Category: Eye Health

What is an Epiretinal Membrane

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An Epiretinal Membrane (ERM) is also known as Cellophane Maculopathy or Macular Pucker. Sometimes it is simply referred to as a “wrinkle.” In most cases, a Posterior Vitreous Detachment (PVD) has occurred. This vitreous activity causes the macula to generate cells and create a scar-like membrane. This thin tissue layer can contract and cause a wrinkle.


In the above picture of the inside of an eye, the whitish irregularities on the left side is the membrane. The photo below shows a normal macula, note the the smooth and regular color on the left side. The dark spot to the left in each photo is the macula.

The macula provides sharp, central vision and allows us to see details. Any change in the surface, like a wrinkle, will cause distortion and blur. ERM usually occurs in one eye only. The initial onset of the blur and distortion can be very alarming, but most people get used to it depending on the extent. Sometimes it resolves on its own, but mostly it stays the same. If you are noticing this type of vision change it is very important to have an examination for a correct diagnosis. Blur and distortion can be symptoms of other conditions, such as a macular hole.

In cases where the vision is significantly impaired a surgical procedure can be done. A vitrectomy is performed to remove the vitreous, then very delicately the surgeon peels the membrane off of the macula. This often reduces distortion and improves the vision, but not completely. Retinal surgery is not without risks, the most common risk is the development of cataracts, but any damage to the macula during the procedure can cause permanent visual impairment.

ERM is not the same as Macular Degeneration.

Firework Safety

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Fireworks

 

For most of us, celebrating the Fourth of July means barbeques and fireworks. Unfortunately, the fun can be cut short when fireworks are used inappropriately and cause serious injuries. One of the most common causes of firework injury is when a device explodes before expected. This often results in cuts, burns and bruises in and around the eye. Sparklers are not exempt, in fact they are responsible for a significant percentage of eye injury cases.

According to a study by the US Consumer Product Safety Commission, fireworks were the culprit for an estimated 8,800 injuries treated in US emergencies departments during 2009. Of these, 54 present were children and teens under the age of 20 years.

Below are tips to help protect and preserve eyesight during the Fourth of July holiday.

  • Discuss firework safety with children and teens prior to the Fourth of July holiday.
  • Do not allow kids to handle fireworks and never leave them unsupervised near fireworks.
  • Wear protective eyewear when lighting and handling fireworks of any kind.
  • Store fireworks, matches and lighters in a secure place where children won’t find them.
  • Refrain from purchasing sparklers. Heating up to 1,800 degrees, sparklers are the number one cause of fireworks injuries requiring trips to the emergency room.
  • Be aware of your surroundings and only light fireworks when family, friends and children are at a safe distance.

Have a happy and safe holiday!

Burning Eyes

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Red rimmed eyes, burning eyes, watery eyes. These are symptoms of eyelid inflammation caused from Meibomian gland dysfunction (MGD), blepharitis or both. Another condition of the eyelid that causes discomfort and redness are styes; when one of the eyelid glands becomes infected. Styes are more localized and found on the edge if the eyelid.
The Meibomian glands are between the eyelashes. They can become plugged and inflamed causing problems with the tear quality. The compromised tears evaporate quickly causing the lacrimal gland to overcompensate and produce too many tears which spill over the eyelids. The inflammation produces a foamy discharge that sits on the lower eyelid margin causing irritation and burning.


Blepharitis in an infection or irritation of the eyelid. The typical sign of “bleph” is flakes and/or debris on the eyelashes. The flakes and debris end up in the eye causing irritation and redness.
At night when we sleep, the eye is closed and not blinking. Tear production is greatly reduced. Anything left on the eyelashes and eyelids will sit on the eye all night causing discomfort, grittiness and redness by morning. Treatment involves removing the potential irritants. This includes thorough removal of make-up and creams. A hot compress will soften the waxy plugs in the meibomian glands. Mild cleaning solution and a washcloth or cotton swab will remove debris from the eyelids and eyelashes. For a printable description of eyelid hygiene click here.

Good lid hygeine will improve contact lens comfort during the day, and reduce dry eye symptoms too.

