Imagine this – you go outside on a beautiful sunny day and realize that you left your sunglasses at home – ordinarily you would be squinting and uncomfortable but not anymore – now your contact lenses turn dark when you go outside! Acuvue Oasys, the wildly popular two week contact lens from Johnson and Johnson has joined technological forces with Transitions Optical to create Acuvue Oasys with Transitions. This new product got so much positive buzz that it was selected by Time Magazine as one of 2018’s BEST INVENTIONS OF 2018. Like the regular Oasys lens, the Oasys with Transitions is a two week lens that can be cleaned with either standard multipurpose solution or a hydrogen peroxide based system. It takes 30 seconds to activate when you go outside and ninety seconds to turn back to clear when you go back inside. When the lens is fully activated outside it filters 70% of outdoor light, and even inside it filters about 15% of indoor light. One important thing to realize is that although you are indeed blocking UV light on the eyeball itself when you wear these contacts, you still need sunglasses to protect the skin around your eyes as well as the other parts of your eye, and the contacts never get as dark as real sunglasses. Acuvue is recommending this lens for any patient who is bothered by light sensitivity, whether indoors our outdoors. They are also recommending it for patients who experience halos and starbursts when they drive at night, as well as to those who are bothered by computer lighting. The lens does change your eye color slightly when it is activated outdoors and in studies that were conducted on patients who tried this lens only 2% were bothered by the color shift. Check out the hashtag #SquintLessSeeMore for more cool information about this innovative product which is available through our office now.
Okay guys, here’s the scoop – there is no such thing as pink eye. Oh sure, your eye can be pink, but “pink eye” is not a diagnosis, it’s a description of the way your eye looks. So now that we’ve cleared that misconception up, what causes eyes to become pink?
One of the most common causes of pink (or red) eyes is some form of conjunctivitis. The term conjunctivitis is also very nonspecific and vague – so let’s break it down into more understandable terms. The conjunctiva is the clear thin covering of the white part of the eye and the insides of the lids and the term “itis” derives from the Greek and means “inflammation of”. So quite simply, conjunctivitis means that the white part of the eye is inflamed, and when body parts become inflamed, they get red or pinkish. There are three main forms of conjunctivitis:
- Bacterial Conjunctivitis – like it sounds, it’s caused by bacteria – not only is the eye red but there is usually green discharge as well that can cause the eyes to be glued shut upon awakening in the morning. This is pretty contagious and is treated with topical antibiotic drops or ointment.
- Viral Conjunctivitis – caused by viruses, the eyes are watery, red and sometimes itchy. This is also very contagious and since it is a virus, antibiotic drops don’t work. This usually runs its course over a week or so – cool compresses and artificial tears can be helpful.
- Allergic Conjunctivitis – the hallmark symptom of this type of conjunctivitis is unbearable itching. Usually this is a reaction to pollen or ragweed during peak allergy season (spring or fall) or to pets, dust, or other known allergens. It is not contagious and can be treated conservatively with cool compresses or high quality artificial tears. Oral antihistamines are helpful if there is also nasal congestion and sneezing, prescription eye drops work best if it only affects the eyes.
Other causes of pink or red eyes are dry eye and blepharitis (inflammation of the eyelids) as well as contact lens complications which can range from infections to corneal ulcers. Environmental causes of pink eye are irritants such as dust, smoke, air pollution and chemical exposure. It is important not to self diagnose or use somebody else’s eye drops. If your eyes get red or pink and your symptoms are getting worse or not going away it is important to have your eyes checked by an eye doctor to ensure proper and prompt treatment.
