Eye Diseases

*CATARACTS - a cataract is a cloudiness of the focusing lens inside the eye. This cloudiness blocks the passage of light through the lens causing blurred vision. Other symptoms include double vision, hazy or filmy vision, glare from headlights and sunlight, poor night vision with haloes around lights and color vision problems. Cataracts usually occur as a result of a normal aging process of the lens, first seen in people between the ages of 40 and 50, but not significantly affecting vision until after 60. Other causes of cataracts can be attributed to heredity factors, poor nutrition, diabetes, smoking, eye injury, steroids and excessive exposure to sunlight.

Treatment usually begins with changing the glasses prescription. Eventually, removing the cataract by surgery is necessary when the loss of vision is great enough to interfere with daily activities. Great advancements in surgical techniques has allowed for cataracts to be removed with such small incisions that usually no stitches are needed and the patient can go home after just a few hours. An intraocular lens is inserted into the eye to replace the old, cloudy lens. This new lens implant sometimes allows a person to be less dependent upon glasses.

In some instances, a person may develop an "after-cataract" or "secondary" cataract months or years after the initial cataract surgery. This cloudiness of the old lens membrane left in the eye is easily removed by an outpatient laser procedure, quickly restoring good vision.

*GLAUCOMA - this condition represents one of the leading causes of blindness in the United States. It is associated with the slow rise in the intraocular pressure inside the eye due to an excessive amount of ocular fluid. This rise in pressure eventually damages the optic nerve on the back of the eye which leads to blindness. There are no symptoms in the early stages of glaucoma. As the disease slowly progresses a person will experience poor side vision and if untreated, will eventually have poor central vision as well. People at high risk include African Americans, anyone over age 40 (especially over 60), those who have a family history of glaucoma, people significantly nearsighted, those who have diabetes or high blood pressure and anyone who has used steroids for several years.

Treatment initially involves using eye drops to lower the eye pressure. Another option, usually attempted later, involves laser surgery. This surgery is becoming more routine. A laser beam of light opens up the existing channels that allow fluid to drain from the eye, leading to a reduction in ocular pressure. If these treatments fail, a more conventional, but riskier surgery can be performed by removing a small piece of tissue from the eye to create a new channel for fluid to drain from the eye.

There are some instances where glaucoma develops without the eye pressure being elevated. An eye doctor can perform tests to determine if glaucoma is present, including a visual fields test, evaluating the appearance of the optic nerve and measuring the amount of pressure inside the eye.

*MACULAR DEGENERATION - this eye disease is also known as age-related macular degeneration and is abbreviated AMD. AMD is the leading cause of legal blindness in the United States in people over the age of 60. At age 75, about 30% of the population have AMD. This condition affects the macula, which is the central part of the retina on the back of the eye. The macula's function is to provide us with the sharp, fine detail vision in the straight-ahead direction. When the macula degenerates, a person's central vision declines. In most cases AMD will not cause total blindness, but eventually a person will have difficulty performing daily activities.

There are two types of AMD, dry and wet. Dry AMD accounts for 90% of all AMD cases. The pigment in the macula slowly breaks down from unknown reasons, causing poor central vision. Since this type moves very slowly, most people lead normal active lives. Wet AMD only occurs in about 10% of people with AMD, however it accounts for 90% of all severe vision lost from this disease. This type occurs when new blood vessels grow into the macula and leak blood and fluid under it, rapidly damaging the macula causing sudden loss of central vision. One early symptom is straight lines appear wavy or crooked.

Treatment in some cases of wet AMD involves laser surgery in which a laser beam of light is placed directly onto the leaky blood vessels to prevent further leaking. Recent clinical studies have indicated that nutrition plays a role in preventing or slowing the progression of certain types of AMD. It would be wise for anyone who has a risk of acquiring AMD to supplement their diet with vitamins, especially those containing antioxidants.

Some risk factors of developing AMD include people over the age of 50, people who are exposed to a lot of sunlight and UV light, those who have light-colored eyes, anyone with a family history of AMD and people who smoke or have high cholesterol. Caucasions have a greater chance of developing AMD than African Americans, and women are slightly more at risk than men.

*DIABETIC RETINOPATHY - this eye disease affects one-half of all Americans diagnosed with diabetes. It usually first appears after a person has diabetes for 10 years. This disease is the leading cause of blindness in American adults. Diabetic retinopathy occurs when diabetes damages the small blood vessels in the retina. This results in the leakage of fluid and blood into the retina resulting in blurred vision. Further loss of vision occurs in the later stages when new, fragile blood vessels grow along the surface of the retina. Without timely treatment, these fragile blood vessels can bleed and destroy the retina. All diabetics are at risk and the risk is higher if a diabetic smokes, drinks alcohol, has high blood pressure or is pregnant.

There are a few treatment options. Laser surgery is usually the initial treatment. One type of laser surgery involves placing a beam of light directly onto the leaking blood vessels to seal them. Another type involves making hundreds of small laser burns in the periphery of the retina, causing abnormal blood vessels to shrink. Laser surgery may have to be performed more than once. Another type of surgery may be necessary if bleeding occurs in the vitreous, the gel-like fluid section of the eye. A procedure is performed to remove the cloudy vitreous and replace it with clear solution.

In general, with early treatment, 90% of the people with advanced diabetic retinopathy can be saved from going blind. An annual, detailed retinal exam should be performed to detect any retinopathy as early as possible. Good control of blood sugar lessens the chance of diabetic retinopathy.

*DRY EYES - there are two main causes of dry eyes - a reduction in the amount of tears produced by the eye, and an increase in the evaporation of tears due to poor tear chemistry. There are many symptoms including burning and stinging, scratchiness, grittiness or foreign body sensation, dryness, itching, sensitivity to light, mattering, excessive tearing and red eyes. Environmental factors increasing dry eyes are air-conditioners, wind, heat, dry air and smoke. Other conditions causing dryness include aging, health problems, menopause and excessive near work. Dry eyes are also influenced by medications that are taken for arthritis, birth control, acne, colds and allergies, thyroid disease, depression, high blood pressure and hormone deficiency.

Dry eyes can make it difficult to wear contact lenses, and severe dryness can damage the cornea and impair vision. Initial treatment usually involves placing lubricating eye drops (artificial tears) on the eye. In some cases, small plugs may be inserted in the corner of the eyelids to block the tears from draining into the tear ducts.

*CONJUNCTIVITIS - this is an inflammation of the conjunctiva, a thin, transparent layer covering the surface of the inner eyelids and the white portion of the eye called the sclera. There are three main causes - infection, allergic response and chemical reaction. Infectious conjunctivitis, commonly known as "pink eye", is usually caused by a virus or bacteria. Your body's allergic response to pollen, cosmetics, animals or fabrics can bring on an allergic conjunctivitis. Irritants like noxious fumes, preservatives in eye drops and chlorine in swimming pools can cause the chemical type of conjunctivitis. Signs and symptoms of any conjunctivitis include red eyes, swollen eyelids, watery or mucous discharge, blurred vision, scratchiness, pain and sensitivity to light. Treatment involves antibiotic eye drops for the bacterial type, usually just monitoring the viral type and removing the toxic substance causing the chemical conjunctivitis.