Allergic eye disease is an inflammatory response of the eye to an allergen, resulting in redness, swelling of the eyelids and surface of the eye, itching and tearing. The symptoms can occur seasonally, in specific age groups or with specific risk factors. The diagnosis is made by history and examination. Allergy testing may be considered to identify specific allergens. Treatments include allergy drops, artificial tears, cool compresses, and avoiding allergens.
What is a cataract?
A cataract is when the natural lens becomes cloudy. Cataracts most often develop gradually, and people may not notice the decrease in vision initially. This can be age-related, after injury, due to medical conditions and medications. Risk factors include diabetes, steroid medications, smoking, ultraviolet exposure, inflammation of eye, prior eye surgery, injury to the eye, and genetics.
What are symptoms of a cataract?
Cataracts cause a decrease in vision including:
How can cataracts be treated?
Currently, there is no effective medical treatment for cataracts. Options that can be tried include, avoiding UV exposure, controlling blood sugar in diabetes, avoiding eye injury, increase lighting conditions for reading, using magnifying lenses.
Cataract surgery is one of the most commonly performed procedures in medicine, and it is one of the most successful surgeries. Most often, the cataract is removed by phacoemulsification in which a small instrument is used to soften and remove the cataract from the eye. The cataract is then replaced with an intraocular lens (IOL). There are many types of IOLs including monofocal, multifocal, near-vision enhancing, and astigmatism correcting. The goal of the IOL is to reduce the dependency on glasses or contacts for distance and/or near vision after cataract surgery.
A more recent technology is the use of the femtosecond laser in cataract surgery to replace some of the manual parts of the cataract surgery with the precision of laser. The laser helps to soften the cataract and can help reduce the need for glasses after surgery by correcting astigmatism.
Your eyesight is a precious gift and guarding against vision loss is essential to maintaining your quality of life. By taking the simple step of making a comprehensive eye examination part of your routine healthcare regimen you can protect the health of your eyes and the quality of your vision for a lifetime.
After reviewing your overall medical history and gathering relevant information on your eye health through the years, we perform a clinical exam to check the health of your eyes and assess your vision through a series of comfortable tests. Your visual acuity, the degree to which your eyes work together, how well your eyes follow a moving object, and your depth perception are all thoroughly evaluated.
As part of your comprehensive eye exam, you are also screened for eye diseases that can lead to vision loss. Many eye diseases including glaucoma, macular degeneration, diabetic retinopathy, as well as other conditions affecting the retina, demonstrate few if any overt signs or symptoms until irreparable damage to your eyesight has occurred. Detecting diseases that can threaten your eyesight in their earliest stages enables the most effective management and care.
If you are interested in wearing contact lenses or you are due to have your current pair of contacts checked, our office will perform a specialized evaluation to measure and assess your eyes. Different from a routine eye exam, an exam for contact lenses not only ensures your contact lenses will fit properly but also makes certain they provide the required vision improvements and that your eyes will be able to tolerate wearing lenses without any harmful consequences. It is important to keep in mind that a contact lens exam does not replace having a comprehensive or routine eye exam to assess the health of your eyes.
The reason different measurements are required for contact lenses is that unlike an eyeglass lens, which is positioned approximately 12mm away from your eye; a contact lens sits directly on the surface of your eye. Once your eyes have been measured and evaluated, our office will discuss the types of contact lenses and wear schedules that are available to you. Depending upon your vision requirements and your lifestyle, we’ll guide you in choosing the most suitable and effective contact lenses to address all your needs.
What is cornea transplantation?
The cornea is the clear, round surface of the eye that helps focus images in the eye. The cornea must be clear, smooth and healthy to be able to see. In certain conditions, the cornea can become cloudy, scarred, and swollen and the vision will decrease. If the cornea cannot be healed, the eye may require a cornea transplant. The cornea has layers and the outer, inner or whole cornea may be replaced with human donor tissue. The donor tissue is carefully checked to ensure that is safe and healthy for transplantation.
What causes cornea problems?
The cornea can become cloudy or scarred by:
What are cornea transplant options?
