Opthalmology

We welcome patients of all ages for every medical service your eyes may need, from routine exams to surgical procedures

Eye Conditions

Conjunctivitis-often referred to as “pink eye”- is an inflammation or infection of the conjunctiva, or the “white part” of the eye and inner lining of the eyelid. Inflammation causes small blood vessels in the conjunctiva to become more apparent, which causes the red or pink cast to the whites of the eye. Inflammation associated with conjunctivitis can be very irritating, but it rarely affects vision.

Viral:

Viral conjunctivitis is often associated with colds or respiratory infection, such as a sore throat. It usually produces a watery discharge, and variable itch. The virus generally begins with one eye, but often spreads to the other. Viral conjunctivitis is highly contagious, so it is very important to limit contact with others when infected, and refrain from touching or itching your eyes. There is no treatment for most cases of viral conjunctivitis, although antiviral medication may be an option if your Doctor determines that the case is caused by herpes simplex virus. Usually, the symptoms will gradually clear on their own after about 2-3 weeks.

Bacterial:

Bacterial conjunctivitis is also associated with respiratory infections and colds. Its symptoms include thick, green-yellow mucous emitted by the eye, crusting of the eye and surrounding skin, and eye redness. Bacterial conjunctivitis is treatable, and your doctor will likely prescribe antibiotic eye drops, which should make the infection subside within a few days. Antibiotic eye ointment may also be administered, and should have the same fast results as eye drops, though due to the thickness of the ointment, it can cause blurred vision for about 20 minutes following application.

Allergic:

Allergic conjunctivitis is a response to an allergy-causing substance such as pollen or dust, and affects both eyes. In response to allergens, your body produces an antibody known as immunoglobulin, which triggers special cells in your eyes and airways to release inflammatory substances, such as histamines. These histamines can produce a number of allergy signs and symptoms, including conjunctivitis. Symptoms include intense itching and tearing of the eyes, sneezing, and watery nasal discharge. Most symptoms of allergic conjunctivitis can be treated with allergy eye drops.

Chemical:

Chemical conjunctivitis generally occurs when the eye comes in contact with a chemical splash or foreign object and must be flushed. Irritation from the flushing can cause inflammation and redness, which usually clears up on its own within about a day.

A hordeolum-often referred to a “stye”- is a tender, painful red bump located at the base of an eyelash or under or inside the eyelid. When the oil glands of an eyelid become clogged from a bacterial infection, an acute infection generally occurs and causes a hordeolum to develop. This type of hordeolum is generally referred to as an “internal hordeolum,” and appears as a visible bump under the eyelid. An infected hair follicle at the base of an eyelash can also cause a hordeolum. This is referred to as an “external hordeolum,” and is also visible as a small red bump.

Signs and Symptoms:

The first sign of hordeolum is a small, yellowish spot at the center of the bump that occurs when pus expands in the area. Other symptoms include: a lump on the top or bottom eyelid, swelling of the eye, eye redness, pain or tenderness in the infected eye, burning, tearing, or irritation of the eye, light sensitivity, and discomfort when blinking.

A very common condition in which the cornea of the eye is asymmetrically curved, causing out-of-focus vision. The image does not focus on the retina in a sharp point. The cause of astigmatism is unknown. It is usually present from birth, and often occurs together with nearsightedness or farsightedness. A minor degree of astigmatism is considered normal and does not require correction.

Farsightedness (Hyperopia) is the result of the visual image being focused behind the retina rather than directly on it. It may be caused by the eyeball being too small or the focusing power being too weak. Farsightedness is often present from birth, but children can often tolerate moderate amounts without difficulty and most outgrow the condition. As aging occurs, glasses or contact lenses may be required to correct the vision. A family history of farsightedness is a risk factor.

