Spring, summer and fall… these months represent the most difficult times for those with seasonal allergies in most areas of the country.
If in addition you suffer with itchy eyes, there are several approaches to treatment depending on the severity of symptoms. The hallmark of allergic conjunctivitis is itching, typically in both eyes. In addition there may be tearing and redness as well as a stuffy nose. Anyone with seasonal allergies is very familiar with these symptoms.
Avoiding the allergen responsible is always the first recommended approach.
If your symptoms are mild, prescription as well as over-the-counter (OTC) systemic medications may control the itching. If not you can try adding cold compresses and OTC tear supplements.
If you are still having problems there are OTC allergy drops. The one that I recommend is Zaditor. Zaditor was originally available only with prescription. It is now available in full original prescription strength, OTC. There are several advantages to Zaditor over other OTC eye drops. With Zaditor, you only need 1 or 2 drops per day as the dosing is every 12 hours. In addition there is no rebound effect with Zaditor since it does not contain any vasoconstrictors that are supposed to “get the red” out. If you wear contact lenses, they need to be removed before applying Zaditor and remain out of the eyes for at least 10 minutes.
The only disadvantage to Zaditor (assuming you are not allergic to any of the ingredients) is that it takes a couple of days to work.
If you experience eye pain, changes in vision, redness of the eye or itching worsens or lasts for more than 72 hours, you need to see your eye doctor. Other possible conditions need to be ruled out.
If your eye doctor's diagnosis confirms allergic conjunctivitis he will likely prescribe topical antihistamines, mast cell stabilizers, nonsteroidal anti-inflammatory drugs, or corticosteroids.
Allergy shots can be an effective treatment for allergies as well as the symptoms of allergic conjunctivitis.
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May 23rd, 2011
In a previous blog I discussed my concerns with the new 3D technologies. I indicated that anyone who did not have good binocular vision might be disappointed in this new television format. These concerns included symptoms such as eyestrain, headaches and even nausea.
The fact that these are real concerns can now be confirmed.
Recently, over 40 major home entertainment corporations including Sony, Walt Disney Home Entertainment and Time Warner have joined together with the American Optometric Association (AOA) to create a website dedicated to 3D technology, binocular vision and vision therapy. The website, www.3Deyehealth.org has some excellent videos as well as educational materials on it.
The concept of 3D TV is an exciting one. We all need to be realistic and understand that it's important that we properly address the visual stresses that this new technology may create for many individuals
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May 10th, 2011
When it comes to eye protection your "street wear" glasses may not be adequate.
Today, all lenses must meet minimal safety standards. For street wear glasses the lenses must be impact resistant. Plastic lenses of proper thickness meet these standards as do chemically tempered or heat treated glasses lenses. When placed in a traditional frame these glasses do meet minimal safety standards.
If you are an athlete or are exposed to hazardous work conditions your street wear glasses (that meet minimal safety standards) are not adequate!
For maximum protection your lenses should be made of polycarbonate. This "bullet proof" material when made in appropriate thickness offers the best protection from breaking on impact. Although industrial safety glass lenses are also available, there is a greater risk of injuries with this material. When polycarbonate safety lenses are placed in an approved safety or sports frame your risk of eye injuries is dramatically reduced, in the case of high speed impact.
In sports like tennis, baseball and raquetball… even if you don't need prescription lenses, protective eye wear should be used.
When you have high risk exposures, safety glasses or athletic eyewear should always be worn.
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May 2nd, 2011
One of the more interesting observations that has been made is that with increased near point demands (reading, computers etc.) there is a greater tendency to become myopic.
What we forget is that printed material is a rather new development. After all the printing press has only existed for the last 600 years. We forget societies for centuries were largely agricultural in nature.
Studies of today's industrialized vs. non-industrialized societies offer some insights.
In highly developed industrialized societies the distribution of refractive measurements tends to be skewed towards myopia. In aboriginal or non-industrialized populations, however, the distribution is often skewed towards hyperopia. In some populations such as arctic Eskimos the prevalence of myopia has increased coincident with the development of settled communities and introduction of schooling.
So… what exactly is happening here?
If you spend most of your day reading (students) or your job demands require a lot of computer use, there is an advantage to being nearsighted (myopic). For many individuals focusing (accommodating) for hours at a computer or printed material "locks in" their focusing. If later they are unable to relax their focusing things at a distance will be blurred and they will have in effect become nearsighted.
So, it's true… those individuals who constantly read (or spend most of their time at a computer) are at higher risk of becoming nearsighted.
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March 24th, 2011
Farsightedness (Hyperopia) and Crossed Eyes (Strabismus) often occur at the same time.
Sadly, not all forms of pediatric and school screenings detect this condition.
