Do You Need to Visit a Retinal Specialist?
A retinal specialist is a medical doctor (M.D.) who treats retinal eye disease – specializing but not limited to diseases such as retinal detachments, advanced diabetic retinopathy, and macular degeneration.
Certain individuals may be at greater risk for eye problems and may need to see an eye physician more often than recommended. If you have the following risk factors:
- A family history of eye problems/diseases
- Age 50 years or older
- Diabetic (Diabetic patients need an annual eye exam)
- Have a personal history of eye injury that required medical or surgical care
You should also be aware of symptoms that could be a serious problem. See an eye specialist right away if you experience any eye problems such as:
- Sudden visual changes
- Sudden loss of vision
- Eye pain
- Flashes/sparks of light
- Sudden increase in the amount of visible floaters
- Seeing spots or ghost like images
- A dark spot appears in your vision
- Lines and edges appear distorted or wavy
- Dry eyes with itching and burning
If you notice any of the above symptoms, call to make an appointment with one of our retina specialists today at (708) 687-2222.
What to Expect at Your First Exam:
Again, thank you for choosing University Retina and Macula Associates, P.C. for your eye care needs. Our staff physicians are vitreo-retinal specialists in the diagnosis of treatments of a large variety of conditions such as macular degeneration, diabetic retinopathy, retinal detachments, and many others. Our staff also serve as faculty at the University of Chicago, Department of Ophthalmology and Visual Science. University Retina is dedicated to providing quality evaluation and treatment for all of your retina needs.
A retinal examination takes longer than most medical or general eye examinations. You can expect to be in our office between one to three hours. Many retinal problems are emergencies – eye trauma, severe eye infections, retinal detachments, retinal tears and other conditions that require immediate attention. Since emergencies are unpredictable, we appreciate your anticipated cooperation and understanding.
Prior to your appointment, please complete the new patients forms and bring them with you to your first appointment. In addition, please bring in a list of all medications you are currently taking, including dosages and frequency. Also, bring the names, phone numbers, and locations of your medical doctors. Be sure to bring along your photo ID, as well as your insurance card(s). If you are insured by an HMO, please bring a referral from your primary care physician.
Upon arrival, our staff will ask you to sign in at the front desk, fill out any necessary information/forms, and provide your insurance card(s), photo ID, and referral (if needed).
After you complete all necessary information, the nurse or ophthalmic technician will call you into a private examination room for an initial assessment. She will obtain information regarding your eye problems. The technician will ask you if you are experiencing any flashers, floaters, doubled vision, blurriness, pain, or recent head/eye trauma.
Next, the technician will ask you to evaluate the amsler grid, eye muscle test, visual field test, pupil reflex test, visual acuity, Ishihara color vision test, and tonometry. Last the technician administers two different dilating drops to each eye to open your pupil. This process is necessary in order for the physician to see the back of your retina. It takes about 20-25 minutes for your eyes to fully dilate. Also, your eyes will be dilated for several hours after examination. It is recommended you have someone drive you home, if possible.
After about 25-30 minutes of dilating, the doctor will exam your eyes, using slit lamp examiniation and ophthalmoscopy. Other examination processes may be utilized and are determined by the physician. When the initial examination is complete, your doctor will discuss their findings with you.
Many patients who come in for a retinal exam will need further tests. Included are, but not limited to: OCT Scan, fluorescein angiography, Indocyanine Green Angiography (ICG), A-Ultrasound, and B-Ultrasound. For your convenience, our office is fully equipped , and your eyes are already dilated, so tests can performed the same day.
Common Tests Performed During an Eye Exam:
Amsler Grid:
The Amsler Grid is useful for monitoring the function of the macula, or the central area of vision. The Amsler Grid consists of evenly spaced horizontal and vertical lines printed on black or white paper. A small dot is located in the center of the grid for fixation. While staring at the dot, the patient looks for wavy lines and missing areas of the grid. This test is especially helpful for monitoring vision at home.
The doctor is especially interested in the following when testing vision with the Amsler Grid:
- Are you able to see the corners and sides of the square?
- Do you see any wavy lines?
- Are there any holes or missing areas?
- Are any of the lines bent or curvy?
- Are there any changes in color?
- Can you see the white dot in the center?
If the lines of grid do not appear straight and parallel or there are missing areas, the doctor will examine the back of the eye (macula) very closely. This test is frequently given to patients for home use to monitor macular degeneration. When using the test at home, notify the doctor if any changes in the appearance of the Amsler Grid are detected.
INSTRUCTIONS TO VIEW AT HOME:
1. Wear the glasses you normally wear when reading.
2. View the chart at arms distance and cover one eye. It is important the eye not viewing the Amsler Grid is completely covered to obtain an accurate reading. With the uncovered eye, stare at the white dot in the center of the grid for only a few seconds.
3. During the entire test, you should have one eye covered, stare at the center of the grid and only see one white dot in the center.
4. If your eye is functioning properly, you should be able to see the center white dot and the four corners and sides of the grid. The lines should appear to be straight and continuous from top to bottom and side to side.
5. Now test your other eye.
Eye Muscle Test:
This test examines the muscles that control your eye movement. The ophthalmic technician or doctor are especially looking for any signs of weakness, poor control, or muscle twitches. As you are seated, you will be asked to move only your eyes in six different directions while following a moving object, typically a pen or finger.
Visual Field Test:
Your visual field is the area in front of you that you can see without moving your eyes. The visual field test determines whether you have difficulty seeing in any areas of your ‘side’ or peripheral vision. There are a few different types of visual field tests:
- Confrontation visual field exam – The ophthalmic technician sits directly in front of you and asks you to cover one eye at a time. Then, you look directly at the ophthalmic technician while they move their hand in and out of your visual field, or ask you to count how many fingers they are holding up.
- Automated perimetry – The ophthalmic technician uses a computer program that flashes small lights as you look into a special instrument. You will press a button when you see the flashing light. The lights will appear brighter and dimmer at different stages of the test.
Pupil Reflex Test:
Pupils are normally approximately equal in size, round, and react to direct light. The pupils are examined by a test known as the swinging flashlight exam, in which the light is alternately shone into the eyes.
Visual Acuity Test:
This test measures how clearly you can see from a distance. The ophthalmic technician or doctor will ask you to be seated and to look straight ahead into a mirror and to cover one eye at a time. The technician or doctor will ask you to identify different letters of the alphabet or numbers positioned at 20 feet away. The letter or numbers will gradually get smaller as the technician moves down the chart.
If the letters or numbers are not visible, you will be asked to cover one eye at a time, and the technician will ask you first if you can see their hand waving (approximately one foot away from your face). If this is visible, you will be asked to count the technician’s fingers at 3, 6, and 9 feet away.
