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What is Lazy Eye (Strabismus)?

We all likely know someone who has a “lazy eye”, or sometimes referred to as “crossed eyes”, but what exactly does this mean? Are the eyes truly lazy?

“Lazy Eye” is one of the most misunderstood topics in the eyecare world.

There are two different technical problems associated with “lazy eye”—strabismus and amblyopia.

 

What is a Strabismus – Lazy Eye?

Strabismus is the term used to describe the physical misalignment of the eyes when looking at a target.

The eyes are controlled by 6 muscles called the extraocular muscles. If one muscle is too strong or too weak, it can result in the eyes being pulled in different directions.

To visualize this, think about a beach ball with six strings attached to it—one on the right side, one on the left side, two on the top, and two on the bottom. To look straight ahead, all 6 strings must be pulled with equal force.

In a strabismic eye, one of the strings is either too weak or too strong. Resulting in the eye (beach ball) drifting away from central gaze.

There are four main types of strabismus—exotropia, esotropia, hypertropia, and hypotropia.

Exotropia is the name given to an eye that sits outward.

Esotropia is the name given to an eye that sits inward (as in cross-eyed).

Hypertropia is the name given to an eye that sits in the upward position.

Hypotropia is the name given to an eye that sits in the downward position.

In any of these four conditions, the off-set position of the eye (up, down, in, or out) can occur all the time (constant tropia) or it can occur only sometimes (intermittent tropia).

Intermittent tropias are often associated with over exertion of the tropic eye and are most noticeable when tired, at the end of the day, after spending extended periods of time reading or doing near tasks, when sick, and during times of extreme stress.

It is also possible to have either a unilateral or alternating tropia. This means that the tropia can always occur with the same eye (i.e. the right eye), or it can switch between eyes (i.e. one day it’s the right eye, and the next it occurs with the left).

Since tropias result in the two eyes looking in different directions, they often result in double vision, eye strain, and eye fatigue.

To treat this, an individual can undergo vision therapy to learn how to better control his or her eye muscles, put prism in their glasses, or in some cases, qualify for a corrective muscle surgery.

 

What is an Amblyopia – Lazy Eye?

Amblyopia is the term used to describe a “weakened” eye, or an eye that does not see quite as clearly as the opposing eye.

Amblyopia is rather complex, so we’ll try to stick to the basics here.

There are 3 major causes of amblyopia—strabismus, refractive, and form deprivation.

As we mentioned previously, strabismus can cause double vision. The brain does not like seeing double.

If the double vision occurs constantly (as in a constant tropia), the brain can essentially “shut off” the tropic eye.

In other words, the brain takes the input from both eyes, and blurs out the information coming from the eye with the tropia to avoid the creation of two separate images.

Refractive amblyopia occurs due to having uncorrected vision. If a person needs glasses and is not wearing them, the brain will choose the eye with the lowest amount of uncorrected prescription and work hard to focus through the blur, as this is easier on the brain than trying to focus through two very blurry eyes.

For example, let’s say Bobby has a prescription of -1.00 in the right eye and -5.00 in the left eye. The right eye is not super blurry, so the brain picks it as its favorite eye and essentially closes off the input from the left eye since an uncorrected -5.00 eye really cannot see much at all!

Refractive amblyopia is the main reason eye doctors recommended children begin to see an eye doctor at around one year of age for their first eye exam. Children’s brains are still developing and are sensitive to changes in their surroundings.

If one eye is significantly worse than the other, and a child is not wearing glasses, the brain may “shut off” the poorer seeing eye and develop learning to focus well with only the one “good” eye. This is exactly what we do not want to happen!

If we put the young child in glasses to correct both eyes so that he or she is seeing well binocularly, the brain will not have to “shut off” an eye, and instead will continue to grow and develop to allow equal input from both eyes.

Form deprivation amblyopia occurs when there is a physical problem blocking vision from one of the eyes during the early developmental years (typically these critical years are considered birth to 7-9 years old).

Causes of vision blockage include congenital cataracts, an abnormally sagging eyelid (called a ptosis), an injury to the eye resulting in severe scarring, and others.

In form deprivation amblyopia, the brain does not necessarily choose to “shut off” an eye, but instead the physical limitation creates a barrier to prevent visual input from reaching the brain. Therefore, the brain develops to favor the unblocked eye.

Regardless of cause—strabismic, refractive, or form deprivation–over time, the brain learns to depend on the “turned off” eye less and less. Eventually, it gets to a point where the eye no longer functions quite right and can not “see” as well as the other, stronger eye.

This is not because the eye itself is physically weak, but because the brain has learned to function without it. Therefore, amblyopia may initially be caused by an eye problem, but it is actually a problem with the brain that cannot be “fixed”.

The current school of thought in the optometry world is that brain development and visual processing skills grow the most from birth to 7-9 years old. This time frame is therefore considered the “critical development phase” of the brain.

If the problem (refractive error, strabismus, or physical blockage) is eliminated (i.e. corrected) during this time period, you may be able to prevent amblyopia from developing as amblyopia is a brain problem with visual processing, not necessarily an eye problem.

The earlier the problem is caught, the more likely it is that it can be corrected, thus preventing amblyopia from developing.

However, this is not to say that at 10, 20, or even 50 years old amblyopia cannot be improved. It is all a case-by-case situation and depends on how deep-set the amblyopia is in the brain.

The main treatment for amblyopia at this time is to wear an appropriate glasses prescription correcting both eyes, vision therapy, and patching/atropine drop therapy.

If you are still confused about what amblyopia is, here’s a quick analogy:

Think about the two eyes as a double headed faucet. You want hot water, but one side of the faucet is only putting out ice cold water. To eliminate this problem, you shut off the cold water side and only use the hot water side.

Over time, the cold water side becomes rusty and unusable—it has been ignored and out of service for years! Now, if you try to use the cold water faucet20 years later and expect it to suddenly put out perfectly hot water, you will realize it does not work very well anymore—for hot OR cold water.

It has been out of commission for so long it just won’t ever quite be the same. However, if you got the ice cold water side of the faucet fixed back at the beginning, it might just be working as it should today.

 

Why are Amblyopia and Strabismus Called “Lazy Eye”?

As you can see, amblyopia and strabismus are two different problems.

People call strabismus a “lazy eye” because one of the muscles is weak, or lazy.

People call amblyopia a “lazy eye” because one of the eyes cannot see well (i.e. is lazy) regardless of being outfitted in a great pair of glasses.

In all reality, a “lazy eye” does not exist. There are conditions that cause an eye to underperform, and it is important to be able to differentiate between them.

 

Our eye doctors at Eye Theory in Houston, TX excel in the prescription of contact lenses, glasses and various eye diseases.  Call our optometrist at 832.831.7386 or schedule an appointment online if you would like to learn more about amblyopia or strabismus or lazy eye.  Our eye doctor, Dr. Jonathan Tsao, provides the highest quality optometry services and eye exams in the Midtown, Downtown, Museum District, Montrose, East Downtown, and Southside Commons (Southside Place) vicinities of Houston, Texas

What Are Calcium Deposits In The Eye?

Throughout our lives we are taught that calcium is good for us, but what happens when we have too much or too little calcium?

Calcium in excess can cause several different problems in the eye, ranging from mild deposits within the eyelids to more severe problems like band keratopathy. On the other hand, too little calcium can also cause serious problems like papilledema, seizures, and heart failure.

The question is, why do these problems develop, and what can we do about them?

 

What Does Calcium Do for Our Bodies?

Calcium is a mineral found in dairy products—milk, cheese, yogurt, etc. as well as leafy green vegetables, and some white flour products.

Calcium cannot be made by the body and therefore must be consumed in our daily diet.

