Eye Health

Seeing Signs: Teen Driving

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Photo of a blurry stop sign.The beginning of the new school year for high schoolers often means the start of driver’s education courses and getting permits for most teenagers. While most kids focus on passing the written portion exam for their permit, there’s another, equally important exam to pass: the vision test. As part of the permitting process, eye exams are given at the state’s motor vehicle facility to ensure that peripheral (side) and distance vision are up to the task of driving.

It can also be a time when teens and their parents first learn about myopia, or “nearsightedness.”

As children grow into their teenage years, their eyes grow as well, and this can change the shape of the eye. This, according to the Mayo Clinic, causes light rays to bend (refract) incorrectly, focusing images in front of your retina instead of on your retina. Thus, making objects farther away, blurry. Objects like road signs and license plates in the car ahead.

Nearsightedness is a rapidly growing concern in the United States. From 1972 to 2004, myopia in people ages 12-54 increased from just 25 percent of the population to nearly 42 percent, according to the National Eye Institute. Why? Computers and hand-held devices are the culprits. The Nielsen Report, which monitors media usage, says that Americans are now spending upwards of 11 hours a day on their devices, up from 10 hours a day last year. All this time spent on computers and smartphones is causing problems for people in their distance vision.

Myopia, for some people, can be associated with other eye disorders like cataracts, glaucoma, and retinal detachment. Signs of the condition include squinting, eye strain, headaches, and feeling tired when driving. Nearsightedness can be corrected with prescription eyeglasses, contact lenses, and in some cases, refractive surgery.

Schedule a comprehensive eye exam today!


National Sunglasses Day is Here!

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Get Your Sunnies On! National Sunglasses Day

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National Sunglasses Day will be on Wednesday, June 27, and it is a perfect day to celebrate protecting your vision with your sunglasses!

Why Sunglasses?

Sunglasses — not just any sunglasses but specifically those with Ultra Violet (UV) protection — can help to protect your eyes against sunburn (yes, your eyes can get sunburnt), pterygium (abnormal growths on your eyes), potential cataracts, age-related macular degeneration, and squamous cell carcinoma (cancer).

What Are Symptoms of Sun Damage?

If you have been outside without sunglasses for a prolonged period of time or around highly reflective surfaces like lakes, the ocean, sand, or snow, you may find that your eyes are affected. The cornea, the outer layer of the eyeball, is like the top layer of skin on your body and can get sunburnt just as easily.

How do you know if your eyes are sunburnt? If you find they are red, swollen, and/or you have blurry vision and light sensitivity, your cornea may have been sunburnt. This is called photokeratitis. Your eyes may water and you may feel like you’ve got sand or grit in them. See your eye-care practitioner for eye drops and stay in a darkened room for at least a day to allow your eyes time to heal. The cornea will usually heal quickly.

How to Protect Your Eyes

IMG_2525It’s easy to protect your eyes, and stylish, too! All About Eyes has a variety of sunglasses to choose from and they are all UV protected.

And it’s okay to go all “Hollywood” and wear your sunglasses on cloudy days, as the sun’s UV rays are present then, too.

Join the fun, share your #SunglassesSelfie on #NationalSunglassesDay and wear your sunnies!


Eyelid Cancers – Shade Your Eyes in Summer!

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SunWith the summer months stretching out before us, there will be plenty of opportunities to be outside. And that means exposure to the sun will increase along with those opportunities. Most people think to apply suncream to protect their skin but they don’t always think about protecting their eyelids from the sun. The eyelid area, according to SkinCancer.org is where up to 10 percent of all skin cancers happen. Most of those, 90 percent, are basal cell carcinomas (benign), just over 5 percent are squamous cell carcinomas, and 1-2 percent are malignant melanomas.

Symptoms

Since most of the tumors grow undetected at first, there are several things to look for — and note that most eyelid cancers happen on the lower lid:

  • Change in appearance
  • Bleeding lump or bump
  • Swelling
  • Sudden loss of eyelashes
  • Chronic infection that doesn’t respond to treatment
  • Wound that won’t heal
  • Spreading, colored mass
  • Flat, irregularly shaped, pigmented lesions

 

Treatment

Once a biopsy has been performed (where they remove a portion of the affected area to test it) and cancer has been diagnosed, a team of doctors will help you. The team usually consists of an ophthalmologist, dermatologist, surgeon, radiation oncologist and/or a medical oncologist.

Surgery can remove the cancerous tissue. In some severe cases, the eye will need to be removed and a prosthetic added, and radiation/chemotherapy treatment may be necessary to prevent cancer from causing tissue damage or spreading to the nasal and orbital cavities behind the eyes.

