Other Eye Conditions Treated at San Diego Eye Care Center
Also Serving Oceanside
Dry Eye Syndrome (DES) or Ocular Surface Disease (OSD)
There are many types of dry eye or ocular surface disease and each case can be very different. The most common types are covered here.
- Lack of tears from autoimmune dry eye or Sjögren’s syndrome is one of the more profound types of dry eye. It is best treated in conjunction with systemic treatment from your rheumatologist and local treatment with your ophthalmologist. Restasis is indicated in this type of dry eye.
- Evaporative dry eye, which may be the most common type, is due more to eyelid oil gland (meibomian gland) dysfunction or blepharitis. Blepharitis is inflammation of the eyelid and can significantly contribute to uncomfortable eyes. It can be allergic, infectious, inflammatory or caused by Demodex mite presence. Clogging or solidification of the oil secretion, which forms the top layer of the tears, is ineffective or absent which allows the aqueous component of the tears to evaporate. This is a very common and chronic issue and may be present in other forms of dry eye combining to make a bad situation worse. Treatment in this case is aimed at improving the lid function, which can include changes in diet toward natural oils from nuts and or fish, rather than processed oils, warm compresses, lid hygiene and sometimes antibiotics. The classic treatment for lid hygiene has been baby shampoo, which works for many people. Other excellent options include pre-packaged lid wipes such as Ocusoft, Ocusoft Plus and Cliradex.
- Neurotrophic dry eye can be a very severe form of dry eye resulting from lack of sensation. Any injury to the cornea can damage the sensory nerves leading to a lack of feeling and therefore secretion of tears. Sometime this can be so severe as to need support of growth factors from the blood done in the form of autologous serum eye drops. This is not routinely done and your doctor can work with a compounding pharmacy to draw your own blood, spinning it down to collect the blood plasma without the cells and use it 100 percent or diluted with saline drops. It is frozen in small amounts, which you then use as needed usually four to six times daily to promote healing and support of a very weak ocular surface. This is a powerful treatment for dry eye.
- Drugs or medications can induce dry eye.
- Graft-versus-host disease is uncommon but a severe form of dry eye.
- Pterygium is an abnormal growth of conjunctiva over the cornea. It usually occurs on the nasal aspect of the cornea, but can occur on the temporal or ear side or both. Exposure to sun, wind, dirt and heat increase the risk of developing it or for progression. Wearing sunglasses and hats to reduce UV light exposure are helpful as well as lubrication with simple artificial tears to reduce friction. They can regress and go away over time or progress and threaten vision. Surgical excision may be indicated and techniques to do this have improved greatly with less recurrence rates.
- Fuchs’ Dystrophy is a genetic condition which can be so mild one never has any symptoms, or can progress to the point of requiring a corneal transplant. The incidence was thought to be about four percent, but new imaging techniques may show it to be more common. On ocular examination, tiny glistening spots are seen on the inner corneal surface, which are called guttata. They can be imaged with specular microscopy, which is much more commonly used and can follow the progress very well. The guttata may indicate a weakness and the cornea may start to swell, causing blurred vision and halos with lights at night. Intraocular surgery may hasten the corneal swelling. Topical steroid eye drops and/or Muro 128 salt drops can control the swelling in some cases; if not, DSAEK AND DMEK procedures are wonderful new partial thickness options for surgical correction rather than full thickness corneal transplants. The visual recovery is faster and the rejection levels lower with these new techniques. San Diego Eye Care Center has been offering DMEK surgery to patients since 2008.
- Subconjunctival hemorrhage is very common. One may awaken with a bloody spot in the white of the eye or suddenly notice a blood spot. Anti-coagulation medications can be a cause, as well as high blood pressure and coughing, sneezing or straining. These hemorrhages can be very small or large but are usually benign and not related to other problems.
- Blepharitis (meibomian gland) dysfunction is inflammation of the eyelid and can significantly contribute to discomfort in the eyes. The lids can be thickened and slightly pink at the margins. The inferior tear lake may have a foamy appearance. It can be allergic, infectious, inflammatory, or caused by Demodex mite presence. Treatment in this case is aimed at improving the lid function which can include changes in diet toward natural oils from nuts and or fish, rather than processed oils, warm compresses, lid hygiene and sometimes antibiotics. The classic treatment for lid hygiene has been baby shampoo suds lid scrubs, which works for many people. Other excellent options include pre-packaged lid wipes such as Ocusoft, Ocusoft Plus and Cliradex.
- Conjunctivitis is inflammation of the thin mucous membrane that covers the inside of the lids and the eye itself. It can be allergic, infectious, toxic or inflammatory. The treatment may be very different depending on the cause. Treatment includes elimination of the offending allergen or toxin, the use of antibiotics, antivirals and/or steroid drops. Warm and cold compresses can be very healing and provide comfort. It is usually not sight threatening but if not treated in time or properly can result in visual loss.
- Chalazion affects all ages and causes a red, inflamed thickening of an area in the eyelid due to a clogged meibomian gland. They can be single or multiple and resolve by themselves. More commonly warm and cold compresses with antibiotics and/or surgery are needed to eliminate them. Steroid injections can also be performed.
- Keratoconus is a corneal degeneration resulting in a thinned area, which creates irregular and excessive astigmatism. Usually one eye is more affected than the other. It is a strong contraindication for laser vision correction. Rigid contacts are a great solution for some people. New techniques of stabilizing rings with corneal cross-linking are promising new treatments to stop progression, improve vision and avoid full thickness corneal transplant. In rare cases, the cornea can tear (a complication called corneal hydrops), creating extreme pain and sudden vision loss.
- Ptosis is drooping or sagging of the upper eyelids or excessive orbital fat that has infiltrated the lid. Common causes can be related to; age, trauma, levator muscle malfunction and nerve damage. Surgery is indicated and covered by most insurance companies, if vision is affected.
Symptoms that may indicate eye problems:
- Seeing flashes or floaters
- Halos, starburst or glare from lights at night
- Curtain or veil in vision
- Change in vision
- Visible changes in the eye
- Blurred vision centrally or distortion of a straight object
If you are experiencing any of these symptoms, please contact our office at (760) 757-1144 to schedule an appointment.