Calcium is used by the body for a variety of things. One of its most important functions is maintaining healthy bones—it is found in largest concentrations within the bones and teeth.

Calcium is also a very important player in many physiologic reactions. It is needed to help make muscles contract—including the heart! It is also responsible for helping to relay messages from nerves to the brain. Without calcium, our bodies’ “electrical grid” would go down and it would not be able to function properly!

Since calcium is not produced by the human body, it needs a little help from another vitamin in order for it to be absorbed by the system. This vitamin is Vitamin D—the vitamin commonly associated with sunlight exposure.

Therefore, it is essential to have proper levels of not only calcium, but also vitamin D. Having correct levels of one, but incorrect levels of the other would do us no good!

What is tricky about calcium is that levels have to be within a certain range in order to be beneficial—too much or too little can cause serious adverse effects.

Since calcium is such an important part of our overall health, the body has created a system to ensure there is always enough calcium, and even some calcium in reserve.

Calcium is important in young individuals for bone growth. As we get older, calcium is stored in the bones. There are a few organs in charge of regulating calcium release—the thyroid and the parathyroid glands, the kidneys, and the digestive tract.

The thyroid, parathyroid glands, and kidneys work together to detect the amount of calcium in the blood. If there is enough, they send a signal out telling the bones that calcium does not need to be released. If there is a shortage, they send a signal out telling the bones to release more calcium. This way calcium release is tightly controlled and used only as needed.

However, having so many different players in calcium regulation (calcium consumption, vitamin D consumption, bones, thyroid, parathyroid, kidneys, and digestive tract) leaves a lot of room for potential problems to arise and therefore affect calcium levels.

 

Problems Associated with Too Little Calcium in the Eye (Hypocalcemia)

Having a lack of calcium within the body can occur simply from having too little calcium or too little vitamin D in the diet, or it can be caused by a systemic disorder.

Some medical problems associated with hypocalcemia include hypothyroidism, hypoparathyroidism, cancers, and kidney disease.

But why do we care about Calcium in the eyes?

The eyes are a doctor’s gateway into the human body as the eyes are the only part of the body we can look into without requiring surgery. With a careful dilated fundus exam, eye doctors look at the retina and its blood vessels.

The health of blood vessels can tell eye doctors a lot about your overall systemic health.

In a person suffering from hypocalcemia, your eye doctor may see papilledema, optic neuritis, or early onset cataracts.

The exact physiology of why these findings occur is still being researched. However, eye doctors are educated on signs and symptoms of hypocalcemia and will be able to refer you for appropriate testing if one of these signs are seen within the eye.

 

Problems Associated with Too Much Calcium in the Eye (Hypercalcemia)

Hypercalcemia problems are a little more commonly seen than hypocalcemia problems.

Hypercalcemia occurs when there is too much calcium in the body. When the bones cannot hold any more calcium in storage or when vitamin D is not telling the bones to absorb calcium, calcium is left to float around throughout the body and deposit itself in random places.

This can occur due to a systemic disease such as hyperparathyroidism, cancer, tuberculosis, kidney failure, or sarcoidosis. However, it can also occur secondary to the aging process or from having extended periods of inactivity.

Thinking about the anatomy discussed earlier, remember that the bones store calcium, and vitamin D is needed to take the calcium we consume and absorb it into the bones for storage.

During extended periods of inactivity—think about someone who broke their leg and is sitting on the couch all day for a couple months—we are not using our muscles like we normally would. Therefore, we can have too much calcium floating around and the body needs to find a place to put it.

Similarly, hypercalcemia can also be seen as we age. As we get older, things start to hurt more than they used to. Many individuals are not quite as active as they used to be, and understandably so, it is hard!

However, if you are consuming more calcium than the body can store, or if you are not consuming enough vitamin D (remember we need vitamin D to absorb the calcium we eat), we can get excessive calcium in the blood.

One of the most common places for excess calcium to deposit itself in is the eye.

Calcium can ball up into little beads called concretions and sit in our inner eyelids. Most people are not bothered by these concretions, but if they get large enough they can irritate the eye. Think about a little hard pinpoint-size calcium ball stuck in your inner eyelid—it would be irritating!

Usually nothing is needed to be done about these findings. If you’re not irritated by them there really is no need to remove them. Many individuals have these and do not even know it! However, if you have one extremely annoying one, your local eye doctor will be able to remove it safely.

Another ocular finding that can be caused in part by hypercalcemia is a pinguecula. Most pingueculas are not caused by hypercalcemia, however, they are an area in which calcium can be deposited.

Pingueculas are areas of raised growths on the bulbar conjunctiva—a thin clear layer that covers the white part of the eyes.

Pingueculas often go unnoticed and are typically of very little concern. They are most often caused from sun exposure and will be seen in a majority of the population over time.

Pingueculas appear as a small, raised, yellowish area of growth. In some patients with hypercalcemia, calcium can deposit in these areas of growth and form a calcium nodule underneath the conjunctiva.

Like concretions, typically no treatment is necessary. If a calcemic pinguecula becomes irritating or a cosmetic concern, your eye doctor may refer you to an ophthalmologist to have it properly removed, however this is rarely necessary.

Now we will move on to findings of a little more concern—early cataracts and band keratopathy.

If hypercalcemia goes uncontrolled for an extended period of time, calcium can deposit itself onto the crystalline lens of the eye, ultimately causing a cataract to form.

Cataracts will form in essentially everyone as a part of the aging process. They typically do not become a major issue requiring surgical removal, however, until 60+ years of life.

In patients with hypercalcemia, however, cataracts can begin to form early in life—even within childhood years!

Hypercalcemic cataracts also tend to be a little faster progressing and denser cataracts than normal aging cataracts. Thus, they become more noticeable to the individual. A patient may begin to see a decrease in vision or note that their vision is cloudy. Other common complaints with cataracts are struggling with glare from overhead lights.

Hypercalcemic cataracts will require surgery. Cataract surgery is a simple process in which the natural lens of the eye is removed and replaced by an artificial one.

Band keratopathy is another more slightly concerning finding. Band keratopathy results in deposition of calcium across the very front clear structure of the eye called the cornea.

Typically band keratopathy starts at the outer edges of the cornea, the 3 and 9 o’clock positions.

In the early stages, band keratopathy does not really affect your vision. It is the later stages when the two side edges grow inward to connect at the middle (like a band across the eye) that it becomes a problem.

When band keratopathy covers the entire cornea, it can make it very difficult to see—it would be similar to looking through a dirty fish tank.

Luckily, band keratopathy does not always progress to this more advanced stage. Many cases do not require any treatment at all!

However, if band keratopathy does progress to cover the cornea, treatment is as simple as using prescription eyedrops to clear up the deposits.

To sum up hypercalcemia, the best treatment is to find out why your blood calcium levels are elevated and get that under control as hypercalcemia (and hypocalcemia) can have very serious systemic complications. Eye findings are typically minor and have simple treatments to reduce irritation and get you back to normal.

The best thing you can do is to see your eye doctor yearly. Eye doctors can detect a plethora of problems—including issues with calcium levels. While most cases of hypocalcemia and hypercalcemia are not of major concern, every now and again a more serious issue can be detected through an annual eye exam. You eye doctor can get you proper referrals and the needed treatment ASAP to potentially save your life!

Our eye doctors at Eye Theory in Houston, TX excel in the prescription of contact lenses, glasses and various eye diseases.  Call our optometrist at 832.831.7386 or schedule an appointment online if you would like to learn more about calcium in the eye.  Our eye doctor, Dr. Jonathan Tsao, provides the highest quality optometry services and eye exams in the Midtown, Downtown, Museum District, Montrose, East Downtown, and Southside Commons (Southside Place) vicinities of Houston, Texas.

