Conditions

Dry Eye

Dry Eye happens when you don’t have enough tears, or when your tears don’t have the right balance of ingredients.

Tears are important. Every time you blink, your eyelids wipe tears over the surface of your eye, washing away specks of dust and grit. In so doing, they keep everything nice and lubricated. And they help prevent infections.

If you don’t have enough tears, or if your tears are lacking in quality, they won’t be able to do their job effectively. Tears are a delicate balance of water, mucus and oil, each of which serves an important purpose.

If your eyes sting, feel gritty and look red, you may have Dry Eye. Maybe they feel worse in the wind, or when you turn the defroster on in your car.

On the other hand, maybe your eyes are intensely watery! That too could point to Dry Eye, oddly enough. Our eyes are supposed to release moisture continuously, like a soaker hose; when irritated, though, those glands start to gush. If your eyes just won’t stop watering, Dry Eye could be the problem.

How can we address it?
We may recommend artificial tears for you, also called tear supplements. We may also suggest nutritional supplements you can take to give your tears the nutrients they need to do their job – omega 3 fish oils for example.

Some patients have also responded well to prescription eye drops, formulated to stimulate normal tear flow. Long story short, we’ll work together to determine which remedy is right for you.

Myopia

Myopia – or nearsightedness – is a refractive error. That means it has to do with the way your eye bends (or refracts) light.

When light enters your eye, it’s supposed to come to a focus on the back wall, the retina, in a single point. If you have myopia, your eye has trouble doing that. Instead, it focuses the light just in front of the retina. As a result, distant objects (like road signs) seem blurry, while objects closer-up (like your hand) look just fine.

Did you know? Myopia is the most common eye condition in our country. Twenty-five to 30% of Americans have it.

How can we address it?
If you’re having trouble with your vision, our first step is to find out why. We start by asking when, how and where you see best and worst. Then we run some tests.

There are two kinds of tests. Objective tests rely on a sophisticated device to provide data about your eyes. For example, when we use an auto refractor (or for kids, a special flashlight) to look inside the eye, that’s an objective test. Subjective tests, meanwhile, focus on your experience. When you look at a target 20 feet away, how well can you see it? How about 16 inches away? Now what if you look through this lens? What about this other lens? Your feedback is important.

Once we understand which condition (or combination of conditions) you’re experiencing, we have a foundation to build on. From there we can figure out which lens is best, and which solution: glasses, contacts or both.

Hyperopia

Hyperopia – or farsightedness – happens when your eyeball is too short to bend (or refract) light properly.

When light enters your eye, it’s supposed to come to a focus on the back wall, the retina, in a single point. With hyperopia, your eye can’t achieve a focus that tight. Instead, the light converges on an imaginary point somewhere behind your retina, so objects close to you (like your smartphone) seem blurry, while objects farther away (like the neighbor’s house) look just fine.

In children, hyperopia is sometimes a hidden problem. When kids have to struggle to focus their eyes on their classwork, it can lead to headaches and poor performance.

How can we address it?
If you’re having trouble with your vision, our first step is to find out why. We start by asking when, how and where you see best and worst. Then we run some tests.

There are two kinds of tests. Objective tests rely on a sophisticated device to provide data about your eyes. For example, when we use an auto refractor (or for kids, a special flashlight) to look inside the eye, that’s an objective test. Subjective tests, meanwhile, focus on your experience. When you look at a target 20 feet away, how well can you see it? How about 16 inches away? Now what if you look through this lens? What about this other lens? Your feedback is important.

Once we understand which condition (or combination of conditions) you’re experiencing, we have a foundation to build on. From there we can figure out which lens is best, and which solution: glasses, contacts or both.

Astigmatism

Astigmatism can be loosely translated “off mark.” It has to do with the shape of your cornea: that’s the clear covering on the surface of your eye.

Your cornea is supposed to be a smoothly-curving dome. If it has any irregularities, it can’t make rays of light converge on a single point inside your eye. Instead, different rays are refracted (or bent) in different directions, creating a blurry or distorted image.

