Eye Diseases

Blepharitis
Cataracts
Conjunctivitis
Diabetes and Your Eyes
Dry Eye
Glaucoma
Hordeolum (Stye)
Keratoconus
Macular Degeneration

BLEPHARITIS

Blepharitis

If your eyelid rims are red and irritated, if they burn and itch or if you’ve noticed an oily discharge or scaly skin around them, you may have an inflammatory problem called “blepharitis”. Blepharitis may be either of two main types or a combination of them.

Seborrheic blepharitis

Characterized by an excessive discharge of oil/grease from the skin around the eyelids. It is usually accompanied by similarly greasy hair and skin.

Staphylococcal blepharitis

A bacterial infection. It is more likely to result in infective eyelid conditions, such as styes.

What are the treatments?

To treat seborrheic blepharitis, keep the lid edges and surrounding skin clean by regularly scrubbing the area with a mild soap. Medicated pads specifically designed for this are also available. For staphylococcal blepharitis, ointments containing antibiotics and sulfonamides should be applied to the edges of the eyelids with a cotton ball.

While over-the-counter treatments for blepharitis are available, it is advisable to seek professional help the first time you experience the condition. If you have had blepharitis before and had experience with its treatment, using the over-the-counter ointments may be adequate. But, whether you have had the condition before or not, if the blepharitis is infectious, you should get appropriate treatment as soon as possible to reduce the risk of having the infection spread and cause more serious conditions.

CATARACTS

What is a cataract?

When the normally clear lens within your eye becomes cloudy and opaque, it is called a cataract. Cataracts vary from extremely small areas of cloudiness to large opaque areas that cause a noticeable loss of vision.

Who gets cataracts?

Cataracts are most often found in persons over the age of 60, but they are also occasionally found in younger people, including newborns.

What causes cataracts?

No one knows exactly what causes cataracts. It is known that a chemical change occurs within your eye that causes the lens to become cloudy. This may be due to advancing age or it may be the result of heredity, an injury or a disease. Excessive exposure to ultraviolet radiation present in sunlight, cigarette smoking or the use of certain medications are also risk factors for the development of cataracts. Cataracts usually develop in both eyes, but often at different rates.

Can cataracts be prevented?

Currently, there is no proven method to prevent cataracts from forming. Wearing sunglasses is a tremendous benefit as they protect your lens from harmful UV rays, which can speed up cataract formation. A diet rich in antioxidants (such as Vitamins A, C, E, Zinc Selenium & Magnesium) is seemingly also beneficial.

What are the signs / symptoms of cataracts?

Cataracts develop without pain or redness, some indications that a cataract may be forming include blurred or hazy vision, the appearance of spots in front of the eyes, or the feeling of having a film over the eyes. A temporary improvement in near vision may also occur and increased sensitivity to glare, especially at night may be experienced.

How are cataracts diagnosed?

A comprehensive eye examination by a Doctor of Optometry can determine if you have a cataract forming.

How are cataracts treated?

In the early stages of a cataract, where vision is only minimally affected, your optometrist can prescribe new lenses for your glasses to give you the sharpest vision possible. When the cataracts start to interfere with your daily activities and glasses cannot improve this vision, your optometrist will refer you to an eye surgeon who may recommend the surgical removal of the cataracts. The surgery is relatively uncomplicated and has a success rate of at least 95 percent.

When will I need to have cataracts removed?

Cataracts may develop slowly over many years or they may form rapidly in a matter of months. Some cataracts never progress to the point that they need to be removed. When a change in glasses can no longer provide functional vision, your optometrist will arrange a consultation with a cataract surgeon.

What happens after cataract surgery?

Intraocular lens implants, inserted in your eye at the time of surgery, serve as a “new lens” and sometimes give you good distance vision without glasses. Your near vision will still be blurred. Your Doctor of Optometry will prescribe new lenses for your glasses about 4 weeks after surgery to maximize your distance and near vision.

CONJUNCTIVITIS

What is conjunctivitis?

Conjunctivitis is an inflammation of the conjunctiva, a thin, transparent layer covering the surface of the inner eyelid and a portion of the front of the eye. This condition appears in many forms and affects people of all ages.

What causes conjunctivitis?

The three main types of conjunctivitis are infectious, allergic, and chemical. The infectious form, commonly known as “pink eye” is caused by a contagious virus or bacteria. Your body’s allergies to pollen, cosmetics, animals, or fabrics often bring on allergic conjunctivitis. Irritants like air pollution, noxious fumes and chlorine in swimming pools may produce the chemical form.