Prevention

Sunglasses with UVA and UVB protection, along with a wide-brimmed hat will go a long way toward preventing eyelid cancers. There is also suncream available for the eyelid with an SPF15 that can help, too. As always, regular comprehensive eye exams with your eye-care professional can help to detect cancers early, leading to faster treatment.

Next month celebrates #NationalSunglassesDay and All About Eyes has a wide-array of sunglasses to choose from! Come see us to get a head-start on prevention!


Are Those Stars in Your Eyes? Or is it VIIP?

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Image of stars.

NASA

Space travel, it’s the future. We’ve been hearing about it for decades. But with NASA’s commitment to a mission to Mars by 2030, Elon Musk’s Space X company single-handedly reigniting the excitement of building better rockets, and the International Space Station (ISS) orbiting Earth for nearly 18 years, life among the stars appears to be humanity’s destiny. But before we jump into our spaceships and don our space suits, there are some down-to-Earth, practical matters to attend to: vision issues.

It all started in 2005 when astronaut John Phillips noticed something when he looked down at planet Earth from the space station: it was blurry. Astronauts are expected to have 20/20 vision, so suddenly developing vision problems was, well, a problem. It’s not like you can schedule a visit to your eye doctor three months into your mission to Mars!

NASA Twins

Mike (left) and Scott Kelly. NASA Astronauts.

Years later, and now with 80 percent of long-duration mission astronauts reporting nearsightedness during and after their missions, NASA has been studying what’s happening up in space and has identified the condition as Vision Impairment and Intracranial Pressure (VIIP). In fact, the vision study is one of ten studies commissioned by NASA in their Twin Study this past year. In this study, identical twin brothers Scott and Mike Kelly are being observed for the biological effects of long-duration missions. Scott Kelly was in the ISS for 340 days while his brother Mike remained on Earth.

While the study on the effect on eyes hasn’t been completed yet, preliminary results are that being in a zero-gravity environment does affect the structure of the eyes. On Earth, we have gravity, which pulls our fluids down toward our feet. In space, there is no gravity, so those fluids can remain in the brain, putting pressure on the eyes and flattening the back of them out, causing nearsightedness. This study will help scientists plan for future space travel.


Eyelids: Focus on Blepharitis

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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.


An Overview: Comprehensive Eye Exams

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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!


Melanoma in Your Eyes

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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.


Itchy Eyes and Their Allergens

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Seasonal Allergic Conjunctivitis

Flowering Tree2It’s that time of year again – spring – or for 20 percent of the population, Seasonal Allergic Conjunctivitis (SAC) season. Seasonal allergies cause red, itchy, watery, and burning eyes, all thanks to blooming trees, flowers, and weeds releasing pollen. Sufferers may have chronic dark circles under their eyes, their eyelids may be puffy, and bright lights may be bothersome. If the eyes are rubbed too much, it can lead to secondary infections requiring medical attention.

When the pollen comes out, allergy sufferers should close their windows, turn on their air conditioning in their homes and cars, and stay indoors for the mid-morning and early evening time periods, when pollen counts are at their highest. If they do go outdoors, sunglasses or eyeglasses are their best defense against blowing pollen.

Obviously, pollen is not completely unavoidable, requiring a trip to the pharmacy for supplies to help alleviate the symptoms. Artificial tears, decongestant eye drops, and oral antihistamines can help to get through the season (just be aware that antihistamines can have a drying effect on eyes).

Perennial Allergic Conjunctivitis

While seasonal allergies tend to affect sufferers during the active growing months of plants (spring, summer, and fall), Perennial Allergic Conjunctivitis (PAC), is a year-long affair. According to the American College of Allergy, Asthma and Immunology, perennial allergies are typically caused by the indoor allergens of dust mites, pet dander, mold spores, or other household/indoor irritants.

The symptoms will appear the same as for its seasonal allergy counterpart and is treated the same with over-the-counter remedies. Sufferers are strongly encouraged to keep their homes, offices, and cars (interior environments) clean and to regularly wash linens and other fabrics (i.e., rugs, draperies, curtains, upholstery) to eliminate dust mites, spores, and dander.

These two types of eye allergies are the most common, affecting 50-85 million Americans each year. If you find yourself being affected, wash your face, use a cold compress on your eyes, try the over-the-counter remedies, keep your environment clean, wipe surfaces with a damp cloth, and if all else fails, see your eye care professional for prescription medications.