Eye Conditions

Amblyopia, which is also called “lazy eye”, is a disorder that affects the visual development in children. Amblyopia is difficult to correct just with the use of contact lenses, or eyeglasses. Ambylopia can cause vision loss if it is not treated early and properly. This vision disorder affects 2-3% of the population.

What are the symptoms of Amblyopia?

Usually children that are born with amblyopia, the symptoms start in early childhood. Some signs of amblyopia in children are squinting, closing one eye in order to see better, poor general vision, headaches, and eyestrain. Usually caretakers such as parents, caregivers, doctors, or nurses notice these symptoms and recommend the child for treatment.

What are the causes of Amblyopia?

Strabismus is usually the cause of amblyopia. Strabismus is the eyes aligning incorrectly. Amblyopia can also be caused when there is a large difference between the eyes in refractive errors (prescription much higher in one eye than the other). For example, one eye is nearsighted, while the other is farsighted. If amblyopia is not treated, the brain will learn to disregard the vision in the eye with amblyopia. The eye that is disregarded does not grow with clear image and vision loss can be permanent. This is why it is very important to get early treatment and take your child to see your eye doctor if any signs are apparent.

How is Amblyopia treated?

There are several treatments for amblyopia, depending on the cause. Often children are treated using vision therapy, which usually includes a patch on the better eye. Other treatments are atropine eye drops, correct prescription eyeglasses, or surgery.

Vision Therapy

Vision therapy consists of eye exercises, which aim to teach the eyes to work together. In cases of amblyopia, the exercises require the brain to recognize the affected eye, which restores vision in that eye. Some doctors place a patch over the more functional eye, which forces the less functional eye to work harder and become stronger. The patch is generally worn for a few hours a day. Depending on the severity of the condition, treatment can last for weeks or months. Some children refuse to wear a patch, in those cases, a prosthetic contact lens is available. These contact lenses look like the regular eye, and are designed to block vision in that eye.

Atropine drops

Some doctors use atropine eye drops to treat amblyopia. These drops blur vision in the child’s better eye, forcing the weaker eye to work harder and get stronger. In the morning, one drop is instilled under eye doctor’s instructions. The advantage to this method of treatment is that the patch is avoided.

Prescription eyeglasses

If your child has developed amblyopia because of uncorrected vision, sometimes all that is needed is a pair of eyeglasses. When there is strong uncorrected prescription, or when there is a large difference in prescription between the two eyes, sometimes amblyopia can result. Your eye doctor may recommend eye patch therapy in addition to corrective lenses.

Surgery

Strabismus surgery is usually required if the amblyopia is due to a large eye turn. This type of surgery aligns the eyes and corrects the problem within the eye muscles. After the surgery the eyes will able to focus better. Additional vision therapy may be required after strabismus surgery.

Amblyopia must be treated as early as possible as there is no chance that it will resolve by itself. Untreated amblyopia can lead to permanent vision loss in that eye and reduced depth perception. Amblyopia needs to be treated promptly so that your child can have the best vision possible in childhood and later in life. When amblyopia is diagnosed and treated before age 9, the weaker eye can often develop significantly better vision. The most critical time to treat amblyopia is from 3 to 6 years of age. If you or anyone sees any signs of amblyopia, go to your eye doctor to find the best treatment for your child.

Many people have never heard of astigmatism, although it is an extremely common eye condition.

Astigmatism is one type of refractive error. Nearsightedness and farsightedness are other types of refractive error. Refractive errors are not eye diseases. Refractive error is a result of and imperfection of the size and shape of the eye, which results in blurry or double vision.

If left untreated, astigmatism may cause eyestrain, headaches, and blurry vision. If you have astigmatism you may not see objects in the distance or near without some form of distortion.

Symptoms of Astigmatism

Small amounts of astigmatism can go unnoticed, however, you may be suffering from eye fatigue, eyestrain, and headaches.

Astigmatism is a condition that usually can develops early in childhood. According to a study from The Ohio State University School of Optometry, 28% of school age children suffer from astigmatism. Parents should be aware that their children might not notice that their vision is blurry, not understanding that this is not normal. Nevertheless, astigmatism should be treated because vision problems can lead to learning problems and in extracurricular activities. Make sure to have your child’s eyes examined at an eye doctor’s office at least once a year.

Causes of Astigmatism

Astigmatism is generally caused by a cornea with an irregular shape. The cornea is the front, clear layer of the eye. With astigmatism, the cornea is not round and spherical and is instead irregular having two curves instead of one curve. Astigmatism in some cases could also be caused by the lens located inside the eye that is irregular in shape.

