Cure For Glaucoma

Inotek Pharma updates on glaucoma drug Phase 2b trial

2011-08-14T21:12:00.001-07:00

Inotek Pharmaceuticals has concluded first two of three stages of a double-masked, dose-ranging, randomized and multi-dose trial evaluating an eye drop, INO-8875 in patients suffering from glaucoma or ocular hypertension.

The trial was designed to investigate the tolerability, safety, efficacy and pharmacokinetics of INO-8875 delivered as an eye-drop formulation in patients with primary open-angle glaucoma or ocular hypertension.

Inotek president and CEO Paul Howes said they believe that expanding the final stage of the Phase 2b study will produce a robust data package to support preparation for late-stage clinical trials and ongoing partnering discussions.

New study explain glaucoma risks

2011-08-14T21:10:00.001-07:00

Glaucoma is one of the leading causes of visual deterioration on the planet, affecting millions of people worldwide, though it is more prevalent among some ethnic groups.

For years, experts have attempted to determine why African-Americans have a higher risk of developing glaucoma than Caucasians, although it seems that experts in the US may have finally found out why this occurs.

Specialists at the Washington University School of Medicine in St Louis claim that oxygen levels are significantly higher in the eyes of African-American glaucoma patients than in Caucasians who have the condition.

In a report published in the July issue of the Archives of Ophthalmology, they theorise that more oxygen may lead to damage in the eye's drainage system in the eye, resulting in elevated pressure which in turn damages the optic nerve and causes blindness.

First author Dr Carla Siegfried pointed out that the report is the first clue about the link between race and risk of glaucoma, which is approximately six times more common in African-Americans than Caucasians, while blindness caused by glaucoma is 16 times more likely.

The expert explained: "Our findings suggest there may be physiologic differences in oxygen metabolism between African-Americans and Caucasians.

"In our studies, we were not looking specifically at African-Americans, but the racial difference in oxygen levels was significant, and we believe this observation deserves further study."

Siegfried, who is also professor of ophthalmology and visual sciences at Washington University, said she is not surprised that oxygen may plays a major role in the development of glaucoma, given it could be a source of 'free radicals' that damage cells.

As with eye diseases such as cataracts, glaucoma is directly associated with ageing, as is oxidative stress, which is an imbalance between these 'free radicals' and antioxidants'.

This, in turn, is linked to the ageing process and several other age-related diseases such as cardiovascular and neurodegenerative conditions, she noted.

"However, more study is required. When we understand the underlying reason for elevated oxygen and how it may damage the eye, we will be in a better position to develop ways to prevent this disease," the expert said.

New Medicare diagnosis codes apply to stages of glaucoma severity

2011-08-14T21:08:00.000-07:00

New Medicare glaucoma diagnosis codes that address glaucoma severity based on visual fields are scheduled to be implemented on Oct. 1, an expert said at the American Glaucoma Society meeting.

Many Medicare carriers already have policies in place allowing certain numbers of visual field or optic nerve imaging tests based on the severity of the glaucoma, and many private payers are currently using claims-based data to profile and rank physicians, according to Cynthia Mattox, MD, the chair of the AGS Patient Care Committee and a member of the AAO Health Policy Committee. Having physicians assign codes that reflect the actual clinical stage of disease will allow for more accuracy in claims-based payment or profiling methodologies that are already in place or may be designed in the future, she said.

“They’re not going to adversely impact our coverage policies now, so there’s no reason to be afraid of them,” Dr. Mattox said. “All of our original glaucoma diagnoses are still in there and will link to any coverage policies that are related to testing that we want to do or procedures that we want to do. … [They’re] also going to allow for some health policy research improvements, to be able to use claims-based codes so that we can understand a little bit more about the populations that everybody is taking care of.”

New device makes glaucoma surgery safer

2011-08-14T21:07:00.000-07:00

Glaucoma is a disease of the optic nerves wherein the nerve fibers progressively disappear causing the field of vision to become narrower and narrower until total blindness ensues.

For patients with glaucoma, it is important to keep the internal eye pressure low, otherwise the damage to the optic nerves gets worse. Usually glaucoma medications will lower eye pressure but sometimes they don’t work very well.

One example is patient ABC. He had very severe glaucoma in both eyes, and, despite four different eye drops, placed one after the other during the course of the day, the targeted eye pressure of 12 mmHg or below could not be achieved. In the right eye, pressure was 26 mmHg, and in the left 20 mmHg.

Ordinarily, a glaucoma filtering operation, where a window in created to act as a passageway of the fluid within the eye to the outside, would be recommended. The problems with the original procedure in the immediate period after surgery would be inflammation and too much exiting of the fluid. Technological improvements have made the procedure less traumatic and much safer.

A patient who benefited from the new technology is Mr. ABC. He chose to follow the recommendation of having a stainless tube-like implant placed in his eye instead. The implant called an Ex-press shunt creates a passageway for the fluid to exit the eye in a controlled manner.

His right eye was operated on first; the procedure took 35 minutes under local anesthesia. The eye was not patched and anti-inflammatory and antibiotic drops were given. His eye pressure went down to almost 10 mmHg even without any glaucoma drops. There was only mild inflammation at the site of operation, otherwise the patient was comfortable.

Mr. ABC was so relieved that he soon scheduled his left eye.

Galileo SurgiCenter believes that the Ex-press shunt which is distributed by Alcon Laboratories is a significant improvement over the traditional filtering surgery where the post-operative course would sometimes be complicated.

Glaucoma-Correction Glasses

2011-08-14T21:06:00.001-07:00

My otherwise ridiculously healthy dad was diagnosed with glaucoma a while back, and though it now appears to be under control thanks to the right prescription meds, his vision isn't as good as it used to be. Specifically, the contrast and brightness of what he sees with that eye has been reduced.

An avid user photographer, my dad posed a fascinating solution to this problem. What if he hooked up a Looxcie-style video camera near his left eye, then fed the resulting video through an auto-contrast filter, which would display on a small screen inside a pair of glasses. It might look weird, but it'd be a real-life use of augmented reality that's actually useful. In rough visual terms, this is what the problem is and what the solution would do:

Glaucoma-Contrast.jpg

To me, the strange thing is that this sounds possible, even plausible. Then again, I don't know how technically challenging it is to provide that kind of real-time video correction. Where are the sticking points? My dad and I would love your help sketching out how this contraption could work -- and then building it.

Searching around for information on how difficult this task might be, I wasn't able to find much. Much of the discussion around augmented reality vision focuses on contact lenses, I suppose because they are futuristic and sexy. But my dad isn't looking for anything that crazy. He just wants a pair of glasses with an auto-contrasting screen for the left eye.

I found a Spanish team was working on a vision augmentation system back in 2005. They seemed to have made some progress, but that was years ago. The trail goes cold after that and I haven't really seen it.

So, how about it, hardware hackers: could you do this?

I pasted in my dad's original query below, so you can hear his specific descriptions. I'd be happy to put any interested hackers in touch with him, as long as you are not a crazy person. Or, rather, as long as you are the right kind of crazy person.

As any user of Picasa or probably any other photo manipulator program knows, there is a button, "Auto-contrast," that will sharpen and lighten up any image unless there is a large bright vs dark gradient e.g., big bright sunny sky on upper half of a composition and say, dark forest in the bottom part in the shot. Normally, if the image is within a relatively narrow range of lighting, it will light up and sharpen it as if by magic.

Well, I have observed that my left eye -- affected by advancing Glaucoma -- perhaps now being controlled by the right mix of prescription eye drops, perceives significantly less light and detail (contrast) than my almost normal right eye, with or without prescription glasses on. Probably there is no way to have a corrective prescription that would restore the ability of the optic nerve to perceive the full details of what it is seeing. However if the lenses themselves could auto-contrast the image as it goes through the lens by the application of some type of software embedded in the glasses frame along with some miniaturized hardware also embedded in the frame, the eye would be looking at the enhanced (brightened and sharpened) image in the lens providing the eyes cones and rods with enough additional light to offset some if not all the lost capacity. The lenses might have to look as Borg-like appendages to accommodate the additional technology.

IOP and primary open-angle glaucoma, pseudoexfoliation glaucoma

2011-08-14T21:04:00.001-07:00

Study shows link between IOP and primary open-angle glaucoma, pseudoexfoliation glaucoma

IOP was the only risk factor associated with both primary open-angle glaucoma and pseudoexfoliative glaucoma, while moderate to high myopia correlated slightly with both conditions, a study found.

Vascular systemic diseases and treatments correlated solely with primary open-angle glaucoma.

“The implications of these differences for the pathogenesis between the two common types of [open-angle glaucoma] should be explored further,” the study authors said.

Data were culled from the Thessaloniki Eye Study, a cross-sectional population-based analysis of chronic eye diseases in Thessaloniki, an urban center in Northern Greece. The study included 2,554 patients age 60 years and older.

Investigators set out to assess risk factors for primary open-angle glaucoma and pseudoexfoliative glaucoma. Open-angle glaucoma patients were compared with a non-glaucomatous control group. Primary open-angle glaucoma subjects were compared with controls without pseudoexfoliation. Pseudoexfoliative glaucoma subjects were compared with controls with pseudoexfoliation for demographic, lifestyle, ophthalmic and systemic factors.

Multivariate analysis was limited to 2,078 patients who attended clinic visits and had at least one phakic eye.

Results showed that IOP (P < .001), pseudoexfoliation (P < .001), history of coronary artery bypass or vascular surgery (P = .017) and moderate to high myopia (P = .009) correlated most strongly with open-angle glaucoma.

Data from 1,840 patients with primary open-angle glaucoma showed that age (P = .048), IOP (P < .001), history of coronary bypass or vascular surgery (P = .01) and history of diabetes treated with insulin (P = .045) were strongly associated with primary open-angle glaucoma.

Among 238 patients with pseudoexfoliative glaucoma, there was a correlation with elevated IOP (P < .001), the authors reported. There was a slight association with moderate to high myopia (P = .06).

Better tracking glaucoma progression

2011-08-14T21:01:00.002-07:00

Having more frequent visual tests could be linked with better tracing of glaucoma progression, a study finds

More frequent visual tests for glaucoma patients could allow physicians to better follow the condition's progression, a study finds.

A study released online Monday in the Archives of Ophthamology examined data on 468 eyes of 381 patients age 35 to 80 who were part of a long-term intervention study. The participants had primary open-angle glaucoma no longer being controlled by medication. This type of glaucoma is the most common form and usually hits people over 50. It causes damage to the optic nerve and usually progresses slowly, sometimes without being noticed. The researchers' goal was to see if more frequent visual field tests to check peripheral vision resulted in earlier discovery of the progression of the glaucoma.

LASIK and Glaucoma

2011-08-14T21:01:00.001-07:00

Glaucoma has affective the vision of roughly 3 million people in the United States. Many of these people do not know they suffer from glaucoma because there are no outward symptoms until the vision has been affected. Your ophthalmologist can catch glaucoma in its early stages before it affects your vision by conducting a routine eye examination.
Information About Glaucoma
Glaucoma is an eye condition that gradually damages the optic nerve in the eye. The optic nerve is responsible for transmitting the visual information supplied by the retina directly to the brain. A damaged optic nerve can lead to permanent blindness.
A thick, watery liquid called the aqueous humor moves through the space called the anterior chamber located between the cornea and the leans of the eye. The aqueous humor supplies nutrition to the tissues of the eye, the lens, and the cornea. The aqueous humor drains from the eye through the trabecular meshwork. Internal ocular pressure (IOP) builds up in the eye when the aqueous humor does not properly drain through the trabecular meshwork.
Increase of IOP will put pressure on the optical nerve and gradually cause damage affecting your vision. The only outward sign of glaucoma is affected vision. It is often too late to save your vision by the time your vision is affected by glaucoma. Early detection and treatment will prevent permanent damage to your vision.
Treatment for glaucoma depends on the severity of the condition and can include:
- Special medicated eye drops
- Laser surgery
- Other eye surgery
LASIK and Glaucoma
You may not be a good candidate for LASIK depending on the severity and stage of your glaucoma. It is important to schedule an initial LASIK surgery consultation with your ophthalmologist for a full eye exam to determine if LASIK is the best procedure for your vision correction needs. Your ophthalmologist will be able to suggest another vision correction procedure if you are not a candidate for LASIK.
During the LASIK procedure, a flap is created in the outer portion of the cornea to allow access to the area of the cornea that needs to be reshaped to improve your vision. The flap is created using a microkeratome. A vacuum ring is used to attach the microkeratome to your eye. The vacuum ring causes suction that will temporarily increase the pressure inside your eye. Patients without glaucoma will not be affected by the suction. However, the increase in pressure can cause negative affects to patients with glaucoma.
You can become a candidate for LASIK once your glaucoma is treated and your condition is stable. There are other laser vision correction procedures that can be performed if you have glaucoma. PRK is a laser vision correction procedure that does not require the use of a microkeratome or the use of suction. It is a good idea to discuss your vision correction options with your ophthalmologist before deciding on a procedure.

Eye-rubbing may indicate glaucoma

2011-08-14T20:59:00.000-07:00

Penny is a 10-year-old cocker spaniel who has had her share of ear problems.

Pat isn't sure whether Penny is having a problem now, but she is noticing a new behavior. Penny is rubbing the left side of her face on the carpet, and she's started to do it more frequently.

Pat thinks Penny is specifically rubbing her left eye. There is some redness around the eye and the eyeball. Pat first thought Penny may have gotten something on her face, but she no longer believes that to be the case.

Well, Pat, there is a problem. That's the easy part. Determining the underlying problem is the not-so-easy part.

I am going to assume that Penny is indeed rubbing her eye and not some other area close to it. So we can conclude there must be something irritating Penny's left eye or the lids around it.

There are many possibilities that can cause eye irritation. Penny may have damaged the corneal layer of the eye, causing significant discomfort. The cornea is a very specialized layer of clear cells that covers the colored portion of the eye, the iris. The pupil is behind the cornea. Damage to the cornea can come from contact with anything that can score or puncture the tissue. Foreign material in the eye is but one possibility.

Penny may have developed a conjunctivitis or inflammation of the conjunctiva. The conjunctiva is a very thin layer of tissue that covers the inside of the eyelids and eyeball itself. It can become inflamed from an allergic response or a bacterial infection or a combination of both. This list can go on, but there is one possible cause that is potentially very serious and could lead to blindness. Cocker spaniels are a high-incidence breed for this disease.

Penny may have glaucoma. Glaucoma occurs because of increased pressure within the eye. The eye is actually filled with a viscous fluid that supports its round structure. The fluid is maintained at a constant pressure through constant production within the eye and constant drainage out of the eye. If this system is disturbed, usually affecting the drainage, the pressure within the eye can increase; if left untreated, this increased pressure will destroy the retina at the back of the eye, causing blindness.

This process can be extremely painful and is considered an emergency.

In humans with acute glaucoma, the increase in pressure and corresponding discomfort can be communicated to the doctor and therapy immediately performed. Pets do not usually do this, at least early on, although Penny may have done so with her rubbing behavior.

Penny needs immediate veterinary attention. If she does have glaucoma and there is still sight present, we may be able to save her eye. If not, she will need to have treatment done to alleviate her pain. This might include removal of her nonfunctioning eye.

New gold standard in glaucoma treatment

2011-08-14T20:57:00.000-07:00

The price of gold is going up but a clinical trial shows it may be worth it for some people with vision problems. Yale glaucoma surgeon Nils Loewen checks on his patient Ron Kortsep.

Ron recently had one of these inserted into his eye. It's called a "shunt made of gold." It's to prevent glaucoma from stealing his eyesight.

"My left eye was getting weaker, I was losing vision, peripheral vision which glaucoma tends to do, the glaucoma was getting more aggressive so we're trying some different things to bring the pressure down," Kortsep said.

Losing his eyesight would be devastating for Kortsep, who loves to travel the world and see the sights. Dr. Loewen is the first physician in the U.S. to insert a gold shunt into a patient's eye. It's part of a trial. The device reduces eye pressure by helping it drain properly.