What is Eye Dilation and Why is it Important?

Dilation—or the eye drops that sting when put in and make you light sensitive and blurry for a few hours—are something many patients dislike about going to the eye doctor. Why do eye doctors want us to undergo this eye torcher?

 

What is Eye Dilation?

Dilation is typically performed by instilling a drop of Tropicamide into the eye. Tropicamide is a cholinergic antagonist, meaning it inhibits the muscarinic receptors of the sphincter muscle of the iris.

What does that even mean? To break it down to a little more understandable language, a cholinergic antagonist is a drug used to inhibit the parasympathetic nervous system—or the controler of the “rest and digest” system.

In the eye, the parasympathetic nervous system controls the iris sphincter muscle—a muscle in the eye that constricts the iris (the colored part of your eye) to make your pupils smaller to help view objects up close.

Therefore, Tropicamide (or any cholinergic antagonist) temporarily inhibits this function—meaning the pupil of the eye stays big instead of small.

 

Why is Eye Dilation Important?

An essential part of any eye exam is for your eye doctor to get a good view of the back structures of the eye—the retina—to get a good health check.

To see the back of the eye, your doctor needs to use a series of lenses to look through the pupil and into the retina. The smaller the pupil is, the more difficult it is to see back into the eye, and the more limited of a view your eye doctor will get.

Think about this as the pupil being a keyhole. When you peak through a keyhole you have a very small, limited view of what is on the other side. Dilation drops turn the “keyhole” into a window and thus provide a bigger area to view through.

 

But Why Exactly do Eye Doctors Care so much about the Retina?

Believe it or not, the retina is the only part of the body that doctors can physically look inside without surgery. Optometrists can see arteries and veins and any of the diseases that go along with these structures.

The retina also connects to the brain through the optic nerve head, allowing for even further evaluation of issues that occur in the central nervous system.

Besides being an important indicator for your overall systemic health, the retina is also the most important part of the eye. The retina is filled with special cells called photoreceptors. Photoreceptors are responsible for detecting light and transmitting it to the brain to be turned into images.

Without a healthy retina, you would not be able to see.

Some examples of things your eye doctor can see through carefully examining the retina include:

  • Retinal Detachments
  • Retinal Holes and Tears
  • Macular Edema (Swelling of the retina)
  • Hypertension (high blood pressure)
  • Multiple Sclerosis
  • Variations of Brain Tumors
  • Diabetes
  • Diabetic Retinopathy
  • High Cholesterol
  • Cancer
  • Various Genetic Diseases
  • Glaucoma
  • Macular Degeneration
  • Medication Adverse Reactions
  • Many More!

Many eye doctors have actually been able to save patient’s lives through careful evaluation of the retina to warn patients of stroke or heart attack!

While your eye doctor may not be the doctor you think about first when you hear some of these diseases, optometrists play a crucial role in detecting these subtilities in the retina and referring you to the appropriate doctor for immediate care. All of this medical help is brought to you through a good dilated exam!

 

What if I Really Do Not Want My Eyes Dilated?

Fortunately with advancing technology there are now retinal cameras that allow doctors to look at the retina without dilation drops. One popular camera is called OptoMap, which can take a picture and allow your doctor to observe up to 200 degrees (out of 360 degrees) of the retina.

Retinal photos are a great tool, they are especially great for doctors to be able to compare photos from year to year to see if anything has changed or is progressing.

However, retinal photos are not a replacement for dilation. It is recommended that if you opt to do photos instead of dilation, that you be dilated the next year—or at least once every 3 years.

It is also always possible that your photo will reveal something your doctor wants to take a closer look at via dilation.

If you take a photo and your doctor asks you to be dilated at that same visit, you should always undergo dilation to allow them a better look.

 

Our eye doctors at Eye Theory in Houston, TX excel in the prescription of contact lenses, glasses and various eye diseases.  Call our optometrist at 832.831.7386 or schedule an appointment online if it is time for your eye exam with eye dilation.  Our eye doctor, Dr. Jonathan Tsao, provides the highest quality optometry services and eye exams in the Midtown, Downtown, Museum District, Montrose, East Downtown, and Southside Commons (Southside Place) vicinities of Houston, Texas.

 

Is LASIK or Refractive Surgery an Option For Me?

Refractive Surgery

Are you tired of wearing glasses or contacts and considering corrective surgery? This article will briefly discuss the different options and how corrective surgery works!

Anatomy of the Eye

To understand how corrective surgery works, a basic understanding of the eye’s anatomy will be beneficial.

The eye has 3 major parts to it—the cornea, the lens, and the retina.

The cornea is the front structure of your eye. It is clear and overlays the pupil and colored part of the eye (iris). It consists of 5 layers—from the most outside layer to inside layer: epithelium, Bowman’s layer, Stroma, Descemet’s membrane, and the endothelium.

The lens is the middle part of the eye. It is a flexible structure that can change shape based on where you want to focus—far away or up close.

The retina is the very back of the eye. It is responsible for actually detecting light and transmitting it to the brain to form images.

Light has to be able to pass easily and undeviated through the cornea and lens to land properly on the retina. If the cornea and/or lens are misshaped, the light will not focus correctly on the retina and vision will appear blurry—hence the need for glasses or contact lenses.

 

How Does Refractive Surgery Work?

Refractive surgery works by a surgeon (ophthalmologist) restructuring your cornea. This can be accomplished a few different ways, but ultimately the surgeon will use a laser to cut and remove part of your cornea to make its’ shape optimal for your refractive error.

If you are farsighted (i.e. hyperopic) the surgeon will want to steepen the central part of your cornea, this can be accomplished by flattening (i.e. removing part of) the outer edges of your cornea.

If you are nearsighted (i.e. myopia) the surgeon will want to flatten (i.e. remove part of) the central portion of your cornea.

 

Am I a Candidate for Refractive Surgery?

There are many aspects of your eyes that must be considered prior to deciding if you are a candidate for refractive surgery.

Your cornea needs to be a certain thickness to allow the surgeon to manipulate the tissue without making it too thin.

You need to have a stable prescription—once you undergo refractive surgery it is much more difficult to perform a second surgery.

You must be at least over the age of 18 years old.

Your prescription must fall within certain parameters—parameters very upon different techniques.

Your eyes must be healthy and free of inflammation. Certain ocular diseases will disqualify you from this procedure.

Your eye doctor will evaluate you closely and weigh the pros and cons of the procedure.

 

Different Types of Refractive Surgery

There are three major types of refractive surgery to date. Over the years these techniques have been improved and perfected, whereas others have been discontinued due to complications.

 

PRK

PRK, or Photorefractive Keratectomy, is a procedure in which the cornea epithelium and Bowman’s membrane are removed with a laser, and the stroma is “shaved down” to create the optimal surface to correct for your prescription.

PRK has a longer post-operative recovery time (about 2 weeks) since the epithelium will need to regrow completely.

PRK is recommended for individuals who live especially active lifestyles or are in the military.

 

LASIK

LASIK, or Laser-Assisted In Situ Keratomileusis, is also a procedure in which a laser is used to correct a patient’s vision by reshaping the cornea.

LASIK differs from PRK in the fact that a laser is used to create an epithelium and bowman’s layer “flap”. The surgeon lifts the flap to access the stroma and “shave it down” to create the optimal surface to correct for your prescription.

Since LASIK does not actually remove the epithelium and Bowman’s layer, it has a quicker recovery time of around 24 hours.

 

SMILE

SMILE, or Small Incision Lenticule Extraction surgery, is the newest form of refractive surgery.

