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ANATOMICAL NARROW ANGLES
The eye is constantly making fluid to bring nutrients to the tissues in the middle of the eye. Older fluid then leaves the eye through a drainage channel. In some patients, access to the drainage channel (also referred to as “the angle”) may become very narrow and increase a patient’s risk of developing high eye pressure and glaucoma. Although uncommon, the angle may become so narrow that the drainage pathway closes off completely. The result of angle closure is an immediate and severe rise in eye pressure that may lead to sudden and permanent vision loss. Patients with narrow angles are often advised to have a laser procedure to reduce their risk of angle closure.
Blepharitis is an eye condition characterized by chronic inflammation of the eyelid. Blepharitis is one of the most common disorders of the eye and is often the underlying reason for eye discomfort, redness, and tearing. The typical signs and symptoms of blepharitis may include: Redness of the eyelids or eye Flaking of skin on the eyelids Crusting at the eyelid margin that is generally worse on waking Cysts at the lid margin Gritty or sandy sensation in the eye Reduced vision
The term chalazion refers to a swelling in the eyelid caused by inflammation in one of the small oil-producing glands located in the upper and lower eyelids. It is an inflammatory reaction to trapped oil secretions. It is not caused by bacteria, although the site can become infected by bacteria.
CONJUNCTIVITIS (PINK EYE)
Conjunctivitis is the term used to describe inflammation of the conjunctiva, which is the very thin membrane that covers the inside of your eyelids and the white part of your eye (the sclera). It is most commonly referred to as “red” or “pink” eye. It can be caused by a viral or bacterial infection, allergies or environmental irritants.
Regardless of the cause, conjunctivitis should not cause a disruption in vision. If your case of “pink eye” affects your vision or you experience eye pain, you should visit your eye care professional immediately.
Symptoms of conjunctivitis may include redness, inflammation, tearing, foreign body sensation, itchiness, mucous, or crusting.
Viral conjunctivitis is more common than the bacterial kind. It may last several weeks and is frequently accompanied by a respiratory infection (or cold). Antibiotic drops or ointments usually do not help, but symptomatic treatment such as cold compresses or over-the-counter decongestant eye drops can be used while the infection runs its course. Conjunctivitis caused by a virus can be very contagious. If you have been diagnosed with viral conjunctivitis or suspect you might be suffering from this condition, practicing good hygiene can help prevent the spread of the condition.
Bacterial Conjunctivitis is less common and characterized by considerable amounts of mucus. Some bacterial infections are more chronic, however, and may produce little or no discharge except for some mild crusting of the eyelashes in the morning. Bacterial conjunctivitis can be treated with a variety of antibiotic eye drops or ointments. These treatments usually cure the infection in a day or two.
As many as 50 million Americans suffer from allergies, with allergic reactions involving the eyes being a very common complaint. Symptoms often develop rapidly after exposure to an allergen and include itching, tearing, burning, red eyes, mucus discharge, and eyelid swelling. The most common allergens are: pollen from grass, trees and weeds, and dust, molds and pet dander.
A Corneal Abrasion occurs when the outer layer of the Cornea, called the epithelium, is scratched or torn away. Because the Cornea has more nerve endings than virtually any other part of the body, damage to the Cornea can be very painful. Abrasions usually heal quickly, often within hours or days. However, while they are healing Corneal Abrasions can cause excessive tearing, pain, redness, blurred vision, and light sensitivity.
A Corneal Erosion may occur when there is a poor attachment of the outermost layer of the cornea to the underlying layers. Patients who experience Corneal Erosions may experience sharp pain, light sensitivity, tearing, and gritty sensation. Erosions often occur upon waking or after rubbing the eyes. If the cornea does not have a chance to heal completely, erosions may recur in the same location.
The outermost layer of the cornea is called the epithelium. If it is damaged in any way, it is possible for bacteria, viruses or fungi to penetrate the cornea and cause an infection. An infection of the cornea is called a corneal ulcer. Ulcers can cause painful inflammation, and if left untreated, can quickly lead to corneal erosion, corneal ulceration and corneal scarring. Corneal scarring results in a loss of corneal transparency and may require a corneal transplant in order to restore vision. Corneal ulcers require urgent and close monitoring.
The effects of diabetes are widespread and affect many organs and tissues throughout your body including the eyes. Diabetes damages small blood vessels, and can impair the normal circulation of blood to the eye. When diabetes causes damage to the small blood vessels in the retina, it is called Diabetic Retinopathy. Diabetic Retinopathy is the most frequent cause of blindness among adults aged 20-74 years old. However, with early diagnosis and treatment, progression of the disease and its associated vision loss can be slowed, and in many cases vision loss from Diabetic Retinopathy can be prevented. It is recommended that diabetic patients have annual dilated eye examinations to monitor the health of the retina.
EPITHELIAL BASEMENT MEMBRANE DYSTROPHY
The outermost layer of the cornea, the epithelium, is attached or anchored to an underlying basement membrane, called Bowman’s Membrane. Sometimes the epithelial basement membrane develops abnormally making it difficult or impossible for the epithelium to adhere properly to the rest of the cornea. If the epithelium does not adhere properly, the corneal surface becomes irregular resulting in intermittent blurry vision along with discomfort and foreign body sensation. Map-Dot-Fingerprint Dystrophy is also known as Epithelial Basement Membrane Dystrophy because it is caused by a lack of the healthy formation of the Basement Membrane. It affects adults between the ages of 40-70 and can sometimes begin earlier.