"It all happens at the front part of the eye where the big surgeries with the drainage implants are at the very back, even back past the equator in some cases," Loewen said.

The procedure is already approved in other countries. In one picture you can make out the tiny shunt at the bottom of the eye. The shunt is made of gold and gold is really expensive, so you must be thinking these must be costly. They're actually only worth pennies apiece, but they do cost a lot because of the price of research and development to create them.

So you may be wondering why gold? It isn't like a bar of gold, it's highly purified. Scientists take out all of the copper and the body does not reject it. Dr. Loewen said this shunt could become the gold standard if approved for glaucoma patients, because results are promising and it's less invasive.

"With these smaller incisions less wound area, equals a quiet eye, equals a comfortable eye," Loewen said.

Glaucoma risks on rise

2011-05-04T00:47:00.000-07:00

The silent killer of sight, glaucoma, is on the rise among the poor people as they are unable to afford surgery or prolonged medication expenses.

Half the population that forms the serpentine queue at the government eye hospital is likely to slip into blindness due to this problem as the disease can be cured only if detected early or would result in the patient losing vision, say doctors.

“Every month, we get as many as 150 new cases of glaucoma, but are able to conduct only 8-10 surgeries. Most of the patients are too poor to afford the drugs for treatment, which is out of reach even for the middle class,” says a doctor at the hospital.

While medicines are a more popular mode of treatment for the disease in western countries, surgeries, despite their complications, are the best option for people here,” explains Dr. Krishnaraj, an ophthalmologist, pointing out that 10 to 15 per cent of patients are not even aware that they are suffering from the disease.

As the cost of eye drops begins from `200 and above depending on the treatment many people do not have enough money to procure it as a long term medical solution.

The progress of glaucoma that affects the optic nerve, causing irreversible vision loss, can be arrested if detected early.

Steroid Can Cause Glaucoma

2011-05-04T00:46:00.000-07:00

CHANDIGARH: When 25-year-old Raman was detected with glaucoma (a disease of retina that usually afflicts the elderly), ophthalmologists were surprised. After seeing his case history, it was found that to cure conjunctivitis, he overused steroids without a doctor's advice, which caused glaucoma. Of 60 to 70 cases of seasonal conjunctivitis (also known as pink eye) coming daily to city government hospitals, one-fourth show glaucoma and eye ulcers ' which eventually can cause loss of vision ' due to overuse of steroids on self-medication. Dr SK Arya, department of ophthalmology at GMCH-32, said, ''We are getting 30 to 40 patients daily and half of them are new cases. Also, most of these are severe cases that have turned into glaucoma due to steroid overuse.''

''Pollen and dust are the common causes of pink eye. On an average, 30 to 40 cases come to our out patient department daily,'' said Dr Jagat Ram, eye specialist at advanced eye centre, PG

New way to diagnose Glaucoma

2011-05-04T00:42:00.000-07:00

Scientists have been constantly pursuing newer tests to diagnose Glaucoma. Glaucoma is an incurable condition of the eye and if left untreated can cause blindness and once it effects the vision � this cannot be restored. It is the second leading cause of blindness in the world - according to the World Health Organization.

Recently scientists they have been combining visual field and imaging data, utilizing the anatomical arrangement of retinal ganglion cells to diagnose the condition more accurately.

In a recent study by Michael V Boland, Assistant Professor of Ophthalmology at The Wilmer Eye Institute, Baltimore, data from 1499 eyes of glaucoma suspects and 895 with confirmed glaucoma eyes was identified to be studied. All the subjects underwent standard automated perimetry and Heidelberg Retinal Tomograph (HRT) imaging. The structure function index (SFI) was defined in three steps by a new technique combining the above two tests. The data was studied to study the following:-

Glaucoma treatment breakthrough

2011-05-04T00:36:00.001-07:00

As part of a team of Australian researchers, scientists at the Queensland Institute of Medical Research (QIMR) have discovered two new genes linked to open angle glaucoma in the only study of severe glaucoma cases in the world.

The study has been published online in the prestigious international science journal, Nature Genetics.  

Dr Stuart MacGregor from QIMR’s Queensland Statistical Genetics Laboratory said this discovery will help to identify patients at the highest risk of severe glaucoma.

“It opens the pathway to developing completely new ways of treating glaucoma patients that could delay disease progression and prevent blindness,” he said.   

"Open angle glaucoma, sometimes called chronic glaucoma, is the most common type of glaucoma, and tends to progress at a slow rate.

"Sufferers may not notice that they have lost vision until the disease has progressed significantly.  

“We found that 18% of the population carry risk variants at these two genes, making them up to three times more likely to develop severe glaucoma than those that don’t.

”  Glaucoma is the leading cause of irreversible blindness worldwide, affecting an estimated 300,000 people in Australia, half of which are currently undiagnosed."

It is the collective name for eye diseases causing irreversible loss of peripheral vision, often associated with too much pressure developing inside the eyeball.

  “Although open angle glaucoma is the most common form of the disease, it is poorly understood and difficult to diagnose in its early stages,” said Dr MacGregor.

"Many cases still remain undiagnosed until irreversible loss of vision has occurred.”

Researchers from QIMR collaborated with groups from five other Australian universities on the ground-breaking study of 4,500 patients from Australia and New Zealand.   Dr MacGregor emphasized the important role of twins in the research.

“The genetic information provided by the twins was used in the study as a comparison to those affected by glaucoma,” he said. 

Glaucoma genes point to increased risk

2011-05-04T00:35:00.001-07:00

Researchers say they have discovered two new genes that increase people's susceptibility to glaucoma.

The findings could lead to better screening and more effective treatments, says study leader Professor Jamie Craig from the Department of Ophthalmology at Flinders University in Adelaide.

Glaucoma is a loss of peripheral vision due to damage to the retina and optic nerve, which occurs mainly in older people, and can lead to blindness.

In a study published online this week in the journal Nature Genetics, Craig and colleagues studied the most common form of glaucoma in Australia, called "open angle glaucoma".

The disease advances very slowly and many people are not diagnosed until they start bumping into things.

"It's a bad thing if people present at that late stage because all the treatments that we have are able to slow the disease down and potentially [stop it] getting worse, but none of the treatments at this stage can bring back vision that's already lost," says Craig.

Genetic link
People with a family history have been known to have a greater risk of glaucoma, says Craig, but until now, only one gene has been linked to the disease.

A mutation in a gene called "myocilin" is believed to account for just 3 per cent of cases, he says.

Craig and colleagues studied 1500 glaucoma cases and 8500 control cases in Australia and New Zealand.

They compared the DNA of the two groups and found two common gene variants that seemed to be associated with a greater risk of glaucoma.

People who had these gene variants were three times more likely to have glaucoma than the general population, says Craig.

Craig says the association is even stronger for severe blinding glaucoma.

He estimates the genes variants could be responsible for a substantial proportion of glaucoma cases in the wider population - possibly 30 per cent.

New treatments?
Craig says the latest genetic discovery could help in the development of more effective treatments.

Current treatments, including eye drops, laser and surgery, are aimed at reducing pressure in the eye but sometimes they don't work, he says.

While glaucoma is usually associated with raised fluid pressure within the eye, 20 per cent of people with glaucoma do not have this raised pressure.

The researchers carried out tests in rats with glaucoma and found that one of the newly discovered gene variants was more active in the retina.

They believe it could be linked to death of the optic nerve, independent of pressure from fluid in the eye.

Craig says further research could show that a drug that blocks the expression of this gene could slow down the damage to the optic nerve in all cases of glaucoma.

He and colleagues are continuing to work with animal models to understand the mechanism by which the genes act to increase the risk of getting glaucoma.

Better screening
Craig says the new genetic association could also be used to identify which people are at a highest risk from glaucoma before any clear signs appear, and to help decide when treatment should be begin.

This is important, as treatment comes with costs and side-effects and is something people must take for the rest of their lives.

Craig is now involved in a study to see whether the new genetic information can be successfully used to help identify people who should be treated for glaucoma.

He advises people to have eye check-ups every two years with an optometrist or ophthalmologist after the age of 40, especially if they have a family history of glaucoma.

The study drew on the Australian and New Zealand Registry of Advanced Glaucoma, funded by The Eye Foundation, with support from Pfizer, which produces current glaucoma treatments.

Another Treatment Option for People With Glaucoma

2011-02-28T01:24:00.000-08:00

A delicate surgery which gives people with glaucoma another treatment option has been performed here for the first time.

Called “glaucoma tube shunt surgery,” the procedure Tuesday at Scott & White-Brenham yielded outstanding results, said Dr. Shawn Khan, a local ophthalmologist who performed the operation.

“She’s doing great,” Khan said of the 67-year-old patient from Bryan. “Her pressure’s back to normal.”

Glaucoma, a disease of the optic nerve that can result in vision loss, is treated by lowering eye pressure.

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“Glaucoma can’t be reversed, but you can stop the progression,” said Khan.

Initial conventional treatment is to use pressure-lowering eyedrops or a laser to treat the drainage angle of the eye.

The laser surgery makes it easier for fluid to flow out of the front part of the eye, decreasing pressure.

But tube shunt surgery is another viable option if the “conventional” methods don’t work, said Khan.

The patient treated Tuesday was using five different eyedrops in an attempt to lower the pressure “and still wasn’t having any success,” he said.

“She was using all these eyedrops ... there’s the expense and hassle of those. And she was using so many drops that the skin around her eyes was getting red and hardened.”

The tube shunt surgery is exactly as it sounds; a tiny flexible tube is inserted in the front of the eye to just behind the cornea, allowing minute amounts of fluid to drain through the back of the eye, said Khan.

A valve ensures that not too much fluid is drained, he added.

Khan said he has performed the surgery many times, but Tuesday was the first time it’s been done locally.

“It’s been around for a while, but there was nobody here with a glaucoma fellowship background,” said Khan.

The outpatient surgery takes about an hour and recovery time is minimal.

“The patient goes home with a patch and a shield,” Khan said. Those were removed Wednesday, and there were not even any restrictions on things like driving.

Khan said he also found it interesting that a patient was Bryan was referred to medical facilities here for treatment.

“Usually it’s the other way around,” he said.

Phacoviscocanalostomy for open-angle glaucoma with concomitant age-related cataract

2011-02-28T01:23:00.001-08:00

Phacoviscocanalostomy controls IOP in eyes with pseudoexfoliation glaucoma, POAG

Phacoviscocanalostomy controlled IOP and improved visual acuity in eyes with pseudoexfoliation glaucoma and primary open-angle glaucoma, a study found.

The prospective study included 30 eyes that underwent phacoviscocanalostomy for cataract and pseudoexfoliation glaucoma and 30 eyes that underwent the procedure for cataract and uncontrolled primary open-angle glaucoma (POAG). Mean age was 70.7 years in the pseudoexfoliation glaucoma group and 58.6 years in the POAG group; the difference was statistically significant (P = .001).

Mean follow-up was 19.7 months. Examinations were performed 1 day, 1 week, and 1, 3, 6 and 12 months after surgery.

Both groups had immediate and statistically significant decreases in mean IOP from baseline (P < .0001).

The pseudoexfoliation glaucoma group had significantly lower mean IOP than the POAG group at all follow-up points (P < .01).

Mean IOP reduction was 12.2 mm Hg (49.7%) in the pseudoexfoliation glaucoma group and 6.7 mm Hg (30.9%) in the POAG group at final follow-up.

Also at final follow-up, 25 eyes in the pseudoexfoliation glaucoma group (83.3%) and 16 eyes in the POAG group (53.3%) achieved IOP of 15 mm Hg or lower without medication; the difference was statistically significant (P < .05).

Uncorrected and corrected visual acuity improved significantly in both groups (P < .005) at all follow-up points.

The complication rate was low and did not influence surgical outcomes. No cases of shallowing of the anterior chamber, hypotony, choroidal detachment or endophthalmitis were reported.

Early Detection of Glaucoma

2011-02-28T01:11:00.000-08:00

PATIALA:Dr Gursatinder Singh, an eminent eye surgeon working in the Government Rajindra Hospital, here Tuesday said that the damage caused to the eye because of glaucoma was irreversible. However, medication or surgery, traditional or laser, could slow-down any further vision loss. Therefore, early detection was essential to limiting visual impairment and preventing the progression towards blindness.

Speaking at a Continuing Medical Education (CME) programme organized under the aegis of the Patiala Academy of Ophthalmology by Aromed Pharmaceuticals in collaboration with the Patiala Eye Hospital and Lasik Laser Centre, he said that glaucoma caused progressive damage to the optic nerve at the point where it leaves the eye to carry visual information to the brain and if left untreated glaucoma progressed to gradually worsening visual damage and could lead to blindness. He said that once incurred visual damage was mostly irreversible and this had led to glaucoma being described as the “silent blinding disease” or “the sneak thief of sight.”

Dr Singh said intraocular pressure was a "risk factor" for glaucoma together with other factors such as racial ancestry, family history, high myopia and age. There is no clearly established difference in glaucoma incidence between men and women.

Dr Ranjit Singh Dhaliwal, an eye surgeon from Nabha, a pioneer in small invision cataract surgery north india. said that SICS is the surgery for the comman man as it does not cost much,though the surgeon's skill involved has to be good.results were as good as any machine surgery world over.

Dr Balbir Khan, from the Gian Sagar Medical College and Hospital, highlighted the management of retinoplastry during the coming times.A large number of practicing doctors from Patiala and the surrounding areas participated in the deliberations.

The academic session was followed by a karaoke music competition in which Bollywood film songs relating to eyes and eyesight were played. It proved to be an icing on the proceedings of the evening wherein academics were blended with entertainment.

Glaucoma treatment for old patients

2011-02-28T01:10:00.000-08:00

About 675 people turned up during the two-day eye check up camp at the Thimphu referral hospital, which was organised by the Druk lions club.

Most patients, who came for the check up had cataract and retina problems, although the camp was for screening glaucoma.

Glaucoma refers to a group of eye conditions that lead to damage of the optic nerve, the nerve that carries visual information from the eye to the brain.

In many cases, damage to the optic nerve is due to increased pressure in the eye, also known as intraocular pressure (IOP).

Secretary of the Druk lions club Duptho Rinzin said there were around 40 patients, who needed immediate treatment for glaucoma.

“We’re now contacting the Siliguri lions hospital for treatment,” he said. “Then we’ll arrange funds for them.”

Treating a glaucoma patient at Siliguri lions hospital costs about Rs 700, he said.

Lions club will be organising a similar eye camp in Trashigang during the moenlam chhenmo in March this year and a blood donation camp in Paro.

“There’ll be more people gathered during the moenlam chhenmo,” he said. “And we can provide services to more people.”

Opthalmologist at Thimphu referral hospital, Dr Nor Tshering Lepcha, said glaucoma is treated at the hospital as well. “Only some complicated cases are referred to eye hospitals in India,” he said. “Most referred patients are children.”

The rapid assessment on avoidable blindness (RAAB) survey 2009 showed 5.9 percent of eye cases in Bhutan are glaucoma-related, while cataract was 68 percent.

Besides the eye camp, the club is also planning to train teachers in counselling in the next two months. “In a way we’d be helping the government to place a counsellor in each school,” said Duptho Rinzin.

Women's Risk of Open-Angle Glaucoma

2011-02-28T01:08:00.001-08:00

Obesity may be associated with reduced risk of the eye disease open-angle glaucoma in women, but not in men, a new study suggests.

Open-angle glaucoma is the most common form of glaucoma, a condition that causes damage to the optic nerve.

In the study, researchers in the Netherlands analyzed data from 3,939 participants, aged 55 and older, who took part in the Rotterdam Study and who did not have open-angle glaucoma when the study began between 1991 and 1993.

Over an average follow-up period of nearly 10 years, open-angle glaucoma developed in 108 participants (2.7 percent). The condition was most likely to occur in those who were older, had severe nearsightedness and in men, said Dr. Wishal Ramdas of the Erasmus Medical Center in Rotterdam, and colleagues.

The investigators found that, for women, there was a link between increased body mass index (BMI) and pressure within the eyes (intraocular pressure), which is a risk factor for open-angle glaucoma. However, they discovered that each one-unit increase in BMI was associated with a 7 percent decrease in the risk of developing open-angle glaucoma, but only among women.