SMILE creates a very small incision—no flap is created. The epithelium and Bowman’s layer remain in tact and the stroma is shaved down to reshape the cornea to the optimal shape to correct for your prescription.

 

Common Questions About Refractive Surgery

Can I get refractive surgery if I am farsighted (hyperopic)? Yes! In the past hyperopes may have been excluded, but today techniques have improved greatly to include our hyperope friends as well.

Can I get refractive surgery if I have astigmatism? Yes! It’s a bit more complicated, and there is a limit to how much can be corrected, but astigmatism does NOT exclude you from refractive surgery.

Is it true that if I get refractive surgery I’ll never need glasses again? No! While the majority of people post-surgery will not require correction, a select few number of patients will still require glasses post-opt. Also, you will still need reading glasses with age as cataracts/the need for reading glasses are an issue with the lens, not the cornea. So, almost everyone will need glasses eventually (typically decades down the road) post-opt.

Is it true that I will be awake during surgery? Yes. You will be given a topical numbing drop so you will not feel anything, but you will be asked to stare at a target for a few seconds. The laser system will tract your eyes so that if you move slightly the system will shut down until proper focus is regained—this prevents the surgery from continuing in case of needing to sneeze or another reason in which focus is lost.

Since a laser is being applied to my eye, does the surgery burn? No! You won’t feel much of anything. The laser is perfectly focused so that it cannot hurt anything besides just reshaping your cornea.

After surgery I won’t need to see my eye doctor yearly, right? Wrong. You will need a few follow-ups with your eye doctor after the surgery, and then it is recommended that you continue to see your eye doctor yearly. Refractive surgery has the tendency to cause an increase in dry eye symptoms, which your eye doctor will be able to help you manage, if needed.

It is also very important to continue to have yearly eye exams to check the health of your eyes as your cornea is being altered during surgery and complications (while uncommon) do occur. The sooner these complications are caught, the better off the prognosis.

 

Our eye doctors at Eye Theory in Houston, TX excel in the prescription of contact lenses, glasses and various eye diseases.  Call our optometrist at 832.831.7386 or schedule an appointment online if you would like to learn more about LASIK and the types of refractive surgery.  Our eye doctor, Dr. Jonathan Tsao, provides the highest quality optometry services and eye exams in the Midtown, Downtown, Museum District, Montrose, East Downtown, and Southside Commons (Southside Place) vicinities of Houston, Texas.

What is Pink Eye?

Pink eye is one of the most commonly referenced eye infections, but do you know what it is?

The answer might surprise you, there really is no one definition for pink eye! Pink eye can be caused by several different things which all require different treatment methods. Getting a proper diagnosis and thus proper treatment is crucial to ensure prompt healing and prevention against worsening infection.

What is Pink Eye?

“Pink eye” is more of a blanket statement—like saying you have a sore throat—it is best to focus on different signs and symptoms, and to seek medical care from an eye doctor specifically—not an urgent care, primary care doctor, or the ER unless an eye doctor is not accessible.

Pink eye is indeed an eye infection, medically called “conjunctivitis”, but there are several different causes. The term pink eye is more of a descriptive factor as the eye literally looks pink, and sometimes even red. Therefore, a better term for pink eye would simply be an eye infection (or conjunctivitis).

Eye infections can be caused from bacteria, fungi, viruses, and sometimes even allergies. Each of these four main categories have their own treatment regimens and the treatment for one category can actually make the symptoms of another category worse!

 

True or False: Common Misconceptions of Pink Eye

Before we get into specifics, here are some things we regularly hear as eye doctors about pink eye—some hold some truth while others are quite false!

Pink eye is only a problem of childhood.

Answer: False! Pink eye can occur in at any age.

 

Pink eye is caused from someone farting in your face.

Answer: While this statement holds some truth, it is not completely correct. Fecal matter and flatulence are the body’s way of getting rid of wastes—this can include bacteria which are one of the many causes of pink eye. So could someone farting in your face cause pink eye?Yes, but it is not the typical cause.

 

Pink eye is very contagious.

Answer: Sometimes. Some forms of pink eye are contagious whereas others are not.

 

Once you have pink eye once, you’ll never get it again.

Answer: False. There is no “immunity” to pink eye. You can have it once or you can have it multiple times—although we recommend if this is a commonly recurrent issue you discuss it with your eye doctor.

 

My brother had pink eye a year ago and he still has some left over eyedrops. I can use those to clear up my pink eye, right?

Answer: Very false! Please do not do this, your pink eye could be very different from someone else’s, and therefore the treatment regimens are quite different.

 

Signs and Symptoms of Pink Eye

Since the cause of pink eye is variable, the signs and symptoms of it also vary. However, some of the most common complaints associated with pink eye include:

-Itchy Eyes

-A pink or red appearance to the eyes

Eye discharge—typically yellow, green, or white in color

-Waking up with eyes “crusted shut”

-A swollen appearance of the eyes

-Occasionally eye pain

-Occasionally reduced vision

 

Common Causes of Pink Eye

As briefly noted before, there are four major categories of pink eye—bacterial, viral, allergic, and fungal.

Bacterial Pink Eye

Bacterial pink eye is what is seen most frequently in children. The two most common culprits are Staph and Strep.

While Staph and Strep sound intimidating, they are actually part of the normal bacterial flora, meaning they exist naturally within the body and typically do not cause problems.

When Staph and Strep become imbalanced or travel to an area outside of their normal body organ they can cause infections like pink eye.

The reason bacterial pink eye is seen so commonly in children is due to their lifestyle. In general, children touch more things than adults—shared toys, shared school supplies, sports equipment, grass, dirt, playground equipment, etc. Children have also been known to wash their hands less frequently than adults—the combination of the two can easily result in an increase in bacteria numbers and thus lead to infections.

Bacterial pink eye has a few unique characteristics to help differentiate it from other pink eye causes. Bacterial pink eye usually affects both eyes and will produce a yellow/green discharge. The eyes may be crusted close upon awakening and you may have difficulty keeping your eyes open due to irritation and light sensitivity.

Bacterial pink eye is indeed contagious, so if you suspect your child has a bacterial eye infection it is best to keep them away from other children and call your eye doctor as soon as possible to initiate treatment and lessen the spread.

Since bacterial pink eye is contagious, it can be spread to adults, especially those who have children or work with children regularly. It is always advisable to wash hands frequently to help limit the spread of bacteria.

Bacterial pink eye is also seen frequently in contact lens wearers who might not have the best contact lens hygiene care routine.

Contact lens associated bacterial infections are serious, if you think you may have pink eye and wear contacts you should discontinue contact lens wear immediately.

Bacteria like cool, moist environments—like contact lens cases. Therefore, if you do not regularly clean your contact lens case prior to putting in the saline and contacts for overnight storage, bacteria could be lurking in the case and hence latch on to your contacts overnight.

Contact lens bacterial pink eye presents similarly to regular bacterial pink eye, however it can be more detrimental to vision as contact lens wearers are more prone to small, unnoticeable scratches (corneal abrasions) since there is something going in and out of the eye regularly.

When bacteria seep into these small abrasions and fester, it makes the eye infection much more miserable to the individual and can be more difficult to treat. Thus, contact lens wearers who have pink eye often report more pain, watery eyes, and a decrease in vision.

Bacterial eye infections are usually treated with antibiotic eye drops. In these cases, you normally want to avoid steroid eye drops, as steroids weaken the immune system to decrease inflammation and therefore result in the eyes having less of a resistance to the bacteria. Taking steroids and not antibiotics, therefore, can cause bacteria to proliferate exponentially and create a much more severe infection.