A child who is significantly farsighted can clear his/her vision by actively using accommodation (focusing the eyes as if to read). This act however can create an abnormal crossing of the eyes even when looking at distance. Since crossed eyes cause us to see double (initially) the brain typically "learns" to ignore one image creating a "lazy eye" or amblyopia. For those individuals who learn to use one eye at a time (alternators) their acuity can remain 20/20 in each eye. In any event, binocular vision is not maintained and depth perception is, at best, poor.
As in many eye conditions the degree of farsightedness can vary between the two eyes (anisometropia). The eye that is the most farsighted almost always becomes the "lazy eye".
When detected at a very young age prescription glasses, or even contact lenses can reduce the degree of eye turn and help maintain good vision in both eye. Various forms of visual therapy (including patching) can help in reducing eye turns and maintaining good vision in both eyes. When necessary muscle surgery can be performed to straighten the eyes.
If you suspect an eye turn or have a family history of "lazy eyes" you should have your child tested as early as possible. It is not necessary for the child to know his alphabet letters for early detection of this condition.
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March 3rd, 2011
True color "blindness" is rare. Most people who have trouble identifying colors have a color deficiency. Someone who is truly color blind would only see in shades of black white and gray.
Most forms of color deficiencies are genetic, are present at birth and remain throughout life. They occur in 5 to 8% of men, only 1/2 of 1% of women. Of these 99% have either a red or green weakness.
There can be acquired color deficiencies as well. These are generally associated with medications, cataracts, glaucoma, macular degeneration and diabetes.
Although some forms of color weakness can cause significant problems, many individuals do learn to function well in most situations.
Fortunately our traffic lights are placed in a consistent order… red, yellow and green. Obviously, certain occupations would be almost impossible for someone with a significant color loss. Electronic wiring for example.
Although there is no cure for color deficiencies special tinted contact lenses and glasses can enhance color for the color "challenged" individual.
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February 14th, 2011
Several times a month a patient will mention to me that they have been told that they are "legally blind without their glasses". This is a misnomer.
Legal Blindness is generally defined as someone who has met one of two criteria.
They have a best corrected acuity of less than 20/200 in their best eye, or their central vision is less than 20 degrees (again, in their best eye).
Many individuals have poor vision without glasses. Acuities without correction of 20/200 or less are not uncommon. But to meet the qualifications of legal blindness ones vision with correction must be less than 20/200 or have a limited field of vision (less than 20 degrees) in their best eye.
Most legally blind individuals have either suffered from a sight threatening eye disease or injury.
If an individual is legally blind they generally would qualify for government benefits.
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February 7th, 2011
Donating your old eyeglasses is a wonderful thing to do. There are some things you should know about donating your glasses.
First, your donated glasses do not remain in this country, they are sent to developing nations. There, glasses are provided to individual through their "joy clinics". The cost of new glasses in these countries can be as much as a years salary!
Several times a year, as a convenience, we take the old glasses that our patients want to donate and place them in one of the nearby drop boxes that the Lions Club provides.
Remember, before you donate your old glasses you should be sure that you have a usable back-up pair just in case something happens to your good pair. It happens every year. A patient will come to our office in dire need of new glasses because they lost or broke, beyond repair, their old glasses. When we ask them whether they have an old pair to get them by… they respond that they donated their old pair. Always keep at least one pair of usable glasses just in case!
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January 30th, 2011
Fuchs endothelial dystrophy is a debilitating corneal disease. It causes pain and eventually threatens sight. A new procedure using advanced laser technologies represents a vast improvement over former surgical techniques.
Previously, a full thickness corneal transplant was the only hope for Fuchs patients. This involved removing the patient’s cornea and replacing it with a donor cornea. The donor cornea was stitched onto the eye, with varying results.
Today using a laser technology initially developed for refractive surgery (lasik) the healthy 95% of the cornea is left intact. IntraLase allows the surgeon to remove only the diseased endothelial layer of the cornea. The endothelial layer lines the inside surface of the cornea.
IntraLase is also used to remove the healthy endothelial layer from a donor cornea. This healthy layer is then placed onto the inner surface of the patient’s cornea through a small incision. Since, there is far less trauma to the patient’s cornea, healing is significantly faster. The patient’s healed cornea has far less distortions, which allows for better visual results.
This surgical transplant technique is known as Descemet's Stripping Endotheleial Keratoplasty (DSEK). Its use in treating all forms of endothelial disease is very promising.
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January 4th, 2011
Recently, a new study confirms the importance of a healthy lifestyle in reducing the risk of developing age-related macular degeneration (AMD).
The University of Wisconsin conducted a study on the lifestyles of over 1,300 postmenopausal women. They concluded that women who smoked and ate poorly were three times as likely to develop macular degeneration than those women who did not smoke and followed a healthy diet…. lots of vegetables, whole grains, fruits and lean sources of protein.
In addition, the study indicates that those who exercise regularly can also reduce their risk of developing age-related macular degeneration.
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