD and How It Changes Your Vision

Age-related macular degeneration (AMD) occurs when cells in your macula begin to thin and deteriorate. The macula is located in the center part of the retina and is responsible for color and clear central vision.

Your ophthalmologist may diagnose you with either of these forms of macular degeneration:

• Wet. New blood vessels grow in your macula and leak blood or fluids.
• Dry. The macula becomes progressively thinner, causing changes to your vision.

Macular degeneration can cause blurry central vision or blank spots in your central vision, which can make reading, sewing, recognizing friends, cooking, using the computer, driving, and other tasks difficult.

The Challenges of Driving with Macular Degeneration

Blurriness or blind spots make it difficult to see traffic lights, spot obstacles, or people entering crosswalks. Obviously, this may affect your ability to drive safely, even if you’re a careful driver.

Australian researchers were curious about the ways macular degeneration affects vision. They asked 33 drivers 65 and older with AMD to drive while being monitored by a driving instructor and an occupational therapist.

During the drive, the occupational therapist scored the driver on multiple tasks, including:

• Lane position
• Observation of blind spots
• Use of turn signals
• Scanning and attention
• Gap selection between other cars and when entering traffic
• Planning and preparation for hazards

The researchers reported that drivers with AMD had trouble with:

• Choosing gaps in traffic when changing lanes or entering the road
• Planning ahead when deciding whether to move forward or yield to traffic
• Staying in their lane
• Scanning and observing their surroundings
• Changing lanes
• Pulling in and out of traffic

Navigating intersections controlled by traffic lights were the most difficult situation for AMD drivers. The researchers theorized that this could be due to the multiple skills needed to drive through intersections, such as scanning the scene, making strategic decisions, and course planning.

Should You Drive If You Have AMD?

Despite the challenges, many people who have early AMD can drive safely. Regular visits with your ophthalmologist are particularly important if you’ve been diagnosed with macular degeneration. Although you may feel that you can see well, you may not realize the extent of your vision loss. Luckily, your ophthalmologist can perform a few tests that will help you determine if driving is a good idea for you.

Driving may be easier if you:

• Avoid Night Driving. Glare from headlights can make it hard to see when you have AMD.
• Turn Your Head. You may need to turn your head back and forth much more than usual if you have a blurry spot in your vision.
• Stay Away from Busy Roads. Although driving around your neighborhood may pose no problem, it may be best to avoid highways or roads with complicated traffic patterns.
• Only Drive When Conditions Are Ideal. Postpone trips if the weatherman forecasts storms.
• Try Bioptic Telescope Glasses. Driving may be easier if you use glasses that contain tiny telescopes. The telescopes magnify objects in the distance. During the majority of your drive, you’ll look through the main part of the glasses. A quick glance through the telescope will make it easier to read road signs or see an upcoming traffic light clearly. Your eye doctor can help you decide if these glasses will be helpful for you. The state motor vehicles department may require you to take a driving test to prove that you can drive safely while wearing the glasses.

Are you not sure if driving is a good idea for you? Contact our office to schedule a comprehensive eye exam.

Sources:

Bright Focus Foundation: Driving and Age-Related Macular Degeneration, 8/18/21

NCBI: Investigative Ophthalmology & Visual Science: Effects of Age-Related Macular Degeneration on Driving Performance: 1/2018

American Academy of Ophthalmology: What Is Macular Degeneration?, 1/26/21

International Academy of Low Vision Specialists: Driving with Bioptic Telescopic Glasses: Confusion, Controversy, False Assumptions, 11/2019

Is Menopause to Blame for Your Dry Eye?

Hot flashes, dry and itchy skin, weight gain, and mood swings aren’t the only issues women face during menopause. Changing hormone levels may also cause your eyes to become dry and irritated.

Why Does Dry Eye Occur?

Dry eye happens due to problems with tear quantity, production, or quality. Your tear film lubricates your eyes, removes debris, and keeps your vision clear. Tears are made up of mucus, oil, and aqueous fluid, three substances that work together to keep your eyes moist and comfortable.

Although everyone’s eyes become dryer as they age, the problem is particularly common in older women. In an Indian study published in The Tropical Journal of Ophthalmology and Otolaryngology, 52 percent of post-menopausal women suffered from dry eye.

In addition to dryness, symptoms of the condition include:

• Itching
• Burning
• Redness
• Watery eyes
• Blurry vision
• Stringy discharge
• Sensitivity to light
• Gritty sensation or a feeling that something is stuck in your eye

Dry eye may make wearing contact lenses uncomfortable, even if you’ve been wearing them without problems for years. Dryness increases your risk of corneal abrasions, painful scratches on the clear layer of tissue that covers your iris and pupil. Corneal ulcers, open sores on your cornea, can also happen if your eye isn’t moist enough. Without prompt treatment, corneal ulcers may damage your vision.

How Hormonal Changes Cause Dry Eye

Hormones control many functions in your body, including sleep/wake cycles, growth, heart rate, energy production, and breathing. Estrogen, progesterone, and androgens, hormones commonly called “sex hormones,” make reproduction possible and also affect your cholesterol level, bone and muscle health, mood, and metabolism, in addition to keeping your eyes well lubricated.

During peri-menopause, sex hormone levels begin to drop. When you no longer have periods, your body stops making progesterone, while the production of estrogen and androgens, including testosterone, decreases dramatically.

When sex hormones decrease, these changes happen:

• Tears evaporate too quickly
• The oil-producing glands make less oil
• Your tears don’t lubricate your eyes properly

Hormone replacement therapy might seem like a simple solution to the problem, but the therapy might be more harmful than helpful in some cases. Some women notice that dryness improves while taking hormone replacement medication, while others experience more severe dry eye symptoms, according to a 2017 article in the Journal of Mid-Life Health.

What You Can Do About Dry Eye

Using lubricating eye drops or artificial tears during the day will relieve your dry eye symptoms and discomfort. Look for drops that are preservative-free, as products that contain preservatives may irritate your eyes.

You may also want to:

• Use Different Drops at Night. Gel-based drops don’t evaporate as quickly as other types of drops. Using these drops may help you avoid middle-of-the-night pain due to dryness.
• Limit Your Exposure to Blowing Air. Dry eye symptoms can worsen due to exposure to blowing air from heating and air-conditioning vents. Moving your desk at work away from vents or closing a vent in the car may help you reduce your symptoms.
• Wear Your Contact Lenses for Shorter Periods. You might not be able to tolerate wearing your contacts all day anymore, but you may be able to wear them for a few hours at a time. Ask your ophthalmologist about switching to a lens type that holds in moisture.
• Use Sunglasses. Wrap-around sunglasses reduce tear film loss and help you avoid irritation on windy and sunny days.
• Treat Your Allergies. Seasonal allergies can make your dry eyes feel even worse. Keeping your allergies under control with allergy medication or eye drops can be helpful.
• Use Warm Compresses. Moist, warm compresses soothe your eyes and remove blockages from oil glands.
• Increase Humidity. Your eyes may feel a little more comfortable if you use a humidifier to increase moisture in the air.
• See Your Ophthalmologist. If your eyes are still dry, your eye doctor can recommend helpful treatments. Treatment options may include prescription eye drops that reduce inflammation or increase tear production. If you have moderate to severe dry eye, lubricating eye inserts that dissolve over the course of the day may be helpful. Other treatment options include an in-office treatment that unclogs blocked oil glands or plugs inserted into the tear ducts to reduce tear drainage.

Are you struggling with dry eye symptoms? Our office offers treatments that can ease your symptoms and improve your comfort. Contact us to schedule an appointment.

Sources:

The Tropical Journal of Ophthalmology and Otolaryngology: Study of Dry Eye in Post-Menopausal Women, 9/19

NCBI: Journal of Mid-Life Health: Dry Eye Syndrome in Menopause and Perimenopausal Age Group, 4-6/17

Healthline: Menopause and Dry Eyes: What’s the Link?, 11/27/17

All About Vision: Dry Eyes After Menopause, 11/21

11 Common Causes of Eye Pain

It’s only natural to worry if you have pain in or around your eyes. Although it’s important to see the ophthalmologist if your eyes hurt, pain doesn’t necessarily mean that you have a serious problem. Your pain could be caused by:

1. Dry Eye. Dry eye is a common complaint in the U.S. According to the National Eye Institute, nearly 16 million Americans have this painful, annoying condition. In addition to pain, you may experience itching, burning, stringy eye discharge, or a feeling that something is stuck in your eye. Lubricating drops that moisten your eyes and relieve your discomfort can help keep dry eye under control. If the drops don’t help, your eye doctor may recommend other treatments, such as medications to increase tear production or reduce inflammation. They may also recommend a procedure that blocks tear ducts and improves your tear film.

2. Eyestrain. Did your pain start after reading, driving, or looking at a digital screen for hours? You may have eyestrain. Other symptoms can include double or blurred vision, dry eyes, sensitivity to light, headaches, and neck or shoulder pain. Using eye drops to moisten your eyes and taking frequent breaks can be helpful if you experience eyestrain.

3. Corneal Abrasion. Pain in your eye could also be caused by a scratch on your cornea, the clear, rounded tissue that covers your iris and pupil. Called “corneal abrasions,” these injuries can be quite painful but usually begin to get better in just a few days. While your eye heals, you may need to take over-the-counter pain medication or use special lubricating drops.

4. Foreign Body. A speck of dust, a shard of glass, or a piece of sand in your eye could be to blame for your pain. Although you may be able to flush out dust or sand with clean water, you’ll need to pay a visit to the ophthalmologist if any other foreign body is stuck in your eye. They will apply drops that numb your eye, then remove the object. In some cases, stitches, antibiotics, or surgery may be needed.

5. Infections. Pink eye is the most widely known eye infection, but any viral, fungal, or bacterial infection in the eye can cause pain. If not treated, some eye infections may even lead to vision loss. Infections can happen if you don’t wash your hands before touching your eyes, handling contact lenses, or have a cut on your eye. Prescription eye drops are helpful in treating infections and reducing inflammation and pain.

6. Periorbital Cellulitis. This painful condition is due to an infection in your eyelid or the skin surrounding your eye. You’ll need to take antibiotics to prevent the infection from spreading to your eye socket.

7. Shingles. Shingles can affect your eyes too. Signs and symptoms include pain, blurry vision, vision loss, light sensitivity, and redness. Prescription eye drops that dilate (widen) your pupils can decrease pain, while steroid drops reduce inflammation.

8. Optic Neuritis. Pain, blurry vision, faded colors, and blank spots in your vision could be symptoms of optic neuritis. The condition occurs when the optic nerve, the pathway between the brain and the eyes, becomes swollen and inflamed. Optic neuritis often gets better on its own, although in some cases, your eye doctor may recommend intravenous (IV) steroids to decrease swelling and inflammation.

9. Optic Neuropathy. Damage to the optic nerve due to blood flow issues can cause optic neuropathy. In addition to pain, symptoms can include vision loss, faded vision, loss of peripheral vision, or flashing lights. Anti-inflammatory medication or blood pressure drugs can help prevent further damage to your vision.

10. Uveitis. Uveitis, a condition that occurs due to inflammation in the middle part of the eye, causes pain, redness, blurry vision, light sensitivity, and small pupil size. Without treatment, uveitis can cause permanent vision loss. Uveitis treatment depends on the severity of the inflammation but may include antibiotics or anti-fungal medication, steroids, anti-inflammatory injections, or medications that suppress the immune system.

11. Glaucoma. A sudden increase in the pressure inside your eye can cause pain, loss of vision, blurry vision, halos around lights, and nausea if you have angle-closure glaucoma. The problem occurs when your iris blocks drainage channels inside your eye. Angle-closure glaucoma treatment involves emergency surgery to improve drainage.

Other Reasons Your Eye May Hurt

You may also experience eye pain due to eyelid inflammation, migraines, sinus infections, or styes. Treating eye pain as soon as possible helps protect your eyesight. Contact our office if your eye hurts or you’ve noticed any changes in your vision.

Sources:

National Eye Institute: Dry Eye, 12/22/20

All About Vision: Eye Pain: Causes of Pain In, Around, or Behind Your Eyes and Treatment Options, 6/ 20

Cleveland Clinic: Eye Pain: Possible Causes

A Broken Blood Vessel In Your Eye: Is It a Cause for Concern?

Seeing a red spot on your eye when you look in the mirror can be a little frightening. Fortunately, subconjunctival hemorrhages, or broken blood vessels, are rarely serious.

What Causes Broken Blood Vessels?

A network of small blood vessels brings oxygen and nutrients to your eyes. If one of these vessels breaks under the conjunctiva, the clear tissue that covers your eye, you may notice a red streak or spot on the white part of your eye. Broken blood vessels may look like a tiny pinpoint of blood or might cover nearly all of your eye.

A blow to the face can cause a broken blood vessel, but an injury isn’t the only reason you may notice a change in your eye’s appearance. Subconjunctival hemorrhages can also be caused by:

• Sneezing or coughing
• Vomiting
• Rubbing your eyes
• Lifting something heavy
• Straining during a bowel movement
• An illness
• Eye surgery

You may be more likely to develop broken blood vessels if you have high blood pressure or diabetes, take blood thinners, are over age 50, have a blood clotting disorder, or wear contact lenses, according to All About Vision. Broken blood vessels are common in newborns. They’re usually related to pressure against the eyes during childbirth.

What Are the Symptoms of a Broken Blood Vessel?

A red spot in your eye and mild irritation may be the only symptoms you’ll experience if you have a broken blood vessel. Although the bloody spot may look scary, broken blood vessels don’t usually cause pain or affect your vision.

How Are Broken Blood Vessels Treated and Prevented?

Broken blood vessels usually go away on their own, although they won’t disappear overnight. Depending on the size of the broken vessel, your spot may begin to fade in a few days or several weeks. Call your eye doctor if your eye does not start to look better in a few weeks. If the broken vessel irritates your eye, use artificial tears to keep your eye moist and improve lubrication.

It’s a good idea to see your ophthalmologist if broken blood vessels are a frequent occurrence. Your eye doctor can determine if the broken vessels are caused by a problem with your eye or are related to an eye care issue, such as wearing contact lenses too long. If your eye doctor suspects that you may be experiencing broken blood vessels due to an underlying health condition, he may refer you to your family doctor or a specialist.

Keeping chronic conditions, like diabetes and high blood pressure, under control can decrease broken blood vessels. It’s also important to protect your eyes when you use power tools, work with chemicals or hazardous substances, or play sports. Goggles or safety glasses with impact-resistant lenses will prevent broken blood vessels and serious eye injuries.

Avoiding the urge to rub your eyes will also lower your risk of broken blood vessels. If your eyes often feel itchy and uncomfortable, you may have allergies. Avoiding allergens that trigger your symptoms and taking allergy medication can improve eye comfort and reduce eye rubbing.

Are you concerned about a broken blood vessel or another eye issue? Contact our office to schedule an eye exam.

Sources:

American Ophthalmology: What Is a Subconjunctival Hemorrhage?, 5/27/21

Medline Plus: Subconjunctival hemorrhage, 5/1/19

All About Vision: Subconjunctival Hemorrhage, 9/21

Can Botox Help Your Eye Condition?

Botox injections aren’t just a good idea if you want to look younger. The injections are also helpful in treating a variety of eye conditions.

The Botox Effect

Botox injections block nerve impulses that control muscle contractions. As a result, the muscle no longer moves. The effect is temporary and usually lasts about three to four months. Botox injections are safe and approved by the U.S. Food and Drug Administration.

Botox Can Stop Eyelid Spasms

Benign essential blepharospasm, a condition that causes spasms in your eyelids, can be improved with Botox treatment. Blepharospasm can affect anyone, but it’s more common in women ages 40 to 60, according to the National Eye Institute.

Although an occasional eyelid spasm is nothing more than an annoyance, frequent spasms interfere with your vision. If you have blepharospasm, you may find it difficult to drive, watch TV, read, or work. Injecting Botox into your eyelid muscles offers a simple way to relieve your spasms.

Retracted Eyelids Respond Well to Botox Treatment

Graves disease, a thyroid-related condition, can cause the eyelids to retract, exposing more of your eyes. Overproduction of the thyroid hormone can lead to eye problems, in addition to weight loss, weak muscles, fast heartbeat, irritability, trouble sleeping, and goiter (an enlarged thyroid gland).

Your eyelids protect your eyes and help keep them moist. When your eyelids begin to retract, you may experience dry eye, redness, and a gritty feeling in your eyes. You may also be more likely to develop corneal ulcers, painful sores that form on the clear, rounded layer of tissue that covers your iris and pupil.

Botox injections weaken the muscles that control your eyelids, allowing them to relax.

Strabismus Symptoms May Improve After Botox Treatment

Strabismus, or “crossed eyes,” occurs when your eyes aren’t aligned properly. One or both eyes might turn inward, outward, up, or down. Strabismus can cause double vision, blurry vision, and depth perception problems, even if you only have a mild misalignment. Without treatment, you’re more likely to develop amblyopia (lazy eye), a condition that occurs when the eye ignores the information from one eye.

Misaligned eyes may be caused by a problem with your eye muscles or the center in the brain that controls the movements of the muscles. Weakening one or more of the muscles with Botox injections offers a simple, non-surgical way to improve eye alignment.

Other Eye Conditions That Can Be Helped with Botox

Your ophthalmologist may recommend Botox to treat other eye conditions, including:

• Hemifacial Spasms. These spasms affect one side of the face, including the eye. Botox injections stop the spasms, ending the bothersome symptoms.
• Bell’s Palsy. Bell’s palsy occurs when one side of the face droops due to paralysis or weakness caused by nerve damage. Botox injections are helpful if your eyes are abnormally watery due to the condition.
• Migraines. Migraines can cause visual disturbances called auras before the headache pain starts. Botox injections reduce the number or severity of migraines you get, helping you avoid auras.
• Sagging Eyelids. As you get older, your upper eyelids may begin to sag and protrude over your eyes, interfering with your vision. Botox can relieve minor sagging, although you may need surgery to correct severe sagging.
• Tourette’s Syndrome. Botox can also be helpful if you have uncontrollable eye movements due to your Tourette’s syndrome tics.

Could Botox improve your eye condition? Contact our office to schedule an appointment to find out if the treatment could benefit you.

Sources:

National Eye Institute: Blepharospasm

MedPage Today: Botox-Type Drugs Can Treat Many Eye Conditions

American Academy of Ophthalmology: Clinical Uses of Botulinum Toxin in Ophthalmology

American Academy of Ophthalmology: Eyelid Spasm and Twitching Treatment, 9/22/20

What is Proptosis?

If your eye bulges outward, you may have an eye problem called proptosis. Although the condition is often related to thyroid disease, it can have other causes. If you are diagnosed with proptosis, your ophthalmologist will offer treatments that will help you protect your eye.

What Causes Proptosis?

Proptosis can be caused by eye injuries, cancerous tumors, bleeding in the eye socket, eye infections, inflammation, or abnormal blood vessels behind the eyes. A thyroid problem called Grave’s disease is the most common cause of the condition, according to the Merck Manual.

Grave’s disease is an autoimmune disorder that occurs when the thyroid gland becomes more active than usual and produces too much thyroid hormone. If you have Grave’s disease, you may notice some of these symptoms:

• Shaky hands
• Trouble tolerating hot temperatures
• Unintended weight loss
• Racing heartbeat
• Irritability
• Anxiety
• Fatigue
• Weak muscles
• Shaking hands
• Difficulty sleeping
• Thick, red skin on the shins or tops of the feet

How Does Grave’s Disease Affect the Eyes?

About a third of people who have Grave’s disease also develop eye symptoms, according to the American Thyroid Association. In addition to bulging eyes, symptoms may include:

• Eye pain or pressure
• Redness
• Puffy or retracted eyelids
• A gritty feeling in the eyes
• Dry eye
• Difficulty closing your eyes
• Sensitivity to light
• Trouble moving the eyes
• Vision loss

How is Proptosis Treated?

Proptosis can make your eyes feel uncomfortable and may even threaten your ability to see. If you can’t close your eyes completely, they may become too dry. When your eyes are dry, you’re more likely to develop sores on your cornea, the clear layer of tissue that covers the iris and pupil. These sores can be very painful and could scar the cornea, causing permanent vision damage.

Fortunately, visiting your ophthalmologist when you first notice changes in your eye can help you avoid vision loss. At your appointment, you’ll discuss your symptoms and review your medical history, including eye infections and injuries.

Your ophthalmologist might order a computerized tomography (CT) or magnetic resonance imaging (MRI) scan to determine why your eye or eyes are bulging, in addition to a blood test to check your thyroid hormone level.

Since many people diagnosed with proptosis have Grave’s disease, your ophthalmologist will want to know if you have any of the common symptoms of the disease. If your eye doctor suspects that Grave’s disease is the cause, they will refer you to an endocrinologist, a doctor who specializes in treating disorders that affect the glands that produce hormones. You’ll see both doctors during your treatment.

Your treatment will depend on the cause. If you have an infection, antibiotics will be prescribed, while surgery may be needed if you have a tumor. Keeping your thyroid hormones under control will be helpful if you have Grave’s disease. Your endocrinologist may prescribe medications that lower the production of the hormones, recommend radiation therapy to shrink the gland, or suggest surgery to remove it.

Although the treatments will help ease your Grave’s disease symptoms, you may still have some eye symptoms. Your ophthalmologist can recommend treatments and strategies that will help, including:

• Eye drops or liquid tears to keep your eyes moist
• Special eyeglass lenses called prisms that reduce double vision
• Taping your eyelids to keep your eyes moist while you sleep
• Corticosteroid injections to decrease pain and inflammation
• Tepezza, an intravenous (IV) medication that reduces inflammation and may help with double vision and bulging
• Surgery to enhance the way your eyes look

Are you concerned about a bulging eye? Contact our office as soon as possible to schedule an appointment.

Sources:

American Academy of Ophthalmology: New Disease Treats Thyroid Disease without Surgery, 2/5/20

Merck Manual: Proptosis, 5/21

Loyola University Medical Center: Proptosis (Bulging Eye)

American Thyroid Association: Graves’ Disease

What Is Optic Neuritis?

Blurry, faded vision accompanied by eye pain could be a sign that you have optic neuritis. The condition affects the optic nerve, which carries electrical impulses from your eyes to your brain. Prompt treatment can help protect your eyesight if you develop optic neuritis.

Optic Neuritis Symptoms

Optic neuritis occurs when one or both of your optic nerves becomes inflamed and swollen. The swelling may affect fibers inside the nerves, making it difficult for light impulses to reach the brain. When the brain doesn’t receive complete signals from the eyes, temporary or permanent vision problems can occur.

If you have optic neuritis, you may notice that things may not be quite as bright as usual or that colors appear faded. Blank spots in your central or side vision and blurred vision may occur. Pain is common at the back of the eyes and when you move your eyes. You may also notice that your pupils don’t react normally to light. Symptoms can happen slowly or occur suddenly.