The different layers of the cornea may be replaced. In DALK (deep anterior lamellar keratoplasty) the outer layers of the cornea are replaced. In EK (endothelial keratoplasty) the inner layers of the cornea are replaced. Most commonly DSEK (Descemet’s stripping endothelial keratoplasty) is performed where 20% of the inner cornea is replaced. In some cases, only the thinnest inner of the cornea is replaced in DMEK (Descemet’s membrane endothelial keratoplasty. When all layers of the cornea are replaced, a PK (penetrating keratoplasty) is performed. The goal is to replace the damaged cornea with healthy tissue and cells that can restore corneal clarity and improve vision.
What is DSEK (Descemet's stripping endothelial keratoplasty)?
DSEK is a form of endothelial keratoplasty in which the inner layer, Descemet’s membrane, is removed and the replaced with donor tissue from 20% of the inner cornea. Compared with a PK, the healing time is shorter, there is a smaller incision, less chance for astigmatism, and there is a lower chance that your body will reject the tissue.
What is DMEK (Descemet's membrane endothelial keratoplasty)?
In DMEK, another form of endothelial keratoplasty, the Descemet’s membrane, is removed and the replaced with donor tissue Descemet’s membrane. In DMEK, compared with DSEK, the tissue is thinner and can be more difficult to transplant, but in DMEK the recovery is faster and the vision may be better.
What are the reasons for needing endothelial keratoplasty?
EK is needed if the cells on the inner cornea, or endothelium, stop working. This can occur after previous eye surgery, previous failed graft or inherited conditions such as Fuch’s dystrophy and Iridocorneal Endothelial Syndrome.
What can be expected after an endothelial cornea transplant?
The eye may feel irritated with mild to moderate pain for the first few days. The patient may be instructed to lie on his or her back for the first few days to help the graft remain in position. The vision will improve gradually over the first few weeks. The initial visit will be the first day after surgery and then scheduled accordingly. The eye will be monitored closely for vision, pressure, signs of infection, graft healing, signs of graft detachment, and signs of graft rejection.
What is a full thickness transplant?
A full thickness transplant is also called a penetrating keratoplasty or PK, which all the layers of the cornea are replaced. The cornea is sewn into place. The healing time is longer for PK, often a year or longer. With a PK compared with an EK, there is a higher risk that your body can reject the transplant tissue. ‘
In the United States, diabetes is the leading cause of blindness in people under the age of 65. While it can cause cataracts and glaucoma, diabetes can cause the devastating eye disease known as Diabetic Retinopathy. Diabetic Retinopathy is a complication of diabetes involving abnormal blood vessels which nourish the retina of the eye. We will perform a comprehensive eye exam that includes a visual acuity test, pupil dilation, and careful examination of your retina.
What is dry eye syndrome?
Dry eye syndrome is a common problem that can range in severity from mild to severe. This is caused by a disruption of the tear layer that normally coats the surface of the eye. Symptoms include:
What causes dry eye syndrome?
What tests can look for dry eye syndrome?
Tests can be done in the office including looking at eye sensation, tear layer stability, damage to the surface of the eye, tear production, and eye inflammation. A blood test can also be performed to look at autoimmune associated dry eye and Sjogren’s syndrome.
What is the management for dry eye syndrome?
Depending on the case, different treatments for dry eye syndrome are used including:
Eye Physicians of Orange County PC, announced the introduction of a new laser that performs Laser Vitreolysis; a highly effective treatment for treating vitreous opacities - commonly referred to as floaters. As many as 70% of all people will experience floaters in their lifetime. While they are only a nuisance for many people, in a significant amount of patients they can have serious quality of life issues, often disrupting a patients ability to read, drive and otherwise function normally.
This minimally invasive, in-office procedure can provide much-needed relief from the symptoms associated with floaters; which are known to bother many people as they approach middle age.
Vitreous Opacities or ‘Floaters’ are pieces of debris that float in the eye’s vitreous humor (the jelly-like substance in the main chamber of the eye). This debris casts shadows onto the retina (the light-sensitive tissue layer at the back of the eye) and can often create a visual disturbance that can interfere with daily activities such as reading, using a computer or driving.
