Health Blog - All About Eyes

Eyelids: Focus on Blepharitis

Sarah Quinn Conditions, Eye Health Comments Off , ,

Eyelids are the thin skin folds covering our eyes. We use them to blink an astonishing 15-20 times per minute/1,200 times an hour to keep our eyes moist and dust-free. Eyelids block out the light when we sleep. And for some, eyelids are a canvas for applying colorful powders and mascara. From time-to-time, eyelids can develop infections that cause them to become swollen and sore. This condition is called Blepharitis.

Types of Blepharitis

There are two types of Blepharitis, anterior, meaning the outside/front of the lid, and posterior, which is the inner part of the lid, next to the eyeball itself.

Photo of a stye in the eye/Blepharitis

Photo Credit: Andre Riemann

Anterior Blepharitis is caused by bacterial infections or scalp dandruff. Posterior Blepharitis tends to be caused by clogged oil glands known as the meibomian glands. These glands can become infected due to acne rosacea or scalp dandruff.

In some cases, parasites (Demodex eyelash mites) can cause the infection. Blepharitis often occurs with pink eye (conjunctivitis), a stye (a tender, red lump near the eyelashes) and/ or a chalazion (a painless, firm lump).

Symptoms of Blepharitis

  • inflamed, red eyelids
  • burning eyes
  • crusty debris at the base of the lid
  • watery eyes
  • dry eyes

 

Treatment

The most important aspect of treating Blepharitis, according to the National Eye Institute is keeping the eyelid clean. As it is difficult to get rid of, people who get this infection will need to practice good eyelid hygiene for the rest of their lives to keep recurring infections to a minimum. To keep the eyelid clean, a warm compress on the lid will help to soften the crusty bits on the eyelashes, then a diluted solution of water and baby shampoo is used with a clean, fresh cotton swab to gently and carefully scrub the debris away. A fresh cotton swab should be used for each eye to avoid cross-contamination.

If the above solution doesn’t work, your eye-care professional may prescribe antibiotics or, if needed, steroid eyedrops.

In the cases where scalp dandruff present, then dandruff shampoo for the scalp is recommended. Similarly, acne rosacea is causing the infection, then acne treatment under the care of a dermatologist is recommended. By treating these other contributing factors, it can help to reduce the cause of inflammation in the eyelid.


General Info on Age-Related Macular Degeneration

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Image Credit: National Eye Institute

Image Credit: National Eye Institute

For 10 million Americans ages 50 and over, macular degeneration looms on the horizon of age-related concerns. Macular degeneration is an incurable vision disease that attacks the center part of the retina (at the back of the eye) where “millions of light-sensing cells that provide the sharp, central vision” reside (National Eye Institute). The macula records the images we see and relays them to the optic nerve, which then passes the information to the brain.

These cells are responsible for our ability to read, to recognize faces, for driving, and for doing any close-up, detail work such as needlepoint. If these cells become damaged, the central field of view can become blurry, distorted, or form dark splotches.

Detection of Macular Degeneration

Comprehensive eye exams are the first line of detection for macular degeneration. During the visual acuity and eye dilation portion of the exam, eye-care professionals are able to look for yellowish deposits called drusen and for any pigment changes in the retina. The size of the drusen deposits will determine how advanced the macular degeneration (if any) has become.

Stages of Macular Degeneration

There are three distinct stages of this disease:

  • Early:  In this stage, the drusen deposits are medium-sized. There typically is no change in vision for the patient.
  • Intermediate:  At this point, the drusen will be large, and there may also be changes in the retina’s pigment.
  • Late:  Drusen deposits will be large, pigment changes will be present, and there will be vision loss at this stage. According to the American Macular Degeneration Foundation, the degeneration will be classified as either atrophic (dry) or exudative (wet).
    • Atrophic cases tend to be age-related, and 85-90 percent of macular degeneration falls into this classification. There is no leakage of blood or serum into the eye. Vision may still be good but may be fluctuating. Patients may have limited reading ability in dim lighting (such as in restaurants at night).
    • Exudative cases make up the remaining 10-15 percent. Exudative – or wet – macular degeneration occurs when abnormal blood vessels grow under the retina and bleed or leak fluid. This distorts vision.
Prevention and Treatment 

While there is no cure for macular degeneration, there is strong evidence that leading a lifestyle that promotes wellness will go a long way toward staving off the advancement of the disease. Not smoking, exercising regularly, eating a healthy diet with plenty of green leafy vegetables, and maintaining normal blood pressure levels, will all go a long way toward overall good health as well as preserving vision.

