The following is a list of some eye conditions we commonly encounter and manage.
Allergic conjunctivitis is inflammation of the conjunctiva (the clear lining of the sclera and inner eyelids) caused by exposure to some external allergen. It may be triggered by pollen, dust, mold, animal dander, cosmetics, or other airborne allergens. The eyes become red, itchy, and swollen with a watery discharge. Treatment may include topical medications, artificial tears, and cold compresses.
Amblyopia (Lazy Eye)
Amblyopia is weak vision in one or both eyes without any detectable anatomic damage to the eye. Amblyopia can be caused by strabismus (eye misalignment) or a large difference in the prescription of one eye compared to the other eye. High amounts of astigmatism can also contribute to amblyopia. Treatments include glasses, occluding or patching the good eye, or blurring the good eye with certain drops to strengthen the weaker eye. In some cases, if there is an eye turn, surgery may be necessary to straighten the eyes.
Although astigmatism sounds like horrific blinding eye disease, is a common refractive error caused by an irregular shaped eye. This results in blur and overlapping ghost images in the vision and blurred vision at night. It is easily corrected with glasses or contact lenses.
Anterior Uveitis (iritis) is inflammation of the iris and ciliary body resulting in a painful red eye. The key symptoms include a deep eye ache and a marked light sensitivity. Often, no cause for the inflammation is detected, however, it can sometimes be associated with underlying systemic inflammatory diseases such as arthritis, sarcoidosis, Crohn’s disease, irritable bowel, lupus, and other autoimmune disorders. For recurrent episodes, certain blood tests can help determine a cause. Anterior uveitis is treated with steroid drops and cycloplegic agents. In severe cases, steroid injections to the eye are required to treat the inflammation.
Blepharitis is a common inflammatory disorder of the eyelids. It is a chronic condition that presents with scaly deposits on the eyelashes and red swollen lids. Other symptoms include foreign body sensation, tearing, burning, and occasionally blurred vision. A common underlying skin disorder associated with blepharitis is rosacea, which is characterized by redness of the cheeks and nose. Blepharitis is treated with special eyelid cleaning regimens, topical medications, and sometimes oral medications.
Bacterial conjunctivitis is a red eye caused by a bacterial infection. Symptoms include redness, swelling of the lids, irritation or foreign body sensation, and a thick yellow or greenish discharge. Treatment includes antibiotic drops and ointments.
A cataract is a condition in which the crystalline lens inside the eye becomes cloudy or opaque. It occurs commonly in people over the age of 60 but may occur at any age. Cataracts cause blurred vision because light cannot easily pass through the cloudy lens to the retina, the light sensitive lining in the back of the eye. For mild to moderate cataracts, periodic eyeglass prescription updates can improve the vision. When the reduced vision interferes with daily activities and lifestyle, surgery with an intraocular lens implant may be necessary.
Diabetic retinopathy is a complication of diabetes that affects the small blood vessels of the retina – the light sensitive lining of the back of the eye. It usually takes many years to develop but it may occur sooner if blood sugar levels are poorly controlled. In nonproliferative diabetic retinopathy, the retinal blood vessels leak blood and fluid and can cause swelling of the retinal tissue (macular edema). As the retinopathy progresses, tiny fragile blood vessels may grow into the vitreous (the clear jelly-like fluid that fills the main cavity of the eyeball) leading to proliferative diabetic retinopathy. If these vessels break and bleed into the vitreous, severe vision loss may result. Laser treatments and various drug injections to the eye have been effective in reducing vision loss. For severe cases, sometimes a vitrectomy is performed in which the vitreous is removed and replaced with a clear fluid. Tight control of blood sugars has been shown to decrease the risk of diabetic retinopathy.
Dry Eye Syndrome
Dry eye syndrome (DES) is a condition caused by either inadequate tear production or increased evaporation of the tears due to poor tear quality. Symptoms include burny, sandy, and gritty eyes, usually worsening later in the day. Common medical conditions that can cause dry eye include arthritis, Sjogren’s syndrome, and thyroid disease. Contact lenses and certain medications can also contribute to dry eye syndrome. Treatment includes artificial tears, topical cyclosporine drops (Restasis), punctal occlusion (closure of the opening to the tear duct with tiny plugs), and nutritional supplements such as omega-3 fish oil. Treatment should be tailored to each person’s specific presentation.