Eyes with astigmatism distort the light that comes into the eyes because the cornea is irregularly shaped. This causes the light rays entering the eye to create two images in the back of the eye (because of the two curves), instead of one image. This is what causes the distortion in sight.

Treatments for Astigmatism

For most people, their astigmatism is fully corrected using prescription glasses or contact lenses. If you select contact lenses to correct your vision, soft contact lenses are the most common option. If for whatever reason soft contact lenses are not an option, rigid gas permeable (RGP or GP) are also a great choice. Rigid gas permeable lenses usually give the clearest vision but the adaptation process will be significantly longer. Another option are hybrid contact lenses. These contacts have a center made from a rigid gas permeable (RGP) lens and an outer ring made of soft contact lens material. This type of lens provides both excellent clarity and comfort. LASIK could be another option to correct astigmatism. LASIK usually only corrects low levels of astigmatism and some patients with higher levels of astigmatism might not be candidates.

Blepharitis is an eye condition characterized by an inflammation of the eyelids which causes redness, itching and irritation. The common eye condition is caused by either a skin disorder or a bacterial infection. Blepharitis is generally not contagious and can affect patients of any age. While it can be very uncomfortable, it usually does not pose any danger to your vision.

There are two types of blepharitis: anterior and posterior.

Anterior blepharitis occurs on the front of your eyelids in the area where the eyelashes attach to the lid. This form is less common and is usually caused by a bacterial infection or seborrheic dermatitis, which is a skin disorder (dandruff) that causes flaking and itching of the skin on the scalp and eyebrows. While it is more rare, allergies or mites on the eyelashes can also lead to this condition.

Posterior blepharitis occurs on the inner eyelid that is closer to the actual eyeball. This more common form is often caused by rosacea, dandruff or meibomian gland problems which affect the production of oil in your eyelids.

Symptoms of Blepharitis

Blepharitis can vary greatly in severity and cause a variety of symptoms which include:

• Red, swollen eyelids
• Itching
• Burning or gritty sensation
• Excessive tearing
• Dry eyes
• Crusting on eyelids

If left untreated, symptoms can become more severe such as:

• Blurred vision
• Infections and styes
• Loss of eyelashes or crooked eyelashes
• Eye inflammation or erosion, particularly the cornea
• Dilated capillaries
• Irregular eyelid margin

Treatment for Blepharitis

Treatment for blepharitis depends on the cause of the condition but a very important aspect is keeping the eyelids clean. Warm compresses are usually recommended to soak the lids and loosen any crust to be washed away. It is recommended to use a gentle cleaner (baby soap or an over the counter lid-cleansing agent) to clean the area.

For bacterial infections, antibiotic drops or ointments may be prescribed, and in serious cases steroidal treatment (usually drops) may be used.

Blepharitis is typically a recurring condition so here are some tips for dealing with flare-ups:

• Use an anti-dandruff shampoo when washing your hair
• Massage the eyelids to release the oil from the meibomian glands
• Use artificial tears to moisten eyes when they feel dry
• Consider breaking from use of contact lenses during the time of the flare-up and or switching to daily disposable lenses.

The most important way to increase your comfort with blepharitis is by keeping good eyelid hygiene. Speak to your doctor about products that he or she recommends.

A cataract is a clouding of the eye’s natural lens, which lies behind the iris and the pupil. The lens works much like a camera lens, focusing light onto the retina at the back of the eye. The lens also adjusts the eye’s focus, letting us see things clearly both up close and far away.

Cataract signs and symptoms

A cataract starts out small, and at first has little effect on your vision. You may notice that your vision is blurred a little, like looking through a cloudy piece of glass or viewing an impressionist painting. However, as cataracts worsen, you are likely to notice some or all of these problems:

• Blurred vision that cannot be corrected with a change in your glasses prescription.
• Ghost images or double vision in one or both eyes.
• Glare from sunlight and artificial light, including oncoming headlights when driving at night.
• Colors appear faded and less vibrant.

What causes cataracts?

No one knows for sure why the eye’s lens changes as we age, forming cataracts. Researchers are gradually identifying factors that may cause cataracts, and gathering information that may help to prevent them.

