Saturday, November 10, 2012

Retinal Detachment

A detached retina is a serious and sight-threatening event, occurring when the retina becomes separated from its underlying supportive tissue. The retina cannot function when these layers are detached. And unless the retina is reattached soon, permanent vision loss may result.

Detached Retina Symptoms and Signs

If you suddenly notice spots, floaters and flashes of light, you may be experiencing the warning signs of a detached retina. Your vision might become blurry, or you might have poor vision. Another sign is seeing a shadow or a curtain descending from the top of the eye or across from the side.
These signs can occur gradually as the retina pulls away from the supportive tissue, or they may occur suddenly if the retina detaches immediately.
About one in seven people with sudden onset of flashes and floaters will have a retinal tear or detachment, according to a study reported in late 2009 in the Journal of the American Medical Association. Up to 50 percent of people who experience a retinal tear will have a subsequent detachment.
No pain is associated with retinal detachment. If you experience any of the signs, consult your eye doctor right away. Immediate treatment increases your odds of regaining lost vision.

What Causes Retinal Detachments?

An injury to the eye or face can cause a detached retina, as can very high levels of nearsightedness. Extremely nearsighted people have longer eyeballs with thinner retinas that are more prone to detaching.

A retinal detachment requires immediate attention. Retinal tears should be monitored and may require repair. The movement of vitreous fluid can sometimes pull the retina away from its underlying supportive tissue.

On rare occasions, a detached retina may occur after LASIK surgery in highly nearsighted people. In a study of more than 1,500 LASIK patients, just four suffered retinal detachment; their pre-LASIK prescriptions ranged from -8.00 D to -27.50 D.
Cataract surgery, tumors, eye disease and systemic diseases such as diabetes and sickle cell disease also may cause retinal detachments.
New blood vessels growing under the retina — which can happen in diseases such as diabetic retinopathy — may push the retina away from its support network as well.
Sometimes fluid movement in the eye pulls the retina away.

Treatment for Detached Retina

Surgery is required to repair a detached retina. The procedure usually is performed by a retinal specialist — an ophthalmologist who has undergone advanced training in the medical and surgical treatment of retinal disorders.

Seeing a shadow coming down across your field of vision is a sign of retinal detachment.

Generally, the sooner the retina is reattached, the better the chances of restored vision.
Surgical procedures used to treat a retinal detachment include:

Scleral buckling surgery. This is the most common retinal detachment surgery, and consists of attaching a small band of silicone or plastic to the outside of the eye (sclera). This band compresses (buckles) the eye inward, reducing the pulling (traction) of the retina and thereby allowing the retina to reattach to the interior wall of the eye.

The scleral buckle is attached to the posterior portion of the eye and is invisible after surgery.

Scleral buckling surgery often is combined with one of the following procedures to fuse the retina to its underlying supporting tissue (called the retinal pigment epithelium, or RPE).
Vitrectomy. In this procedure, the clear jelly-like fluid is removed from the posterior chamber of the eye (vitreous body) and replaced with clear silicone oil to push the detached portion of the retina back onto the RPE.
Pneumatic retinopexy. In this procedure, the surgeon injects a small bubble of gas into the vitreous body to push the detached portion of the retina onto the RPE.

If the detachment is caused by a tear in the retina, the surgeon usually uses a laser or a freezing probe to "spot weld" the retina firmly onto the RPE and underlying tissues and thereby seal the tear. If a laser is used, this is called laser photocoagulation; use of a freezing probe is called cryopexy.
Surgical reattachment of the retina isn't always successful. The odds for success depend on the location, cause, and extent of the retinal detachment, along with other factors.
Also, successful reattachment of the retina doesn't guarantee normal vision. Generally, visual outcomes are better after surgery if the detachment is limited to the peripheral retina and the macula is not affected.

Note: The above article was reproduced from "All About Vision." A vast array of eye care information can be found on their website, www.allaboutvision.com.

To Your Eye Health,

Kevin L. Crosier, O.D.

http://www.clearvision-eye-care.com

Tuesday, October 30, 2012

Glaucoma

Glaucoma is one of the leading causes of vision loss in people over the age of 50. According to the American Health Assistance Foundation's National Glaucoma Research program, 2.2 million people have the disease, with another 3.3 million persons expected to acquire glaucoma by the year 2020. It is estimated that as many as 120,000 people have been blinded by the disease. Interestingly, up to 50% of those affected by glaucoma may not even realize that they have the disease. This is because glaucoma is a slowly progressive eye disease that does not present with visual symptoms until it has advanced nearly 40%.

