Now that the smoke has cleared we can appreciate the transitioning of the Sonomaroma from essence of dairy to scent of marijuana. Oh, the olfactory challenges we endure living in Sonoma County.
Marijuana has many effects on the eyes. The THC component causes the blood vessels to dilate which lowers the eye pressure, the blood pressure and visual processing. The vasodilation also increases the blood flow to the surface of the eye creating the glassy redness commonly associated with being “stoned.”
There are 2 main active chemicals in marijuana, THC and CBD. CBD is non-psychotic and THC is psychotic. The THC crosses the blood brain barrier and is a vasorelaxant. The activation of smooth muscle in the blood vessels contributes to many of the effects one experiences with marijuana, the light-headedness and the “high.” It also causes decrease in tear production and reduces the blink rate making the eyes feel dry. This vasodilation also effects the salivary glands causing a dry mouth. A marijuana strain with more CBD and less THC will reduce the redness, but also many of the effects one enjoys about marijuana.
Although marijuana lowers the intra-ocular pressure for the first couple of hours after ingesting, it is not an effective treatment for glaucoma. Marijuana doesn’t offer any protection against developing glaucoma either. Glaucoma is treated successfully with prescription eyedrops and/or surgical intervention, both treatments offer consistent control of the ocular pressure and minimal side effects.
Colder temperatures, winter winds and moisture zapping heaters can cause dry, red and irritated eyes. Tears are essential for good eye health and clear vision. They bathe the eye, washing out dust and debris, and keep the surface moist and clear. The natural tear film also contains enzymes that neutralize microorganisms, reducing the risk of eye infections. The most common signs and symptoms of dry eyes are persistent dryness and irritation, scratchiness, a burning feeling in your eyes and red eyes. Oddly enough, dry eye syndrome also can make your eyes watery, as dryness can cause a protective overproduction of the watery component of your tears.
How to prevent dry eyes in winter:
Cold winter wind outdoors and dry heat indoors can cause or worsen dry eyes. Follow these tips to keep dry eyes at bay.
Wear sunglasses or goggles. Wearing close-fitting sunglasses outdoors reduces exposure to sun and wind that can dry out your eyes. If it’s especially cold and windy, try foam-lined goggles that provide even greater protection from tear evaporation.
Supplement your diet. Fish oil and other nutritional supplements containing omega-3 fatty acids can help prevent or relieve dry eye symptoms.
Drink more water. Mild dehydration often makes dry eyes worse, especially during dry and windy weather.
Switch contact lenses. If your contact lenses feel dry and uncomfortable, ask me about trying different lenses that are replaced more frequently and/or are better for someone with dry eyes.
Maintain good eyelid hygiene. This includes thorough removal of all make-up and cleaning of the eyelashes and eyelids.
Dry eyes may not be completely curable but the dryness, scratchiness and burning sensation can be managed. In addition to dry eye evaluations, Westside Optometry carries products we have found most beneficial for dry eye treatment.
Rosacea affects the eyes in many patients, and may result in a watery or bloodshot appearance, irritation and burning or stinging. The eyelids may also become swollen, and styes are common.
April has been designated as Rosacea Awareness Month with the intent to educate the public on the warning signs of this chronic but treatable facial disorder. Rosacea is a common but poorly understood disorder of the facial skin that is estimated to affect well over 16 million Americans — and most of them don’t know it. In fact, while rosacea is becoming increasingly widespread as the populous baby boom generation enters the most susceptible ages, a National Rosacea Society survey found that 95 percent of rosacea patients had known little or nothing about its signs and symptoms prior to their diagnosis.
Photo from National Rosacea Society
Rosacea typically presents anytime after the age of 30 and may initially resemble a simple sunburn or an inexplicable blush. Suddenly, without warning, a flush comes to the cheeks, nose, chin or forehead. This recurs over and over with the redness lasting longer each time and eventually visible blood vessels may appear. Without treatment, bumps and pimples often develop, growing more extensive over time and burning and itching are common.
In severe cases, especially in men, the nose may become enlarged from the development of excess tissue. This is the condition that gave comedian W.C. Fields his trademark red, bulbous nose. The eyes can be affected too. Ocular involvement includes watery, burning and bloodshot eyes.
Ongoing research has suggested that rosacea may be caused by various possible factors, including defects of the immune system, nervous system, facial blood vessels and genetics. Most recently the presence of microbes and Demodex mites on the skin can trigger symptoms. Demodex are normal inhabitants of human skin but occur in far greater numbers in people with rosacea. It is believed that an immune response to bacteria associated with the mites may lead to the inflammatory bumps and pimples.
A study by a dermatologist at Duke University found a significant association between the relative presence of the mites and the development of rosacea, suggestion that the microscopic mites may be involved in the disease process. The study authors also proposed that increased mite density in the skin might trigger inflammatory response, block hair follicles or help transmit other bacteria in the skin , leading to signs and symptoms of rosacea.
