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Eye Allergies

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Spring is in the Air
And so is the pollen

75% of allergy symptoms involve the eye. These symptoms include itching, watering and redness. In moderate to severe cases, contact lenses can not be tolerated.

Oral allergy medications can help, but not as quickly or effectively as an allergy eye drop. There are several allergy drops available, some prescription and some over-the-counter. Some of the drops contain antihistamines, decongestants and/or mast cell stabilizers. Antihistamines provide immediate relieve of itching, the mast cell stabilizers provide long-lasting relief. Decongestants constrict the blood vessels to minimize redness, but offer no reduction in the allergic reaction. None of these drops can be used while wearing contact lenses. I will be happy to assist you in selecting the best pharmaceutical solution to your ocular allergies.

Below are some suggestions to minimize the symptoms of ocular allergies and related discomfort.

Recommendations to Reduce Allergic Reactions
 Avoid exposure to allergens
 Rinse eyes with sterile saline solution.
 Cold compresses – place a couple of ice cubes in a clean washcloth
 Maintain contact lens integrity by replacing and cleaning the lenses as prescribed
 Reduce irritation with proper eyelid and eyelash hygiene
 Control ocular dryness with artificial tear drops, proper hydration and supplements
 Begin allergy drops at the first signs of a reaction
 Wear wraparound sunglasses to shield the eyes

Save Your Vision Month

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March is Save your Vision Month

It is important to be proactive and protect your eyesight and vision for the future. 

For adults in their 20s and 30s, the eyes are generally healthy as are the other organs in the body. Start protecting your vision now.

 Eat right! Include lots of fruits and vegetables in your diet
 Quit smoking
 Wear sunglasses to protect against harmful ultraviolet radiation.

For adults in their 40s and 50s, you are probably noticing some significant changes in vision, especially close-up. Menopause can increase dry eye symptoms for women.

 Ask family members about eye diseases. Many conditions run in the family
 Invest in accurate and quality reading glasses
 Your general health can have profound effects on your eyes. Be prepared to discuss medications and health conditions with your optometrist

After 60 it is crucial to maintain regular eye examinations. The incidence of many eye diseases increases. Many of these conditions like glaucoma, have no symptoms.

 Schedule annual exams or as recommended.
 Report all changes in general health to the eye doctor. Don’t accept declining vision as just a part of aging.

Reliability of Vision Screenings

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     The department of motor vehicles, the school nurse and the pediatrician use vision screening to identify vision problems. Screening usually involves standing a given distance from a lettered chart, covering one eye and reading down the chart to the smallest letter possible.
     According to a recent study in Australia, researchers found that results for detecting myopia in 12 -13 year olds was nearly 98%. Good news for the nearsighted, but not so good for the tweens with astigmatism or hyperopia. Only half of the hyperopic children were identified by the vision screening and 25% of the kids with astigmatism were missed.
Screenings are best designed to detect problems with distance vision, and that is important for children socially and physically, but myopia represents the least risk for reading and learning. A myopic child is more likely to notice that the board is blurry and move to the front of the classroom. Hyperopia on the other hand, makes it more difficult to see things close up and astigmatism effects vision at all distances. Children with uncorrected hyperopia and astigmatism will have more difficulty reading and writing and may not even be aware that the difficulty is due to his or her vision. These are the children that may complain of headaches, avoid reading and school related tasks.
     A vision screening test identifies some vision problems, but can miss disorders that have a profound effect on a child’s ability to succeed in school.

Spring Eyewear Event

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Dr. Karen Griffith and her staff cordially invite you to a special eyewear event featuring the Clearvision frame collections of:

IZOD, Ellen Tracy, BCBG, Cole Haan, OP and Fisher Price

 We are also pleased to present the entire Maui Jim Sunglass line

Saturday, March 5, 2011
10:00 – 2:00

There will be refreshments

Bring a Friend
Call ahead to make an appointment for an eye examination

Maui Jim Sunglasses

Subconjunctival Hemorrhage

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moderate blood on eye 

Many of us have had a blood red spot on the white of the eye at one time or another. Usually there was no injury or discomfort. Many people wake-up with the red spot and may not even be aware of it until a family member or co-worker asks about it. Subconjunctival hemorrhages look worse than they are and do not need treatment. 

