Ocular Disease

Some of the more common ocular disease that is seen at our practice are dry eye syndrome, glaucoma, cataracts, macular degeneration, and diabetic retinopathy.  Please scroll down or click on the above disease to learn more.  

Dry Eye Management

 

WHAT IS DRY EYE?

Dry Eye Syndrome is actually a collection of symptoms that make up an eye condition that stems form an imbalance in the quantity or the quality of tears. Once the severity of the dry eye syndrome is diagnosed and the correct treatment is used your ocular health will greatly improve.

HOW ARE TEARS INVOLVED?

Tears are one of the body's natural mechanisms of defense. They are produced by the lacrimal glands in the eye and secreted to coat, protect and nourish the ocular surface.

Tears carry essential vitamins and nutrients across the surface of the eye. They also act as a shield against damaging factors such as wind, heat, smog or foreign particles. Normally, every time you blink, you add another protective coating of tears over the eyes.

There are three layers of the tear film . If each is not adequately present it will cause dry eyes. The three layers are:

Outer Lipid (Oily) Layer - Reduces evaporation of the watery layer of tears.

Middle Aqueous (Watery) Layer - 98% water, cleanses the front surface of the eyes.

Inner Mucin (Mucus) Layer - Stabilizes the tear film.

WHAT ARE THE SYMPTOMS OF DRY EYE?

Dry eye symptoms can include one or more of the following conditions:

• Burning and stinging
• Scratchiness, grittiness or a "foreign body" sensation
• Dryness
• Itching
• Sensitivity to bright light (photophobia)
• Mucous secretions in the eye (mattering)
• Red Eyes
• Foreign Body Sensation
• Watery Eyes
• Seasonal Allergies
• Dry Throat Or Mouth
• Arthritis/Joint Pain

 

Interestingly, continual tearing is a sign of dry eyes . This is why a lot of patients get confused. This is called reflex tearing and occurs when your body detects dry eyes. This is caused by an imbalance in the tear film going form dry to wet to dry. This inconsistency causes the many different symptoms of dry eyes to occur. Restoring a normal tear film will reduce the occurrence of reflex tearing.

WHAT CAUSES DRY EYE SYMPTOMS?

There are a number of factors that can lead to dry eye. These include:

• Reduction or loss of your eyes' ability to manufacture tears
• Reduction or loss of the ability to blink adequately to fully coat the eye with tears
• Preservatives contained in some bottled products for use in the eye, such as eye drops or artificial tears. Frequent use of these products can aggravate dry eye conditions.
• Eye infections
• Wearing contact lenses
• Medications

HOW DO MEDICATIONS AFFECT DRY EYE?

Some medications taken for arthritis, birth control, acne, colds, allergies or other medical conditions can cause the eyes to produce fewer tears than normal.

HOW DO I KNOW IF I HAVE DRY EYE?

We can readily determine if you have dry eyes by performing a few routine tests.

 

 

FIVE COMMON CAUSES OF DRY EYE SYNDROME

• Blinking: Blinking helps lubricate the eye by spreading tears across its surface. As you blink, tears are forced inward to the nose, where they flow into the tear drainage ducts, and drain into the nose and throat. If the tear drainage system is overactive, dry eye symptoms or related congestion of the nose, throat or sinus may occur.
• Aging: Tear production decreases with age. In fact, the volume of lubricating constant tears can be as much as 60% less at age 65 than at age 18. This reduction in constant tear flow and resulting eye irritation may cause occasional excessive reflex tearing.
• Environment: High altitudes; sunny, dry, windy conditions; and the use of heaters, blowers and air conditioners increase tear evaporation and reduce eye lubrication.
• Contact Lenses: Contact lens wear can dramatically increase tear evaporation, causing irritation, infection, protein deposits, and pain. Research shows that dry eye is the lending cause of contact lens discomfort.
• Medications: Some medications decrease the body's ability to produce lubricating tears. These include decongestants, antihistamines, diuretics, heart disease and ulcer prescriptions, antidepressants, anesthetics and drugs containing Beta Blockers.