Vision loss is more likely to be temporary if you start treatment soon after you notice optic neuritis symptoms.

Causes of Optic Neuritis

According to the American Academy of Ophthalmology, it’s not always clear why someone develops optic neuritis, although the condition could be caused by an immune system mix-up. Your immune system could attack the optic nerve by mistake, causing your optic neuritis symptoms.

Optic neuritis often affects people who are between 20 to 40 and tends to be diagnosed in more women than men. You may be more likely to develop the condition if you have:

• A viral infection, like the flu
• An upper respiratory infection
• Toxoplasmosis
• Herpes simplex
• Lupus, Sarcoidosis, and other auto-immune disorders
• Lyme disease
• Measles
• Shingles
• Mumps
• Cat scratch fever
• Leber hereditary optic neuropathy
• Neuromyelitis Optica-spectrum disorder
• Acute Disseminated Encephalomyelitis
• Anti-MOG Ab-Associated Syndrome

Poor Nutrition, exposure to toxins, or side effects of tuberculosis medication may also cause optic neuritis. Your risk of being diagnosed with optic neuritis increases if you have multiple sclerosis (MS). In fact, optic neuritis is the symptom 20 percent of people who have MS notice first, according to the Review of Ophthalmology.

Optic Neuritis Treatment

Optic neuritis doesn’t always require treatment and can get better on its own in some cases, although it may take a few weeks to see an improvement in your vision. If your condition doesn’t improve, your ophthalmologist may prescribe corticosteroids, medications that reduce swelling and inflammation.

Intravenous steroids (IV) may be more helpful than oral medication when it comes to preventing a new bout of optic neuritis. Optic neuritis patients who participated in the Optic Neuritis Treatment Trial and received only oral corticosteroids were twice as likely to develop the condition again compared to patients who received IV corticosteroids or a placebo (a drug that did not affect optic neuritis). A combination treatment of IV and oral corticosteroids can help you protect your vision.

Are you worried that you may have optic neuritis? Call our office as soon as possible to schedule an appointment.

Sources:

Review of Ophthalmology: Optic Neuritis: Who Is at Risk for MS?

American Academy of Ophthalmology: What Is Optic Neuritis?, 6/1/21

All About Vision: Optic Neuritis and Neuropathy: Symptoms, Causes, Treatments

Medline Plus: Optic Neuritis

Ophthalmology: The Optic Neuritis Treatment Trial, 4/1/20

Are You Using Your Eye Drops Correctly?

Eye drops ease redness, itching, and dry eye and also treats eye conditions ranging from glaucoma to infections. Unfortunately, the drops won’t be effective if you don’t use them properly. These eye drops do’s and don’ts will help make sure that you benefit from the drops.

• Do Start with Clean Hands. You may unwittingly transfer bacteria from your hands to your eyes if you don’t wash your hands with soapy water before you use eye drops. If you’re away from home and a sink isn’t available, use hand sanitizer before applying drops.
• Don’t Use Eye Drops in These Circumstances. Germs can contaminate the tip of the dropper bottle if you drop the uncapped bottle on the floor or touch the tip with unclean hands. Throw out the bottle if this happens.
• Do Take Out Your Contact Lenses. Unless you’re using contact lens wetting drops, you’ll need to remove your lenses before using eye drops. Wait for at least 15 to 20 minutes before putting your contacts back in your eyes (or longer, depending on your eye doctor’s instructions).
• Do Tilt Your Head. Tilt your head back or lie down when using eye drops. Pull down gently on your bottom eyelid, then squeeze a drop in your eye. Keep the dropper about an inch from your eye. Close your eyes after putting in the drop to increase absorption.
• Don’t Waste the Drop. Eye drops may not relieve your symptoms if they drain from your eyes too quickly. The American Academy of Ophthalmology (AAO) recommends gently pressing on the area where your eye meets your nose to prevent drops from immediately draining through your tear ducts.
• Don’t Use More Drops than Recommended. Using more drops won’t improve the effectiveness of the medication. If you squeeze too many drops in your eye, some of them will be washed away and wasted.
• Do Follow the Instructions on the Label. It may take longer for your eye problem or condition to improve if you don’t follow the instructions. If you’re using prescription eye drops, be sure to use them as long as your ophthalmologist recommends. Stopping the eye drops too soon, even if your eye feels better, could worsen your condition or infection.
• Don’t Reuse Prescription Eye Drops. It may seem a shame to throw away a bottle of eye drops if you still have some left. Unfortunately, the drops may not be sterile if you decide to use them a few months from now. Using old drops could lead to an eye infection or could allow your symptoms to worsen if the drops are no longer effective. Don’t use old drops without checking with your eye doctor first, even if you have the same condition or think you have the same condition.
• Do Space Out Eye Drops. Do you need to take more than one kind of eye drop? Wait 5 or 10 minutes before applying the next medication. Waiting ensures that the first drop is completely absorbed by your eye.
• Do Store Your Drops Out of the Reach of Children. Curious kids have gotten very sick by drinking eye drops used to reduce redness. The drops contain tetrahydrozoline, an ingredient that could cause slow breathing and heartbeat, drowsiness, low body temperature, or coma, according to the AAO. Ingredients in other types of drops could also cause problems if someone accidentally drinks them.

Do you have a question about your eye drops or need to schedule an appointment? Contact our office to schedule an appointment or get more information about how to use your eye medication.

Sources:

American Academy of Ophthalmology: How to Put in Eye Drops, 3/10/21

American Academy of Ophthalmology: Red-Eye Drops: Poisonous to Drink, Safe If Used Correctly

All About Vision: How to Put in Eye Drops, 4/21

Do You Know What to Do in Case of an Eye Care Emergency?

Do you know how to handle an eye emergency? Learning these first aid basics can help you protect your sight.

Cuts to the Eye

Protecting the eye is an important step after a puncture to the eye or eyelids. The American Academy of Ophthalmology suggests making a shield by taping the bottom of a paper cup to the bones around your eyes. If a fishhook, nail, or other object is stuck in your eye, don’t pull it out, as you may worsen your injuries.

Go to the emergency room or see your ophthalmologist immediately if you have a cut or puncture. Don’t rinse the eye with water or apply pressure to it.

Although cuts and punctures can be painful, it’s not a good idea to take non-steroidal anti-inflammatory pain medication, like ibuprofen, naproxen sodium, or aspirin, as these medications can increase bleeding.

Scratched Eye

Scratches can happen if you get something in your eye or an object brushes against any part of your eye. Rinsing your eye with water or saline solution may help wash away any debris.

Even after the debris is gone, it may still feel like something is stuck in your eye. Resist the urge to rub your eye, as rubbing can worsen a scratch. If your eyes are sensitive to the light, sunglasses may help reduce tearing and discomfort.

Your eye doctor may recommend eye drops that decrease your pain, antibiotic eye drops to treat or prevent infections, or special drops that reduce inflammation.

Debris in the Eye

Nearly everyone gets something in their eyes from time to time. In many cases, it may be possible to rinse away a speck of dirt and sand with water or saline solution. Lifting your upper eyelid up and over the bottom lid, then rolling your eye, may also help dislodge debris.

If debris is still stuck in your eye, don’t try to remove it yourself with your fingers, tweezers, or a cotton swab, as you may damage your eye. Your ophthalmologist or the emergency room staff can safely remove objects stuck in your eye.

Chemicals

Chemicals and caustic cleaning products can be very damaging to the sensitive tissues of your eye. Rinse your eye with clean water immediately after contact with the chemical. WebMD recommends flushing your eye for at least 15 minutes after exposure to a chemical.

Follow flushing with a trip to the emergency room, or call 911. Be sure to remove contact lenses if you can. The lenses may trap the chemicals against your eye, increasing pain, irritation, and burning. Bringing the chemical or product with you will make it easier for the doctors to determine the best type of treatment.

Eye Trauma

Blows to the face can also hurt your eyes. If you’ve been hit in the eye, gently place a cold compress against your eye. Don’t apply pressure to the compress. If you notice any changes in your vision or the way your eye looks, call your ophthalmologist or visit the emergency room.

A fall or blow to the face could fracture one of the bones surrounding your eye. If this happens, you may notice one or more of these symptoms:

• Blurred or double vision
• Sunken eye
• Bulging eye
• Swelling under the eye or on the forehead or cheek
• Pain when opening your mouth
• Numbness
• Difficulty moving your eye

Fractures often heal on their own but may require surgery in some cases.

First aid treatment and a trip to the ophthalmology office or emergency room will help you protect your eyesight in the event of an eye injury. If you’ve experienced an injury or need to schedule an eye exam, give our office a call.

Sources:

American Academy of Ophthalmology: What Is an Orbital Fracture?, 9/28/17

Prevent Blindness: Your Sight

WebMD: First Aid for Eye Injuries, 9/11/20

All About Vision: 7 Common Eye Injuries and How to Treat Them

Are Your Eyes Misaligned? Eye Muscle Surgery May Offer the Perfect Solution

Eye muscle surgery can help improve your vision if you or your child have strabismus, a condition that affects the alignment of the eyes. Even a seemingly minor misalignment can cause vision problems that may make your life more difficult.

What Are the Symptoms of Strabismus?

Although it’s commonly called “crossed eyes,” strabismus actually refers to any misalignment of the eyes. The condition affects about 4 percent of people in the U.S., according to the American Association for Pediatric Ophthalmology and Strabismus.

If you have strabismus, your eyes may be crossed, one eye may be higher or lower than the other, or one eye might turn inward or outward slightly more than the other.

Symptoms of strabismus can include:

• Blurred or double vision
• Poor depth perception
• Difficulty reading
• Tilting the head to see objects clearly

When strabismus occurs in children, the brain may eventually ignore the signals from one of the eyes, causing a condition called amblyopia (lazy eye).

What Causes Strabismus?

Strabismus can be caused by problems with the eye muscles but may also happen if the brain can’t properly control the muscles.

Symptoms of strabismus are often noticeable during early childhood. Adults who have strabismus may have had the condition since they were children or might have developed it as a result of a stroke, head injury, damage to the eye muscles, diabetes, thyroid disease, or other diseases and conditions.

How Does Surgery Treat Strabismus?

Strabismus surgery may be recommended for both adults and children if eye exercises, prism eyeglass lenses, or Botox treatments aren’t helpful in improving eye alignment. During surgery, your ophthalmologist tightens or loosens your eye muscles to change the alignment of your eyes. The outpatient procedure is performed under local or general anesthetic.

Your eye doctor will use one of these surgical techniques to perform strabismus surgery:

• Recession: Recession is helpful if your eye muscle is too tight. The procedure involves detaching the muscle and reattaching it farther back on the eye with a suture (stitch). Relocating the muscle makes it a little weaker, which improves eye alignment.
• Resection: A resection strengthens a weak eye muscle. During resection, a small part of the eye muscle is removed or folded over, then the shortened muscle is reattached to the eye with a suture.
• Adjustable Suture: An adjustable suture procedure is only recommended for adults. During this procedure, your ophthalmologist reattaches your eye muscle with a slip-knot suture. After your surgery, your doctor can make small adjustments to the results by adjusting the knot.

What Happens After Strabismus Surgery?

Your eye will probably be red and feel a little sore after your surgery. It may also feel as if something is stuck in your eye. These symptoms will gradually improve over the next few days and weeks. Over-the-counter pain medication can help control pain. Most people can return to their normal activities just a few days after surgery.

You’ll notice an improvement in eye alignment immediately after surgery, although it may take four to six weeks to see the permanent results, according to All About Vision. In some cases, a second or third surgery may be necessary to fine-tune the results.

Do you have strabismus? Surgery can help improve the alignment of your eyes, end double vision, and other symptoms. Contact our office to schedule an appointment to discuss treatment options.

Sources:

American Association for Pediatric Ophthalmology and Strabismus: Strabismus

American Academy of Ophthalmology: What Is Adult Strabismus?, 12/3/20

American Association for Pediatric Ophthalmology and Strabismus: Strabismus Surgery, 3/19

All About Vision: Strabismus Surgery

Medline Plus: Strabismus

Have you ever wondered why your ophthalmologist dilates your eyes during your annual eye exam? Here are a few things you should know about dilating eye drops and the benefits of dilation.

What Dilating Eye Drops Do

Dilating eye drops enlarge your pupils, which gives your eye doctor a better view of the interior of your eye. Your eyes begin to dilate soon after the drops are placed in your eyes, although full dilation can take 20 to 30 minutes. Once your eyes are dilated, your pupils will remain enlarged for four hours or longer. Your eyes may stay dilated longer than normal if you have light-colored eyes, according to Medical News Today.

Although reading the eye chart helps your ophthalmologist to determine your visual acuity, or ability to see images clearly, you could still have a problem with your eyes that hasn’t yet affected your vision.

When your eyes are dilated, your eye doctor can see the clear lens inside your eye that focuses light rays on your retina. A dilated eye exam also provides clear views of your retina, blood vessels, and optic nerve. The retina, a layer of light-sensing cells that line the back of your eye, transforms light into electrical impulses that are sent to the brain. The optic nerve serves as the pathway between the retina and the brain.

Issues with any of these structures may affect your ability to see well. For example, diabetic retinopathy could cause blood vessels in your retina to leak, interfering with your vision. Changes in your optic nerve could be related to a buildup of pressure due to glaucoma or inflammation of the nerve, while damage to the cells in the center of your retina might be an indication that you have age-related macular degeneration. Your ophthalmologist may be able to diagnose these and other diseases and conditions simply by performing a dilated examination of your eyes.

Since eye diseases don’t always cause symptoms in their earliest stages, a dilated eye exam can help you protect your vision. If you are diagnosed with an eye disease, prompt treatment can help you avoid or minimize vision loss.

Common Side Effects of Dilating Eye Drops

You may notice that your vision is a little blurry after dilating eye drops are placed in your eyes or might find focusing on close objects a little difficult. These side effects will gradually improve as the effects of the drops diminish.

Blurriness or a temporary change in your focusing ability may affect your ability to drive safely. If you’ve noticed that your vision has become blurry after eye dilation in the past, ask a friend or family member to drive you home from your appointment.

Sensitivity to light is the most common complaint about dilating eye drops. Sensitive or bright indoor lights may cause your eyes to water or feel uncomfortable. Some people also experience mild headaches due to light sensitivity.

Until the drops wear off, wearing sunglasses can help your eyes feel better. If you don’t arrive at the ophthalmology office with sunglasses, your ophthalmologist can give you a disposable pair. Although they won’t be quite as stylish as real sunglasses, they’ll keep your eyes comfortable on the trip home.

Are you due for a dilated eye examination? Contact our office to schedule your visit.

Sources:

American Academy of Ophthalmology: What Are Dilating Eye Drops, 5/14/20

Medical News Today: Eye Dilation: How Long Does It Take to Wear Off?

National Eye Institute: Get a Dilated Eye Exam

All About Vision: Why Does My Doctor Want to Dilate My Eyes?, 1/21

What to Do About Eye Irritation

Eye irritation is a common complaint, particularly during allergy season. Itchy, watery, burning eyes aren’t just uncomfortable but can make reading, using your laptop, or even driving unpleasant or difficult.

Common Causes of Eye Irritation

It’s difficult to find a solution to a problem if you don’t understand the cause. Although eye irritation can be caused by many factors, these are among the most common causes:

Debris and Foreign Objects

A tiny piece of dust or sand may be responsible for your eye pain, light sensitivity, or the red, watery appearance of your eye.

What to Do About It. In many cases, rinsing your eyes with clean water will remove the stray object. If it doesn’t, call your ophthalmologist as soon as possible. If you try to pry a stubborn object out of your eye, you may injure your eye and damage your vision.

Allergies

Sneezing and nasal discharge aren’t the only symptoms of allergies. Allergies, whether they occur seasonally or year-round, could be the reason your eyes are red, watery, and itchy.

What to Do About It. Using eye drops or artificial tears can keep your eyes more comfortable. If over-the-counter products aren’t helpful, your eye doctor may recommend prescription eye drops, oral antihistamines, or allergy shots. Decreasing your exposure to allergens by staying inside when pollen counts are high and using your air-conditioner can be helpful.

Uncomfortable Contact Lenses

Occasional eye irritation can be an issue when you wear contact lenses. Irritation may be due to seasonal allergies, allergies to your contact lens solution or lenses, dry eyes, or even inadequate cleaning. Approximately 40 to 90 percent of contact lens wearers don’t follow the recommended care instructions for their lenses, according to a fact sheet created by the Centers for Disease Control and Prevention. In addition to irritating your eyes, poor contact lens hygiene can cause a serious eye infection that could damage your vision.

What to Do About It. Treating seasonal allergies may help make your contacts more comfortable. If you think you’re allergic to your solution or lenses, trying different brands or switching to daily wear lenses may be helpful. In some cases, eliminating eye irritation may be as simple as improving your cleaning habits. Be sure to use fresh solution every day and clean and dry contact lens cases after every use. Replace your contact lenses as recommended by your ophthalmologist.

Conjunctivitis (Pink Eye)

Pink eye is a contagious infection or inflammation that affects the conjunctiva, the clear layer of tissue that covers the whites of your eyes and the insides of your eyelids. Conjunctivitis can be caused by a viral or bacterial infection and spreads quite easily, particularly if you share washcloths, towels, bedding, or clothing with an infected person. Your eyes may look red or pink if you have conjunctivitis. Other symptoms include watering, itching, discharge, burning, or a feeling that something is stuck in your eye.

What to Do About It. Viral pink eye usually goes away when the cold, flu, or other illness that caused it gets better. Cold compresses may help decrease pain and discomfort. Bacterial conjunctivitis may require treatment with antibiotic eye drops or ointment. If your child has pink eye, the school may require you to keep him or her at home until the redness disappears.

Dry Eye

Dry eye is a common cause of red, irritated eyes. The condition can also blur your vision or make it feel as if something is stuck in your eye. Watery eyes may also be a dry eye symptom. If your eyes get too dry, tear production increases in an attempt to keep your eyes lubricated. Some people naturally have dry eyes, but the condition can also be caused by medication side effects, certain diseases, viewing digital devices for a long time, wearing contact lenses too long, or spending time outside on a windy or dusty day.

What to Do About It. Artificial tears and eye drops will help keep your eyes moist. If you wear contact lenses, be sure to choose dry eye products that are safe to use with your lenses. Taking frequent breaks when using digital devices or reading can also be helpful. If your condition is severe, your ophthalmologist may recommend adding tiny plugs to your tear ducts to prevent tears from draining away or surgery to close the ducts.

Are your eyes red, dry, itchy, or just plain uncomfortable? Contact our office and we’ll schedule an appointment to find out why your eyes are bothering you.

Sources:

All About Vision: Common Eye Disorders

American College of Allergy, Asthma & Immunology: Eye Allergy

American Academy of Ophthalmology: What IS Dry Eye, 2/8/21

Centers for Disease Control and Prevention Fast Facts

Cancer can affect any part of the body, including the eyes. The disease can start in the eyes or may spread from other parts of the body. Treatment for this kind of cancer is focused on killing the cancer cells while preserving as much of your vision as possible.

Types of Eye Cancer

Treatment for eye cancer depends on the type and the stage of the disease. Common eye cancer types include:

• Melanoma. Ocular melanoma is the most common type of primary eye cancer, according to the National Organization for Rare Disorders. “Primary” means that the cancer started in the eye. Ocular melanoma is classified as a secondary cancer if the disease developed in another part of the body and then spread to the eye.
• Retinoblastoma. This type of cancer primarily affects children and occurs when tumors form in the retina, the layer of light-sensing cells that lines the back of the eye.
• Orbital Cancer. Orbital cancer may develop in the muscles, nerves, blood vessels, or other tissues in the eye socket.
• Adnexal Cancer. Adnexal cancer can affect the tear glands or eyelids.
• Primary Intraocular Lymphoma. Lymphoma starts when white blood cells in your blood begin to mutate. Occasionally, the cells may travel through the bloodstream to the eye and cause cancer.

How Do Ophthalmologists Treat Eye Cancer?

Treatment for ocular cancer depends on the type and stage of the cancer. Your cancer treatment plan may include one or more of these options:

• Watchful Waiting. If you have a small melanoma, your eye doctor may recommend treatment only if your tumor starts to get bigger.
• Radiation Treatments. Radiation treatment is one of the most common ocular cancer treatments. The treatment kills cancerous cells by exposing them to X-rays, protons, gamma rays, or electron beams. External beam therapy involves aiming a high-energy beam at your eye. During brachytherapy, small radiation seeds are applied inside the tumor or to the outside of your eye close to your tumor. Brachytherapy is a very effective treatment for ocular melanoma and cures 90 percent of small- to medium-size tumors, according to the American Cancer Society.
• Transpupillary Thermotherapy (TTT). TTT is a laser therapy that heats the cancerous cells in the tumor, which kills them.
• Chemotherapy. Chemotherapy uses medication to target and kill fast-growing cancer cells. You may receive the medication through an intravenous (IV) line or might take prescription chemotherapy pills.
• Other Drug-Based Therapies. Targeted or immune therapy drugs may be part of your ocular cancer treatment plan. Immune therapy drugs enhance your immune system’s ability to attack cancerous cells. Targeted therapy uses medications that target the proteins cancerous cells need to grow and spread.
• Surgery. Surgery may be needed to remove the tumor or all or part of your eye in some cases.

Will Cancer Treatment Affect My Vision?

Partial or complete vision loss can sometimes occur due to the damage caused by the tumor itself or the treatments used to kill cancer. If you’ve had radiation treatment, you may experience dry eye, cataracts, or permanent changes to your vision.

Although laser therapy quickly kills cancerous cells, the treatment may increase your risk of retinal detachment, abnormal blood vessel growth, or other issues that could affect your eyesight.

Your ophthalmologist will carefully consider the effectiveness of the treatment and the possible effects on your vision when recommending treatment options. Although your eye doctor will do everything possible to save your eyesight, sometimes vision loss is unavoidable.

Eye cancer is most treatable when it’s diagnosed in the earliest stages. Annual eye examinations can help you protect your eyes and your health. If it’s been a while since you’ve seen the ophthalmologist, or you are having problems with your vision, contact our office to schedule an appointment.

Sources:

American Cancer Society: Radiation Therapy for Eye Cancer

American Cancer Society: If You Have Eye Cancer

Cancer.Net Eye Cancer: Treatment Options, 8/15

American Academy of Ophthalmology: Eye Cancer, 3/27/20

American Cancer Society: Laser Therapy for Eye Cancer, 11/30/18

National Organization for Rare Disorders: Ocular Melanoma

Ready to Give Up Your Glasses or Contacts? These Refractive Procedures Can Improve Your Vision

Eyeglasses and contact lenses aren’t the only options if your vision is less than perfect. Refractive procedures can help you see clearly and offer long-term results.

