June = Cataract Awareness Month

pexels-photo-902194.jpegContrary to popular belief, a cataract is not an eye disease, rather it is a natural age related change to the lens of the eye which causes it to become opaque and difficult to see through. Generally cataracts are very slow growing and most commonly develop in people over the age of 55. Signs and symptoms can be subtle at first, ranging from blurry vision, glare from headlights, difficulty driving at night and frequent eyeglass prescription changes. Most people come into the office complaining that their glasses are not working when in reality they are experiencing blurred vision from cataracts.

So what exactly is a cataract? There is a part of the eye called the lens which is located behind the iris, the colored part of the eye and it functions to focus light on the retina. When we are young the lens is clear and flexible but as we age the lens becomes opaque or cloudy and consequently images on the retina become blurred. Cataracts can also form in patients with diabetes, smokers, and those on certain medications like steroids. There is no proven way to prevent cataracts but UV protection, smoking cessation and a healthy diet that includes antioxidants can help prevent their premature development.

pexels-photo-690887.jpegHow do we treat cataracts? When cataracts start to interfere with quality of life and ability to function, surgical removal of the cataract is indicated. The lens of the eye is removed and replaced with an artificial lens which greatly improves vision. The most common comment I get on the first day after the operation is how bright and beautiful colors look. As with any surgery there are risks, but we co-manage surgery with the best cataract surgeons in order to ensure the best possible outcomes.

Vitamin “See”

yellow health medicine wellness

If you’ve read enough of my blog posts, you’ve probably figured out that I am a little obsessed with both the short and long term effects that digital devices have on our eyes. I am particularly interested in the effects it has on kids since many of them are exposed to some kind of tech as early as the first year of life. Recently,  a company called EyePromise debuted a vitamin named Screen Shield Teen aimed at kids aged 4-17 that is a supplement meant to support and preserve visual comfort and wellness for this age group. The main ingredients are 5 mg of dietary zeaxanthin and 2.5 mg of lutein which are antioxidants that help eradicate free radicals produced by blue light and help protect the macular pigment which is crucial for developing eye health. The vitamin is a fruit punch flavored chewable that is gluten free and can be taken together with regular multivitamins. Increasing amounts of children and teens are coming into my practice with complaints of tired eyes, headaches and eye strain from too much screen time and aside from the common sense advice of decreasing screen time this vitamin could play a part as well in protecting young eyes from future damage. 

photography of women using mobile phones

Should Babies Have Screen Time?

boy wearing blue t shirt using black laptop computer in a dim lighted scenario

When my daughter was a toddler in the 1990’s we bought her a Sesame Street computer game, fully prepared to teach her how to wield the mouse and click her way around Elmo’s playroom. To our shock and delight she was a natural, skillfully manipulating her way around the game as if the mouse was an extension of her hand. Twenty years later we take it for granted that our kids are born with a natural affinity for anything involving technology and researchers are trying to figure out exactly how the digital world should fit into our children’s lives.

girl holding green leafA few days ago the World Health Organization (WHO) came out with their first ever guidelines for how much screen time is healthy for kids under the age of five. They recommended no screen time at all for babies under a year old and less than an hour a day for kids ages three to four. Their definition of screen time included TV and videos, electronic devices, and computer games. Their recommendations were based not necessarily on the fact that screen time is inherently bad for little ones, but that increased screen time increases sedentary behavior which in turn leads to decreased physical activity. It is the emphasis on physical activity which is the key point to these WHO guidelines. Dr. Fiona Bull, a program manager at WHO had this to say: “Improving physical activity, reducing sedentary time and ensuring quality sleep in young children will improve their physical, mental health and well-being, and help prevent childhood obesity and associated diseases later in life”. Other childhood researchers disagreed with the new guidelines saying that they did not take into account the quality of the digital interactions, only the quantity. So what’s the upshot of these new recommendations? As with most things in life, moderation and common sense go a long way in figuring out how to interpret this kind of advice.

 

Do I Have Pink Eye?

pink-eye-md

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:

  1. 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.
  2. 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.
  3. 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.  

February Is Age Related Macular Degeneration Month

pexels-photo-902194.jpegAge 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.

blur-close-up-focus-906055Symptoms 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.