Dry Eye Disease Management
Dry eye is a common condition that occurs when the eyes are insufficiently moisturized, leading to itching, redness and pain from dry spots on the surface of the eye. The eyes may become dry and irritated because the tear ducts don’t produce enough tears, or because of a chemical imbalance in the tears. Patients with dry eyes often experience irritating symptoms that may result in more serious damage to the vision if the condition is left untreated.
Treatment for dry eye depends on the cause and severity of the condition, as well as the patient’s overall health and personal preference. Non-surgical treatments are often effective, and may include increasing humidity levels at home or work, use of artificial tears or a moisturizing ointment and avoiding air conditioning or windy conditions outdoors.
Tears are normally produced by the lacrimal gland and flow across the eye, as we blink, and eventually flow into the punctii, 2 openings in the eyelids, near the nose. The tears subsequent flow into the nasolacrimal sac which empties into the nose. An effective way to treat dry eyes is to occlude the openings, the punctii, preventing tears from leaving the eyes. Occlusion can be achieved by inserting small silicone plugs into the openings, the punctii. This procedure can be performed safely and effectively in our office by Dr. Matthews.
Glaucoma is a group of related diseases that damage the optic nerve, resulting in vision loss and possible blindness. Many people affected with glaucoma do not experience symptoms, and may not be aware that they have the disease until they have lost a significant amount of vision. With early detection and treatment, however, eyes can be protected against the serious loss of vision or blindness. Catching glaucoma at an early, treatable stage is one important reason to have regular, thorough eye examinations. A leading cause of blindness and visual impairment in the United States, glaucoma affects patients of all ages.
Risk Factors for Glaucoma
There are several factors, including the following, that increase the risk of developing glaucoma:
- Being older than 60
- Being of particular descent, such as African-American or Asian
- Having a family history of glaucoma
- Having elevated intraocular pressure
- Having poor vision, or other eye disorders or injuries
- Having certain medical conditions, such as diabetes
- Taking certain medications, such as corticosteroids, for prolonged periods
Diagnosis of Glaucoma
The diagnosis of glaucoma is made after a comprehensive medical examination of the eye, and a review of the patient's medical history. Tests are conducted to confirm the diagnosis. Testing may include the following:
- Dilated-eye examination
- Visual field test (perimetry)
- Retinal evaluation
- Visual acuity test
Once glaucoma is diagnosed, treatment should begin as soon as possible to help minimize the risk of permanent vision loss.
Treatment of Glaucoma
There is no cure for glaucoma, so treatments, including those below, focus on relieving symptoms and preventing further damage.
Eye drops or oral medication may be used to either reduce fluid production in the front of the eye or to help drain excess fluid. Medication requires regular use to keep eye pressure under control.
Trabeculoplasty, iridotomy and cyclophotocoagulation are laser procedures that aim to increase the outflow of fluid from the eye, or eliminate fluid blockages.
A trabeculectomy creates a new channel to drain fluid from the eye, and reduce the pressure that causes glaucoma. Surgery is performed only after medication and laser procedures have been unsuccessful.
Thyroid Eye Disease Care
Hyperthyroidism, also known as an overactive thyroid gland, involves an excess of hormone production that can lead to weight loss, irregular heartbeat and irritability. One of the most common reasons for an overactive thyroid gland is Graves’ disease, an autoimmune disorder in which antibodies cause the thyroid to produce too much thyroxine.
Graves' disease is diagnosed through a physical examination and a blood test to determine the patient's serum level of thyroid hormones. Imaging tests such as a CT scan or MRI scan may also be performed. Since the thyroid gland requires iodine to produce its hormones, the physician may also order a radioactive iodine uptake test.
This condition may cause symptoms involving the eyes such as bulging, redness of the eyes, excess tearing, swollen eyelids and light sensitivity. If symptoms are mild, conservative treatment may be attempted using lubricating eye drops, protective eye coverings and prism lenses. Oral steroids are sometimes prescribed for short-term use to relieve swelling and discomfort.
In more severe cases of thyroid eye disease, surgical treatment may be recommended. Depending upon the way the condition is affecting the eyes, procedures may be considered to relieve the pressure on the optic nerve, reposition the muscles of the eye or alter the eyelid skin and tissue.