For intermediate- and late-stage atrophic (dry) macular degeneration, studies have shown that high doses of vitamins C and E, along with zinc and copper, can reduce the disease by up to 25 percent. For the exudative (wet) cases, anti-VEGF treatment (periodic injections in the eye of Avastin or Eylea) allows patients to remain stable instead of getting progressively worse.

The National Eye Institute has more comprehensive information available on the studies.


Going Bump in the Night

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Do you find yourself bumping into furniture and doorways when the lights are out at night? How about being able to clearly see faces when it’s dark out? Or how about having trouble driving when winter comes and the nights are longer? These may all be signs of nyctalopia, more commonly known as night blindness.

The American Optometric Association describes night blindness as not being able to see outside at night under starlight or moonlight, or in dimly lit interior areas such as movie theaters or restaurants.

While most people experience temporary vision adjustments when suddenly moving from a bright space into a dark one, night blindness is usually a lingering sensation and a symptom of other vision problems. The American Academy of Ophthalmology lists the following conditions as contributors to having difficulty seeing in the dark or in dim light:

  • Myopia (nearsightedness)
  • Glaucoma (a change in medication could help with this)
  • Cataracts (surgery to remove cataracts can help to improve night blindness)
  • Diabetes
  • Vitamin Adeficiency (can be corrected by eating carrots, cantaloupe, pumpkin, green-leafy vegetables, and sweet potatoes – all foods very high in Beta Carotene/vitamin A)

 

Interestingly, our day vision and night vision changes fairly dramatically. At night, we become essentially colorblind and typically only see shades of gray instead of the full-color spectrum (without any light source). The center of our vision is less clear, while our peripheral vision becomes better, allowing us to see objects moving.

If you find that it is becoming harder to see at night, schedule a visit with your eye-care professional here at All About Eyes to see if there are remedies available to you.


Scary Eyes for Halloween? Scarier Than You Think!

Sarah Quinn Articles, Eye Safety, Lenses Comments Off , ,

Decorative contact lenses.Halloween is nearly here! Time to get the decorations out, purchase the candy, and assemble your costume. For some, the devil is in the details and colored or decorative contact lenses can give that finishing touch to their costume.

But before you rush out to buy those cool, spooky lenses from your nearby pop-up Halloween store, consider this:  they are contact lenses. The U.S. Food and Drug Administration (FDA) classifies all contact lenses as medical devices, and because of that, they are regulated by the FDA. Which means, quite simply, you need a prescription for them. You can’t just run out to the store to buy them.

Why You Need a Prescription for Decorative Contact Lenses

Corneal Infections. Tight Lens Syndrome. Corneal Scratches. That doesn’t scare you? How about conjunctivitis (pink eye), decreased vision, or blindness?

Unlike picking up a pair of nerdy-geek glasses that have clear lenses and don’t affect your vision in any way, contact lenses can and do. They are not a “one-size-fits-all” item — they need to be fitted to your eyes. Otherwise, the lens could be too small and result in Tight Lens Syndrome where the lens acts as a suction cup and sticks to your eye. Ouch! Or, as is the case with the “anime” lenses that make your eyes look like a cartoon character’s, the contact lens is too big, causing oxygen deprivation and may lead to infection. And of course, for people who don’t wear contact lenses normally, putting them in and taking them out wrong could cause scratches on the cornea. Those freaky-looking designs may also cause allergic reactions. All pretty scary stuff.

How to Safely Get Spooky Eyes

You can still have fun! You can still buy decorative lenses from FDA-approved distributors!

But first, you need to get examined by your eye doctor. Get a prescription for properly fitting contact lenses. And learn from your eye-care professional how to put lenses in, take them out, and clean them – just as you would if you were being fitted for vision-correcting lenses.

Be scary safely.


September: Sports Safety Month

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September, the month when crisp air makes its return, school buses make their way down neighborhood streets, and school sports start for elementary children on up to college students. And with those sports come eye injuries, unfortunately. In fact, every 13 minutes, an emergency room in the United States treats a sports-related eye injury (U.S. Consumer Product Safety Commission. 2000). Each year, 25 percent of the estimated 2.4 million eye injuries reported are due to sports.

Sports with the Highest Injuries

The number one eye-injury causing sport for those aged 14-25: college basketball, with the Coalition to Prevent Sports Eye Injuries reporting one in ten college players having an eye injury playing the game. For the under 14 age group, it’s baseball.

Coming in second highest on the list are all manner of water sports: swimming, surfing, scuba diving, and water skiing. And it turns out, Mom was right about those BB guns taking your eye out. Third highest on the list of eye injury offenders (ages 14 and under) are air, gas, spring, and BB guns.