Although the high intraocular pressure among obese women should have put them at increased risk for glaucoma, that didn't appear to be the case, the authors noted. "High estrogen levels and hormone therapy might be protective to open-angle glaucoma, and obesity seems to be positively related with postmenopausal plasma estrogen levels," Ramdas and colleagues wrote.

The study was released online Feb. 14 in advance of publication in the May print issue of the journal Archives of Ophthalmology.

The Best Hope for Glaucoma

2011-02-28T01:06:00.000-08:00

The cause of glaucoma is still largely a mystery to medical researchers, but the increasingly common eye disease is among the leading causes of blindness all over the world.

These are some of the points that will come into renewed focus next month when Antigua & Barbuda’s ongoing glaucoma awareness gets an annual booster.

A packed programme has been planned for Glaucoma Week, which begins on March 6 and continues until World Glaucoma Day on March 12.

Optometrist and president of Antigua & Barbuda Glaucoma Support Group Dr Jillia Bird is also president of the World Glaucoma Patients Association.

“Glaucoma is the leading cause of blindness in people of African descent,” she told The Daily OBSERVER. “It is silent and therefore you have to be tested in order to be aware if you have it. The statistics in our part of the world are particularly staggering in black Caribbean eyes. It is probably the leading cause of blindness in Antiguans.”

According to Dr Bird, people should be examined for glaucoma “even in childhood.” She said the condition “is really a group of diseases.”

The optometrist stressed that early diagnosis and treatment offer the only hope of preventing loss of sight from the disease.

She adds that this is even more important, given the type of glaucoma that tends to be common in countries such as Antigua.

She expanded further on why the risk should be treated with utmost seriousness. “The problem with the type that affects us black Antiguans – mainly the open angle glaucoma – is that as doctors we have a patient for one visit at one particular time of the day where the pressure (inside the eye) may be normal or considered normal, and we really have no way of knowing what that pressure is throughout the rest of the day.”

She added that “scientists have worked in the dark for a very long time trying to figure out what is this disease that damages the optic nerve and seems to be related to the intra-ocular pressure, but may not always be.”

Stressing how essential it is to get tested early, Dr Bird noted that “so many people are unaware they have it. It is a silent disease that steals sight slowly, painlessly and you may have well advanced disease before you are even aware that it exists.”

Activities for Glaucoma Week will include a donation of closed circuit TV for visually impaired readers, and glaucoma screenings.

World Glaucoma Day on March 12 will feature a march for sight and a rally.

Comparing glaucoma treatments

2011-02-28T01:05:00.000-08:00

It is estimated that around 4,000 people are registered blind or partially sighted in the UK each year because of the eye disorder.

Diagnosing glaucoma can be difficult but new diagnostic tests are available and easy to perform.

However there is a need for robust evidence to guide how best to use these tests which could be potentially very useful, particularly as eye clinicians are already dealing with high numbers of patients.

University of Aberdeen researchers have been commissioned by the National Institute for Health Research Health Technology Assessment programme to compare three new diagnostic technologies - Heidelberg retina tomograph, scanning laser polarimetry and optical coherence tomography.

Augusto Azuara-Blanco, Professor and Honorary Consultant Ophthalmologist at the University’s Health Services Research Unit, is leading the research.

He said: “If one or more of the tests prove to be sufficiently accurate and easy to perform, people would not need to attend lengthy examinations in the hospital eye department in order to establish whether or not they have glaucoma.

“This would give ophthalmologists more time and resources to treat patients who do have eye diseases.

“The majority of people who are referred to hospital by their optometrist do not have glaucoma, however they must be checked out because glaucoma can cause blindness and must be treated early.

“Clinicians in Scotland see 400,000 patients with eye problems a year and glaucoma is a big part of that.

“In the UK the NHS deals with more than one million visits by patients with glaucoma in a year so we are trying to deal with a very large flow of patients.”

The study will involve patients who have been referred by their optometrists with suspected glaucoma or who may be at risk of developing the disease.

The centres involved in the study are Aberdeen Royal Infirmary, St Paul’s Eye Unit in Liverpool, Moorfields Hospital in London and Hinchingbrooke Health Care NHS Trust in Cambridgeshire and patient recruitment will begin in March.

The tests are based on imaging the posterior part (fundus) of the eye where glaucoma damage can be observed. The team will evaluate the performance of these new tests by identifying those who are most likely to have glaucoma and require treatment.

Tiny Device for Tracking Progress of Glaucoma

2011-02-28T01:02:00.000-08:00

Scientists at the University of Michigan have developed a pressure monitor device which can be implanted in an individual's eye ball to track the progress of glaucoma. They claim that it is the world's smallest computer system which is just 1 sq mm in size. This device has been developed by Professors Dennis Sylvester, David Blaauw and David Wentzloff. It is yet to be named.

The device contains an ultra low-power microprocessor, a pressure sensor, memory and a thin film battery. It also consists of a solar cell and a wireless radio with an antenna which can transmit data to an external reader device. This radio does not require tuning to find the right frequency and so it can link to wireless network of computers. To charge the battery, the device requires 10 hours of exposure to indoor light or 1.5 hours of sunlight. Information can be stored in the device up to a week. The device takes measurements every 15minutes and consumes an average of 5.3 nanowatts energy.

This device is being seen as the future of the computing industry, though it requires few more years to be available commercially.

Focusing Eyes

2010-03-07T00:02:00.000-08:00

Question
About 2 days ago I started with some focusing problems almost as if I was drunk. The next day I woke up and could not focus on anything. It seems my left eye will not track to the right. I have had allergy and sinus issues in the last week or so. Also my eyes have been bloodshot throughout. Thanks.

Answer
Dear Matt,

For some reason, it appears that my reply did not reach you.

Since this was a much earlier post, trust that you are better today.

If you are still facing any visual disturbances, it would be best to seek the help of an optometrist or medical expert who can examine and guide you better.

However, yes, allergy and sinusitis does give rise to similar issues but get resolved with the medications.

Hope this helps,

Best,

Dr Shroff

Eye Color Change?

2010-03-06T23:44:00.000-08:00

Question
Hi there! I'm 18 years old and when I was younger (until about 14) my eyes were bright blue and then they started turning dark green in color so now they're kind of a weird mix that doesn't even have a name... They look like an ocean so they're pretty but... Is that normal...?

Answer
Dear Ash,

yes, this is normal for light coloured eyes which change in colour as they grow because the colour depends on the pigment. However, if the change happens at a later age, it is usually due to some medication etc which then needs to be seen by an eye specialist.

Hope this helps,

Best,

Dr Shroff

Change in vision in one eye with pain

2010-03-06T23:26:00.000-08:00

Question
QUESTION: Hello,

I am an otherwise healthy 26 year old female. Last week I had several "rough" days where I got very little sleep. On the second day I noticed a slight change in vision in my right eye but attributed it to lack of sleep. The next day, the problem was worse. It is hard to describe, sort of like a blurring, but more like there is too much light in my visual field (like if you are outside in the snow all day). The eye also has pain when I move it to the extremes of the eye orbit (way up, way left, or way right). My eye doctor diagnosed it as allergy related as I have been having sinus issues and my allergies have been horrible this year. But after several days of allergy meds and drops there is no improvement. I returned to the eye doc and he has scheduled me for a CT scan. The vision has gotten slightly worse, but my color perception hasn't changed. Any ideas?

ANSWER: Dear Sarah,

A good physician could also rule out some possibilities with clinical checks like sinusitis were the symptoms are similar.

The CT Scan could be to diagnose this instead of guesswork.

It won't hurt to do the check.

The vision since it shares similar nerve supply also gets affected in sinusitis.

Hope this helps,

Best,

Dr Shroff

---------- FOLLOW-UP ----------

QUESTION: Okay I had the CT scan done and all is clear, even the sinuses. The eye doc also has mentioned to me that the pressure in my eyes was elevated the last time I was in 20 mmHG, where it usually is 14-15mmHG. Any more ideas? The vision problem and pain in the eye is still the same.

Answer
Dear Sarah,

If the eye pressure is high...then there are some steps which need to be done:

1. Determine why? as if it stays elevated, then a condition called 'Glaucoma' needs to be diagnosed (it has some tests for this).

2. The elevated pressure needs to be controlled with medication.

3. Also make sure that the pressure is actually elevated (true) by doing the pachymetry or cornealss measurements.

You can e mail any eye report on dranand@lasikindia.in

If you want to learn more about Glaucoma please visit www.shroffeye.org

Regards,

Dr Shroff

Lightninglike flashes

2010-03-06T23:08:00.000-08:00

Question
I've experienced lightning-like flashing in both of my eyes. Before the last few days, it happened maybe three times. Day before yesterday I had it in my left eye which lasted a few minutes, then yesterday it happened in my right eye and lasted a few minutes, this morning, it happened in my right eye, then moved over to my left. I've never had it three days in a row or even that close to each other, and never in both eyes one directly after the other. I'm 29 years old, and in good health. What could this be?

Answer
Dear Heather,

This could be due to migraine or even arising from the retina of the eye.

A good physician should be able to guide you in the right direction, or even an eye centre where you could do the eye check for the retina.

Hope this helps,

Best,

Dr Shroff

Retina Detachment

2010-03-06T22:50:00.000-08:00

Question
Today I had my eyes examined under dilation. The doctor said that it looks like there is a threat of a hole in my retina in one eye. She said the retina there is kind of sticking to the vitreous matter surrounding the retina, which could cause a hole to develop. She has suggested that I - as a precaution - have the area lasered to cause scar tissue to form and seal the hole. I believe this area was also seen about 15 years ago and lasering was suggesting to me at the time but I didn't do it and in fact forgot about it. Is it advisable to laser the retina as a precaution or is that like repairing something that isn't really damaged? And is laser these days the best thing to do? Thank you for your help.

Answer
Hi Cheryl,

The best answer will come from a retinal specialist who will consider other risk factors you may or may not have with respect to current research and treatment options. I understand your situation and it can be frustrating to be a part of the decision given different opinions if that is what happens. But so far you only have two similar opinions and the test of time to argue it. I cannot advise you except to say get additional opinions until you are comfortable with your care and decision.

Best regards,

Mitch Axelrod, OD.

re: question regarding eye prescription

2010-03-06T22:32:00.000-08:00

Question
i AM 47 YEARS OLD IN 2005,

O.D. SPH-3.75, CYL-0.25, AXIS 015

O.S. SPH-3.75, CYL-O.50, AXIS 100

2009

O.D. SPH-4.25, CYL+1.00, AXIS 95

O.S. SPH-4.00, CYL+0.75, AXIS 121

COULD THIS MUCH CHANGE BE RIGHT? MY GLASSES & CONTACTS GIVE ME POOR VISION AND HEADACHES WITH THE NEW PRESCRIPTION. I'VE MOVED TO A DIFFERENT STATE, HENCE, THE NEW DOCTOR. ANY THOUGHTS OR SUGGESTIONS, OR EXPLANATION WOULD BE GREATLY APPRECIATED. THANK YOU.

Answer
Dear Theresa,

This needs to be examined to see if you have the correct prescription, you can check with the centre if with the new prescription you are seeing 6/6 or 20/20 then it is fine.

Yes, there is a change, but not totally unacceptable.

Also, they may have needed to adjust your near reading numbers as well.

Best would to speak with your treating optometrist.

Also, it does take about a week to 10 days to adjust to new glasses, but if still bothering you, you must go back to where they gave you the prescription.

Hope this helps,

Regards,

Dr Shroff

Lazy eye and laser operation

2010-03-06T22:13:00.000-08:00

Question
I am 24 years of age. From the child hood itself i have short sight in my left eye alone.My right eye was normal. At the starting the power was -3.0 . Year by year it

got increased though i had consistently used glasses, now it is 6.5 . One year before(from now) my right eye which was normal also blurred and i have a short sight

with -1.0 power. So i have started using contact lens for both the eyes . After using it also the power raised .5 in each eyes( left eye 6.0 to 6.5 and right eye 1.0 to

1.5).

During my last visit i came to know that i have a disease called "Lazy Eye" in my left eye.

Now left eye power is -6.5 and right eye is -1.5 .

Questions 1:

1.For the left eye , If i use -6.0 i can read the newspaper well ,but i am not able to view the far objects clearly. If i use -6.5 i can't read the newspaper, but i am able to view the far objects clearly.

i have mentioned the above point competitively(-6.0 , -6.5).

When the power was -5.0 i never felt like this.

Please clarify why is it so? Also please clarify which lens(-6.0 or -6.5) i have to use or is there any other possible solution?

Question 2:

Why my right eye which was well before last year also started to diminish? Is it any way related to the left eye?

Question 3:

Can i go for lasik for both the eyes? Will it provide a permanent solution?

Question 4:

I am feared whether my both the eyes will goes on diminishing. Provide me a best solution so that i can't lose my vision any more.

Answer
Dear Poongudran,

Lazy eye means that no matter what power or number is used in your spectacles, then too you cannot see 'normally what others can see- which is 6/6 vision or 20/20 vision). this means the last line of the alphabet chart (visual acuity) chart that you are asked to read.

This happens because when growing up, you have not been helped with correct spectacle numbers or have not got this checked.

Once an adult, you cannot improve the vision to being 20/20 or 6/6.

So, basically, yes, you can consider LSASIK, however keeping and bearing in mind that your vision after LASIK will be that of what you enjoy best with glasses.

secondly, it seems to me that there is some confusion regarding the exact prescritption you need to wear, only an eye check can determine this so please see a good eye doct or.

If in Mumbai or willing to visit us, please write to dranand@lasikindia.in for an appointment.

Best Regards,

Dr Anand Shroff

www.shroffeye.org

eye irritating

2010-03-06T21:55:00.000-08:00

Question
Good Afternoon, Doc.Am a regular user of a system and i start noticing eye irritating me when ever i start working on any system both desktop or laptop what is the problem? Please help.

Answer
Dear Buba,

I presume you refer to computer related work.

The cause could be a possible dry eye situation or allergy. Of course a visit to an optometrist would help differentiate between the two.

meanwhile a simple lubricating eye drop should help.

Please read more about this and tips to prevent the same on www.shroffeye.org under computer vision syndrome.

Thanks,

Dr Shroff

swollen eyes some swelling in face

2010-03-06T21:37:00.000-08:00

Question
I woke up this morning i felt like my face was heavy and my eyes didnt seem to wan to open well i go to look it the mirror and the right eyes is worse than left but both are so swollen that dont look like they belong onmy face a doc had recently pu tme on trazodone 100mg to try to help me sleep i am 5'3 119lbs i know im allergic to sulfa drugs but the first night i took a half of the pill didnt help me sleep so i took a whole pill 2nd night and i wake up likr this but thats not only the new medication i am on i have kidney stones so i am on a antibotic ampicillin tr 500mg 3xs day for three days i am allergic to benadryll it makes me itch allover within an hour of taking it is there anything i can take other than benadryll or would cold rag help the swelling

Answer
Dear Crystal,

It seems like your swelling of the eyes is a result of some systemic reaction, (something inside your body), yes allergy being one of them.

The treatment lies in finding the cause of the allergy, and only a good physiocian can help you.

Symptomatically using anti allergy eye drops may just help you feel better but may not treat it as the cause will still be around.

Hope this helps,

Best,

Dr Shroff

www.shroffeye.org

possible bruised eye

2010-03-06T21:19:00.000-08:00

Question
Two nights ago, I fell and busted my lip and mustve hit my eye too because the next day my eye felt irritated, like watery and scratchy. I went to eye doc and he didn't see anything. Said to keep drops to wet it. Today it hurts like a bruise when I'm in the light. Is this serious? Its the weekend and he is closed. Should I go to ER?

Answer
Dear Shannon,

This is called photophobia.

One cause could be that there is a corneal abrasion (but should have been noticed by the eye doctor, but if moissed, this can cause severe pain and local irritation.

What to do in the interim period?