Why Refraction Is Important for Good Vision

Light rays must focus precisely on your retina, the layer of light-sensing cells at the back of the eye, for clear vision. As light enters your eyes, the lens and cornea bend (refract) the rays onto the retina. The lens is a clear, disc-shaped structure behind your iris and pupil, while the cornea is a clear layer of tissue that covers the iris and pupil.

You will be diagnosed with a refractive error if light rays don’t reach the optimum spot on your retina. Refractive errors are common and can occur if your eyeball is shorter or longer than normal. Myopia (nearsightedness), hyperopia (farsightedness), astigmatism (blurred vision due to an asymmetrical cornea), and presbyopia (trouble seeing near objects as you grow older) are types of refractive errors.

These Refractive Procedures Can Enhance Your Eyesight

Eyeglasses and contact lenses correct refractive errors by changing the way light enters the eye. Of course, the moment you take off your glasses or contacts, everything looks blurry again. Refractive procedures permanently change the shape of your cornea, eliminating the need for eyeglasses or contact lenses.

Common types of refractive procedures include:

• LASIK (Laser in-situ keratomileusis). During LASIK surgery, your ophthalmologist uses a surgical instrument or laser to create a flap in your cornea. After the flap is folded back, your eye doctor reshapes your cornea using a laser, then replaces the flap. Wavefront LASIK uses computers to map the cornea and can enhance the effectiveness of the procedure. According to the American Refractive Surgery Council, vision is better than 20/40 in 99 percent of LASIK patients after their procedures. Ninety percent of people who have LASIK have 20/20 vision or better.
• PRK (Photorefractory Keratectomy). If you’re not a candidate for LASIK due to corneal thickness, scarring, or dry eye, PRK may be a good choice for you. PRK involves removing the top layer of the cornea, called the epithelium, and reshaping the layers underneath with a laser. Contacts that act as bandages are placed in the eye while it heals. After the procedure, the epithelium grows back.
• LASEK (Laser Epithelial Keratomileusis). The epithelial layer is separated from the rest of the cornea, although it remains attached by a flap during LASEK. Your ophthalmologist positions the epithelial flap to the side then reshapes the cornea with a laser. After the cornea is reshaped, the epithelium is repositioned over the cornea. A bandage contact lens placed over the cornea helps the epithelium heal.
• SMILE (Small Incision Lenticule Extraction). Used for myopia and astigmatism in people 22 and older, SMILE doesn’t require a flap. Instead, your ophthalmologist removes a small, circular piece of corneal tissue called a lenticule that is about the size of a contact lens. Removing the lenticule instantly reshapes the cornea.
• (LTK) Laser Thermal Keratoplasty. LTK is used to improve your vision if you have presbyopia or mild hyperopia. Your ophthalmologist applies laser energy to the edges of the cornea, causing it to shrink and change shape.

Are You a Good Candidate for Refractive Surgery?

Refractive surgery may be right for you if:

• You are 18 or older.
• Your vision is stable and has been for the past year.
• You’re not pregnant.
• You don’t have certain diseases or conditions, such as corneal abrasions, glaucoma, severe dry eye, poorly controlled diabetes, Sjogren’s syndrome, AIDS, or rheumatoid arthritis.
• Your corneas are healthy and thick enough for surgery.

In the past, thinner corneas or severe nearsightedness may have prevented you from improving your eyesight with surgery. Thanks to procedures, like SMILE or PRK, refractive procedures are now possible for many people who wouldn’t have qualified in the past.

Have you been considering a refractive procedure? Schedule an appointment with our office to discuss your options.

Sources:

American Refractive Surgery Council: What Is the LASIK Success Rate?, 10/23/17

American Academy of Ophthalmology: Alternative Refractive Surgery Procedures, 9/27/17

American Refractive Surgery Council: SMILE Procedure Expands Laser Vision Correction Options, 5/25/17

American Academy of Ophthalmology: LASIK – Laser Eye Surgery, 10/21/20

University of Rochester Medical Center: Types of Eye Surgery for Refractive Errors

Regular eye examinations are not only essential for good vision but also help you maintain your health. Changes in your eyes can be the first signs of serious diseases and conditions ranging from diabetes to multiple sclerosis to high blood pressure.

Eye Exams Provide Valuable Information About Your Visual and General Health

In addition to detecting vision problems, an eye exam can also help your eye doctor spot symptoms of general health conditions and diseases, including:

• Diabetes. Blurry vision doesn’t always mean that you need a new eyeglass or contact lens prescription. If you have untreated diabetes, blurriness can be caused by swelling in the lenses of your eyes. The lenses are clear discs inside your eyes that focus light rays on your retinas. High blood sugar causes water to build up in the lenses, causing blurriness. Your ophthalmologist may also suspect that you have diabetes if tiny blood vessels in your retinas leak fluid or blood. Although leaking vessels can affect your vision, vision changes may not be obvious at first.
• Lyme Disease. Conjunctivitis (pink eye), sensitivity to light, floaters, and inflammation of any part of the eye may occur if you have Lyme disease. You may be more likely to develop optic neuritis, an inflammation that affects the optic nerve. The nerve transmits light impulses from your retina to your brain and plays a crucial role in vision. Symptoms of optic neuritis include pain, blurred vision, loss of color vision, and flashing lights.
• High Blood Pressure. Arteries or veins in your eyes that are larger or smaller than normal can be signs of high blood pressure, as can tiny blood clots. Since the clots won’t necessarily impair your vision if they’re small enough, you may not know that you have a problem unless you visit the ophthalmologist.
• Multiple Sclerosis. Optic neuritis can also occur if you have multiple sclerosis (MS). The disease affects the central nervous system and may cause numbness, tingling, muscle spasms, and balance problems in addition to optic neuritis. Other vision problems that may affect people who have MS include double vision and nystagmus (involuntary eye movements).
• High Cholesterol. A change in the appearance of your cornea, the clear layer of tissue that covers the iris and pupil, may be a sign that you have high cholesterol. Cholesterol deposits tend to collect in the outer edges of the cornea, creating a blue ring around it.
• Thyroid Disease. Thyroid eye disease (TED) affects between 25 to 50 percent of people diagnosed with a thyroid problem, according to a November 2018 article in the Review of Ophthalmology. TED can cause a variety of eye symptoms, including dry eye, redness, gritty eyes, light sensitivity, tightening of the eyelids, double vision, swelling, misalignment, and bulging eyes.
• Blockages in Your Arteries. A tiny blood clot in your eye may be a sign that you have a clogged artery. The clots can form when small pieces of plaque inside an artery break off and travel to your eye. As waxy plaque builds up in your arteries, blood flow decreases, while your heart attack and stroke risk increases. Clots may cause blurry vision or sudden loss of vision.
• Rheumatoid Arthritis. Eye problems can also occur if you have rheumatoid arthritis. Symptoms may include dry eyes, redness, pain, blurred vision, cataracts, and sensitivity to light.

Thanks to annual eye examinations, it’s possible to detect subtle changes in your eyes that could indicate that you have one of these diseases or conditions. Visiting your ophthalmologist once a year is a simple way to protect your visual and general health. Contact our office if you are ready to schedule your yearly visit or have been experiencing any eye issues.

Sources:

Chicago Medicine: Lyme Disease and the Eye

National Multiple Sclerosis Society: Vision Problems

Review of Ophthalmology: Thyroid Disease: It’s Causes and Prognosis, 11/9/18

CNN: These Health Problems Can Be Predicted with a Look into Your Eyes, 3/1/18

American Academy of Ophthalmology: 20 Surprising Health Problems an Eye Exam Can Catch, 1/16/20

U Chicago Medicine: What Can Your Eyes Tell You About Heart Disease?, 4/26/18

All About Vision: Infographic: 10 Health Problems Your Eyes Could Be Showing Signs Of, 1/17

What Are Ocular Migraines?

If you’ve ever experienced your own private light show, complete with flashing lights and colorful zigzags, you may have had an ocular migraine. Although these symptoms seem alarming, they usually go away quickly without damaging your vision.

Common Ocular Migraine Symptoms

Whether you call them ocular migraines, ophthalmic migraines, or migraine with aura, the symptoms are the same. Before the visual symptoms, or auras, start, you may feel a little lightheaded or dizzy. Soon you’ll experience some strange changes to your vision, which may include:

• Flashing Lights in Colorful Patterns
• A Blind Spot That Affects Part of Your Vision
• Light and Sound Sensitivity
• Nausea and Vomiting
• Numbness and Tingling
• Coordination Problems or Weakness
• Trouble Speaking Clearly

These symptoms can last about 30 to 60 minutes and usually affect both eyes. Even if you close your eyes, you’ll notice that you’ll still see the patterns and lights. It’s difficult to read when you experience these visual disturbances, and it’s not a good idea to drive until your vision returns to normal.

As the visual symptoms gradually fade, head pain may start. The headaches that accompany ocular migraines can be mild to severe and may last hours to days. It’s also possible to experience the visual disturbances of an ocular migraine, yet never get a headache.

Auras with migraines are very common. In fact, 25 to 30 percent of people who get migraines experience auras, according to the American Migraine Association.

Ocular Migraine Causes

Just like with classic migraines, it’s not always possible to determine why you have an ocular migraine. Many of the things that trigger classic migraines can also be responsible for ocular migraines, such as:

• Waiting Too Long to Eat
• Not Getting Enough Sleep
• Sleeping Too Much
• Working on Your Laptop or Using Other Digital Screens for Long Periods
• Hormonal Changes Related to the Menstrual Cycle in Women
• Dehydration
• Spending Hours Under Bright Lights
• Drinking Alcohol or Too Much Caffeine
• Exposure to Strong Scents and Odors
• Stress and Anxiety
• Eating Certain Foods, Such as Chocolate, Preserved Foods, Aged Cheeses, or Foods That Contain Monosodium Glutamate (MSG)

You may be more likely to get these types of migraines if other people in your family also have them.

Treating Ocular Migraines

If you only get ocular migraines occasionally, you may not need to do anything special to treat them. Avoiding stress and known migraine triggers may help you avoid future episodes.

If you get ocular or other migraines frequently, you may benefit from medications that prevent migraines and reduce the number of migraine days you have in a month. In some cases, Botox injections can also be used to reduce migraines.

When It’s a Good Idea to See Your Ophthalmologist

It’s important to report any change in your vision to your ophthalmologist. If you’ve never had visual auras before and suddenly begin experiencing them, let your doctor know. He or she can perform a thorough examination and determine if your symptoms are most likely caused by ocular migraines.

Ocular migraines can sometimes be confused with a potentially serious type of migraine called retinal migraine. Retinal migraines only affect one eye and can cause temporary blindness, blurred or dim vision, and sparkling lights. You may get a headache before, during, or after the visual changes.

These migraines occur when the blood vessels in your eye suddenly narrow. Although retinal migraines don’t usually damage your vision, they can be responsible for permanent vision loss in some cases.

Medications that prevent migraines or relax your blood vessels might be recommended if you have retinal migraines often.

Have you had any of these ocular or retinal migraine symptoms? A visit to the ophthalmologist can help put your mind at ease. Contact our office to schedule your appointment.

Sources:

American Migraine Association: Understanding Ocular Migraine, 10/19/17

Medical News Today: Ocular Migraine: Everything You Need to Know

Stanford Medicine: Stanford Headache Specialist Demystifies Migraine Auras, 7/11/17

Brain & Life: Should I Be Concerned About Ocular Migraines, 6/14

Do you know the symptoms that may occur when your retina has become detached? Recognizing common retinal detachment symptoms can help you protect your vision and reduce your risk of permanent changes to your vision.

What Is Retinal Detachment?

A retinal detachment occurs when part of your retina peels away from the back of the eye. The retina is a layer of cells that lines the back of the eyes. Retinal cells capture light rays and change them into electrical impulses that are sent to the brain. Once the impulses reach the brain, they’re transformed into recognizable images.

What Are the Symptoms of Retinal Detachment?

Retinal detachment symptoms include:

• Floaters: You may notice a sudden increase in floaters after a retinal detachment. Floaters are wispy fibers that separate from the vitreous, the gel-like fluid that fills the inside of the eye. The fibers cast shadows when you look into the light and seem to float across your vision. Although floaters are common as you age, the sudden appearance of many floaters is a cause for concern.
• Flashing Lights: You may also see flashes of light when the retina detaches.
• Sudden Vision Changes: It may be difficult to see clearly, or you might notice changes in your central or side vision after a retinal detachment.
• Loss of Vision: If your retina is detached, you might notice a partial loss of vision. People who’ve had retinal detachments have mentioned that it seems as if a dark curtain has fallen over their eyes.

Who Is at Risk for Retinal Detachments?

You may be more likely to experience a detached retina if:

• You Had an Injury: A blow to the eye can cause retinal detachment. See your ophthalmologist as soon as possible after a blow, even if your vision seems fine. Eye injuries may not always be obvious immediately after an accident.
• You Have an Eye Disease: Some eye diseases and conditions increase your retinal detachment risk, including lattice degeneration, diabetic retinopathy, extreme nearsightedness, and posterior vitreous detachment.
• Other Members of Your Family Have Had Detached Retinas: Your risk of a detachment might increase if other people in your family have had retinal detachments.
• You Had an Eye Surgery: Cataracts, glaucoma, and other types of eye surgery can raise your retinal detachment risk.

How Are Retinal Detachments Treated?

It’s important to go to the emergency room immediately if you notice any symptoms of retinal detachment. The sooner you receive emergency treatment, the better the chances that your vision can be restored. Retinal detachment treatment is successful for about 9 out of 10 people, according to the National Eye Institute.

Keep in mind that symptoms aren’t always dramatic, particularly if you don’t have a severe detachment or tear in your retina. Any sudden change in vision, no matter how mild, should always be investigated. Unfortunately, if you don’t see an ophthalmologist promptly, you may develop a permanent loss of vision.

Ophthalmologists use several different methods to treat retinal tears and detachments, including:

• Cryopexy. Your ophthalmologist applies a freezing probe to the borders of the tear or detachment during cryopexy. The treatment causes scarring, which seals the retina to the back of the eye.
• Laser Surgery. Laser surgery also seals a torn or detached retina to the back of the eye. Laser light causes scarring by creating small burns.
• Scleral Buckle. Your eye doctor sews a sponge or band on to the sclera (white part of your eye). The buckle pushes the sclera closer to the back of the eye, which helps the detached area of the retina reattach. Cryopexy or laser surgery is then used to seal the retina.
• Pneumatic Retinopexy. Injecting gas or air into your eye creates a bubble that helps your retina reattach. Laser surgery or cryopexy may be used in conjunction with pneumatic retinopathy.
• Vitrectomy. Vitrectomy involves removing the vitreous gel from your eye to allow easier access to the detached area. Laser surgery or cryopexy may be performed during the procedure. The surgery might also include the injection of a gas bubble to hold the retina in place. Saline solution or silicone oil is added to replace the removed vitreous gel.

Have you noticed any sudden changes in your vision? Call our office immediately or go to the emergency room if you experience any potential retinal detachment symptoms.

Sources:

National Eye Institute: Retinal Detachment, 626/19

American Society of Retina Specialists: Retinal Detachment

American Society of Retina Specialists: Retinal Detachment

What Is Strabismus?

Strabismus occurs when the eyes aren’t properly aligned. Commonly called “crossed eyes,” the condition affects about four percent of the U.S. population, according to the American Association for Pediatric Ophthalmology and Strabismus.

What Causes Strabismus?

Strabismus can occur if the eye muscles are weak or damaged. It may also happen as a result of a nerve issue or due to a problem in the part of the brain that controls eye muscle movements. Children who have certain conditions, such as cerebral palsy or Down syndrome, may be more likely to have strabismus.

Most people associate strabismus with eyes that turn inward, but the condition may cause the eyes to turn upward, downward, or to the side. Even slight variations in eye alignment can lead to vision problems.

It’s not uncommon to see crossed eyes in young infants, although eye alignment usually improves after the first few months. Alignment issues that continue longer may need to be treated to prevent vision problems.

Why Is Strabismus a Problem?

Your vision may be affected if your brain receives different images from your eyes due to the misalignment. If you have strabismus, you may experience blurry or double vision, headaches, eyestrain, and depth perception problems. You may also notice that it’s easier to see if you tilt your head. Concentration problems and difficulty reading can also happen if your eyes aren’t aligned correctly. Difficulty focusing on near objects may also occur, as can motion sickness.

If the condition isn’t treated, you may develop amblyopia (lazy eye) as a result. In amblyopia, the brain eventually becomes overwhelmed by the mismatched input it receives and ignores the information provided by one of your eyes.

Symptoms of amblyopia can also include blurry vision and problems with depth perception. If you have the condition, you may assume that you’re just naturally clumsy because you constantly bump into things.

Does Strabismus Only Affect Children?

Strabismus can be a problem even if you’re an adult. The condition may not have been diagnosed and treated when you were a child, or you may have developed it as an adult. A head or eye injury could cause strabismus, as could a stroke, issues with blood vessels, diabetes, a nerve condition, or a thyroid disorder. Fortunately, your vision can improve no matter what your age.

How Is Strabismus Treated?

Treatment options for strabismus include:

• Exercises: Exercises help your eyes work together and can be helpful if you have trouble with near vision. Pencil pushups are one type of exercise that can improve your ability to see close items clearly. You’ll keep your gaze fixed on the pencil as you move it closer to your face. When your vision blurs, you’ll start the exercise over again. If you practice every day, you may soon notice that you can move the pencil closer to your face without experiencing blurred vision.
• Prism Lenses: Prism eyeglass lenses change the way light rays bend when they enter your eyes. The lenses keep light rays focused directly on your retinas, preventing double vision and other strabismus symptoms.
• Surgery: Surgery may be needed if your eye muscles are weak or don’t work properly. The procedure is performed on both children and adults, although it’s somewhat more successful in children.

Do you think that you or your child may have strabismus? Contact our office to schedule an appointment to discuss your concerns.

Sources:

American Academy for Pediatric Ophthalmology and Strabismus, 2/12/18: Strabismus

American Academy of Ophthalmology: What Is Adult Strabismus?, 5/29/20

All About Vision: Strabismus And Crossed Eyes, 1/17

Harvard Health Publishing: Crossed Eyes, 12/18

You’re more likely to suffer from dry eye if you don’t make enough tears or the tears you make are low quality. Although the condition can be very uncomfortable, home remedies and treatments provided by your ophthalmologist can ease your discomfort.

What Causes Dry Eye?

Most of us have experienced dry eyes from time to time. You may have noticed that your eyes feel drier than usual when you take a walk on a windy day or spend time in a smoky room. Fortunately, eye lubrication usually improves once you move to a more comfortable environment.

If your eyes often feel dry, you may have chronic dry eye. The problem becomes more common as you get older. Dry eye may also be related to hormonal fluctuations during pregnancy, perimenopause or menopause, or may happen if you take birth control pills.

Did your dry eye symptoms begin after you started taking medication for high blood pressure, depression, or allergies? Drugs used to treat the conditions may cause dry eye as a side effect. Certain conditions may also increase your dry eye risk, including eyelid inflammation, diabetes, Parkinson’s disease, thyroid disorders, Sjogren’s syndrome, or rheumatoid arthritis.

Other risk factors may include looking at digital screens for long periods of time, wearing contact lenses, or having LASIK or other refractive surgeries to improve your eyesight.

What Can I Do About Dry Eye?

Making a few simple changes to your routine can improve your comfort. If dry eyes and eyestrain frequently occur after you’ve been working on your laptop or playing video games, it may help to remind yourself to blink more often. Blinking releases tears and helps keep your eyes well lubricated. Taking frequent breaks and looking at an object 20 feet in the distance for 20 seconds every 20 minutes can also reduce dry eye symptoms.

Over-the-counter artificial tears add moisture to your dry eyes. Drops that contain preservatives last longer but may irritate your eyes. If this happens, switch to preservative-free drops instead.

When you’re outside, wear wraparound sunglasses to reduce the effects of the wind and the sun on your eyes. Wearing sunglasses also reduces your risk of developing cataracts and age-related macular degeneration, a condition that causes the loss of central vision.

Applying warm compresses to your eye several times a day may also be helpful. The warmth can cause tears to start flowing by unblocking your Meibomian glands. The glands, located on your eyelids, produce the oily outer layer of the tear film. The oil prevents tears from evaporating too quickly and prevents dry eye. If the glands become clogged, you won’t produce enough of the oily substance, and your eyes will soon feel dry and uncomfortable.

If your dry eye persists despite making these changes, your opthalmologist can offer a few treatment recommendations, including:

• Prescription Eye Drops: If you have chronic dry eye, you may benefit from using Restasis or Xiidra drops. Restasis prompts your eyes to produce more tears and also reduces eye inflammation, while Xiidra stops an inflammatory response that causes dry eye symptoms and prevents changes that can occur in the surface of your eyes if you have dry eye. You may need to use these drugs for weeks or months before you notice an improvement.
• Steroid Eye Drops: In addition to Restasis or Xiidra, your doctor may also recommend that you use steroid eye drops, particularly when you first begin using these medications. Steroid drops help reduce the inflammation that can make your dry eyes uncomfortable.
• Punctal Plugs: Punctal plugs are tiny devices that fit into tear duct drainage ducts. They keep your eyes moist by preventing tears from draining from your eyes.
• Lacrisert: The Lacrisert insert is added to your lower eyelid once a day and slowly releases a lubricant that lasts all day.
• Unclogging Meibomian Glands: Your eye doctor may recommend a meibomian gland expression to remove clogs or suggest another treatment called LipiFlow. During Lipiflow treatment, a device placed over your eye uses heat to dissolve clogs.
• Intense Pulsed Light (IPL) Therapy: IPL is often used in conjunction with Meibomian gland expression to warm and unclog the glands and reduce redness and inflammation in the eyes.

Do you struggle with dry eyes? We can help you find the ideal treatment for your condition. Contact our office to schedule a convenient appointment.

Sources:

American Optometric Association: Dry Eye

American Academy of Ophthalmology: How Hormones Can Affect Eyes and Vision, 10/9/18

All About Vision Dry Eye Syndrome; 12 Ways to Get Relief, 7/19

Harvard Health Publishing: The Fix for Dry Eyes, 2/10/17

Do you have vision problems due to an eye disease or condition or want to see better without eyeglasses or contact lenses? Your ophthalmologist offers a variety of eye procedures that will help you protect or improve your eyesight.

Laser Procedures Protect Your Eyes from Glaucoma Consequences

Glaucoma occurs when the pressure inside your eye is dangerously high. If the pressure isn’t reduced, vision loss may occur due to optic nerve damage. About 3 million people in the U.S. have glaucoma, which is the second leading cause of blindness worldwide, according to the Centers for Disease Control and Prevention.