The procedure to treat floaters uses a specially designed YAG laser to vaporize the vitreous strands. During the procedure, the laser emits short (3 nanosecond) bursts of energy. This laser energy does not simply break the vitreous strands into smaller pieces, but rather converts the collagen and hyaluronin molecules within the floater into a gas, which is then resorbed into the eye.
Recent studies have demonstrated a low complicated rate for Laser Vitreolysis. Most patients will experience an almost immediate improvement in visual function and are able to return to normal day-to-day activities directly following the procedure.
“Typically, many of my patients describe floaters as ‘strands’ or ‘blobs’ obstructing their line of vision which can significantly affect their day-to-day activities. Patients may have been told that they should just learn to live with their floaters or if they are particularly severe or troubling, they should consider a surgical intervention. We are so pleased to be able to offer these patients a non-surgical; minimally invasive procedure that offers the potential to deliver a notable improvement in functional vision.”
“Since commencing this treatment in my practice, I have come to appreciate the negative effect that floaters can have on a patient’s quality of life. To date, the overwhelming response from my patients has been that floaters pose a major hindrance in their daily lives. As clinicians we believe we must embrace the growing need to manage floaters – we can no longer diminish the impact that they can have on a patient’s quality of life.”
What is glaucoma?
Glaucoma is when damage occurs to the optic nerve, which connects the eye to the brain. Most often fluid builds up in the front of the eye, causing pressure that damages the optic nerve. Glaucoma is a leading cause of blindness in people over 60 years old. Damage from glaucoma can be prevented if treated early.
What are some types of the glaucoma?
There are two main types of glaucoma:
1. Primary open angle glaucoma
This is the most common type of glaucoma. The drain of the eye does not work effectively, and fluid builds up in the eye. This causes pressure on the optic nerve and damage to the nerve. Often the pressure builds gradually and people do not symptoms, until there is significant loss of peripheral vision.
In some people, the optic nerve is sensitive to a normal pressure and glaucoma develops even when the pressure is normal. In these cases other tests can be performed to determine if there is optic nerve damage. Routine exams are necessary to diagnose and prevent glaucoma.
2. Angle-closure glaucoma
This occurs when the iris is close to the drainage angle of the eye. When the iris suddenly closes off the drain, the pressure in eye increases rapidly and an “angle closure attack” occurs. This is an eye emergency as sudden and permanent vision loss can occur.
These are signs of an angle closure attack:
Some people can develop chronic angle closure, in which the angle gradually closes of. As this happens slowly, they may not have symptoms until there is significant damage.
What are risk factors of glaucoma?
Risk factors for glaucoma include intraocular pressure (IOP), older age, race, higher prescription, thinner cornea, and family history.
What are symptoms of glaucoma?
Frequently people do not have symptoms from glaucoma, especially if it develops gradually. When the disease becomes advanced, symptoms include loss of peripheral vision, blurry vision, difficulty seeing from one eye.
What is the management for glaucoma?
Damage from glaucoma is reversible so it is important to prevent damage before it occurs. Management for glaucoma is targeting at reducing the pressure in the eye with medication eye drops, laser treatments and glaucoma surgery.
Hypertension can affect different parts of the eye including the retina, blood vessels, and the optic nerve. The high blood pressure damages the blood vessels, which can lead to breaks in the blood vessels, bleeding, and leakage of fluid. The optic nerve can also develop bleeding and swelling. This is diagnosed by eye examination. The main treatment is focused on reducing the blood pressure.
Taking your child for a comprehensive eye exam at an early age, and maintaining regularly scheduled eye care checkups as they are growing up, is the best way to ensure that your child’s vision development reaches its full potential and to make certain that your child acquires the visual skills needed to fully participate in all activities.
According to guidelines established by the American Optometric Association a child should receive an eye exam at the ages of 6 months, 3 years, before kindergarten, and then once every two years. However, in the presence of certain risk factors or diagnosed vision issues, more frequent exams may be recommended. Children who are wearing eyeglasses or contact lenses should be checked annually.
