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Eye Conditions

Please choose from the following common disease of the eye to learn more.
Blepharitis   Dry Eye
Cataracts   Glaucoma
Conjunctivitis   Macular Degeneration
Diabetic Retinopathy   Vitreous Floaters

Blepharitis

Blepharitis is inflammation of the eyelid. It commonly occurs from Seborrhea, an oily build-up around the lid lashes, or staphylococcus.

There is a colonization of staphylococcal bacteria at the margin of the eyelid. This causes redness, scaling and chronic irritation on the lid edge. If it continues, the oily flakes along with bacteria fall into the pocket between the eyelid and the eye, causing secondary inflammation of the conjunctiva.

On awakening, the eyes may have increased matter and may feel gritty and sandy. If this continues for months or years, the eyelashes may turn in or fall out. In many situations the meibomian (oil) glands at the base of the eyelashes become involved and the and the glands stagnate and the secretion accumulates in the lids. The lids thicken an undergo degenerative changes and secondary inflammation, including styes and chalazions.

When Blepharitis is present, it demands long term care and meticulous hygiene, forever. It may clear or appear to clear up, but it is chronic and recurrent.

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Cataracts

When the lens (located behind the pupil) becomes cloudy or opaque, it is called a Cataract. Cataracts can cause blurry vision, glare (such as from car headlights), double or distorted vision, faded colors, and trouble with depth perception (such as judging the distance to a curb while driving). Generally occurring in people over the age of 60, cataracts are usually caused by aging. Other causes include certain medications, systemic diseases, injuries, and diabetes. Changing the prescription of eye glasses may be necessary and helpful as cataract progress. At some point, changing the glasses will be of no benefit and, if a certain level of vision has been reached, cataract surgery becomes an option available to you.

Although many people believe lasers are used to remove a cataract, this is not true. Lasers are never used to remove a cataract. Modern cataract surgery today is performed using a process called Phacoemulsification. During this process, an ultrasound is used to break the cloudy lens in to many small pieces. These pieces of lens particles are then removed by vacuum through the initial incision. The cloudy lens is then replaced with a clear man-made lens thus restoring vision to the eye.

Modern technique requires no stitches to seal the wound. Surgery is performed on an out-patient basis at Baylor Surgicare, near Baylor Medical Center of Garland. Healing time is about five weeks during which you will be instructed to use various eye drops to help the healing process. Once healed, you will be given a fine tuned glasses prescription to provide you with the best vision possible.

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Conjunctivitis - "Pink Eye"

The conjunctiva is the delicate outer covering of most of the eye and the inner lining of the eyelids. It extends from the lid edge, inside the lids, an dup over the white sclera of the eye to the edge of the cornea. It contains many small blood vessels that are most evident when the eye is irritated.

When bacteria, viruses, allergies, chemicals or seborrhea get into the eye, they cause an irritation which produces an increase in the size and visibility of the blood vessels of the conjunctiva. This irritation produces mucus, watering, thick matter or discharge or a combination of these. The eye usually feels irritated, often scratchy and burning. The vision may blur to a varying degree from these excretions. The eyelids may feel stuck together in the morning.

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Diabetic Retinopathy

If you have diabetes, your body does not use and store sugar properly. High blood sugar levels can damage blood vessels in the retina causing mild to severe vision loss. This damage is referred to as diabetic retinopathy.

An early stage of diabetic retinopathy is commonly known as background retinopathy. Tiny blood vessels within the retina leak blood or fluid causing the retina to swell or to form deposits called exudates. It is possible to have background diabetes with no affect to vision. However, if vision is affected it is the result of macular edema or macular ischemia.

Macular edema is a swelling of the macula, the most sensitive part of the retina in terms of detail recognition. Macular ischemia results from small blood vessels closing causing the macula to receive insufficient blood supplies for proper function.

Proliferative diabetic retinopathy is a more advance stage of diabetic retinopathy during which abnormal new blood vessels begin to grown on the retinal and optic nerve. These new vessels (neovascularization) can leak causing mid to severe vision loss. Scar tissue associated with neovascularization can pull and wrinkle areas of the macula and retina causing visual distortion. Laser treatment may be recommended to decrease fluid leakage and or to shrink abnormal vessels and reduce the chance for future abnormal vessel growth.

Maintaining strict control of your blood sugar and yearly dilated exams by an ophthalmologist will significantly lower your risk of vision loss. Remember, even if you notice no sign of visual problems it does not mean diabetic retinopathy is not occurring.

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Dry Eye

Dry Eye is a common problem that occurs when not enough tears are produced to keep the eye healthy and comfortable. Symptoms include stinging or burning eyes. scratchiness. stringy mucus in or around the eye. irritation from wind or smoke. blurred vision, excess tearing, and difficulty wearing contect lenses. "But how can my eye be dry when it is tearing all the time?" If normal tearing does net keep the eye wet enough. the eye becomes irritated. This irritation causes the eye to overproduce teors to the point that fhey may overflow from your eye. Tear production normally decreases as we age. Women are more frequently effected fhan men. This is especially true after menopause. Dry eye can also occur when performing visually concentrated tasks such as reading. working on a computer. or watching TV. we become involved in what we ore doing and simply forget to blink often enough. Circulating air such as fans and cor air-conditioning can dry out the eyes as can different types of medication such as antihistimines, pain relievers. and diuretics. Dry eye can also be associated with certain medical conditions such as Sjogren's syndrome. Treatment generally includes:

1) remembering to blink frequently enough
2) avoidence of direct air currents and
3) use of preservative-free artificial tears as needed.