What are the signs / symptoms of conjunctivitis?

Common signs / symptoms of conjunctivitis are red eyes, inflamed inner lids, watery eyes, blurred vision and sandy or scratchy feeling in the eyes. With the infectious form, there may be a pus-like or watery discharge around the eyelids.

Since infectious conjunctivitis is contagious, what measure can be taken to prevent spreading this condition?

To avoid giving infectious conjunctivitis to others, keep your hands away from your eyes; thoroughly wash your hands before and after applying eye medication; do not share towels, washcloths, cosmetics or eye drops with others and seek treatment promptly. Small children, who may forget these precautions, should be kept away from school, camp and the swimming pool until the condition is cured.

Will conjunctivitis harm my eyes?

Certain forms of conjunctivitis can develop into a serious condition that may harm your vision. Therefore, it’s important to have your condition diagnosed and properly treated quickly.

How is infectious conjunctivitis treated?

Infectious conjunctivitis, caused by bacteria, is usually treated with antibiotic eye drops and/or ointment. Other infectious forms, caused by viruses, can’t be treated with antibiotics. They are fought off by your body’s immune system. But, some antibiotics may be prescribed to prevent secondary bacterial infections from developing.

How are the allergic and chemical forms of conjunctivitis treated?

The ideal treatment for both forms is to remove the cause of the allergy or irritation. For instance, avoid contact with any animal if it causes an allergic reaction. Wear swimming goggles if chlorinated water irritates your eyes. In cases where these measures won’t work, other types of prescription and over-the-counter eye drops are available to help relieve the discomfort.

DIABETES & YOUR EYES

What is diabetes?

Diabetes, simply stated, is a disease that prevents your body from making or using insulin which in turn leads to increased sugar levels in your bloodstream.

How does diabetes affect the eye?

Diabetes and its complications can affect many parts of the eye. Diabetes can cause changes in nearsightedness, farsightedness and premature presbyopia (the inability to focus on close objects). It can result in cataracts, glaucoma, paralysis of the nerves that control the eye muscles or pupil, and in decreased corneal sensitivity. Visual symptoms of diabetes include fluctuating or blurring of vision, occasional double vision, loss of visual field, and flashes and floaters within the eyes. Sometimes these early signs of diabetes are detected in a thorough optometric examination. The most serious eye problem associated with diabetes is diabetic retinopathy.

What is retinopathy?

Diabetic retinopathy occurs when there is a weakening or swelling of the tiny blood vessels in the retina of your eye, resulting in blood leakage, the growth of new blood vessels and other changes. If diabetic retinopathy is left untreated, blindness can result.

Can vision loss from diabetes be prevented?

Yes, in a routine eye examination, your optometrist can diagnose potential vision threatening changes in your eye that may be treated to prevent blindness. However, once damage has occurred, the effects are usually permanent. It is important to control your diabetes as much as possible to minimize your risk of developing retinopathy.

How is diabetic retinopathy treated?

In the early stages, diabetic retinopathy is monitored through eye health examinations.
If necessary, it may be treated with laser therapy. A bright beam of light is focused on the retina, causing a burn which seals off leaking blood vessels. In other cases, surgery inside the eye may be necessary. Early detection of diabetic retinopathy is crucial, as treatment is much more likely to be successful at an early stage.

Are there risk factors for developing retinopathy?

Several factors that increase the risk of developing retinopathy include smoking, high blood pressure, drinking alcohol and pregnancy.

How can diabetes-related eye problems be prevented?

Monitor and maintain control of your diabetes. See your physician regularly and follow instructions about diet, exercise and medication. See your optometrist, an eye care specialist, for a thorough eye examination when you are first diagnosed as a diabetic, at least annually thereafter and more frequently if recommended.

DRY EYE

What is “dry eye?”

The tears your eyes normally produce are necessary for overall eye health and clear vision. Dry eye occurs when your eyes do not produce enough tears or produce tears which do not have the proper chemical composition.

What causes “dry eye?”

Dry eye symptoms can result from the normal aging process, hormonal changes, exposure to environmental conditions, problems with normal blinking or from medications such as antihistamines, oral contraceptives, diuretics or antidepressants. Dry eye can also be symptomatic of general health problems, or other diseases or can result from chemical or thermal burns to the eye.

What are signs/symptoms of “dry eye?”