 

Viral Conjunctivitis and Pink Eye

Viral pink eye is more commonly seen in adults—especially in times of stress. Viral pink eye tends to be a little less concerning than bacterial, but it is still irritating and seeing your eye doctor is always a good idea.

Viral pink eye can affect only one eye or both eyes. It does not usually have discharge—if it does the color will usually be clear to mildly white.

The two most common causes of viral pink eye are adenovirus and herpes simplex virus.

Adenovirus is one of the common culprits of flu-like symptoms. If you are experiencing a sore throat, sneezing, fatigue, or other common cold symptoms, be sure to relay this information to your eye doctor.

Adenovirus pink eye is contagious for the first few weeks of the disease, but later becomes non-contagious.

Herpes Simplex related pink eye is the other major viral culprit of eye infections.

Herpes is a scary sounding diagnosis to hear, but in all actuality, it is not something to fret over. There are two subtypes of herpes simplex—type 1 is what causes cold sores and is typically the cause of Herpes simplex eye infections. The majority of the population would actually test positive for Type 1 Herpes Simplex Virus.

Type 2 is the sexually transmitted disease—just because you hear “herpes” does NOT necessarily mean you have the STD form.

Herpes viral pink eye is not typically contagious, it is mostly just annoying to the individual. It is commonly seen in times of stress—before a big exam, an important work meeting, during pregnancy, while planning a wedding, etc.

Lastly, a current area of viral pink eye research is with the COVID-19 epidemic. There has been a reported increased in pink eye cases, however there has not yet been many studies proving or disproving a connection between the two. It is definitely a topic to keep an eye on in the future.

Regardless of cause, viral eye infections tend to be self-limiting, meaning the body will take care of them on its own with due time. However, there are cases of more stubborn or severe viral pink eye in which treatment by your eye doctor will be necessary.

Viral pink eye needs to be treated with an anti-viral eye drop—antibiotics and steroids will not help in these situations. Again, steroid eye drops can actually make viral pink eye worse for the same reason it can worsen bacterial pink eye.

 

Allergy Related Pink Eye

Allergies are another common cause of pink eye. Allergies can be seasonal from pollen, grass, hay, etc. or can be from contact with certain materials including cosmetics, lotions, contact lens solutions, soaps, or even laundry detergent!

Allergic pink eye is not contagious whatsoever and almost always affects both eyes. It often presents with excessive watering, eye swelling, and occasionally white stringy mucous. The #1 complaint with allergic pink eye is itchiness.

If allergies are what is causing your pink eye, antibiotics and anti-virals will not help. Usually your eye doctor will prescribe an over-the-counter allergy eye drop such as Pataday or Zaditor, but sometimes this method of treatment is not enough.

Your eye doctor may recommend a prescription-grade allergy eye drop or a steroid eyedrop to help weaken the immune response and dampen inflammation (the underlying cause to your allergic pink eye).

It is also recommended if you have tried using any new cosmetics, lotions, soaps, etc. that you discontinue use in case it is the underlying agitator. If you wear contact lenses those should also be discontinued until your allergies clear up.

 

Fungal Pink Eye

Out of all four categories of pink eye, fungal is the most rare but also the most serious.

Fungal pink eye is commonly transmitted from contact with trees, bushes, soil, or other organic substances. For example, when doing yard work a tree branch snaps back and hits your face. You may not have any obvious cuts or injuries, but the fungus can transfer to the eye and cause a serious infection.

Unique symptoms to a fungal pink eye are pain and cloudy vision. You may have some discharge and the eye itself may appear white and cloudy instead of clear.

If you have pink eye and have been out hiking, doing yard work, swimming in a lake, or other outdoorsy activities and suspect you may have a fungal infection you need to call your eye doctor immediately as fungal infections can be permanently sight threatening.

Your eye doctor will want to get you started on an intense anti-fungal treatment program to get the situation under control as quickly as possible.

 

What Should I Do if I Think I Have Pink Eye?

As you can see, different causes of pink eye are treated quite differently. Without proper treatment your pink eye could get worse and even become sight threatening.

Eye doctors have many special, unique tools in office to look at your eyes and determine what the underlying cause is—therefore it is best to have your eye doctor handle your pink eye situation. When you call to make an appointment you should be prepared to answer the following questions:

-Are both eyes involved, or just one?

-When did you first notice your eye was bothering you?

-Is there any discharge? If so, what color is it? Is there a lot of discharge, or just a little bit?

-Are you in any eye pain?

-Can you still see well, or is your vision affected?

Based on your answers to these questions, your eye doctor will already have a decent idea as to what is going on. He or she will therefore determine how urgent the matter is and fit you into the schedule accordingly.

If the doctor says he or she cannot get you in until the following day or two, do not panic! Your eye doctor knows best, if it is an emergency they will find a way to fit you in ASAP. Many eye doctors even have an after-hours emergency number for eye-related problems, so always call us first!

 

Our eye doctors at Eye Theory in Houston, TX excel in the prescription of contact lenses, glasses and various eye diseases.  Call our optometrist at 832.831.7386 or schedule an appointment online if you would like to learn more about pink eye.  Our eye doctor, Dr. Jonathan Tsao, provides the highest quality optometry services and eye exams in the Midtown, Downtown, Museum District, Montrose, East Downtown, and Southside Commons (Southside Place) vicinities of Houston, Texas.

How to Treat a Corneal Abrasion

A cut to the eye can be one of the most physically painful experiences in an individual’s life. The front surface of the eye, the cornea, is a delicate structure important for transmitting light and protecting the eye.

This structure has many nerves and is very sensitive to all stimuli. People may experience trauma to the cornea via an abrasive injury, such as a scratch from a fingernail, a tree branch, or even a metal foreign object.

In these cases, a visit to the eye doctor is important to ensure a successful recovery.

What Causes a Corneal Abrasion?

As stated above, a corneal abrasion is a cut on the eye which can result from a variety of causes. This could be from a foreign object that enters the eye and disrupts the surface, either from impact or continued eye rubbing.

Metal, dirt, and sand are common examples. Another cause could be from blunt trauma, whether it is a fingernail or bush branch to the eye.

What to Do if You Have a Scratched Cornea

If one of the above scenarios has occurred and the cornea has been injured, here are the immediate steps that can be taken.

First, try to flush out the eye using saline solution, if it is available. It is best to avoid other sources of water, including tap water.

Other sources may contain microbes that can cause the abrasion to become infected, doing more harm than good. Any type of sterile water is best, and you could also use an over the counter antibiotic eye drop until you can get in to see our eye doctor.

Next, try blinking lightly. Your eyelids are designed to keep out debris and protect the eye, so gentle blinking may move the foreign body out of the eye.

However, in some cases, the particle may be trapped under the eyelid, making blinking even more painful and harmful as the particle repeatedly scrapes the cornea. If you feel that it is getting worse with blinks, stop blinking and try to keep the eye closed.

Generating tears is helpful in these situations. Your tears are constantly being replenished onto the surface of the eye and are useful in washing away debris.

Allow the eye to naturally wash away the particle if possible.

Make sure to visit our optometrists to ensure proper healing of the abrasion. Our optometrist will assess the depth and severity of the cut.

If the particle is still in the eye, our optometrist may apply an anesthetic eye drop and subsequently remove the offending item that may be lodged in the eye. This is done with specialized tools while viewing the cut and item under high magnification.

In some cases, a bandage contact lens may then be used to help with discomfort from the injury, and a prophylactic antibiotic eye drop may be prescribed for you to use to decrease the risk of an infection.

What NOT to Do When You Have a Corneal Abrasion

It is important to remember that rubbing your eyes with your hands can easily make the situation worse. In cases when the debris is trapped under the eyelid, rubbing your eyes will cause the particle to further scratch the front surface of the eye.

