Dry Eyes
Ocular Diseases

What is Dry Eye?

Dry eyes can be caused by a multitude of factors, including age, inflammation, air conditioning, hormonal changes, and prolonged digital screen time. Symptoms of dryness can include: irritation, discomfort, redness, watering, itching, and foreign body sensation. Symptoms can range from mild to extremely severe. There are many options to alleviate dry eye, including artificial tears and punctal plugs, as well as medicated eye drops prescribed by an eye doctor. Since dry eye is multifactorial, it is important to be seen by an eye doctor to create a custom treatment plan for you. 

There are medicated eye drops as well as lubricating eye drops. It is important to talk to your eye doctor about the proper eye drops for you and your specific needs. Eyes actually can tear when they are dry! It doesn’t make intuitive sense, however, when eyes are dry, there is a signal sent to the brain to produce more tears. Sometimes this results in over-tearing. Another reason for tearing eyes could be due to issues with the drainage system of tears, including the puncta and nasolacrimal ducts.

What is Meibomian Gland Dysfunction?

Along the “water line” or “eyelid margin,” there are microscopic glands called meibomian glands, which secrete an oily substance. These oils make up a part of the tear film that prevents the tears from evaporating too quickly. When these glands become clogged, inflamed, or unhealthy, there is a reduction in the amount of oils entering the tear film. This can cause dryness and discomfort.

What is a Chalazion/Stye? 

When the meibomian glands become clogged and infected, the formation of a “stye” occurs. Treatment may include warm compresses or medications, such as antibiotics, prescribed by an eye doctor. 

What is Ocular Rosacea? 

Rosacea is often known to occur on the face. Most commonly, people may have redness on their cheeks and nose.  Surprisingly, it can also affect the eyelids; this is  known as ocular rosacea. Ocular rosacea alters the meibomian glands, causing inflammation and discomfort. Ocular rosacea is treated with medications and natural remedies, such as high dose omega-3 supplements.

What is Blepharitis? 

The human body has a plethora of normal flora bacteria. This bacteria can abnormally build up on the eyelids and eyelashes, which leaves behind a flaky debris usually only seen through a microscope by your eye doctor. Bacterial build-up can be extremely irritating to the eyes and eyelids, and cause inflammation, redness, and discomfort.  As it is microscopic, it is normally diagnosed in routine eye exams when seen under the microscope. Treatment for blepharitis may include proper lid hygiene, and, in chronic conditions, topical medications. 

What are Cataracts?

Cataracts are a normal aging change to the natural lens inside the eye. It is located behind the iris, the colored portion of the eye. The natural lens becomes hazy and opacified causing visual changes. There are different varieties of cataracts that affect vision and can cause visual discomfort and light sensitivity, especially during night driving. Because cataracts are located inside the eye, reduction in vision cannot always be completely corrected with glasses or contacts.  Understanding the limitation of glasses correction with cataracts is essential to realistic visual expectations when choosing to defer surgical intervention.

There is currently no medical cure for cataracts, however, it can be surgically removed when you and your eye doctor agree it is the proper time. Cataracts are a normal aging change that occurs in the body. Certain conditions, such as diabetes, steroid use, myopia, and trauma may accelerate the formation of cataracts.

What are Flashes and Floaters?

Floaters are opacities in the liquid portion inside the eye, which cast a shadow on the retina. Floaters can be described as many different shapes and sizes. Some people describe them as “bugs” or a “spider web” floating in their vision. An eye doctor’s main concern when hearing symptoms of new flashes/floaters is making sure the retina is not torn or detached. This is done with a dilated fundus exam to check for any tears, breaks, or disruptions in the retina. Floaters are also a normal aging process that occurs in the eye. It is the composition of the liquid in the eye changing over time. Conditions such as high myopia or trauma may cause floaters to happen earlier in life. The chances of getting floaters increase with age.  Floaters are permanent. Sometimes the brain learns to ignore the floater due to constant exposure, or gravity will pull your floater down and out of your line of sight.  Generally, the risks outweigh the benefits for surgery to treat floaters. Surgery will be offered only if a retina specialist feels it is absolutely necessary.

Flashes, which are often described as a lightning bolt, are caused when the gel inside the eye (vitreous) is tugging on the retina. If you are experiencing flashes of light, you should immediately see your doctor, as this is a sign of something occurring inside the eye. Flashes commonly precede floaters.

What is a Retinal Detachment? 

A retinal detachment is when the tissue in the back of the eye becomes torn and detached from its original location. It is extremely sight-threatening and is considered an emergency.

What is Glaucoma

Glaucoma is damage to the optic nerve, usually due to high eye pressure. The optic nerve is the cable connecting the eye to the brain, which sends all visual information to the brain to be interpreted. Scans and tests are routinely done to check for progression or change over time.  Glaucoma is usually a slowly progressing condition, which initially has no symptoms. Therefore, glaucoma is typically detected during routine eye exams. Treatment includes prescribed eye drops, lasers, or surgery to decrease eye pressure, although any loss of vision and damage to the optic nerve due to glaucoma is currently irreversible. Glaucoma can be hereditary, making it even more important to be checked if you have a family history of this disease. Effects of glaucoma include decreased peripheral vision, which can progress toward the center of the eye and eventually lead to permanent blindness.

What is Macular Degeneration? 

