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Limbal Relaxing Incisions

Astigmatism is a relatively common eye disorder that causes the vision to be blurred or distorted. It occurs when the lens part of the eye, known as the cornea, isn’t perfectly curved and instead resembles a football rather than a soccer ball. This means that the light entering the eye comes through at a distorted angle, making the object appear blurry and out of focus. There are several ways in which it is possible to treat astigmatism, including laser eye surgery and corrective lenses. However, another possibility is a solution referred to as limbal relaxing incisions.
 

What are limbal relaxing incisions?

Limbal relaxing incisions are microscopic cuts to an area in the eye known as the limbus. This helps to relax the curve in the cornea and improve its ability to focus light correctly. It can significantly improve your astigmatism and the overall quality of your vision.
 

Am I a good candidate for limbal relaxing incisions?

If you have astigmatism, are over 18, in good general health and have no major eye conditions, then chances are you are a good candidate for limbal relaxing incisions. Make an appointment with your eye doctor to discuss your candidacy further.


Refraction Test

A refraction test, also called a vision test, is usually performed as a part of a routine eye examination. The purpose of this test is to determine if a person has a refractive error which would then mean the patient would need glasses or contact lenses.
 

What Is The Normal Value for Refraction Test?

A value of 20/20 is normal (optimum) vision. This means that individuals who have 20/20 vision are able to read letters that are 3/8-inch (1 centimeter) tall from 20 feet (6 meters) away. The normal uncorrected vision (without glasses or contact lenses) refractive error is zero (plano). Individuals who don’t have 20/20 vision, have what is called a refractive error. A refractive error means that the light is not bending properly when it passes through the lens of the eye. The refraction test will tell the doctor what prescription lens should be used in order to have 20/20 vision.

For people over age 40 who have normal distance vision but difficulty with near vision, a refraction test with a small type size is used to determine normal near vision and the correct power of reading glasses.
 

How Is The Refraction Test Performed?

The test is performed by having the patient seated in a chair that has a special device (called a phoropter or refractor) attached to it. The patient looks through the device and focuses on an eye chart 20 feet (6 meters) away. The device contains lenses of different strengths that can be moved into the patient’s view. The test is performed one eye at a time. If the patient is wearing contact lenses, they should be removed before the test.

In case the final vision is less than 20/20 even with lenses, then there is probably another non-optical problem with the eye. The vision level achieved during the refraction test is called the best-corrected visual acuity (BCVA).
 

What Are The Causes of Abnormal Refraction Test Results?

  • Abnormal results may be due to:

  • Astigmatism (abnormally curved cornea causing blurred vision)

  • Hyperopia (farsightedness)

  • Myopia (nearsightedness)

  • Presbyopia (inability to focus on near objects that develop with age)
     

Other conditions under which the test may be performed:

  • Corneal ulcers and infections

  • Loss of sharp vision due to macular degeneration

  • Retinal detachment (separation of the light-sensitive membrane (retina) in the back of the eye from its supporting layers)

  • Retinal vessel occlusion (blockage in a small artery that carries blood to the retina)

  • Retinitis pigmentosa (an inherited disorder of the retina)
     

There is an art to refraction and the optometrist will always answer the patient’s questions and as well as discuss their findings. Based on the results of the refraction test, they can determine the amount of myopia, hyperopia or astigmatism.
 


Macular Degeneration

Macular degeneration, commonly referred to as age-related macular degeneration (AMD), is the single largest cause of sight loss in the developed world and affects more than 10 million Americans. It usually affects people over the age of 60, but has been known to affect those who are younger. It is a painless condition that usually affects both eyes with the loss being experienced in the central vision. It does not affect the peripheral vision, meaning that it does not cause total blindness.
 

What is the macula?

The macula is the most sensitive part of the retina and is responsible for our central vision and what allows us to see fine details with clarity.
 