Demodex mites also live in the eyelash follicles. they survive on dead skin and protein. We have found that reducing the number of Demodex living on the eyelid can reduce dry eye symptoms of burning and waterness. Controlling the Demodex requires a special cleaning solution containing a derivative of Tee Tree Oil. If you have or suspect you have rosacea and are suffering from burning red eyes, make an appointment in our dry eye clinic for evaluation and treatment.
Although the definitive cause of rosacea remains unknown, a vast array of lifestyle and environmental factors have been found to trigger flare-ups of signs and symptoms in various individuals. Common rosacea triggers include sun exposure, emotional stress, hot or cold weather, wind, heavy exercise, alcohol, spicy foods, heated beverages, humidity, certain skin-care products and potentially an overabundance of Demodex mites.
Eye allergies, or allergic conjunctivitis, develop when the body’s immune system reacts to an allergen that gets into the eyes. This is worse on windy days because the environmental irritants are blowing all over the place. There are mast cells under the upper eyelid. The allergens cause the mast cells to release histamine and other substances or chemicals that cause blood vessels in the eyes to swell and itch.
Although allergic conjunctivitiscan’t harm your vision, it can be extremely uncomfortable, annoying and disruptive. You may become intolerant to wearing your contact lenses due to the swelling and discharge. The best way to treat your eyes for allergies is to avoid the allergens that trigger your symptoms. The most common outdoor allergens include grass, trees and weed pollens. Indoor allergens include pet hair/dander, dust mites and mold.
Complete avoidance is impossible, so treatment may be indicated. Many sufferers choose to treat their symptoms with over-the-counter allergy medication. Unfortunately, antihistamine tablets and nasal sprays commonly used for allergies are not designed to relieve eye symptoms; in fact, 73% of patients who take oral or nasal allergy medication still suffer from itchy, red eyes. Clinical research has shown that these antihistamines can cause drying of the eyes, resulting in a reduction of tear flow of up to 50%. This means there is the potential for symptoms to be more severe and longer in duration because pollens aren’t rinsed as quickly from the eyes and may accumulate.
Over-the-counter eye drops may provide some relief, but many consist of a short-acting vasoconstrictor with an antihistamine, which result in a short duration of action (usually 2 hours) and a masking of the redness rather than a treatment of the cause. There are combination drops which treat the mast cells and inhibit the histamine. To work properly, correct usage is required.
Additionally, self-diagnosis and treatment can make other conditions such as an eye infection or dry eyes worse as some of the symptoms are the same.
Contact lens wearers may suffer added discomfort because allergens can get on the lenses, and can also cause the eye to produce excessive amounts of discharge that adhere to the contact lenses too. Clinical studies have shown that contact lens wearers suffering from allergic conjunctivitis who used prescription eye drops before inserting their lenses had significantly greater comfort. Call to make an appointmentat the first hint of allergies. Treating the condition sooner results in faster and less complicated relief.
For temporary relief before you can get an eye examination, use a cold compress ( a clean washcloth with ice cubes) over the eyes for ten minutes. An artificial tear or sterile saline solution can remove allergens from the eyes. Chilling the solution adds even greater comfort.
Allergies are widespread, affecting 30% or more of the U.S. population. Allergic conjunctivitis and rhinitis (runny nose) can exact a significant toll on individuals. The most common symptom of eye allergies is itching, which can range from mildly uncomfortable to severely bothersome. Itching and other symptoms which include watery eyes, redness, pain, soreness, stinging and swelling, may reduce a persons ability to perform daily routines or activities at school or work.
There are two common forms of ocular allergy, seasonal and perennial. Of the two, seasonal allergies are the more common. Seasonal allergies are triggered by seasonal items such as tree, grass and weed pollens that abound in spring and fall. People sensitive to these allergens tend to have symptoms most frequently during those seasons. When the allergies are no longer present, a seasonal allergy sufferer doesn’t have symptoms. Perennial allergies, by contrast, are triggered by environmental allergens commonly found in the home – such as dust mites, mold spores or animal dander – and do not follow a seasonal distributions. As a result, if you have perennial allergies, you suffer all year long.
Treatment
Avoidance of the allergen or cause of the allergy is the most successful, but unfortunately isn’t always possible. Minimizing contact can still reduce symptoms however. Many people have found relieve with air filters that remove airborne allergens from the home or office. Dust mites or animal dander control measures can help. Keeping the house and car windows closed will minimize allergens. Simply wearing sunglasses as a mechanical barrier and washing hair in the evening can help reduce allergen exposure.
If your symptoms are minimal or intermittent, applying a cold compress (10-15 minutes) may relieve symptoms, especially itching. Artificial tears can bolster ocular defenses by flushing out antigens and can relieve mild ocular allergy symptoms. Benefits of these measures include simplicity, minimal expense and no side effects.