Many studies suggest that exposure to ultraviolet light is associated with cataract development, so eye care practitioners recommend wearing sunglasses and a wide-brimmed hat to lessen your exposure. Other types of radiation may also be causes. For example, a study conducted in Iceland suggests that airline pilots have a higher risk of developing a nuclear cataract than non-pilots, and that the cause may be exposure to cosmic radiation. A similar theory suggests that astronauts, too, are at greater risk of cataracts due to their higher exposure to cosmic radiation.

Other studies suggest people with diabetes are at risk for developing a cataract. The same goes for users of steroids, diuretics and major tranquilizers, but more studies are needed to distinguish the effect of the disease from the consequences of the drugs themselves.

Some eyecare practitioners believe that a diet high in antioxidants, such as beta-carotene (vitamin A), selenium and vitamins C and E, may forestall cataract development. Meanwhile, eating a lot of salt may increase your risk.

Other risk factors for cataracts include cigarette smoke, air pollution and heavy alcohol consumption.

Cataract treatment

When symptoms of cataracts begin to appear, you may be able to improve your vision for a while using new glasses, stronger bifocals and greater light when reading. But when these remedies fail to provide enough benefit, it’s time for cataract surgery.

If you need cataracts removed from both eyes, surgery usually will be done on only one eye at a time. An uncomplicated surgical procedure lasts only about 10 minutes. However, you may be in the outpatient facility for 90 minutes or longer because extra time will be needed for preparation and recovery.

Presbyopia-correcting IOLs: Frequently asked questions

Presbyopia-correcting IOLs are a relatively new option, so you may have questions such as:

1. What are presbyopia-correcting IOLs?

2. Aren’t presbyopia-correcting IOLs a lot more expensive? How much extra do I have to pay?

Yes, presbyopia-correcting IOLs are more expensive than standard IOLs. Costs vary, depending on the lens used, but you can expect to pay up to $2,500 extra per eye. This added amount is usually not covered by Medicare or other health insurance policies, so it would be an “out-of-pocket” expense if you choose this advanced type of IOL for your cataract surgery.

3. Why won’t Medicare or health insurance cover the full cost of presbyopia-correcting IOLs?

A multifocal or accommodating IOL is not considered medically necessary. In other words, Medicare or your insurance will pay only the cost of a basic IOL and accompanying cataract surgery. Use of a more expensive, presbyopia-correcting lens is considered an elective refractive procedure, a type of luxury, just as LASIK and PRK are refractive procedures that also typically are not covered by health insurance.

4. Can my local cataract surgeon perform presbyopia-correcting surgery?

5. Are any problems associated with presbyopia-correcting IOLs?

At a 2007 American Society of Cataract and Refractive Surgery conference, some reports indicated that even experienced cataract surgeons needed to perform enhancements for 13% to 15% of cases involving use of presbyopia-correcting IOLs. Enhancements don’t mean that the procedure itself was a failure, because you likely will see just fine with eyeglasses even if your outcome is less than optimal. But it’s possible you may need an additional surgical procedure (such as LASIK) to perfect your uncorrected vision after cataract surgery with a presbyopia-correcting IOL. Depending on the arrangement you make with your eye surgeon, you also may need to pay extra for any needed enhancements.

A cornea transplant, also known as keratoplasty or a corneal graft, replaces damaged tissue on the clear front surface of the eye.

When disease or injury damages the cornea, eyesight is affected. Light that enters the eye becomes scattered, resulting in blurred or distorted vision. When the cornea is extremely scarred or damaged, a corneal transplant is needed to restore functional vision.

Keratoplasty is performed routinely and is regarded as the most successful of all tissue transplants. According to the National Keratoconus Foundation, over 40,000 cornea transplants are done annually in the United States.

In recent years, an innovative type of corneal transplant has gained popularity. Known as Descemet’s Stripping Endothelial Keratoplasty (DSEK), this new procedure removes a smaller and thinner portion of the cornea. In 2009, DSEK was declared by the American Academy of Ophthalmology as superior to the conventional surgery because it may provide better vision outcomes and more eye stability. It is also associated with less risk factors. However, when the majority of the cornea is damaged, a more comprehensive removal may still be necessary to facilitate a successful transplant.