Types of Injuries

Prevent Blindness, sponsors of the September Sports Safety Month program, notes that sports-related injuries include infections, corneal abrasions, blunt trauma, inflamed iris, fracture of the eye socket, swollen or detached retinas and traumatic cataracts.

Photo of children wearing sports safety glasses.

Prevention

The National Eye Institute says that 90 percent of all eye injuries can be prevented by wearing proper eyewear. All About Eyes recommends eyewear that is ASTM F803 approved, providing the best protection for your eyes. Stop by and pick yours up!

 


Safely See the Solar Eclipse

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US map of the eclipse

Credit: Michael Zeiler / GreatAmericanEclipse.com

On Monday, August 21, 2017, portions of North America will experience a total eclipse of the sun. Total eclipses occur when the moon passes over the sun and covers it from view on Earth. The last such event was in 1918, and the next one won’t happen again until April 8, 2024. So it is something to see, albeit safely. Remember, looking directly into the sun may permanently damage your vision.

The American Optometric Association, NASA, and the American Astronomical Society have put together detailed guidelines on how to safely see the solar eclipse. The main points they each discuss are:

DON’T look directly at the sun without eye protection, even briefly. When is the right time to take off the viewers? “If you’re wearing your eclipse glasses and it becomes so dark you can’t see anything, you know it’s safe, and it’s time to take them off,” says Alex Young, a solar scientist at NASA’s Goddard Space Flight Center in Greenbelt, MD. Note that in New Jersey, the eclipse will be around 75 percent, so the filtered glasses must be worn throughout the eclipse.

DO get special approved solar eclipse viewers. The only safe way to view a partially eclipsed sun is through special-purpose solar filters such as “eclipse glasses” or viewers that meet international standard ISO 12312-2 for safe viewing. All About Eyes will be selling a limited number of eclipse glasses available for $2.

Credit: Courtesy Mark Margolis / Rainbow Symphony

Credit: Courtesy Mark Margolis / Rainbow Symphony

DON’T use sunglasses, smoked glass, unfiltered telescopes or magnifiers, or polarizing filters. They are unsafe for viewing an eclipse.

DO put the special glasses on before looking at the sun to view the eclipse, and when removing them, turn away from the sun before doing so.

DON’T use any filter if it is scratched or damaged.

If you should experience discomfort or vision problems following the eclipse, visit All About Eyes for a comprehensive eye examination.


An Overview: Comprehensive Eye Exams

Sarah Quinn Articles, Eye Health, Eye Safety, Procedures Comments Off , , , ,

We have a lot of blog posts here at All About Eyes that mention and/or encourage our visitors to get a comprehensive eye exam. So we thought we take this opportunity to talk about what it is and why it’s important to not just your eye health, but your overall health as well.

The first phase of the comprehensive eye exam focuses on your vision and any issues you may have there. The second phase of the exam evaluates your eye health.

What is a Comprehensive Eye Exam?

At the start of the visit, a technician will have a medical history conversation with you and will perform a pre-test using an autorefraction machine that measures the eyes for the preliminary prescription and also does keratometry, an examination of the curvature of the eye itself. This is useful in determining astigmatism. Then they perform what’s called tonometry with the non-contact tonometer (no drops needed). A tonometer is used to apply a puff of air onto the eye to measure eye pressure and is used to determine if you have glaucoma.

If the results from that test are high, then the doctor will apply numbing drops in the eyes and a further check of the intraocular pressure with an applanation tonometer will happen. Applanation tonometry uses a small lens to rest on the tear film/cornea to check the pressure. This test is usually painless and quick.

The other tests offered during pretesting are the Optomap digital retinal imaging which gives a wider, more complete picture of the retina and can detect problems not seen with the other tests. All About Eyes also uses an ocular coherence tomographer (OCT) which is a non-invasive imaging machine used to check the layers of the retina. It is beneficial for early glaucoma detection and in diagnosing macular problems.

Classic Eye Chart: Comprehensive Eye Exam

A visual acuity test will be given, where you will be asked to read off rows of random letters that gradually decrease in size until you reach a point to where you can no longer read with certainty. Also in included in the visual acuity testing are checking your vision for color blindness (if any) and 3-D testing to check your depth perception.

In the visual mobility tests, your practitioner will use various instruments (lights, eye covers) to see how your eyes are working. They will watch for eye muscle movements, check your peripheral (side) vision, and for your pupils’ response to light. Phoropter: Comprehensive Eye Exam

A phoropter is a refractor machine that determines the lens power needed for glasses (nearsighted, farsighted, and/or astigmatism). The doctor will give you an option of which lens looks clearer (“one or two”) and this helps to set your prescription for glasses or contact lenses if needed.