Medication often helps lower pressure, but sometimes medication alone isn’t enough. If medications don’t help, or if the increase in pressure occurs after your iris blocks drainage canals in your eye, you may benefit from a surgical laser procedure.

During a trabeculectomy, your ophthalmologist creates a flap in the white part of the eye to improve the drainage of fluids in the eye. If a blockage causes the change in pressure, an iridotomy may be helpful. The procedure involves making a small hole in the iris to allow fluid to flow freely once again.

Cataract Surgery Clears Your Vision

Cataracts cloud and harden the lens in your eye, causing blurry vision and light sensitivity. Removing a clouded lens and replacing it with an artificial lens called an intraocular lens implant (IOC) restores your vision. Surgery may be recommended if your cataracts begin to interfere with your life.

Phacoemulsification, the most commonly performed cataract procedure, involves making a small incision at the edge of your cornea to access the lens. The cornea is the curved, clear layer of tissue that covers the iris and pupil. Your ophthalmologist breaks apart the lens with a small probe that emits ultrasound waves, then pulls the pieces through the tiny opening in your eye.

If you’re not a candidate for phacoemulsification, extracapsular surgery may be an option. In this procedure, a larger incision in the cornea is made, allowing the entire cataract to be removed.

Injections Stop Leaks if You Have the Wet Form of Age-Related Macular Degeneration (AMD)

Leaky blood vessels in the macula causes blurred visions and blind spots if you have the wet form of AMD. The macula is the area of the retina responsible for color and central vision. Anti-VEGF (vascular endothelial growth factor) injections are often used to treat this form of AMD. Injecting the anti-VEGF agent into the vitreous prevents new blood vessels from forming. The vitreous is the clear, gel-like fluid that gives your eyeball its shape.

Injections may be combined with photodynamic therapy. The first step in the procedure involves injecting Visudyne (an anti-VEGF agent that’s absorbed by your blood vessels) into your arm. Your eye doctor then focuses a laser on your retina, activating the agent.

Several Procedures Offer Hope if You Have Diabetic Retinopathy

High blood sugar can damage vessels in the retina, causing them to leak blood or fluid. Your ophthalmologist may recommend photocoagulation, a laser treatment that seals the leaks or causes abnormal blood vessels to shrink by creating tiny burns on the vessels.

Although photocoagulation can stop new leaks, you may still have trouble seeing due to blood that has already collected inside your eye. Vitrectomy, a surgical procedure that removes scar tissue and the bloody part of the vitreous can be helpful. Anti-VEGF injections may also be recommended if you have diabetic retinopathy.

LASIK Improves Your Vision Whether You’re Nearsighted, Farsighted, Have Astigmatism, or Presbyopia

Laser-assisted in situ keratomileusis (LASIK) improves your eyesight, eliminating or reducing the need for eyeglasses or contact lens. During the procedure, your ophthalmologist creates a flap in your cornea and reshapes it using a laser. Reshaping the cornea alters the way light rays bend when they enter your eye. Light rays must focus precisely on the retina for sharp, clear vision.

You’ll probably notice a significant improvement in your vision immediately after your procedure and may completely recover from the LASIK surgery in just a few days.

PRK Offers Another Vision Improvement Option

Photorefractive keratectomy (PRK) offers an alternative to LASIK. During PRK, your eye doctor removes the top layer of corneal cells, then uses a laser to improve the shape of your cornea. Your vision may improve more gradually with PRK, and full healing may take a month.

Could an eye procedure help you protect or improve your vision? Contact your office to schedule an appointment to discuss your eye issues.

Sources:

American Academy of Ophthalmology: Glaucoma Treatment, 2/6/20

All About Vision: Cataracts

Bright Focus Foundation: Treatments for Wet Macular Degeneration

Mayo Clinic: Diabetic Retinopathy

Healthline: What’s the Difference Between PRK and LASIK?

Centers for Disease Control and Prevention: Don’t Let Glaucoma Steal Your Sight

How Your Eyes Age

No matter how attentive you are with the care of your body, signs of aging are inevitable. Hair begins to turn to gray, joints ache, and dropping a few extra pounds becomes much more challenging. Aging also affects your eyes, causing vision changes and an increased risk of several eye diseases. As you get older, a few of these things may happen.

You Develop Presbyopia

Presbyopia makes reading difficult for people who are 40 and older. The problem occurs when the lens in your eye becomes less flexible. The clear lens, located inside your eye behind the iris and pupil, must constantly change shape as you focus on near, far, and mid-range objects.

As the lens flexibility decreases, you may have to hold papers or your smartphone at arm’s length to see words clearly. If you currently wear eyeglasses, you might find that it’s easier to read small print if you take off your glasses.

Reading glasses, bifocals, trifocals or progressive eyeglass lenses, or multifocal contact lenses make reading much more comfortable. Laser refractive surgery offers another option to improve your vision if you have presbyopia.

Colors Become Less Vivid

Cones, the cells in your retina responsible for color and central vision, lose sensitivity as you age. Colors may appear duller, or you may have difficulty distinguishing between shades, particularly in the blue and purple color groups.

Your Eyes Are Dryer

Dry eye is more common in older adults, due to a natural decline in tear production or poor tear quality. According to the American Optometric Association, most people over age 65 experience dry eyes.

Artificial tears can help keep your eyes moist. If you have severe dry eye, your ophthalmologist may recommend blocking tear ducts with tiny plugs to improve your tear film or might prescribe drops that increase tear production.

Cataracts May Cause Your Vision to Cloud

Do things look a little blurry and faded lately? You may have cataracts. The condition occurs when the lenses of your eyes become cloudy. If you have cataracts, you may notice halos around lights or increased glare, particularly at night. Half of all Americans have cataracts by age 75, according to the American Academy of Ophthalmology.

Replacing your clouded lens with an artificial lens during cataract surgery will improve your vision.

Peripheral Vision Decreases

Your peripheral (or side) vision may gradually shrink over the course of your life. In fact, you may experience a 20- to 30-degree loss of side vision as you reach your 70s and 80s, reports All About Vision.

Floaters and Flashers Increase

Floaters drift across your field of vision and look like shadowy specks or cobwebs. They form when the gel-like vitreous that gives your eye its shape begins to shrink with age. As the vitreous shrinks, small fibers detach, forming floaters. Floaters can sometimes be accompanied by flashes of light. Although floaters or flashers aren’t harmful, seeing a large number of them can be a sign of retinal detachment.

You Need More Light for Reading or Close Work

Aging weakens the muscles that control your pupil size. Your pupils constantly change size to control the amount of light that enters your eyes. When the muscles weaken, your pupils become smaller and less responsive to light, according to the National Institutes of Health (NIH). The NIH notes that people in their 20s need three times less light for reading than those in their 60s.

Your Risk of Certain Eye Diseases and Conditions Rises

As you grow older, you’re more likely to develop:

• Age-Related Macular Degeneration (AMD). AMD causes loss of central vision and also affects your ability to see colors.
• Diabetic Retinopathy. If you’ve had diabetes for years, you may be at increased risk of diabetic retinopathy. The condition causes blood vessels in your retina to leak, clouding your vision.
• Glaucoma. Glaucoma occurs when the pressure inside your eye becomes dangerously high. It can damage your optic nerve, causing partial or complete loss of vision.
• Retinal Detachment. Retinal detachments can also threaten your vision. The condition happens when part of the retina begins to tear or peel away from the back of the eye. If your retina isn’t successfully reattached, you may experience permanent vision loss.

Has your vision changed as you’ve gotten older? Regular eye exams can help you protect your eyesight. Contact our office to schedule your appointment.

Sources:

American Optometric Association: Dry Eye

American Academy of Ophthalmology: Eye Statistics

National Institutes of Health: Your Aging Eyes, 1/11

American Optometric Association: Adult Vision: 41 to 60 Years of Age

American Optometric Association: Adult Vision: Over 60 Years of Age

AARP: How Your Eyes Change with Age, 1/7/19

Facts and Myths about Cataracts for Cataract Awareness Month

When enough people repeat misinformation about cataracts, myths tend to be regarded as the truth. June is Cataract Awareness Month and it’s the perfect time to examine the myths and facts regarding cataracts and cataract surgery.

Myth: Vitamins and herbal medications clear cataracts.

Fact: Surgery is the only way to improve your vision if you have cataracts.

Cataracts occur when the lens inside your eye becomes cloudy. The normally clear lens sits behind your iris and pupil and focuses light rays on to your retina, the layer of photosensitive cells that lines the back of the eye.

The eye condition may cause blurry or double vision, light sensitivity, increased glare, faded colors, and trouble seeing at night. During cataract surgery, your opthalmologist replaces your cloudy lens with an artificial lens called an intraocular lens implant (IOL). Once the IOL is in place, you’ll be able to see clearly once again. Cataract surgery is very effective and has a 95 percent success rate, according to Prevent Blindness.

Myth: Only adults get cataracts.

Fact: Although cataracts primarily affect adults, babies and children can have cataracts too.

Pediatric cataracts can be present at birth or develop later. These cataracts are also treated with surgical replacement of the lens. Prompt removal of cataracts is crucial, as a cloudy lens can affect the development of normal vision in children.

Myth: Recovering from cataract surgery takes a long time.

Fact: Most people recover from the surgery in four to six weeks.

Although full recovery takes a few weeks, you’ll probably notice improvements in your vision within a few days of your surgery.

Myth: There’s nothing you can do to prevent cataracts.

Fact: It may not be possible to prevent all cataracts, but you can do a few things to reduce your risk.

These steps may help you avoid cataracts or slow the progression of your condition if you already have cataracts:

• Use Sun Protection. Sunglasses that block both UVA and UVB light protect your eyes and reduce your risk of cataracts and cancer in and around your eyes.
• Don’t Smoke. People who smoked more than 15 cigarettes a day had a 42 percent higher risk of having cataract surgery than non-smokers in a study published in JAMA Ophthalmology. Quitting smoking not only helps you avoid cataracts but also offers multiple health benefits.
• Keep Chronic Diseases Under Control. Diabetes and high blood pressure may increase the likelihood that you’ll develop cataracts. Taking your medication as prescribed and monitoring blood sugar and blood pressure levels will help you protect your vision.
• Eat a Healthy Diet. Although vitamins won’t reverse cataracts, eating fruits and vegetables that contain lutein, zeaxanthin, or vitamins A and E may lower your cataract risk.
• Wear Goggles or Safety Glasses. Eye injuries increase your risk of cataracts. Using eye protection at work or when you complete home improvement projects offer an easy way to protect your vision.

Myth: Cataract removal only improves your eyesight.

Fact: Clearer vision enhances your quality of life and helps you avoid injuries.

Driving, reading, or enjoying a hike in the woods becomes difficult when you have cataracts. Surgery restores your ability to see road signs clearly, read prescription labels, or tackle the latest blockbuster novel.

When you can’t see well, you’re more likely to trip and fall over a tree root during a hike or even injure yourself at home. A 15-year mortality study conducted by Australian researchers determined that older people who had cataract surgery had higher long-term survival rates than those who decided against surgery.

Do your cataracts complicate your life? Cataract Awareness Month is a great time to decide what surgical treatment options are best for you.

Sources:

Prevent Blindness: Know the Risk Factors for Cataracts

American Academy of Ophthalmology: Pediatric Cataracts

JAMA Network: JAMA Ophthalmology: Smoking Cessation and the Risk of Cataracts, 3/14

NCBI: Ophthalmology: Correction of Visual Impairment by Cataract Surgery and Improved Survival in Older Persons: the Blue Mountains Eye Study Cohort, 9/13

American Academy of Ophthalmology: What Are Cataracts?, 10/1/19

National Eye Institute: Cataracts

All About Vision: Cataracts: 3 Common Types, Causes, Symptoms and Treatment, 6/19

Retinal diseases are notoriously hard to treat. The diseases, many of them inherited, cause cells in the retina to degenerate or die. Without these crucial cells, vision impairment or blindness can occur. A recent gene therapy breakthrough offers promise in treating one type of retinal disease and may help scientists devise treatments for other forms of retinal disease.

What Does the Retina Do?

The retina is a layer of light-sensing cells at the back of your eye. When light rays enter your eyes, your retina transforms the rays into electrical impulses. These impulses travel to the brain via the optic nerve and are processed into recognizable images. When retinal cells deteriorate or die, blurred vision and blind spots may begin to appear.

Other symptoms, such as light sensitivity, loss of color, or night vision can occur, depending on the particular retinal disease. If the disease is progressive, partial or total blindness can eventually occur.

Who Will Benefit from the Breakthrough?

Thanks to gene therapy, people who have Leber’s congenital amaurosis have seen some lost vision restored. Symptoms of the inherited condition often appear in infancy and soon cause severe vision impairment due to a faulty RPE65 gene. Although scientists have known for many years that gene mutations interfere with normal retinal development, effective treatment wasn’t available until recently.

How Does the Treatment Work?

The treatment involves injecting a fully functioning, genetically modified version of the gene under the retina in people who have Leber’s congenital amaurosis. The healthy gene is placed inside an adenovirus to transport it into the eye. The virus was chosen specifically because it doesn’t cause illness once it enters the body. After entering the retina, the gene triggers the production of enzymes that improve vision.

During a research study, participants ranging in age from 4 to 44 experienced significant improvements in vision. After treatment, participants could recognize faces, read or see stars in the sky, according to the Foundation Fighting Blindness, a research organization that supported the study.

Can Gene Therapy Treat Other Types of Retinal Diseases?

The RPE65 gene therapy, known as LUXTERNA, may also help people who have a form of retinitis pigmentosa (RP) caused by a mutation of the RPE65 gene. RP is a group of inherited retinal disorders that cause loss of night vision and gradual loss of peripheral, or side vision.

Gene therapy studies have been conducted or are underway to find effective treatments for other retinal diseases, including macular degeneration. Macular degeneration affects the macula, the center part of the retina responsible for central and color vision. The disease is often age-related and causes distorted vision or blind spots in the center of your vision.

Researchers are studying the effects of gene therapy on a number of other retinal diseases, including X-linked RP, Stargardt disease, achromatopsia, Usher syndrome, X-linked juvenile retinoschisis, and Leber hereditary optic neuropathy.

In a January 2020 report, Applied Genetic Technologies Corporation reported positive six-month data from its ongoing gene therapy trial for X-linked RP. The corporation noted that visual function improved in the nine study participants who received central treatment for the disease.

These gene therapy advances are incredibly exciting and offer hope to anyone dealing with vision loss due to retinal disease.

Do you have a retinal disease? Your ophthalmologist can help you manage your symptoms and offer treatments in some cases.

Sources:

Foundation Fighting Blindness: Leber Congenital Amaurosis Research Advisory, 2/1/19

Ophthalmology Times: Blazing a New Trail in Gene Therapy for Retinal Disease, 2/12/20

American Society of Gene and Cell Therapy: Inherited Retinal Diseases

Healio: Retina: Emerging Gene Therapy Treatments for inherited Retinal Diseases, 7/19/18

AGTC: AGTC Reports Positive Six-Month Data from its Ongoing Phase 1/2 Clinical Trial in X-Linked Retinitis Pigmentosa

Corneal Disease Symptoms, Diagnosis, and Treatments

Blurriness, pain, sensitivity to light, and other eye symptoms can occur if you have a disease that affects your cornea. The clear, curved layer of tissue covers your iris and pupil and focuses light rays on to the retina at the back of your eye. Changes to the cornea due to corneal disease can result in temporary or permanent vision problems. Fortunately, ophthalmologists offer a variety of treatments that can protect your vision.

Keratoconus

Keratoconus changes the curvature of the cornea, causing it to become cone-shaped. The change in the shape of the cornea may result in progressively worsening nearsightedness and astigmatism. Other symptoms can include sensitivity to glare and light. Keratoconus runs in some families but may also be caused by sun exposure, poorly fitting contact lenses, rubbing your eyes frequently, or long-term eye irritation.

Treatment: Eyeglasses and contact lenses can improve vision distorted by keratoconus. If soft contact lenses don’t sharpen your vision, you may need harder gas permeable lenses, scleral lenses that rest on the white parts of your eyes, or hybrid lenses that feature a harder center and softer outside ring. Corneal cross-linking, a treatment that involves applying riboflavin drops to your cornea, then exposing it to ultraviolet light may stop the progression of the condition. Corneal transplants might be needed if scarring or thinning occurs.

Keratitis

This condition occurs when the cornea becomes painfully inflamed due to an ulcer, eye injury, infection, contaminated contact lenses, or wearing contact lenses longer than recommended. In addition to pain, you may notice redness, blurred vision, tearing, discharge, sensitivity to light, trouble opening your eye, or the feeling that something is stuck in your eye.

Treatment: Treatment varies depending on the cause of keratitis but may include artificial tears, eye drops to control pain, antibiotics, or anti-fungal medication. If the condition isn’t treated promptly, permanent vision loss can occur.

Fuch’s Dystrophy

Most common in people over age 50, this inherited corneal dystrophy causes deterioration in the endothelium, the layer of the cornea responsible for maintaining the optimal moisture level. When the cornea can no longer remove water efficiently, it begins to swell. The swelling causes blurred or foggy vision, particularly in the morning. Other symptoms can include glare, colored haloes around lights, pain, and difficulty seeing at night.

Treatment: Your eye doctor may prescribe a salt solution or ointment that removes excess water from your corneas. Surgery to replace the inner two-thirds of the cornea may be needed if the solution is no longer helpful.

Ocular Herpes

The same virus that produces cold sores can also cause sores on your corneas. Ocular herpes can also be caused by the sexually transmitted form of the herpes virus. The disease affects about 50,000 people in the U.S. every year, according to the American Academy of Ophthalmology. Just like cold sores, ocular herpes can occur more than once. Symptoms of ocular herpes include pain, tearing, sensitivity to light, blistering rash on your eyelids, headaches, and a foreign body sensation.

Treatment: Antiviral medication and eye ointments are used to treat ocular herpes. Steroid drops can help decrease inflammation.

Lattice Dystrophy

Abnormal protein fibers form a pattern in your cornea that looks like a lattice in this inherited corneal dystrophy. The disease can affect the clarity of your vision and cause painful corneal erosions, tearing and sensitivity to light. In many cases, lattice dystrophy is diagnosed during childhood or adolescence.

Treatment: Prescription eye drops, ointments, and bandage contact lenses can be helpful initially. If the disease is severe, your eye doctor may recommend laser treatment to reshape or remodel the cornea or a corneal transplant.

Diagnosing Corneal Disease

Your eye doctor may use one or more of these instruments and tests to diagnose corneal disease:

• Slit-Lamp: During a slit-lamp exam, your ophthalmologist uses a low-powered microscope and a high-intensity light beam to examine your cornea and other parts of your eye. The exam can help your eye doctor diagnose corneal infections, abrasions, and abnormal changes.
• Keratometer: This machine projects light on to the front part of your cornea and helps your ophthalmologist determine if your cornea is abnormally curved.
• Corneal Mapping: Corneal mapping uses a computer to create a digital map of your cornea. The test provides valuable information on the surface and thickness of your cornea.

Your eye doctor can detect and diagnose early symptoms of many types of corneal diseases during annual eye examinations. If it’s time for your exam, or you’ve been having trouble with your vision, call us to schedule an appointment.

Sources:

American Academy of Ophthalmology: Demystifying the Ocular Herpes Simplex Virus

Cleveland Clinic: Corneal Disease, 3/15/15

WebMD: Common Cornea Problems, 12/9/17

American Academy of Ophthalmology: What Causes Cornea Problems, 9/10/19

American Academy of Ophthalmology: Corneal Dystrophy Diagnosis and Treatment

Diabetes may increase your risk of developing several serious eye diseases, whether you have Type 1 or 2 diabetes. Without prompt treatment, an eye disease may damage your vision or even cause blindness. Carefully controlling your blood sugar and learning the warning signs of diabetic eye disease can help you avoid vision loss.

When Blood Sugar Rises

Blurry vision is often one of the first signs of diabetes. The symptom occurs when the lens in your eye swells in response to a higher-than-normal blood sugar level. The lens, a clear, flexible disc located inside your eye behind your iris, focuses light rays on your retina, the light-sensing layer of cells that lines the back of your eye. If the lens becomes swollen, the light rays are disrupted and your vision blurs.

Although your vision usually returns to normal once your blood sugar drops, it’s not a good idea to ignore bouts of blurry vision. If you don’t lower your blood sugar level with dietary changes and/or medication, blurriness will continue, and you may increase your risk of developing diabetic retinopathy and several other eye diseases.

Four Eye Diseases That May Affect Your Eyes If You Have Diabetes

People who have diabetes are at an increased risk of developing these eye diseases:

• Diabetic Retinopathy. Diabetes causes blood vessels in your retina to leak fluids or blood and may also trigger the formation of new, abnormal vessels. Both of these changes can interfere with clear vision, although you may not notice any changes in your vision during the first stage of the disease. One-third of people 40 and older who have diabetes have diabetic retinopathy, according to the Centers for Disease Control and Prevention.
• Glaucoma. Glaucoma damages the optic nerve, the pathway between your eyes and your brain, and can cause permanent vision loss. The trouble starts when the pressure inside your eye becomes too high. Like diabetic retinopathy, the disease doesn’t usually cause symptoms at first.
• Cataracts. Cataracts occur when the normally clear lens becomes cloudy, causing dim or blurred vision, light sensitivity, glare and color changes. Although cataracts often occur due to aging, people who have diabetes are more likely to develop them.
• Diabetic Macular Edema. Swelling in the macula, the part of the retina responsible for central and color vision, can also occur if you have diabetes. If edema isn’t treated promptly, permanent damage to your central vision can occur.

Diabetic Eye Disease Symptoms

In most cases, you won’t notice any change in your vision during the earliest stages of diabetic eye disease. Unfortunately, by the time you do notice symptoms, the damage may be irreversible. Symptoms vary depending on the type of eye disease but can include:

• Blurred Vision, Either Constant or Intermittent
• Dark or Missing Spots in Your Vision
• Flashing Lights
• Sudden Increase in Floaters
• Cloudy or Dim Vision
• Sensitivity to Lights and Glare
• Frequent Changes to Your Eyeglass Prescription
• Changes in Color Vision

Call your eye doctor as soon as possible to schedule an appointment if you experience any of these symptoms. If you suddenly notice blank or dark spots in your vision, go to the emergency room immediately.