Criteria for a Corneal Transplant

A multitude of reasons indicate candidacy for a corneal transplant. Possible reasons include:

• Eye diseases, such as keratoconus
• Complications from laser surgery, such as LASIK
• Extreme inflammation on the cornea
• Scarring as a result of infections, such as eye herpes or fungal keratitis
• Thinning of the cornea and an irregular shaped cornea
• Hereditary factors
• Corneal failure due to previous surgical procedures
• Chemical burns or injuries that damaged to the cornea

Cornea Transplant Procedure

Once a patient has been recommended and approved for a corneal transplant to restore vision, the patient’s name is added to a list at an eye bank. The United States has a very advanced eye bank system, and the general wait time for a donor eye is one to two weeks. The tissue of donor corneas is checked for clarity and screened meticulously for disease before it is released for transplant.

The actual surgery is generally performed as an outpatient procedure that does not require hospitalization. General or local anesthesia may be used, depending upon the patient’s preference, age and health condition. Local anesthesia is injected into the skin surrounding the eye, which relaxes the muscles that control movement and blinking. Eye drops numb the eye itself.

Once the anesthesia has taken effect, the surgeon inspects and measures the damaged corneal area in order to decide upon the size of the transplantation. Eyelids are held open during this time. The surgeon then removes a round, button-shaped piece of the corneal tissue and replaces it with a nearly identical sized button of donor tissue. The new, healthy tissue is sutured into place. The entire procedure takes approximately one to two hours.

Following the surgery, a plastic shield must be worn over the eye in order to protect it against any inadvertent bumps or rubbing.

Rejection of the Corneal Graft

Although the vast majority of cornea transplants are successful, sometimes the new tissue is rejected. Warning signs of rejection include:

• Extreme sensitivity to light
• Redness
• Pain
• Decreased vision

These symptoms may be experienced as soon as one month after the surgery, or as delayed as five years later. Medications can be prescribed to reverse the rejection process. If the corneal graft fails completely, the transplant can be repeated and the outcome is generally positive. Yet the total rejection rates do increase with the total number of corneal transplants.

Recovery and Healing

It can take up to a year or longer to heal completely from a corneal transplant. At the beginning, vision is blurry and the transplant site is often swollen and thicker than the rest of the cornea. As vision returns, patients are able to return to normal daily tasks and most people can return to work within three to seven days after surgery. However, heavy lifting and exercise must be avoided for the first few weeks.

To help the body accept the corneal graft, steroid eye drops must be applied for several months. A pair of eyeglasses or a protective shield must also be worn for eye safety. Depending upon the health of the eye and the healing rate, stitches may be removed at any time from three months to more than a year later. Astigmatism often occurs as a result of an irregular corneal surface, and adjustments may be made to the sutures around the new cornea in an effort to reduce this problem.

Vision after a Cornea Transplant

Vision improvement after a cornea transplant is a process that can last up to one year later. Eyeglasses or contact lenses must be worn immediately after the surgery, since the curvature of the corneal transplant will not precisely match the natural corneal curve.

When healing is complete and stitches are removed, laser surgery may be indicated to correct vision. LASIK or PRK are both procedures that can help decrease dependence on eyeglasses or contacts. An irregular corneal surface may point to the need to wear rigid gas permeable (GP) contact lenses for vision correction.

Allergy signs and symptoms

Common signs of allergies include: red, swollen, tearing or itchy eyes; runny nose; sneezing; coughing; difficulty breathing; itchy nose, mouth or throat, and headache from sinus congestion.

What causes eye allergies?

Many allergens (substances that can evoke an allergic response) are in the air, where they come in contact with your eyes and nose. Airborne allergens include pollen, mold, dust and pet dander. Other causes of allergies, such as certain foods or bee stings, do not typically affect the eyes the way airborne allergens do. Adverse reactions to certain cosmetics or drugs such as antibiotic eyedrops also may cause eye allergies.

Eye allergy treatment

Avoidance. The most common “treatment” is to avoid what’s causing your eye allergy. Itchy eyes? Keep your home free of pet dander and dust, and stay inside with the air conditioner on when a lot of pollen is in the air. If you have central air conditioning, use a high quality filter that can trap most airborne allergens and replace it frequently.

Medications. If you’re not sure what’s causing your eye allergies, or you’re not having any luck avoiding them, your next step will probably be medication to alleviate the symptoms.

Over-the-counter and prescription medications each have their advantages; for example, over-the-counter products are often less expensive, while prescription ones are often stronger.

Eyedrops are available as simple eye washes, or they may have one or more active ingredients such as antihistamines, decongestants or mast cell stabilizers. Antihistamines relieve many symptoms caused by airborne allergens, such as itchy, watery eyes, runny nose and sneezing.

Decongestants clear up redness. They contain vasoconstrictors, which make the blood vessels in your eyes smaller, lessening the apparent redness. They treat the symptom, not the cause.

