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Common Eye Disease FAQ's

Glaucoma

What is glaucoma? Glaucoma is damage to the optic nerve that is related to blood flow. Although high pressure in the eye is a risk factor for glaucoma, and is important in treatment, it is not the definition of the disease.

What would I notice if I have glaucoma? The most common hronic glaucoma has no symptoms until it is very advanced. This is why routine eye examinations and screening is so important (especially if there is a history if glaucoma in the family). When glaucoma becomes advanced, you may notice gradually decreasing vision starting at the edges of your vision, then progressing toward the center.

How does my eye doctor diagnose glaucoma? There are three basic criteria that we use to diagnose glaucoma. The first is intraocular pressure. Although high pressure in the eye is not glaucoma, it is the greatest risk factor for developing glaucoma. If we are suspicious for glaucoma we also check a visual field test to determine whether there are areas of vision loss in the periphery, not noticed by you. Finally, and most importantly, we evaluate the optic nerve for evidence of damage. Besides our own examination of the nerve, there are several tools available to analyze the optic nerve and the nerve fiber layer. In our office we use the GDx Optic Nerve Fiber Layer Analyzer.

How is primary open angle glaucoma treated? Treatment is focused on lowering the intraocular pressure. We start with eye drops, usually once a day. The choice of drops is individualized for each patient based on side effects, other medical problems, and efficacy of the drops. The most important thing in this treatment is that YOU actually take the prescribed drop, and try not to miss doses. If we need more improvement in pressure or you want to try to avoid eye drop use, we can do Selective Laser Trabeculoplasty. A laser procedure done in the office that is generally very well tolerated. If drops and laser are not likely to be effective enough, surgical treatment would be pursued, often a trabeculectomy.

Cataract

What is a cataract? A cataract is basically a clouding up of some portion of the lens inside the eye.

Is my cataract ready for surgery? Primarily YOU tell us when the cataract is ready for surgery, depending on how it is affecting your daily life: reading, driving, etc. There is no specific time when the cataract is "ripe". We can tell your visual acuity and we can see how dense your cataract is, but only you can tell us how much it is affecting your lifestyle. The most common symptoms include blurring and glare (especially with night driving).

Is cataract surgery done with a laser? NO. Although there are many procedures we perform on the eye with a laser, cataract surgery cannot be performed with laser. It does involve an incision in the eye. We do use ultrasound to help to remove the lens material from the eye.

Will I need glasses after the surgery? Yes. Although we usually try to put an artificial lens in that will help you see as good as possible at distance, you may still need glasses for distance, and you will most likely need glasses for reading. Although there are some new artificial lens implants available that are designed to help you see far away and near without glasses, these are expensive and not covered by insurance, may not make your best corrected vision as good as with traditional lens implants, and are only a good option for a select group of patients.

Dry Eye

What does dry eye syndrome feel like? Generally surface irritation worse late in the day and after prolonged reading, computer work, or dry/windy environments. May also have fluctuating blurred vision and light sensitivity.

If my eye is dry, why is it tearing? Occasionally you may have increased watery tears with dry eye. The tear film on the eye has three layers. If there is a problem with any of the layers you may feel your eyes are always moist, but still have the dry eye syndrome.

How is dry eye treated? We start with lubrication with artificial tears, gel or ointment depending on severity. Omega-3 fatty acid supplements may also help. We also treat any other related abnormalities, such as eyelid inflammation. If more treatment is needed we may use Cyclosporin A eye drops or block the tear drainage ducts to keep the eye more moist.

Conjunctivitis

Conjunctivitis, with redness and discharge from one or both eyes is the most common reason people present at physicians' offices and emergency rooms with red eyes. It accounts for approximately 30% of eye complaints going to the ER.

What is the most common cause of conjunctivitis? The most common infectious cause of conjunctivitis is viral, usually adenovirus, causing the classic pink eye. Common characteristics include a history of exposure, discharge, lid redness and swelling, and swollen lymph nodes. It generally starts in one eye, but often is passed to the other. Bacterial conjunctivitis can be difficult to differentiate from viral conjunctivitis but the discharge may be thicker and white.

What else might be causing my red eye? While simple viral and bacterial conjunctivitis is generally self limited, there are other causes for a red eye that requiring specific treatment and may have serious effects (such as acute glaucoma, orbital cellulites, herpetic infections, uveitis, scleritis, and corneal ulcers).

What is the treatment of conjunctivitis? The treatment for simple conjunctivitis is largely supportive. Regardless of treatment, it generally worsens for about a week then gradually resolves. Treatment includes: Antibiotic eye drops are given to prevent secondary infection even in viral conjunctivitis.

Prevent transmission with frequent hand washing, no sharing of towels, and avoiding close contact with others is recommended, but the infection may spread anyway. Cool compresses may help symptoms, as well as artificial tears (especially if kept in the refrigerator).

Diabetes in the Eye

What can diabetes to in the eye? Although diabetes is a risk factor for cataracts, glaucoma, and other eye problems, the most important effect it has is on the retina. It can affect the blood vessels in the retina and cause them to bleed, leak (causing retinal swelling or edema), or cause new unhealthy blood vessels to grow into the eye (neovascularizion). Edema or neovascularization can cause vision loss and even blindness, especially if not monitored and treated.

What can I do to prevent diabetic retinopathy? The most important thing you can do is to control your blood sugars, in cooperation with your primary care physician. Also you can control other factors like high blood pressure that can make the diabetic retinopathy worse.

How often should I see an ophthalmologist if I have diabetes? If you do not have diabetic retinopathy, you should see your eye doctor once a year for a full evaluation, since you wouldn't notice the changes with early diabetic retinopathy yourself. If you have diabetic retinopathy, the frequency of exams will depend on the severity of your disease.

What is done to treat diabetic eye disease? Treatment is generally needed when there is significant edema or when there is new blood vessel growth (neovascularization). Argon laser treatment is most often used, but there are other options including injection of medications into the eye or surgery, depending on the severity and complications from the disease.

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