This can lead to more damage, although it is reversible in most cases. If there is an open wound on the front surface of the eye, touching the eye with non-sanitized fingers may also increase the risk of infection.

Stay away from using water sources other than saline solution. In some situations, such as a chemical eye injury, tap water will be a better option for rinsing than using nothing if saline is unavailable, but saline is ultimately the best option.

If you wear contact lenses, make sure to discontinue contact lens wear. This will encourage healing of the cornea and prevent infection.

As mentioned above, a bandage contact lens can be instilled by the optometrist, but this may differ from the lenses that you wear for vision correction. Only certain lenses are approved by the FDA for safe overnight wear and give an optimal healing environment for the eye injury.

 

Our eye doctors at Eye Theory in Houston, TX excel in the prescription of contact lenses, glasses and various eye diseases.  Call our optometrist at 832.831.7386 or schedule an appointment online if you think you have a scratched cornea or corneal abrasion.  Our eye doctor, Dr. Jonathan Tsao, provides the highest quality optometry services and eye exams in the Midtown, Downtown, Museum District, Montrose, East Downtown, and Southside Commons (Southside Place) vicinities of Houston, Texas.

The Basics of Keratoconus

Keratoconus is a condition that causes thinning and bulging of the clear front of the eye, the cornea. There are a variety of causative factors for keratoconus and more is being understood about its diagnosis and treatment all the time. This article will outline keratoconus, its causes, and its treatment.

What is Keratoconus?

The cornea is the front transparent surface of the eye and is largely responsible for focusing light onto the back of the eye, the retina, to allow for clear vision.

When there are deformities or changes in the curvature of the cornea, vision is therefore affected. Keratoconus is when the central cornea thins and the pressure from fluid inside the eye pushes it forward, leading to a bulging out and, if severe, a cone shape at the front of the eye.

It is a progressive disease with the highest rate of change in the teenage years and twenties with the process completing around age thirty.

The rate of progression can vary and the condition can sometimes progress later on in life as well or occur following a surgical procedure involving the cornea.

Symptoms of keratoconus include reduced vision even when corrected with glasses or contact lenses and inconsistent and highly variable prescriptions.

If the cornea is severely thinned and bulged, a break can occur where fluid from inside the eye drains into the cornea itself, leading to severe pain and visual disturbance. This acute condition, called hydrops, resolves with time and proper treatment.

What Causes Keratoconus to Occur?

Keratoconus is under constant study and causative factors are being investigated all the time. Family history and other genetics like ethnicity can play a role.

Excessive eye rubbing is an important risk factor as it increases eye pressure and strain on the cornea, leading to further degeneration.

Eye rubbing is associated with allergic or atopic conditions that cause the eyes to itch. Another possible cause can be refractive surgery, as this procedure involves altering and thinning the cornea in order to change the power of the eye.

This is why extensive testing of the cornea must be done before laser surgery to ensure that this does not occur.

Keratoconus is also associated with other genetic or connective tissue disorders, like Down syndrome and Marfan syndrome.

How is Keratoconus Treated?

In the early stages of keratoconus, it is often easily corrected with glasses or soft contact lenses. In the later stages, vision will be optimal only with the use of rigid gas permeable (RGP) lenses or scleral lenses.

RGP lenses are hard lenses that are smaller than the diameter of the colored part of the eye. These lenses will often take some time to get used to but provide excellent vision for patients.

They sit on the front surface of the eye and create a tear layer between the cornea and the lens that corrects the keratoconic irregularity and allows for better vision. Scleral lenses sit on the white part of the eye and are larger than RGP lenses.

They are also more comfortable and easier to get used to than RGP lenses. There are also hybrid lenses, which have a RGP center and soft contact lens edge, allowing for better comfort while still optimally correcting vision.

Corneal cross-linking is another treatment option for patients with keratoconus. This procedure helps to slow the progression of the cornea bulging outwards and maintains the integrity of the cornea as it is.

The procedure involves riboflavin (vitamin B2) being applied to the front surface of the eye with ultraviolet radiation exposure for 30 minutes. This makes the cornea stronger and more resilient against further change.

In severe and advanced stages of keratoconus, penetrating keratoplasty may be needed. This procedure involves transplanting a cornea from donor tissue and replacing the cornea of the patient.

Following the surgery, the patient will often be fit with a scleral lens for optimal vision.

 

Our eye doctors at Eye Theory in Houston, TX excel in the prescription of contact lenses, glasses and various eye diseases.  Call our optometrist at 832.831.7386 or schedule an appointment online if you would like to learn more about keratoconus.  Our eye doctor, Dr. Jonathan Tsao, provides the highest quality optometry services and eye exams in the Midtown, Downtown, Museum District, Montrose, East Downtown, and Southside Commons (Southside Place) vicinities of Houston, Texas.

What is Ocular Rosacea?

Acne rosacea is a condition in which the skin on your face looks red or flushed chronically, often being worse during episodes of a flare-up. This can also be associated with acne in various regions of the face as well as have effects on the eyes. When rosacea affects the eyes, it is referred to as ocular rosacea. Below is a quick summary of the causes, symptoms, and treatment for ocular rosacea.

 

The Cause of Ocular Rosacea

At this time, it is uncertain exactly what causes rosacea. It is hypothesized that it may be genetic or due to something in the environment. There have been speculations that it may be caused by a bacteria known as Helicobacter pylori, the same organism that is responsible for infections along the digestive tract. This bacteria could be blocking the glands on the face, thus making the skin swollen and red. The redness could also be due to swelling of the blood vessels. Women are more likely than men to have rosacea.

Flare-ups of rosacea have different causes and can vary for each person. Some triggers include sun, wind, or cold exposure, very active exercise, alcohol, spicy foods, or stress.

 

Ocular Rosacea: Signs and Symptoms

Ocular rosacea is associated with red, gritty eyes or a burning sensation. It may feel like something is stuck in the eye and causing the eyes to water. Individuals may also find that their eyelids are swollen and red and their oil glands, located within the eyelids, get clogged. This is referred to as Meibomian gland disease and can lead to recurrent development of lumps growing on the inside of the eyelid. Demodex blepharitis is also more common in patients with ocular rosacea, referring to an inflammation of the eyelid caused by mites that live at the base of the lashes. Demodex is associated with crusty dandruff at the base of the lashes.

 

Ocular Rosacea Treatment Options

At this time, there is no cure for rosacea, though there are many ways to treat the symptoms. Often the first step is to avoid the triggers that can cause flare-ups.

In order to reduce the redness and swelling, our optometrist may prescribe a steroid eye drop. Antibiotics, taken either orally or topically, can be used to treat ocular infections as well as artificial tears to keep the eyes moist. It is often advised that individuals do not use eye drops meant for reducing the look of bloodshot eyes as this can make the rosacea worse and lead to a rebound effect of more red eyes after discontinuation. Eyelid hygiene will also need to be improved with the use of lid scrubs and hot compresses. In cases where the individual also has Demodex blepharitis, tea tree oil will need to be used.

 

Our eye doctors at Eye Theory in Houston, TX excel in the prescription of contact lenses, glasses, and various eye diseases.  Call our optometrist at 832.831.7386 or schedule an appointment online if you would like to learn more about ocular rosacea.  Our eye doctor, Dr. Jonathan Tsao, provides the highest quality optometry services and eye exams in the Midtown, Downtown, Museum District, and Southside Commons (Southside Place) vicinities of Houston, Texas.

Can Smoking Affect My Eyes?

Smoking has a variety of adverse effects on the body and the eyes are no exception. It is often a risk factor for developing several diseases or exacerbates existing conditions. Here are some of the interactions that smoking has with the health of your eyes.