Varieties of AMD

 

Wet AMD

Wet AMD is one variety of the condition in which abnormal blood vessels grow into the macula, leaking blood or fluid which then causes scarring and a rapid loss of central vision. Wet AMD can develop suddenly and rapid referral to a specialist is essential as it can be treated if caught quickly.
 

Dry AMD

Dry AMD is the most common variety of age-related macular degeneration and is a gradual deterioration of the retina as the cells die off over time and are not regenerated. Up to 15% of people with dry AMD go on to develop wet AMD, and so any sudden changes in your vision should be followed up with your optometrist as soon as possible.
 


Demodex

What Is Demodex?

The Demodex mite is a type of parasite that lives on humans and can reside in hair follicles and sebaceous glands. These mites are arachnid (eight-legged) and invisible to the naked eye, varying in size from 0.1mm to 0.4 mm long. They typically live on the face and in the hair follicles of the eyebrows, eyelids, roots of the eyelashes, facial hair, and around the ears and are associated with various skin problems of the eyes and face, such as blepharitis and acne rosacea.

Demodex can affect humans at any age, but their presence increases in prevalence with increasing age. Immunity compromised patients such as diabetics, patients on long-term corticosteroids or chemotherapy, or patients who have HIV/AIDS also have increased risk and prevalence of Demodex infection. Usually, when the immune system is weakened and the parasitic population has colonized, this disease can badly damage the skin.
 

How Can Demodex be Transmitted?

For transmission of mites from one person to another, direct contact of hair and sebaceous glands on the nose, or dust containing eggs is required. Since the disease processes begin when there is an overpopulation of Demodex, the vast majority of cases of mites go unobserved and don't show any adverse symptoms. However, in certain cases, the mite populations migrate and multiply in the eyelashes.
 

What Are The Types of Demodex?

There are two existing types of Demodex mites: the longer kind, Demodex folliculorum, which live in the hair follicles and the short ones, Demodex brevis, which live in the sebaceous (oil) glands in the skin.
 

What Are The Symptoms of Demodex?

In the early stages, there are often no noticeable symptoms, but if left untreated Demodex can progress. Symptoms vary among patients and may include dry eye, red eyes, severe itching along the eyelid margin and eyebrow, especially in the morning, eyelid irritation, burning sensation, foreign body sensation that seems to originate beneath the eyelids, heavy lid, and blurry vision. One of the earliest signs of mite infestation is cylindrical dandruff (CD), which is the accumulation of fine, waxy, dry debris that collects at the base of the lash and extends up to 2 mm along the length of the lashes and is most noticeable on the upper lashes.
 


Low Vision

Low vision is a term for conditions that result in reduced sight and cannot entirely be corrected with eyeglasses, contact lenses, medicines or surgery. Several eye diseases or conditions can cause low vision and here we will discuss the four most common causes of low vision and their risk factors.
 

Macular Degeneration

Macular degeneration is a disorder that affects the retina, which is the light-sensitive tissue lining the inside of the eye. Within the retina, the area responsible for sharp central vision (called the macula) deteriorates, causing blurred vision. This can cause a blind spot in the central area of vision, which leads to low vision.

There are two types of macular degeneration – non-exudative (dry form) and exudative (wet form). The dry form usually progresses slowly, while the wet form causes more rapid and severe vision loss due to abnormal blood vessels developing under the macula and leak fluid and blood. The biggest risk factor for macular degeneration is age. Other risk factors include genetics, race, smoking, and high blood pressure.
 

Diabetic Retinopathy

Diabetic retinopathy is a diabetes complication that affects the eyes. High blood sugar levels cause damage to blood vessels in the retina. These blood vessels can swell and leak (called macular edema). Sometimes they close, stopping blood from passing through (called macular ischemia). At first, diabetic retinopathy may cause no symptoms or only mild vision problems. However, over time, it can severely damage the retina, leading to low vision. Anyone who has diabetes can develop diabetic retinopathy. The risk increases for those who have had diabetes longer, as well as those with poor control of blood sugar levels, high blood pressure or cholesterol as well as those who smoke.
 