Reducing Your Risk of Eye Disease

These steps can help you lower your risk of diabetic retinopathy:

• Embracing a Healthy Diet. Prevent blood sugar spikes by eating a low-carb diet that’s high in fruits, vegetables, whole grains, and lean meats, poultry, and fish.
• Taking Medications as Instructed. Don’t skip your diabetes medication, even if you feel fine. Failing to take insulin or other medications as prescribed can result in blood sugar fluctuations that may increase your likelihood of developing eye diseases.
• Watching Your Weight. Obesity can be a factor in diabetes and many other diseases. Shedding extra pounds sensibly may help extend your life and lower your diabetic eye disease risk.
• Quitting Smoking. Giving up your tobacco habit offers multiple benefits, including better eye health.
• Visiting the Eye Doctor Annually. During annual eye exams, your eye doctor can spot changes in your eyes that can occur if you have a diabetic eye disease. Dilation is an important part of a comprehensive eye exam and allows your eye doctor to view your retina, macula, lens, and optic nerve clearly. Since diabetic eye diseases can be symptomless at first, these visits are crucial to your eye health.

Protect your sight with regular eye exams. Contact us to schedule your next appointment.

Sources:

Centers for Disease Control and Prevention: National Diabetes Statistics Report

National Institute of Diabetes and Digestive and Kidney Diseases: Diabetic Eye Disease

American Academy of Ophthalmology: Diabetes Eye Disease, 1/28/19

American Optometric Association: Diabetic Retinopathy

Diagnosis and Treatments for Wet and Dry AMD

Age-related macular degeneration (AMD) may affect your vision as you grow older, causing a blank or blurry spot in the center of your vision. The eye disease is the primary cause of vision loss in people who are 50 or older, according to the American Academy of Ophthalmology.

Which Form Do You Have?

Dry and wet forms of AMD produce similar symptoms but have different causes. Both forms affect the macula, the area of the retina responsible for central and color vision. The retina lines the back of the eye and converts light rays into electrical signals that are sent to the brain via the optic nerve. If cells in the retina are damaged or die, you’ll notice blank or distorted spots in your vision.

Most people diagnosed with AMD have the dry form, which occurs when the macula thins and yellow deposits called drusen collect under the retina. The drusen eventually kill the cells in the macula, causing central vision loss.

Leaking blood vessels are responsible for the wet form of the disease. The trouble starts when abnormal vessels begin to grow under the retina. As these new vessels leak blood and fluids, the macula becomes scarred.

What Are the Symptoms of AMD?

AMD symptoms tend to develop very gradually and often aren’t noticeable until your central vision is significantly diminished. Fortunately, your eye doctor can detect changes in your macula long before you notice a difference in your vision.

As AMD progresses, you’ll lose vision in the very central part of your visual field, but your peripheral (side) vision will remain unchanged. Blurred vision or blank spots will make it difficult to see objects clearly when you look straight ahead. Objects may also appear wavy, or you might notice a decrease in brightness. Central vision loss can make recognizing faces, reading, driving and other everyday tasks difficult.

Who Gets AMD?

Age is a key risk factor in AMD, but it’s not the only one. You may be more likely to develop the disease if:

• Other People in Your Family Have Had AMD
• You Have High Cholesterol, Uncontrolled High Blood Pressure or Heart Disease
• Your Meals Often Include Foods That Are High in Saturated Fats
• You Smoke
• You Rarely Wear Sunglasses
• You’re Overweight
• You Have Light-Colored Irises
• You’re Far-Sighted
• You’re Female or Caucasian

How Is AMD Diagnosed?

AMD can often be detected during a simple test at your eye doctor’s office. During the test, you’ll be asked to look at a grid pattern. Your eye doctor will want to know if the boxes appear the same size; if the lines are straight, blurry or wavy; or if you notice any missing lines or dark areas.

Your eyes will also be dilated to provide your doctor with a clear view of your retina, macula, and optic nerve. If your eye doctor suspects that you have AMD, he may recommend a fluorescein angiography test to evaluate the blood vessels in your retina.

What Types of Treatments Are Available for AMD?

Although there’s no way to treat the dry form of AMD, you may be able to slow the progression of the disease by making healthy eating choices, losing weight, quitting smoking, controlling your blood pressure, and wearing sunglasses.

Taking certain vitamins may also slow the disease’s progression. Results from the Age-Related Eye Disease Study 2 conducted by the National Eye Institute showed that taking these vitamins can be helpful in some people:

• Vitamin C – 500 mg
• Copper – 2 mg
• Vitamin E – 400 IU
• Lutein – 10 mg
• Zeaxanthin – 2 mg
• Zinc – 80 mg

Several research studies are underway to evaluate new treatments to slow or halt the progression of dry AMD.

Wet AMD treatment targets the leaky blood vessels in your retina using Anti-VEGF or laser treatment. VEGF (vascular endothelial growth factor) is a molecule needed for the growth of new blood vessels. Unfortunately, in some cases, the presence of the molecule may trigger the formation of weak or abnormal vessels. Injecting anti-VEGF into your eye prevents new vessels from developing. Laser surgery may also be used to seal leaky vessels in the macula.

Sources:

American Academy of Ophthalmology: Vitamins for AMD, 5/12/18

American Academy of Ophthalmology: What is Macular Degeneration?, 5/10/19

National Eye Institute: Age-Related Macular Degeneration

Glaucoma affects more than three million people in the U.S., according to the Glaucoma Research Foundation, yet many people are unaware that they have the disease. Glaucoma Awareness Month, observed every January, draws attention to the symptoms of this disease, helping countless people avoid vision loss.

What is Glaucoma?

Glaucoma occurs when high pressure inside your eye damages your optic nerve. The nerve transmits light impulses between the eyes and the brain. Once the impulses reach the brain, they’re transformed into recognizable images. If the impulse transmission is disrupted anywhere along the optic nerve, partial or complete vision loss can occur.

What Causes Glaucoma?

Poor drainage is responsible for the increase in pressure in the eye. The aqueous humor, a clear fluid that fills the space between the lens and cornea, drains from the eye through a network of tiny channels. If the drainage channels become blocked, eye pressure rises, increasing the risk of optic nerve damage. (The lens of the eye is located behind your iris and pupil and focuses light on your retina, while the cornea is the clear layer of tissue that covers the iris and pupil.)

What Are the Symptoms of Glaucoma?

Glaucoma symptoms vary depending on the type of the disease. If you have primary open-angle glaucoma, the pressure inside your eye increases gradually. Although you may not notice any symptoms initially, the disease can slowly impair your vision. If primary open-angle glaucoma isn’t diagnosed and treated promptly, you’ll eventually notice blind spots in your field of vision.

Acute angle-closure glaucoma happens suddenly and can occur if part of your iris blocks the drainage canals, preventing fluid from leaving your eye. If you have acute angle-closure glaucoma, your vision may become blurry, and you may see halos around lights.

Other symptoms may include severe pain in your eye, headache, redness in the white part of your eye, nausea, and vomiting. If you experience these symptoms, go to the emergency room immediately. Prompt treatment is essential if you have this form of glaucoma.

In some cases, optic nerve damage can occur even if the pressure inside your eye is normal. Called normal-tension glaucoma, this form of the disease can eventually damage your peripheral vision.

Who Gets Glaucoma?

Although anyone can develop glaucoma, you may be at increased risk if:

• You’re Over Age 60 (Or Over Age 40 if You’re African American)
• You Have Heart Disease, Diabetes or High Blood Pressure
• You’re Native Alaskan, African American or of Asian Descent
• Other Members of Your Family Have Had Glaucoma
• You Injured Your Eye or Had Surgery on Your Eye
• You’re Severely Nearsighted
• You Used Corticosteroids
• You Have Irregularities in Your Cornea or Optic Nerve

What Treatment Options Are Available?

Prescription eye drops are often used to treat primary open-angle glaucoma. Depending on the type, the drops may lower the amount of fluid your eye produces or increase fluid drainage. In some cases, oral medication may be needed in addition to drops.

Laser or traditional surgery is usually required if you have acute open-angle glaucoma or if primary open-angle glaucoma has not responded well to eye drops. During surgery, your ophthalmologist may make tiny holes in your iris to improve drainage, create new drainage channels, place a drainage tube in your eye, or reduce pressure by damaging the part of the eye that makes aqueous humor.

Medication or surgery is also used to treat normal-tension glaucoma.

How Can I Avoid Vision Loss Due to Glaucoma?

Annual eye examinations offer a simple way to protect your eyesight. During your exam, your ophthalmologist measures your eye pressure and uses drops to dilate your pupil. Once the pupil is dilated, he or she has a better view of your retina and optic nerve.

Dilation is a particularly important part of your eye exam, as subtle changes to the optic nerve can be a warning sign of glaucoma. If you’re diagnosed with glaucoma, you’ll immediately begin treatment to protect your sight.

Don’t let glaucoma damage your vision. Contact our office to schedule your appointment.

Sources:

American Academy of Ophthalmology: What Is Glaucoma?, 8/28/19

American Optometric Association: Glaucoma

Glaucoma Research Foundation: Glaucoma Facts and Stats

Laser Therapy May Reduce Vision Loss Caused by Wet AMD

We rely on good central vision for so many things, from reading to driving to recognizing faces. Unfortunately, your central vision may be in jeopardy if you have age-related macular degeneration (AMD). Although there are no treatments for the dry form of the disease, laser therapy may be helpful if you have the wet form of AMD.

What Is AMD?

AMD affects the macula, the center area of the retina responsible for central and color vision. Two kinds of AMD, wet and dry, can cause changes in your vision.

Macular cells thin and fatty deposits called drusen form on the retina if you have the dry form of the disease. The wet form of AMD occurs when fluids and blood leak from abnormal blood vessels that grow in the macula. The blood or fluid collects under the macula and distorts your vision.

If you have the wet form of AMD, you may experience one or more of these symptoms:

• Blurred central vision
• A blank spot in the center of your vision
• Straight lines that appear bent or wavy
• Faded colors
• Sensitivity to light
• Difficulty reading, watching TV, driving or avoiding obstacles when you walk

AMD can affect one or both eyes and may occur very suddenly. Prompt treatment of your symptoms can help you avoid or reduce vision loss. Call your eye doctor immediately if you notice any of these symptoms listed above.

If you have the wet form of AMD, your ophthalmologist may recommend laser therapy to stop the leaks. No matter what type of laser therapy you have, you’ll receive a sedative and anesthetic eye drops or injections to ensure that you remain comfortable and pain-free during the procedure. You can leave your eye doctor’s office shortly after receiving laser therapy, although you’ll need to ask a friend or family member to drive you home.

Laser Photocoagulation Therapy

Laser photocoagulation therapy can be helpful in treating leaky blood vessels, particularly if the vessels are located close to each other. During the treatment, short pulses of laser light are aimed at the abnormal blood vessels. The heat generated by the pulses seals the leaky areas instantly.

Eye drops are used to dilate your pupil before the procedure begins. Enlarging the size of the pupil gives your doctor the best view of your macula.

A special mirrored contact lens will be placed on your eye after your pupil is dilated. The mirror helps your eye doctor aim the laser beam precisely. You’ll see short bursts of light as the laser is aimed at your macula.

You’ll need to visit your ophthalmologist for periodic checkups after your treatment. Additional treatments may be needed if some vessels start to leak again.

Photodynamic Therapy

Photodynamic therapy combines laser therapy with medication to close and destroy leaky blood vessels. The process starts with the intravenous injection of Visudyne, a drug that’s sensitive to light. Visudyne travels from the blood vessel in your arm to the abnormal vessels in your macula.

After the medication reaches your eyes, your doctor shines a laser beam in your eye. Unlike the laser used in photocoagulation therapy, this laser uses cold instead of heat to produce results.

The laser beam activates the medication, which creates blood clots that close the abnormal veins. You may need additional photodynamic therapy if the vessels begin to leak in the future.

Laser therapy offers a safe, effective way to preserve your vision if you have wet AMD. Contact us if you would like to find out if laser treatment is a good option for your eye condition.

Sources:

American Academy of Ophthalmology: How Is AMD Diagnosed and Treated?

Mayo Clinic: Wet Macular Degeneration

AllAboutVision: Macular Degeneration Treatment

American Macular Degeneration Foundation: Wet Macular Degeneration

Glaucoma Treatments Can Help You Avoid Vision Loss

Glaucoma raises the pressure inside your eye, increasing your risk of visual impairment or blindness. Fortunately, treatments offered by your ophthalmologist can help you protect your ability to see.

How Glaucoma Affects Your Vision

Glaucoma damages your optic nerve, the crucial connection between your eyes and your brain. The damage occurs when the aqueous humor, a fluid that nourishes your lens and cornea, builds up inside the eye. A well-functioning drainage system is essential to aqueous humor balance. As new fluid is produced, the older fluid drains from the eye. When drainage channels become blocked, fluid builds up and presses on the optic nerve, damaging it.

Symptoms vary depending on the type of glaucoma you have. Common types include:

• Primary Open-Angle Glaucoma. Pressure builds slowly if you have this form of the disease. Most people don’t even know that they have primary open-angle glaucoma until they experience blind spots in their vision. Unfortunately, once the damage occurs, it can’t be corrected. Scheduling yearly eye exams with your ophthalmologist may help you avoid the devastating effects of glaucoma. A quick test can determine if the pressure inside your eye is too high. Your eye doctor will also examine your optic nerve after dilating your eyes.
• Angle-Closure Glaucoma. Angle-closure glaucoma can happen very quickly and may cause obvious symptoms, unlike primary open-angle glaucoma. The trouble starts when your iris blocks drainage channels in your eye, causing pressure to rise. If the blockage occurs suddenly, you may experience severe pain in your eye, redness, blurred vision, nausea, vomiting, headache, and halos around lights. Emergency treatment can prevent or limit the damage to your eye.
• Normal-Tension Glaucoma. In some cases, glaucoma can occur even if the pressure inside your eye is normal. You may be at increased risk of developing normal-tension glaucoma if you have a family history of the disease, are of Japanese descent or have systemic heart disease, according to the Glaucoma Research Foundation. You may lose peripheral or side vision if you have the disease, although you may have no symptoms at first.

Glaucoma Treatments Can Help Preserve Your Vision

Glaucoma treatment can be as simple as using special eye drops every day. The drops lower the pressure in your eye by decreasing fluid production. Some drops also improve fluid drainage.

Although the drops are very beneficial, they can cause a few side effects, including stinging, blurred vision, headaches, dry mouth or fatigue. Stinging and blurry vision often gets better as your eyes adjust to the drops. If you’re concerned about side effects, don’t stop using the drops. Call your ophthalmologist to discuss your problems. He or she may prescribe a different type of drop that is less likely to cause side effects.

If drops alone don’t decrease your eye pressure enough, your eye doctor may add an oral medication to your treatment plan. The medication also decreases fluid production and improves pressure.

Other treatment options include:

• Trabeculoplasty. If you have primary open-angle glaucoma, and your pressure hasn’t decreased after using drops or pills, your eye doctor may recommend a trabeculoplasty. This procedure involves using a laser to improve drainage inside your eye. The surgery only takes about 15 minutes and is performed on an outpatient basis. Over the next several weeks, the pressure in your eye will drop. You may still need to use prescription eye drops after the procedure, although some people will be able to discontinue the drops.
• Laser Peripheral Iridotomy (LPI). LPI creates a new drainage route by making a small opening through your iris with a laser. It’s used to treat angle-closure glaucoma.
• Cycloablation. Cycloablation damages the ciliary body, the part of the eye that produces the aqueous humor. As a result, fluid production declines. This laser procedure is used if your pressure is still high after you’ve had other treatments, or you can’t undergo other treatment options due to the shape of your eye.
• Trabeculectomy. During a trabeculectomy, your ophthalmologist makes a flap in your sclera, the white part of your eye. The flap allows extra fluid to drain easily. It’s performed for both open-angle and angle-closure glaucoma and is used when other treatments haven’t been helpful.
• Drainage Implant Surgery. Adding a small silicone tube to the front chamber of the eye creates a permanent drainage path and lowers pressure inside the eye.
• Micro-Invasive Glaucoma Surgery (MIGS). MIGS uses less invasive surgical techniques to improve drainage, decrease fluid production, and reduce pressure. Some of these surgeries can be performed at the same time as cataract surgery.

If you suffer from glaucoma and would like to find the best treatment option for you, contact us to schedule an appointment.

Sources:

Glaucoma Research Foundation: Normal-Tension Glaucoma

https://www.glaucoma.org/glaucoma/normal-tension-glaucoma.php

National Eye Institute: Facts About Glaucoma

https://nei.nih.gov/health/glaucoma/glaucoma_facts

Bright Focus Foundation: Six Questions to Ask Before Starting Glaucoma Treatment

https://www.brightfocus.org/glaucoma/article/six-questions-to-ask-before-starting-glaucoma-treatment

The Glaucoma Foundation: Treating Glaucoma

https://glaucomafoundation.org/aboutglaucoma/treating-glaucoma/

Caused by the same irritants as hay fever, runny nose, coughing, and sneezing, eye allergies commonly affect those who suffer from other allergy symptoms. Not only do eye allergies cause discomfort, but they can also interfere with daily activities.

Eye Allergy Causes

Medically referred to as allergic conjunctivitis, individuals who are predisposed to allergic reaction experience eye allergies when they come into contact with allergens (substances which prove harmless to others, like pollen, mold, dust, and pet dander). In addition to these allergens, some eye allergy sufferers also experience reactions to perfumes, smoke, cosmetics, insect bites/stings, foods, and the preservatives found in eye drops.

When an allergy sufferer’s eyes come into contact with an allergen, his or her immune system reacts, and cells known as mast cells release histamine to try to combat the allergen. Histamine causes the symptoms associated with eye allergies.

Eye Allergy Symptoms

When mast cells in the eyes release histamine to fight off allergens, the eye lids, conjunctiva (membrane covering the underside of the eyelid), and sclera (white of the eye) become irritated. This leads to swelling, redness, watering, burning, and itching. Severe eye allergies can also cause light sensitivity. Though it appears similar, unlike pink eye (bacterial or viral conjunctivitis), allergic conjunctivitis is not contagious.

Who Is at Risk?

Eye allergies affect up to 30 percent of adults and 40 percent of children. While anyone can be born with or develop allergies, people whose parents suffer from allergies are more likely to have allergies.

Diagnosis and Treatment

If you suffer from eye allergy symptoms, an eye care professional can provide you with a proper diagnosis, ruling out bacterial or viral conjunctivitis. Often over the counter eye drops formulated for allergy relief are often sufficient treatment. If they do not provide enough relief, an eye care professional can recommend or prescribe other methods of treatment such as decongestants, oral antihistamines, eye drops with antihistamine and mast stabilizer, corticosteroids, or immune therapy shots.

Eye Allergy Prevention

The best way to prevent eye allergies is to avoid eye allergens. Keep windows closed and stay indoors as much as possible during allergy season, replace air conditioning filters with high quality filters that trap allergens, reduce exposure to animals, wash bedding in hot water to remove allergens, and reduce humidity in the home to prevent mold growth.

Optometry warnings about the damaging effects of ultraviolet radiation on our eyes have not yet reached the degree of public awareness of that of skin damage. Yet, the sun can be just as damaging upon our eyes with unprotected exposure. Short-term exposure to very bright sunlight can result in a type of sunburn to our eyes regardless of the season. Photokeratiitis — also known as “snow blindness” and “flash burns” — is a sunburn to the eye’s cornea and conjunctiva, the membranes lining the eyelids and the outermost lining of the eye. Like a skin sunburn, the initial inflammation, pain and redness can last up to 48 hours before subsiding. Treatment such as cold cloths over the eyes and an over-the-counter anti-inflammatory medication can help relieve some of the painful symptoms, but the best treatment is prevention best obtained by wearing sunglasses and a hat with a brim.

The Damage Adds Up

One day on the beach and a couple of days of sore eyes doesn’t seem like much, but eye care providers warn that the effect is cumulative and the damage increases with every day of unprotected overexposure. Long-term damage goes beyond crow’s feet from squinting in the bright sunlight. Years of unprotected exposure to the sun can result in increased chances of cataracts, damage to the retina, macular degeneration, cancer of the eye itself and cancer of the eyelid. Pterygium, a recurring condition where the conjunctiva grows over the cornea to restrict vision, requires repeated surgeries to keep in check is also common.

Not All Sunglasses Are Equal

Any pair of sunglasses is better than wearing none at all, but not all sunglasses provide the same degree of protection to the eye. Ask your eye care provider for recommendations to fit your lifestyle and your budget.

Dry Versus Wet AMD and Their Treatment Options

Everything changes as you get older, even your vision in many cases. If you’ve noticed a little difficulty with your central vision, you may have age-related macular degeneration (AMD). The condition is the leading cause of vision loss in people 50 and older, according to the American Academy of Ophthalmology (AAO).

How Macular Degeneration Changes Your Vision

The macula is located in the center of the retina, the thin layer of cells that lines the back of your eye. The retina sends light impulses to your brain, which turns the impulses in easily recognizable images.

Your macula is responsible for central and color vision. If cells are damaged or abnormal blood vessels form in the macula, colors may appear dull, or blank and blurry spots may appear in your central vision. Macular degeneration can affect one or both eyes.

Dry AMD: The Most Common Form

The dry form of macular degeneration affects 80 percent of people who have the condition, the AAO notes. If you have dry macular degeneration, the cells in your macula gradually get thinner. Drusen may also be present under the macula if you’ve been diagnosed with the dry form of the condition. Drusen are yellow spots that form when fatty proteins clump together.

AMD is painless and doesn’t cause any symptoms, at first. In fact, you may not even be aware that you have a problem with your eyes unless you visit an eye doctor yearly for eye examinations.

Distorted vision can be a symptom of the dry form of AMD. The change in vision occurs if drusen lift the center of the macula slightly. You may notice that straight lines suddenly appear bent or curved if this happens. It may also take longer for your eyes to adjust when you enter a dark room.

If the condition progresses, you may eventually notice blank or blurry spots in the middle of your vision. Although the spots can get bigger with time, they usually don’t affect your peripheral, or side vision.

Wet AMD

The wet form of AMD occurs when new blood vessels grow under the macula, causing it to bulge or swell. These abnormal vessels begin to leak fluid and blood, which can interfere with vision. If wet AMD isn’t treated, permanent scarring can occur in the macula.

The same symptoms occur whether you have dry or wet AMD. In addition to a white or dark spot in the center of your vision or blurred vision, you may notice wavy lines and colors that seem less intense. Unlike dry AMD, wet AMD symptoms can happen very suddenly.

AMD Treatment Options

Treatment options vary depending on the type of AMD. At this time, there is no treatment available for dry AMD, but you may be able to delay or stop the progression of the condition by taking supplements and vitamins identified in the National Eye Institute’s Age-Related Eye Disease Study. They include:

• Copper (2 mg)
• Zeaxanthin (2mg)
• Lutein (10 mg)
• Zinc (80 mg)
• Vitamin E (400 IUs)
• Vitamin C (500 mg)

An implantable miniature telescope may be an option if you have severe vision loss due to the dry form of AMD. The telescope replaces the lens of one of your eyes and projects larger than normal images on to the retina, allowing healthy areas of the retina outside the macula to provide color and central vision.