Smoking Worsens Macular Degeneration (ARMD)

Smoking is one of the main modifiable changes to prevent age-related macular degeneration (ARMD) development and progression. In ARMD, the nerve fiber at the back of the eye, the retina, is damaged. Specifically, this disease involves damage to the macula, the portion of the area on the retina that is responsible for your central vision. This results in loss of vision centrally and currently, there is no treatment that can reverse this disease. Various studies have shown that smokers are more likely to develop ARMD compared to non-smokers.

Smoking Can Cause Cataracts

A cataract is the clouding and yellowing of the lens within your eye. This lens is responsible for focusing light on the nerve fiber layer at the back of the eye. The clouding causes people to experience blurry vision, glare, and a dimming effect with a diminished ability to distinguish colors. The change occurs gradually and the treatment includes cataract surgery to remove and replace the lens within the eye. Smoking increases the risk of developing cataracts and increases the likelihood that surgery will be needed sooner.

 

Glaucoma

Smoking is a risk factor for developing glaucoma as well. Glaucoma involves the loss of peripheral vision due to changes to the optic nerve at the back of the eye. The optic nerve transmits information from the eye to the brain and thus damage to this area will have detrimental effects on vision.

 

Diabetic Retinopathy and Cigarettes

Diabetic retinopathy (DR) refers to damage to the back of the eye as a result of diabetes. In DR, the blood vessels at the back of the eye are damaged and are leaky. This can result in hemorrhages and can cause swelling. This can blur and distort vision, ultimately leading to blindness if left untreated. Cigarette smoke can increase the likelihood of blockages in the blood vessels and the dysfunction of the vessel walls. This can in turn increase the chance of leakage of blood or the formation of excess and weak blood vessels that can cause permanent damage to the eye.

Dry Eye Disease is Exacerbated by Smoking

Dry eye disease could easily be exacerbated by the smoke produced by cigarettes. The smoke contains many chemicals and debris that can enter the eye, irritating and drying out the tear film that lubricates the front surface of the eye. Secondhand smokers will often also be consistently affected by this and unfortunately can develop dry eye disease as well. Symptoms include irritated, red, gritty, and itchy eyes.

 

Our eye doctors at Eye Theory in Houston, TX excel in the prescription of contact lenses, glasses, and various eye diseases.  Call our optometrist at 832.831.7386 or schedule an appointment online if you would like to learn more about how smoking can affect your eyes.  Our eye doctor, Dr. Jonathan Tsao, provides the highest quality optometry services and eye exams in the Midtown, Downtown, Museum District, and Southside Commons (Southside Place) vicinities of Houston, Texas.

Corneal Abrasions and Eye Injuries

Most of us try our best to take care of our eyes. When something comes close to our faces that might hit us, we immediately shut our eyes and turn our faces away to protect them. Even with caution, however, injuries to our eyes still happen and these often affect the clear front of the eye, the cornea. Below is explained how injuries to the cornea commonly proceed, what treatment for them entails, and some ways to prevent their occurrence and recurrence.

Types of Eye Injuries

When an injury occurs to the cornea that scratches its surface but does not pierce it, this is called a corneal abrasion. There will be immense pain when this occurs and likely some light sensitivity will develop afterwards as well. The cornea can heal very quickly, within a couple of days depending on the size, when this happens, but steps must be taken to ensure that this healing proceeds normally. Scratches can also occur as a result of debris lodged under the upper eyelids, and these must be removed.

Sometimes, a small bit of a fast moving object can enter into the cornea and embed itself there. This can be a piece of metal, wood, dirt, etc. The cornea is tough and can often stop these foreign body projectiles, but they must be removed to prevent scarring and further damage. If the cornea is completely pieced or perforated, more complex surgical treatment may be required depending on the extent of damage deeper in the eye and on how large the entrance hole is.

Regardless of the source of the injury, corneal trauma carries a secondary risk. The wound itself heals quickly, but requires months to completely reattach to the underlying tissue. This means that the area that was injured has an increased sensitivity to further damage and may spontaneously lift up with the eyelids when first waking in the morning, reopening the original injury site. This is called recurrent corneal erosion.

Corneal Abrasion Treatment

Our eye doctors will usually either put on antibiotic eye drops in office or prescribe them to prevent infection of the injury. If something is stuck in the eye, it will be removed if possible after the eye has been numbed with eye drops. This can be done with various metal tools like forceps or tweezers and tiny hockey sticks, or with motorized drills that gently scrape off dirty tissue.

If there is nothing in the eye, the loose edges of a corneal abrasion may be manually removed to quicken healing. If the wound is large, a bandage contact lens may be put on your eye to shelter it while it recovers, then removed after a few days.

Other drops may be used depending on how inflamed the eye is, such as corticosteroid eye drops to reduce inflammation or painkiller eye drops if you are in a great deal of pain. Drops that dilate your pupils help both with pain and with speeding healing of inflammation within the eyes.

 

How to Prevent Corneal Abrasions and Eye Injuries

Obviously, avoiding risky activities for the eyes and wearing safety glasses when performing activities with eye hazards are both useful ways to prevent eye injuries. In addition, after an initial injury has occurred, one can prevent recurrent corneal erosion by using lubricating eye drops often during the day and hypertonic ointment before bed at night. This ointment provides a barrier between the eyes and the lids and dries out the cornea, reducing the chance of the lids ripping the cornea open in the morning and causing the injury to recur. Medications such as steroids or doxycycline may also sometimes be prescribed to help healing and thus reduce the chance of this happening.

Our eye doctors at Eye Theory in Houston, TX excel in the prescription of contact lenses, glasses and various eye diseases.  Call our optometrist at 832.831.7386 or schedule an appointment online if you would like to learn more about corneal abrasions and other eye injuries.  Our eye doctor, Dr. Jonathan Tsao, provides the highest quality optometry services and eye exams in the Midtown, Downtown, Museum District, and Southside Commons (Southside Place) vicinities of Houston, Texas.

Presbyopia and Vision Changes As You Age

Most middle-aged adults experience vision changes related to a condition known as presbyopia.  Presbyopia results in the gradual loss of the ability to focus on near objects.  It is a normal age-related change that begins to occur around the early to mid-40s and continues throughout adulthood.  Though this vision condition can be frustrating, confusing, or even embarrassing at first, it is a completely normal occurrence and there are many different options to help correct the blurry near vision caused by presbyopia.  

 

What Causes Presbyopia?

The focusing system of the eye is what allows us to view objects that are up-close, far away, and all distances in-between.  In youth, the focusing system of the eye is robust and flexible, and can easily focus to a wide range of distances.  However, as we age, the focusing system becomes more rigid, making it more difficult to clearly view objects at a close distance.  The acquired rigidness of the focusing system is a normal, age-related change and has no impact on the overall health of the eye or visual system.  Presbyopia gradually worsens over time, and near objects will become blurrier and blurrier.

 

Symptoms of Presbyopia

The early symptoms of presbyopia can be confusing at first. One of the most common early signs of presbyopia is needing to hold objects further away than normal in order to see them clearly.  While holding objects further away may work temporarily, presbyopia causes progressively blurred near vision as time goes on.  It may be more difficult to focus on fine print, and near work may be accompanied by headaches or significant eye strain.  People who are naturally farsighted may experience the symptoms of presbyopia sooner and more severely, while those who are nearsighted typically do not notice the symptoms quiet as early in life. Unfortunately, the blurred vision caused by presbyopia cannot simply be fixed by “focusing harder.”  For most, this vision condition requires optical correction in order to clearly and comfortably see close objects again. 