Slit Lamp: Comprehensive Eye ExamTo look at the back of the eye, the doctor will use a small, high magnification lens in addition to a biomicroscope. The biomicroscope, also called a slit lamp, is used to shine a light onto the eye so that its structure can be examined up close. This binocular microscope looks at all the areas towards the front of the eyes: eyelids, cornea, conjunctiva, iris (colored area), and the lens itself. This test can detect many diseases including cataracts, macular degeneration, corneal ulcers, and diabetic retinopathy. Sometimes dilating drops are necessary during this exam if the patient has tiny pupils, is very light sensitive, or they have retinal problems.

Why are Comprehensive Eye Exams Important?

First and foremost, as the American Optometric Association says, annual comprehensive eye exams can help with early diagnosis of vision issues which can help to prevent vision loss. Quite simply, they help to save your sight.

But, as we talked about in our article, Eye Checkup = Health Checkup, a comprehensive eye exam can also go a long way toward early detection of other major health issues such as stroke, heart disease, and sexually transmitted diseases, to name a few.

So schedule an appointment with either Dr. Dave Roell or Dr. Cheryl Roell today!


New Sunglasses for National Sunglasses Day!

Sarah Quinn Eye Safety, Products Comments Off

 

SoMe_StackedLogoIt’s that time of year again:  time to break out your sunnies and celebrate National Sunglasses Day on Tuesday, June 27. Don’t have any sunglasses? Not to worry! All About Eyes has you covered. We are running a special two-week promotion on sunglasses starting on Thursday, June 22, and running through to Saturday, July 8! 

All About Eyes is happy to work with the sponsors of National Sunglasses Day, the Vision Council, in raising awareness about the importance of wearing sunglasses to protect eyes from the sun’s ultraviolet (UV) rays. UV radiation is well-known to cause sunburns and skin cancer, but according to the Vision Council, “Most people don’t realize the damaging impact the wavelengths inflict on their vision.”

Temporary issues from unprotected UV exposure can cause swollen, red eyes and hypersensitivity to light. Years of unprotected exposure, however, can cause cancer to the eye and eyelid, and accelerate conditions like cataracts and age-related macular degeneration.

So be smart and protect your eyes! Wear your sunnies — not just for National Sunglasses Day but every day — and drop by All About Eyes to pick up the latest fashions!


Condiciones y enfermedades de los ojos

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For our Spanish-speaking patients, we’re providing a link to articles in Spanish about common eye conditions at AllAboutVision.com. This site provides information about the following conditions:

If you have specific questions about your eyes, call us at (609) 653-9933 and ask to speak to Fransheska who speaks both English and Spanish and can help you.


Melanoma in Your Eyes

Sarah Quinn Conditions, Eye Health Comments Off ,
Eye Graphic - Melanoma

Graphic courtesy of National Cancer Institute

When people generally think of melanoma, they usually think of skin cancer. And while it is rare, melanoma can develop in the eyes. It is called ocular melanoma and, according to the Ocular Melanoma Foundation, up to 2,500 Americans are diagnosed with this form of cancer each year.

“Melanomas are a type of cancer that develop in the cells that produce pigment. Pigment is the substance that gives your skin, hair and eyes color,” explains the American Academy of Ophalmology’s website. Melonaomas tend to develop in the uveal part of the eye, which is one of the three layers of the eye, the other two being the sclera (outer layer) and retina (innermost layer).

The problem with ocular melanoma is that it typically doesn’t have symptoms and is usually only detected during a routine, comprehensive eye dilation exam.

Who is at Risk?

Research suggests that there is a strong genetic component for people who develop eye cancer and that it tends to affect those with lighter skin tones who have blue or green eyes and of that group, it tends to affect people ages 50 and above. Another major factor, not surprisingly, is overexposure sunlight or ultraviolet light from tanning beds. The simple act of wearing sunglasses can go a long way toward reducing the risk of developing ocular melanoma.

How is it Detected?

As mentioned above, a routine eye exam where eyes are dilated is the best detection method, given that the cancer is relatively symptom-free. That said, if you notice dark spots on your iris (colored part of your eye), a change in the shape of your pupil, blurred vision, or a loss of vision, you should see your eye care professional. These issues can also be present for other eye problems, so further assessment will be needed.

If eye cancer is suspected during the routine eye exam, the next step may be to see a specialist for an ultrasound of the eye, a fluorescine angiography (where dye is injected into your body and a special camera takes pictures of the contrast image), or a biopsy (where eye tissue is removed and examined).

How is it Treated?

Depending on the severity of the ocular melanoma, radiation and/or surgery are the traditional treatments. In the last few years, medical oncologists at Memorial Sloan Kettering Cancer Center have been testing experimental drug therapies and are having promising results.