Ishihara Color Vision Test:
The Ishihara color vision test consists of a looking at a number of colored plates, each of which contains a circle made of many different sized dots of slightly different colors, spread in a seemingly random manner. Within the dot pattern, is a number. What, or even if, a number is visible indicates if and what form of color blindness you may have. The full test consists of thirty-eight plates, but the existence of a color deficiency is usually clear after no more than four plates.
Glaucoma Tests (Tonometry):
Tonometry measures your intraocular pressure (pressure inside your eyes). A glaucoma test helps your eye doctor detect and maintain glaucoma, a disease that causes pressure to build up inside your eyes and can cause blindness. Normal pressures range from about 10 to 21 mmHg. Glaucoma can be treated if it is caught early.
Your eye doctor or the ophthalmic technician may perform one or more of the following glaucoma tests:
- Applanation Tonometry: Your eye doctor measures intraocular pressure (IOP) by measuring the force needed to temporarily flatten a part of your cornea. A few drops of fluorescein dye, a bright orange dye, are used to help locate the cornea. (Fluorescein does not have iodine in it, so if you are allergic to iodine, you need not to worry. Your eye’s natural tears will wash away the dye from your eye.) A few drops of anesthetic are also used. Using the slit lamp, your doctor moves the tonometer to touch your cornea. It will not hurt, and the anesthetic will wear off within about two hours.
- Electric Indentation Tonometry: A Tono-Pen is a portable electronic, digital pen-like instrument that determines your IOP by making gentle contact with your cornea four times and then takes the average of the individual readings. A few drops of anesthetic are used prior to testing; therefore this test is not painful.
- Pneumotonometry: Also known as noncontact tonometry or air-puff tonometry, this test uses an instrument that senses reflections of the cornea in reaction to a puff of pressurized air. Since there is no contact with the cornea, anesthetic drops do not need to be used. You may feel a mild pressure on your eye, which can be uncomfortable, but it only lasts a few seconds. This technique is not considered the most accurate way to measure IOP, and is rarely used by eye doctors.
Slit Lamp Examination:
A slit lamp is a type of microscope that enlarges and lights up the front of your eye with an intense light. Your doctor uses this light to examine the cornea, iris, lens, and anterior chamber of your eye.
When examining your cornea, your doctor may use a few drops of fluorescein dye. This orange dye is used to help determine if you have any tiny cuts, scrapes, tears, foreign objects, or infections on your cornea.
Ophthalmoscopy (Retinal Examination):
Ophthalmoscopy, or retinal examination, examines the back of your eye, including the retina, optic disk, and underlying layer of blood vessels that nourish the retina (choroid). Before a retinal examination, your eyes will need dilating drops in both eyes so your doctor can fully see the back of your eye. The eye drops may sting for a few moments and may leave a medicinal taste in your mouth as the medication drains from your tear ducts into your throat. It takes about 20-25 minutes for your eyes to fully dilate, therefore after your examination you will go to the waiting room until your eyes are dilated.
After you are dilated and seated back into an exam room, your doctor may use one or more techniques to view the back of your eye:
- Direct Examination: For this examination, your eye doctor will shine a beam of light into your pupil using an ophthalmoscope to see the back of your eye. You may see images after the doctor shines the light into your eyes. This is normal and will go away.
- Indirect Examination: For this examination, you may tilt your head back or lie down in the examination chair. Your eye doctor will hold each eye open one at a time and examine it with a bright light mounted to their forehead and a lens in their hand. This exam allows the eye doctor to see your eye in great detail and in three dimensions. Since this light is brighter than a direct examination, you are more likely to see images after examination. Again, these are normal and will disappear.
Retinal examination will generally take five to 10 minutes. If you are given dilating drops, their effects will last for about four to five hours. Your vision will be blurry and you will have a hard time focusing on things, especially fine print. You may or may not be able to drive, so you may need someone to accompany you.
Floaters:
What are Floaters?
Floaters can be described as small specks or clouds moving in your field of vision. More often, floaters are visible when looking at a plain background, or blank wall. Floaters can be described in the shape as round dots, donuts, wavy lines, or spider webs.
Actually, floaters are caused by tiny clumps of gel or cells inside the vitreous, or the clear, jelly-like fluid that fills the inside of the eye. While it may seem that these objects are floating on the outside, or front of the eye, there are really floating on the inside. What you are seeing are shadows these tiny clumps of gel or cells cast on the retina. The retina is the nerve layer at the back of the eye that senses light and allows you to see.
What Causes Floaters?
People over the age of forty may experience the vitreous gel start to thicken or shrink, which then forms the clumps or strands inside the vitreous part of the eye. The vitreous gel then pulls away from the back wall of the eye, causing posterior vitreous detachment.
This is the common cause of floaters.
Posterior vitreous detachment is more common for people who:
- Are near-sighted
- Have undergone eye surgery
- Have had laser surgery of the eye
- Have inflammation or bleeding inside the eye
Are Floaters Serious?
The retina can tear if the shrinking vitreous gel pulls away from the wall of the retina, which then may cause tiny bleeding of the eye. This bleeding may produce new floaters.
If a retinal tear occurs this is a serious problem, since it may cause a retinal detachment.
You should a retina specialists if the following occurs:
- One or more floaters appear suddenly
- You see sudden flashes of light
- Sudden loss of peripheral vision
Floaters that appear suddenly or the development of new floaters require attention from an ophthalmologist, especially for patients over the age of 45. Even if you have had floaters for years, but suddenly notice new floaters, you need attention from a retinal specialist.
The Good News:
While some floaters may persist, many of your floaters will fade over time. Floaters can get in the way of clear vision, which may be quite annoying. What you can do is to try moving your eye – look up, down, left to right to try to move the floaters out of your vision.
Flashes:
What are Flashes?
Flashers may be described as repeatedly flashing lights, lightning bolts, or having the sensation of seeing stars.
What Causes Flashes?
When the vitreous gel of your eye rubs or pulls on the retina, people experience what seems to look like flashing lights, or lightning bolts. The flashes of light can appear off an on for several weeks or even months. As we grow older, it is more common to experience flashers.
Are Flashers Serious?
If you are to notice a sudden appearance of flashing lights, you should see a retina specialist immediately to see if there is a retinal tear or retinal detachment.
The Good News:
Flashes of light become more common as we grow older. While not all flashers are serious, you should always have a yearly eye exam by a retina specialist to determine if there is any serious damage.
Diagnostic Testing
Optical Coherence Tomography
An optic nerve analyzer, referred to as an OCT scan, is a quick and painless diagnostic test which measures the thickness of the macula. Once the pupils are fully dilated, the patient is seated in front of the scanner so that their chin rests comfortably on the chin rest. The technician will slowly move the scanner very close to the eye to gain a thorough scan, however the machine never makes contact with the eye. Once the equipment is in place, the patient will see lights in a series of dots and rotating lines while the scan is aligned. A flash photograph is taken at the end of the scan. The entire test takes only a matter of minutes. OCT results are available immediately, allowing the retina specialist to discuss their findings with the patient at the conclusion of the office visit.