The common sign/symptoms include stinging, itchy, scratchy and gritty eyes; and sometimes having a burning feeling or a feeling of something foreign within the eye. You may experience increased dry eye symptoms on awakening. Some people experience an overly wet or watery eye. This is a natural reflex to comfort a dry eye.

How is “dry eye” diagnosed?

During the examination, your Doctor of Optometry will ask you questions about your general health, your use of medications and your home and work environments to determine any factors which may be causing dry eye symptoms. This information will help your doctor decide whether to perform dry eye tests. These tests use diagnostic instruments, which allow a highly magnified view of your eyes and sometimes use special dyes. Your doctor will evaluate the quality, the amount and the distribution of tears to detect signs of dry eyes.

Can “dry eye” be cured?

Dry eye usually cannot be cured, but your eyes’ comfort can be improved and eye health maintained through use of artificial tears. For more severe dry eye, gels and ointments can be used, especially at bedtime. In some cases, small plugs may be inserted in the corner of the eyelids to slow drainage and loss of tears. Treating any underlying systemic disease, or a change of diet can also be helpful at times.

Will “dry eye” harm my eyes?

If dry eye is untreated, it can harm your eyes. Excessive dry eye can damage tissue and possibly scar the cornea of your eye, impairing vision. Dry eye can make contact lens wear more difficult due to increased irritation and greater chance of eye infection. To keep dry eye symptoms in check, you and your Doctor of Optometry need to work together. Follow your doctor’s instructions carefully. If you have increased dryness or redness that is not relieved by the prescribed treatment, let your optometrist know as soon as possible.

GLAUCOMA

What is glaucoma?

Glaucoma is an eye disease in which it is thought the internal pressure of your eye rises to a point that the optic nerve is damaged. The pressure that builds up is due to a problem in the production, flow or drainage of fluid normally produced in your eye. Glaucoma is one of the leading causes of blindness in Canada.

What causes glaucoma?

The exact cause of glaucoma is not known. For some reason, there is an overproduction of fluid and / or the passages that normally allow fluid within your eye to drain out become clogged or blocked. This results in fluid building up within your eye and increasing pressure on the optic nerve. The nerve fibers and blood vessels in the optic nerve can easily be damaged by this pressure. An injury, infection or tumor in or around the eye can also cause the pressure to rise.

Who gets glaucoma?

Glaucoma most frequently occurs in individuals over the age of 40 and there is a hereditary tendency for the development of the disease in some families. Primary open-angle glaucoma causes damage at an earlier age and leads to blindness at a much greater rate. There is also a greater risk of developing glaucoma when you have diabetes, high blood pressure and eye injuries. Regular optometric examinations are important for all ages to assess your risk for glaucoma.

Why is glaucoma harmful to vision?

The optic nerve, at the back of the eye, carries visual information to the brain. As the fibers that make up the optic nerve are damaged, the amount and quality of information sent to the brain decreases and a loss of vision occurs.

Will I go blind from glaucoma?

If diagnosed at an early stage, glaucoma can be controlled and little or no further vision loss should occur. If left untreated, side awareness (peripheral vision) and central vision will be destroyed and almost complete blindness may occur.

How can I tell if I have glaucoma?

Primary open-angle glaucoma often develops painlessly and gradually. There are no early warning signs. It can gradually destroy your vision without you knowing it. Acute angle-closure glaucoma may have symptoms such as nausea, eye pain, red eyes, blurred vision and haloes around lights.

How is glaucoma detected?

A comprehensive ocular health examination is often the only way to detect glaucoma. Your optometrist can include in your examination a simple and painless procedure called tonometry, which measures the internal pressure of your eye. Your optometrist will also look into your eye to observe the health of the optic nerve and measure your field of vision.

How is glaucoma treated?

Treatment via eye drops and surgery is usually effective in maintaining your remaining vision. Once vision is lost due to glaucoma, it cannot be restored. This is why regular preventive eye exams are so important.

HORDEOLUM (STYES)

A small area of redness and pain on the margin of your eyelid may indicate that you have a stye, known in medical terms as an external hordeolum. A stye is a blocked gland at the edge of the lid that has become infected by bacteria, usually Staphylococcus aureus.

The area of redness and pain will eventually form a ‘point’. Until this occurs, warm compresses should be applied to the area for 15 minutes three-to-four times a day. The compresses should be followed by the application of sulphonamide or antibiotic ointment to the stye, available by prescription. Check with your eye care practitioner.