Age Related Macular Degeneration (AMD) is one of the leading causes of vision loss in patients over the age of 60 in the United States. Since February is AMD awareness month let’s talk a little about the detection, diagnosis, and treatment of this potentially visually devastating condition. The macula is the central part of the retina and if it is damaged central vision becomes impaired. There are two types of AMD, one is “dry” and one is “wet”. Dry AMD comprises roughly 90% of AMD patients and is characterized by thinning of the central retina and deposition of yellow spots (called drusen) in the macula. Although dry AMD is slow to progress and vision loss may be minimal, it can progress to a more intermediate or advanced form of dry AMD which can then progress to wet AMD. Wet AMD happens when abnormal and fragile blood vessels grow underneath the retina and then bleed (this is why it is called ‘wet’) causing destruction of the central vision. Dry AMD has no treatment per se, however there are lifestyle changes that can be taken in order to deter the progression from dry to wet. These lifestyle changes include smoking cessation, UV protection such as sunglasses, and ingestion of nutrients such as lutein and zeaxanthin in foods such as spinach or kale or in a vitamin supplement. Wet AMD is treated with drugs that are delivered into the vitreous (inner jelly like portion of eye) and go under the the broad umbrella term of “anti-VEGF” agents. Laser treatments and PDT (photodynamic therapy) are other treatments utilized in wet AMD.
Symptoms of macular degeneration include blurry vision, darkening of vision, loss of color vision and visual distortion. Once the central vision is lost, there is no way to restore it and low vision devices such as telescopes and magnifiers can be helpful to maximize the remaining vision. Early detection of AMD is crucial in order to preserve central functional vision which is why yearly eye exams are so important.
We know that excess sugar is bad for diabetics so patients with diabetes turn to foods with artificial sweeteners to get that burst of sweetness without the dangers of sugar. A recent study in the journal Clinical and Experimental Ophthalmology has reported a linkage between diabetics who drink more than four cans of diet soda and the development of the blinding complications of diabetic retinopathy (severe leakage of blood vessels in the eye). It was not associated with the development of the less severe eye complications of diabetes or macular edema which is swelling in the central part of the eye.
This study is pretty scary. Diabetics rely on these artificial sweeteners on a daily basis to keep them safe from sugar and here is a study that says that these sweeteners can cause severe eye complications. Now what? This research is very new and the results have to be repeated in order to make definitive decisions about cutting sweeteners out of a diabetics diet. A confounding factor in the research also notes that people who consume a lot of artificial sweeteners also have a higher body mass index (they weigh more) as well as a worse cardiovascular profile. In other words, more studies are needed.
So if I am diabetic and drink a lot of diet soda what do I do now? Admittedly this is a tough call. It would probably be wise to cut down the consumption of diet soda and try to switch over to water and stay tuned for further studies to be done.
November is National Diabetes Month and this gives me the opportunity to get up on my soapbox and shout through my megaphone about the importance of yearly eye exams. For patients who know they have diabetes, dilated eye exams are crucial in order to ensure that there is no diabetic retinopathy in the back part of the eye which if not treated can lead to blindness.
So what is diabetes and how does it affect your eyes? Diabetes is a disease which according to the CDC affects more than 100 million Americans and interferes with the body’s ability to store and utilize sugar. Very often patients who are unaware that they are diabetic will experience scary fluctuations in vision which will bring them into my office to see what’s going on. At this point I will refer them out for blood work and a visit with the primary doctor to check for diabetes. Changes in blood sugar can cause these wild changes in the prescription which will stabilize once the glucose (sugar) levels are under control. Once someone has had diabetes for many years and/or has poor control of their sugar levels, the risk of having diabetic retinopathy skyrockets. Diabetic retinopathy happens when the small blood vessels on the back surface of the eye weaken and leak blood and fluid into the retina. If this progresses further without blood vessels shutting off and the creation of new abnormal blood vessels creating scarring which can cause vision loss and/or blindness.
How do you prevent this? The key is keeping blood sugar levels under tight control. This is accomplished by paying attention to diet, exercising, keeping blood pressure and cholesterol under control and not smoking – in other words – maintaining a healthy lifestyle. One important number to be aware of when you come in for your eye exam is your HA1C (or glycosylated hemoglobin) which reflects the overall blood sugar levels over a three month period. Generally this number should be under 7.
All diabetic patients get a letter sent to their primary doctor after their eye exam with the results of the retinal evaluation. If there is retinopathy the primary doc may have to tinker with the meds in order to achieve better glucose control. Above all, be vigilant about any vision changes that are scary or unusual. As I always tell my patients, nothing is stupid or trivial and I’d rather check you and find nothing than have you ignore something serious.