1. Keep eyes closed and rested as much as you can

2. Use lubricating eye drops often

3. Take an anti inflammatory tablet or pain killer

4. Cold local compresses with eyelids closed may soothen eye

However, the faster the medicated eye drops are started the faster you will heal.

So, makes sense to visit an emergency clinic if in pain.

Hope this helps,

Best,

Dr Shroff

www.shroffeye.org

is this normal?

2010-03-06T21:01:00.000-08:00

Question
Hi, I have mild shortsightednes, but ive got this weird ability to make my eyes go blurrier on demand and then clear, i tend to do this more when im daydreaming, its especially noticable when ive got my glasses on

is this normal and what are my eyes doing when this happens?i made my eyes go like taht once when i was in the opticians on their autorefrecator machine and it gave me a really high reading and after the subjective bit, the doctor lowered the prescription . is doing that blurry thing with my eyes a signal taht i could be more short sighted than i already am?

Answer
Hi D,

Each of our eyes have inside an adjustable lens controlled by a circular ring shaped muscle. The muscle squeezes on the soft lens and causes it to bulge thereby changing focusing power. This is why we can autofocus from far to near even though your glasses only focus you for far. As we get old we the lens hardens and we can't focus up close; welcome to adulthood and bifocals. So enjoy your youth and powerful autofocus mechanism. You are blurry sometimes because you are over or under focusing. No worries. And if you over focus while looking through the autorefractor you will appear more nearsighted than you really are. The drops we use to dilate pupils also paralyzes the focusing muscle so you cannot autofocus: you see the near blur (as if you're old) if wearing your distance glasses (and you won't fool the autorefractor.

Hope that helps,

Mitch Axelrod, OD.

allergies

2010-03-06T20:43:00.000-08:00

Question
i am a 22 yr ols woman i have suffered from allergies for a few years now which includes itchy watery eyes especialy my right eye, and sneezing ans sometimes my asthma is effected. i have has a blood test done which has confirmed im allergic to dust mites, pollen and cats and dogs, i have a kitten and cant get rid of it and also many of my family have pets, i have tried all the tablets and drops but nothing seems to work the main problem is my eyes they itch and i get whit string stuffin it every five mins, i also have to wear glasses with a thicker right lense for reading and tv as the optition said i have dry eye and my right eye gets blury. please help! sammy

Answer
Dear Sammy,

treating allergies permanently is by working towards the cause.

In your case since your allergy has been defined towards pets which you do not want to get rid of, you can only work towards treating the symptoms as and when they happen with anti allergy eye drops and medicaions.

You can also see locally if there are any good reliable homeopathy or naturopathy places which may help boost your immunity.

Hope this helps,

Best

Dr Shroff

www.shroffeye.org

Drooping eyelid

2010-03-06T20:25:00.000-08:00

Question

EYE COMPARISON

My 24 year old son has been experienceing some drooping in his right upper eyelid which is causing him significant anxiety. He says the iris it the eye with the droop is darker in color and the pupil seems bigger. We are not sure if the droop is causing the anxiety or anxiety maybe causing the droop or whether there maybe a medical problem with the eye.

Answer
Dear Lisa,

He may need to be examined by an eye specialist first and if no eye related issues, probably a neurologist opinion may be required.

However, an eye doctor can guide you best.

This needs an examination, just the image does not give much information.

You may however email the report to dranand@lasikindia.in for any suggestions.

Hope this helps,

Best,

Dr Shroff

www.shroffeye.org

opthalmologyy

2010-03-06T20:07:00.000-08:00

Question
I got new glasses this past August. Since that time my vision has gotten worse. My eye doctor examined my eyes last week. He said there is no sign of glaucoma or cataracts. He also dilated my pupils and examined the backs of my eyes. He also said that everything looked fine. I have had blood work done and my sugar and thyroid levels are normal. In fact all of my blood work is normal except for high cholesterol. I have also noticed a slight twitching under my left eye for a few weeks which my eye doctor said wasn`t related to my vision problem.

Answer
Dear Sarah,

If you have had a check for the eyes, it would have showed up if there was an issue with the vision.

The twitching is external and could be an allergy. Anti allergy eye drops or oral medicines may help.

If the vision is tested, please send us the eye report on dranand@lasikindia.in to know if all has been checked.

I can guide better after that.

Thanks,

Dr Shroff

www.shroffeye.org

Humprey Fields

2010-03-06T19:49:00.000-08:00

Question
I have just started using a Humphrey fields machine recently but am not sure how to record the results of the c-30 screening programme as it does not contain threshold information or information on how many of the presentations were missed. ( I am used to using a Henson for screening which gives you the threshold and number of missed presentations so it is easy to record results). Can you help please?

Answer
Please address this to your senior optometrist as it will be not only difficult but also possibility of errors in interpretation of steps by doing this online.

Alternatively, the company always helps in this technical support in training, so you can approach them.

Regards,

Dr Shroff

getting perscription correct

2010-03-06T19:31:00.000-08:00

Question
I am 57, f, an albino, have been to hundreds of optometrists. I resisted wearing their glasses as they didn't make a difference in my eyesight. Four years ago I tried on my husbands' glasses and was shocked to see that I could read without my eyes getting tired, could see smaller print.

I did finally figure out that they have been giving me perscriptions for distance vision. I can't use glasses for distance vision as I can't wear them outside.   They collect the light and I'm sensitive to light. I guess that was a breakdown in communication. But I trusted them. I tried my best to cooperate during the exam and ask questions I should.

I did now get a perscription for near vision but it's still not as good as my husbands. I ask for my husbands perscription, and they say, 'my perscription will be better. Try mine, and if it doesn't work I'll give you your husbands'.'   But when theirs doesn't work,   they don't.

The last perscription I got does at first make print larger and clear. But my eyes seem to have to refocus and refocus, and within fifteen minutes They're tired and I can't use those glasses!

With my husbands perscription I can read for hours without getting eye strain.

When I go to walmart and want to order glasses from his perscription they give me a hard time. 'You need your own perscription.' Ect. I am so frustrated!!

The newest one I got is r; +550, -0.75, 15 and    l; +6.00,-1.50, 165   I paid $50. for a perscription I can't use.

I had one, ONE chance in my adult lifetime to have a job, (due to no drivers license becuase of eyesight) and I couldn't do the job because my distance vision glasses didn't allow me to see small print I needed to see.

Answer
Hi Darcy,

I didn't see a question, but i appreciate the story. I can't explain why they wont give you an Rx like your husbands. You didn't include his Rx for me to compare but no matter, I would think one the optometrists would study the difference in order to understand your experience. All I can suggest is another visit to the doctor with yours and your husbands glasses to sort it out.\

Best of luck,

Mitch Axelrod,OD

Halo's in line of vision

2010-03-06T19:13:00.000-08:00

Question
I have had halo's in my line of vision for about a year ago. There is one in each eye, it almost looks like impression. They are worse when I look hard to the left of right. They are dark but during the night they are light. I have been to an OD and the health of my eyes is great. I have been to a neurologist for migraines and have had a CT's and my brain is fine. Help please!

Answer
Did you mention this particular symptom to the neurologist? If not, a different type of testing may need to be done regarding this symptom. If a general neurologist cannot find an answer for you, consider seeing a neuro-ophthalmologist. These are not so easy to find, but most likely your OD knows of one in your area to recommend.

Foggy vision

2010-03-06T18:55:00.000-08:00

Question
For the last 3 months I am suffering from Foggy and cloudy Vision. My Eyesight is normal. Feel as if vision is not clear although I can see everything properly. I have the feelings of lethargy/fatigue, the drunk/hungover feeling and the feeling that my eyes aren't focussed, even though I can see everything fine. I have almost all the blood test which came normal. also had brain MRI which also came normal. Doctor is this a eye problem or something else.

Answer
Dear Manish,

If the eye check up and MRI have revealed no abnormality, it would unlikely be a cause that could have been missed or eye related.

Yes, a good physician on the basis of history and symptoms and signs would be able to guide you better.

If the eye check is not done, then get it done in any case, if in Mumbai we could do it too.

Regards,

Dr Anand Shroff,MS (OPHTH), FICS

www.shroffeye.org

vision therapy

2010-03-06T18:37:00.000-08:00

Question
Dr,

i have hereditary macular degeneration and high myopia.i am 20 yrs old.my best corrected visual acuity is very poor.can vision therapy/orthoptics help me get 20/20 best corrected visual acuity?There are expensive programs available here where i live promising excellent results for retinal problems (they show me testimonials of people with diseases like RP being benefited).But i dont think i might be helped by such vision therapy sessions as i do have proper binocular vision.what is your advice?Also the cost of such sessions is exorbitant.so i am confused.kindly advise.

Answer
Dear Adrin,

Vision therapy usually helps in Amblyopia where the internal eye apparatus is normal but the pathway to the brain needs stimulation.

In your case, the main issue lies in the retina where the macula is having a problem, hence do not think that vision therapy will give you mush help.

However, you may want to check an Low Visual Aids which may enhance vision and improve visual tasks for you like on the PC, while reading etc.

Hope this helps,

Regards,

Dr Anand Shroff

you may want to read more about this on www.shroffeye.org

Strange effects of certain colours

2010-03-06T18:19:00.000-08:00

Question
I've noticed that there are certain colours which make my vision in slightly strange ways. It happens mostly with a particular strong, bright red colour, but also with the corresponding shade of blue. If I see this colour out of the corner of my eye, it appears as if it is flashing. I've also noticed that when websites use these colours (particularly the shade of blue) I find those pages impossible to read, because of a similar sort of 'flashing' effect. I was wondering what it might be that causes this, and how common it is?

Answer
Dear Hannah,

Am not sure if I have understood this correctly, but what we experience visually is explained very subjectively.

If your eye check has determined you fit and healthy for the eyes, what you are visualizing is what others also see, but do not describe it this way.

there are certain ''cells' that we see floating in bright light, sometimes the image of the retina is seen too against reds colours, so what you must be describing may be a normal phenomenon but since you have concentrated and focussed on it, it is more noticeable.

The actual 'flashes' of light that happen in the eye occur with vitreous detachment and this is not just with certain colours but all the time.

However, do have an eye check if not had one done.

Best,

Dr Shroff

Eye prescription accuracy

2010-03-06T18:01:00.001-08:00

Question
In June 2008, my eye prescription:

O.D. SPH-1.25, CYL-0.50, AXIS 090

O.S. SPH-1.50, CYL-O.25, AXIS 100

At the end of 2008, my eye prescription from another office:

O.D. SPH-2.00, CYL+1.00, AXIS 180

O.S. SPH-1.75, CYL+0.25, AXIS 180

Now in Sept 2009, my eye prescription from a new office:

O.D. SPH-2.25, CYL+0.75, AXIS 170

O.S. SPH-2.25, CYL+0.50, AXIS 05

I am 47 with type 2 diabetes. I moved 2 states since last yr, that's why I had three eye doctors. The eye doctors through 3 eye exams all said that no problem from diabetic. Could this mean some problem with my eye vision (distance) or just testing variation? If eye vision issue, what could cause it? I have no distance vision change through the last 20 years. I don't really feel much difference when I wear these 3 pair of glasses.

Appreciated your help!

Answer
Dear Pearl,

The changes are acceptable.

In a person's late forties and fifties the number turns more positive and changes can happen in spherical and cylindrical powers.

The eye is a fluid filled ball and any changes in the optics or shape can change the number.

Just so long as with the current powers you are reading 6/6 for distance and N6 for near, the powers cannot be wrong.

Hope this helps,

Best,

Dr Shroff

www.shroffeye.org

blue sclera

2010-03-04T08:06:00.000-08:00

Question
Hello doctor, I read someone else's question, but don't think the answer applies to me. I am 22 years old, female and the last eye test I had 2 years ago said I had perfect vision. A few days ago a friend said she thought my eyes (sclera) were turning blue. I took a look and they are quite blue all the way around. I read this could be a sign of anemia, however I tested negative for anemia four months ago and from my diet it is unlikely I am anemic. I don't suffer from fractures, i do appear to bruise easily on my lower legs, and suffer from migraine. I don't really know what is relevant or what could be the cause of the blueness, I have booked an eye exam for two days time however, which will refer me to the hospital to check my scleral thickness.

I have been put on propranolol for my migraines, so I don't know if that would have an effect? I am not aware of any osteogenesis imperfecta in my family, I think my grandfather had osteoporosis.

Please put my mind at ease, I really don't know what it could be.

Thank you, Sameera.

Answer
Dear Sameera,

Blue sclera could be heriditary and may not have been noticed by you earlier.

only a doctor can diagnose if this 'bluish ' colour is actually a discoloration which has happened as a result of some external or internal factor.

A good cornea specialist would be a helpful opinion.

Hope this helps,

Best,

Dr Shroff

Lazy eyelid and misshapen iris in baby

2010-03-04T07:48:00.000-08:00

Question
My four-month-old son's left eye sometimes appears smaller than the right, especially when he is sleepy or just woken up. It's quite subtle and predominantly noticeable from a foot or so away. When he falls asleep, the left eye seems on the other hand to remain slightly more *open* for longer than the other. On one occasion I saw him blink with the right eye only (again, he was nodding off to sleep when this happened.) It's as if the muscle in the eyelid is weaker.

It doesn't overhang his pupil or appear to obscure his vision in any way, but I've also noticed that the iris in the same (left) eye looks a slightly odd shape - not fully round at the bottom, and almost with a tiny point to it at the outer edge. (This very also very subtle and hard to spot.) He was born with red birth marks on both eyelids, which sometimes look a bit swollen.

My pediatrician seemed keen to refer him to a pediatric ophthamologist immediately, but we're about to go on holiday and I couldn't understand the urgency. Should we be worried? My husband also has a droopy eyelid the same side so I thought it was just a harmless heriditary thing, but it does seem to be getting a bit more pronounced.

Thanks in advance.

Answer
Well, you do definitely need to see a pediatric ophthalmologist. This sounds like a nerve deficit of some sort but you do need an official diagnosis from a specialist to know whether it is serious or just a harmless anomaly.

As for how urgent it is to have your son seen, I would say if your vacation is only a week or two, you could call for the appointment before you leave and make it for a day as soon as you get back. It may take a few weeks to get the appointment anyway - UNLESS your pediatrician wrote you a referral indicating it was urgent.

If the trip is longer than two weeks or so, I would consider other options, such as finding a pediatric ophthalmologist in the holiday location, if that is possible, or consider deferring the trip.

New Glasses blurry ness off center

2010-03-04T07:30:00.000-08:00

Question
Hi

I recently got new glasses and am having a problem with blurriness when looking probably even 20 degrees off of center. Basically if I am not looking at the object straight on its blurry.

I have a high index lens, I think my prescription is in the +5.00 region ....

I just had my eye exam 3 weeks ago and there was no change in my prescription so I simply ordered a new pair.

I got them, they were blurry then so they sent them back to be remade. I picked them up again and I am seeing the same problem. My other pair of glasses that I got 2 years ago has no blurriness whatsoever and I don't have any problem with them. The eye doctor says they have been remade and there is nothing wrong with the prescription, but driving with them is hard since I have to turn my entire head just to make sure I am clear of traffic at a stop sign.

Also my new glasses are actually bigger than my older pair and have bigger lens so I am confused to as why I am having a problem with this new pair. In the past my eye doctor had said that I was allergic to polycarbonate lens and such I shouldn't use them and thus I have used plastic lens ever since including these ones.

Any suggestions ??

Thanks

Chris L

Answer
Dear Chris,

of course there is a short temporary transisiton period of 'getting used to' your glasses.

But to me this sounds like it will affect your safety while driving if not comfortable with them or getting distracted with the blurred vision.

You may take another opinion ...thats best I can suggest as you have already re visited the centre which made these in the first place.

Regards,

Dr Shroff

www.shroffeye.org

Frames

2010-03-04T07:12:00.000-08:00

Question
Hi

This may seem like a dumb question...

I have two pairs of eyeglasses.

I had the eye exam and the frames done at the same place.

I wasnt happy with the frames-they werent what I wanted, but the sales girls assured me I looked better in the ones(more expensive)they picked out.