Histamine is central to the allergic reaction and symptoms. Antihistamines are intended to block the effects of histamine. Oral antihistamines can relief systemic symptoms, but may have side effects of sleepiness, dry mouth, and dry eyes. Topical antihistamines target the eye allergy and have less side effects.
Some allergy eye drops combine the antihistamine with mast cell inhibitors. The mast cell inhibitors inhibit the release of histamine and prevent the allergic reaction from starting. I recommend starting this drop at the first sign of symptoms.
For severe eye allergies, a steroid eye drop may be necessary to interrupt the allergic cycle. Steroid eye drops are very effective but have many potential side effects and must be used only as prescribed.
Don’t suffer from allergies. Discuss your symptoms and concerns with Dr. Griffith or Dr. Staton.
The last thing to touch your contact lens before it goes into your eye is your finger.
I can’t stress enough the importance of proper hand-washing before handling contact lenses. Wash your hands thoroughly with mild soap, rinse completely, and dry with a clean lint-free towel.
Recent studies reinforce the importance of clean hands:
1. Poor or no hand-washing before handling contact lenses increased lipid deposits on the lenses. This can adversely affect contact lens comfort, fit, wearing time, and visual acuity – not to mention attract microbial contamination to the contact lens surface.
2. Poor hand-washing results in increased bacterial deposits on the lens and/or eye. There may also be an inflammatory response to the bacteria, including redness and inflammation of the anterior surfaces of the eyes. Ultimately, less frequent hand-washing is a risk factor for microbial keratitis (eye infections and ulcers). Good hand hygiene, meanwhile, removes hand lotions, makeup, and other oils, which can make lenses uncomfortable or blurry.
Winter winds and moisture zapping heaters can cause dry, red and irritated eyes.
Tears are essential for good eye health and clear vision. They bathe the eye, washing out dust and debris, and keep the surface moist and clear. The natural tear film also contains enzymes that neutralize microorganisms, reducing the risk of eye infections.
The most common signs and symptoms of dry eyes are persistent dryness and irritation, scratchiness, a burning feeling in your eyes and red eyes. Oddly enough, dry eye syndrome also can make your eyes watery, as dryness can cause a protective overproduction of the watery component of your tears.
How to prevent dry eyes in winter
Cold winter wind outdoors and dry heat indoors can cause or worsen dry eyes. Follow these tips to keep dry eyes at bay.
Wear sunglasses or goggles. Wearing close-fitting sunglasses outdoors reduces exposure to sun and wind that can dry out your eyes. If it’s especially cold and windy, try foam-lined goggles that provide even greater protection from tear evaporation.
Supplement your diet. Fish oil and other nutritional supplements containing omega-3 fatty acids can help prevent or relieve dry eye symptoms.
Drink more water. Mild dehydration often makes dry eyes worse, especially during dry and windy weather.
Switch contact lenses. If your contact lenses feel dry and uncomfortable, ask me about trying different lenses that are replaced more frequently and/or are better for someone with dry eyes.
Dry eyes may not be completely curable in certain cases, but the unpleasant dryness, scratchiness and burning sensation can be managed. We are carrying a new artificial tear called Oasis that contains long-molecule hyaluronic acid which keeps the moisture on the eye longer. Click here to read more about dry eye syndrome.
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.
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.
Last time I talked about the risks of dry eye. This included the increase incidence for people with diabetes. Today let’s talk about the symptoms. Dry eye presents in many different ways: the eyes can sting, burn, feel gritty, scratchy and even watery. That’s right, you can suffer from dry eyes and produce too many tears. The other significant symptom of dry eyes is fluctuating vision. If the tears evaporate too quickly, vision is best right after a good blink and blurs until the next blink. Identifying which layer or layers are compromised is the first step to finding the right treatment.
The tears consist of 3 different components:
1. Oils or lipids from the meibomian glands (in the eyelid)
2. Mucus from the goblet cells (surface of the eye)
3. Water or aqueous from the lacrimal gland (under the brow)
The eyelid can be a problem too. Inflammation of the eyelid margin is often a factor. The eyelid changes with age, it may be scarred or looser causing the lid to turn inward or outward. Either direction has a negative effect on the tears and blinking.
The goal of dry eye treatment is to restore the tear film balance. Addition of a humidifer, drops, ointments, supplements, change in diet, and/or punctal plugs can all be helpful. Once the cause of dry eye disease is identified I can create a treatment plan.
The first thing I recommend in treating dry eye disease is to control the factors that you can. Check out the last blog for a list, you can’t change your age or gender, but you can control your blood sugar, and some environmental factors. What you eat or do not eat matters too. Too much caffeine will dehydrate you. If you are a fan of energy drinks that are high in caffeine and sugar, try a week or two without them and see if your eyes feel better. I’ve seen significant improved in contact lens tolerance with the elimination of these drinks.
