MEDICAL EYE CARE
Many medical eye conditions can be more successfully treated when diagnosed early. Having regular comprehensive eye exams are vital to maintaining the health of your eye. These exams are covered by regular medical health plans because they address the medical eye conditions.
Tearing problems may be caused by an obstruction in the tear duct (lacrimal obstruction). Tears become trapped within the sac which may become infected, causing a painful swelling in the inner corner of the eyelid.
Topical antibiotic ointments and oral antibiotics can be used to reduce infection. The infected or inflamed area may be massaged, to push open the membrane causing the obstruction. If the obstruction is still present, it may be necessary to clear the tear duct by probing and irrigation. There is minimal pain associated with this procedure. Complete obstruction requires surgical intervention to prevent future recurrences. This procedure (dacryocystorhinostomy or DCR) can be done with a small incision near the nose or with an endoscope.
Glaucoma causes damage to your eye's optic nerve and is a leading cause of blindness. Damage to the optic nerve may be due to rising fluid pressure inside the eyes. Glaucoma tends to be inherited and may not show up until later in life. If left untreated, glaucoma can cause total permanent blindness within a few years. Risk factors for glaucoma include older age, family history, smoking, high eye pressure and the optic nerve appearance. Anyone at risk requires a yearly exam since prevention is key and vision loss is irreversible.
Glaucoma treatment may include prescription eye drops, laser surgery, or microsurgery.
Presbyopia is a common age-related vision condition which occurs when the lens of your eye loses its flexibility making it difficult to focus on objects up close. This is the reason that reading glasses become necessary in most people over the age of 40. You can have excellent distance and near vision when you are younger without glasses, and require reading glasses when you develop presbyopia. Since nearly everyone develops presbyopia, if a person also has nearsightedness (myopia), farsightedness (hyperopia) or astigmatism, the conditions will combine. Vision correction surgery (LASIK) is excellent for treating even small amounts of nearsightedness or farsightedness, but will not correct presbyopia. Lens implant surgery can treat presbyopia.
Macular Degeneration or age-related macular degeneration (AMD) is a medical condition which usually affects adults over 50. It causes vision loss in the center of the visual field (the macula), the part of the eye that provides sharp vision.
While there is no cure for age-related macular degeneration but medication into the eye, special vitamins and laser surgery may delay its progression or even improve vision. Adults over 50 should be checked for any signs of macular degeneration since preventive treatment can prevent some permanent vision loss.
HIV RELATED ISSUES
HIV breaks down the body's immune system causing all areas of the body to be susceptible to infections, including the eye. It is not uncommon for HIV patients with low immunity (T cells less than 100) to get eye infections. Eye problems due to a suppressed immune system include the following:
COTTON WOOL SPOTS
White spots, as a result of a blood vessel blockage, accumulate on the retina. While the cotton wool spots do not interfere with vision, they can occasionally bleed and appear red.
CMV retinitis is caused by cytomegalovirus. Symptoms include vision loss, floating spots, flashes of light and bleeding. While there is no cure for CMV, medication can help slow progression and prevent vision loss.
CMV can sometimes cause a detached retina (where the retina shifts away from the back of the eye). Surgery is required to put the retina back in its proper position.
Kaposi's sarcoma is a rare form of cancer that can occur in AIDS patients. This cancer can cause purple-red lesions that form on the eyelids or a red fleshy mass that forms on the conjunctiva or a thin filmy membrane that covers the white part of your eye. Patients with compromised immunity should have regular eye exams to screen for these diseases.
DIABETIC EYE DISEASE
Diabetic retinopathy is a leading cause of blindness in adults and is caused by changes in the blood vessels of the retina (a light-sensitive tissue at the back of the eye necessary for good vision). In some cases, blood vessels may swell and leak fluid and in others abnormal new blood vessels grow on the surface of the retina.
The best treatment for diabetic retinopathy is prevention. All diabetics should control their levels of blood sugar, blood pressure, and blood cholesterol. This is the best way to prevent blindness. Your ophthalmologist can also use a laser to cauterize the abnormal blood vessels to stop the leakage of fluid and blood. These important treatments can help reduce vision loss. However, these conditions may progress especially if the diabetes is not medically controlled.
Regular eye exams are important for diabetic patients.
THYROID DISEASE (GRAVES DISEASE)
Thyroid eye disease, also known as Graves’ disease, occurs when an overproduction of hormones is produced in the thyroid (hyperthyroidism). The symptoms include dry eyes, watery eyes, red eyes, bulging eyes, a "stare," double vision, difficulty closing the eyes, and problems with vision.
Your eye doctor will monitor eye protrusion and eyelid retraction by taking precise measurements of your eyes. If the measurements are increasing, or if your symptoms are getting worse, treatment may be needed.
A combination of non-surgical and surgical methods are used to treat your symptoms. We treat both the medical and surgical aspects of this condition.
EYELID SKIN CANCERS
Eyelid skin cancers may occur in the lower eyelid, corners of the eye, eyebrow skin, or adjacent areas of the face. They appear as painless elevations or nodules and/or distortion of the normal skin structure. Such lesions need to be evaluated and may require a biopsy to confirm the diagnosis of cancer.
Complete removal of the tumor is critical to minimize the possibility of recurrence. Once the tumor has been completely removed, reconstructive surgery is performed. Patient who have had skin cancers in any part of their body, or pre-cancerous lesions, need regular examinations of the skin around the eyes and face.
Tears are necessary for maintaining the health of the surface of the eye and for providing clear vision. When your tears can’t provide the adequate moisture your eyes need, your eyes may sting, burn or feel uncomfortable. This is known as dry eye syndrome. The best eye doctor for dry eye treatment is one that can educate you on all options. Our New York City practice has been featured in the press for treating dry eye syndrome with IPL (also known as photo rejuvenation), just watch the videos above to learn more.
Dry eye reatments include lifestyle changes (avoiding heating or air conditioning vents, hair dryers, and cigarette smoke) and eye drops. Artificial tears can be purchased without a prescription or products such as RESTASIS®, can be prescribed to improve tear function. Other options include punctal plugs (a small plug your doctors inserts in the tear duct), eye vitamins, flax seed or fish oil supplements, and intense pulsed light therapy (IPL).
Intense Pulsed Light (IPL) therapy improves the meibomian gland’s function in the eye. The light acts as a powerful warm compress to liquefy the secretions plugging up the oil-secreting meibomian glands. This is an “off label” treatment for dry eye but can be effective in select patients whose dry eye is a result of oil secretions (blepharitis). IPL therapy is recommended for four to six treatments spaced one month apart.