Did you know? Astigmatism often occurs in combination with other refractive errors, including myopia (nearsightedness) and hyperopia (farsightedness).

How can we address it?
If you’re having trouble with your vision, our first step is to find out why. We start by asking when, how and where you see best and worst. Then we run some tests.

There are two kinds of tests. Objective tests rely on a sophisticated device to provide data about your eyes. For example, when we use an auto refractor (or for kids, a special flashlight) to look inside the eye, that’s an objective test. Subjective tests, meanwhile, focus on your experience. When you look at a target 20 feet away, how well can you see it? How about 16 inches away? Now what if you look through this lens? What about this other lens? Your feedback is important.

Once we understand which condition (or combination of conditions) you’re experiencing, we have a foundation to build on. From there we can figure out which lens is best, and which solution: glasses, contacts or both.

Presbyopia

Presbyopia means “aging eye.” As you might expect, it’s just a natural part of getting older.

As time goes by, the lens of your eye becomes gradually more rigid, making it harder to flex. As your lens becomes less flexible, it gets harder for it to adjust to different distances – something you may not notice until you can no longer focus your eyes effectively.

When this happens, objects close to you (like your grocery list or a text message) may appear blurry, while objects farther away (like oncoming traffic) could look just fine.

How can we address it?
If you’re having trouble with your vision, our first step is to find out why. We start by asking when, how and where you see best and worst. Then we run some tests.

There are two kinds of tests. Objective tests rely on a sophisticated device to provide data about your eyes. For example, when we use an auto refractor (or for kids, a special flashlight) to look inside the eye, that’s an objective test. Subjective tests, meanwhile, focus on your experience. When you look at a target 20 feet away, how well can you see it? How about 16 inches away? Now what if you look through this lens? What about this other lens? Your feedback is important.

Once we understand which condition (or combination of conditions) you’re experiencing, we have a foundation to build on. From there we can figure out which lens is best, and which solution: glasses, contacts, multi-focal glasses, even multi-focal contacts may be an option.

Cataracts

A cataract is a cloud on your lens. The lens is supposed to be clear and flexible; its job is to focus incoming light at just the right angle. If it turns opaque, though, it blocks the light out instead.

Cataracts can show up naturally as you get older, but age isn’t the only culprit. There are plenty of other health-related issues that can cause cataracts: diabetes, for example.

Worst-case scenario, cataracts can lead to blindness. In less advanced cases, they can make it hard for you to tell colors apart or notice contrasts; they may also make you overly sensitive to a glare.

How can we address it?
If you have cataracts, we’ll probably be able to tell as soon as we look at your intra-ocular lens with a microscope. Sometimes, a patient may have cataracts and not even know it. In that case, we may advise waiting to address it until later.

If, on the other hand, cataracts are interfering with your daily activities, we may recommend surgery. Cataract surgery is highly refined; there are no shots, no stitches, and it’s usually very fast. (Your pre- and post-operative care may take quite a bit longer, but the procedure itself is usually just about ten minutes.) In cataract surgery, the specialist removes your old lens and replaces it with a clear implant. This can actually help improve your vision in and of itself. For some patients, bifocal implants are an option.

Glaucoma

Glaucoma isn’t just one disorder; there are several problems called by that name. What do they have in common? A buildup of pressure in the eye, which damages the optic nerve.

The optic nerve is a bundle of many nerve fibers, about a million of them, at the back of your eye. Their job is to relay information from your retina to your brain. If this bundle is damaged, and the information can’t reach your brain, you lose vision – even if the rest of your eye is working fine!

There are two types of glaucoma, open-angle and acute-angle closure. The first develops little by little. The second usually happens all at once.

How can we address it?
Glaucoma screening is part of our routine eye exam, because – while it’s certainly more common among older folks – it can develop at any age.