If you have the wet form of AMD, your eye doctor may recommend injectable medications that prevent abnormal blood vessels from growing in your eye. The injections use very small needles and can be placed in the corner of your eye.

No matter what type of AMD you have, you may benefit from magnifiers, eyeglasses with telescopic lenses, large print books, software programs that convert text to speech, and other low vision aids.

Are you concerned about your central vision? Contact us to schedule an eye examination.

Sources:

Sight Matters: What is Macular Degeneration?

https://www.sightmatters.com/what-is-amd/pgrid/69417078842/ptaid/kwd-58061546?utm_term=age-related%20macular%20degeneration&mkwid=n01fpobg-dc_pcrid_337203807318_pkw_age-related%20macular%20degeneration_pmt_e_prodid__slid__&utm_campaign=nb_sightmatters_understand_exact&utm_medium=cpc&utm_source=google&gclid=eaiaiqobchmiijlrk9qc5aivzudich0zpqroeaayasaaegl0spd_bwe

American Academy of Ophthalmology: What Is Macular Degeneration?, 5/10/19

https://www.aao.org/eye-health/diseases/amd-macular-degeneration

Bright Focus Foundation: Treatments for Dry Macular Degeneration

https://www.brightfocus.org/macular/dry-macular-degeneration/treatments

VisionAware: What Treatments Are Available for Wet Macular Degeneration?

https://www.visionaware.org/info/your-eye-condition/age-related-macular-degeneration-amd/treatments-for-wet-macular-degeneration/125

What to Expect Before, During, and After Your Cataract Surgery

Cataracts cause blurred vision, sensitivity to light and other symptoms that make reading, walking and driving much more difficult. Fortunately, surgery offers a safe, effective way to improve your eyesight. If cataract surgery is on your calendar, here’s what will happen before, during and after your procedure.

Before Surgery

A cataract forms when the clear lens located behind your iris and pupil becomes cloudy. During cataract surgery, your ophthalmologist replaces your clouded lens with an artificial lens called an intraocular lens implant (IOL).

Before your surgery, you and your eye doctor will decide which type of IOL is right for you. Types of IOLs include:

• Monofocal: These lenses only offer one focusing distance. Depending on your preference, your monofocal lens can provide clear vision up close, at a distance or at a mid-range point. Many people prefer monofocal lenses that offer clear distance vision. They rely on glasses for reading and viewing near objects.
• Multifocal: Multi-focal lenses offer multiple focusing zones that enable you to see objects clearly at any distance.
• Accommodative: Accommodative lenses also allow you to see clearly at various distances. These lenses move with your eye muscles, allowing you to focus on near objects one second and far objects the next.
• Toric: Toric lenses are a good choice if you have astigmatism. Astigmatism causes blurred vision due to an irregularly shaped cornea (the clear layer that covers your iris and pupil).

The pre-surgery process involves a few eye measurements and tests, including a test that will help your eye doctor determine the correct focusing power for your IOL. You’ll also discuss your health and provide a list of current medications. One day before surgery, you’ll begin using drops that help prepare your eye for surgery. These drops reduce the risk of infection and decrease inflammation.

You’ll need to stop eating or drinking after midnight the night before your surgery in most cases. You may need to temporarily discontinue some medications before your cataract surgery. Your ophthalmologist will tell you which medications you should skip.

The Day of Surgery

A friend or family member will need to drive you to and from your surgical appointment. After you arrive at the facility, drops will be placed in your eye to dilate the pupil. You’ll receive either local or intravenous anesthesia before surgery begins. Although you won’t feel a thing during cataract surgery, you may see some hazy shapes.

Phacoemulsification, the most common way to perform cataract surgery, usually only takes about 15 minutes. During the phacoemulsification procedure, your eye doctor makes a small incision in your cornea or in the white part of your eye using a scalpel or laser. Sound waves from an ultrasonic device break the cataract into small pieces for easy removal. After the pieces of the cataract are suctioned out of your eye, your doctor inserts your IOL.

After Surgery

You’ll probably be able to go home just an hour or two after your surgery. Before you step outside, you’ll want to put on a pair of sunglasses, as bright light will irritate your eyes.

It’s important to use your eye drops as prescribed and wear an eye shield for sleeping for the first week after surgery. You may also need to wear an eye patch for several days after your surgery.

While your eye heals, you may notice that it looks a little red. Redness is completely normal and will gradually disappear in a few days or weeks. Although your eye may be a little inflamed, it probably won’t hurt very much. Over-the-counter pain relievers can be helpful if you have mild pain for a day or two after the procedure.

You may notice that your vision is clearer and colors are brighter just a few hours after surgery, although it will probably take a week or more for the full benefits of the surgery to become obvious.

You’ll need to avoid heavy lifting, exercising or bending during the first week. Water, dust, and dirt can irritate your eye and cause an infection. It’s best to keep your eyes closed when bathing, avoid swimming and put off home improvement projects until you fully recover.

Have your cataracts begun to interfere with your daily activities? Cataract surgery can clear your vision. Contact us to schedule an appointment to discuss your options.

Sources:

AAO: Cataract Surgery Infographic

https://www.aao.org/eye-health/news/cataract-surgery-infographic

All About Vision: Cataract Surgery

https://www.allaboutvision.com/conditions/cataract-surgery.htm

Mayo Clinic: Cataract Surgery

https://www.mayoclinic.org/tests-procedures/cataract-surgery/about/pac-20384765

Prevent Blindness America: Guide to Cataract Surgery

https://www.preventblindness.org/sites/default/files/national/documents/fact_sheets/MK13_GuideCataract_0.pdf

National Eye Institute: Facts About Cataract

https://nei.nih.gov/health/cataract/cataract_facts

Fuchs corneal dystrophy affects the cornea, the clear window over the front of your eye. It causes swelling that leads to cloudiness, glare and increasing visual impairment. Women are slightly more likely than men to develop Fuchs. Onset usually happens after the age of 50; though early signs might start to become noticeable between the ages of 30 and 40. Fuchs usually affects both eyes.

Cause

The cornea’s extremely thin inner layer is called the endothelium. Its main task is to pump excess fluid out of the cornea. Fuchs dystrophy causes the endothelial cells to deteriorate, thereby interfering with the pumping action. This makes vision increasingly hazy and distorted as fluid accumulates. Some people inherit Fuchs dystrophy, but other family members are unaffected.

Symptoms

Normally, your cornea is thicker in the morning since it retains fluid while you sleep. If you have Fuchs dystrophy, you awaken with blurred morning vision, which clears as the day progresses. However, as the disease progresses, this blurry vision will stay with you all day.

Other symptoms may include:

• Light sensitivity
• Seeing halos around lights
• Glare
• Hazy or swollen corneas
• Tiny, painful blisters on your corneas

Usually Fuchs progresses slowly, but the timeline varies with this unpredictable disorder.

Diagnosis

Ophthalmologists use various tests to diagnose Fuchs dystrophy. In addition to a standard visual acuity test, your eye doctor will use special instruments to examine your cornea. He or she will be checking for bumps on the back surface of your cornea as well as corneal pressure, thickness and cell count.

Treatment

If you have the early stages of Fuchs dystrophy, your doctor will use ointments, drops or soft contact lenses to reduce corneal swelling. To dry out blisters, you may be instructed to hold a hair dryer at arm’s length and blow-dry your eyes.

If the disorder progresses to the point where your vision is seriously compromised, your eye doctor will suggest surgery. This could mean replacing the back of your cornea with donor tissue or the entire cornea with a cornea transplant. These procedures are generally performed on an outpatient basis using local anesthesia. According to the Fuchs Corneal Dystrophy Foundation, corneal transplants have a success rate of more than 95 percent.

It you’re experiencing any symptoms of Fuchs corneal dystrophy, call our office today so we can test your eyes and help you understand your best treatment options.

Would you like to improve your vision without glasses or contacts but aren’t sure which laser surgery option is the best choice? Learning a little about LASIK, LASEK and SMILE procedures can help you make your decision.

Laser-Assisted In-Situ Keratomileusis (LASIK)

LASIK is an excellent choice if you’re nearsighted, farsighted or have astigmatism or presbyopia, an age-related condition that makes it hard to see close objects clearly. During LASIK surgery, your eye doctor uses a laser to create a flap in your cornea, the clear layer of tissue that covers your iris and pupil.

After lifting the flap, he or she uses another laser to make a few changes to your cornea. Reshaping the curvature of your cornea changes the way light rays are focused on your retina, which makes your vision clearer. After the cornea is reshaped, the flap returns to its normal position and heals naturally. No stitches are required for LASIK surgery.

The surgery only takes a few minutes and significantly improves your vision. More than 90 percent of people have 20/20 to 20/40 vision after LASIK, according to the American Academy of Ophthalmology. Most people notice the beneficial effects of the treatment within 24 hours.

Laser-Assisted Epithelial Keratomileusis (LASEK)

LASEK may be a better choice if you have a thin cornea, dry eyes or a high level of nearsightedness. Unlike LASIK, only one laser is used to perform LASEK surgery. Before the laser is used, your eye doctor loosens a thin layer of corneal cells called the epithelial layer with an alcohol solution. He moves these cells to one side of your cornea and uses a laser to reshape the cornea.

The epithelial layer is then moved back to its original position and covered with a special contact lens that acts as a bandage. You’ll wear the contact lens for about four or five days after the procedure.

It takes a little longer for your vision to improve if you have LASEK instead of LASIK. Although your vision will be much better within a week, it may take weeks or months to achieve the final results.

Small Incision Lenticule Extraction (SMILE)

During a SMILE procedure, there’s no need to create a flap or dislodge the epithelial layer. After tiny incisions are made in the cornea with a laser, your eye doctor removes a thin, disc-shaped layer of corneal tissue called a lenticule. Removal of the lenticule changes the shape of your cornea and improves your visual acuity. The small incisions in your cornea will heal on their own without stitches.

Currently, SMILE is only being used to treat nearsightedness. Although you may not notice improvements quite as soon as with LASIK, your vision will be much clearer in just a few hours and will improve more and more every day. Final results may take a few weeks to appear.

Questions to Ask Before You Make a Decision

Asking a few of these questions can help you decide if laser surgery is right for you:

Will I Have 20/20 Vision?

Although 20/20 vision is the goal of laser surgery, it may not be possible to achieve perfect vision in some cases. If you won’t be happy with 20/30 or 20/40 vision, you may want to reconsider laser surgery.

Will There Be Any Side Effects?

Your vision may be a little blurry initially no matter what type of surgery you choose, although it should gradually improve. Glare and halos around lights can occur for several weeks or months after laser surgery. Dry eye is another potential side effect depending on the type of laser surgery.

Will I Still Need Glasses After Surgery?

You may need glasses for reading and other activities if your vision isn’t quite 20/20 after laser surgery. If you have presbyopia, you will need reading glasses unless your surgeon adjusts one eye for near vision and one for far. Although this is certainly an option, it can make some people feel a little dizzy.

Are you ready to improve your vision with laser surgery? Contact us to make an appointment to discuss your options.

Sources:

All About Vision: SMILE Laser Eye Surgery, 12/17

All About Vision: LASEK Eye Surgery, 9/17

American Academy of Ophthalmology: LASIK – Laser Eye Surgery, 12/12/15

Diabetes is a condition that involves high blood sugar (glucose) levels. This can affect many parts of the body, including the eyes. One of the most common diabetic eye diseases is diabetic retinopathy, which is also a leading cause of blindness in American adults.

Diabetic Retinopathy

Diabetic retinopathy includes several conditions that affect the light-sensitive layer of tissue on the back of the eye, known as the retina. This tissue is responsible for capturing light and passing on images to the brain.

There are two main types of diabetic retinopathy:

• Nonproliferative retinopathy. This is the most common type. In this condition, the tiny blood vessels (capillaries) at the back of the eye swell and form pouches. As this condition gets worse, it can starve the retina of its blood supply.
• Proliferative retinopathy. When the retina doesn’t get enough blood, new blood vessels grow. These tend to be weak and can leak blood, which can cause vision loss or blindness.

Diabetic retinopathy can also cause vision loss when fluid leaks into the macula, the part of the retina that is responsible for the sharp, central vision. The leakage of fluid can lead to swelling of the macula (macula edema) and blurred central vision.

Glaucoma

Diabetics have a higher risk of developing glaucoma than people without diabetes. This risk increases with age and the length of time that you’ve had diabetes.

Glaucoma causes pressure to build up inside the eye, often because the fluid in the eye drains more slowly. The increased pressure can squeeze the tiny blood vessels that feed the optic nerve and retina. Over time, this can damage these structures and lead to loss of vision.

Cataracts

Cataracts are another condition that affects diabetics more often than non-diabetics. In this condition, the lens of the eye becomes cloudy, which prevents some of the light from reaching the retina.

In its early stages, treatment for cataracts may involve the use of prescription lenses. As cataracts advance, however, surgery may become necessary to remove the cataractous lens, replace it with an intraocular lens implant (IOL) and restore vision.

If you suffer from diabetes, it is particularly important to keep all your yearly eye exams, so your eye doctor can monitor the health of your eyes. If you notice changes in your vision, contact us immediately, so we can help diagnose and treat any eye conditions you may have.

Somewhere around the age of 40, most people’s eyes lose the ability to focus on close-up objects. This condition is called presbyopia. You may start holding reading material farther away, because it is blurry up close. Reading suddenly gives you eyestrain. You might wonder when manufacturers started putting such small print on everything. Symptoms of presbyopia may worsen if the light is dim, you are tired or you have been drinking alcohol.

Causes and Risk factors

Presbyopia is one of the common refraction-related vision disorders. The shape and condition of your cornea and lens affects refraction, or the way light bends as it enters your eye. With presbyopia, an age-hardened lens is no longer flexible enough to change shape to focus on nearer images. This causes light to focus behind your retina, causing near images to appear out of focus.

Some people notice this difficulty focusing on up-close objects when they are as young as 35, but the onset of presbyopia typically occurs as individuals enter their 40s. The condition can worsen until individuals are about 65 years old.

Nonsurgical Treatment for Presbyopia

For people who previously had good vision, the solution may be as simple as buying over-the-counter reading glasses. If you have a more complicated vision situation — such as being nearsighted while also developing presbyopia — you may need prescription bifocals. These allow you to read up-close text by looking through the lower portion of your eyeglass lenses as well as see far things clearly by looking through the upper portion of the lenses.

Contact lenses are an option for some patients. However, bifocal contact lenses are more difficult to fit than regular contact lenses. Monovision contacts are another choice. This means one of your contacts is used for distance while the other is used for close work. Successfully using monovision contacts can require time and practice.

Surgical Treatment for Presbyopia

Several types of surgery may also improve presbyopia. Most of these involve tiny lasers that are used to reshape the cornea. In another surgical procedure called refractive lens exchange (RLE), the ophthalmologist removes the lens in each eye, replacing them with synthetic lenses.

If you want to be able to enjoy reading again without headache or eyestrain, call our office so we can help you see your best.

The only way to correct the clouded vision caused by advanced cataracts is surgical intervention. If you find yourself pursuing cataract surgery to remove one or both cataract-disease lenses, you may be wondering what surgical approaches are available for treatment.

Although eye surgeons have successfully removed cataracts using manual surgical techniques for decades, new laser techniques give them more control over this delicate procedure.

The Laser Procedure

Both traditional and laser cataract surgery involve removing the natural cataractous lens and replacing it with an artificial lens. The traditional approach involves making a tiny incision in the eye with a manual surgical device. In laser cataract surgery, a femtosecond laser is used to make the incision instead. The ophthalmologist also uses a laser to break up the cataract-diseased lens before removing it, instead of using ultrasonic energy to perform this step. By replacing the manual steps in the procedure with the use of a laser, the ophthalmologist is able to provide an added level of precision during treatment and minimize any risks associated with the manual actions.

Laser Precision

While human eyes are similar, each is slightly different in terms of depth, size and the curve of the cornea. Laser surgery techniques take advantage of advanced technology to precisely map your eyes. This information is then used to calibrate the laser used during some surgical procedures, allowing extremely precise treatment.

Faster Recovery

The laser’s precision speeds up both the surgery and the recovery time. Because the eye is less disturbed by the laser than with a mechanical blade, it may heal faster.

Results

Laser cataract surgery is still new, and study results have varied. Some studies have found the results to be comparable to traditional cataract surgery. Others conclude the superiority of the laser. A study published in a 2014 issue of Optometry Times found that the vision of the group treated with lasers was overwhelmingly better. The endothelial cell count on the cornea was also healthier after laser versus traditional cataract surgery.

One drawback: The cost of laser cataract surgery is higher than the standard procedure. Talk to your insurance company to find out about your coverage level.

If you need cataract surgery and want to explore your treatment options, call us today so we can help.

With cataract surgery, your ophthalmologist removes the cataract-diseased lens of your eye. The ophthalmologist then replaces your natural lens with an artificial one.

The Procedure

This outpatient procedure is generally safe and takes less than an hour. Your ophthalmologist will dilate your pupil with eye drops and administer local anesthetic eye drops. You may also be prescribed a sedative to counter anxiety.

Once your eye surgeon has made a small, self-sealing incision in the eye, he or she performs a step called phacoemulsification. During this step of the procedure, the ophthalmologist inserts a thin probe into the cataractous lens and uses ultrasound waves to break it up, before suctioning out the pieces.

Once your eye surgeon removes your cataract, he or she implants an intraocular lens (IOL). IOLs come in a wide variety of materials and functions. Some help with both near and distant vision, similar to bifocals. Others block ultraviolet light. You and your doctor will discuss the best type for you.

If you need cataract surgery in both eyes, your doctor will likely recommend doing one at a time, with a healing period in between.

Recovery

Usually, you can go home on the day of your surgery. However, you’ll need to arrange for somebody to drive you home from the surgical facility. You might also need help around the house, as your doctor may restrict bending and lifting for a few days.

Expect mild discomfort, light sensitivity, fluid discharge and itching for a few days after surgery. For a short period of time after surgery, you may need to wear a patch or eye shield while sleeping or take medications that control eye pressure.

Your eye doctor will schedule follow-up visits to monitor your progress. Once healed, you’ll get a new prescription for eyeglasses, if necessary.

After surgery, some people develop a secondary cataract, also called posterior capsule opacification. Eye surgeons can usually treat a secondary cataract with a quick, painless outpatient procedure.

Risks

Cataracts are usually treated safely and successfully. However, risks — while uncommon — do exist. These include swelling, infection, inflammation, retinal detachment, glaucoma and loss of vision. People with serious medical conditions or other eye diseases are at increased risk of complications.

If you suspect you need cataract surgery, call us today to discuss your options.

Normal sight includes central vision (the field of view straight ahead) and peripheral vision (the field of view outside the circle of central vision). The inability to see within a normal range of view often indicates peripheral vision loss. In severe cases of peripheral vision loss, individuals only see with their central vision, which causes the sensation of looking through a narrow tunnel. For this reason, peripheral vision loss is sometimes referred to as tunnel vision.

Peripheral Vision Loss Signs and Symptoms

The primary symptom of peripheral vision loss is tunnel vision. When this symptom occurs, you are only able to see a small circle straight ahead. You may also have difficulty seeing in low light and have trouble walking.

Peripheral vision loss does not always occur rapidly. As a result, many sufferers do not immediately realize they are experiencing a loss of peripheral vision, and do not receive diagnosis until examined by an eye care professional.

Peripheral Vision Loss Causes

Several conditions cause peripheral vision loss. Some conditions are serious and require immediate treatment, while others will simply clear up on their own. Any loss of vision or change in sight, however, should prompt an immediate examination by an eye care professional to rule out or begin treatment for any serious medical conditions.

Conditions which cause peripheral vision and require medical treatment include glaucoma, damage to the retina, detached retina, retinitis pigmentosa, brain damage due to stroke or loss of blood, occlusions (eye strokes), optic nerve damage, optic neuritis, compressed optic nerve head, and concussions or other head injuries.

In addition to these conditions which can lead to permanent vision loss, some factors cause temporary tunnel vision and may not require medical treatment. These include alcohol and drug use, high levels of adrenalin, extreme stress, panic, and anger. Peripheral vision loss due to these factors will clear up on its own with no treatment.

Diagnosis and Treatment

Eye care professionals diagnose peripheral vision loss by using a field of vision exam to test your range of vision. If peripheral vision loss is detected, the eye care professional will determine the specific cause by performing further medical testing, observation, and by looking at your medical records. Once an underlying cause is determined, an eye care professional will recommend the treatment options. Depending on the cause, this might include surgery, medication, or vision therapy.

How to Tell if You Have a Retinal Detachment

A retinal detachment can cause permanent vision loss if you don’t receive prompt treatment from an ophthalmologist. Recognizing common signs and symptoms of the condition will help you protect your eyesight.

What Happens During a Retinal Detachment?

The retina is a layer of light-sensing cells that lines the back of your eye. Light rays enter your eye through your pupil and are directed to your retina through the clear lens located just behind your iris. Your retina sends the light impulses via the optic nerve to the brain, which converts them to images.

During a retinal detachment, part of the retina pulls away from the back of the eye. If this happens abruptly, you’ll notice a sudden change in your vision. When the detachment occurs gradually, symptoms may be more subtle, and vision changes may happen more slowly.

What Symptoms May Occur If I Have a Detached Retina?

You may notice one or more of these symptoms:

• Floaters. If you’re over 40, you’re probably used to seeing stringy floaters drift across your field of vision occasionally. As you age, the gel-like vitreous humor that gives your eyeball its shape begins to shrink slightly. Floaters occur when fibers in the shrinking vitreous clump together. When you look at a bright object, you see shadows formed by the clumps. Seeing a few of these shadowy threads, cobwebs or shapes is perfectly normal. However, the sudden appearance of many floaters may be a sign of a retinal detachment.
• Flashes. Flashing lights are another sign of a possible retinal detachment. The flashes may look like miniature bolts of lighting or tiny stars.
• Vision Loss. You may notice that a curtain seems to cover part of your visual field or that you can no longer use your side vision. The area of lost vision may increase if you don’t receive treatment immediately.
• Wavy Lines. Objects may lose their sharp edges when your retina detaches. You might notice that lines that normally look straight may now appear curved.

Could a Retinal Detachment Happen to Me?

Anyone can develop a retinal detachment, but they’re more likely to happen if you’ve recently injured your eye, are very nearsighted, had cataract surgery, had a detached retina in the other eye, or have a family history of retinal detachment. You may be at increased risk of the condition if you have certain eye conditions, such as lattice degeneration, uveitis or retinoschisis.

How Do Ophthalmologists Treat Retinal Detachments?