Fundus Photography
Fundus photographs are highly magnified photos of the eye that assist the retina specialist in viewing areas of concern and aiding in a diagnosis. The photographs are also very beneficial in illustrating the physician’s findings for the patient. Many patients visiting a retina specialist will have fundus photographs taken during their examination. In some instances, photographs are taken to serve as a baseline in documenting the progression of a disease such as diabetes or age-related macular degeneration.
After the pupils are fully dilated, the patient is seated comfortably in front of the fundus camera with their chin positioned in the chin rest. The photographer aligns the fundus camera close to the eye and takes several color and red-free photographs. The photography session lasts only a few minutes. The retinal physician will then discuss the photos and their findings with the patient. Patients are given copies of their fundus photographs to share with the primary care physician, optometrist, or general ophthalmologist.
Fluorescein Angiography
Fluorescein angiography is a very helpful tool in tracking the progression of retinal disease and in monitoring the progress of various treatments. Fluorescein angiography allows the physician to evaluate the circulation of blood in the retina and is commonly preformed on patients with age-related macular degeneration, diabetic retinopathy, or central retinal vein occlusion.
Similar to fundus photography, highly magnified photographs of the eye are taken once the pupils are fully dilated. The patient is seated in front of the fundus camera with their chin resting comfortably in the chin rest. The photographer aligns the fundus camera close to the patient’s eye. The patient then has fluorescein dye injected into their hand by the physician or highly-trained technician. The dye quickly travels through the bloodstream and is visible in the eye’s blood vessels. A series of photographs are taken over a period of five minutes which clearly illustrate the path of any abnormal leakage in the eye. The results of fluorescein angiography testing are available instantly, allowing the physician to discuss their findings along with treatment options at the conclusion of the test. The procedure itself takes about 15 minutes to complete, however this does not include the time waiting for dilation to take full effect and the patient’s conference with the retinal physician.
After the procedure, patients will notice blurred vision which should resolve within a few hours. Blurry vision is a result of the dilation drops combined with the repeated flash of the fundus camera. Patients are urged to bring someone along to drive them home following the procedure. Patients will also notice a discoloration in their urine and slight yellowing of the skin following the injection. Drinking plenty of water after the procedure will flush the dye out of the patient’s system.
The injection of fluorescein dye is a very safe, routine procedure, however there are risks associated with the dye. Fluorescein is a vegetable dye which means it carries no risk to patients allergic to iodine. The most common side effects of fluorescein, although rare, are nausea and vomiting. Patients who may feel sick to their stomachs will experience this side effect within several seconds of the injection. Our staff is fully prepared to assist, should this occur. Some patients may feel light-head following the injection. We recommend that anyone scheduled for angiography, especially diabetics, have a snack or light meal before attending their office visit to reduce the chance of this happening. The injection of fluorescein dye also carries the risk of an allergic reaction to the dye itself. This is extremely rare, and for your safety, our office is prepared to treat any reactions you may encounter immediately. We urge you to tell your doctor if you are experiencing any symptoms out of the ordinary immediately. As a precaution, pregnant women are never injected with fluorescein dye.
Indocyanine Green Angiography
In addition to fluorescein angiography, some patients will undergo indocyanine green angiography (ICG) in which a second type of dye is injected. ICG evaluates circulation in a different area of the eye known as the choroid which is not detected by fluorescein angiography. ICG is typically preformed on patients with age-related macular degeneration.
Once the pupils are fully dilated, the patient is seated in front of the fundus camera with their chin positioned in the chin rest. The photographer aligns the fundus camera and takes several fundus photographs. The patient then has fluorescein dye and indocyanine green dye injected into their hand by the physician or highly-trained technician. The dye quickly travels through the bloodstream and is visible in the eye’s blood vessels. A series of photographs are taken over a period of ten minutes. The photographer constantly changes functions on the camera to allow both types of angiography to be completed at the same time. Like fluorescein angiography, the results of ICG angiography testing are available instantly, allowing the physician to discuss their findings along with treatment options at the conclusion of the test. The procedure itself takes about 25 minutes to complete, however this does not include the time waiting for dilation to take full effect and the patient’s conference with the retinal physician.
After the procedure, patients will notice blurred vision which should resolve within a few hours. Blurry vision is a result of the dilation drops combined with the repeated flash of the fundus camera. Patients are urged to bring someone along to drive them home following the procedure. Patients will also notice a discoloration in their urine and slight yellowing of the skin following the injection. Drinking plenty of water after the procedure will flush the dye out of the patient’s system.
Patients who are allergic to iodine should not receive an injection of indocyanine green dye. Need more info on side effects.
B-Scan Ultrasound
B-scan ultrasounds use sound waves to aid the physician in evaluating the retina. The B-scan is typically used when conditions such as cataracts or a vitreous hemorrhage obscure the physician’s view of the retina.
Anesthesia eye drops are administered to the eye. The physician then places the tranducer directly on to the eye. Need more info.
The B-scan takes only minutes to complete and results are available instantly.
Procedures
Intravitreal Injections
Intravitreal injections are injections administered into the eye. Although this sounds scary, intravitreal injections are actually a very simple procedure. The injection itself takes a matter of seconds, however the preparation for the injection takes about 40 minutes. We take every opportunity to sterilize and disinfect the eye and its surrounding area before the injection is administered to reduce the patient’s chances of infection.
A series of antibiotic eyedrops are administered into the eye to receive the injection. The antiobiotic eyedrops sterilize the area, similar to alcohol cleansing the skin before an inoculation. Once the drops are administered, the patient is given anesthetic eyedrops to numb the area. To prepare for the injection, the patient’s eyelid and lashes are cleansed with betadine, an antiseptic cleanser. Next, a lid speculum is inserted to keep the eye open throughout the procedure. The area to be injected is cleansed with betadine placed on cotton-tipped applicators. Finally, the drug is injected into the eye with a fine tipped needle.
After the injection, the lid speculum is removed and the patient’s eye area is cleansed of betadine. The patient is given a prescription for antibiotic eyedrops to be administered for several days following the injection to reduce the chance of infection. The day the injection is received, the patient should administer one antibiotic drop every hour until bedtime. For the next four days, one drop should be administered four times per day.
Following the injection, it is normal for the patient to see a floater. The floater will become smaller each day and finally disappear. The eye may also appear red and feel slightly painful prior to the injection. The redness and pain should dissipate within a few days. The retina specialist will recommend an over-the-counter drug for the pain. The persistence of pain or the presence of discharge from the eye may suggest an infection so any patient experiencing these symptoms should contact our office immediately. Please click on the link to download a copy of our post-injection instructions for patients.