FLASHES AND FLOATERS
Floaters may appear as tiny specks or as small dark shadows, “thread-like” strands, or even “squiggly” lines that actually float around in your field of vision. They tend to move as your eyes move, but not necessarily in the same direction, and often just drift away when your eyes stop moving. Generally, floaters are a normal and expected consequence of the aging process of your eyes. Sometimes other eye conditions or problems inside the eye may cause floaters such as infections, inflammation, hemorrhages, retinal tears or trauma to the eye. It is recommended that you see your doctor if you have a change in floaters. Floaters accompanied by flashes of light or loss of side vision should be seen urgently.
Fuchs’ Dystrophy is a slowly progressive disease of the corneal endothelium (innermost layer). It is slightly more common in women than men and usually does not compromise vision until people are in their 50’s or 60’s. The endothelial cells are responsible for pumping water out of the cornea and helping to maintain the corneal transparency. While the reason is poorly understood, in Fuchs’ Dystrophy, the endothelial cells die, which make the endothelium less efficient in its pumping activity. This results in corneal swelling and distorted vision.
Glaucoma is a term that is used to describe a broad range of eye problems that can damage the optic nerve and cause loss of vision. The pressure inside the eye, called Intraocular Pressure (IOP), generally falls within a range that is considered “normal”. Many patients believe that Glaucoma is simply due to a high pressure within the eye. Although high IOP can be one cause of Glaucoma, it may not be the only cause of Glaucoma. High IOP and early nerve damage typically do not cause symptoms for the patient, making routine examinations by an eye doctor imperative.
Glaucoma--if not diagnosed early, treated properly and controlled--will result in permanent vision loss and potentially blindness.
In fact, glaucoma is one of the leading causes of blindness for patients between the ages of 18-65 years of age. It is estimated that approximately 3 million people have Glaucoma, yet only half of these actually know that they have it. In the United States alone, there are approximately 100,000 patients who are believed to be legally blind from glaucoma.
Herpes Simplex, the same virus that causes cold sores in and around the mouth, can infect the cornea. Once infected, the virus stays dormant in your body and may reactivate again and again. Symptoms may include pain, light sensitivity, tearing, redness and blurred vision. Corneal infections from herpes simplex are often treated with topical and sometimes oral antiviral medications. Because corneal ulcers can lead to corneal scarring and permanent loss of vision, any infection of the cornea should be treated urgently and closely monitored. Herpes Zoster (Shingles) is actually caused by the same virus that causes chicken pox. After an initial exposure to Varicella-Zoster, the virus stays in your body for life, although usually dormant. For a number of possible reasons, the Varicella-Zoster Virus can reactivate later in life and travel through the nerves in your body causing a painful blistering rash. If the Varicella-Zoster Virus travels to your head, it can affect the eye and thus cause a corneal infection. It is critical for our Corneal Specialists to diagnose this quickly as the infection can lead to corneal scarring. The infection may also result in a loss of corneal sensation, which can be permanent. Our Corneal Specialists may prescribe both oral medications and eye drops to try and resolve the infection and prevent serious damage from occurring.
Inflammation of the tissues inside the eye is referred to as uveitis. Typically, the inflammation occurs in the iris (colored part of the eye) and is given the name iritis. Symptoms of iritis and uveitis include light sensitivity, pain, redness, and blurred vision. Occasionally, patients may see floaters. Uveitis may have many different causes including infection or systemic inflammatory conditions such as arthritis. Treating uveitis quickly is important to prevent secondary complications. Patients given anti-inflammatory medications to stop the inflammation need to be monitored closely.
Keratoconus is disorder of the cornea characterized by progressive thinning of the corneal tissue. As the dystrophy progresses, the cornea begins to bulge outward and become cone-like. It is the most common corneal dystrophy in the United States, and typically presents when patients are in their 20’s. Because the bulging cornea causes considerable changes in the refractive power of the eye, patients often need custom rigid contact lenses to obtain clearer vision. Signs and symptoms of Keratoconus include: blurred or distorted vision, monocular double vision, rapidly changing eyeglass prescriptions especially with high degrees of astigmatism, increased sensitivity to bright light and glare, and difficulty with night vision.
Low Vision is when a patient has loss of eyesight that cannot be improved with eyeglasses, contact lenses, medicine, or surgery. Patients with low vision often require special devices and technology to make the most of their remaining sight. Low vision devices, such as magnifiers and telescopes, can often help patients with reduced vision more functional in their daily tasks and maintain their independence.
Age-Related Macular Degeneration (AMD) is a degenerative condition of the retina in which the central portion, also known as the macula, is damaged as a result of the hardening of the small arteries supplying oxygen and nutrients to the retinal tissue. This results in a slow, progressive loss of central vision. Treatment of Macular Degeneration has improved tremendously in the 21st century. If Macular Degeneration is diagnosed early enough, we are very fortunate to have a number of possible treatment options—including nutritional supplements, lasers and injectables—that may help to slow or even halt the progression of vision loss. However, patients must understand that once the macula has been damaged, there is no treatment that currently reverses the damage and the associated loss of vision.
Rosacea is a chronic, inflammatory skin condition that affects the capillaries and oil glands of the face and eyelids. More than half of all rosacea patients have ocular symptoms that include red, bloodshot eyes, burning, tearing, and foreign body sensation. Many people who have rosacea also have blepharitis, which often exacerbates their ocular symptoms.
A pinguecula is a thickened, callous-like area of conjunctival tissue overlying the white part of the eye. It often has a yellowish appearance, but may be red when inflamed. Pingueculas are worsened by UV light and dry environments.
A pterygium is a fleshy triangular growth of tissue onto the cornea. It often occurs in people who live in sunny climates and are exposed to high amounts of UV light. Pterygia may become red, swollen and inflamed. Occasionally they need to be removed. Removal of a pterygium requires a surgical procedure where the growth is removed and replaced with a thin layer of the patient’s own conjunctival tissue.