Cataracts

A cataract is a clouding of the lens in the eye that affects vision. This clouding can block the light from reaching the retina at the back of the eye, resulting in a general loss of vision. In some cases, a cataract can be surgically removed. Cataract surgery has a high success rate in otherwise healthy eyes but it is not always possible for people who also have other eye diseases. While the risk of cataract increases as you get older, other risk factors include diabetes, smoking, alcohol use, and prolonged exposure to ultraviolet sunlight.
 

Glaucoma

Glaucoma is a disease that damages your eye’s optic nerve. Most commonly, this occurs when fluid builds up in the front part of your eye which increases the pressure in your eye, damaging the optic nerve. There are four types of glaucoma: open-angle, normal tension, angle-closure, and secondary.
 


Implantable Contact Lenses

If you dislike wearing glasses and you are not a suitable candidate for laser eye surgery, then implantable contact lenses (ICL’s) may offer the permanent vision correction solution that you require.
 

How do implantable contact lenses work?

Implantable contact lenses basically work in exactly the same way as standard, external contact lenses do. ICL’s alter the shape of the cornea in order to correct refractive errors such as near and far-sightedness, and astigmatism. However, unlike non-permanent contact lenses, ICL’s are surgically placed inside the eye rather than over the top of it. 

Implantable contact lenses are also sometimes known as phakic intraocular lenses (IOL’s). The reason for this is because the two share a number of characteristics. IOL’s are seen in cataract surgery where they take the place of the affected natural lens after it has been removed. However, when used as implantable contact lenses they work in conjunction with the natural lens of the eye in order to correct your vision.
 

What happens during the procedure?

The procedure requires your surgeon to make a tiny incision into the cornea to allow access to the natural lens underneath. The ICL is then inserted through the incision and placed either in front of or behind the iris which is the colored part of your eye and in front of the natural lens. The incision into the cornea is able to heal naturally without stitches, and the entire process is extremely quick.
 

Will it hurt?

Your surgeon will give you anesthetic, usually in the form of eye drops, ahead of the procedure and therefore you should experience very little, if any, discomfort.
 


Cataracts

If you’ve been diagnosed with cataracts, you may wonder if cataract surgery is right around the corner. Not to worry. There are many preventive steps you can take to slow the progression of cataracts and preserve your vision. That doesn’t mean you won’t eventually need surgery, but you can at least delay the need for quite a while.
 

Protect Your Eyes from the Sun

The National Eye Institute recommends protecting your eyes from the sun's harmful ultraviolet (UV) and high-energy visible (HEV) rays by always wearing good quality sunglasses while outdoors. Look for sunglasses that block 100 percent of UV rays and absorb most HEV rays with large lenses or a close-fitting wraparound style. Remember that the peak hours for sun exposure are between 10 am and 3 pm or 11 am and 4 pm during daylight savings time and that the sun’s rays are strong enough to pass through clouds, so you need your sunglasses every day.
 

Avoid Steroid Eye Drops

Steroid eye drops are routinely prescribed to treat dry eyes or an arthritic flare-up in the eyes. Unfortunately, they can also speed up the progression of cataracts. Talk to your Optometrist about how you can manage both conditions without inadvertently making your cataracts worse – and hastening the need for surgery.
 

Check Your Medications

There are over 300 commonly prescribed medications with side effects that may impact cataract progression. Since your primary care physician may not have access to your eye doctor’s medical records, be sure to ask your doctor if your current medications will affect your cataracts. If you must stay on the medication, it’s even more important to avoid sunlight during peak hours and to wear sunglasses.
 


Common Eye Disorders Explained

People will often experience some type of eye disorder during the course of their lives. While the majority of these are minor and don’t require treatment, even minor problems can have significant adverse impacts on your vision, and you should seek the guidance of a licensed medical professional.

We’ve compiled some of the most common eye disorders, their causes, and treatments below. This guide is meant to be educational and not all of the disorders listed below require medical attention, but if you are concerned, you should contact your medical provider immediately.
 

