Blepharitis is a disease of the eyelids and is one of the more common culprits for the patient’s symptoms of dry eyes. The margin of the eyelid becomes chronically inflamed and often causes itching, burning, redness, tearing of the eyes and recurrent Styes. Patients often feel that their eyes are dry and complain of a gritty “sand in the eye” sensation. Generally, lubricating eye drops due not improve the symptoms.
Blepharitis is typically caused by dysfunction of the oil-producing glands of the eye. Known as Seborrhea blepharitis, this condition is associated with a decrease id physical health, stress, poor diet and hormonal imbalance.
Less commonly, Blepharitis is caused by a bacterial overgrowth at the base of the eyelashes resulting in infection and inflammation of the small oil glands, which line the base of the eyelashes (meibomian glands). This condition is often associated with a build up of yellow material around the eyelashes.
It is difficult to distinguish between the two causes of Blepharitis. Fortunately, they are both treated similarly.
Improved hygiene is the initial goal in treatment. Dr. Switch will give you several techniques to clean the base of he eyelashes. Warm compresses are used to help the oil glands drain and improve flow. Often, gentle massaging of the eyelids promotes expression of the infected oil secretions. In many cases, a mild antibiotic ointment is used to eliminate the bacteria and the oil glands to cleanse. Rarely, oral antibiotics are required to control the bacterial component of blepharitis.
Treatment of blepharitis not only improves dry eye symptoms but also prevents the deeper infection of oil the meibomian glands known as chalazions (Styes).
Dry eye syndrome is a common condition in which a lack of moisture results in many different symptoms. A tear film that is composed of three layers coats the eye. A deficiency of any one of these layers can result in a lack of moisture of the corneal surface.
Common Symptoms Include:
- Gritty sensation
- Sensitivity to wind or fans
- Excessive tearing (yes, this may indicate dry eyes): Reflex tearing is a result of dry eyes. Lack of proper lubrication from the oil glands of the eyelid result in a tearing reaction.
- Difficulty wearing contacts
Dry eyes can occur in younger and older patients. It is more common in older people and women are more likely to suffer from this condition than men. Although there are many causes, commonly there is an association with prescription medication, allergy medication, blepharitis, allergies and eye exposure while sleeping.
Treatment for Dry Eyes
- The first step in therapy for mild cases includes hydrating the eye with a good artificial tear. Dr. Switch can help you decide which moisturizing agent is appropriate for your condition.
- There are several prescription medications designed to help you produce better tears and reduce inflammation. Dr. Switch will discuss the benefits and any associated risks of these medications with you if you are a candidate for this therapy.
- Environmental factors that worsen symptoms will be discussed during your exam. Using a fan at night or having the air conditioning blowing on your face in the car are some examples of an avoidable situation that worsen dry eye symptoms.
- Omega-3 fatty acid supplements may be beneficial in some cases. Dr. Switch will tell you if your dry eyes are likely to benefits from this supplement.
- Tear Conservation through the use of punctual plugs is another option for sever dry eye patients. If other therapies fail, Dr. Switch may suggest plugging the outflow of normal tears from the eye with silicone plugs that are placed in the office.
A brief description can be viewed below. Please click on the ADA link here to visit the American Diabetic Association for further information.
Diabetes is a disease that affects the small blood vessels (capillaries) throughout the whole body. These vessels are abundant the kidneys and eyes. Damage to the vessels in the back of the eye from elevated blood sugar is called diabetic retinopathy.
The Retina is the small layer on the back of the eye responsible for sensing light and color. Any damage to the retina results in loss of sight. The retina is rich in blood vessels which can be damaged be elevated blood sugar. For this reason, the American Diabetes Association recommends that patients with type I and type II diabetes have an annual dilated eye exam.
Types of Diabetic Retinopathy
There are two types of diabetic retinopathy:
- Proliferative (PDR)
- Nonproliferative (NPDR)
Nonproliferation diabetic retinopathy (NPDR) is also commonly referred to as background retinopathy. This early form of diabetic retinopathy occurs when the smallest blood vessels of the retina are damaged and begin to leak into the retina. Many people with diabetes develop NPDR without any visual loss to alert them to the presence of the damage that is starting to occur in their eyes.
Proliferative diabetic retinopathy (PDR) Is a more advanced form of damage. It carries a high risk of vision loss and follows after NPDR has been left untreated. PDR occurs when new blood vessels grow in the retina in response to the damage that has occurred. These new blood vessels grow (neovascularization) are abnormal and result in problematic complications for the retina including:
- Vitreous hemorrhage
- Retinal Detachment
- Retinal Tear
- Secondary Glaucoma (neovascular)
What are Floaters and Flashes?