Glaucoma is described as a progressive optic neuropathy, or a disease of the optic nerve. More specifically, glaucoma develops as a result of irreversible damage to the optic nerve head, which is located in the back of the eye. If enough optic nerve fiber bundles are damaged, irreversible vision loss takes place.

The causes of glaucoma are varied and many types of glaucoma exist. Most commonly however, glaucoma results from increased intraocular fluid pressure (IOP) over an extended period of time, typically over the course of many years. Most susceptible to this constant tension is the optic nerve, which over time loses it's battle with the eye's aqueous fluid. This is known as open angle glaucoma. Closed angle glaucoma, more commonly found with eye injuries, develops when the eye's fluid pressure rises to extremely high levels as a result of complete blockage of it's drainage angles. This can be painful and may lead to blindness within 24 hours if not treated immediately. Yet a third type of glaucoma, known as normal tension glaucoma, can develop with seemingly adequate IOP's. This type of glaucoma is the most perplexing from a practitioner's point of view, and is believed to result from poor blood flow from behind the eye.

The risk factors for glaucoma include older age, race (African American, Asian, Native American, & Hispanic's are at greater risk), a prior family history of glaucoma, high corticosteroid or cortisone levels, eye trauma, and having diseases such as high blood pressure, diabetes, and heart disease.

The visual symptoms of glaucoma don't occur for many years, but over time, peripheral vision becomes diminished, followed by a loss of central vision. The goal of glaucoma treatment is to reduce the pressure within the eye, which is typically accomplished with eye drops. In cases of unrelenting glaucoma, surgery may be necessary.

Everyone should be examined regularly for the presence of glaucoma, so schedule a comprehensive eye exam with your eye care provider every year.

Yours in eye health,

Kevin L. Crosier, OD

http://www.clearvision-eye-care.com
kevinlcrosier@msn.com
(303) 657-2848

Tuesday, September 11, 2012

Fluorescent Lighting and Your Eyes

(adapted from an article by Jacquelyn Jeanty)

Fluorescent lighting has been around for more than one hundred years, when bulbs were first made available for commercial use in the early 1900's. Because it is considered a more efficient use of heat energy as opposed to incandescent lighting, fluorescent lighting has long been a preferred modality to it's more expensive counterpart(s).

Fluorescent lights work by combining electricity, argon gas, and mercury inside of a glass tube, where excited electrons incite the gas within to generate ultraviolet wavelengths, which then react with the mercury to produce visible light. Light is produced along the entire length of the electrode running through the glass tubing. In essence, fluorescent lighting is composed of green, blue, and violet wavelengths which pulsate at 120 cycles per second (cps).

While economical, fluorescent lighting may exert unwanted effects on our eyes. Our eyes are constantly receiving a variety of light wavelengths throughout our awakened hours; our intra-retinal photoreceptors continuously transforming light energy into visual images. Fluorescent energy, as opposed to incandescent or infrared energy, is believed to cause higher amounts of eyestrain due to it's pulsating nature. The shorter, more frequent wavelengths associated with green, blue, and violet light can be potentially more dangerous and fatiguing to the eyes than the longer end of the electromagnetic spectrum.

Although the pulsating nature of fluorescent light is not easily perceptible to the human eye, it nonetheless has been associated with eyestrain, ocular migraines, and classic migraine headaches. Studies comparing the effects of standard fluorescent lighting to the newer, shorter pulse rate fluorescents have shown a reduction in complaints of headaches and eyestrain in the contemporary designs.

For those persons predisposed to migraine headaches, fluorescent light may exacerbate or even precipitate the onset of symptoms. The molecular processes required by the eye's photoreceptors to interpret incoming light waves naturally produces by-products, which if not given enough time for elimination, is believed to cause the symptoms of eyestrain and headache. It has been long known that light is a "trigger" for migraine symptoms in some individuals, so it is not surprising that fluorescent lighting can produce these same symptoms.

To help individuals who are prone to the effects of fluoresecent lighting, it would be reasonable for the eye care practitioner to prescribe anti-reflective eyeglass lenses as well as lightly tinted lenses to lessen problematic symptoms.

Yours in Health,

Kevin L. Crosier, O.D.
http://westminstereyedoctor-com.webs.com
kevinlcrosier@msn.com

Monday, August 20, 2012

BACK TO SCHOOL VISION

It's hard to believe, but it's that time of year again... already! Kids are beginning to head back to school to embark upon another learning journey, where vision accounts for nearly 80% of the skills acquired in school (reading, writing, following overheads, etc). Without a properly and efficiently working visual system, school for thousands of children each year can be a nightmare. In fact, research has shown that nearly 1 in 4 school-aged children has a visual problem, often undetected by the school or pediatrician vision screening, that can adversely affect the ability to learn. Following are some of the basic vision skills needed for school, all of which can be addressed by a licensed optometrist at a comprehensive eye examination:

1. Distance Vision. The ability to see clearly and comfortably beyond arms reach.

2. Near Vision. The ability to see clearly and comfortably from 10-18 inches.

3. Binocular Vision. The ability to use both eyes together efficiently.

4. Eye Tracking Skills. The ability to follow words on a page, shift the eyes in space, and accurately aim the eyes at objects on demand.