I wanted the good old fashioned black 'Buddy Holly' style!

There is a new discount optical shop in my town.

Can I take them there and get new frames? They might have to grind the lenses to fit but thats OK.

Thanks!

Answer
Hi Bud,

You can take your glasses to any optical shop but take your current glasses prescription with you that your doctor gave you after your eye exam (had to by law). They may not be able to regrind the lenses, though. Certainly I would first go back to the first place and try to get satisfaction as I'm sure they don't want a customer leaving as you want to do. They may have other frames or be able to get other frames for you.

Regards,

Mitch Axelrod, OD

Dislocated lens implant

2010-03-04T06:54:00.000-08:00

Question
Is it possible for a lens implant that functioned well for 8 years to be dislocated due to a strong auto collision from the side?

Answer
Dear William,

Yes, the lens can be dislocated due to trauma. However, re implanting another lens is the query?

Dislocation requires a vitreo- retinal surgeon to remove the same and assess the situation for implanting another lens as various types are available.

This depends on the condition of the eye.

However, definitely needs to be acted upon immediately.

Hope this helps,

Best,

Dr Shroff

Toric lens fit

2010-03-04T06:36:00.000-08:00

Question
Hi, I have had a very difficult time getting the right fit in my Toric lenses. I have worn torics for years, but am changing from Acuvue Advance to Oasys. The trial pair (3rd try) that had the perfect fit had the correct strength, with an axis of 10 and a cylinder of 75. The new lens I received didn't seem clear at all and I see they have an axis of 70 and a cylinder of 75. The doctor is out for for the next week, but his receptionist claims that is the prescription he wrote...can this possibly be correct???

Answer
Dear Jo Anna,

Torics are tricky and hence need to be fitted and dispensed by a good contact lens specialist.

Only the treating person can verify this for you.

If you are not seeing clearly and it is not temporary, then this has to do with either the prescription or the fit, both which ned to be checked by the doctor.

Hope this helps,

Best,

Dr Shroff

clarification

2010-03-04T06:18:00.000-08:00

Question
dear ma'am,

I had a recent eye check up. my power details are as follows-

right eye: sph : -9.5 cyl: -0.5 axis: 75 degrees

left eye: sph: -8.5 cyl: nil axis: 25 degrees

my old prescription-

right eye: sph : -10 with same cylindrical.

left eye : sph: -9.5

The problem is when I got my new pair of glasses, the glass seems to be very thick at its edges and causes discomfort when I try to look at the corners. whereas by old pair of glasses don't appear that way, though made with a higher power compared to the new one. I use a high index glass of 1.8. totally I don't feel comfortable wearing the new specs. I would be glad if you can help me with this problem.

thanking you,

yours sincerely

Sudha

Answer
Possible reasons for your problem are listed below:

1) are your sure both your old glasses and the new ones are made of high index material? Are you sure they are GLASS? We don't really use glass lenses in the US anymore.

2) Even if they are both high index material, there could be differences between one brand from one lens company and another.

3) there could be different base curves used. Base curve is not part of the prescription but it refers to the curve of the front side of the lens. the same prescription could be made with any number of different base curves by altering the back curve. Only a very few people are sensitive to base curve differences so usually no attention is paid to matching base curves to a prior pair. If you find that this is the problem, have your optician tell you what base curve your old glasses were and then always ask for that curve when ordering glasses. You can go back to the optical shop and have them measure the base curve of both sets of glasses. if there is a difference, ask to have the new glasses remade with the curve of the old glasses.

4) there could also be a difference in the way the optical centers were measured. Ask the optical shop to remeasure the OC's on both pairs to see if they fall in a different spot on your face.

5) the new glasses may be adjusted in such a way that the lenses fall at a different angle on your face. Ask the optical shop to try and match the adjustment of the new pair to the way the old pair was adjusted.

6) the new frame may be larger than the old one. The larger the frame, the farther from the center the lens goes out and the more likely there are aberrations in the lenses at the edges. Picking a smaller frame (with fewer millimeters from your pupil to the edges in all dimensions) may resolve this.

7) If none of the above suggestions work, you should go back to the doctor who wrote the prescription to see if by chance the new one is not correct for you.

C3R for mild keratoconus?

2010-03-04T06:00:00.000-08:00

Question
Hello,

I'm 29 years old and was diagnosed with relatively mild keratoconus 10 years ago. I was unable to wear contact lenses due to extreme sensitivity, but fortunately my condition has not progressed. You seem to be very high on C3-R, and I've heard good things about it from others. I'm wondering if the treatment is recommended for milder case of keratoconus, and if it is likely to improve my vision without additional treatments such as INTACS.

Thank you,

Alex F.

Answer
Dear Alex,

Yes, we do advocate C3R. For me it is pointless to wait on a conditon which is known to progress.

Keratoconus cannot be reversed, hence it would be more beneficial to do C3R in early stages when the vision is not that affected so that it stays that way, or even improves (we have over 70% of patients showing an improvement in visual acuity).

However, some doctors believe in waiting till there are changes in the Topography maps.

Please read more about this procedure, patients experiences on www.lasikindia.in

Hope this helps,

Best,

Dr Anand Shroff, MS (OPHTH), FICS

www.shroffeye.org

migrainesquintingcolor

2010-03-04T05:42:00.000-08:00

Question
Greetings,

In a recent human biology class numerous questions regarding eye function were asked and I was hoping you could provide some insight. I haven?t been able to find any answers from trustworthy, reputable sites. First, why are you more sensitive to light when you have a migraine? Mayo clinic has a great video on aura associated with migraine but nothing on sensitivity. Second, why does it seem to help you focus when you squint? Third, do adults normally experience changes in eye color? Numerous students claim that their eyes change color back-and-forth.

Thank you very much for providing your expertise.

Answer
Dear Elaine,

1. The nerves supplying the eyes and eye muscles are the same which supply other parts of the head, face and neck. When there is a bright light, the natural reaction is to reduce the size of the pupil or squint to let in less light inside the eye.

Even a normal perosn with no migraine will feel a little discomfort in bright light, which is exacerbated in migraine and the nerve supply being common, this comes as an uncomfortable reaction.

2. The central rays of light passing through the pupil or the central hole in the coloured part of the eye, pass without bending and fall on the retina. the rays of light on the periphery need to bend.

hence a pin hole or seeing by squinting tends to allow only the central rays to apss through without being bent and hence the vision is clear since it blocks the peripheral rays which bend light and cause the uncler part of vision.

3. Yes, eye colour can change as you age in some who have light pigmented eyes, which gain more pigment as they grow older as this is to do with changes (natural) in the melanin cells of the iris. Also, some medications can cause a change in colour.

Hope this helps,

Best,

Dr Shroff

90 year old Mother

2010-03-04T05:24:00.000-08:00

Question

My MOM

My mother is 90. I recently became her caretaker and am responsible for taking her to all her doctor appointments. She had a cornea transplant about 18 years ago and it created more problems than it resolved. Her vision in the left eye has deteriorated over the years since the transplant. Now her vision is almost completely gone in that eye (left eye). She can see only a little light and a little motion with the left eye. The doctor has prescribed the following eyedrops for pressure in her left eye. COSOPT 2X/DAY, ALPHAGEN 2X/DAY, LUMIGAN 1X/DAY @ Night. She does TRAVATAN 1X/DAY @ morning in her right eye. She has been taking these meds for at least a year. On her last doctor visit in October, the doctor said her pressure in her left eye was 21 (17 using a mechanical tonopin?). On her previous doctor visit in August, her pressure in the left eye was 13. (The right eye pressure is always 9 or 10).

The left eye very often looks like it is red and painful. The left eye looks like it is sinking back into her head and the left eyelid is starting not to close completely when she is sleeping.

The right eye looks beautiful and healthy.

The eye doctor says to keep doing what we have been doing.

I don't think there is any chance for her vision to return in the left eye.

Do you think there is any way to help my mother even if only to help her eye feel more comfortable?

Do you think the meds are appropriate?

I will relly appreciate your help and advice.

Thank you

Answer
Your question is very hard to answer without actually examining your mother (although the picture did help - thanks!) Additionally, it involves mainly ophthalmological issues (regarding surgery) so is a little bit outside my area of expertise. Nonetheless, I will do my best to answer.

There is very little likelihood your mother will ever regain vision in the left eye. If it has been 18 years since the transplant, we have to consider the possibility that she is rejecting the graft. Just like any other foreign tissue, there is always a chance the body will reject the transplant after a period of time. Now we get into the part I cannot answer. I do not know what the standard of care would be for a 90-year old with a graft rejection. If the eye is chronically uncomfortable AND the vision loss is from some retinal problem like macular degeneration - as opposed to the cornea being cloudy from a rejected graft, it might be better just to remove the eye. (I know that may be shocking to you, but with a 90-year old, our options are more limited than in a young person.)   And if the vision loss IS from a cloudy corneal graft, I still very much doubt they would re-implant a 90-year old, so you may have a dilemma on your hands.

Next time your mom sees her eye doctor, I would try to pin him down as to two things:

        1) Why is the vision so poor? (cornea versus retina, or something else)

        2) Why is the eye chronically red and painful? (and what can be done about it?)

From there you can begin to discuss what options you have to relieve the discomfort, given that the vision will most likely not be restored in any case.

babys pupils

2010-03-04T05:06:00.000-08:00

Question
i have a week old baby and am wondering if it is normal for her pupils to be round on top and oval shaped at the bottoms

Answer
No, that is not really normal. There is no hurry but eventually you should take your baby to a pediatric ophthalmologist. Your baby may have a partial coloboma, a fairly harmless (usually) condition where parts of the eye did not fully form before birth. In most cases, this poses few or no problems (minimal or no vision loss) for the child but you do need an official diagnosis to be sure it is not something else.

eyes

2010-03-04T04:48:00.000-08:00

Question
Hello everyone,I've had this prescription for one year.I apologize because the vv is broken on my keyboard. I feel like I see the second image or distorted images at times. It feels like I am hallucinating. My eye doctors intention vvas to get my muscles in both of my eyes to vvork together.She said it vvould get better in time and has gotten vvorse. Im seeing a nevv eye doctor next vveek.I am 39 and have had this lazy eye my vvhole life. I just vvant to knovv if this happens vvith this type of prescription vvhere they are trying to get the eyes to vvork together.I have a lazy eye and have never tried this type of prescription before. My eyes are healthy and no have no damage to them. It seems like from the corner of my eye things pop up that don't belong.It is very nerve vvracking and do you think a nevv prescription might help this? Nothing stays solid vvhen I turn slighlty but nothing is blurry or cloudy.The stigmatism has become more bothersome and even that seems distorted . Thankyou for your reply, Cindy

Answer
Dear Cindy,

According to your history, since your vision has changes for the worse, one needs to rule out other causes and not just put it down to the 'lazy eye'.

You will need to see a good eye specialist, preferably one that is a strabismus surgeon or knows how to deal with eye deviations, prescribe prismatic lenses etc.

If you have any eye report you may send it to dranand@lasikindia.in

Hope this helps,

Best,

Dr Anand Shroff

www.shroffeye.org

my siter

2010-03-04T04:30:00.000-08:00

Question
my sister was born with an under developed eye she can see but not as good as she can with here other eye would lasik eye surgery work in her favor and if not as she gets older will she have problems will her vision diteriate or anything of that matter

Answer
Hi Marlon,

It is not likely that Lasik could do anything glasses couldn't do. Usually the lazy eye is stable and not likely to deteriorate. Eye safety is always a concern though, and worth emphasizing: keep the eyes protected with protective glasses. Also routine eye exams, especially as she gets older are important and the eye doctor will be happy to address your concerns if you go with her to the eye exam and ask your questions.

Best of luck,

Mitch Axelrod, OD

Increased IOP after ICL

2010-03-04T04:12:00.000-08:00

Question
Hi,I am 23 yrs old.I recently and had Visian ICL implant in both my Eyes as i was not suitable for LASIK due to High Myopia.After the surgery the Pressure in my Right Eye was 20 and my Left Eye was 25.The doctor said it is nothing to worry about as i didn't experience any change in my vision and has prescribed Timolast 0.5% twice daily for Two weeks.Will this bring my pressure down and am i under a risk for Glaucoma?And should i be using the medication throughout my life?

Answer
Dear Saranya,

The doctor is right, ICL can tend to (in the first few eeks) increase the eye pressure. This may be reduced with the eye drops prescribed, in some a simple laser procedure is also needed.

But it is temporary and should settle. It does not mean that you will have 'glaucoma'

However, recommend that you visit the doctor regularly.

Best,

Dr Anand Shroff,

www.shroffeye.org

eye infection

2010-03-04T03:54:00.000-08:00

Question
hello,

I have been having a recurring infection in my eyes since I was 15 years old, I am now 30. The infection starts off as a white discoloration at the corneal rim (junction of cornea and sclera). This is the only area affected. It never shows up isolated over the iris or the center of the cornea. It is always touching the corneal rim. Sometimes its just a small dot, and other times its larger white discoloration following the corneal rim. Occurs most often at the medial and lateral cornea.

Onset: I find it occurs when I am stressed (tests, money problems, etc.), if I am near an open fire, if I work on cars (possibly the carbon/grease mixture), if I dont wash my face (my face gets very oily especially when I sleep), if sweat gets into my eyes and i dont wash my face shortly afterwards, and if the heater is on causing dry air. These are the most common signs prior to onset.

Provocative: Sunlight or bright light, if I think about it, and heat.

Palliative: Lately Ice seems to decrease pain, pain killers do not work, only makes me drowsy but pain is still there. When I was 23 I was prescribed blephamide, it numbed the eye and the pain stopped but the infection came back. I dont think it was the right thing because what I have maybe viral.

Symptomology: Extreme pain 5/10-8/10 at worst. Sharp stabbing pain as if a large pebble is in my eye. Causing reddening of the sclera, becomes very vascular. Pain can radiate causing headaches. Runny eyes, photophobia, blurred vision.

Timing: I usually wake up with it in the morning, lasts about 2-3 days, the second day being the worst in terms of symptomology. Occurs most often in the winter. It keeps me up at night due to pain. If I dont sleep the infection lasts longer.

Medical History: I am generally a healthy active individual, on two occasions I was told that my white blood cell count was just below normal, otherwise blood test have come back normal. I have been to 5 different doctors over 15 years. At UCSF a sample was scraped off for testing, the doctor said I was allergic to the oils I produce on my eyelids. She then prescribed blephamide. My vision is perfect, but I have been told that there is significant scarring on the Iris and getting worst.

My question is what can I do? Where can I find a doctor that specializes in infections? I have looked online with not good results. Do you think this maybe Herpes? if so how can I get tested to confirm of ddx from bacterial infection? please let me know what you think. I am very desperate because it seems to be getting worst. The pain is debilitating, I cant do anything. Your help is greatly appreciated.

Answer
Dear JWD,

No this is not Herepes, but from the history, symptoms and your description seems to fit more as a diagnosis of ocular rosacea.

You will need to see a good skin specialist for this.

You can read more about this on the net (http://www.about-rosacea.com/ocular-rosacea.htm or http://ibmi.mf.uni-lj.si/acta-apa/acta-apa-07-2/9.pdf) but would request you not to go about finding where you fit until you meet a skin specialist and confirm diagnosis.

Hope this helps,

Best

Dr Anand Shroff, MS OPHTH, FICS

dranand@lasikindia.in

Dr Safala Shroff

Refractive and Surgery Coordinator

Shroff Eye Hospital-LASIK

222, S V Road,

Bandra West

Mumbai 400 050

India

Phone: 022 - 66921000/ 66939372

Cell:098211-63901

www.lasikindia.in

Shroff Eye Clinic

Gobind Mahal

86 - B Netaji Subhash Road

Marine Drive

Mumbai 400 002

Phone: 022 - 22814077, 2811863, 22029242

www.shroffeye.org

Shroff Eye Hospital is India's First Eye Hospital that the Joint Commission International (International Division of JCAHO, USA) has given accreditation for excellence in patient care and health care delivery. Shroff Eye is also India's first and only Wavelight Concerto 500 Hz LASIK center- The Worlds Safest and Fastest LASIK.