The patient will attend a followup visit within a week of receiving an intravitreal injection. Depending on the drug received, the patient will then return in 4 to 6 weeks for the next injection. Typically full testing including OCT, fluorescein angiography, and indocyanine green angiography are preformed every other time for patients receiving intravitreal injections to monitor their progress and ensure the patient is benefiting from receiving the injections.
Diseases of the Eye
Age-Related Macular Degeneration
Age-related macular degeneration (AMD) is the leading cause of blindness in Americans over the age of 50. AMD is a disease in which the blood vessels in center of the retina, known as the macula, begin to leak causing the patient’s central vision to deteriorate or be destroyed. AMD has both a dry and wet form.
Dry AMD is the most common type in which a patient’s central vision is blurry and gradually becomes worse. Patients diagnosed with dry AMD should see a retina specialist regularly because they are at risk for turning to wet AMD.
Wet AMD is less common than the dry type of the disease, however the effects of wet AMD are much more severe. Patients diagnosed with the wet type may find it difficult or even impossible to complete daily tasks like reading and driving. Wet AMD can progress slowly or rapidly. As the disease progresses, central vision loss increases. At this time, there is no cure for AMD but several drugs are available for intravitreal injection to slow or stop the progression of the disease.
People at risk for developing wet AMD are the elderly, those with a family history of the disease, smokers, and those exposed to secondhand smoke. Exposure to ultraviolet rays from the sun may also be a cause of the disease.
Because the disease may progress slowly, many people have the beginning stages of AMD but do not realize there is a problem until they have sustained irreversible vision loss. The Amsler grid test is a simple tool that can be used to test vision regularly at home for any slight changes. Someone with the early stages of AMD may notice lines on the grid appear wavy or distorted. Although the Amsler grid is a helpful tool for patients, it does not replace a thorough dilated exam by a retina specialist.
When a patient, their optometrist, or ophthalmologist suspects the presence of AMD, the patient is advised to schedule an exam with a retina specialist. After a thorough dilated exam by the retina specialist, most patients with AMD undergo full testing including an OCT scan, fundus photography, fluorescein angiography and possibly indocyanine green angiography to document their condition prior to treatment. The retina physician discusses the treatment options available and works with the patient to establish a treatment plan specific to that individual patient. Diagnostic testing is typically repeated within two months of initiating treatment to monitor the progress of treatment.
Treatment options currently available for wet AMD are intravitreal injections of Avastin, Macugen, or Lucentis, photodynamic therapy, and laser treatments.
Posterior Vitreous Detachments
As we age, the vitreous, the gel which fills the middle of the eye, may pull away from the retina, the rear part of the eye, which is known as a posterior vitreous detachment. When this occurs, a patient may begin to see floaters. Although they may be harmless, the onset of new floaters should be evaluated by a retinal specialist as they may signify a more serious condition such as a retinal detachment.
Retinal Tears and Detachments
A retinal detachment is a condition that occurs when the retina is moved from its normal position at the back of the eye. As we age, the vitreous, the gel which fills the middle of the eye, may pull away from the retina which is known as a posterior vitreous detachment. In some instances, as the vitreous pulls away from the retina, the retina may be torn. The tear in the retina allows fluid to pass through, lifting the retina from its normal position and resulting in a retinal detachment.
Retinal tears can often be treated with in-office laser surgeries to avoid progressing into a retinal detachment.
Retinal detachments must be repaired through outpatient surgery. Symptoms of retinal detachments are the onset of flashing lights and/or new floating objects. Anyone experiencing these symptoms should contact a retina specialist immediately. Retinal detachments can cause blindness until they are repaired, so it is crucial that they are addressed emergently.
The presence of other factors may indicate an increased risk of experiencing a retinal detachment. The factors include previously having a retinal detachment, having a family history of retinal detachments, undergoing cataract surgery, having glaucoma, or having a serious eye injury. Anyone with these risk factors should be evaluated by a retina specialist regularly.
Cataracts:
What are Cataracts?
A cataract is a cloudiness of your eye’s natural lens, which lies behind the iris and the pupil. Cataracts may affect one or both eyes however typically, both eyes are symmetrically affected.
When your eyes work properly, light passes through the cornea and the pupil to the lens. The lens focuses this light, producing clear, sharp images on the retina — the light-sensitive membrane on the back inside wall of your eyeball that functions like the film of a camera. As a cataract develops, the lens becomes clouded, which scatters the light and prevents a sharply defined image from reaching your retina. As a result, your vision becomes blurred.
Also, your eye’s lens is mostly made of water and protein. The protein is arranged which keeps the lens clear and allows light to pass through it. As people age, some of the protein may clump together and start to cloud a small area of the lens. This is what causes the cataract, and over time, your cataract may grow larger and cloud more of the lens, making it harder to see clearly.
Symptoms of Cataracts:
Cataracts usually develop slowly and cause no pain. At first, the cloudiness may affect only a small part of the lens and you may be unaware of any vision loss. Over time, however, as the cataract grows larger, it clouds more of your lens. When significantly less light reaches your retina, your vision becomes impaired.
Symptoms of a cataract include:
- Clouded, blurred or dimmed vision
- Increasing difficulty with vision at night
- Sensitivity to light and glare
- Glare and halos around lights
- Frequent changes in eyeglasses or contact prescriptions
- Fading or yellowish-tint of colors
- Double vision in one eye
- Blinking more often to clear vision
Cataracts usually do not affect your health, unless the cataract becomes completely white, known as an overripe (hypermature) cataract. If this occurs, you may experience inflammation, pain, and headaches. A hypermature cataract is uncommon but it requires removal if it is accompanied by inflammation and pain.
Causes of Cataracts:
No one knows for sure why the eye’s lens changes as we age, forming cataracts. General wear and tear on your lens over the years may cause changes in the eye’s protein fibers.
Risk Factors for Cataracts:
- Age – Age is the single largest risk factor to cataract development
- Genetic disposition to cataracts
- Previous eye trauma
- Previous eye surgery
- Exposure to Ultraviolet (UV) rays
- Smoking
- Prolonged use of steroids
- Diuretics
- Heavy Alcohol Consumption
Age-related changes in your eye’s lens are not the only causes of cataracts. Some people are born with cataracts or develop them throughout childhood. This may be the result of a mother contracting rubella during pregnancy. Metabolic changes can also affect the lens of a child, forming congenital cataracts. These types of cataracts may not affect vision. If vision is affected, they will need to be removed.
Treatment:
When symptoms of a cataract begin to appear, you may be able to improve your vision for a while using new glasses, magnification, or brighter lighting. However the only effective treatment is to remove the clouded lens and in most cases replace it with an intraocular lens (IOL).
Cataract surgery is a simple, relatively painless procedure to regain vision. However, cataracts need to be fully developed before surgery can be an option. Surgery is performed frequently and 90% of patients undergoing cataract removal regain very good vision.