What is the treatment for Dry Eye Syndrome?

There are numerous approaches to patients afflicted with Dry Eye Syndrome: artificial tears, punctual plugs, anti-inflammatory drugs, oral doxycycline, and oral omega 3-fatty acid supplements. Deciding which approach will best serve the needs of each individual patient depends on the severity and cause of the dry eyes.

 

Artificial Tears -There is many different types (low, medium or high viscosity; preserved, non-preserved or transiently preserved; solution, emulsion, gel or ointment; bottled tear versus unit-dose.). Then the frequency of instillation for optimum results has to be determined.

 

Punctal Plugs -As the name suggests, these devices occlude (block) the punctum, or tear duct, which is the drainage duct that carries tears away form the surface of the eye. Blocking these drainage ducts prevents tears form draining away too quickly. Punctal occlusion can be compared to putting a stopper in a sink drain, keeping the tears on the eye's surface for longer periods. This widely performed procedure is safe, quick, painless, and totally reversible. The procedure only takes a few minutes. Punctal occluders are made of very soft flexible silicone, similar to that used in contact lenses. If you are tired of having to constantly use artificial tears throughout the day this is a great treatment. These are some of are most satisfied patients. Be sure and call us for a dry eye consultation.

 

Anti-inflammatory medications - Biomedical research has confirmed that inflammation plays a clinically significant role in many patients with dry eye syndrome. This is the mechanism of action in Restasis medicated drops. This is a good method of treatment in conjunction with artificial tears for some patients.

 

Doxycycline and oral omega-3 fatty acids - Evaporative dry eye results when meibomian gland function is compromised. Both oral doxycycline and oral omega-3 fatty acids can enhance meibomian gland function and result in a more stable, well-functioning tear film.

 

 

Finally, Natural relief from dry eyes! Daily supplements of fish oil, when used alone or in conjunction with lubricating eye drops, appear to reduce dry eye symptoms, including the burning, stinging, and redness that come with Dry Eye syndrome. Doctor Bovio recommends Nordic Naturals for our Dry Eye sufferers, and now you can order it online!

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Glaucoma

 

 

Glaucoma is one of the leading causes of preventable blindness. It occurs when fluid pressure inside the eye damages the optic nerve, resulting in a permanent loss of vision. Like diabetes and high blood pressure, glaucoma can be controlled with many forms of treatment but currently cannot be cured.

 

Glaucoma is often called "the sneak thief of sight". In most cases, there is no pain or other signal to warn the victim that they have the disease and risk blindness. Glaucoma generally strikes adults and becomes more common with increasing age. Adults of all races whose mothers, maternal relatives, or siblings have glaucoma are at a greater risk of getting glaucoma than the general population. People of African descent have 5 times more risk of getting this disease than Caucasians or Orientals. Diabetes and nearsightedness are also risk factors. Although glaucoma is rare in children, we still check them as early as age four or five.

 

The best way to prevent blindness from glaucoma is early detection through annual comprehensive eye examinations. Your eyes are tested for glaucoma using the most advanced clinical instrumentation available. We measure your eye pressure (tonometry) and compare the results against previous measurements, measure your peripheral vision (via computerized visual fields), determine there is no obstruction to the fluid drainage system in your eyes (via biomicroscopy or goniscopy), GDx Nerve Fiber Analyzer and stereoscopically evaluate your optic nerves through dilated pupils.

People with risk factors, elevated eye pressure, suspiciously shaped optic nerves, partially blocked drainage systems (narrow angles), or reduced peripheral vision should be evaluated two or four times per year.

 

All current forms of treatment for glaucoma are designed to preserve vision by reducing the amount of fluid entering the eye or increasing fluid drainage. The most common treatment is medicated eye drops. Depending on the type and severity of glaucoma, treatment may also include laser or other outpatient surgical procedures.