Eyestrain

Eyestrain is a prevalent eye disorder. Most people have experienced this at one time or another. This optical issue can be caused by placing excessive strain on the eyes. It often occurs when reading, viewing a screen or driving for too long. The eyes may begin to feel tired, or a mild burning sensation can occur. Simple rest is often enough to correct this issue. However, if you continue to feel discomfort for a few days, its time to visit your doctor.
 

Eye Redness

Eye redness can often be a minor issue that is caused by the inflammation or irritation of blood vessels near the eye’s surface. This can be caused by an irritant, lack of sleep, or allergies. If the redness in your eyes is linked to some type of traumatic injury, you should see a doctor. Typical treatments for this condition are eye drops to help lubricate the eye, resting your eyes, or taking medication to treat your allergies. Eye redness can also be a warning sign for conjunctivitis, pink eye, or sun damage. These conditions should receive medical treatment from a licensed professional.
 

Night Blindness

Some people find that they have difficulty navigating in darker areas like movie theaters, dark rooms, or driving at night. Several possibilities could lead to night blindness. Some may have been born with this condition, or it could be the result of a degenerative retina. These issues cannot be resolved by a medical professional. However, night blindness can also be caused by nearsightedness, vitamin A deficiency, cataracts, or keratoconus. All of these issues can be corrected by a doctor.
 

Strabismus (Crossed Eyes)

Crossed eyes are not a condition that you can fix by yourself. This issue is seen in the eyes not properly lining up with each other. However, an optometrist may be able to help correct this issue, so it’s worth scheduling an appointment.
 

Nystagmus (Shaky Eyes)

Nystagmus is the constant shaking of the eyes of which the patient has no ability to control it. Medical professionals have several options for treatment at their disposal. Sometimes vision therapy is enough to strengthen the muscles and correct the issue. If this doesn’t work, surgery can also correct the problem. Your doctor can discuss your best options with you.
 

Colorblindness

Red and green color blindness is the most common form of colorblindness, although other types may affect your ability to see different color combinations. Color blindness is caused because the eyes lack the appropriate “cones” that help to interpret and differentiate these colors. This makes certain colors appear identical to colorblind individuals. Very severe forms of colorblindness only allow individuals to see shades of gray, but this is very rare.

While there is no current treatment for the correction of color blindness, special contact lenses or eyeglasses can be prescribed to help.
 

Uveitis

This condition is the inflammation of the uvea. There are several potential causes of uveitis that can be very serious, but uveitis is an umbrella phrase that covers all causes that create inflammation of the middle layer of the eye.

Some of these causes can be compromises of the immune system, like AIDS, rheumatoid arthritis, or ulcerative colitis. If you have light sensitivity, blurred vision, eye pain, and eye redness that lasts more than a few days you should see your eye care professional.
 

Knowing When to Get Help

Your eyes are a sensitive and critical organ for your health and small injuries or damage to your eyes can have lasting effects. For this reason, if you sense that something is wrong with your eyes, it’s always a good idea to visit your eye care professional. Additionally, make sure to get your regular annual eye exams which can help detect any issues that your eyes may be having and assure that you get the appropriate care more quickly.


Glaucoma Testing

You might be surprised at how many tests eye doctors use to diagnose glaucoma. A proper diagnosis requires careful evaluation of many aspects of your eye’s health – from eye pressure to cornea thickness to the health of your optic nerve. This article describes how your eye doctor assesses your risk and all the tests needed to properly diagnose glaucoma.
 

