Posterior Vitreous Detachment (PVD) is common and occurs when the vitreous gel that fills the eye separates from the retina. Symptoms include floaters and flashes in your vision. In this photo, the patient had cataract surgery, so the floater is more visible. Symptoms usually subside over several weeks. Rarely, a PVD can develop into somethingContinue reading “A Huge Floater!”
Category Archives: Patient Cases
Cheap and Convenient is a Disaster Waiting to Happen
from The Los Alamos Daily Post Online shopping has truly revolutionized the way we purchase things. Indeed, many of us prefer online shopping to in-store shopping. Now, coming to a theater near you, the first online eye exam that gives you a prescription! This is where the lure of “cheap and convenient” is a disasterContinue reading “Cheap and Convenient is a Disaster Waiting to Happen”
Epithelial Ingrowth
Epithelial ingrowth is the presence of corneal epithelium in an area where it does not belong. After LASIK, epithelial ingrowth can occur in the interface between the flap and the stromal bed of the patient’s cornea. If the ingrowth is peripheral and not vision threatening, it can just be monitored.
OCT in Scleral Lens Fitting
I use my optical coherence tomographer (OCT) for evaluating complex contact lenses, such as sclerals. It is important that there is enough space between the cornea and the contact lens. TABLE 1 Applications for Anterior Segment OCT in a Specialty Contact Lens Practice • Evaluating pachymetry and corneal edema • Measuring soft and GP lensContinue reading “OCT in Scleral Lens Fitting”
Scleral lens compression
A scleral lens that is fit too tightly in the periphery can result in vascular blanching. To remedy this situation, flatten the midperipheral curves to loosen the fit.
A Wrinkle After Lasik
After lasik, stria can occur. Visual acuity determines their severity and the need for surgical revision.
Corneal Edema After Cataract Surgery
This is a common complication of cataract surgery, which usually resolves after 1 week. Those who have more advanced cataracts pre-existing corneal disease are more likely to have corneal edema. The primary treatment is typically steroid drops and hyperosmotic agents such as Muro 128 (a hypertonic saline agent) which pulls the edema fluid outContinue reading “Corneal Edema After Cataract Surgery”
A Corneal Scratch
Did you scratch your cornea? The cornea is one of the most sensitive parts of your body, so even a very small corneal abrasion can be uncomfortable. In addition to pain and feeling that something is in your eye, other symptoms include redness, tearing, light sensitivity, headache, blurry or decreased vision, eye twitching, a dullContinue reading “A Corneal Scratch”
Inflamed Caruncle
The lacrimal caruncle is the small nodule at the inner corner of the eye. It is made of skin covering sebaceous and sweat glands. Sometimes it can get inflamed and swollen. Artificial tears and steroids usually resolve the problem.
Neovascular Membrane
Did you know that bleeding underneath your retina can cause devastating vision loss? Choroidal neovascular membranes are new blood vessels that grow beneath the retina in an area called the choroid. These membranes are associated with many serious eye diseases, most commonly wet age-related macular degeneration. CNVM are also found in patients with histoplasmosis, eye injury, and myopicContinue reading “Neovascular Membrane”
When Contacts Cause Bumps in the Eye
Giant papillary conjunctivitis is a common complication of contact lens wear. This condition requires anti-inflammatory and/or anti-histamine eye drops. Contact lens wear should be temporarily discontinued. Daily disposable contact lenses are recommended. The inner eyelids usually return to normal appearance following the resolution of giant papillary conjunctivitis. However, sometimes, there can be permanent, small, white,Continue reading “When Contacts Cause Bumps in the Eye”
Preserving Macular Health
by Damon Dierker, OD, FAAO Can We Eat Our Way to a Healthy Macula? The answer is YES! You are what you eat — we’ve heard it since we were children. Not surprisingly, what we eat today is simply not as nutritious as a generation or two ago. Industrial farming techniques have caused many ofContinue reading “Preserving Macular Health”
Glaucoma: the Importance of Early Intervention
According to the Glaucoma Research Foundation, an estimated 2.2 million individuals in the United States have glaucoma. More than half of those who have glaucoma are unaware because there are NO SYMPTOMS, especially in the early stages. Studies show that the risk of blindness related to glaucoma 20 years after diagnosis has decreased byContinue reading “Glaucoma: the Importance of Early Intervention”
Cataract Surgery Comanagement
Meibomianitis
Meibomian refers to a particular type of gland in the eyelids. There are about 25 to 40 meibomian glands in the upper eyelid and 20 to 30 in the lower eyelid. The function of these glands is to secrete oils, which help keep the tears from evaporating too quickly. Meibomian gland dysfunction is blockage orContinue reading “Meibomianitis”
Central Retinal Vein Occlsion
The retina is nourished by blood flow, which provides nutrients and oxygen that nerve cells need. When there is a blockage in the veins into the retina, retinal vein occlusion may occur. Central retinal vein occlusion (CRVO) is a blockage of the main vein in the retina. Blockage of the small veins in the retinaContinue reading “Central Retinal Vein Occlsion”
Corneal Pannus
Corneal pannus is the growth of fine blood vessels onto the clear corneal surface. The treatment depends on the cause. For instance, a common cause of corneal pannus is a poorly fit contact lens. Also, pannus can occur if the contact lens does not allow enough oxygen to the eye. Contact lens may need toContinue reading “Corneal Pannus”
Episcleritis
Episcleritis is a self-limited inflammation that does not cause lasting damage. Most patients with episcleritis may not require any treatment. Either Prednisolone Acetate 1.0% or Fluorometholone .1% 1 drop 3x/day can be prescribed. Cold compresses can also help relieve the discomfort.