Black spots floating in a person’s field of vision can be disconcerting at times, however, most people at some point experience this symptom. These spots often last only a short time, though some can last for a longer duration.
Flahes are bright arcs or points of light that flash in a person’s field of vision, even when the eyes are closed. These flashes are typically in one eye. These flashes often represent a mechanical tug on the back part of the eye (The Retina) by the vitreous, which is the gelatinous material in the back of the eye. Both floaters and flashes are often harmless symptoms, particularly of aging eyes; however, they can be the first symptoms of a serious eye condition such as retinal tears or retinal detachments.
Is this serious?
Because flashes of light or a new set of floaters in the eye can indicate a retinal detachment or tear, it is necessary to be evaluated as soon as possible by and eye care professional. Treatment options for Flashes, Floaters These symptoms often require no treatment and may be the result of a natural part of aging of the back of the eye. However, If a serious condition is the culprit of these symptoms, such as a retinal tear, a small in office laser can be used to “spot weld” the tear back into place. It is important to diagnose this condition early, because untreated retinal tears and detachments have a high risk of compromising useful vision in the affected eye. The longer treatment is delayed, the worse a person’s prognosis will be.
Glaucoma is a disease that results in injury to the optic nerve. The optic nerve is the portion of the eye that takes the images collected from the eye and transmits them to the brain. Each eye naturally maintains a certain internal pressure, which is called intraocular pressure. When this pressure rises above normal levels, it can injure the optic nerve, causing significant damage. Optic nerve damage results in vision loss, pain, and left untreated, blindness.
The anterior (front) portion of the eye is always producing a fluid called aqueous humor. A healthy eye will produce a constant supply of aqueous humor to maintain consistent pressure within the eye, which is matched by a draining mechanism that allows the fluid to escape into the blood stream. When drainage becomes blocked or limited, pressure increases and may result in glaucoma. There are two main types of glaucoma: open-angle glaucoma and closed-angle glaucoma.
Chronic open-angle glaucoma is the most common form of glaucoma. It usually develops with increasing age. This form of glaucoma results in a chronic and gradual pressure increase in the eye, which over time begins to damage the optic nerve. Most people have no perceptible symptoms until the disease has become advanced after many years. Loss of peripheral vision is usually the first symptom patients will notice. As the disease progresses untreated, larger portions of vision will disappear. If left untreated, it can develop into blindness.
Early detection is key
Vision loss from glaucoma is permanent. This visual loss can often be prevented if detected and treated early enough. Glaucoma treatment is a lifelong process that requires monitoring of the eye pressure and, most commonly, a daily set of eye drops. As with most eye diseases, by the time the patient realizes that a problem exists, permanent damage and visual loss has already occurred. For this reason, during every eye visit, Dr. Switch specifically evaluate the optic never to ensure no early warning signs are present to indicate an previously undiagnosed glaucoma.
Risk factors for chronic open-angle glaucoma include:
- Increasing age
- African-American heritage
- Elevated blood pressure
- Family history of glaucoma
- Long-term steroid treatment
- Injury or trauma to the eye
A less common form of glaucoma, Closed-angle glaucoma, is likely to result in an ocular emergency. This type of glaucoma occurs when a patient’s pupil dilates in such a way that it actually blocks the drainage structures inside the eye. This is considered an emergency and can result in permanent vision loss in a short period of time if untreated by and ophthalmologist.
Symptoms of closed-angle glaucoma:
- Severe eye pain in one or both eyes.
- Boring Headache.
- Blurred vision or halos around vision.
- Nausea or vomiting.
Risk factors for closed-angle glaucoma:
- Abnormal shape of the iris.
- Increasing age.
- Family history of closed-angle glaucoma.
- Asian decent.
Treatments options for glaucoma:
There are many treatments for glaucoma, including medicated eye drops, LASER surgery and traditional surgery. The specific treatment for an individual patient is based upon the type of glaucoma. Medication options include drops that decrease the production of fluid in the eye as well as improve the eye’s ability to drain normally. LASER surgery is a more advanced treatment for glaucoma. For open-angle glaucoma, Dr. Switch may choose a procedure called a trabeculoplasty, which is a painless procedure that utilizes light to open the drainage canals of the eye. For closed-angle glaucoma, another painless option incorporates the use of a LASER to open a small drainage port in the iris called a peripheral iridotomy.
SLT (Selective Laser Trabeculoplasty) is an in-office laser procedure that reduces eye pressure for most patients with chronic forms of glaucoma. The SLT laser selectively targets the type of cell that clogs the drainage mechanism of the eye, in essence, unclogging the drain without the use of medications or invasive surgery.