In fact, with extended use, the blood vessels can become dependent on the vasoconstrictor to stay small. When you discontinue the eyedrops, the vessels actually get bigger than they were in the first place. This process is called rebound hyperemia, and the result is that your red eyes worsen over time.

Some products have ingredients that act as mast cell stabilizers, which alleviate redness and swelling. Mast cell stabilizers are similar to antihistamines. But while antihistamines are known for their immediate relief, mast cell stabilizers are known for their long-lasting relief.

Other medications used for allergies include non-steroidal anti-inflammatory drugs (NSAIDs) or corticosteroids. In some cases, combinations of medications may be used.

Immunotherapy. You may also benefit from immunotherapy, in which an allergy specialist injects you with small amounts of allergens to help your body gradually build up immunity to them.

Eye allergies and contact lenses

If you see specks or what appears to be debris, or perhaps pieces of lint floating in your vision, these are “floaters”. They are usually harmless. They would be seen most easily while looking at a plain background, like a white wall or clear sky.

Floaters are in reality clumps of gel-like cells inside the vitreous – the clear, jelly-like fluid that fills the inside of your eye. Floaters look like webs, specks, strands, and other shapes. What you are seeing are in fact the shadows of floaters cast on the retina, the light-sensitive inner lining of the back eye panel.

Symptoms of Spots or Floaters

With a special eye light, your doctor will detect floaters in your eyes even if you don’t notice them yourself. If a shadowy shape or spot passes in your field of vision or near the side, you are seeing a floater. Because they are inside your eye and suspended within the gel-vitreous, they move with your eyes as you scan and try to see them.

What Causes The Spots or Floaters?

Some floaters are present forever as part of the eye’s development. Others can grow over time.

In middle age, the gel-vitreous begins to liquefy and contracts. Some parts of the vitreous form clumps or strands inside the eye. The vitreous pulls away from the back eye-wall causing a posterior vitreous detachment (PVD). PVD is a common cause of floaters.

Floaters are more common:

• With nearsightedness
• After cataract surgery
• After laser surgery of the eye
• During or after inflammation in the eye

Treatment for Spots and Floaters

As mentioned above, most spots and floaters are harmless and only annoy the visual field. Many fade away on their own to become insignificant. Some doctors may perform surgery to remove floaters, but this should be advised only in rare cases.

Flashes of Light

Flashes of light occur often in older people and are usually due to mechanical stimulation of photoreceptors when the gel-like vitreous “pulls” on the light-sensitive retina. They may be an early warning sign predicting a detached retina – a serious problem which could lead to blindness if not treated immediately.

Some experiences of light flashes appear as jagged lines or “wavy heat” in both eyes, lasting 10-20 minutes. These types of flashes are usually caused by a spasm of the blood vessels in the brain, also called a migraine. If a headache follows the flashes, these are known as migraine headaches. Jagged lines or “heat waves” however can and do occur without a headache. These light flashes are called an ophthalmic migraine -a migraine without a headache.

Are Spots Flashes, or Floaters Emergencies?

The sudden appearance of significant numbers of floaters, especially if accompanied by flashes of light or other vision disturbances, could indicate a retinal detachment or other serious problem in the eye. A study reported in the Journal of the American Medical Association in 2009 found that one in seven people with the sudden presence of eye floaters and flashes will have a retinal tear or detachment. If you suddenly see floaters, visit your eye doctor immediately.

Hyperopia -Farsightedness, is a common vision problem affecting about 25% of the U.S. population. Hyperopia sufferers can see distant objects well, but have difficulty seeing up close objects.

Hyperopia Symptoms

Farsighted people might have headaches or eyestrain, and find themselves squinting or fatigued doing anything which is close-range. If you still experience symptoms such as these with glasses or contact lenses, your eye prescription most likely needs to be updated.

What Causes Hyperopia?

Farsightedness is typically when the eyeball is shorter than normal so the light rays entering the eye focus behind the retina, rather than on it. Many children are born with hyperopia, and some outgrow the problem as the eyeball lengthens with normal growth.

Some confusion exists between hyperopia and presbyopia, since both conditions involve difficulty with up close vision. Presbyopia has a different cause and occurs after age 40.

Hyperopia Treatment

Eyeglasses or contact lenses almost always can correct farsightedness by changing the way light rays bend as they enter the eyes. Your glasses or contact lens prescription will begin with plus numbers, +2.50, +4, etc. when you are farsighted.