Air Optix Multifocal Contact Lenses
Are you having difficulty focusing on your Ipad and computer monitor? Is the morning newspaper becoming more difficult to read? No worries! Multifocal contact lenses may be the perfect solution for you. The AIR OPTIX® AQUA Multifocal contact lenses allows for a range of prescription strengths to blend across the lens. It works with yourContinue reading “Air Optix Multifocal Contact Lenses”
Blepharitis
If you are diagnosed with chronic blepharitis, an ongoing regimen of eyelid hygiene is recommended. We often prescribe over-the-counter lid scrubs such as Ocusoft. Eyelid hygiene is the cornerstone of treatment for most cases of blepharitis. Besides a program of eyelid hygiene, supplemental treatment with topical and oral medicine can be helpful. We alsoContinue reading “Blepharitis”
Subconjunctival Hemorrhage
A subconjunctival hemorrhage occurs when a tiny blood vessel breaks under the conjunctiva. A subconjunctival hemorrhage often occurs without any injury to your eye. Even a strong sneeze or cough can cause a blood vessel to break in the eye. You don’t need to treat it. A subconjunctival hemorrhage is usually a harmless condition thatContinue reading “Subconjunctival Hemorrhage”
Asteroid Hyalosis
Asteroid hyalosis is a common condition in which calcium-lipid complexes are suspended throughout the collagen fibrils of the vitreous.
Bad Eye Burn
Chemical alkali burns of the cornea, are the most severe and painful. Treatment requires medical intervention, sometimes surgery, acutely and in the long term, for maximal visual rehabilitation. Common goals of management include: (1) removing the offending agent, (2) promoting ocular surface healing, (3) eliminating inflammation, (4) preventing infection, and (5) controlling intraocular pressure. ImmediateContinue reading “Bad Eye Burn”
Confluent Drusen in Macular Degeneration
Small, yellowish deposits known as drusen, can have discrete or indistinct margins. Macular degeneration can be classified according to the number and size of drusen, amount of geographic atrophy, and pigmentary changes. This patient has dry macular degeneration, which is being carefully monitored with photos, as well as daily Lutein supplements.
Lasik Complication
Epithelial ingrowth
Corneal neovascularization
When you over wear your contact lenses, blood vessels begin to grow onto your cornea. This causes redness and corneal edema.
Wound after cataract surgery
1 week after cataract surgery. The first week is always the most uncomfortable. There is injection and inflammation. You must stay on your anti-inflammatory and anti-biotic drops, 4x/day without fail!
Lasik Complication
Epithelial ingrowth
Corneal Neovascularization
Symptoms include foreign body sensation, photophobia, tearing, burning, and pain. Treatment includes bandage contact lens, cyclosporine, and ocular steroids.
Intraocular Lens Implant
Sometimes the intraocular lens implant, in cataract surgery, can become opacified.
A Film Over My Eye
If you do not properly disinfect and clean your contact lenses or over wear them, you can develop bacterial keratitis. This is a serious condition that can cause permanent vision loss and damage to your eye. It must be treated aggressively with antibiotics.
Bacterial Conjunctivitis
Treatment with an antibiotic-steroid combination is effective.
Eyelid Lesion
Verruca Vulgaris Usually caused by epidermal infection with the human papilloma virus (type VI or XI). Although these growths are less common on the eyelids, they are typically located near the lid margins. Treatment options include simple excision or cryotherapy.
I Can’t See
This patient had a dense cataract, so it was not a glasses problem! I referred this patient for surgery.
Viral Conjunctivitis
Antibiotics will not help this condition! It is very contagious, so time away from work is recommended. Steroids, artificial tears, and cold paks can relieve symptoms.