The bottom line:
Regular eye exams allow Dr. Switch to evaluate your eyes for any signs of glaucoma. He will be able to diagnose a problem before you notice symptoms, which means treatment can be started early enough to prevent damage from ever occurring. There are many treatment options available, Dr. Switch will be able to help you decide which option is best for your situation and will work with you to help you maintain your vision for the rest of your life.
For more detailed information and resources, please visit http://www.macular.org/
Macular degeneration affects the portion of the retina responsible for central vision. This central vision is essential for detailed tasks like reading, recognizing faces, driving, etc. Although macular degeneration does decrease a person’s peripheral vision, it can be especially disabling if left untreated.
Macular Degeneration has two forms: Dry (Milder and more common) and Wet (more severe and less common). Dry Macular Degeneration is characterized by a gradual development over many years and typically results in less severe central vision loss. Typically, small particles of lipid develop underneath the Macula, known as Drusen. Ultimately, this results in slow atrophy and loss of the Macular photoreceptors, which in turn decreases the patient’s ability to see their central vision.
When abnormal blood vessels begin to grow in the Macula, a patient is said to “Wet” Macular Degeneration. These blood vessels may begin to leak and the fluids can permanently damage the photoreceptors of the Macula and surrounding Retina. Although much more rare, this form of Macular Degeneration is responsible for the vast majority of central vision blindness caused by Macular Degeneration.
The cause of macular degeneration has yet to be discovered. There are several risk factors that make a person more likely to suffer from this condition. Age greater than 60, family history, smoking, hypertension, obesity and high cholesterol may all contribute to the development of macular degeneration. It is thought that genetics likely place key role, though the exact gene has not yet been isolated.
Symptoms of Macular degeneration:
- Difficulty with central vision blurriness, shadows or holes in the vision.
- Distortion of Straight lines, often appearing curved or wavy.
- Difficulty differentiating colors, especially ones similar color tones.
- Sensitivity to bright light and a delay in visional adaption after exposure to bright light.
Dry Macular Degeneration Treatment:
The only proven treatment for the dry form of macular degeneration is dietary supplementation with specific vitamin antioxidants and zinc to help slow the development of dry macular degeneration. Patients who have risk factors should schedule a checkup with their ophthalmologist at least once every year, in order to identify the disease at its earliest stage.
Although there is no cure for wet macular degeneration, there are multiple treatment options designed to slow or treat the damage caused by the disease. Early detection is paramount. Once vision is lost from macular degeneration, there are currently no treatments to restore sight that has already been lost. Wet macular degeneration treatment options:
- LASER photocoagulation. Microscopic laser spots are used to seals leaking blood vessels. This treatment may halt the disease and help preserve the remaining vision of a patient. However, a small scar is created which results in a permanent blind spot in the patient’s vision. This treatment is only an option for a small portion of cases, as it requires the sacrificed of a portion of vision to halt the progression of the disease into other parts of the vision.
- Photodynamic therapy: This light-activated “cold” LASER uses a drug that is injected intravenously. Then the surgeon directs the LASER on the affected area, which activates the drug as it passes through the abnormal blood vessels. Unlike other LASER treatments, this procedure leaves no scar and may be repeated multiple times.
- Anti-VEGF drugs: These newer treatment options inhibit the molecules that cause the body to develop abnormal blood vessels. They are known as anti-VEGF (anti-vascular endothelial growth factor) drugs. There are a variety of drugs in this category. Avastin is the most commonly used drug for the treatment of wet macular degeneration, though several new drugs have recently been approved, including Lucentis and VEGF-trap.
Monitoring your vision every day is important – print out this grid and keep it in a convenient place. Click here to download the printable Amsler Grid.
Myopia is a condition in which the visual images come to a focus in front of the retina of the eye resulting especially in defective vision of distant objects. Myopia is typically a result of the eyeball be slightly longer than normal.
Hyperopia is a condition of the eye in which vision is better for distant objects than for near objects; although this may also result in blurriness of distant object as well. It results from the eyeball being too short from front to back, resulting in images focusing behind the retina.
Presbyopia is the gradual loss of your eyes’ ability to focus between far and near objects. This natural part of aging usually becomes noticeable in the early to mid-40s and continues to worsen until around age 65.
Astigmatism is a refractive defect in which vision is blurred due to the inability of the cornea and lens of the eye to focus an object into a focused image on the retina. This may be due to an irregular or toric curvature of the cornea. Glasses or toric contact lenses can correct astigmatism arising from the cornea. A ‘toric’ surface resembles the surface of a football, rather than the spherical surface of a regular cornea. This optical shape gives rise to astigmatism in the eye.
Three options exist for the treatment of astigmatism, myopia or hyperopia: Refractive surgery, contact lenses and eyeglasses.