The conjunctiva is a thin membrane that covers the surface of the inner eyelid and the white part of the eyeball. The conjunctiva contains many small, fragile blood vessels that are easily ruptured or broken. Subconjunctival hemorrhage occurs when a small blood vessel in the conjunctiva breaks and bleeds. It may occur spontaneously or from heavy lifting, coughing or vomiting. In some cases, it may develop following eye surgery or trauma. Subconjunctival hemorrhage tends to be more common among those with diabetes and hypertension. 

Certain medications can make the bleeding worse, including: Coumadin, Aspirin, Plavix, St. John’s Wort and Ginkgo. 

While it may look frightening, a subconjunctival hemorrhage is essentially harmless. The blood from the broken conjunctival vessel becomes trapped in the space underneath the clear conjunctival tissue. The blood naturally absorbs within one to three weeks and may turn greenish or yellow during this time. 

A subconjunctival hemorrhage does not affect vision or cause pain, and treatment is usually not required. Exceptions to that are when bleeding: is a result of trauma or injury; lasts more than 10 days; starts again. 

And of course, if you are unsure call our office.  

red eye
subconjunctival hemorrhage

Infant Eye Examinations

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Acuity Testing Infants
Preferential Looking Test

 How do you Check a Baby’s Eyes?

 

Last time I wrote about the value of having a baby’s eyes examined. Now I will address the question of how do you check a baby’s eyes?

Obviously an infant is not able to read the letters on the eye chart or perform subjective tests such as selecting the clearest image. An example would be when I ask “which is better 1 or 2” question. Fortunately, there are other ways to determine visual acuity. Measurements of visual acuity and refraction are intended to identify nearsightedness, farsightedness and astigmatism. All are risk factors for amblyopia. Amblyopia is caused from non-use or deprivation that negatively impacts the development of the visual system. Instead of an eye chart with letters  that I use on school age children or a chart with shapes that I would use on a preschooler, I use a preferential-looking technique. Humans prefer to look at interesting objects instead of plain ones. I have several paddles with different size gratings and one paddle that is only gray. I flash the paddles in front of the infant and watch his/her response. This tells me how small the baby can see at a given distance. The smaller the gratings, the better the acuity. If the baby doesn’t prefer the gratings to the solid gray, I know we have passed the acuity threshold.

Retinoscopy is the other technique I use to measure the refraction, how much correction is needed for the baby to see clearly. Retinoscopy is the same technique my staff uses to get a starting prescription on most of my patients. They use a computerized system that measures the light as it comes off the retina (back of the eye). I do the same thing for the babies, but with a hand-held scope and some lenses.

Other assessments for eye alignment, motility and binocularity are done with various penlights, small toys and puppets. These tests measure eye coordination, which is the ability of both eyes to work together as a team to create one three-dimensional image in the brain. Good eye coordination, a skill that is not innate and must be developed, keeps the eyes in alignment. Later in life, poor eye coordination can make reading for extended periods of time difficult and may result in avoidance of detail work, such as writing or artwork, poor reading comprehension and clumsiness.

To evaluate the overall health of the baby’s eyes I dilate the pupils. The dilation causes little to no discomfort for the infant and allows a much more thorough examination. With light and magnifiers I can see the anterior eye structures like the cornea, lens, lids and lashes and the posterior structures such as the retina, optic nerve and blood vessels.

As an InfantSee provider, I provide a complimentary comprehensive eye assessment to all baby’s less than a year. (Nine months old is perfect for the exam).

Infant Eye Exams

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Fixation and Convergence Testing
Testing Infants

 Why Should I have my Baby’s Eyes Examined?

When I bring up the discussion about examining an infant’s eyes, I am asked 2 questions:

Why should I have my baby’s eyes examined and how do you check a baby’s eyes?

I am going to answer the first question today, why should I have my baby’s eyes examined?

The first year of a baby’s life is one of the most critical stages of visual development. 1 out of 10 children is at risk from undiagnosed vision problems. Early detection and treatment can prevent many of the complications vision and eye health problems cause. Some of the problems detected during infant eye exams include lazy eye (amblyopia), muscle imbalance and ocular disease.