Episcleritis is inflammation of the episclera, the layer of the eye between the conjunctiva and sclera. It presents as a slightly tender red eye. It may involve a section of the eye and contain a raised nodule (nodular episcleritis) or it may be more ill-defined (diffuse episcleritis). It is often self-limiting but topical steroid drops are frequently used to treat the inflammation. It is important to differentiate episcleritis from scleritis. Scleritis involves the deeper eye tissues and requires oral medicines for treatment.
Flashes & Floaters
Flashes and floaters may be caused by many underlying conditions. Flashes that are brief in duration (seconds), usually involve a pulling or traction on the retina (the sensitive lining of the back of the eye). One common cause of intermittent flashes is a posterior vitreous detachment. This occurs when the vitreous gel, which fills the main cavity of the eyeball, separates from the retina. After separation, the flashes diminish and a floater becomes apparent in the vision. It is typically a benign condition, however, the retina should be examined carefully for holes, tears, or retinal detachment, since these conditions can cause identical symptoms. Retinal tears and detachments require prompt treatment. Flashes that last longer (several minutes) can be associated with migraines. These may occur with or without a headache. Other less common conditions associated with flashes include vascular problems, retinal disease, neurological problems, and brain tumors. While floaters are often a normal finding caused by free-floating debri in the vitreous, sudden onset floaters should be checked by an eye doctor as soon as possible.
Glaucoma is characterized by damage to the optic nerve caused by increased fluid pressure inside the eye. Left untreated, it can cause blind spots in the vision, reduced peripheral vision, and eventually blindness. It is usually painless and slowly progressive (open angle glaucoma) but it can occasionally occur suddenly with pain (angle closure glaucoma). Some other specific types of glaucoma include pigmentary glaucoma, neovascular glaucoma, and normal tension glaucoma. At Siegmund Eye Care, we have the latest technology to diagnose and manage glaucoma. Prescription eye drops are used to treat the disease by lowering the fluid pressure in the anterior chamber of the eye. Different drops either reduce aqueous humor production or increase aqueous outflow thereby lowering pressure. Glaucoma that is resistant to treatment with medicines can be treated by laser procedures (argon laser trabeculoplasty or selective laser trabectuloplasty). Advanced glaucoma can be treated surgically (trabeculectomy). Future procedures and new novel devices are in clinical trials and show significant promise.
Hordeolum (Stye)/ Chalazion
A hordeolum (stye) is localized painful raised area on the margin of the eyelids. It is caused by infection or inflammation of an oil gland. A chalazion is a lump in the eyelid caused by formation of granular tissue in an oil gland. Both conditions may be treated with hot compresses and topical or oral medications. Hordeolums usually respond rapidly to treatment while chalazia improve more slowly. Sometimes, a nonresolving chalazion must be excised or injected with steroids to shrink the nodule, especially if the appearance is cosmetically unacceptable.
Hyperopia is a condition in which light entering the eye focuses behind the retina instead of on the retina. It can result in blurred vision, both near and far, and eyestrain. It is corrected with glasses and contact lenses.
Keratitis is an irritation or inflammation of the cornea- the transparent membrane covering the iris and pupil. Symptoms include a red, irritated, light sensitive eye. Causes include dry eye syndrome, contact lens overwear, and various types of infections. Depending on the type of infection (viral, bacterial, fungal or others), specific topical medications are used for treatment.
Keratoconus is a hereditary degenerative corneal disease involving thinning and a cone-shaped protrusion of the cornea. It is usually bilateral but it may be asymmetric in presentation. Early in the disease, vision decrease is mild and may be corrected adequately with glasses. As keratoconus progresses, irregular astigmatism worsens and may necessitate the need for rigid contact lenses. In severe cases, a corneal transplant may be required to maintain vision. Corneal Collagen Cross-Linking with Riboflavin (CXL or X Linking) is a new treatment used to stabilize keratoconus, and prevent it from progressing. Intacs are a new surgical procedure for mild to moderate keratoconus. When inserted into the cornea, the Intacs segments make the central corneal profile flatter and more regular, and this reduces the optical defect.