 

Seeing Clearly with Presbyopia 

Luckily, there are many corrective options for those affected by presbyopia.  Many people choose to use reading glasses to help them see up-close, but these glasses need to be removed in order to see clearly far away.  For people interested in a single pair of glasses that can be worn full time, there are several different options that can provide clear vision for near and distance objects.  Lined bifocal lenses contain a distance prescription at the top of the lens, and a reading prescription at the bottom.  Similarly, progressive lenses, or “no-line bifocals,” contain a gradient of prescriptions to allow for clear vision at a range of distances.  Many people prefer these lens options in order to avoid putting on and removing glasses many times throughout the day.  There are even contact lens options for those affected by presbyopia that want to avoid glasses altogether.  Multifocal contact lenses are special soft lenses that provide correction for both distance and near vision.  They come in many different brands and designs, so almost all contact lens wearers can find a multifocal lens that works for them.  

 

Our eye doctor at Eye Theory in Houston, TX excels in the prescription of contact lenses, glasses and various eye diseases.  Call our optometrist at 832.831.7386 or schedule an appointment online if you would like to learn more about presbyopia.  Our eye doctor, Dr. Jonathan Tsao, provides the highest quality optometry services  and eye exams in Houston and Midtown Texas area.

Diabetes and Your Eyes

Diabetes is becoming an increasingly prevalent problem in the United States, and is expected to become even more common in the upcoming years.  Beyond being an overall health risk, diabetes can pose serious threats to the health of the eyes.  Both Type 1 and type 2 diabetes have the potential to cause sight threatening damage if not properly controlled.  Monitoring blood sugar levels and maintaining control of the condition with options such as diet, exercise, or medication is important.  Those affected by diabetes should work closely with both their primary care doctor and their optometrist to protect their eyes. 

 

Diabetic Retinopathy

Diabetes can cause a multitude of problems in the eyes, but one of the most common and concerning complications is diabetic retinopathy.  This condition affects the retina, which lines the back of the eye and receives all visual information.  The retina receives vital blood flow from lots of small and fragile blood vessels, which can become affected in diabetes if blood sugar levels are poorly controlled.  In mild cases of diabetic retinopathy, the blood vessels in the retina may leak, leaving small hemorrhages in the retinal tissue.  If the disease continues to progress, it can lead to areas of the retina losing oxygen, or proteins leaking out of blood vessels and causing large areas of retinal swelling.  Many times, these changes can occur in the retina without causing any significant symptoms until lots of damage has already occurred. In the most severe cases of diabetic retinopathy, complications like retinal detachments can occur.  If not promptly addressed, these severe complications can lead to permanent vision loss. 

 

Who is at Eye Disease from Diabetes?

There are two main factors that increase the risk of developing diabetic retinopathy.  The first is how long the person has been diabetic.  Those who have been diabetic for several decades are more likely to develop diabetic retinopathy than those who have recently been diagnosed.  This is because fluctuations in blood sugar levels can cause damage to blood vessels over long periods of time, and the retinal vessels that have been affected for many years are more likely to be compromised.  The second factor is how well diabetes is controlled.  Diet and exercise are important in keeping blood sugar levels under control, and in many cases medication may also be required.  Following the directions of the primary care doctor or endocrinologist can not only help control diabetes, but it can also help protect the eyes.  

 

Treating Diabetic Retinopathy 

The most important aspect of preventing or treating vision loss due to diabetic retinopathy is early detection of the condition, which is why routine eye examinations are so important.  Mild cases of diabetic retinopathy may simply be monitored and can improve if the blood sugar becomes better controlled.  In cases of diabetic retinopathy where retinal swelling is affecting vision, treatment options can include injections or laser procedures.  If diabetic retinopathy has resulted in a retinal detachment, then a major surgical procedure may be required in an attempt to preserve vision.  If you have diabetes, working closely with your optometrist and your doctors can help prevent vision loss from diabetic retinopathy.   

 

Our eye doctor at Eye Theory in Houston, TX excels in the prescription of contact lenses, glasses and various eye diseases.  Call our optometrist at 832.831.7386 or schedule an appointment online if you would like to learn more about diabetes and diabetic retinopathy.  Our eye doctor, Dr. Jonathan Tsao, provides the highest quality optometry services  and eye exams in Houston and Midtown Texas area.

Digital Screens and Computer Vision Syndrome

For many people, extensive use of digital screens is an important part of maintaining a professional or personal life.  Unfortunately, extended and uninterrupted screen time using computers, tablets, or smart phones may cause a group of symptoms known as Computer Vision Syndrome or Digital Eye Strain.  The more time spent viewing digital screens, the worse the symptoms of this condition may be. Computer Vision Syndrome is becoming increasingly common. In fact, research suggests that the vast majority of people who use computers or other digital screens show some degree of symptoms associated with the condition. Continue reading to learn more about how Computer Vision Syndrome may be affecting your eyes. 

 

What are the Symptoms of Computer Vision Syndrome?

Computer Vision Syndrome, also called CVS, can cause a wide range of symptoms.  Most commonly, people affected by this condition can experience blurred vision, eye fatigue or strain, and dry uncomfortable eyes. In more severe cases, symptoms can include headaches or double vision.  Using digital screens late at night can also disrupt the body’s natural circadian rhythm and may result in difficulty sleeping. The more time spent using digital screens, the more likely the symptoms of Computer Vision Syndrome are to be severe and bothersome.  For some people, these symptoms improve when they stop using a screen, but for others the symptoms can persist long after screen use has stopped. Those people may need to turn to other options for relieving the symptoms of CVS.

 

Specialized Computer Glasses

Eyestrain and fatigue is one of the most common symptoms associated with prolonged computer use. These symptoms occur because working on a computer or other digital screens in close proximity creates a lot of extra work for the focusing system of the eye. If you frequently experience this eye strain, a prescription can be written for specialized computer glasses to help improve visual comfort.  A computer prescription can be determined during a comprehensive eye examination, and will take into account factors like your traditional glasses prescription and the distance you sit from your screen.  These glasses can be made in a wide variety of lens designs, including progressive or bifocal glasses for those who view digital screens at a range of distances. They can also incorporate blue-blocking lenses to reduce additional eye fatigue associated with screen use.   

 

Treating Digital Dryness

When we look at digital screens, we tend to blink less often than normal.  This reduced rate of blinking leads to uncomfortable symptoms of dryness and irritation.  To address these symptoms of CVS, ask your optometrist for recommendations for a lubricating eye drop.  These over-the-counter artificial tears can be used during and after using digital screens to nourish the front surface of the eye and reduce discomfort associated with prolonged screen use. 

 

Remember to Take a Break from Digital Screens

As we have discussed, using digital screens for a long period of time can place a burden on the focusing system of the eye.  In addition to specialized computer glasses, one way to reduce eyestrain associated digital screens is to periodically give your focusing system a break.  To do this, try following the “20-20-20 rule.” This rule states that for every 20 minutes, you should look at an object at least 20 feet away for 20 seconds.  This temporary change in focus helps relieve the visual system and can reduce symptoms such as blurred vision, eyestrain, and headaches.  

If you are affected by Computer Vision Syndrome or Digital Eye Strain, make an appointment with one of our optometrists to discuss your symptoms and determine a treatment plan.

 

Our eye doctor at Eye Theory in Houston, TX excels in the prescription of contact lenses, glasses and various eye diseases.  Call our optometrist at 832.831.7386 or schedule an appointment online if you would like to be evaluated computer vision syndrome or for us to help with the visual requirements of your digital screens.  Our eye doctor, Dr. Jonathan Tsao, provides the highest quality optometry services  and eye exams in Houston and Midtown Texas area.