Depending on the amount of farsightedness you have, you may need to wear glasses or contact lenses all the time, or only during reading, or work.

If you work prolonged periods on a on a computer screen or do other close-up work for long periods consult with your eye doctor for special work prescription glasses.

Refractive surgery, such as LASIK or PRK, is another option for correcting hyperopia.

Keratoconus is a rare, progressive disease that affects the cornea, which is the clear, transparent layer at the front of the eye. The cornea is responsible for focusing the light that comes into your eye onto the retina for clear, sharp vision. Keratoconus causes the corneal tissue to thin out and bulge into a cone-like shape which deflects the light entering the eye and distorts vision.

Causes of Keratoconus

The exact cause of keratoconus is not known. The disease usually starts to appear in the late teens or twenties and can affect one or both eyes, usually progressing at a slow pace and slowing or stabilizing after around 10-20 years. It is believed that there is a genetic component as often it runs in families.

New research suggests that there may be a link between keratoconus and oxidative damage which weakens the cornea. There is also an association with overexposure to ultraviolet (UV) radiation from the sun and chronic eye irritation.

Symptoms of Keratoconus

With the gradual change in the shape of the cornea, vision becomes progressively worse. The patient may experience nearsightedness, astigmatism, distorted vision (straight lines look wavy), blurry vision, light sensitivity and glare, and eye redness or swelling. Typically, patient’s eyeglass prescription will change often as the vision becomes worse and contact lenses will be difficult to wear due to discomfort and improper fit.

When keratoconus become more severe (which usually takes a long time however on occasion can happen rather quickly), the cornea can begin to swell and form scar tissue. This scar tissue can result in even further visual distortion and blurred vision.

Treatment for Keratoconus

In the early stages of the disease, standard eyeglasses and soft contact lenses will usually correct the nearsightedness and astigmatism experienced by the patient. As the disease progresses however, glasses and soft contact lenses may no longer correct vision and soft lenses may become uncomfortable. This is when other forms of vision correction will be recommended.

Gas Permeable and Scleral Contact Lenses
At the more advanced stage of keratoconus rigid gas permeable (RGP) contact lenses, scleral or semi-scleral lenses may be used for increased comfort and visual acuity. Since they are more rigid, RGP and scleral lenses are able to create a smooth, round shape around the cornea, creating a smoother surface for better vision. Scleral or semi-scleral lenses have a larger diameter which covers the entire cornea and reaches over into the white part of the eye, which is known as the sclera. Many patients find these more comfortable than regular RGPs and find that they move around less when the eyes move. The main disadvantage of these rigid lenses is that for some, they are somewhat less comfortable than soft lenses and they must be continually refit as the shape of the eye changes.

Whether it is glasses or contact lenses being used to correct vision, patients will likely have to undergo many tests and prescription changes as their vision needs change.

Intacs
Intacs are small, surgically implanted plastic inserts which are placed on the cornea to flatten it back to shape. Usually they are able to restore clear vision, with the continued use of glasses. Intacs are often recommended when contact lenses and eyeglasses are no longer able to correct vision adequately. Intacs take about 10 minutes to insert and can delay the need for corneal transplant.

Corneal Crosslinking (CXL)
In corneal crosslinking, a UV light and eye drops are used to strengthen and stiffen the cornea which helps to reduce bulging and restore the cornea to its natural shape.

Corneal Transplant
When corneal scarring occurs and eyeglasses and contact lenses no longer help, doctors may suggest a corneal transplant to replace the corneal with healthy donor tissue to restore vision. Most patients will still require eyeglasses or contact lenses for clear vision following the transplant.

Keratoconus is a condition that requires ongoing treatment by a qualified eye doctor. If you or a loved one suffers from this disease make sure that you find an eye doctor that you like and trust to accompany you on this journey.

Ocular hypertension means the pressure in your eye, or your intraocular pressure (IOP), is higher than normal levels. Elevated IOP is also associated with glaucoma, which is a more serious condition that causes vision loss and optic nerve damage. By itself, however, ocular hypertension doesn’t damage your vision or eyes.

Studies suggest that 2% to 3% of the general population may have ocular hypertension.

Signs and symptoms of ocular hypertension

During routine eye exams, a tonometer is used to measure your IOP. Your eye typically is numbed with eye drops, and a small probe gently rests against your eye’s surface. Other tonometers direct a puff of air onto your eye’s surface to indirectly measure IOP.