As always, a thorough exam will help determine the best course of treatment.

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Glaucoma

Glaucoma is a disease of the optic nerve, the part of the eye that carries the images to the brain. The eye constantly produces and drains a clear fluid called aqueous humor. This is different than the tears produced on the surface of the eye.  If the eye cannot drain the fluid quickly enough, a pressure builds in the eye much like standing on a garden hose builds pressure in the hose. As pressure increases, damage to the optic nerve may occur causing blind spots to develop. These blind spots usually affect peripheral vision first and may go undetected until the nerves are significantly damaged. If the entire nerve is destroyed, the result is irreversible blindness. Glaucoma is referred to as the “silent thief of vision” because permanent and serious vision loss can occur before you are aware of any changes to your vision. Risk factors include age (generally over 40), a positive family history of glaucoma, African American race, and past eye trauma).

Regular eye exams by an ophthalmologist are the best way to detect glaucoma.  A glaucoma screening for pressure (such as screening tests at local health fairs) is not sufficient to determine if you have glaucoma.

Pressure may appear normal leaving optic nerve damage undetected without further testing. These tests may include inspection of the drainage system (Gonioscopy), evaluation of the optic nerve (Ophthalmoscopy), testing of the peripheral vision (Visual Field Test), scanning the thickness of the nerve fiber layer (Ocular Coherence Tomography), and digital documentation (Fundus Photography), for a permanent record to reference any optic nerve changes for future comparison.

Potential treatment includes topical eye drops, laser surgery, or surgical intervention followed by periodic exams to monitor your condition.

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Macular Degeneration

Age-Related Macular degeneration (AMD) is the leading cause of central vision loss in the United States in the population over the age of 55. Macular degeneration is caused by the deterioration of the central portion of the retina. This central area is called the macula and is responsible for focusing the central vision of the eye and controls our ability to see images in fine detail. When the macula does not work properly, central vision can become blurry along with areas of darkening and distortion. Although macular degeneration reduces vision centrally, it does not affect the eye’s side vision. For example, you may see the outline of a picture in the newspapers but not be able to see the central detail of the picture. Even in advanced cases, macular degeneration does not result in total blindness and in many cases its impact on your vision may be minimal.

The most common type of macular degeneration is called age related macular degeneration and it is either “dry” or “wet”. Dry macular degeneration is caused by the aging and thinning of the tissues of the macula. Wet macular degeneration accounts for about 10% of all cases and results when abnormal blood vessels form underneath the retina and leak fluid or blood – blurring the central vision.

The causes of macular degeneration are poorly understood. Much research is ongoing in an effort to prevent and cure this vision threatening condition. Although there is no cure for dry macular degeneration, nutritional supplements may slow the process.

Research has shown that patients with wet AMD have a certain factor in their eye that is critical in causing the abnormal blood vessels to form under the retina. This factor is called vascular endothelial growth factor, or VEGF. New drug therapies, such as Avastin, have been developed to block the trouble-causing VEGF. Stopping VEGF can reduce and even reverse the growth of the abnormal blood vessels, slow the leakage, slow the vision loss and can sometimes even improve vision.

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Vitreous Flashes and Floaters

The spots you see floating before your eyes are not your imagination, these are vitreous floaters and occur for various reasons. This condition is almost always a normal part of the aging process and affects everyone to some degree.

The most common of these spots are opacities of varying size, shape and density suspended in the vitreous gel inside the eye. The vitreous humor is the gel-like substance that fills the inside of the eye. As we become more mature, this gel liquefies and this allows small particles to float through he vitreous body. The light passing through the  eye falls upon these floating particles and casts a shadow on the retina that our brain perceives as objects such as small grayish flies, spiders, cobwebs, straws, strings, circles, gnats, dots, etc. They are best seen against a neutral background such as plain paper, a well lit wall, or the blue sky.

Some floaters are small remnants of eye tissue formed before birth.  It is more common for you to experience floaters if you are myopic (nearsighted), due to the long length of the eye, however, everyone will experience theses symptoms at some point during their lifetime. Degeneration, ocular surgery and other diseases of the eye can increase the number or size of floaters. After cataract surgery, your floaters may be more visible as more light is capable of entering the eye.

Vitreous separation caused from the normal aging process or injury of the eye causes the vitreous body to shrink and pull away from the back surface of the eye, being replace with a more liquid form of vitreous.  If you experience brief flashes of light in the outer aspects of your vision, this is usually due to vitreous traction on the retina. As the vitreous “jiggles” and “shakes”, the brain interprets this traction or tugging on the retina as flashes of light. These flashes can be quite frequent until the vitreous completely separates from the back of the eye, at which point it is called a posterior vitreous detachment. Flashes can be a sign of a much more urgent situation – a retinal detachment.  It is in your best interest to have a dilated exam if any flashes increase or persist.

The separation of the vitreous may cause bleeding which may appear as many black pepper spots or sand-like floaters. Vitreous separation is usually not a problem as long as it does not result in a retinal tear.

Ordinary floaters are a nuisance and do become less prominent over time. However, floaters can be a sign of a more serious condition and should not be ignored.  A retinal tear or detachment may produce a sudden onset of floaters, or appear as a cloud or curtain obscuring a portion of your vision. It is important that a thorough retinal examination be performed with any changes or an increase in floaters to check for retinal holes, tears or detachment which would require immediate surgery.

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