Pediatric well baby checks include many tests, but they do not include refractive measurements for unusual or unequal amounts of astigmatism, nearsightedness or farsightedness. These conditions are risks for amblyopia that develops in an otherwise healthy eye. The effected eye is not used properly because the vision is too blurry. Uncorrected blur in an infant’s developing eye can cause the brain to favor the better seeing eye, suppressing vision in the other eye which prevents the vision from developing and causes impairment. This visual impairment can be prevented if detected early enough.

A routine well baby check does not include a dilated pupil examination either. By viewing more of the retina, a better ocular health exam can be performed.

And the best reason to have your baby’s eyes examined is that it is free. Many optometrists, including myself think that infant eye examinations are so important we have signed on to the American Optometric Association’s InfantSEE program. We offer a one-time comprehensive eye assessment to infants in their first year of life. If you have a grandchild, niece, nephew or friend that lives in another area, you can find an InfantSEE provider on the website infantSEE.org.

Don’t Become a Statistic

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I saw a few statistics about protective eyewear and sports this week. The most important fact about wearing safety eyewear for sports is that it prevents you and your children from becoming one of the following statistics. This information is from the US Department of Health and Human Services:

 Nearly 2.5 million eye injuries occur each year.
 More than a quarter of these injuries occur during sporting and recreational activities.
 Children under 15 years of age account for nearly one-third of all eye trauma hospital admissions and 43 % of sports and recreational eye injuries overall

It is important to remember that even if an eye injury seems to be minor it may be serious. Loss of vision, severe pain or tenderness and cuts around the eye require immediate medical attention. Secondly, if you do go to the emergency room, are discharged, but your vision and/or eye still do not seem right, give me a call. I have seen patients after ER visits with foreign bodies still in the eye and undiagnosed broken orbit bones (the bones around the eye).

More than 90 % of all eye injuries can be prevented with the use of appropriate protective eyewear. Sports participants using corrective eyewear or sunglasses that do not conform to safety standards are at greater risk of eye injury than participants using no eye protection at all. Safety frames must pass two rigorous impact tests, which dress frames do not undergo. Basically, a steel ball and a pointed projectile are dropped on the lenses of the glasses. No parts or fragments of the frame or goggle can fly off which might contact the eye.

The lenses in regular eyeglasses could easily pop out and puncture or cut the eye. A frame mangled from impact could also injure the eye and face.Slam safety glasses

Contact Lenses and Comfort

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Eye Hygiene Care - set of contact lens casesMost contact lens wearers use their lenses for an average of 13 hours a day. To stay comfortable all day it is important that the lenses maintain hydration (stay wet).   There are many factors that can make the lenses dry out quickly, dry environment, medications and poor tear quality. Sometimes the type of lens is to blame. The newer silicone materials allow more oxygen to the eye, but silicone is hydrophobic which means it does not absorb moisture. Contact lens manufacturers use special surface treatments on the silicone lenses to improve wettability and comfort. Not all contact lens solutions and lens materials are compatible with each other. Some disinfecting solutions work better on the silicone lenses than others, both in maintaining comfort and safety. If your lenses feel dry and or filmy, it could be the contact lens solution that you are using. If the lenses are older than recommended, the effect of the special surface treatment may be gone too. Use recommended solutions and replace your lenses as prescribed for optimal wearing comfort.

I think the safest and most comfortable lens choice are the dailies. The lenses are used one time and thrown away. There is no confusion or complications with solutions and the user has a new clean lens each day.

National Diabetes Awareness Month Conclusion

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The most important thing you can do if you have diabetes, is educate yourself about the disease. There are some excellent resources available. Start with the National Diabetes Education Program (NDEP) sponsored by the National Institute of Health. http://ndep.nih.gov/ . In addition to information about diabetes and other resources, you can order free pamphlets about controlling your diabetes and preventing type 2 diabetes. Information is available in English and Spanish.

Another resource is the American Diabetes Association, http://www.diabetes.org/. There is information about food, fitness and medications.

Most American are aware that being overweight and physically inactive increases the risk for type 2 diabetes. Unfortunately, that awareness does not translate into action. The NDEP was created to provide tools and resources to help people be proactive in preventing and controlling diabetes. If you have a family history of diabetes, had gestational diabetes and/or are overweight, you are at risk.  Take action. Check out the NDEP website and educate yourself.