***Retinal detachments may rarely occur as a side effect of cataract surgery. Therefore, the doctor performing your cataract surgery may have you visit a retinal specialist pre and post surgery. If you experience: excessive pain, vision loss, or nausea contact our office at (708) 687-2222 immediately.***
Cystoid Macular Edema (CME):
What is a Cystoid Macular Edema?
Cystoid Macular Edema (CME) is swelling of the macula, usually swollen with fluid. Fluid collects within the layers of the macula causing blurry or distorted central vision. The macula is the part of the retina which is responsible for your sharp, detailed central vision. Typically, CME is caused by an eye injury or rarely, as a result of eye surgery.
Symptoms of a Cystoid Macular Edema:
Symptoms of CME may include:
- Blurred central vision
- Distorted “wavy” vision
- Vision may be tinted pink
- Difficulty reading or seeing detailed objects
- Light sensitivity
Causes of a Cystoid Macular Edema:
The causes of a cystoid macular edema may include, but are not limited to:
- Eye injury
- Eye surgery, including cataract removal and surgery for a detached retina
- Diabetes
- Age-related macular degeneration
- Blockage in the small arteries or veins in your eye
- Inflammation of the eye
- Side effects of medication
Treatment of a Cystoid Macular Edema:
In order to detect cystoid macular edema (CME), your retina specialist may require fluorescein angiogram or optical coherence tomography (OCT) testing since symptoms are always not as obvious. After your doctor has discussed the results of your testing,
a treatment course will be planned.
Typically, the first line of treatment is anti-inflammatory eye drops. If this does not help, a more aggressive course of treatment may be discussed. In certain cases, an intravitreal injection is used for a more concentrated effect. Oral medications are sometimes prescribed to reduce inflammation.
It is important to keep following your doctor's recommendations, even if it seems like the treatment is not working at first. Eventually, the treatments should work and improve your vision. Sometimes it takes anywhere from two to about 15 months. However, the good news is: normal vision will almost always return after CME has been treated. If the cystoid macular edema is being caused by some other condition such as diabetes, that condition will have to be treated first. If it seems to be the side effect of a medication, the doctor might change that prescription.
Ocular Melanoma:
What is Ocular Melanoma?
Ocular melanoma is a type of cancer of the eye. Melanoma is a type of cancer that originates within the melanocyte cells that form melanin, or dark-colored pigment throughout the body. While most melanomas are commonly found on the epidermis (skin), it can also occur on other areas of the body, including the inside and surface of the eye(s).
Typically, there are three types ocular melanoma: choroidal melanoma, iris melanoma, and conjunctival melanoma. The pigmented areas of the eye, choroid and iris are most commonly affected although melanoma can occur on the conjunctiva (the thin, filmy membrane that covers the inside of your eyelids and sclera).
Symptoms of Ocular Melanoma:
Choroidal Melanoma:
Choroidal melanoma is the most common form of ocular melanoma. Symptoms of medium to large malignancies can include blurred vision, flashing lights, shadows, or vision loss. However with smaller melanomas, often no symptoms are noticed.
Iris Melanoma:
Malignant melanoma of the iris is a rare type of eye cancer. The tumor is often noticed when there is a dark spot on the iris. A suspicious lesion should be evaluated by an eye specialist and followed up to document any changes over time.
Conjunctival Melanoma:
A malignancy may arise from a freckle or nevus on the conjunctiva. Any brown, speckled area that changes over time is suspicious and must be evaluated by routine follow-up examinations.
Causes of Ocular Melanoma:
Although ocular melanoma is a rare type of tumor, the exact cause is unknown. However, there seems to be a strong correlation with the development of melanoma and exposure to ultraviolet (UV) light (either from the sun or tanning beds). Most people with melanoma have had excessive exposure to UV light. People whose skin burns easily are most at risk: people with fair skin, light or red hair, and light-colored eyes.
Treatment of Ocular Melanoma:
Treatment depends on the size and position of the tumor, as well as other factors such as your general health, age, and overall vision in both eyes. The aim of treatment is to destroy or remove the cancer cells, stop the cancer from coming back, and to save your vision as much as possible.
A number of various treatments may be used for ocular melanoma. Some treatments are standard (already in use) and other methods are based on clinical trials. Currently, there are five standard procedures used in treating ocular melanoma:
Surgery
Surgery is the most common form of treatment. The following types of surgery may be used:
- Local tumor resection – Surgery to remove the cancerous cells and small amounts of healthy tissue surrounding the melanoma. Surgery may be followed by cryotherapy, which involves freezing the area to kill any melanoma cells that may be left behind after surgery.
- Enucleation – Surgery to remove the eyeball and part of the optic nerve. This is typically performed if the tumor is large and vision cannot be saved. The patient may be an artificial eye (prosthesis) made to match the remaining eye. Also, an implant may be inserted which makes the artificial eye move realistically.
- Exenteration – Although a rare operation, this is surgery to remove eye and eyelid. Orbital exenteration is performed to remove the eye and surrounding tissues when cancer of the orbital contents cannot be controlled by simple removal or irradiation. It is often the only course of treatment for advanced cancers of the eyelid, eyeball, optic nerve, or retina. Prosthesis may be used.
Watchful Waiting
Watchful waiting is closely monitoring the patient’s condition without proceeding with treatment until symptoms progress or change. A series of pictures (fundus photography, fluorescein angiography, or Indocyanine Green Angiography (ICG) may be used to monitor any changes.
Radiation therapy
Radiation therapy treatment uses high-energy rays to destroy the cancer cells, while doing as little harm as possible to the surrounding normal cells. Radiation therapy may be given externally or internally. The way the radiation therapy is given depends on the type and stage of the cancer being treated.
- External radiation therapy uses a machine outside the body to send radiation toward the cancer. The treatment is normally given as small doses, over a few days. Charged-particle radiation therapy is a type of external radiation therapy. A special radiation therapy machine aims tiny, invisible particles, called protons or helium ions, at the cancer cells to kill them with little damage to nearby normal tissues. Charged-particle radiation therapy uses a different type of radiation than the x-ray type of radiation therapy.
- Internal radiation therapy may be administered by a localized plaque radiation therapy technique where a radioactive substance sealed in needles, seeds, wires, or catheters that are placed directly into or near the cancer. Radioactive seeds are attached to a disk, called a plaque, and placed directly on the wall of the eye where the tumor is located. The side with the seeds faces the eyeball and delivers radiation to the eye. The plaque, which is often made of gold, helps protect nearby tissues from radiation damage. This procedure requires a short stay at the hospital to monitor the patient. Certain precautions need to be taken while the radioactive substance is in your eye. You will not be allowed to be exposed to other people for long periods of time throughout the day. This is to avoid any unnecessary radiation exposure.
- Gamma knife radiosurgery may be used for some melanomas. This non-surgical treatment aims tightly focused gamma rays directly at the tumor so there is little damage to healthy tissue. Gamma Knife is a type of stereotactic radiosurgery.
