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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.

Eye Problems and Down’s Syndrome

Down’s syndrome is a condition in which chromosome 21 is duplicated, resulting in three copies rather than just two. It is associated with intellectual, developmental, and physical changes.

The eyes are one component and there are a variety of conditions that individuals diagnosed with Down syndrome may be affected by or more susceptible to. Read on to learn about some of the most common ocular findings.

 

Refractive Error and Glasses

This refers to an individual’s prescription in corrective eyewear such as glasses or contact lenses in order to see as clearly as possible. Patients with Down syndrome are more likely to need corrective eyewear whether for nearsightedness, farsightedness, or astigmatism.

 

Strabismus is a Common Feature in Down Syndrome

Strabismus refers to an eye turn that the individual may have. This could be one eye turning in and out, or both eyes turning and switching back and forth. It could also be present at all times or only at some points in the day and associated with certain activities.

An eye more often turns inward, but in either case amblyopia or lazy eye may develop. This means that because the turned eye is not being used as frequently, it will not receive as much visual stimuli and its pathways to the brain will not fully develop, leading to permanent vision reduction in that eye if the eye turn is not fixed in childhood.

 

Down’s Syndrome Can Cause Keratoconus

At the very front of the eye is the clear cornea, which is thinned in this condition, causing the fluid from inside the eye to push outwards. This causes the cornea to bulge outwards into a cone shape and distorts the curvature, affecting vision. This condition has been shown to be associated with eye rubbing and our optometrist will check to make sure that there are no underlying causes inducing this.

Cataracts

A cataract refers to the clouding of the lens within the eye, causing blurry vision or a spot in vision. If noted, our optometrist will assess to see how severe the cataract is and, if needed, refer the patient to receive surgical treatment to replace the lens. Patients with Down syndrome are at higher risk for either congenital cataracts (present at birth) or developing cataracts as they age earlier than the general population.

Glaucoma

This is a group of disorders that refer to the death of the nerve cells at the back of the eye, which are responsible for providing peripheral vision. This is often associated with higher eye pressure but this is not the only variable.

Treatment includes eye drops, instilled everyday, to lower eye pressure or certain laser procedures that help with outflow of the fluid within the eye to lower the pressure. Individuals with Down syndrome are at higher risk for higher eye pressures and glaucoma.

Blepharitis

This is a condition that leads to inflammation of the eyelids and the glands within them. It is often associated with a dry or burning feeling in the eyes and redness. Eyelid hygiene is an important component for this condition and it can be treated with eyelid cleaning, warm compresses, steroids, or antibiotics.

 

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 Down’s syndrome can affect the eyes.  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.

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.