The members of our professional team are skilled and experienced providers of comprehensive vision care for children and do their best to make sure that your child’s eyes are strong and healthy as they grow. Our specialized pediatric eye care services include child friendly and age appropriate exams to assess visual acuity, eye tracking, and focusing skills, as well as to detect problems such as nearsightedness, farsightedness, lazy eye (amblyopia), crossed eyes, dyslexia, a color blindness, disease or medical conditions. Depending upon the findings of your child’s eye exam visit, eyeglasses, vision therapy, or additional procedures may be recommended.
Keratoconus is an eye condition in which the shape of the cornea becomes distorted. The cornea is a clear structure that covers the front of the eye and does 85% of the focusing of the light as it passes through the eye. In a healthy eye, the cornea curves like a dome. In an eye with keratoconus, the center of the cornea slowly thins and bulges so that it sags and has a cone shape distorting vision.
The primary treatment options for keratoconus are contact lenses and surgery. In the very early stages of keratoconus, vision problems can be corrected with prescription glasses or contact lenses. As keratoconus progresses, special gas permeable contact lenses may be necessary. Advanced keratoconus may require surgery. There are new treatments for this condition being introduced all the time and by speaking with an expert you are sure to get the best care.
What is laser vision correction?
Laser vison correction is a method of correcting the vision for myopia, hyperopia, astigmatism and presbyopia. The treatment is applied to the cornea on the surface of the eye. In people who are nearsighted or myopic, the treatment reduces the curvature of the cornea that is too steep, and this brings images in focus on the retina. In people who are farsighted or hyperopic, the treatment results in a steeper cornea to increase the eye’s focusing power. In astigmatism, the treatment smooths the cornea to make it more regular. Refractive surgery can be a good option in people who:
The most common methods of refractive surgery include LASIK (laser in situ keratomileusis) and surface ablation or PRK (photorefractive keratectomy). LASIK involves creating a flap, applying laser to the cornea and then replacing the flap. Surface ablation involves removing the surface layer, applying the laser to the cornea and the often placing a contact lens to help the surface heal. If you are considering refractive surgery, you and your ophthalmologist can discuss the best treatment to suit your vision needs and your lifestyle.
What are the alternatives to refractive surgery?
Alternatives to laser refractive surgery include wearing glasses or contacts, other cornea surgery to correct the vision or placing an intraocular lens to correct the vision.
The high success rate of LASIK and laser vision correction can be attributed to the advanced technology available today as well as the thorough evaluation process by which candidates are selected for the procedure.
Please call the office to make an appointment for a laser vision correction consultation.
Macular degeneration is a progressive disease that affects the cells in the back part of your eye, which allows you to visualize objects that are straight ahead. Over time it damages your capacity for sharp, central vision. With macular degeneration, it becomes increasingly more difficult to perform daily tasks such as reading or writing as well as recognizing faces or colors. Among the early signs of vision loss from macular degeneration, are shadowy areas in your central vision and unusually fuzzy or distorted vision. While individuals with advanced cases of macular degeneration are considered legally blind as the result of a profound loss of central vision, their peripheral vision, which is less clear than central vision, is retained. Most people do not experience vision loss in the early stage of age-related macular degeneration and the progression can be slow and painless.
An eye doctor can often detect early signs of macular degeneration before any symptoms are experienced. If signs of the condition are found, additional tests to verify the diagnosis may be ordered. Once the diagnosis has been confirmed, treatment to manage the condition and to slow the progression will be prescribed.
According to the National Eye Institute, over two million adults in the United States have age-related macular degeneration with that number expected to double within the next thirty years. While one defense against age-related vision loss is a nutritious diet and a healthy lifestyle, regular comprehensive eye exams are essential in order to protect the health of your eyes and the quality of your vision.
What is a pterygium?
Pterygium is a growth of tissue extending from the conjunctiva overlying the white of the eye onto the cornea. It has been associated with UV exposure. Risk factors include UV radiation, dry climate, and spending time outdoors.
What are symptoms of pterygium?
Pterygium can cause an increased redness to the surface of the eye, irritation, tearing, or sensation of dryness. As the pterygium grows, it can astigmatism and obstruction of vision.
What is the management for pterygium?
Pterygium can be initially managed with eye drops and ointments to reduce discomfort and redness. If symptoms persist, surgical excision with conjunctival graft can be performed. Some people are prone to recurrence of pterygium, which can be more aggressive.