Photocoagulation
Photocoagulation is a procedure that uses laser light to destroy blood vessels that supply nutrients to the tumor, causing the tumor cells to die. Photocoagulation may be used to treat small tumors. This is also called light coagulation.
Transpupillary thermotherapy
Transpupillary thermotherapy is the use of heat to destroy cancer cells. This can be used to treat very small ocular melanomas, or as an additional treatment after radiation. The tumor is heated with a special type of laser beam. Cancer cells are more often susceptible to heat than normal cells and will in turn be destroyed. Several treatments are normally needed for transpupillary thermotherapy.
Follow-up:
After your method of treatment is completed, you will need to have regular check-ups and possible testing. This will probably continue for several years. Ocular melanoma can sometimes spread to other parts of the body, mainly the liver, but also to the lungs and bones. Therefore, it is important to let your specialist know if you notice any new symptoms, where ever they may in the body, as soon as possible so further treatment can be given.
Uveitis:
What is Uveitis?
Uveitis is an inflammation of the eye’s uvea. The uvea is the middle layer of the eye, which consists of the iris, ciliary body and choroid.
Many causes of uveitis are chronic and can produce numerous complications:
- Cataracts
- Changes in intraocular pressure
- Glaucoma
- Neovascularization
- Retinal Detachment
- Macular Edema
- Band Keratopathy
All of these complications can result in vision loss
More than 3000,000 people are affected each year with uveitis and an estimated 30,000 new cases of blindness each year are caused by uveitis. Uveitis is more common in women and more likely to develop with age (although studies have shown uveitis can be prevalent in people ages 25-44).
Signs and Symptoms of Uveitis:
Since there are many types of uveitis, symptoms may vary.
The most common form of uveitis, anterior uveitis (refers to inflammation of the iris alone of the iris and ciliary body) and symptoms will likely affect only one eye. You may feel mild to strong pain and will have redness and light sensitivity. Your vision may also be blurred.
Intermediate uveitis (refers to an inflammation of the ciliary body) and posterior uveitis (the inflammation of the choroid) symptoms usually are painless. Symptoms are blurred vision, and floaters, typically in both eyes. Most people who develop intermediate uveitis are in their teens, twenties or thirties.
Diffuse uveitis (refers to an inflammation in all areas of the uvea) has a combination of all symptoms of all types of uveitis.
Causes of Uveitis:
Uveitis has a multitude of causes, including viral, fungal, and bacterial infections, but in many cases, the cause is unknown. Eyecare specialists can sometimes identify the cause if there has been trauma to the eye, such as from surgery or a blow, or if you have an infectious or immunological systemic disorder.
Some of the many different systemic disorders that can cause uveitis include:
- Acute posterior multifocal
|
|
- Placoid pigment epitheliopathy
|
|
|
- Presumed ocular histoplasmosis syndrome
|
|
|
- Birdshot retinochoroidopathy
|
|
|
|
|
|
|
- Systemic lupus erythematosus
|
- Inflammatory bowl disease
|
|
- Juvenile rheumatoid arthritis
|
|
|
|
|
- Vogt-Koyanagi-Harada syndrome
|
Treatment of Uveitis:
Your eye care physician will likely prescribe a steroid to reduce the inflammation in your eye. Whether the steroid is in eyedrop, pill or injection form depends on the type of uveitis you are diagnosed. Anterior uveitis affects the front of the eye and can easily be treated with eyedrops. Intermediate uveitis can go either way, and posterior uveitis usually requires pills or injections.
Steroids and other immunosuppressants can produce many serious side effects, such as kidney damage, higher blood sugar, higher blood pressure, osteoporosis, and glaucoma. This is especially true of steroids in pill form because the dosage must be relatively high in order for enough of the drug to find its way to the back of the eye. So it is important to follow your eye specialist’s dosage instructions carefully and to keep visiting him or her regularly to monitor your progress.
Conjunctivitis:
What is Conjunctivitis?
Conjunctivitis, most commonly referred to as “pink eye,” is the term used to describe an inflammation of the conjuctiva – the thin, filmy membrane that covers the inside of your eyelids and the white part of your eye, or sclera.
The conjunctiva, which contains tiny blood vessels, produces mucus to coat and lubricate the surface of your eye. When the conjunctiva becomes irritated or inflamed, the blood vessels become larger, making your eye appear red or pink. Conjunctivitis may occur in one or both eyes. Conjunctivitis is a very common eye condition. It is not serious but can be very uncomfortable and irritating.
There are typically three types of conjunctivitis: viral conjunctivitis, bacterial conjunctivitis and allergic conjunctivitis. Allergic conjunctivitis and conjunctivitis caused by an infection can be hard to distinguish. Both have similar symptoms, such as redness, itching and swelling in the eye area. However, when conjunctivitis is caused by allergies, both eyes are usually affected. Viral or bacterial conjunctivitis can affect either a single eye or both eyes. It is important for a physician to pinpoint whether someone with conjunctivitis because of allergies or infection since each condition requires a different course of treatment.
Symptoms of Conjunctivitis:
Viral Conjunctivitis:
The eyes are red and there may be a watery discharge. The eyes are uncomfortable and there may also be symptoms of a cold. Sometimes there are tender lymph nodes around the ear or the neck. This type of conjunctivitis may also spread to affect the cornea, also known as “keratitis,” and it may persist for several weeks.
Bacterial Conjunctivitis:
This condition usually makes your eye(s) feel gritty with a sticky discharge (pus). Eyes are red or a pinkish-red hue. Your eyelids may be stuck together particularly in the mornings, and there may be discharge on the eyelashes. Bacterial conjunctivitis usually does not affect your vision.
Allergic Conjunctivitis:
Allergic conjunctivitis is usually associated with intense itching or burning of both eyes. Symptoms also include tearing, enlarged vessels in the sclera (the white part of your eye), and puffy eyelids. Vision is rarely affected. Symptoms are very similar to viral or bacterial conjunctivitis and diagnosis is confirmed by the lack of infectious signs on a slit-lamp examination by an eye specialist.
Causes of Conjunctivitis:
Viral Conjunctivitis:
Viral infection is the most common cause of conjunctivitis. In many cases, onset follows an upper respiratory infection or the common cold. This may be caused by a virus called “adenovirus.” This type of conjunctivitis can spread rapidly between people and may cause an epidemic of conjunctivitis. This is highly contagious.
Bacterial Conjunctivitis:
Bacterial conjunctivitis is an infection caused by bacteria such as staphylococci (staph), streptococci (strep) or gonococcal (gonorrhea). These organisms may come from the patient's own skin or upper respiratory tract or they may be caught from another person with conjunctivitis. This is highly contagious.