What causes ocular hypertension?

Anyone can develop ocular hypertension, but it’s most common in African-Americans, people over 40, those with family history of ocular hypertension or glaucoma, and those with diabetes or high amounts of nearsightedness.

IOP may become elevated due to excessive aqueous fluid production or inadequate drainage. Certain medications, such as steroids, and trauma can cause higher-than-normal IOP measurements as well.

Ocular hypertension treatment

Signs and symptoms of retinal detachment

There is no pain associated with retinal detachment. If you experience any of the above symptoms, consult your eye doctor right away. Immediate treatment increases your odds of regaining lost vision.

What causes retinal detachments?

Treatment for retinal tears and detachments

Surgery is the only effective treatment for a torn or detached retina. The procedure or combination of procedures your doctor uses depends on the severity and location of the problem.

Laser surgery. Also called photocoagulation, laser surgery is generally used for retinal breaks and tears that have not yet become retinal detachments. The surgeon directs a laser beam into your eye through the pupil to “spot weld” the damaged retina to its underlying tissue. Photocoagulation requires no surgical incision and causes less irritation to the eye than other treatments.

Cryopexy. In this treatment, the surgeon applies a freezing probe to the outer surface of the eye over the area of defective retina. The scarring that occurs from the freezing reattaches the retina to its support tissue.

Pneumatic retinopexy. This surgery is generally used to treat a retinal detachment in the upper half of the retina. The surgeon injects an expandable gas bubble inside the eye, positioning the bubble over the torn and detached retina. As the gas bubble expands, it pushes the detached retina against its support tissue. The surgeon then may use laser photocoagulation or cryopexy to firmly reattach the retina to the underlying tissue. Over time, your body absorbs the gas bubble. Until that occurs, certain precautions are necessary.

In a variation of pneumatic retinopexy, the surgeon may inject silicone oil rather than expandable gas into the eye to press the detached retina against its support tissue. In this procedure, the silicone oil must be removed from the eye after the retina is reattached.

Scleral buckling. This is the most common surgery used to treat a retinal detachment. In this procedure, the surgeon places a soft silicone band around the eye, which indents the outside of the eye toward the detached retina. The band is sutured against the tough outer white coating of the eye (the sclera). The surgeon then drains any fluid between the retina and its support tissue, and reattaches the retina with laser photocoagulation or cryopexy.  

In about 90% of cases, detached retinas are successfully reattached with a single surgery. However, this does not mean your vision will return to normal. Patients who have the best visual outcomes from retinal detachment surgery are those who seek attention immediately upon noticing symptoms and have detachments that do not involve the central retina (the macula).

Retinitis pigmentosa (RP) is a rare, inherited eye disease in which the light-sensitive retina slowly and progressively degenerates. This causes progressive peripheral vision loss, night blindness, central vision loss and, in some cases, blindness.

RP affects approximately 1 out of every 4,000 Americans.

Signs and symptoms of retinitis pigmentosa

“Night blindness” is the primary symptom of the disease in its early stages. During later stages of retinitis pigmentosa, tunnel vision can develop, with only a small area of central vision remaining.

In one study of RP patients who were at least 45 years old, 52% had 20/40 or better central vision in at least one eye, 25% had 20/200 or worse vision and 0.5% had no light perception (total blindness).

What causes RP?

Not much is known about what causes retinitis pigmentosa, except that the disease is inherited. It is now believed that RP can be caused by molecular defects in 100 different genes, causing significant variations in the disease from person to person.

Even if your mother and father don’t have retinitis pigmentosa, you can still have the eye disease when at least one parent carries an altered gene associated with the trait. In fact, about 1% of the population can be considered carriers of recessive genetic tendencies for retinitis pigmentosa that, in certain circumstances, can be passed on to a child who then develops the disease.

In RP, the light-sensitive cells in the retina gradually die. Usually, cells called rods are primarily affected. These cells are needed for night vision and peripheral vision. However, other cells called cones can also be affected. Cone cells are responsible for our central vision and color vision.

Retinitis pigmentosa tests and treatment

Visual field testing likely will be done to determine the extent of peripheral vision loss. Other eye exams may be conducted to determine whether you have lost night vision or color vision.

Researchers are looking into ways to treat RP in the future, such as retinal implants and drug treatments.

A stye (known by eye doctors as a hordeolum) is an infection of an oil gland which forms a pimple-like bump on the base of the eyelid or within the eyelid itself. Sytes can be uncomfortable, causing swelling, pain, redness, discomfort, and sometimes excessive tearing. If the stye is large and it distorts the front surface of the eyes, it can cause blurred vision.

