Eye Health

#NationalSunglassesDay is Coming! Get Your Sunnies

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Every year on June 27, we here at All About Eyes celebrate National Sunglasses Day! It’s a time for us to remind our patients (and ourselves) about the benefits of wearing sunglasses while outside (year-round). Now that the weather has finally warmed up and the rainy season is behind us, we’re good to go for getting our sunnies on! We have a large selection of sunglasses for adults and children that meet the standards of protection against ultra-violet rays, so please stop into our office to get a pair.

Sunglasses help to protect our eyes from the sun’s harmful rays. You may have heard of UV-A and UV-B rays. Those are two different types of ultra-violet rays, both are invisible and both are very harmful to the eyes. UV-A rays can penetrate to the back of the eye and may cause macular degeneration problems later in life. Macular degeneration affects the center of vision by blocking it out. UV-B rays can cause sunburn on the front of the eyes, namely on the cornea and the lens. The Centers for Disease Control (CDC) suggest that people use wrap-around sunglasses to prevent the harmful rays from sneaking in on the sides of the sunglasses too. It is worth noting that in the United States, most sunglasses sold meet the standards of blocking out both UV-A and UV-B rays.

The sun can damage eyes in other ways, too. Prevent Blindness, an organization devoted to raising awareness on visual impairments notes these other concerns with ultra-violet rays:

    • Cataracts: A film that forms over your lens, causing vision problems.
    • Pterygium: Tissue growth on the cornea.
    • Basal Cell Carcinoma: The most common type of eyelid (skin) cancer.

 

So shade your eyes and protect them when you’re outside!


Multiple Sclerosis and Vision

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IMG_4109Multiple Sclerosis (MS) is a disease of the central nervous system. It affects the brain, optic nerves, and spinal cord, which is why vision problems are often the first symptom of the disease. Inflammation — where parts of the body become reddened, swollen, and painful — is the main issue with MS, as it causes damage to the nerves. MS is characterized by flare-ups of inflammation that typically go away after some time or will need to be treated with steroids. (For more information please see the Multiple Sclerosis Association of America’s website.) Stress, fatigue, infection, and elevated temperature can all affect vision in people with MS, so reducing those factors is an important part of managing the disease.

How MS Affects Vision

Optic Neuritis

The most common symptom is optic neuritis, which is an inflammation of the optic nerve. According to the National Multiple Sclerosis Society, most times, it happens in one eye only. The good news is, it usually goes away on its own after a couple of weeks or more and vision returns to normal. Here’s what optic neuritis looks like:

  • Pain with eye movement.
  • Blurred vision.
  • Dimmed vision.
  • Loss of being able to see colors accurately.
  • Difficulty seeing at night.

In some cases of blurred and/or dimmed vision, the center of the visual field can be blocked out. Side, or peripheral vision, usually isn’t affected. This is called central scotoma.

Diplopia

Another common symptom is called diplopia, or double vision. This occurs due to nerve damage or inflammation as well. Diplopia may resolve on its own. If not, using an eye patch can help to retrain the affected eye. As with many symptoms of MS, a course of corticosteroids may be helpful in relieving the symptoms.

Nystagmus

Not as common, nystagmus — also known as “dancing eyes” — is caused by muscle weakness. It is an involuntary rapid eye movement to where eyes may go from side-to-side or up-and-down rapidly. Mild cases may not cause any change in vision, but severe cases will affect vision to where things don’t seem to stay still. Treatment is usually to wait and see if it resolves on its own as the overall MS symptoms resolve, and again, steroids may be necessary to help with the symptoms.

If you have any concerns about your vision, or suspect you may have MS, please consult with your health care provider and eye-care provider for an accurate diagnosis.


Anisocoria: One Pupil Larger Than the Other

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In last month’s blog post on how a concussion affects vision, we discussed that having one pupil larger than the other is a cause for concern if you’ve recently suffered a concussion. This month, we’re going to take a deeper dive into that condition, known as Anisocoria.

Causes

Anisocoria naturally affects about one-fifth of the population without any problems in vision. Outside of being born with the condition, most people who are affected by it usually have had an eye disorder of some sort or an issue with their nervous system.

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Photo from The Express UK Article on David Bowie

According to the Merk Manual, eye disorders include birth defects, injuries to the eye, drugs, inflammation of the pupil itself, or are glaucoma-related. The late David Bowie, a well-known British musician and icon, is an excellent example of anisocoria. Most people think he had different colored eyes, a condition known as heterochromia, but he did, in fact, have anisocoria as a result of being hit in the eye as a teenager. To learn more about that story, here’s the link to The Express UK article on David Bowie.

Sometimes there are issues with the nervous system that result in one pupil being larger than the other. Those issues include pressure on the 3rd cranial nerve (nerve affecting the movement of the eye), stroke, injury, tumors, infections, or problems with the autonomic nervous system that result in drooping eyelids and misaligned eyes.

Symptoms to Watch For

See a medical professional if you experience any of the following and your pupils suddenly appear to be different sizes:

    • Drooping eyelid 
    • Double vision
    • Loss of vision
    • Headache or neck pain
    • Eye pain with bright light
    • Recent injury to the head or eye

 

Treatment

Eye-care professionals will first take a look at your history — and even perhaps an old photograph or your driver’s license — to see if anisocoria has been present all along. Then they will perform a series of examinations to make sure that both of your eyes are tracking correctly, responding to light and dark appropriately, and will use a slit lamp to magnify your eye for further examination.

While there isn’t anything that can be done to treat the condition itself, there may be a need and/or opportunities to treat the underlying condition that is resulting in anisocoria.

For more information on this condition, check out All About Vision, the Merk Manual for Professionals, and the American Academy of Ophthalmology.


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.