Macular degeneration is damage to the macula, which is what we use to obtain central vision in the retina. This disease can also be genetic. Symptoms include decreased or distorted central vision. There are several stages of macular degeneration, and treatment depends on each stage; dry or wet. A proper dilated fundus exam, in conjunction with retinal scans, can help detect disease and determine treatment. Macular degeneration can be treated with certain eye vitamins and sometimes requires injections into the eye. Since the macula is responsible for central vision, advanced macular degeneration can cause central vision loss and blindness.

What is Diabetes? 

Diabetes can affect the blood vessels in the entire body, including the eyes. Diabetic changes to the eye may include bleeding in the retina, accumulation of fluid in the retina, retinal detachment, and the acceleration of cataracts. Advanced disease in the eye can cause blindness due to the changes that occur in the retina. Keeping sugar and blood pressure levels stable can prevent these changes from occurring. Prolonged spikes in blood pressure can cause changes in the retina, which may remain permanent. Typically, mild cases are monitored by your primary eye doctor. More severe cases are sent to a retina specialist for injections or lasers into the eye. A yearly dilated exam is important for patients with diabetes, a family history of diabetes, or pre-diabetes, to check for changes to the retina, which may affect your vision.

What is Strabismus?

Strabismus is the medical term for an “eye turn” or “lazy eye,” which occurs when the eyes are no longer aligned. This can cause complications such as double vision in adults and amblyopia, or loss of vision, for children. Not all people with strabismus have double vision, but they may be bothered by the appearance of a deviated eye. There are many optical and surgical treatments for strabismus and these should be discussed with a strabismus specialist. You should always consult a doctor for an eye turn. You may be surprised at the different treatment options that are available to make you more comfortable in regards to your vision and appearance. 

Some of the treatments available include exercises, glasses and contact lenses, Botox, and surgery. You should have a discussion with a strabismus specialist to find out which would be the best fit for you. There are also many options for surgical and non-surgical correction of eye-turns . Glasses very much depend on why you have an eye turn, how large of a turn it is, and the reason for the eye turn. Only a strabismus specialist will be able to answer all of these questions. 

What is Amblyopia?

Amblyopia is sometimes called a lazy eye. What it means is that there is a decrease in vision in one or both eyes. Amblyopia can be caused by several things. These include high prescriptions, a significant difference in prescriptions between the two eyes, eye turns, cataracts, lid droops, and many other things. If you worry that your child has amblyopia, they should be checked out by a pediatric ophthalmologist. The treatment for amblyopia is very individualized. It is based on the cause of amblyopia. Some treatments include glasses, patching, and/or strabismus surgery. You should have an examination and discussion (took out should be had) with your eye doctor to get a better idea of what treatment would benefit you or your child.

What is a Nasolacrimal Duct Obstruction

Also known as a tear duct infection, which is caused by the nose and tear duct system being connected to each other, which allows tears to drain from the eyes down to the nose and throat. Complications and infections can occur if this passageway becomes blocked. Infants are born with a valve, which must open for this passageway to function properly. The most important treatment is to massage the nose. This is called the Crigler massage. This works in 90% of infants with nasolacrimal duct obstruction. If the eye gets red or there is pus, this must be treated with topical antibiotics. If the valve does not open naturally and complications arise, a procedure is done to manually open the valve and allow natural passage of the tears. This procedure is done by a pediatric ophthalmologist.

What is Myopia?

Commonly known as nearsightedness, myopia is typically when you can see well at near, but have difficulty at distance without glasses or contacts. It occurs when the shape of the eye is longer than normal or when the cornea is too steeply curved. 

Myopia progression in children can pose risks such as retinal detachments, macular degeneration, glaucoma, and cataracts. In these cases, there are many options of myopia control to slow the progression. 

There is no cure for myopia, but lenses can improve vision to help reach optimal visual acuity. Myopia control is a set of treatments to prevent myopia progression in children. It usually includes progressive-lens glasses, specialty contact lenses, and a low-dose of an eye drop called atropine. When it comes to wearing glasses all the time, it depends on each individual and their age.

What is Astigmatism?

Astigmatism is the most misunderstood of all refractive errors. Put simply, it is when the eye has two prescriptions, causing blurred vision at both distance and near. Its symptoms are sometimes described as lights stretching diagonally at night or the appearance of shadows when looking at objects. Astigmatism is caused by an eye that is shaped slightly oval instead of round.

What is Hyperopia? 

Otherwise known as farsightedness, hyperopia typically causes difficulty with both near vision and possibly distance vision. It occurs when the shape of the eye is smaller than normal or when the cornea is too flat. Complications that occur with hyperopia are eye strain and headaches with prolonged computer or near work.  Headaches are sometimes associated with eye strain and an eye exam can help determine if glasses will help alleviate the discomfort.

What is Presbyopia? 

Presbyopia is the joy of reaching your 40s! It is when the focusing system begins to deteriorate and help is needed to see nearby objects such as the computer, phone, or books. A commonly asked question is if there is anything to do to prevent presbyopia. Unfortunately, there is not. It is a normal aging process that is not to be feared, but embraced! Certain medicated drops are newly FDA-approved for the treatment of presbyopia; please feel free to ask us about these. While presbyopia cannot be prevented, some nearsighted people may be able to read without reading glasses, depending on their natural refractive error.  LASIK is typically not an option, since it usually corrects distance vision, which means you will still need reading glasses after the age of 40.

Nearsightedness on the Rise in Children During Pandemic

Eye doctors are starting to see an eye-opening and alarming trend in checkups for children. Dr. Bach estimates the rate of nearsightedness among children is three times higher during the pandemic compared to five years ago.