 

With today's technology and medical advances, glaucoma can be successfully managed and treated. The key to maintaining vision is early detection and careful long-term monitoring.

 

 

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Cataracts

 

 

A Cataract is a clouding or opacity of the natural internal lens of the eye which causes a visual impairment. The natural lens is located behind the iris, or "colored part" of the eye. The opacity may be a small dot or may involve the entire lens. The opacity in the lens causes the light entering the eye to be scattered, causing images to appear hazy or blurred.

Scientists do not know the exact cause of cataract formation. They do know that a chemical change takes place within the natural lens of the eye causing it to become clouded. This clouding progresses with age, and if left untreated, can cause severe visual impairment. We co-manage with ophthalmic surgeons to provide complete treatment for cataracts.

 

For more information on cataracts, visit our EyeCyclopedia® or click here for the topic on Cataracts.

 

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Macular Degeneration

 

 

Macular Degeneration is a condition in which the tissue of the macula (a portion of the retina responsible for visual clarity) becomes thin. It is believed to be a natural part of the aging process. Aging or systemic disease can be causes. As the disease progresses, central vision diminishes. It is believed that this breakdown may be due to a lack of nutrients being supplied to the region. Additional studies have found a genetic link to this disease.

 

Symptoms may include a gradual loss of visual clarity, a dark or blank area in your field of vision, a loss of clear color vision, or visual distortion. If you have symptoms, please schedule an appointment with our office today.

For more information on macular degeneration, visit the EyeCyclopedia® or click here for the topic on Macular Degeneration.

 

New for Macular Degeneration patients.  Macular Risk is a prognostic DNA test intended for patients who have a diagnosis of early or intermediate Macular Degeneration.  The test identifies those most likely to progress to advanced Macular degeneration with vision loss, allowing us to know which patients need to be followed more frequently.  This test is reimbursed by most insurance providers including Medicare.  The patient sample is a cheek swab taken at our office.  Please call our office to learn more about this test.  You can also visit their web site at www.macularisk.com .

 

Patients often ask what can they take for macular degeneration.  Based on the original Age Related Eye Disease Study (AREDS), doctors concluded that patients with any stage of macular degeneration could benefit from carotenoid supplements.  Of the 600 available carotenoids, only Lutein, Meso-zeaxanthin, and Zeaxanthin are found in the Macula.  Currently the only supplement on the market that has all three of these in one bill is MacuHealth.  That is why our office recommends MacuHealth along with fish oil as the only proven supplements for macular degeneration.  Currently MacuHealth is only available either at our office or threw the internet.  Please call our office to learn more.  In addition, you can link to MacuHealth web site at www.macuhealth.com to learn more as well. 

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Diabetic Retinopathy

 

 

Diabetic Retinopathy is condition where a diabetic person's blood sugar gets too high. When this occurs, the high blood sugar level starts a series of events which end in damaged blood vessel walls.

 

Blood vessels in the eye are small and delicate. As such, the blood vessels in the eye are easily damaged. The damaged vessels can then leak fluid or bleed, causing the retina to swell and form deposits.

 

Symptoms, while often not present, may include blurriness, blind spots or cloudiness in the vision. Laser and surgical treatments may be used to slow the progression and decrease the risk of vision loss.

For more information on macular degeneration, visit the EyeCyclopedia® or click here for the topic on Diabetic Retinopathy .

 

Flashes and Floaters

As a rule of thumb some of the signs to look for with respect to flashes and floaters that may be indicative of a serious eye problem:

• Spots and floaters that suddenly increase in number and frequency and appear in parts of the eye where they have not been usually seen.
• Flashes that appear frequently at an early age of flashes that appear at a later age but continue for a longer period than is normal: that is for several weeks.

A thorough exam is the best advice for anyone experiencing flashes, spots, or floaters at any time under any conditions.

For a more in-depth explanation please visit Flashes and Floaters in the Eyecyclopedia® section of our web site.