If we find that you have glaucoma, we make a plan to manage it. We measure your eye pressure, and we evaluate your optic nerve under microscope. We may prescribe eye drops that affect the “plumbing” of your eye: either turning down the faucet or unclogging the drain, so to speak.

Then we monitor your condition carefully, looking for changes over time. We want to make sure you’re not losing any sensitivity in your field of vision, and that we’re not seeing any changes in the structure and function of your optic nerve. While we can’t reverse the damage caused by glaucoma, for many patients we can stop it in its tracks.

Macular Degeneration

Macular Degeneration is just what it sounds like: a breakdown of the macula. So what’s that? Short answer, it’s the center of your retina.

The retina is the back wall of your eye. Think of it as a black screen, on which incoming light is focused to create the images you see. The center of this screen, the macula, is the part that handles pinpoint vision – letting you see things when you look directly at them. It also handles color and detail. The rest of your retina handles your peripheral vision.

As you might imagine, when the macula breaks down, you lose the ability to see things straight-on, though your peripheral vision may remain unchanged.

How can we address it?
If you have “dry” macular degeneration, we may prescribe a specially-formulated vitamin supplement that’s very effective at stopping the damage. We’ll also advise you to eat plenty of leafy greens and, if you’re a smoker, to stop smoking. These lifestyle changes can make a big difference.

If you have “wet” macular degeneration, that means you have extra blood or fluid in your retina. In this case we would refer you to a retinal specialist for a series of injections that could help to reverse the bleeding and swelling.

Moving forward, we monitor your condition carefully, looking for changes over time. That may range from simple observation under microscope, to evaluating the various layers of the retina with ultrasound. While we can’t reverse the damage caused by macular degeneration, for many patients we can stop it in its tracks.

Diabetic Retinopathy

Diabetic Retinopathy has to do with damage to the retina. As the name suggests, it’s one of the consequences of diabetes.

In fact, it’s the most common cause of vision loss in the U.S. The retina is the back wall of your eye, where light is focused to create the images that you see. When there’s too much sugar in your blood, it can’t deliver enough oxygen. As a result, the blood vessels of the retina begin to swell or close off. As they do, new vessels start to grow on its surface: fragile, leaky ones.

Thus your eye loses the ability to perceive incoming light in a way that your brain can interpret into images. Ultimately, blindness is the result.

How can we address it?
If you have diabetes, we’ll check for Diabetic Retinopathy routinely. We’ll likely be able to tell right away: the retina’s “cry for help” is easily visible under microscope.

In the early stages, Diabetic Retinopathy is reversible. When advanced, it requires management by a retinal specialist, possibly with laser treatment to halt the damage.

Either way, we always send a report to your primary care physician after we see you, so your doctor can adjust your diabetic control plan to address any issues we detect.

Even if you’re doing fine, that too is useful info. As doctors of optometry, we have unique training and equipment to see your retinal blood vessels in action. By communicating what we observe with your doctor, we can help you get the best care possible.

Floaters

Floaters are swaying, sinking specks that don’t seem to go away, even when you blink. They’re caused by little clumps of cells suspended in the clear gel that fills your eyeball: the vitreous.

These cell clumps block or bend light as it’s entering your eye, casting tiny shadows on your retina, which register as dots or lines floating across your field of vision. Because they’re actually inside your eye, they move when your eye moves. This makes it hard to look at them directly: they always float away!

How can we address it?
First step, we need to understand why you have floaters. Not all floaters are harmless; some require immediate attention.

If you start seeing new floaters, or there’s some other noticeable change, please seek care right away. It’s possible this could be a symptom of a retinal tear or hole, which can lead to retinal detachment, which leads in turn to blindness. Floaters can also be a symptom of other conditions, too. Bottom line, it’s important to seek out a proper diagnosis.

The good news is that in most cases, floaters are nothing to worry about. As long as we’ve confirmed they’re harmless, there’s not a lot we can do about them. You’ll probably tune them out to some extent over time, and those you don’t, well, they’re just going to be your friends from now on!