Once the stye has ‘pointed’, it can usually be expressed (squeezed gently to empty its contents), after which the lids should be cleaned. Treatment with the ointment should be continued until symptoms have cleared. Sometimes it is necessary for the stye to be lanced to assist with expression.

KERATOCONUS

Poor vision that cannot be corrected fully with glasses may indicate a condition known as conical cornea or keratoconus. A rare condition, keratoconus primarily affects people in their early 20’s.

With keratoconus, the cornea, the “clear window” at the front of the eye, may become thin and bow outwards. It is this irregular distortion of the cornea that makes vision correction with glasses less than optimal. For this reason other means of correcting vision are often necessary.

Vision correction with rigid gas permeable lenses.

Mild to moderate keratoconus is best corrected with rigid gas permeable contact lenses, which provide a smooth surface in front of the cornea, making clear vision possible. Because the lens is rigid, the tears between the lens and the cornea form a ‘liquid lens,’ which smoothes the irregularities of the cornea and makes clear vision possible again. Soft lenses, which ‘wrap’ onto the cornea and take up its shape much more closely than rigid lenses, are less successful at correcting keratoconus.

Corneal replacement surgery may be necessary

As keratoconus progresses, some scarring of the cornea can occur. Eventually, contact lenses may no longer be a successful treatment. Instead, the cornea may need to be replaced surgically with a cornea of more regular shape. The prognosis for corneal replacement surgery is generally very good.

MACULAR DEGENERATION

What is macular degeneration?

The macula is the central most part of the retina that is responsible for detailed sharp vision. It is used for reading, driving, recognizing people’s faces and fine work. Macular Degeneration is a condition that causes the centre of your vision to blur while the side or peripheral vision is unaffected. It is generally related to the aging process, and is also commonly referred to as Age-related Macular Degeneration (AMD). It is the leading cause of blindness in North America in adults over the age of 55.

What are the symptoms of Macular Degeneration?

Initially, the most common symptom is slightly blurred vision when performing tasks that require seeing detail. A blurred spot or sense that there is dirt in the way of clear vision may develop. Over time, the blurred spot may increase in size and interfere with reading and recognizing faces. Wet AMD causes a straight line to look wavy or distorted, and dark spots may blank out portions of the central vision. There is no pain with AMD.

Are there different forms?

There are two types of AMD: dry and wet. The most common is the dry form. This is the milder form where there is a gradual degeneration of the tissue cells that make up the macula and symptoms generally develop slowly over time. The wet form is a severe leakage, or even bleeding, from weak blood vessels under the macula and symptoms progress rapidly. Wet AMD accounts for approximately 10 percent of all cases, but the dry form can develop into the wet form over time.

Who is at risk of developing Macular Degeneration?

The risk of developing AMD increases with age. High risk groups include smokers and people who have had extensive UV exposure. AMD is also associated with conditions such as high blood-pressure, arteriosclerosis, and those with a family history of AMD.

How can I prevent Macular Degeneration?

Lifelong UV protection and general nutrition are believed to play a key role in preventing AMD. Living a healthy lifestyle by keeping your blood pressure down, reducing your intake of fatty foods and not smoking are all recommended. A diet high in antioxidants such as beta-carotene (a form of vitamin A), vitamins C and E, zinc, lutein, zeaxanthin and selenium can also help prevent AMD. Most of these antioxidants are found in fruits and leafy green vegetables. Recent information indicates that Omega-3 fatty acids are important in retinal health as well. Regular eye examinations are also important in the early detection of AMD. Early stages of AMD may be found during an eye examination even if no symptoms are noticed. Your optometrist can discuss ways to minimize the possibility of vision loss due to AMD.

Is there treatment for Macular Degeneration?

Currently, dry AMD has no treatment. Many cases of wet AMD can be treated with Photodynamic Therapy (PDT). Early detection and prompt intervention are crucial to the success of PDT for wet AMD. Certain vitamins can assist in slowing down the progression of AMD. It is important to realize that the use of vitamins will not reverse any vision loss that has already occurred, nor will it stop the progression of AMD completely. Regular eye examinations and counseling from your optometrist will let you know of any new treatments that become available.

Is there help available?

Many patients with sight loss due to AMD can benefit from low vision aids. Your optometrist can prescribe magnifying devices to enhance both distance and reading vision. These aids will not restore sight to normal levels but they allow people to maximize their remaining vision. Your optometrist may also train you to use the Amsler grid, which is a tool that can assist in testing the progression of AMD.

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