90 year old Mother

2010-03-04T03:36:00.000-08:00

Question
QUESTION: My mother is 90. I recently became her caretaker and am responsible for taking her to all her doctor appointments. She had a cornea transplant about 18 years ago and it created more problems than it resolved. Her vision in the left eye has deteriorated over the years since the transplant. Now her vision is almost completely gone in that eye (left eye). She can see only a little light and a little motion with the left eye. The doctor has prescribed the following eyedrops for pressure in her left eye. COSOPT 2X/DAY, ALPHAGEN 2X/DAY, LUMIGAN 1X/DAY @ Night. She does TRAVATAN 1X/DAY @ morning in her right eye. She has been taking these meds for at least a year. On her last doctor visit in October, the doctor said her pressure in her left eye was 21 (17 using a mechanical tonopin?). On her previous doctor visit in August, her pressure in the left eye was 13. (The right eye pressure is always 9 or 10).

The left eye very often looks like it is red and painful. The left eye looks like it is sinking back into her head and the left eyelid is starting not to close completely when she is sleeping.

The right eye looks beautiful and healthy.

The eye doctor says to keep doing what we have been doing.

I don't think there is any chance for her vision to return in the left eye.

Do you think there is any way to help my mother even if only to help her eye feel more comfortable?

Do you think the meds are appropriate?

I will relly appreciate your help and advice.

Thank you

IMAGE: My MOM

ANSWER: Your question is very hard to answer without actually examining your mother (although the picture did help - thanks!) Additionally, it involves mainly ophthalmological issues (regarding surgery) so is a little bit outside my area of expertise. Nonetheless, I will do my best to answer.

There is very little likelihood your mother will ever regain vision in the left eye. If it has been 18 years since the transplant, we have to consider the possibility that she is rejecting the graft. Just like any other foreign tissue, there is always a chance the body will reject the transplant after a period of time. Now we get into the part I cannot answer. I do not know what the standard of care would be for a 90-year old with a graft rejection. If the eye is chronically uncomfortable AND the vision loss is from some retinal problem like macular degeneration - as opposed to the cornea being cloudy from a rejected graft, it might be better just to remove the eye. (I know that may be shocking to you, but with a 90-year old, our options are more limited than in a young person.)   And if the vision loss IS from a cloudy corneal graft, I still very much doubt they would re-implant a 90-year old, so you may have a dilemma on your hands.

Next time your mom sees her eye doctor, I would try to pin him down as to two things:

        1) Why is the vision so poor? (cornea versus retina, or something else)

        2) Why is the eye chronically red and painful? (and what can be done about it?)

From there you can begin to discuss what options you have to relieve the discomfort, given that the vision will most likely not be restored in any case.

---------- FOLLOW-UP ----------

QUESTION: Dr. Margaret, thanks for your quick reply.

If it was decided the best thing would be to remove the eye, is that procedure safe for a 90 yr old?

How do they remove the eye? Do they replace it with something or just leave a void space there?

Are there any issues surrounding the removal procedure or the after care?

Being such a sensitive and personal issue, normally how might a 90 yr old

react to such an idea?

Thank you,

Joe

Answer
Well, let's not jump to conclusions about this unless and until your eye doctor says it is your only option for relieving her discomfort. But I believe the eye could be removed (remember I am not a surgeon) without much risk to your mother's health. An artificial eye can be made for strictly cosmetic reasons if you feel this is important, but an artificial eye must be removed and cleaned periodically, so you may want to consider whether it is worth it as you would either have to do this for her, or take her to someone who can.   As for how a 90 year old might react, I suppose that could vary greatly, depending upon how rational your mother is at this point. Can you explain the reason to her and is she cognizant enough to understand? If not, I very much doubt you can do this because the emotional strain might be more than she can bear if she does not understand.

eye flashes of light

2010-03-04T03:18:00.000-08:00

Question
What are eye flashes 0f light from. I would like to get rid of them. I also feel like there is something in my eye when there isn't. I take Restasis for dry eye syndrome. I have been told that I may never stop having the flashes. Of course, they are worse at night, but my right eye, where they appear, never feels normal. I have been to two Optometrists.

Answer
Dear Linda,

The dry eyes is not associated with the flashes of light. This is another entity insode the eyes and is not pathological.

Sending you the link to read more about this and its tips.

http://shroffeye.com/flashes-and-floaters-0

Best,

Dr Shroff

Elevated Optic Discs

2010-03-04T03:00:00.000-08:00

Question
I'm an 24 year old female.

I visited my Ophthalmologist today...everything seemed normal at first and then he seemed to be concerned and started to ask if I had headaches often or blurry vision.

He said my optic discs were elevated in both eyes.

Then he told me not to worry because he could see venous pulsations.

...That this might just be my regular physiology.

Is it possible to have something wrong and still have venous pulsation?

I still need to do a visual field in 2 days, he says.

I haven't noticed regular intense headaches, but I do seem to regularly experience a dull ache which is more of an annoyance than anything else.

I've been getting floaters in my left eye more often.

I have experienced a lot of nausea in the past 6 months...and I've lost about 30 lbs in that time. (20 of it from April to May)

I'm still just concerned.

Answer
The issue with the elevated discs is that there is concern you could have something behind your eyes (like a tumor) pressing the discs outward and causing pressure. IF there are venous pulsations, that is reassuring that there is not pressure from behind. Venous pulsations are often used to differentiate elevated looking discs that are dangerous from the ones that are not dangerous. A visual field is always a good idea in a case like this.

If it were just for the discs, with the presence of the venous pulse, I would not be too concerned.

BUT when you say you have been nauseous, have headaches and have lost weight without trying, that IS cause for concern. I hope the ophthalmologist asked you about these symptoms. If not be sure to tell him. If the field turns out normal, and the ophthalmologist doesn't recommend any further testing, it sounds like you still would benefit from a visit to your primary physician because of all the other symptoms!

Progressive Lenses?

2010-03-04T02:42:00.000-08:00

Question
I am 52 years old. I was prescribed my first set of glasess for readding at 48.

I went to an eyeglass chain store and was prescribed a stronger set of reading glasses, I also received another set for computers that my plan allocated.

Both sets of reading glasses were not prescribed properly.

I went back and the Opptometrist re-evaluated me for stronger lenses for both eyes. She stated I needed the glasses now for reading and for Driving (Distance for reading signs)

When I went to pick out the frames the salesman suggested progressive lenses.

My question is. Are progressive lenses what I need at this point or are they overkill and they will ruin my eyes. Other than for a slight issue with signs in the distance while driving and reading up close, I don't relley need them when doing other activities ( Like walking, cleaning, yard work, TV)

Answer
Glasses are like tools. There are multipurpose tools and dedicated tools, each with their pros and cons. You simply use glasses to see better when you want to see better or more easily. You need to have a discussion with our optician about the various choices and pros/cons. Choose the tool that makes the most sense to you and realize that you will be choosing glasses for the rest of your life. You can try different types but with progressives make sure you get a good one, not a cheap one. Glasses don't ruin your eyes, age does: welcome to adulthood.

Best of luck,

Mitch Axelrod, OD

Reading Glasses

2010-03-04T02:24:00.000-08:00

Question
I went to the eye doctor because sometimes I have trouble seeing far. I was told that I can see 20/20 but I was prescribed Reading glasses. She said that would reduce the strain on my eyes when reading or working and that would help me see long distance better without glasses. Does that make sense?

Answer
Hi Mike,

It would make sense if your age is above 40 years as reading glasses are related to age related changes.

However, the similar 'plus numbers' are prescribed as a full glass for some younger people (less than 40 years)working on the PC for long hours and then these work as 'computer prescription ' glasses.

Thanks,

Dr Shroff

www.shroffeye.org

Eyes focus differently

2010-03-04T02:06:00.000-08:00

Question
This week I got my first pair of glasses at the age of 25. I had noticed things far away or across the room would get hard to see, especially after reading or computer use. Since I'm a graduate student, that's pretty much all the time.

I got the glasses this week. As far as I can tell, the left eye is now perfect -- feels like back to the 20-15 vision I used to have. But the right eye, while improved, is noticeably blurrier beginning at about 3 meters away. (I don't wear the glasses while reading or using the computer.)

Assuming the lenses properly follow my prescription, should I be looking to get a different prescription? This may be causing some strain, but I may also be generating discomfort because I'm preoccupied by this.

The main question is, is this something that can be avoided, or am I stuck with one eye being noticeably better than the other? Is this simply a case of the wrong prescription? I felt the eye exam was a bit rushed, but since it was my first one, I had no point of reference.

Rx is

OD -0.25 sph OS -0.50-0.50X45

Thanks!

Answer
Hi Graham,

The only way you will know if the prescription is correct is by knowing how much of the visual acuity chart you can read independently with each eye.

This should be 20/20 in each eye with the prescription.

If seeing less in one, then you know that it could be better with another prescription.

Only an optometruist can help you with this.

Best,

Dr Shroff

www.shroffeye.org

why does my perscription keep changing?

2010-03-04T01:47:00.000-08:00

Question
I have been wearing reading glasses for three years. Prior to that, I?ve never had any eye issues. About four weeks ago I noticed that my reading glasses were no longer working. I had an exam and ordered the new glasses. These were computer glasses. When I tried them on for the first time, everything was blurry, so I had another examination. To my surprise and my doctor's, my script changed drastically. He wrote a script for progressive bifocals that also had correction for astigmatism. I wore these for two weeks as prescribed before returning to the doctor complaining of the same blurriness. He checked my eyes today and again my script has changed. I am to return for tests next week where he'll dilate my eyes and retest. Why does he get different results every time he tests me? Should I see another doctor?

Answer
Dear Tracy,

Always better to do the eye check with dilation and a full eye examination.

Get the complete eye check done and lets see what comes out of that. Do not invest in an expensive pair of glasses until sure bout the prescription.

The doctor may want to look inside the eye for factors like ageing changes in lens and retina. Then prescribe whats best suited.

Let me know after this check is done. Ask for your exact prescription and also the visual acuity (i.e if you are reading 20/20 or 20/40 etc).

Hope this helps,

Best,

Dr Shroff

www.shroffeye.org

Pigment deposits

2010-03-04T01:29:00.000-08:00

Question
How do you get rid of pigment deposits on the white of your eye? Because i have a brown spot on the white of my right eye and i want to get rid of it. Ive tried eyedrops but they arent effective.

Answer
I am sorry to tell you - it is not really possible to get rid of those spots. It would be sort of like asking to "get rid" of freckles. As pigment deposits, the spots have actually become part of the conjunctiva - the clear skin covering the white of your eye. While it may be possible to have them surgically removed, I have never heard of this being done and do not think a reputable surgeon would be willing to do it. You can however try visiting a surgeon who does cosmetic lid surgery for example to check if they would consider removing that spot for you.

one pupil is dilated more then the other

2010-03-04T01:11:00.000-08:00

Question
For the past two months my husband has had headaches everyday. He went to the doctor and was given muscle relaxors, ear drops. Today I noticed his left pupil is dialated much more then the right. I am concerned as to what this could be.

Answer
Hi Brandi,

Different pupil size, called anisocoria, is normal in about 25% of us. You may want to examine old photos of your husband using a magnifying glass to see if he's always had it. Pupil testing is straight forward an involves checking the pupil size of each eye when shining a bright light into each eye and alternating eyes and comparing the pupils' responses. There are some common pupil abnormalities that are not concerning, one is called Adies Tonic pupil where one pupil is stuck at one size but nothing otherwise is wrong. Anyway, if you don't prove it was pre-existing by examining old photos, then an eye doctor should be consulted and specifically address the pupil size as your chief complaint. Be sure eye drops for red eyes haven't been used as they dilate pupils.

Hope that helps,

Mitch Axelrod, OD.

eyes

2010-03-04T00:53:00.000-08:00

Question
My son has been saying his vision is blurry for a week so I took him for an eye test. The optician said he could not get an accurate prescription as none of the lenses he tried seemed to improve the vision. He said the eyes themselves look healthy. He has got to go back and have eye drops to relax the eyes to try and get a prescription. The eyes seem to be trying to focus and relax too much. Should I be worried? What could it be? Thank you

JS Hants

Answer
Dear Jacqui,

No do not be worried. This is a routine practice.

Children have strong eye muscls that they try to overcome their prescription or spectacle error during check ups by using these muscles. this then gives erroneous numbers or powers,.

The optometrist you are visiting seems experienced in this regards and must be checking children, as the correct way is to dilate the eyes and relax these eye muscles so that they do not interfere in the process of prescription.

yes, this may require you to visit the optometrist at least 3 times before prescription, but that is the correct methodology in children.

Hope this helps,

Regards,

Dr Anand Shroff, MS OPHTH, FICS

dranand@lasikindia.in

Shroff Eye Hospital-LASIK

222, S V Road,

Bandra West

Mumbai 400 050

India

Phone: 022 - 66921000/ 66939372

Cell:098211-63901

Fax: 022 - 66949880

www.lasikindia.in

Shroff Eye Clinic

Gobind Mahal

86 - B Netaji Subhash Road

Marine Drive

Mumbai 400 002

Phone: 022 - 22814077, 2811863, 22029242

Fax: 022 - 22812751

email: shroffeye@vsnl.com

www.shroffeye.org

Shroff Eye Hospital is India's First Eye Hospital that the Joint Commission International (International Division of JCAHO, USA) has given accreditation for excellence in patient care and health care delivery. Shroff Eye is also India's first and only Wavelight Concerto 500 Hz LASIK center- The Worlds Safest and Fastest LASIK.

focus

2010-03-04T00:35:00.000-08:00

Question
On two seperate occasions my sight has went out of focus. Both times it was a minute or less before my sight went back to normal. Each time this occured i had stretched. I have worn glasses all my life, i'm in my fifties. what is causing my eyes not to focus?

Answer
Dear Marilyn,

This could be related to fluctuations in the blood pressure and not originating from the eyes. Please have a good physical examination done to rule out systemic causes.

Best,

Dr Anand Shroff

dranand@lasikindia.in

www.shroffeye.org

Axis altered for convenient ordered??

2010-03-04T00:17:00.000-08:00

Question
Hello! I have in my hand, a prescription that reads:

right: -3.5-0.75X180

left: -3.25-1.25x005

I am trying to purchase lenses online because they are significantly less expensive; however, my left axis is 005 when all that is offered is increments in 10. Should I just get the 010?

Thank you,

Karoline

Answer
Dear Karoline,

One cannot order a contact lens prescription without a contact lens trial. You need elements like Base Curve diameter etc.

Please ask your treating optometrist to check which lens suits you, as many could have similar prescription but different fits of lenses.

It may be worth considering doing this step first as it will give you not only an accurate prescription, but also save your money (you may order wrong lenses with the current prescription and be stuck with them).

Hope this helps,

Best,

Dr Shroff

www.shroffeye.org

Discoloured eye whites.

2010-03-03T23:59:00.000-08:00

Question
Hello, so today i haven't really been doing anything out of the norm, and for some reason i have been quite faint, dizzy, and I'm suffering from shifty vision, which is cause a feeling of sea sickness, i have an extreme migraine, and i just noticed that the whites of my eyes are completely a yellowish green colour.

Is this something i should be concerned about? and if so what can i do before heading to the doctor.

Thank you for your time,

Cody Mittendorf

Answer
Dear Cody,

This yellowish discoloration commonly happens in Hepatitis or Jaundice.

Please visit a physician as soon as possible.

Best,

Dr Anand Shroff

Shroff Eye Hospital-LASIK

222, S V Road,

Bandra West

Mumbai 400 050

India

Phone: 022 - 66921000/ 66939372

Cell:098211-63901

www.lasikindia.in

Shroff Eye Clinic

Gobind Mahal

86 - B Netaji Subhash Road

Marine Drive

Mumbai 400 002

Phone: 022 - 22814077, 2811863, 22029242

Fax: 022 - 22812751

email: shroffeye@vsnl.com

www.shroffeye.org

Shroff Eye Hospital is India's First Eye Hospital that the Joint Commission International (International Division of JCAHO, USA) has given accreditation for excellence in patient care and health care delivery. Shroff Eye is also India's first and only Wavelight Concerto 500 Hz LASIK center- The Worlds Safest and Fastest LASIK.