Allergic Conjunctivitis:
This may occur at particular times of the year, also known as seasonal allergies. Or, it may occur when your body is exposed to materials that cause an allergic reaction, such as dust mites, dander, or cosmetics. Allergic conjunctivitis is not infectious or contagious.
Treatment:
Viral conjunctivitis:
There is no effective treatment for viral conjunctivitis but the eyes may be made more comfortable by using a lubricant ointment. Also, discomfort can be alleviated with a warm compress applied to the infected eye(s). In some where vision may be affected, steroids may sometimes be recommended to control symptoms and speed recovery. However it is quite possible that once the steroid treatment is discontinued, the disease may continue and will need to run its course.
Bacterial conjunctivitis:
Bacterial conjunctivitis is usually treated with a broad spectrum of antibiotic drops or ointment. A warm compress with baby shampoo may be used to help alleviate the sticky/crusty sensation around the eye(s) and eyelashes. If treated, symptoms usually last about 5-7 days.
Allergic conjunctivitis:
Treatment of allergic conjunctivitis often includes using topical antihistamine drops or ingesting antihistamine drugs. Also, a cool compress may be used to help alleviate the symptoms associated with allergic conjunctivitis.
Generally, conjunctivitis is easily treated. However, if symptoms persist for an extended period of time after treatment, you should have your eyes examined by an eye specialist, as these symptoms may indicate a more serious eye problem, some of which can lead to blindness unless diagnosed and treated.
Epiretinal Membrane (ERM) or Macular Pucker:
What is an Epiretinal Membrane?
An epiretinal membrane (ERM) or also known as a macular pucker is a condition when a scar tissue-like membrane forms over the macula. The macula is the part of the eye responsible for sharp, clear central vision. An epiretinal membrane is typically slow progressing, causing blurred or distorted vision.
Symptoms of an Epiretinal Membrane:
- Blurred central vision
- Distorted “wavy” vision
- Difficulty reading or seeing detailed objects
- Gray area in central vision
- Blind spot in central vision
- Doubled vision
Causes of an Epiretinal Membrane:
- Vitreous Detachment
- Retinal Detachment
- Uveitis
- Diabetic Retinopathy
- Eye injury
- Eye surgery
- Age
Treatment of an Epiretinal Membrane:
The doctor is able to detect ERM with ophthalmoscopy during an examination of the retina. It has a glistening, cellophane-like appearance. The affect of ERM on your central vision is determined with a visual acuity test and the Amsler Grid. If the retinal specialist suspects macular swelling or CME, they may order fluorescein angiography.
An epiretinal membrane (ERM) usually requires no treatment. In many cases, the symptoms of blurriness and/or distortion are mild and do not require treatment. Eye drops, medication, nor vitamins will help ERM.
If your vision deteriorates to the point of impairment, pars plana vitrectomy surgery may be needed to remove the puckered scar tissue affecting your macula. In addition, a membrane peel may be performed.
After surgery, while vision improves in most cases, it does not usually return to normal. On average, about half of the vision lost from an epiretinal membrane is restored; some people have significantly more vision restored, some less.
Macular Hole:
What is a Macular Hole?
A macular hole affects the central portion of your retina, known as your macula. Your eye’s macula is the small, highly sensitive and specialized central area of the retina. The macula is the part of the retina which is responsible for our sharp, detailed, central vision.
Symptoms of a Macular Hole:
Patients with partial holes affecting part of the macular layers may experience:
- Blurred central vision
- Distorted “wavy” vision
- Gray area in central vision
- Difficulty reading or seeing detailed objects
Patients with full-thickness macular holes may experience:
- Blurred vision
- Distorted “wavy vision”
- Complete loss of central vision
Causes of a Macular Hole:
The causes of a macular hole can be for a variety of reasons such as: eye injuries, certain diseases, and inflammation inside the eye. However, the most common cause is related to the normal aging process.
The vitreous gel inside the eye is firmly attached to the macula. With age, the vitreous becomes thinner and separates from the retina. Sometimes this creates traction on the macula, causing a hole to form. Usually the vitreous changing causes no problems to vision at all but it may cause an increase in floaters or flashing lights. If new or sudden floaters or flashes appear, contact us immediately at (708) 687-2222.
Treatment of a Macular Hole:
There are a number of different stages to a macular hole. These stages are usually classed by the size of the hole and the layers of the eye which are affected. This is important to know because in the early stages it is possible for macular holes to heal themselves. This means that sometimes an ophthalmologist (eye specialist) will want to monitor the progression of a macular hole before recommending any treatment.
However in most cases, a macular hole will develop and distort vision. In the final stages of a macular hole, most central vision will be lost. Macular hole surgery attempts to stop the macular hole developing to this stage.
A pars plana vitrectomy (PPV) with a gas bubble may be required to help alleviate sight problems that a macular hole can cause. The macula needs to lie flat on the back of the eye to receive, through blood vessels, all the nourishments needed to work properly. Surgery is an attempt to help the macula lie flat on the back of the eye.
The operation may be performed using general or local anesthetic. Your retinal specialist will perform a PPV and then remove some of the vitreous jelly in your eye; this is to leave space inside the eye to insert the gas bubble. The gas is inserted to help the macular hole heal in the correct place. The gas bubble is lighter than air, so it floats upward. The gas acts like a bandage pressing the macula hole flat onto the back of the eye, repairing the hole and making sure that there is no risk of further damage or a retinal detachment.
To make sure that the gas bubble is putting pressure on the correct part of your retina, it is necessary for you to position your head facing downward. The gas puts a small amount of pressure on the macula which encourages the hole to close and repair itself. Positioning your head face down is called “posturing.”
Posturing:
Posturing after surgery requires you to keep your head facing downward for approximately two weeks after surgery. If the gas does not put pressure on the correct area, the macular hole will not repair itself and the macular hole could continue to develop.
Usually 50 minutes of every hour is needed to be spent with your head face down. The other ten minutes can be used using the restroom, eating, or putting your eye drops in. It is not necessary to lie completely flat, most patients posture sitting in a chair. When sleeping, your head must remain face down. There are pillows designed for this comfort, or you may place pillows on either side of you to keep you from rolling onto your back.
In this two weeks of posturing, the gas bubble is slowly getting smaller so that eventually it is no longer in the eye. As this happens, the space that was taken up by the gas is filled with aqueous fluid, the natural fluid made by the eye.
While the gas is in place there may still be some distortion to sight, but when this gas has been absorbed and the aqueous fluid has taken its place, sight should be improved.
In many patients, there is some improvement in vision following the surgery and recovery time. However in others the operation’s main effect is to stop the sight becoming any worse.
Glaucoma
Glaucoma is the third most common cause of blindness in the United States. Glaucoma is a disease caused when fluid which normally passes through the eye becomes obstructed, increasing pressures in the eye. The elevated pressure damages fibers in the optic nerve causing symptoms which vary in severity.