A nearsighted person sees near objects clearly, while objects in the distance are blurred. As a result, someone with myopia tends to squint when viewing far away objects.
This blurred vision results when the visual image is focused in front of the retina rather than directly on it. It occurs when the physical length of the eye is greater than the optical length. For this reason, nearsightedness often develops in the rapidly growing school-aged child or teenager and progresses during the growth years, requiring frequent changes in glasses or contact lenses. It usually stops progressing as growth is completed in the early twenties.
Nearsightedness affects males and females equally, and those with a family history of nearsightedness are more likely to develop it. Most eyes with nearsightedness are entirely healthy, but a small number of people with myopia develop a form of retinal degeneration.

Presbyopia is the age-associated progressive loss of the focusing power of the lens, resulting in difficulty seeing objects close to the eye.
The focusing power of the eye, which depends upon the inherent elasticity of the lens, is gradually lost with the aging process. This results in a gradual decrease in the ability of the eye to focus on objects that are close up. It is usually noticed around the age of 45, when you realize that you need to hold reading materials further away in order to focus on them. Presbyopia occurs progressively in everyone during the aging process. Your doctor may recommend over the counter reading glasses, prescription reading glasses or a bifocal/progressive lens.

Glaucoma affects approximately 3 million Americans and over 120,000 will go blind from this disease. Glaucoma ranks as a leading cause of blindness worldwide. And when it does not cause blindness, it can severely impair vision.

There are two major types of glaucoma:

  • Acute closed-angle glaucoma.
  • Chronic or primary open-angle glaucoma.

Other variations include congenital glaucoma, pigmentary glaucoma and secondary glaucoma.

There are no warning signs of Chronic glaucoma. About half of Americans with chronic glaucoma don’t even know they have it. Glaucoma gradually reduces your peripheral vision. By the time you notice it, permanent damage has already occurred. If your intraocular pressure remains high, you can develop tunnel vision. You will only be able to see objects straight ahead.
Other signs to watch for include headaches, blurred vision, difficulty adapting to darkness or halos around lights. Chronic glaucoma normally develops after age 35.

Selective laser trabeculoplasty (SLT) is one of the greatest advances in the surgical treatment of intraocular pressure (IOP) in patients with open-angle glaucoma. SLT is a safe and simple 5 minute in-office laser treatment that effectively reduces the pressure in the eye for most patients with glaucoma. SLT can reduce or eliminate the need to use daily glaucoma medications. Studies have shown that less than 50% of glaucoma patients actually take their medications as prescribed and many stop taking them due to the numerous side effects experienced, cost, busy lifestyle and all other daily variables and challenges we all experience. Compliance is now controlled by your physician. The low percentage of non-responders to SLT therapy can simply begin traditional medications.

A cataract occurs when the normally clear lens in your eye becomes cloudy, eventually impairing your vision.
The most common complaint due to cataracts is blurred vision in one or both eyes. The vision may worsen slowly over months or years. Some people experience difficulty reading, especially small print. Some have trouble driving in bright sunlight or at night, especially if it’s raining. Cataracts need no treatment if you can see well enough to do all of your daily activities without difficulty.

Signs and symptoms of cataracts may include:

  • Blurry or dim vision
  • Poor night vision
  • Halos around lights
  • Sensitivity to light and glare
  • Need for brighter light for reading and other activities
  • Frequent changes in eyeglass prescription

Age related macular degeneration is one of the leading causes of blindness in the United States. It is a medical condition which affects older adults that results in a loss of vision in the center of the vision because of damage to the retina. It occurs in “dry” and “wet” forms. It is a major cause of visual impairment in older adults over 50 years of age. Macular degeneration can make it difficult to read or recognize faces, although enough peripheral vision remains to allow other daily activities. Although some degeneration affecting younger individuals are sometimes referred to as macular degeneration, the term generally refers to age-related macular degeneration (AMD or ARMD).
The inner layer of the eye is the retina, which contains nerves that communicate sight, and behind the retina is the choroid which contains the blood supply to the macula. The macula is made up of millions of light-sensing cells that collectively produce central vision. AMD occurs in two forms:

  • “Dry” AMD – Advances slowly, and may be hardly noticeable. Ninety percent of all people with AMD have this type. Exactly why it develops is not known, but it seems to be caused by aging and thinning of the tissues of the macula. A slow breakdown of the light-sensing cells in the macula leads to a gradual loss of central vision. While there is no current treatment for Dry AMD, there are studies that show Preservision AREDS II can help slow the progression of vision loss.
  • “Wet” AMD – Although only 10 percent of all people with AMD have this type, it accounts for 90 percent of all blindness from the disease. As dry AMD worsens, abnormal blood vessels may form underneath the retina. These new blood vessels tend to be very fragile, and will often leak blood and fluid. This causes damage to the overlying retinal tissue, and can lead to rapid and severe loss of central vision.