RCE Recurring Chronic Erosion

2010-03-03T23:41:00.000-08:00

Question
Treatment for Chronic Eye Erosion.

Answer
Well, there are a few treatments. At first they usually try heavy use of artificial tears. If that does not work there are two surgical options. One, is to scrape all the epithelium (top layer of cells) off the cornea, hoping it will regrow properly. 2) a fine needle can be used to puncture all around the eroding area to encourage new growth that holds on better. I believe in really stubborn cases, a laser can even be used to take off the top layer of cells in hope that it will regrow properly.

Hard spot on eyeball

2010-03-03T23:23:00.001-08:00

Question
I have a very small, hard spot on my right eyeball. It showed up as a softer spot about a week ago, and has gradually hardened. It doesn't hurt really, but it does scratch the inside of my eyelid which causes my eye to itch badly and sting somewhat. The spot is just above my lower eyelid when I have my eyes open normally and is just to the lower right of my iris.

I have tried eye drops but they pretty much only make it itch more. My eye will get red when the itching is bad and will go back to normal when the itching subsides. I've searched this topic a lot and I'm not sure if this is a cyst or sty. It is very definitely attached to my eyeball, not my eyelid. It's also clear if that helps any... It's a very small spot no larger than the tip of a dull pencil. Thank you for any info you can provide.

Answer
Hi Shauna,

look at Google Images and search the terms pinguecula, conjunctival cyst, nerve loop of Axenfeld. It may be a less common lesion. It's not a stye b/c that's on the lid. It may be a cyst because it's clear but on the eye those are usually soft and bubble-like. You will probably need to see an eye doctor to have it diagnosed as it probably needs to be seen with the biomicroscope we use in the office also called a 'slit lamp.' Hope that helps,

Mitch Axelrod,OD

glaucoma

2010-03-03T01:51:00.000-08:00

Question
Hello

You are a very busy person. I am afraid, You will not answer my so many questions. But you are a merciful person. So I will wait for your answers.

Question 1:

I am a patient of primary chronic open angle glaucoma and my anterior chamber angle is narrow. I have severe cataract. I am using glaucoma medicines (Travatan and Betagan), and my I.O.P. is reduced from 37 to 17 mmHg. I will need perimetry after every few months to know whether my visual field loss progression has stopped or not.

Which type of perimetry (White-on-White / Blue-on-Yellow) will be better for me? If, in cataract obstructing view of the retina, neither White-on-White perimetry nor Blue-on-Yellow perimetry can be performed reliably, then how my visual field loss progression can be evaluated? I do not want to remove cataract now, because I want to wait for few years for a combined surgery of cataract and glaucoma.

Question 2:

What are pre-requirements for perimetry? I mean, is evaluation of Visual Acuity and Refraction, necessary before perimetry?

Question 3:

Perimetry result is written on a chart. Many things are written on it. e.g. GHT, PSD, d B, Total deviation, Pattern deviation, False negative errors, False positive errors, Fixation losses, Fovea off, Strategy Sita Fast, Visual Acuity Rx Ds Dc X.

I want to know the meanings of above words. I want to understand graphs on the chart. I want to get deep information of perimetry. I want to get deep information of glaucoma. Is there any website from where I can read such deep information?

Thank You,

Best regards,

Allen.

Answer
Hi Allen,

In general you need to know the current glasses prescription, but it doesn't have to be perfect. Of course the greater the acuity the better, but you do with what you have. If your cataract is severe as you say, your ability to help fine tune your prescription may be poor and the visual field may not be very reliable or useful. Sometimes just having the cataract surgery will alter the anatomy of the angle enough to relieve some of the glaucoma and improve the acuity to make field testing reliable and useful. If you don't have faith in your eye doctor seek a second opinion for your cataract and glaucoma treatment. Perhaps the second opinion would suggest cataract surgery but not specific glaucoma surgery.

If you remain interested, I suggest you search the Internet for articles on evaluating Humphrey Visual Field reports, and there are good books out there too. Here is a link to get you started:

http://www.glaucoma-eg.org/lectures%20online_files/aashafik%20how%20to%20read%20...

But you hopefully have better things to do with your life than recreate the wheel. I wouldn't suggest relying on one visual field test, rather look at a series of them over time and probably stick to a white target.

Mitch Axelrod, OD

glaucoma

2010-03-03T01:33:00.000-08:00

Question
Hello

You are a very busy person. I am afraid, You will not answer my so many questions. But you are a merciful person. So I will wait for your answers.

Question 1:

I am a patient of primary chronic open angle glaucoma and my anterior chamber angle is narrow. I have severe cataract. I am using glaucoma medicines (Travatan and Betagan), and my I.O.P. is reduced from 37 to 17 mmHg. I will need perimetry after every few months to know whether my visual field loss progression has stopped or not.

Which type of perimetry (White-on-White / Blue-on-Yellow) will be better for me? If, in cataract obstructing view of the retina, neither White-on-White perimetry nor Blue-on-Yellow perimetry can be performed reliably, then how my visual field loss progression can be evaluated? I do not want to remove cataract now, because I want to wait for few years for a combined surgery of cataract and glaucoma.

Question 2:

What are pre-requirements for perimetry? I mean, is evaluation of Visual Acuity and Refraction, necessary before perimetry?

Question 3:

Perimetry result is written on a chart. Many things are written on it. e.g. GHT, PSD, d B, Total deviation, Pattern deviation, False negative errors, False positive errors, Fixation losses, Fovea off, Strategy Sita Fast, Visual Acuity Rx Ds Dc X.

I want to know the meanings of above words. I want to understand graphs on the chart. I want to get deep information of perimetry. I want to get deep information of glaucoma. Is there any website from where I can read such deep information?

Thank You,

Best regards,

Allen.

Answer
Dear Allen,

Chronic OPEN ANGLE glaucoma and narrow anterior chamber angle cannot go together !! They are mutually contradictory !!

We need to know vision, pupillary reactions, angle structures(goniscopy) findings, disc findings and reports of previous perimetry tests done to be able to guide you better.

There is no logic of waiting to do the cataract surgery to combine with TRAB; in fact the longer you wait to do cataract, the more riskier the surgery later as the cataract gets harder.

You need to follow the advise of a good eye specilist who is specialized in both cataracts and treats glaucoma.

You may read about glaucoma on www.shroffeye.org

Hope this helps,

Best,

Dr Shroff

www.shroffeye.org

dialation

2010-03-03T01:15:00.000-08:00

Question
I had a cataract (len Implant) three weeks ago, still my pupil is dialated, sometime difficult to see bright light. Is it normal like that, how long will it take to become normal? the doctor could not give a good reason for the dialation. he asked me to use Cyclogyl 2% for aweek and see.

Answer
Dear James,

The drops or gel of Cyclopentonate is a dilatingeye drop/ gel so the symptoms you face are a result of that.

the reson some doctors prescribe this post surgery is to 'quieten' the eye to avoid any inflammation and help recovery.

Hope this helps,

Best,

Dr Shroff

www.shroffeye.org

Lightheaded

2010-03-03T00:57:00.000-08:00

Question
Hi,iam a 28 yo male, i experience a headache and lightheaded after taking a known eye vitamin for 2 month, i stopped taking the meds. but still having the symptoms,eye test is normal, cheers.

Answer
Dear Sam,

This may be co incidental or something to do with the tablets not agreeing, but nothing to do with the vision or eyes...I would say it will not be proved, but only trial and error...so no harm in stopping these vitamins and seeing how you feel.

If you still feel the same, please visit a physician since the reasons could be then related to other issues like high or low blood pressure, stress etc.

Best,

Dr Shroff

www.shroffeye.org

eye exam

2010-03-03T00:39:00.000-08:00

Question
I'm in my 50's and wear both soft contact lenses and glasses (not at the same time) and am scheduled for an eye exam that I get every year or two. Is it necessary to take out my contacts out before I go or do I take them out right before the exam? I think it's right before the exam, but can't remember. Thanks

Answer
Hi Lee,

It depends on the doctor's preference and the contacts. If the contacts are in good condition and the specifics of the contacts are known, I like to examine you after you've had them in for some hours. Otherwise, starting with an eye that isn't wearing an old or unknown lens is best (for me). So you are best off calling your doctor and asking their advice.

Mitch Axelrod, OD

red spot in vision

2010-03-03T00:21:00.000-08:00

Question
Yesterday, I had a sudden red spot appear in the line of vision in my right eye. I red splotch... and it wouldnt go away. Today my dr by phone organised me to go to hospital and I saw the eye surgeon/specialist. He popped eye drops in my eyes and after a thorough examination explained that a tiny blood vessel infront of my retina had burst and released a little blood. He assured me that over the next couple of weeks it would fade and disappear. He ssid my vision was most likly to return to normal. Could offer no explanation for why it happened. I am 41 years old and am otherwise healthy. I was doing nothing streneous at the time and I do not have diabetes or high blood pressure. I want to know if this is likely to happen again? and he could see no reason why I had a sore eye. Suggested perhaps it was muscle ache from trying to focus on the spot so much. Can there be any other reason for it hurting? He was certain my eye looked healthy and normal other than this wee spot of blood. I am booked to have a dye injected into me and eyes rechecked for weak blood vessels.

Answer
Dear Peta,

You seem to be on the right track.

This bleed can happen in anyone, called retinal haemorrhage.

Yes, it is known to be of higher incidence in those with diabetes, high blood pressure, high myopia etc, but still can happen in anyone.

The dye injected could bean FFA test or Flurescein angiography to check where the bleed is and then stop it from spreading if necessary with help of a short simple laser procedure- Argon laser.

However, whether this laser is needed is determined by this dye test.

Meanwhile do not do any strenuous work, lifting weights, avoid jerks and jumping.

Hope this helps,

Best,

Dr Shroff

Converting Toric to nontoric

2010-03-03T00:03:00.000-08:00

Question
Hi Dr. Axelrod,

I am 22 years old, and I have astigmatism, but would like to order non toric because they are cheaper and there is more of a selection. I know that I can wear regular lenses just fine, because when I first started wearing contacts my Dr. gave me non toric when I lost the first trial pair, and they worked great (in fact I think I liked them better).

My right eye is: BC: 8.8, DIA: 14.4, PWR: -0.75/-1.25x170

My left eye is: BC: 8.8, DIA: 14.4, PWR: -1.25/-1.25x10

Thanks very much!

Answer
Hi Sara,

It's one thing to mathematically answer your question as far as power goes, but other factors come into play. Those are: lens brand, model, size, curve, and of course the law. You legally need a prescription to buy contacts. You need to discuss your switch from toric to non-toric with your doctor. Certainly discuss price of potential lenses to see if there is a cheap enough one as ignoring your astigmatism will leave you pretty blurry.

Mitch Axelrod, OD

Eye is closed due to unkown

2010-03-02T23:45:00.000-08:00

Question
Hi,

my girlfriend has been dealing with her eye for the las few days. I have noticed her using tweezers to pluck her eyebrows alot. Well, this is the question, she popped a "Zit" and it pussed but the swelling increased and now it has closed shut and looks like a bad black eye. She can't open her eye and she's in excruiating pain. What can I do? What does she have? Conjuctivitis......staff msra?

please help!

Philip

Answer
Hi Phillip,

sorry not to answer sooner. By now I hope she has seen a doctor to have it checked. It sounds like she may have cellulitis, a worrisome infection of the lid that necessitates antibiotic and possible IV. Do not let her tough it out unless it suddenly got a lot better.

Mitch Axelrod, OD

eye issues

2010-03-02T23:27:00.000-08:00

Question
a year ago I had an extreme headache and was told it was a migraine. Since then my left eye will stay dilated. If i go from bright light to dark that eye will not adjust for a max of 30min. I have a lot of floaters as well as some flashes of light in my periferal occassionally. I recentley hit my head on the left side (had a concussion about 6 months ago on that side) and now have 2 red blood blisters on the inside of my lower eyelid. I also occassionally experience numbness on the left side of my face.

Answer
Dear Nancy,

One needs to look into the resons why your eye continues to be dilated...a good option would be to see a neuro ophthalmologist.

Also, some symptoms may not be associated with the eyes, but could be neurological in origin.

The red blisters which you describe, will fade away eventually.

Hope this helps,

Regards,

Dr Anand Shroff

www.shroffeye.org

EYE DROP

2010-03-02T23:09:00.000-08:00

Question
Dear Anand

I would like to change my colour eyes frown brown to hazel. Isn?t there any eye drop for there?ISn?t there any eye drop than reduce melanin pigmentation on eye safely?

Answer
Hi Andrea,

Unfortunately there is one. In fact you will find some similar queries in the archive and also one form a person who underwent some procedure to change his eye coulr and faced a lot of problems.

I would stick to using coloured lenses when I want to change the eye colour as it is safe and reversible.

Hope this helps,

Best,

Dr Shroff,

www.shroffeye.org

CONTACT LENSES problems

2010-03-02T22:51:00.000-08:00

Question
Can wearing contact lenses (the kind that has a prescription that you can wear everyday and that are soft - not disposable ones) cause problems like glaucoma, new vessels to appear in the iris or bleeding in the retina ? Do they block the oxygen going into the eye ? Thank you.

Answer
Dear Sophy,

The contact lenses only affect the surface of the eyes and reducing oxygen at a great level may result in conreal infections, repeated allergies, dry eyes etc.

However, the other issues like glaucoma, retinal issues are inside the eyes not connected with contact lens use.

Best

Dr Shroff,

www.shroffeye.org

8 year old with eye pain

2010-03-02T22:33:00.000-08:00

Question
My daughter had her first routine eye exam 3 days ago. When the exam was complete she started crying and saying her left eye felt like it was burning and had sharp prickling. After 3 days it's only burning but still we don't know what is wrong. I took her back to the Dr. and he looked at her again but said there was nothing wrong. Could a test have caused this? Her eyes were not dilated. first they did the standard eye chart. then she looked into a machine and gave the assistant a print out. the Dr. used the equipment and my daughter had to say which looked clearer 1 or 2 while she looked at chart. Lastly, he looked into her eyes with a very bright light while her chin rested on a support. I feel silly not knowing what all these tests and equipment are for. I described it the best way I know how. He said she looked fine and had 20/25 vision.

Answer
Dear Stephanie,

The dilating drops sometimes can cause a reaction, but this settles down without causing any concern or issue in the eyes.

Without using this, it could be co incidental that she had these symptoms, which could have been an allergy (but would have been ruled out by the test you describe where the chin rests on an equipment).

The chart describes her unaided vision and the need if she requires glasses.

Do not worry, you can always ask the doctor what the test he is doing signifies, no doctor will mind.

Best,

Dr Shroff

www.shroffeye.org

Poked in eye

2010-03-02T22:15:00.000-08:00

Question
my daughter got poked in the eye at daycare- although i did not see this or was told about it i saw a part of the eye pink, just below the pupil. She does not appear to be in pain or any complaints or crying but as this is the eye i am worried. Should i hear to the opthal or just treat this as another incident and let it slide?

Answer
Dear Ramya,

Usually with a definite history of a poke or injury it is advisable to see an ophthalmologist.

However, a pink eye could also be allergy or sometimes due to hard rubbing of the eyes.

You could be vigilant and wait and watch or if it is at the 'back of your head and you cannot seem to get it out of your mind" then...best to make an appointment.

Hope this helps,

Best,

Dr Anand Shroff

www.shroffeye.org

I just got my first pair of glasses and now I feel crosseyed when I take them off.

2010-03-02T21:57:00.000-08:00

Question
I am 26 years old. I recently had my first eye exam. I always thought I had very good vision until I took an eye-test to renew my driver's license. I realized my left eye was not as good as my right and it was difficult to read the letters with my left eye. I was always able to focus on anything I wanted to before. My job requires a lot of reading, particularly fine print, and computer use. I recently started getting headaches at the end of long days, or it may be difficult to focus on words. I also have a terrible "starburst" that comes off bright lights.