Chronic or open-angle glaucoma can result in a patient’s loss of peripheral vision, blurred vision, halos around lights, blindspots, difficulty in adjusting vision from light to dark, and poor night vision.
Acute or closed-angle glaucoma can result in severe eye pain, headaches, redness in the eye, blurred vision, halos around lights, and dilated pupils.
Risk factors for developing glaucoma include a family history of glaucoma, smoking, stress, fatigue, age. Glaucoma is most common in adults over the age of 60. Everyone over the age of 40 should have their intraocular pressures evaluated annually during their ophthalmic examination.
The symptoms of glaucoma can be controlled with prompt treatment. Most patients with glaucoma are treated with eyedrops which lower the pressure in the eyes, this relieving the symptoms. The physician’s instructions for administering the eyedrops must be followed to properly control the disease, even when the symptoms are relieved.
In cases of acute glaucoma, laser surgery may be required to control the disease and relieve the severe pain and pressure.
Dry Eye Syndrome:
Dry eye syndrome is a chronic lack of sufficient lubrication and moisture in the eye (tears). Tears are produced to keep your eye healthy and comfortable. Not enough production of tears can irritating to your eyes and can be caused by various reasons.
Tears bath the eye, washing out dust and debris and keeping the eye moist. They also contain enzymes that neutralize the microorganisms that colonize the eye. Tears are essential for good eye health.
In dry eye syndrome, the eye doesn't produce enough tears, or the tears have a chemical composition that causes them to evaporate too quickly.
Symptoms of Dry Eyes:
- Persistent dryness
- Stinging or a burning sensation
- Scratchiness
- Excessive tearing
- Foreign body sensation
- Difficulty wearing contact lenses
- Stringy mucus around the eyes
These symptoms alone may be enough for your eye doctor to diagnose dry eye syndrome. Sometimes the physician may want to measure the amount of tears in your eyes. A thin strip of filter paper placed at the edge of the eye, called a Schirmer test, is one way of measuring this. Another way to measure dry eye is using a diagnostic drop, such as fluorescein, to look for certain patterns of dryness on the surface of the eye.
Some people also experience a foreign body sensation, the feeling that something is in the eye. And it may seem odd, but sometimes watery eyes can result from dry eye syndrome, because the excessive dryness works to over stimulate production of your eye's tears.
Causes of Dry Eye Syndrome:
Dry eye syndrome has several causes. It occurs as a part of the natural aging process, especially during menopause, therefore women are most often affected with dry eye syndrome due to changes in hormones.
Another cause can be associated as a side effect of many medications, such as:
- Antihistamines
- Antidepressants
- Certain blood pressure medicines
- Diuretics
- Sleeping pills
- Pain relievers
- Parkinson's medications
- and birth control pills
Environmental components are another common source to dry eye syndrome. If you live in a dry, dusty or windy climate or if your home or office has air conditioning or a dry heating system, this too can dry out your eyes.
Another cause is insufficient blinking, such as when you're staring at a computer screen all day. Also, smoking is very bothersome to the eyes. Avoid second hand smoke at all times.
Treatment of Dry Eye Syndrome:
Eye drops called artificial tears are man-made to simulate the same functions as your own tears; lubricate and maintain moisture. Artificial tears help alleviate the dry, scratchy feeling of dry eyes. Artificial tears are available over-the-counter and your local drug store. Check with your optometrist or ophthalmologist before buying any over-the-counter eye drops. It will probably save you a lot of money, because he or she will know which formulas are effective and long-lasting and which ones are not,
If you wear contact lenses, be aware that many eye drops, especially artificial tears, cannot be used while your contacts are in your eyes. You'll need to remove them before using drops, and wait 15 minutes or even longer (check the label) before reinserting the lenses. If your eye dryness is mild, then contact lens rewetting drops may be sufficient to make your eyes feel better, but the effect is usually only temporary.
If the problem is environmental, you should always wear sunglasses outdoors to reduce your exposure to wind, sand, dirt, dust, and the sun. Indoors, you may want to use an air purifier to clean the air and then use a humidifier or a pan of water to add moisture to the air when air is dry due to air conditioning or heaters.
Corneal Abrasion:
What is the Cornea?
The cornea is the clear front window of the eye. The cornea covers the iris (colored portion of your eye) and the pupil. The cornea is composed of five layers: epithelium (the outermost layer), Bowman's membrane, stroma, Descemet's membrane and the endothelium.
Because there are no blood vessels in the cornea, it is normally clear and has a shiny surface. The cornea is extremely sensitive - there are more nerve endings in the cornea than anywhere else in the body.
What is a Corneal Abrasion?
A corneal abrasion is an injury (scratch or cut) to the epithelium.
Symptoms of a Corneal Abrasion:
- Sensation of a foreign object in your eye (eyelash or dust)
- Pain or soreness
- Redness
- Sensitivity to light
- Tearing
- Blurred vision
Causes of a Corneal Abrasion:
Commonly, abrasions are caused by fingernail scratches, papercuts, make-up applicators or brushes, scrapes from tree branches, or simply rubbing the eye. Some eye conditions, such as dry eye, can increase the chance of an abrasion.
Treatment of a Corneal Abrasion:
To detect an abrasion to your eye’s cornea, your eye doctor will use a few drops of fluorescein (a bright orange dye) in your eye to illuminate the injury.
Treatment may include patching the injured eye to prevent further irritation. Also, your eye doctor may prescribe a lubricating ointment or lubricating eye drops to form a soothing layer between the eyelid and the abrasion. Additionally, your eye doctor may prescribe an antibiotic to prevent infection.
Minor abrasions usually heal within a day or two; larger abrasions usually take about a week. It is important not to rub the eye while it is healing. Do not wear contact lenses while your eye is healing and ask your ophthalmologist when you may start wearing contact lenses again.
Recommendations to Reduce Risk of Eye Disease:
1. Make sure your diet includes the following foods:
- Plenty of green leafy vegetables:
- Spinach
- Broccoli
- Kale
- Collard Greens
- Omega-3 rich fish and low mercury levels:
- Salmon: 1 gram of omega-3 fatty acids per 2 ounces of fish
- Herring: 1 gram of omega-3 fatty acids per 1 ounce of fish
- Sardines: 1 gram of omega-3 fatty acids per 2-3 ounces of fish
- Trout: 1 gram of omega-3 fatty acids per 3-4 ounces of fish
- Pollock: 1 gram of omega-3 fatty acids per 6.5 ounces of fish
- Flounder: 1 gram of omega-3 fatty acids per 5 ounces of fish
2. Take the following supplements (Talk to your primary physician
before taking nutritional supplements):
- I Caps with Lutein (2 tablets twice daily)
- Centrum Silver ( 1 tablet daily)
- Omega-3 Supplement
3. Always wear sunglasses whenever outside or driving
4. Avoid second-hand smoke
|