5. Focusing Skills. The ability to accurately focus the eyes from distance to near in a short amount of time, as well as the ability to sustain focus on an object for a period of time.

When a vision problem is suspected, look for these signs and symptoms from your child:

1. Squinting

2. Complaints of headaches or tired eyes.

3. Eye rubbing.

4. Losing place while reading or avoiding reading altogether.

5. Poor tracking skills.

6. Eye tearing or redness.

7. Head tilting.

8. Poor attention span.

9. Excessive clumsiness. Remember that whether or not a vision problem is suspected from your child, it is important that a licensed optometrist conduct a comprehensive eye examination to ensure that he/she is prepared to learn.

Yours in Eye Health,

Kevin L. Crosier, OD
ClearVision Eye Care
http://www.clearvision.info

Associates Posted 18th August 2009 by Kevin Crosier

Tuesday, July 10, 2012

Dry Eyes

The number one complaint I get from patients (aside from the need for vision correction), is the daily aggravation of dry eyes. This is not surprising given our arid climate and higher elevation in Colorado. Add in our many windy and sun drenched days, and you have the perfect recipe for red, scratchy, watery, & irritated eyes.

Dry eye disease presents in a variety of forms and levels of severity, and it can be caused by several factors. The most common causes of dry eye include:

1) Aging.... with age, tear production decreases. Post-menopausal & pregnant women are at greater risk.
2) Environment... exposure to wind, dry air, sun, sand, dust, pollen, smoke, computer use, higher altitude, and air conditioning can reduce eye lubrication.
3) Medications... A number of medications reduce tear production from the lacrimal gands, including antihistamines, beta blockers, decongestants, sleeping pills, alcohol, diuretics, and anti-depressants.
4) Contact Lenses... contact lenses cause increased tear evaporation, leading to protein deposits and increased allergen concentrations. This may cause irritation and infection.
5) Autoimmune Disease... rheumatoid arthritis and systemic lupus are examples. Sjogren's syndrome is characterized by the combination of dry eye, dry mouth, and arthritis.
6) Eye Surgery... LASIK and other ocular surgeries can temporarily disrupt the balance and production of our natural tears.

The most common symptoms of dry eye include watering, burning, stinging, itching, redness, soreness, and not surprisingly, a dry sensation on the eye.

Dry eye is treated in a variety of ways, depending upon the cause and severity of the disease. Artificial tears (both preserved and non-preserved) are the mainstay in dry eye relief, but in many cases of unrelenting dry eye, steroidal or non-steroidal medications may be used in combination with artificial tears. Punctal occlusion is a viable option in moderate to severe dry eye, whereby a tiny silicone plug is inserted into the drainage duct of the eye (puncta) to prevent tears from draining into the nose prematurely.

Yours in eye health,

Kevin L. Crosier, O.D.
http://www.clearvision.info

Tuesday, July 3, 2012

The Sun & Your Eyes

With summer upon us, our days longer, and our activities focused on the outdoors, it's important to protect our eyes from the sun's damaging rays. Just as sunblock helps protect our skin's delicate layers from immediate and long-term sun damage, wearing a sturdy pair of sunglasses with full UV protection goes a long way in helping to prevent sun-related vision damage. Some eye diseases and conditions long known to be caused by prolonged sun exposure include cataracts (metabolic change in the lens of the eye), macular disease (solar maculopathy), and occasionally corneal damage. Because the skin protecting our eyes is so thin, it isn't uncommon for certain people to acquire skin cancer of the eyelids, namely basal cell carcinoma, squamous cell carcinoma, and melanoma. Although all ethnic groups are at risk, those most predisposed to vision and eye related sun damage are fair skinned people of European descent. In addition to protecting the eyes from harmful UV radiation, sunglasses are helpful in protecting the eyes from wind, dust, pollen, and dry air. Enhanced contrast and reduced eyestrain are benefits as well.

When choosing a pair of sunglasses, be sure that they provide 99% UV protection, are polarized for improved glare reduction and better acuity, and have a slight wrap around design to further keep the sun's rays away from the eyes.

Yours in Eye Health,

Kevin L. Crosier, OD
ClearVision Eye Care
Go to: http://www.clearvision.info

The Eye Care Advisor