I received the following prescription and was advised to wear them always, not just for reading:

OD +1.00 -0.25 x 147

OS +2.25 -0.75 x 055

I have been wearing my glasses for nearly a week now. When I first put them on, it made me feel slightly cross-eyed. My eyes seem to have adjusted to the glasses and everything seems clear to me, I am wearing them right now and they seem to help with work. The "starbursts" have not gone away, but I believe they are smaller. Computers and TV's still seem very bright to me, and often create trails of light, particularly if I am tired or if the light is very bright.

However, now when I take my glasses off I feel very cross-eyed and I feel like I cannot see well at all. It is difficult to focus on most anything. Is this normal? My husband tells me it's because I needed glasses. The optician just laughed when I came back to ask her that.

Also, I feel very sensitive to the rim around my lenses. I got a pair of light weight flex frames and the lenses seem to stick out past the glasses. The edge of the lenses catch light and create a bright oval around the frames of my glasses. It's particularly bad when looking at a computer/TV, or driving looking at headlights or brake-lights (the oval is red then).

I have returned to the optometrist and was told it may be an issue with the "bevel" and perhaps it could be fixed with a "polishing." They also said I might just have to get used to it - that's it's part of wearing glasses. They told me to come back next week.

Is this typical? I feel like it obstructs my vision and after a while makes my eyes water, which makes more light trails appear from bright lights. When I am out in bright sunlight, there is light trial lines through my lenses, when the sun is over head. A hat helps, but really, is this typical?

Thank you in advance for reading this. This is all very new to me. Will wearing glasses make my vision without my glasses worse? Is there any way for me to correct my vision with therapy, as opposed to relying on corrective lenses?

Answer
Seeing that your Rx is significant, and you never wore glasses before, I would expect you to have some problems adapting to the use of glasses. With the Rx you have, it would not be uncommon for you to spend your youngest years not at all suspecting the need for glasses and then finding out later that your eyes are strained. It would also not be uncommon with a prescription such as you have, for that prescription to increase as the years go on, so you may as well find a way to get comfortable with eyewear.

With the type of Rx you have, your eyes have been straining for some time, especially if you have been doing a lot of reading and computer work. It may take some time for them to relax enough to be comfortable with the new glasses.

Now, in making the glasses and adjusting them to your face there are some factors that could contribute to a longer period of adjustment than usual. I HOPE you got anti-reflective coating on your glasses. If not, this may be a large part of the problem you report of seeing the edges of the lenses catch light. If you did not get it this time, let me just say that it may almost be worthwhile to keep the first pair as a sort of spare and now order a new pair that HAS anti-glare coating. It is generally not added once the glasses have been dispensed. But I assure you, you would be more comfortable with this coating.

I am not sure polishing the edge would eliminate the glare, but that depends on the style of the frame and some other factors. I have to assume if that is what your optometrist recommended, it must be that your type of glasses could benefit from polishing so perhaps you should try it.

Another consideration that is not commonly used anymore is something called edge-coating. This is where they sort of paint along the edge of the lens to reduce the glare that comes from it. This probably can be added to your current pair. Of course there is the cosmetic consideration - depending what type of style you have, it may not look that great.

You can relax about the fear that wearing the glasses will make your eyes worse. on the contrary, it should allow them to relax more while you are working and your visual system may become more flexible after a while and you may not feel you need them as much. If that happens though, do NOT stop wearing them at work, for reading and the computer. With that type of Rx, it is very important that you wear it for all near tasks. While it is helpful to also wear them for distance viewing, that is not as critical as the nearpoint tasks.

And no, with your type of Rx, I really cannot imagine that any type of eye exercises would help. Do not however rule out contact lenses! They might give you very good relief from the optical aberrations that occur with glasses and may be easier for you to wear.

Estropia vs Amblyopia

2010-03-02T21:39:00.000-08:00

Question
I went to two pediatric ophthalmologists. She was referred by pediatrician after my husband stated to the pediatrician my five yr old daughter was cross-eyed and he could see this in her pictures which I couldn't see. Looking at her you do not see cross-eyed behavior like some kids. If I hold an object close to her and have her focus on it with one eye, the other eye will go inward. Pediatrician stated it may be estropia. 1st dr stated her vision was 20/20, farsighted, and cross-eyed. He stated this was a good catch that someone noticed this. He prescribed glasses +2.25 in both lens and followup in 4 mths. 2nd dr stated amblyopia in left eye and 20/20 in right and 20/30 in left. He stated that her eyes were working together and she didn't need glasses and her crossing eyes was minimal and he prescribed Atropine 1% eye gtts in right eye Saturday and Sunday for 3 mths and follow-up in 4 mths. I am confused and not sure which dr to follow. I want the best treatment for my child's vision. Which dr's regimen do I follow?

Answer
Dear Tee,

It is possible that you may be having accomodative esotropia. This needs to be thoroughly evaluated and then take a call.

There's no right or wrong... everyone has a different strategy for management.

Also, see where you are more comfortable.

If in doubt, you may seek another opinion from a third pediatric ophthalmologist and

discuss with him/her about what needs to be done.

Best,

Dr Shroff

www.shroffeye.org

Optical measurements

2010-03-02T21:21:00.000-08:00

Question
I would like to order glasses online but they required information for OD-SPH, OD-CYL, OD-AXIS, OD-ADD on both eyes. I went to a local eye doctor and asked what to fill in for each and received a paper saying Right: -350 DS and Left: -350 DS. What does this mean?

Answer
OD is the right eye and OS is the left eye

the -3.5 is the power you have ...DS is the Dioptres (measurement of the power like cm, inch etc)

However, from what you have written cannot be sure if this is purely spherical (SPH) or has a cylindrical error (Cyl), if a cylindrical error, then usually has an axis like 10 degrees etc.

You may be having a simple spherical power of -3.5 D in both eyes, but this needs to be confirmed from your treating optometrist.

It may be better for you to check this rather than guesswork as it may cost some!

Regards,

Dr Shroff

www.shroffeye.org

Eye redness & sore

2010-03-02T21:03:00.000-08:00

Question
I got an eye sore on both of my eyes and I got headache as well due to the fresh paint and varnish I used while painting the office. What is the treatment so it won't get worse. Do I need to see a doctor- optometrist or ? Please advise also any home treatment. Thanks a lot!

Answer
Wow - I am having a hard time understanding what you mean by an "eye sore." If there is actual pain, is there a chance the paint or varnish splashed into your eyes? If not, there is the chance you have a chemical burn from the fumes - especially if you did not have a window open or good ventilation.

For tonight if you can get them I would use artificial tears liberally - every few minutes when you are awake. If in the morning you still have any pain and especially if you are light sensitive or still have the headache, I would definitely get in to see an eye doctor. You may have damage that needs prescription level treatment.

contact prescription differences

2010-03-02T20:45:00.000-08:00

Question
I had my annual eye exam yesterday and the doctor said my prescription changed just slightly...from -3.50 to -3.25 in my right eye.. the left stayed the same. I also wear contacts but can only wear the Acuvue Oasis for about 4 hours before I start getting headaches. I was given an new type of lens called Optix with a -3.5 strength to try to see if I can wear them longer. My question is that could the difference of -3.5 to -3.25 be causing the headaches instead of the brand of contacts? Or is this change truly insignificant? Thank you for any clarification you can offer...

Answer
Hi Jamie,

You don't say how old you are and age makes a difference. Usually if not too old a .25 too strong/weak lens won't cause a headache. It may be an imbalance between the eyes such that one is is over or under corrected as compared to the other eye or something else. Brand of contact shouldn't matter unless there is a comfort issue your brain is interpreting as a headache.

Best to discuss with your doctor.

Hope that helps,

Mitch Axelrod,OD

ocular hypertension

2010-03-02T20:27:00.000-08:00

Question
Dear Dr. Shroff,

I had my visit 3 weeks ago with my opthamoligist. The Dr. performed all test for my exam,{at my optometrist office my air puff was 26 and he referred me to specialist}, my specialist told me i have ocular hypertension and put me on Xalaton drops . I returned for a follow up and my pressure came down to 17, and he was happy with that. I go back in 4 months for check up.

I am very nervous about this condition, my physician assures me that I will be fine , just keep taking my meds and regualr visits, but I have much anxiety{driving my poor wife batty}.

Any thoughts from you are greatly appreciated.

Thank You,

Tomas

Answer
Dear Tomas,

Nothing to be concerned about. You seem to have also responded well to the basic line of treatment.

This is called Glaucoma and you can read more about this on www.shroffeye.org

A good eye doctor or glaucoma specialist is best to look after your eye condition.

Regards,

Dr Shroff

dark ring around iris

2010-03-02T20:09:00.000-08:00

Question
I have a middle school student who has a dark ring around both irises. I'm wondering if I need to refer him for further evaluation.

Answer
Dear Kay,

If not got a thorough eye check till date with an eye surgeon then best to see one.

As it is difficult to comment on just a description, it is best to take an experts adviseHowever, the reasons could vary from being something like a pigment which is natural or something systemic as well. hence best that a doctor evaluates this.

Best,

Dr Shroff

Contact Lens Overwear

2010-03-02T19:51:00.000-08:00

Question
Dear Dr. Shroff,

I am 27 years old, got my first pair of glasses (for myopia) when I was 6, and have worn primarily contact lenses (Acuvue, then Acuvue Advance) since I was about 12.

I was experiencing mild headaches and nausea for several days (very akin to motion sickness), along with a feeling that something was "off" with my right eye (perhaps some blurriness and maybe a feeling of pressure?). I went to an optometrist, who diagnosed me with contact lens overwear (the kind where you use two-week disposables for more than two weeks) and said I had swollen corneas, slightly worse on the right side. He told me not to wear contacts for a week and scheduled me for a follow-up.

After two and a half days of just wearing glasses, the feeling of motion sickness has lessened slightly, but yesterday I started feeling actual pain in my eyes -- it feels sort of like eye strain, I suppose -- which means I'm still experiencing headaches.

My questions are: (1) Is it possible for corneal edema due to contact lens overwear to cause a persistent feeling resembling motion sickness? (The optometrist I saw didn't seem to think my symptoms matched up with his diagnosis.) (2) I read that corneal edema can cause decreased corneal sensitivity. Is it possible that the new eye pain is actually a good sign, as in, my corneas are regaining their normal sensitivity as they heal?

Thank you so much!

Jess

Answer
Dear Jess,

The description that you have sent is elaborate, however in absence of any eye examination or physical check up, please bear in mind that I can just help you as guidance.

The nerve syuppy of the eyes is often common with that around the head, and yes, one with prescription change, heavy eye usage and eye strain and even dry eyes can caus similar symptoms which are like a general dull headache, heavy head etc.

Motion sickness is a specific symptom and one may need to explore other reasons for this.

A good guide for you would be to continue the treatment and see if your symptoms phase out.

If not it may be worth your while to visit a general physician.

Hope this helps,

Best Regards,

Dr Shroff

www.shroffeye.org

Contact lens axis availability

2010-03-02T19:33:00.000-08:00

Question
Hi

My current contact lens prescription has an axis of 80 in one eye and 90 in the other. My glasses prescription is 77.5 and 85.

I'm looking to change my lens type from fortnightly to dailies, so have been looking to see what is available here in the UK.

It seems that the lenses that I could use only come in axis of 90. I know with my current prescription that one eye is 2.5 out and the other is 5 degrees out (77.5 v 80 and 85 v 90), but would a difference of 12.5 be too much (ie. 77.5 v 90)?

I'd just like to know whether this is doable, before spending money on a formal optician consultation.

Many thanks in advance,

Simon

Answer
Dear Simon,

yes, a slight change in axis can affect your clarity of vision.

Best would be to consult the perosn who has prescribed you the glasses and ask them for the lens precsription.

usually lens prescription for first timers requires a trail and fitting to know which suits you best.

It is best not to sink money down the drain by any guesswork in this as lenses do not come cheap and you also cannot take a chance with your eyes!

Hope this hels,

Best,

dr anand Shroff

www.shroffeye.org

Cataract !!!!

2010-03-02T19:15:00.000-08:00

Question
Hello Doctor

I just wanted to ask you about the post cataract operation that one has to take ? Many people say that after the operation one should not go near fire (like cooking)or wash clothes in the first week after the operation ?

Is it true ? What other precautions should be taken after

cataract surgery ?

Please reply at your earliest.....

Regards,

Manish

Answer
Dear Manish,

Please read more about cataract on www.shroffeye.org

Precautions after cataract are fairly simple to:

1. Not lifting very heavy weights

2. Starting your routine work after you are comfortable, usually 2-3 days post cataract

3. using sunglasses outdoors

4. Yes, one can cook, go near the fire (not so close that it can cause any flames to reach you, but heat is not an issue).

5. Hairbath after few days

6. Avoid rubbing and knuckling the eyes for few days.

Regards,

Dr Anand Shroff

ocular hypertension

2010-03-02T18:57:00.000-08:00

Question
QUESTION: Dear Dr. Shroff,

I had my visit 3 weeks ago with my opthamoligist. The Dr. performed all test for my exam,{at my optometrist office my air puff was 26 and he referred me to specialist}, my specialist told me i have ocular hypertension and put me on Xalaton drops . I returned for a follow up and my pressure came down to 17, and he was happy with that. I go back in 4 months for check up.

I am very nervous about this condition, my physician assures me that I will be fine , just keep taking my meds and regualr visits, but I have much anxiety{driving my poor wife batty}.

Any thoughts from you are greatly appreciated.

Thank You,

Tomas

ANSWER: Dear Tomas,

Nothing to be concerned about. You seem to have also responded well to the basic line of treatment.

This is called Glaucoma and you can read more about this on www.shroffeye.org

A good eye doctor or glaucoma specialist is best to look after your eye condition.

Regards,

Dr Shroff

---------- FOLLOW-UP ----------

QUESTION: Dear Dr. Shroff,

Thank you for your quick response and help.

I do have a follow up question. My Dr. explained that I did not have glacoma, no optic damage, my visual test were normal and all other tests were fine, and that he was placing me on drops as a prophalatic to keep my pressure down{it went down from 26 to 17.

Being a suspect as it is termed, I was told I do not have it, my other question is, if I get glacoma and Dr treats it right away, will I have decent vision for my normal life span, I am 60 years old.

I am a worrier, and I am so appreciative of your help.

I again thank you Dr. Shroff.

Tomas

Answer
Dear Tomas,

Absolutely. Glaucoma does not mean loss of vision, it is 'loss' only if not controlled.

You have not only responded to the treatment, also may not be even having glaucoma!

Your doctor seems to be on top of things if he is calling you for follow ups.

thats all that you need to do...regular visits.

You will enjoy the vision you have today with this control. So, do not worry.

Best,

Dr Shroff

contacts

2010-03-02T18:39:00.000-08:00

Question
I had a cataract removed fron left eye in April 09 - am wearing a toric lens in my left eye now - just found out that the office I went to approved the wrong presription when I ordered them on line - can wearing the wrong contact (power) cause damage to my sight? power should have been 0.0 and they approved -1.50.

Answer
Dear Patricia,

Not really. long term use makes your muscles kind of get used to seeing through a more powerful prescription.

However, it would have been difficult to bear it as it should have given some eye strain.

Hope this helps,

Best,

Regards,

Dr Shroff

muscle under eye twitching

2010-03-02T18:21:00.000-08:00

Question
I've read the others stories about being on the computer for a long period of time and that being the cause of the twitching, but I have the same problem, but I don't frequently use a computer and I have the same problem. Any suggestions, would be greatly appreciated.

Thank You !!!

Answer
Dear Khoa,

yes, compuetrs do stress the eyes...unfortunately we cannot do without them.

One needs frequent breaks, but sometimes tha too is not possible.

It may help to read about the tips on how to use the PC better for no eye strain by logging onto www.shroffeye.org under computer vision syndrome.

This can also be an allergy, soalso rule that possibility. Sometimes over the counter available safe lubricating eye dros or artifical tears from a pharamcy can help when using long hrs on the Pc

Thanks,

Dr Anand Shroff