Treatment involves reattaching the retina and also addressing issues that may have caused the detachment, such as a tear in the retina or leaking blood vessels. Therapy for retinal detachment may include:

• Vitrectomy. Vitrectomies remove the vitreous humor, making it easier to make repairs to the retina. Salt water or a vitreous substitute replaces your natural vitreous humor at the conclusion of the surgery.
• Laser Surgery. The laser creates a series of small burns around a hole in the retina. The scars that form help the retina reattach.
• Cryopexy. During cryopexy, a special probe freezes the area around a retinal tear. Freezing also creates scar tissue that fuses the retina to the back of the eye.
• Scleral Buckle. In some cases, a scleral buckle, a tiny band sewn into the white part of your eye, will be used to facilitate reattachment after you’ve had laser surgery or cryopexy.
• Pneumatic Retinopexy. Your treatment may involve injecting a gas bubble over the tear with pneumatic retinopexy, then sealing the tear with laser surgery or cryopexy.

More than 90 percent of retinal detachments can be successfully treated with modern therapies, according to the National Eye Institute. Although surgery can help preserve your eyesight, it may take a few weeks or months to see an improvement in your vision.

Are you worried that you or a family member may have a retinal detachment or another vision condition? Contact us to schedule an appointment. (Call us immediately if you suspect that the problem is caused by a retinal detachment or visit the emergency room.)

Sources:

National Eye Institute: Facts About Retinal Detachment, 10/09

https://nei.nih.gov/health/retinaldetach/retinaldetach

National Eye Institute: Facts About Floaters, 10/09

https://nei.nih.gov/health/floaters/floaters

American Society of Retinal Specialists: Retinal Detachment

https://www.asrs.org/patients/retinal-diseases/6/retinal-detachment

Medical News Today: What You Need to Know About a Detached Retina, 1/23/18

https://www.medicalnewstoday.com/articles/170635.php

Vitreoretinal surgery refers to a group of surgeries which take place inside the eye’s interior where the vitreous (gel-like material) and retina (photosensitive membrane) are located. Vitreoretinal procedures are either performed with traditional surgical tools or lasers, and address a range of ophthalmic issues including diabetic retinopathy, macular degeneration, detached retina, macular hole, CMV retinitis, epiretinal membrane, and diabetic vitreous hemorrhage.

Vitrectomy

A specific type of vitreoretinal eye surgery, a vitrectomy procedure removes the vitreous, a gel-like substance located in the middle of the eye. A vitrectomy is usually performed under general anesthesia, but depending on the patient’s health, is sometimes performed with local anesthesia.

During a vitrectomy, an eye surgeon inserts small instruments into the eye. The surgeon cuts the fibers which attach the vitreous gel to the retina, and suctions out the vitreous. The surgeon then repairs any holes or tears in the retina or macula (center of the retina), flattens any areas where the retina is detached, and removes any vitreous fibers or scar tissue still attached to the retina. At this point, the eye care provider fills the vitreous cavity with either a gas, saline solution, or a silicone oil to restore normal eye pressure.

Why Vitrectomy?

The vitrectomy procedure was developed to address several eye-related problems such as retinal detachment, macular hole, epiretinal membrane, proliferative vitreoretinopathy, endophthalmitis, and intraocular foreign body removal. Commonly, vitrectomy is used to treat diabetic vitreous hemorrhage, a condition in which the retina bleeds into the vitreous.

Vitrectomy has been shown to vastly improve the visual acuity of patients suffering from vision loss, distortion, or disruption due to vitreous hemorrhage. The procedure also reduces the risk of severe bleeding in patients who have begun to experience vitreous hemorrhage and for patients with abnormal blood vessels in the iris.

When is Vitrectomy Needed?

A vitrectomy is a complicated surgical procedure with the potential for complications like elevated intraocular pressure, retinal detachment, continued bleeding into the vitreous, corneal edema (fluid buildup in the cornea), or internal eye infection. As a result, this type of eye surgery is only used as a last resort in extreme cases of vitreous hemorrhage which do not clear up without treatment.

Every patient and every eye is different, and therefore responds differently to treatment. For this reason, diagnosis from an eye care professional specializing in retinal conditions and procedures is necessary before undergoing a vitrectomy.

Myopia, or nearsightedness, means that your eyes can see close objects clearly but struggle to see things in the distance. Nearly 30 percent of Americans are nearsighted.

This condition usually develops in children and teenagers, up to about the age of 20. A teacher or parent might notice a child squinting at the chalkboard or TV. Other common symptoms include headaches, frequent blinking and rubbing of the eyes and failing to notice distant objects.

Causes

If the curvature of your cornea — the clear part on the front of your eye — is too steep, you will be nearsighted. Myopia can also be caused by an eyeball that is too long, relative to the lens’ and cornea’s focusing power. Light entering your eye will not be correctly focused, causing things in the distance to look blurry.

However, what causes these defects is still under debate. Heredity and visual stress are leading contenders. If both parents are nearsighted, the child is at higher risk. Examples of visual stress include excessive reading, computer use or other tasks that demand the eyes to focus on close objects. Note: Myopia due to close work is sometimes temporary.

Eye problems can also be symptoms of other disorders, such as diabetes or a cataract developing in the eye.

Testing and Diagnosis

Eye doctors test patients’ vision by having them read letters on a Snellen chart that is placed about 20 feet away from the patient. Your doctor may also use lighted instruments to determine the focusing power of your eyes. Sometimes, eye doctors use eye drops to dilate the eyes. This temporarily prevents the eyes from changing focus, so he or she can examine them more easily.

Once your eye doctor finishes the test, he or she can determine whether you have myopia. If you suffer from myopia, you and your eye doctor will discuss possible treatment options.

Non-Surgical Treatment Options

Eyeglasses are the most commonly prescribed and least invasive method of treating myopia. Depending on how nearsighted you are, you might need to wear glasses some or all of the time. If you also have trouble seeing things close-up, your eye doctor might prescribe bifocals. These let you see both far and close objects more clearly, and are popular with patients over the age of 40.

Contact lenses can provide a wider field of vision and may let you see more clearly. However, because they are worn directly on the eye, they need extra care and cleaning. Contact lenses are not recommended for those who are squeamish about touching their eyes.

Orthokeratology, also called corneal refractive therapy, involves wearing rigid contact lenses that reshape your cornea’s curvature. This therapy changes how light enters your eyes, eventually making your eyes focus correctly. The results from orthokeratology are temporary, and patients must continue to use these specialized contact lenses to maintain results.

Surgical Treatment Options

Laser procedures such as photorefractive keratectomy and LASIK have become more prevalent over the last few decades. With laser vision correction surgery, the ophthalmologist uses laser energy to remove a small amount of corneal tissue, thus reshaping the curvature of the cornea and correcting the refractive error that is causing myopia.

Highly nearsighted people may be better suited for another type of refractive surgery, including refractive lens exchange (RLE). The ophthalmologist implants a corrective lens directly into the eye. This lens is placed either right in front of the eye’s natural lens or it replaces the natural lens entirely.

Many treatments are available to myopic patients. Call our practice today, so we can help you decide which one is best for your visual needs and lifestyle practices.

People with hyperopia, also known as farsightedness, can usually see objects in the distance, but their close vision is blurry. Symptoms of untreated hyperopia include:

• Difficulty concentrating on near work, such as reading
• Eye strain
• Headaches after reading or other activities involving close focus
• Aching, burning eyes
• Irritability from concentrating on tasks
• In children, eyes may look crossed

Causes and Risk Factors

If your cornea lacks an insufficient degree of curvature or your eyeball is too short, you’ll be farsighted. These defects, called refractive errors, prevent light from focusing correctly inside your eye. Instead of an image being focused on the retina, your eye focuses it behind the retina. This results in blurred close vision.

About 5 to 10 percent of Americans have hyperopia. You’re more likely to be farsighted if your parents are.

Diagnosis

To diagnose hyperopia, your eye doctor will give you eye drops to temporarily suspend your eye’s focusing mechanism. Then, he or she can assess how farsighted you are.

Prescription Lens Treatment

If you are only a little farsighted, your eyes might be able to compensate without any intervention. Many hyperopic people can benefit from corrective lenses, either eyeglasses or contact lenses. Corrective lenses help your eyes focus correctly by altering how light enters them.

Eyeglasses are the simplest way to correct hyperopia. However, many people prefer contact lenses, since they provide slightly clearer vision than glasses do. Your doctor can discuss the pros and cons of each.

Surgical Treatment

Several types of refractive surgery permanently alter the shape of the cornea, decreasing or eliminating the need to wear corrective lenses. The ophthalmologist uses a small laser to reshape your cornea by sculpting tiny amounts of corneal tissue. To treat hyperopia, he or she increases the curvature of the cornea.

If you think you might be farsighted, call us today so we can help find the most appropriate treatment option for you.

There are several types of refractive surgery available to correct vision problems caused by refractive errors, including:

• LASIK (laser-assisted in situ keratomileusis)
• Custom or bladeless LASIK
• Photorefractive keratectomy (PRK)
• Laser epithelial keratomileusis (LASEK)
• Epi-LASIK
• Conductive Keratoplasty (CK)
• Phakic Intraocular Lenses (IOLs)
• Refractive Lens Exchange (Clear Lens Extraction)

Most of these procedures involve reshaping the curvature of the cornea with laser or heat. Sometimes, a very thin flap is made in the cornea, so the ophthalmologist can access and reshape the cornea underneath. Afterwards, the flap is replaced and the cornea is allowed heal on its own, without the need for sutures.

Before deciding on a type of refractive surgery, talk to your ophthalmologist about the potential risks and side effects. Keep in mind that there is not a single best procedure for everyone. Your ophthalmologist can help you choose a procedure that fits your visual requirements and lifestyle.

Collagen crosslinking (CXL) is a relatively new procedure used to treat patients with keratoconus. Keratoconus is a thinning of the corneas which causes them to form a cone shape and bulge outwards. Many countries outside the U.S. use CXL, but the procedure hasn’t yet received FDA approval. However, since 2008, many people with keratoconus have participated in nationwide clinical trials in the U.S.

The Idea

Strong crosslinks between collagen fibers help healthy, normal corneas retain their shape. However, people with the thin corneas characterized by keratoconus lack adequate collagen support beams. The idea behind CXL is to strengthen these beams, to stabilize the corneas, allow them hold their shape, improve their focusing power and halt the thinning process before vision is further impaired.

The Procedure

This outpatient procedure takes about 90 minutes if both eyes are being treated. Your doctor may prescribe a sedative or anti-anxiety pill to help you relax. You’ll lie on your back in a reclined chair and receive numbing drops in your eyes. Your ophthalmologist will remove the epithelium, the thin outermost layer of your cornea. She or he will insert riboflavin drops into your eye or eyes while you focus on a blue ultraviolet light. The combination of riboflavin and light strengthens your collagen crosslinks. The procedure is painless, but you may experience soreness afterwards.

The Epithelium Question

A less invasive CXL approach called transepithelial CXL is available for patients whose corneas are still thick enough to withstand this treatment option. This technique allows the epithelium to stay on, rather than be removed. A study by CXL-USA, a research group of eye doctors working on keratoconus and other corneal disorders, concluded that visual acuity was better in the transepithelial group. Results were about 20-percent better three and six months after CXL in the patients who retained their epitheliums. However, studies are still in the early stages.

Risks

All surgery has risks. With CXL, risks include infection, delayed epithelial healing, hazy vision and scarring. According to a 2012 article in the Journal of Ophthalmology, the doctors interviewed found these risk only affected a very small percentage of the total cases. Risks must also be weighed against the alternatives, which include progressive vision loss and the need for corneal transplantation, a much more invasive procedure.

Recovery and Results

Post-surgery, most patients may find their vision is worse than before. However, they notice improvements within two months. Some patients experience a major vision improvement three to six months after the procedure. Their vision may continue to improve for five years. Patients who have the transepithelial procedure, wherein their epithelium remains intact, generally report faster recovery and improvements to their vision.

If you suffer from keratoconus and want information about CXL clinical trials, call us today. We’ll help you determine the best options to maximize your vision.

Treatment for glaucoma often begins with medicated eye drops. The goal of these medications is to lower the pressure in the eye (intraocular pressure) and prevent damage to the optic nerve.

To gain the most benefits of these medications, use them exactly as prescribed by your eye doctor. Sometimes your doctor may prescribe more than one type of eye drop. In this case, check with your doctor about how long to wait between using each kind.

Side Effects of Medicated Eye Drops

Although eye drops for glaucoma can help save your vision, all of these medications have some side effects. In addition, some of the medication may be absorbed into the bloodstream, which can cause side effects that affect body parts other than your eyes.

The most common side effects of medicated eye drops include:

• Redness of the eyes or skin around the eyes
• An itching or stinging sensation
• Blurred vision
• Changes in the color of your eyes, the skin around your eyes or the appearance of your eyelid
• Growth of your eyelashes
• Changes in your heartbeat or pulse
• Changes in your energy level
• Breathing changes, especially if you have asthma or other lung conditions
• Dry mouth

If you experience any of these side effects, tell your eye doctor. Do not stop taking your medicated eye drops unless you have spoken with your doctor. Using these eye drops as directed is the best way to help save your vision.

Types of Medicated Eye Drops

Your doctor may prescribe one or more type of eye drop. Some of the most common ones include:

• Prostaglandins. These help reduce the pressure in your eye and increase the flow of fluid out of the eye.
• Beta blockers. Beta blockers help decrease the pressure in the eye and how much fluid is made in the eye.
• Alpha-adrenergic agonists. With this type of eye drop, you can increase the flow of fluid out of the eye and reduce how much fluid is made in the eye.
• Carbonic anhydrase inhibitors. These are used to reduce how much fluid is made in the eye. These types of eye drops are not used very often.
• Miotic or cholinergic agents. Using this type of eye drop helps increase the flow of fluid out of the eye.

If you have a family history of glaucoma or are noticing problems with your vision, contact your ophthalmologist immediately for an appointment. He or she can help diagnose your vision problem and suggest appropriate treatment options.

Presbyopia is the gradual decline in close vision that occurs with age. The condition occurs as the lens in the eye stiffens and loses its flexibility, thereby impairing its ability to focus at images or objects up close.

While multifocal prescription glasses, such as bifocals, are one possible treatment option for presbyopia, the popularity of vision correction surgery to treat presbyopia is increasing. Your ophthalmologist may use one of several surgical approaches to treat presbyopia.

About Monovision

With all of the following presbyopia treatment options, the surgical goal is to create monovision. With monovision, the ophthalmologist corrects one eye so that it can see up close and the other eye so it can see in the distance. Over time, many patients are able to adapt to monovision, so they can ultimately see at multiple distances.

LASIK

When performing LASIK, or laser-assisted in-situ keratomileusis, the ophthalmologist creates a hinged flap in the surface of the cornea. After gently lifting back the flap, the eye surgeon removes tiny particles of corneal tissue to reshape the curvature of the cornea. In traditional LASIK surgery, this corrects the refractive error that is causing nearsightedness, farsightedness and / or astigmatism.

When performing LASIK to treat presbyopia (by creating monovision), the ophthalmologist typically reshapes the curvature of cornea in the dominant eye so it can see in the distance. He or she intentionally leaves the non-dominant eye slightly nearsighted, so the patient can see up close with that eye.

Photorefractive Keratectomy

With photorefractive keratectomy (PRK), the ophthalmologist removes the front layer of the cornea (the epithelial layer) instead of creating a hinged flap in it. The remaining steps of PRK to treat presbyopia are the same as with LASIK. PRK is often a suitable treatment option for patients with corneas that are too thin to withstand corneal flap creation.

Conductive Keratoplasty (CK)

Unlike LASIK and PRK, conductive keratoplasty (CK) involves the use of low-energy radiofrequency (RF) waves instead of laser energy to reshape the curvature of the cornea.

During the CK procedure, the ophthalmologist uses an extremely thin probe that is finer than a human hair to apply RF energy around the outer section of the cornea. The connective tissue that was treated with RF energy shrinks, thereby creating a tightening effect around the circumference of the cornea. This causes the cornea to steepen, which helps restore near vision.

To treat presbyopia, the eye surgeon, again, only corrects one eye for near vision, leaving the other eye farsighted.

Monovision Candidacy

Some patients may not be able to adapt to monovision. To find out whether you might benefit from undergoing LASIK, PRK, CK or another type of vision correction procedure that addresses presbyopia by providing monovision, please schedule an appointment with us. That way, you can try out monovision in our office to determine whether it is a suitable treatment option for you.

If you are not an appropriate candidate for monovision, don’t worry. We will suggest alternative treatment options to help correct your presbyopia.

Laser-assisted in-situ keratomileusis, or LASIK, is the most common type of refractive surgery. If the curvature of your cornea deviates from the ideal curvature, light entering your eye will bend (refract) incorrectly. This is known as a refractive error and can cause vision problems. For many patients, LASIK safely and successfully corrects the shape of the cornea, often allowing them to dispense with eyeglasses.

Vision Problems That LASIK Improves

There are several types of refractive errors. Myopia, or nearsightedness, typically occurs as the result of having a cornea that curves too sharply. Hyperopia, or farsightedness, often means that the curvature of your cornea is too flat. Unevenly curved corneas lead to astigmatism, which affects both your near and far vision. LASIK can address all these conditions.

About the LASIK Procedure

Before starting the LASIK procedure, your ophthalmologist uses wavefront imaging technology to create a digital image, or map, of your eye’s refractive errors. He or she uses this information to calibrate the excimer laser used to reshape the curvature of the cornea.

The LASIK procedure itself is performed on an outpatient basis and takes about 30 minutes. Your doctor may prescribe anti-anxiety medicine before the surgery starts. You’ll recline in a chair. The ophthalmologist uses eye drops to numb your eyes. Once numb, an instrument holds your eyelids open.

The eye surgeon uses a surgical blade (microkeratome) or, in bladeless LASIK, a femtosecond laser to create a small hinged flap in the front of your eye. This allows him or her to access the underlying corneal tissue. The ophthalmologist then uses the calibrated excimer laser to remove tiny particles of corneal tissue, thereby re-contouring the curvature of the cornea, which corrects the refractive error. Once the surgeon is satisfied with the newly shaped cornea, he or she puts the corneal flap back in its original place, where it will heal, without the need for stitches.

Patients treating both eyes with LASIK can usually have them done during the same appointment. You may have itchy, watery eyes and need pain medication immediately after surgery. You will likely notice a dramatic improvement in your vision within 24 to 48 hours after surgery and can usually resume your normal activities at that point. Over the next couple of months, your eyes will heal completely and your vision will stabilize. You will need to return to the office for follow-up appointments with your eye doctor.

Risks

Some people are better candidates for LASIK than others. For example, individuals with extreme refractive errors, severe dry eye or corneas that are too thin to withstand corneal flap creation may not be suitable candidates for LASIK. If you have heard that you are not an appropriate LASIK candidate, don’t worry. There are several alternative vision correction procedures that can help you reduce or eliminate your daily dependence on prescription lenses.

All surgeries carry risks. The risks associated with LASIK include:

• Dry eyes. Following LASIK, patients may experience dry eyes; although this is usually temporary.
• Undercorrection. If too little corneal tissue is removed, the visual outcome may not be ideal.
• Overcorrection. Likewise, if too much corneal tissue is removed, the visual results may not be ideal. Overcorrection is more difficult to correct than undercorrection.
• Regression. Sometimes, patients’ vision slowly returns to how it was before surgery.
• Halos. For some, undergoing LASIK affects their night vision, causing glare and halos around lights.
• Astigmatism. Uneven removal of corneal tissue may cause astigmatism.
• Flap Issues. Rarely, problems with the corneal flap occur, potentially causing infection or inflammation in the eye. One way to reduce this surgical risk is to choose bladeless, or all-laser, LASIK. Using a laser instead of a microkeratome for corneal flap creation eliminates all risks associated with manual corneal flap creation.

If you’re considering LASIK, call us today so we can help determine if it’s right for you.

When the cornea is misshapen, light bends (refracts) incorrectly, leading to vision problems. Refractive surgeries aim to reshape the cornea, thereby improving vision.

LASIK is one of the most popular types of refractive surgeries. However, not everyone is an appropriate candidate for LASIK. Fortunately, photorefractive keratectomy (PRK) is often a suitable treatment option for patients who are not good candidates for LASIK. Although PRK, also known as advanced surface ablation (ASA), predates LASIK, it yields the same visual results as LASIK.

Suitable Candidates

People who suffer from nearsightedness, farsightedness or astigmatism may be suitable candidates for PRK. Your ophthalmologist might recommend PRK instead of LASIK if you:

• Have corneas that are too thin to withstand the corneal flap creation required with LASIK
• Are especially prone to dry eyes
• Play contact sports or have a type of job that makes you likely to be hit in the eye
• Have large pupils
• Have corneal scars, have had a corneal transplant, have epithelial basement membrane disease or have previously undergone radial keratotomy

The PRK Procedure

During LASIK, the eye doctor creates a small flap in the cornea that allows him or her to access and reshape the underlying corneal tissue. During PRK, the doctor removes the whole epithelium, the cornea’s outer layer. The ophthalmologist then proceeds in the same way as he or she would with LASIK, using a tiny laser to reshape the curvature of the cornea.

Recovering From PRK

Because the body must regenerate the entire corneal epithelium after PRK, recovery time is longer with PRK than it is with LASIK. Initial healing can take a week, plus a few more weeks before visual acuity stabilizes. Again, however, the visual results are ultimately the same as with LASIK.

Following PRK, most patients wear a contact lens for five to eight days, to help protect the eye. Your doctor will put the contact in and take it out for you. You may also take prescription or over-the-counter pain pills and use anti-inflammatory eye drops. Protect your eyes with good sunglasses during healing.

Unlike with LASIK, PRK patients usually have one eye treated at a time. Your ophthalmologist may recommend a healing period of between one week and one month before operating on the second eye. This helps you stay functional while you heal. Your eye doctor will adjust your glasses or contact lenses accordingly.

Advantages of PRK

Despite the longer recovery time, PRK has some advantages over LASIK. A small percentage of LASIK patients experience complications associated with corneal flap creation. PRK patients do not have to worry about this.

PRK and LASIK both typically cause dry eyes for three to six months. However, this problem is often less pronounced in patients who undergo PRK. People who opt for PRK might also end up with better night vision than those who opt for LASIK.

Success Rate

Success rates vary, and eye surgery always bears risks of under-correction, loss of vision, infection and inflammation. However, about 70 percent of patients achieve 20/20 vision after PRK, and 92 percent end up with 20/40 vision or better.

If you are considering your refractive surgery options, call us today so we can help you decide which type of vision correction surgery will work best for your eyes.

Corneal transplantation is a surgical procedure to replace part of a damaged or diseased cornea with corneal tissue from a donor. The cornea is the transparent, dome-shaped surface on the front of the eye. It plays a large part in vision by helping to focus light onto the retina.