UV Damage and Your Eyes

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Most people (79%) know the importance of sun protection for the skin, but only 6% know how important it is for the eyes.
Studies from all over the world have shown that Ultraviolet (UV) damage due to chronic exposure to UV light is a factor in many diseases of the eye. Some of these conditions include pterygium ( a growth on the cornea), cataracts (clouding of the lens) and possible age-related macular degeneration (a condition causing decreased vision).

  •  No amount of UV exposure is healthy for the eyes.
  • The eye is the only place where internal tissues of the body are directly exposed to environmental UV.
  • UV damage is cumulative and often irreversible
  • Almost half of your UV exposure occurs when you are not in full sun and less likely to wear sunglasses or protection.

There are several things to consider when selecting sunglasses. The glasses should be comfortable and provide complete UV protection. More than one pair may be indicated; the sunglasses you wear running to the store, will be different than the pair you use for golf or boating. The style of frame and type of lens vary to the task.

The staff at Westside Optometry can help you make the best decisions to maximize your UV protection and maintain good eye health. They are very excited about a new lens that becomes polarized as it darkens.

Itchy, Watery Eyes

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girl with allergies

I hope this is the peak of the allergy season and the air clears soon. There are a lot of people suffering from itchy watery eyes. Besides locking yourself indoors or wearing goggles to avoid the cause of seasonal allergies there are a few things you can do.

  • Wear sunglasses outdoors to minimize exposure to wind
  • Start using an allergy drop with mast cell inhibitors to reduce the allergic response. At your next visit to Westside Optometry we can write a prescription and make recommendations.
  • Rinse your eyes with cool, sterile saline. This soothes and rinses out allergens.
  • If you wear contact lenses, consider switching to glasses temporarily. Pollen and irritants stick to the lens creating more time for the eye to react to them. The glasses will create a barrier between the eye and wind too.
  • Do not rub your eyes! This will only create more of a reaction and cause swelling. Instead put ice cubes in a washcloth and gently rest on closed eyes to soothe them.

Allergies are so common in Petaluma, I wrote about them in April, Eye Allergies. If you suffer all year long, I have more information about indoor allergies such as dust and animal dander, too.  Your Eyes and Allergies

 

GLARE

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glarePeople suffer from 4 types of  glare: distracting, discomforting, disabling and blinding. Distracting glare is caused by reflections on eyeglass lenses. This can be eliminated with anti-reflective coating. At Westside Optometry, we recommend this type of non-glare coating on the back side of sunglasses also.
Discomforting glare is caused by everyday light conditions that cause squinting and eye fatigue. Tinted or photochromic lenses will reduce this type of glare.
Disabling glare occurs when excessive, intense light reaches the eyes. The effects of disabling glare can cause long-term eye damage. Good sunglasses with maximum ultraviolet protection eliminates disabling glare.
Blinding or reflective glare comes from light reflected off smooth, shiny surfaces such as water, sand, snow or wet roads. A polarized sunglass is the ideal solution for blinding glare.

Glare is a problem during the day and night. It bothers people working at a computer, driving on the freeway and fishing on a boat. Don’t squint and suffer any longer, let us eliminate the discomfort of glare with appropriate glasses.

Eating for your Eyes

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Everyone knows that proper diet and nutrition have advantages for health, but did you know that it is beneficial to your eyes as well? A diet rich in beta carotene, lutein, zeaxanthin, zinc, omega-3 fatty acids and certain vitamins can also help protect against vision loss, particularly age related macular degeneration (AMD).

AMD diminishes central vision and currently affects the vision of more than 2 million Americans, ages 50 and older. AMD is a progressive disease that if left untreated, can result in severe vision loss and even blindness. The exact cause of AMD is unknown, but risk factors for the disease include age, race, smoking, family history and health conditions such as cardiovascular disease and hypertension.

eyes and nutrition

A wide variety of foods including lentils, grapes, carrots, bell peppers, broccoli, spinach, sweet potatoes, kale, certain kinds of fish, turkey and some kinds of nuts, have been shown to aid eye health. Although there are a variety of available over-the-counter supplements designed for vision and eye health, a doctor should always be consulted before use.