Risk Factor Assessment

Your eye doctor will begin by assessing your risk level for developing glaucoma. This will help determine the frequency and extent of testing needed. Through a family history and medical questionnaire, the eye doctor is looking for the following risk factors:

  • Over the age of 60

  • Ethnic background such as African or black Caribbean descent, Hispanic, or Asian

  • Family history of glaucoma, such as a sibling or parent with glaucoma

  • History of eye conditions, injuries or surgeries

  • Prolonged corticosteroid use (eye drops, pills, inhalers or creams)

  • Chronic conditions that affect blood flow, such as migraines, diabetes, low blood
    pressure or hypertension

  • Current or former smoker
     

If you’ve already had a comprehensive eye exam, your eye doctor will also consider these risk factors:

  • Eye pressure higher than normal (above 21 mm Hg)

  • Thin corneas (less than 0.5 millimeters)
     

Your type of eyesight is also important. People with farsightedness are at a higher risk for narrow-angle glaucoma, a more serious type that can advance quickly. While nearsightedness is associated with open-angle glaucoma, which progresses slowly without any symptoms.
 

Standard Glaucoma Tests

During a comprehensive eye exam, your eye doctor will always check for glaucoma, regardless of the risk level. This provides a baseline for comparison as you age. There are two tests: tonometry and ophthalmoscopy.
 


Seasonal Allergies And The Eyes

Seasonal allergies is a medical condition similar to other forms of allergies that occur when the body's immune system reacts to an external material in the environment during seasonal periods when plants and trees are pollinating. Seasonal allergies have a tremendous effect on millions of individuals annually causing a negative effect on eyesight. Seasonal eye allergies cause the eyes to become itchy, watery and red which in medical terms is referred to as allergic conjunctivitis. There are many allergens that can make our eyes go itchy and very red including dust, pollen, and smoke. These allergens, however, vary from one person to another. For example, while dust can cause itchy eyes for me, it might not be the same for you as it all depends on our immune system and the way it reacts against such substances.

When something is regarded as a dangerous substance by the eye, a chemical response is elicited to fight against the allergen which is what leads to the itchiness, redness, and soreness in the eyes. These reactions are usually a result of a change in seasons, mostly occurring in the spring when plants and trees are pollinating and during the fall when the ragweed plants are pollinating.
 

Seasonal Allergies Effect on the Eyes

As we mentioned earlier, allergens affect people differently, but there are general ways in which everyone reacts. You would know an individual is suffering from allergies through the following symptoms.

  • Teary eyes
    Since the eyes perceive substances like dust, smoke, pollens as harmful to the normal conditioning of the eyes, there is an automatic release of water in order to clean the eyes which is more of a defense mechanism against these foreign items.

  • Swollen eyes
    After the entry of these foreign items, it is very natural to feel itchy and want to scratch the affected eyes. During the scratching, the skin covering the eyes would become swollen due to continuous friction.

  • Dry eyes
    Dry eyes occur most times during winter seasons, not because of allergens like dust or pollen, but whenever there is extreme cold or snow. This causes the eyes to become dry which leads to soreness and redness.

  • Itchy Eyes
    Allergens are carried by air and could end up in your eyes at any time. A reaction to these allergens would cause your eyes to feel irritated from the inside and would create the urge to then scratch your eyes in an attempt to provide some relief.

  • Red Eyes
    Redness of the eyes is usually accompanied by other symptoms such as itchy eyes which cause the eyes to become swollen and very red. There are also capillaries inside the eyes that can become red whenever one is faced with an allergy.
     

Prevention

It is nearly impossible to prevent allergens due to the fact that they are carried around by air. There are, however, some things that can be done by you to help reduce your chances of being exposed to allergens. One of the first precautions is to remain indoors on windy days since more allergens are carried around at a faster pace. If it is necessary to go out, be sure to wear a pair of sunglasses that provide adequate coverage for the eyes. Furthermore, wearing pollen masks and/or sunglasses when working in the yard could help to prevent anything from blowing into your eyes.
 

Treatment

Whenever you are suffering from allergies, be sure to stay hydrated, use any doctor recommended eye drops you may have to help reduce irritation, and if you use contact lenses, switch to a pair of glasses to add some extra protection as well as prevent further eye discomfort. Lastly, try to avoid scratching your eyes as much as possible to prevent any additional complications.