Reasons for Corneal Transplantation

If the cornea is cloudy or scarred, the light passing through the eye has trouble reaching the light-sensitive retina on the back of the eye. This can result in poor vision or blindness.

Several conditions can damage the cornea severely enough that a cornea transplant is needed, including:

• Injury or infection of the cornea
• Swelling or clouding of the cornea
• Ulcers in the cornea, sometimes caused by infections
• Problems caused by a previous eye surgery
• Thinning of the cornea
• Bulging outward of the cornea (keratoconus)

Risks of Corneal Transplantation

Cornea transplants have good success rates, but this surgery still carries some risks, such as:

• Infection of the eye
• Swelling of the cornea
• Problems caused by the stitches used to attach the donated corneal tissue
• Increased pressure inside the eye (glaucoma)
• Clouding of the lens of the eye (cataracts)
• Rejection of the donated corneal tissue

Cornea Rejection

Because the donated corneal tissue comes from another person, your body’s immune system may mistakenly attack (reject) that tissue. This kind of cornea rejection occurs in about 20 percent of corneal transplantations.

If you have any of the following symptoms of cornea rejection for more than six hours, contact your eye doctor immediately.

• Vision loss
• Increased redness of the eye
• Increased pain
• Increased light sensitivity

Alternatives to Corneal Transplantation

Recent advances in technology have made it possible for doctors to treat certain corneal problems without the need for a corneal transplant. One of these new treatments is phototherapeutic keratectomy (PTK), which uses an excimer laser and computer technology to remove irregular areas on the cornea that are interfering with vision.

If you are suffering from vision impairment or irregular symptoms affecting the eye, contact us to schedule an appointment, so we can evaluate your eye health and make treatment recommendations.

Intacs

Intacs, or intracorneal ring segments (ICRS), is a non-laser treatment for mild nearsightedness. It can also be used to treat the astigmatism and nearsightedness that occurs with keratoconus, one type of corneal disorder.

How Intacs Works

Intacs is a pair of crescent-shaped plastic devices that are implanted in the eye. During the procedure, an eye surgeon makes a small incision in the cornea and then inserts the ring segments in the eye. The segments are placed at the outer edge of the eye, which leaves the center area free.

This device is left in place, and the cornea is allowed to heal. The ring segments work by flattening the cornea. This changes the direction of the light rays entering the eyes so that they land in the correct location on the retina.

The result is more focused vision. Intacs can also be used along with glasses or contact lenses to provide better vision.

Conditions Treated With Intacs

Intacs can be used to treat eye conditions that involve the cornea, the transparent, dome-shaped front part of the eye. This includes:

• Nearsightedness (myopia), a condition which causes distant objects to appear blurry; although near objects are in focus
• Keratoconus, a thinning and bulging outward of the cornea, which leads to blurry vision and sensitivity to glare and light

Pros and Cons of Intacs

Once in place, the Intacs segments do not need any further adjustment. They can also be removed and new ones can be implanted. This procedure may also enable people with keratoconus to delay having a corneal transplant.

People may experience up to four days of discomfort or pain after the ring segments are implanted. In addition, the vision may fluctuate for several weeks or months after the procedure. In some cases, Intacs may not improve the vision.

Conductive Keratoplasty

Conductive keratoplasty (CK) is sometimes combined with Intacs for keratoconus patients. CK shrinks collagen, helping to reshape the cornea. It may be done at the same time as Intacs surgery or after the sutures are removed. CK is not approved by the FDA for treating keratoconus, but some eye doctors use it as an off-label approach.

To learn more about Intacs treatment or other treatment options for corneal or refractive problems, contact our office today.

Glaucoma is a condition characterized by excessive pressure in the eye, or intraocular pressure. This irregularly high pressure is due to a buildup of fluid in the eye. As intraocular pressure increases, it can compress the eye’s optic nerve, eventually leading to vision loss.

Around 3 million people in the United States have glaucoma; although only half are aware of it. For people over 60 years old, glaucoma is a leading cause of blindness. The loss of vision is often so gradual that by the time you notice any difference in your vision, the glaucoma is already at an advanced stage.

Symptoms of Glaucoma

Different types of glaucoma have different symptoms. The most common form of glaucoma is open-angle glaucoma. It usually has no symptoms in the early stages. Later on, though, as the optic nerve is increasingly damaged, the following symptoms appear:

• Blank spots in your field of vision, typically the peripheral vision
• Tunnel vision during the later stages

Another type of glaucoma, called acute angle-closure glaucoma, happens very quickly. This is a medical emergency and can lead to blindness if untreated. If you experience any of the following symptoms, contact an ophthalmologist or visit the emergency room immediately:

• Sudden blurry vision
• Severe eye pain
• Headache
• Nausea or vomiting
• Halos or rainbow-colored rings around lights
• Reddening of the eye

Risk Factors for Glaucoma

Certain factors may increase your risk of developing glaucoma, including:

• Already having increased intraocular eye pressure due to another reason
• Being older than 60 increases the risk of glaucoma in general; people who are over 40 years old may have an increased risk of acute angle-closure glaucoma.
• Being of certain ethnic descents, such as being of African-American, Japanese or other Asian descent
• Family history of glaucoma
• Medical conditions such as diabetes, heart disease, elevated blood pressure and underactive thyroid
• Other eye conditions such as eye inflammation, injury, lens dislocation, retinal detachment or tumor
• Use of corticosteroid medications over a long time

When to See an Eye Doctor

The most effective way to limit damage to your vision caused by glaucoma is with early diagnosis and treatment. This means having regular eye examinations that include measuring your intraocular pressure.

The American Academy of Ophthalmology recommends that people have a comprehensive eye exam at age 40. If you have no risk factors for glaucoma, you should have an exam every three to five years after that. If you are over age 60 or have other risk factors, you should have your eyes checked every one to two years. Ethnic groups with a greater risk of glaucoma may need to have an eye exam earlier.

If you experience gradual changes in vision, contact your eye doctor for an exam. If your vision changes suddenly, or if you have any other symptoms of acute angle-closure glaucoma, seek immediate care with an eye doctor or at the emergency room. Again, if left untreated, glaucoma can lead to blindness.

The iStent Trabecular Micro-Bypass is a surgical device that is available for use in treating patients with mild-to-moderate open-angle glaucoma.

Glaucoma is characterized by an excessive accumulation of fluid inside the eye, which leads to an increase in the inner eye pressure (intraocular pressure). This can damage the optic nerve and lead to a gradual loss of vision.

How iStent Works

One cause of glaucoma is poor drainage of the fluid inside the eye, which, again, leads to increased intraocular pressure. The iStent device works by providing a permanent path for fluid to flow out of the eye. By restoring the flow of fluid, the pressure inside the eye is reduced.

While the device is used to treat glaucoma, it is implanted during cataract surgery. This is done as an outpatient surgery, which means you can go home after the procedure is finished.

The device is made of titanium and is very small (only 1 millimeter long). Once it is in place, you will not be able to see or feel it.

Safety and Benefits of iStent

After iStent surgery, most patients’ vision improves that day. Many are also able to stop using medicated eye drops to reduce the pressure inside their eye. Others may be able to reduce the number of eye drops they need to use to control their inner eye pressure.

The iStent device is implanted during a surgical procedure. The most common side effects after surgery are:

• Swelling of the cornea (corneal edema)
• Decrease in how well you can see with glasses or contacts (best corrected visual acuity)
• Thickening of the back of the eye’s lens capsule, which causes cloudy vision
• Blockage of the iStent device
• Blurred vision
• Increased pressure inside the eye

The iStent device is not recommended for people with certain conditions such as angle-closure glaucoma, certain eye tumors and thyroid eye disease.

Please contact our office to schedule an appointment and find out whether you are an appropriate candidate for iStent treatment.

While keratoconus can happen at any stage of life, young people between the ages of 10 and 25 are most likely to develop this disorder. For individuals with keratoconus, their cornea, the clear layer in the front of your eye, gradually thins and begins to bulge outward. Keratoconus typically causes nearsightedness and astigmatism in both eyes.

The first signs of keratoconus are rapid changes in vision that require frequent adjusting of prescription lenses. Other symptoms include increased sensitivity to light, eyes strain and irritation, halos around lights at night, headaches and an incessant urge to rub your eyes. Eventually, the corneas become noticeably cone shaped.

Keratoconus is the most common type of corneal dystrophy, or degenerative corneal disorder. It affects one in every 2,000 Americans, according to the National Eye Institute.

Diagnosis

Many symptoms of keratoconus are similar to those of other corneal disorders, especially during the onset of the condition. This makes keratoconus difficult to diagnose.

Nonetheless, to diagnose keratoconus, ophthalmologists use a slit lamp to inspect your cornea at the microscopic level. Telltale signs of keratoconus include corneal thinning, an iron-colored ring around the cone-shaped cornea, stress lines and scarring at the top of the cone. Your eye doctor will also use instruments and lights to measure the curvature of your cornea.

Causes and Risk Factors

Researchers are not exactly sure why some people develop keratoconus. Leading theories center on genetics, environment and hormones. Some scientists have noted a slightly higher chance of developing keratoconus if a family member has it, but this correlation has not been proven with absolute certainty. Possible environmental causes include allergies that lead to excessive eye rubbing or poorly fitted contact lenses. Some researchers hypothesize that keratoconus is related to the endocrine system (the collection of glands that secrete certain hormones), because the onset often happens at puberty and worsens during pregnancy.

Treatment

Usually, the cornea stabilizes, so vision can be corrected with glasses or contacts. But between 10 and 20 percent of people with keratoconus will have more severe problems that require an alternative form of treatment, such as the following

Corneal Crosslinking. Healthy corneas keep their shape because cross-linked collagen fibers serve as supports. Corneal collagen cross-linking (CXL) involves saturating the cornea with riboflavin drops and activating them with an ultraviolet light. This strengthens the cornea by increasing the amount of collagen cross-linking. While CXL doesn’t cure keratoconus, it can arrest the progress of the disorder.

Intacs Surgery. Your eye doctor may suggest inserting Intacs, extremely thin plastic semi-circles. These flatten the cornea, improving vision. You may or may not still need to wear prescription lenses after Intacs surgery.

Corneal transplant. If keratoconus progresses until the cornea is too thin or scarred to tolerate contacts, your ophthalmologist may recommend a corneal transplant. According to the National Eye Institute, this operation is successful in more than 90 percent of those suffering from advanced keratoconus.

If you are experiencing signs of keratoconus, call us so we can diagnose your vision condition and suggest an appropriate plan of action for your visual needs.

If your vision is blurred due to cataracts and you are pursuing surgical intervention to correct the problem, you are likely considering which intraocular lens (IOL) to choose, to restore your vision after cataract surgery. There are a variety of IOL options to choose from. Your ophthalmologist can help you decide which is appropriate for you and your lifestyle.

Materials

IOLs used to be made of rigid plastic. Now, softer, foldable silicone and acrylic IOLs allow the eye surgeon to roll up an IOL and insert it through a smaller incision. Once inserted, the IOL opens up to full size. Many IOLs now include built-in protection from damaging ultraviolet rays.

Monofocal IOLs

The most popular type, monofocal IOLs allow eyes to focus at a single distance. This could be far, near or in between. Your most important activities dictate which distance you should choose. Readers and crafters might opt for clear near vision and wear glasses for distance vision. People who drive a lot or prefer TV to books can get an IOL for distance vision and wear glasses for close-up activities. If you spend a lot of time at the computer, you can choose the intermediate IOL, which focuses best at a distance of 18 to 36 inches. Most people get IOLs equipped for distance vision.

Monovision

If you are getting cataract surgery in both eyes, you could choose monovision. With monovision, your ophthalmologist places an IOL in one eye that allows you see well close up while placing an IOL in the other eye that allows you to see objects in the distance. Over time, your eyes should adjust to monovision, allowing you see well at both distances. However, not everybody adjusts well to monovision, which compromises depth perception. If you’re considering this strategy, discuss it with your ophthalmologist. Your eye doctor can usually let you test out monovision using contact lenses in the office before your procedure.

Accommodating IOLs

Accommodating IOLs move, or flex, with the eye’s natural muscle movement, often allowing the patient to see well at multiple distances, instead of at a single distance as with monofocal lenses.

Multifocal Lenses

Many people who get multifocal IOLs no longer need glasses for distance or close vision. This type of IOL is like bifocal eyeglasses, but it allows patients to see well at more than just two distances. Different areas of the IOL have different focusing power. However, some patients experience problems with night vision, glare and halos after getting multifocal IOLs.

Let us help you navigate the exciting but sometimes overwhelming world of IOLs. Call us today and we’ll work together to help you achieve your best possible vision.

In order for your eyes to focus normally, six muscles around each eye must work together. When your two eyes see different images, your brain tends to favor the stronger eye. This means the weak eye gets weaker, resulting in amblyopia, or “lazy eye.”

Risk factors for developing strabismus may include farsightedness and a family history of the disorder. Both adults and children suffer from strabismus, but the causes are different. For adults, causes include:

• Diabetes
• Stroke
• Botulism
• Graves’ disease
• Shellfish poisoning
• Guillain-Barré syndrome
• Cranial nerve palsies
• Tumors
• Eye injuries
• Traumatic brain injury
• Vision loss

Treatment

Treatment for strabismus involves a few steps. First, your eye doctor will determine whether you need glasses. Then, he or she will treat your amblyopia. This typically involves wearing a patch over the stronger eye, forcing the weak eye to work harder. This can be frustrating and tiring, but is an important step.

Next, you might need surgery to help the eye muscles work together correctly. This surgery can be done at any age. Eye alignment surgery is generally performed as an outpatient procedure, often with local or regional anesthetic. However, in some cases, it might require hospitalization. Most people can return to their regular activities within a few days. Your doctor might restrict swimming and heavy lifting for several weeks.

The reasons to have eye alignment surgery go way beyond cosmetic benefits. Eye misalignment can cause disabling and dangerous double vision. Since people with strabismus are often self-conscious about this condition, getting alignment surgery may improve your circumstances emotionally, socially and even economically.

What to Expect After Treatment

Any type of surgery bears risks, including infection, bleeding and anesthetic complications. The most common risks for strabismus surgery are double vision and residual misalignment. In rare cases, patients may suffer retinal detachment or decreased vision. However, most patients experience a significant improvement in eye alignment after surgery. They may feel pain and a pulling sensation around the eyes for a few days. Usually over-the-counter pain relievers can address this level of discomfort.

If you suffer from strabismus and would like to discuss your treatment options, call our clinic today.

Commonly called crossed eyes, strabismus is a condition in which eyes do not work together, failing to maintain proper alignment. While one eye focuses on an object, the other does not. The failure of the eyes to work together causes double vision, and if untreated can lead to an extreme reduction of vision in one eye, amblyopia. Strabismus is classified by the direction of misalignment, frequency, and the eye or eyes in which strabismus occurs. These classifications include:

• Esotropia – inward turning eye
• Exotropia – outward turning eye
• Hypertropia – upward turning eye
• Hypotropia – downward turning eye

Strabismus is further classified by the frequency of the condition (constant or intermittent), whether one (unilateral) or both eyes (alternating) show signs of strabismus, and the degree of the turn (large or small angle).

Causes

Six external (extraocular) muscles control each eye’s movement and position. In order for binocular vision to work properly, the positioning, function, and neurological control of these muscles must work together perfectly to control the eyes. An anatomical problem, neurological condition, or trouble with the center of the brain which controls binocular vision can make it difficult to control the extraocular muscles, leading to strabismus.

Individuals with uncorrected farsightedness can also develop strabismus. If the eyes are overly strained while attempting to focus on a distant object, they can become crossed. This condition is known as accommodative esotropia, and can usually be treated with corrective lenses.

Genetics also play a prominent role in strabismus. Those with a parent who has strabismus have a much greater chance of developing the condition themselves. In addition, certain medical conditions such as Down syndrome, cerebral palsy, and stroke put individuals at a higher risk or developing strabismus.

Signs and Symptoms

The most prominent sign of strabismus is the misalignment of eyes, which can lead to amblyopia and vision problems. Small angle strabismus often leads to eye strain and headaches. In addition, strabismus often causes young sufferers significant emotional stress, as it affects the ability to make normal eye contact with others.

Diagnosis and Treatment

Eye care professionals diagnose strabismus using a series of tests: visual acuity, refraction, alignment and focusing, and an examination of eye health. Once strabismus is diagnosed, it can be treated according to its cause and severity. A case of accommodative esotropia can be corrected with glasses, but more serious cases of strabismus might require muscle surgery and vision therapy.

Sources:

Centers for Disease Control and Prevention: Learn About Age-Related Macular Degeneration

American Academy of Ophthalmology: What Is a Pinguecula and a Pterygium (Surfer’s Eye)?, 11/22/2021

PubMed: Retina: History of Sunlight Exposure Is a Risk Factor for Age-Related Macular Degeneration, April 2016

National Eye Institute: New Research Sheds Light on How UV Rays May Contribute to Cataract, June 3, 2014

Laser-assisted in situ keratomileusis (LASIK) makes clear, sharp vision possible without eyeglasses or contact lenses. Wondering if one time of year is better than another to schedule the procedure? Winter may be the ideal time for your vision-enhancement procedure.

What Is LASIK?

LASIK permanently corrects your vision whether you have myopia (nearsightedness), hyperopia (farsightedness), or astigmatism. The procedure changes the shape of your cornea, improving the way light rays focus on your retina, the light-sensing tissue that lines the back of the eye. The cornea, a clear layer of rounded tissue, works together with the lens of the eye, to focus rays on the retina. Once light rays reach the retina, they’re turned into electrical impulses which are then sent to the brain.

Light rays must be focused precisely on the retina for clear, sharp vision. If you have myopia, the rays fall in front of the retina, while hyperopia causes light rays to be focused behind the retina. Astigmatism occurs when the cornea is irregularly curved. This type of refractive error also makes it difficult to properly focus light rays on the retina and may cause blurry vision at both near and far distances.

During LASIK surgery, your ophthalmologist creates a flap in your cornea. After pushing the flap aside, he or she uses an excimer laser to reshape your cornea. Changing the shape of the cornea ensures that light rays are focused directly on the retina. Once the cornea is reshaped, the flap is moved back in place and soon reattaches to the corneal tissue.

Why Is Winter a Good time for LASIK?

Choosing winter for your LASIK procedure can be a good idea for several reasons, including:

• Fewer (Paid Time Off) PTO Hours Needed. As with any type of surgery, you’ll need to rest for a little while after the procedure. Most people can go back to work in a day or two, although that timeframe does vary from person to person. Your vision will be a little blurry immediately after your procedure. If your job requires clear vision, you may want to take more than one or two days off. When you schedule your procedure just before paid holidays, you’ll have more time to recover and won’t have to use PTO. Even if you do need to draw from your PTO bank, it may be easier to take time off during the winter, depending on the type of work you do.
• More Downtime. Spring and summer are the busiest times of the year for many people. When the weather finally turns warmer, your days are filled with picnics, vacations, beach days, gardening, home improvement projects and sporting events. During your recovery from LASIK, it’s best to avoid non-contact sports for three days, strenuous or contact sports for four weeks, and swimming, hot tubs, or whirlpools for up to eight weeks, according to the U.S. Food and Drug Administration. When you schedule your LASIK surgery for the quieter winter months, you won’t miss out on your favorite activities.
• Better Weather Conditions. Back in 2004, researchers at Wake Forest University Baptist Medical Center (now Atrium Health Wake Forest Baptist) discovered that heat and humidity can affect the success of LASIK procedures. Both indoor humidity levels during the surgery and outdoor temperatures and humidity up to two weeks before LASIK had an impact on the results. The researchers reported that none of the patients in the study who had LASIK in the winter needed a follow-up procedure to fine-tune their vision. They noted that the need for additional procedures increased during the more humid months of the year. According to Keith Walter, MD, one of the researchers, humid air could decrease the amount of laser energy absorbed by the thickest part of the cornea, while moister corneas due to high humidity might make removing tissue harder. Obviously, ophthalmologists carefully control the humidity in their offices during the spring and summer but can’t control outdoor conditions.

Would you like to improve your vision with LASIK this winter? Call us to schedule a consultation with your ophthalmologist.

Sources:

Atrium Health Wake Forest Baptist: Temperature and Humidity Can Affect LASIK Surgery Results, 4/20/24

https://newsroom.wakehealth.edu/news-releases/2004/04/temperature-and-humidity-can-affect-lasik-surgery-results

U.S. Food and Drug Administration: What Should I Expect Before, During, and After Surgery?

https://www.fda.gov/medical-devices/lasik/what-should-i-expect-during-and-after-surgery

American Academy of Ophthalmology: LASIK – Laser Eye Surgery, 11/9/2022

https://www.aao.org/eye-health/treatments/lasik

Symptoms and Problems Caused By Autism

Autism is a neurological disorder in which the person has difficulty processing and reacting to information received from their senses. The individual also has trouble communicating and interacting socially.

Signs of autism include:

• Lack of shared social interaction
• Postponement in development
• Untimely response to sensory information

As a result of the condition, autistic people commonly have visual problems, including:

• Lack of eye contact
• Gazing at spinning objects or light
• Short-lived peripheral glances
• Side viewing
• Difficulty using visual information efficiently
• Trouble staying visually focused
• Eye movement disorders
• Crossed eyes
• Problems with motor skills and depth perception
• Troubles with eye-hand coordination
• Sensitivity to light

In addition to the above complications, there are often challenges with coordinating central and peripheral vision. So, for instance, if asked to track an object with their eyes, an autistic person generally will not look directly at the target. Rather, they will glance over or look off to the side of the object. On the other hand, individuals may disregard peripheral vision all together and stay fixated on a specific spot for extended periods of time.

The inability to merge both peripheral and central vision can result in problems processing and incorporating visual information. And when visual processing is inhibited, motor, speech, mental and perceptual capabilities could be impacted.

Testing for Autism

Many times, autistic people are visually or tactually defensive. As it specifically relates to vision, this means that the person tends to continuously scan visual information as a way of trying to process its meaning.

A primary care physician will and can diagnose autism, but an optometrist can evaluate vision and perform tests that examine the individual’s visual abilities. Tests usually consist of having the person perform actions—like sitting, standing, walking and throwing a ball—while wearing specialized lenses and/or yoked prisms. By doing this, the optometrist is able to inspect their postural adaptations and how they see and react to visual stimulation.

Once information from the tests is gathered, the specialist can prescribe lenses to help with astigmatism, farsightedness or nearsightedness. Vision therapy may also be recommended and can be used to encourage visual stimulation, eye movement and awakening of the central visual system. All forms of treatment are intended to help autistic individuals establish visual space, increase peripheral stability, improve central vision, have better eye coordination and enhance how the person processes visual information.

A follow-up examination will likely be scheduled every three to five weeks to evaluate progress.