Age related macular degeneration (AMD) is characterized by damage to the macula, the central and most sensitive part of the retina. The macula is responsible for detailed central vision. AMD is the leading cause of severe vision loss in Americans over the age of 50. There are two forms of the disease. The dry type, which is most common, progresses slowly and usually results in less severe vision loss. The wet type in which fragile blood vessels leak into the retina, causes scarring and more profound vision loss. Fortunately, patients with AMD retain their peripheral vision. Treatment includes certain antioxident supplements, such as Centrum Specialist, thought to slow the progrssion, and drug injections into the eye to stop the bleeding and the growth of the new fragile blood vessels (neovascularization). Laser treatments may also be used. Low vision devices are helpful in maximizing the remaining vision. For vision rehabilitation services, the Westmoreland County Blind Association (WCBA) has been a valuable local resource.
Myopia is a condition in which light coming into the eye focuses in front of the retina instead on the retina causing blurred distance vision. It occurs because the eye is either too elongated or the front of the eye (the cornea) is too curved. It is corrected with glasses, contact lenses, or laser vision correction.
Pingueculae & Pterygia
Pingueculae (singular form = pinguecula) are yellowish, slightly raised lesions that form on the surface tissue of the white part of your eye (sclera), close to the edge of the cornea. They are typically found in the open space between your eyelids, which also happens to be the area exposed to the sun.
While pingueculae are more common in middle-aged or older people who spend significant amounts of time in the sun, they can also be found in younger people and even children – especially those who spend a lot of time in the sun without protection such as sunglasses or hats.
Pterygia (singular form = pterygium) are wedge- or wing-shaped growths of benign fibrous tissue on the surface tissue of the sclera. Because pterygia also contain blood vessels, they are considered a fibrovascular growth. In extreme cases, pterygia may grow onto the eye’s cornea and interfere with vision.
Because a pterygium is usually quite visible to others, a person who has one may become concerned about their personal appearance. As with pingueculae, prolonged exposure to ultraviolet light from the sun may play a role in the formation of pterygia.
Presbyopia is a refractive condition in which the eye gradually loses it’s ability to change focus and see up-close (accommodation). It is caused by a decrease in the elasticity of the crystalline lens and a weakening of the ciliary muscle inside the eye. It is part of the normal aging process and usually begins affecting the near vision of people in their early forties. Reading glasses, bifocals, and multifocal contact lenses can correct the blurred vision.
Strabismis (Eye Turn)
Strabismis is a misalignment of the eyes (an eye that turns out or in). It is usually diagnosed in childhood and it is common cause of amblyopia (lazy eye). Treatment may include glasses, contacts, visual therapy (eye exercises), and sometimes muscle surgery.
The classic “pink eye”. Viral infections are a common cause of conjunctivitis (inflammation of the conjunctiva). We can diagnose it with a test of your tear film and perform proper treatment including a betadine wash to get rid of the virus. Symptoms of redness, irritation, itching, and discharge usually begin in one eye and shortly after, the fellow eye becomes involved. It is a contagious condition, often accompanied by an upper respiratory infection, and precautions such hand washing and refraining from direct contact with others should be taken to minimize the spread of the virus. Certain viral strains can affect the cornea causing corneal infiltrates and may require the use of specific eye drops. Antibiotic drops are ineffective and overprescribed. Other types of viral infections include herpes simplex and herpes zoster (the chickenpox virus). Each requires specific treatment.
Vision Over 40
If your “arms are not long enough” to read the menu or your phone, it’s time for multifocal lenses. The 85 million Baby Boomers in the United States and Canada (born between 1946 and 1964), probably noticed their eyes have changed. Most notably, presbyopia – the normal, age-related loss of near focusing ability – usually becomes a problem in our 40’s, requiring new vision correction solutions.
Vision Over 60
Just as our physical strength decreases with age, our eyes also exhibit an age-related decline in performance – particularly as we reach our 60’s and beyond. Some age-related eye changes are perfectly normal, but others may signal a disease process. It’s important to recognize signs and symptoms, and perhaps even more important to mitigate the effects of aging with some simple and common-sense strategies.