Foods that contain refined starches and are high in sugar can be damaging to vision. A study by Tufts University showed that high-glycemic foods cause a dramatic rise in blood sugar, which over time, may damage the retina and capillaries in the eye by promoting oxidative stress and inflammation. Soda and sugary drinks, candy, baked goods,  some cereals , white rice, foods made with white flour, such as white bread and pasta, should be avoided or limited.

Other healthy habits can lead to healthy vision. The risk of eye disease and vision loss can be lowered by:

  • Avoiding trans fats
  • Quitting smoking
  • Controlling blood pressure and cholesterol
  • Exercising regularly
  • Visiting your optometrist regularly

Eye Allergies

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Driving through the Sonoma wine country last weekend, I thought how lucky I am to live in such a beautiful place. The fields were green, the lambs were frolicking and the mustard was in full bloom. Gorgeous! But if you suffer from allergies, Sonoma County can be wicked to your eyes and sinuses. Petaluma tends to be particularly windy, stirring up the pollen even more.

Eye allergies are also called “allergic conjunctivitis.” It is a reaction to indoor and outdoor allergens (such as pollen, mold, dust mites or pet dander) that get into your eyes and cause inflammation of the conjunctiva, the white tissue that lines the inside of the eyelid and eyeball. Eye allergies are not contagious.

Other substances called “irritants” (such as dirt, smoke, chlorine, etc.) and even viruses and bacteria, can compound the effect of eye allergies, or even cause irritating symptoms similar to eye allergies for people who are not even allergic. The eyes are an easy target for allergens and irritants because like the skin , they are exposed and sensitive. Dry eyes tend to be more susceptible to ocular allergies because there are less tears to rinse allergens and irritants away.

Certain medications and cosmetics can also cause eye allergy symptoms. By way of response to these allergens and irritants, the body releases chemicals called histamines, which in turn causes inflammation. This reaction makes the eye tissues red and swollen.

The signs of eye allergies are red, itchy, burning, tearing, swollen eyes, along with a gritty sensation. These symptoms may be accompanied by a runny or itchy nose, sneezing, coughing, or a sinus headache. Many sufferers also find that their vision is temporarily blurred.

I find it best to treat eye allergies before the onset of symptoms, but treatment can improve comfort and the appearance of the eye anytime. Do not suffer, there are treatments to control eye allergies.

Save your Vision

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Here we are closer to the end of March than the beginning and I have not talked about Save-Your-Vision month yet. March is Save-Your-Vision month. The American Optometric Association (AOA) selects a theme for Save-Your-Vision month and this year the theme is the importance of annual eye examinations. Having an eye exam every year can, ..well…, save your vision.

There are a number of eye conditions that do not have symptoms, like glaucoma, diabetic retinopathy and brain lesions. In most cases, early detection and the proper treatment can prevent blindness, disability or death. Some conditions do have symptoms, but they are still ignored. Blurred vision, eye strain and red eyes can be treated to make your life much more comfortable.

If you have not had a comprhensive eye examination in the last 12 months, make that call (707)762-8643, it can save your vision.

What to Expect from your Eyes when Expecting

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During pregnancy a woman’s body undergoes miraculous changes, some good, some uncomfortable and some that are puzzling. Everyone experiences different things as every pregnancy is unique.

The eyes do not escape the wild hormonal ride during pregnancy. The lens and/or cornea respond to fluctuations in hormones. Not every pregnant woman will see vision changes but for those who do the impact is significant. Ocular structures swell and deswell causing refractive changes. The result of these changes is blurry vision. The women I have treated with vision changes notice shifts in their vision for most of their pregnancy. Some woman experience increased dry eye and/or contact lens intolerance.

The good news is I can usually help patients through their pregnancy with temporary vision corrections. And the best news is that most symptoms resolve post-partum.

Another ocular concern during pregnancy is the exacerbation of pre-existing conditions such as Graves disease and diabetes. Although these are systemic diseases, they have significant effects on the eye health.