If you have diabetes mellitus, your body does not use sugar properly. High blood-sugar levels can damage blood vessels in the retina. This is called diabetic retinopathy. If you are diabetic it is important for you to be seen for a dilated eye exam yearly.
There are two major types of diabetic retinopathy: nonproliferative diabetic retinopathy (NPDR) and proliferative diabetic retinopathy (PDR). Many diabetics have mild NPDR. NPDR is an early form of eye disease which usually does not affect vision. PDR, on the other hand, represents more advanced disease and can cause severe loss of central and peripheral vision.

Diabetics who strictly control their blood-sugar levels can prevent or delay the onset of vision problems. Those who develop vision-threatening complications such as macular edema (swelling), PDR and neovascular glaucoma can be treated with laser surgery. Some patients may need multiple laser treatments over time.

Flashes of light are caused by tension between the vitreous gel in the eye and the retina. As the gel pulls on the retina, the retina is stimulated, sending signals to the brain that are interpreted as flashes of light. As a person ages, the vitreous gel liquefies and separates from the surface of the retina. Imperfections in the gel may cast shadows on the retina that appear as fine dots, strands, and strings in your vision. Since these seem to float, they are called floaters.
Flashes and floaters are a normal factor of aging, and generally become less noticeable with time. However, patients should be examined if these symptoms occur. Flashes and floaters can be a warning sign of more serious conditions as well such as a retinal tear, posterior vitreous detachment or retinal detachment.

Retinal holes and tears are small breaks in the retina. Sometimes the tissues of the retina begin to thin or weaken over time. The retina is light sensitive tissue at the back of the eye. Holes and tears can develop in areas of thinning. The vitreous (the clear gel in the center of the eyeball) may pull the retina and tear it.
Eye problems that may increase the risk of retinal holes and tears include:

  • Nearsightedness
  • Eye injuries
  • Cataract or certain other types of eye surgery

You are more at risk of a retinal detachment if you:

  • are nearsighted
  • have had eye surgery (Cataract, Glaucoma or other surgery)
  • take glaucoma medications that make the pupil small
  • had a serious eye injury
  • had a retinal tear or detachment in your other eye
  • have family members who have had a retinal detachment

A chalazion is a localized inflammatory response involving sebaceous glands of the eyelid that occurs when the gland duct is obstructed. A chalazion may resolve spontaneously or with warm compresses, lid scrubs, and lid massage. When there is no improvement, the chalazion may be excised.
After local anesthesia, a chalazion instrument is put in place and an incision is made in the inner aspect of the eyelid. The contents of the chalazion are then carefully drained with a curette followed by gentle pressure or heat cautery to control any bleeding.
A chalazion can develop and you might not see any symptoms. When there are symptoms, they can include:

  • A bump on the eyelid, sometimes becoming red and swollen. Occasionally it can be tender.
  • Rarely, an entirely swollen eyelid
  • Blurry vision, if the chalazion is large enough to press on the eye.

An eyelid lesion is a growth that develops on the eyelid, this can be a serious tumor or just a benign lump. Lesions may appear on the eyelid for a variety of reasons, including infection, benign and malignant tumors, and structural problems.
Benign (noncancerous) eyelid lesions may be pigmented or flesh colored, and often do not cause any pain or discomfort— unless they are scratched, in which case they may bleed and become painful.
Malignant (cancerous) growths on the eyelid can appear brown, black, red, or flesh-colored. These lesions may change in appearance, spread, or not respond to treatment.
Treatment of eyelid lesions includes healing or removing the lesion— and greatly depends on the type of presenting lesion.

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