What causes a stye?

The oil glands on the eyelid sometimes become blocked with dirt, dead skin, or a buildup of oil. When this occurs, bacteria can grow inside. Blockage is also commonly from eye cosmetics that block the orifices within the lid. This blockage causes the gland to become infected and inflamed, resulting in a stye. A stye can form on the inside or the outside of the eyelid and can cause swelling around the eye, sometimes affecting the entire eyelid.

Treating a stye

Styes are treated with antibiotics, often in moderate and severe cases with a prescription for oral antibiotics to reduce the bacteria responsible for the infection. Treatment for a stye is recommended otherwise there is a likelihood of recurrence. Applying a hot compress to the eye for 10-15 minutes a few times throughout the day will bring some relief and speed up the healing process.

Similar to a pimple, the stye will likely rupture, drain and heal on its own. Occasionally a stye, especially one on the inside of the eyelid will not resolve itself and may require the assistance of an eye doctor for additional treatment. In such a case the stye is surgically opened and drained to reduce the swelling and cosmetic issues associated with the style.

You should never pop a stye! This can cause the bacteria to spread and worsen the infection. The infection can then spread around the top and bottom eyelids and even reach the brain. If a stye is getting worse, painful, or irritated, contact your eye doctor for treatment.

In cases where styes occur frequently, your eye doctor may decide to prescribe topical antibiotic ointment or a cleansing regimen to prevent recurrence.

Chalazia: Another type of bump on the eyelid

Similar to a stye, a chalazion is a blocked oil gland on the eyelid that becomes enlarged. The main difference between a chalazion and stye is that the chalazion is usually non-infectious. A chalazion in most occasions is an old hordeolum that did not resolve. Treatment involves lid hygiene, warm compresses, and lid massage. In most cases, a chalazion requires surgical removal.

Uveitis is a general term for an inflammatory response in the eye that can be caused by a broad range of diseases or conditions. It is called uveitis because the area that is inflamed is the uvea, although the condition can also affect other areas in the eye such as the lens, the optic nerve, the retina and the vitreous. Uveitis can cause swelling and tissue damage and lead to reduced vision or in more serious cases, even blindness.

What is the Uvea?

The uvea is a layer in the middle of the eye containing three main elements including: the choroid, which is a network of small blood vessels which provides nutrients to the retina; the iris, which is the colored layer around the pupil; and the ciliary body which produces fluid to shape the lens and provide nutrients to keep it healthy.

Types of Uveitis

Uveitis is classified by four different types, depending on the location of the inflammation within the eye. Anterior uveitis, which is the most common form, is when the iris is inflamed, sometimes in combination with the ciliary body. Intermediate uveitis is inflammation of the ciliary body and posterior uveitis is when the choroid is inflamed. When the entire uvea is inflamed, this is called diffuse or pan-uveitis.

Symptoms of Uveitis

Uveitis generally affects individuals between the ages of 20 and 50 and can present a variety of symptoms depending on the cause. The condition can affect one or both eyes and sometimes the symptoms can come on very rapidly. They include:

• Blurred vision
• Eye pain
• Red eyes
• Light sensitivity
• Seeing floaters in the field of view

If you experiences these symptoms seek medical attention immediately. Uveitis is usually a chronic disease which can lead to vision loss as well as other eye problems such as glaucoma, retinal detachment and cataracts.

Causes of Uveitis

The cause of uveitis is still somewhat of a mystery. It is often found in connection with eye injuries, viral infections, toxins or tumors in the eye or with systemic autoimmune disorders (such as AIDS, rheumatoid arthritis or psoriasis), or inflammatory disorders (such as Crohn’s disease, colitis or Multiple Sclerosis).

Treatment for Uveitis

Uveitis treatment is designed to reduce and eliminate inflammation and pain and to prevent damage to the tissues within the eye, as well as to restore and prevent vision loss. The inflammation is typically treated with anti-inflammatory steroid eye drops, pills, dissolving capsules or injections, depending on where the condition presents in the eye. Additional medications or treatments may be prescribed depending on the cause of the condition. For example, when the cause is an autoimmune disease, immunosuppressant medications may also be used. If there is a viral infection or elevated intraocular pressure, appropriate medications will be given to treat those issues. Often uveitis is a chronic disease so it’s important to see the eye doctor any time the symptoms appear.