Ocular Disease Diagnosis and Treatment
Your ocular health is as important to us as getting you the perfect pair of corrective lenses. We use state of the art equipment to detect and manage a wide range of conditions during your comprehensive examination including but not limited to:
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- Macular degeneration
- Glaucoma
- Diabetic retinopathy
- Cataracts
- Dry eye
- Strabismus
- Amblyopia
- Keratoconus
- Hydroxychloroquine toxicity
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Managing your eye health is amongst the most important eye care services provided at our eye clinic. Our optometrists use state of the art equipment to detect and manage a wide range of conditions during your eye exam.
Common eye diseases
Macular degeneration
Macular degeneration is a disease which primarily affects the elderly, and causes progressive deterioration of the macula, the part of the retina which is responsible for central vision. While it does not cause complete blindness, it can make it difficult to drive, see faces, read, and perform other activities of daily living. The disease is separated into two categories, dry and wet macular degeneration. In wet macular degeneration, the macula is impeded by the growth of abnormal, leaky blood vessels. It is typically treated with intraocular injections. Dry macular degeneration on the other hand is characterized by progressive thinning of the macula caused by drusen, small, yellowish deposits which accumulate under the retina. Management usually involves risk factor modification (smoking cessation, diet changes, optimizing cardiovascular health, UV light protection, etc), and nutritional supplementation (PreserVision AREDS, Bausch & Lomb Ocuvite, other supplements containing lutein and zeaxanthin).
Glaucoma
Glaucoma is the leading cause of irreversible blindness in the US and the world. It is a progressive disease which causes damage to the optic nerve resulting in complete loss of vision. Typical progression of the disease first involves loss of peripheral vision, followed by loss of central vision. Intraocular pressure is identified as the most significant risk factor. Therefore glaucoma is usually managed by reducing the intraocular pressure with drops, laser therapy, and/or surgery.
Diabetic retinopathy
Diabetic retinopathy is a medical condition in which the retina is damaged due to high blood sugar levels caused by diabetes mellitus. The disease initially begins when the blood vessels in the eye begin to swell, become leaky, bleed, and reduce blood flow. If blood sugar remains uncontrolled beyond this point, irreversible vision loss may occur by neovascularization (abnormal blood vessel growth), and macular edema (swelling of the macula). Treatment may then be required by either direct cauterization of retinal tissue by laser, or intraocular injections. Having a normal A1C and blood sugar readings does not eliminate your risk of diabetic retinopathy, as the degree of stress each person is capable of handling is unique. It is therefore recommended that all diabetic patients at an absolute minimum, have their retina completely evaluated yearly. In addition your primary care provider, or endocrinologist may find your examination essential to your management, as the retina is one of the few places you can directly observe the health of the blood vessels, and is a direct reflection of the health of the arteries and veins throughout the body.
Cataracts
Cataracts are the leading cause of reversible vision loss in the US and the world. Cataracts are the clouding of the eye’s natural lens, a structure which sits just behind the iris (the colored part of your eye). Symptoms may include blurry vision, halos around light, glare, double vision, and trouble seeing at night. Prevention usually includes routinely wearing UV blocking sunglasses, and reducing UV light exposure. Fortunately cataracts can be treated with great success surgically.
Dry eye
Dry eye occurs when either the eye does not produce enough tears, or when the tears evaporate too quickly. Causes are often multifactorial, and can be difficult to pinpoint. Therefore a comprehensive examination is often required to establish a treatment protocol. Click here to learn more about dry eyes.
Strabismus
Strabismus is the misalignment of the eyes when focused on an object, creating a cross eye appearance. It is characterized by the direction of the misaligned eye: esotropia (misaligned eye deviates to nose), exotropia (misaligned deviates towards ear), hypertopia (misaligned eye deviates upwards), hypotropia (misaligned eye deviates downwards). The condition may be present occasionally or constantly. It is important to address strabismus early as it can lead to the development of amblyopia. Several treatment options exist including: special eyewear with prism, use of an eye patch, vision therapy, and surgery.
Amblyopia
Amblyopia, often referred to as a lazy eye, is a disorder in which the brain is unable to process clear input from one eye, and as a result favors the other. This results in a neurological imbalance between the eyes. If amblyopia is allowed to develop, the vision in the affected eye will be compromised even with glasses, contacts, or surgical correction. Additionally binocular vision tasks such as depth perception are severely compromised. Treatment may consist of prescribing optimal vision correction, patching, atropine eye penalization, correction of an eye deviation, and/or management of other pathology causing unilateral vision disruption.
Keratoconus
Keratoconus is a disease which results in the progressive thinning of the cornea, the clear layer of the eye that sits over the iris (the colored part of the eye). Causes of keratoconus are suggested to be both genetic as well as environmental including risk factors such as eye rubbing and allergies. Patients with keratoconus often exhibit blurry vision, double vision, glare, and worsening astigmatism. The type of astigmatism patients with keratoconus often may develop is unique as it is irregular, and is unable to be optimally corrected with glasses. Fortunately patients with irregular astigmatism can usually obtain functional vision with the aid of specialty contact lenses. This type of lens is able to correct the irregular cornea by creating a smooth regular surface. Treatment for early keratoconus usually involves a procedure called corneal cross linking, while treatment for advanced stages may involve a corneal transplant.
Hydroxychloroquine toxicity
Hydroxychloroquine, sold under the brand name Plaquenil, is a drug used to treat a variety of conditions such as systemic lupus erythematosus, rheumatoid arthritis, and malaria. Toxicity from hydroxychloroquine may be seen at the cornea, the clear layer of the eye that sits over the iris, and macula, the part of the retina which is responsible for central vision. Routine monitoring with a visual field, ocular coherence tomography, slit lamp, and fundus autofluorescence is necessary to ensure treatment is not causing irreversible vision loss.