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October 10, 2019
Fall brings a lot of fun, with Halloween bringing loads of it. But did you know that some Halloween practices could harm your vision? Take Halloween contacts, for instance. They vary widely, with e...

Bargain Halloween Contacts?

Fall brings a lot of fun, with Halloween bringing loads of it.

But did you know that some Halloween practices could harm your vision? Take Halloween contacts, for instance. They vary widely, with everything from monster eyes to goblin eyes to cat eyes to sci-fi or a glamour look. They can be just the added touch you need for that perfect costume. However, some people do not realize that the FDA classifies contact lenses as a medical device that can alter cells of the eye and that damage can occur if they are not fit properly.

Infection, redness, corneal ulcers, hypoxia (lack of oxygen to the eye) and permanent blindness can occur if the proper fit is not ensured. The ICE, FTC, and FDA are concerned about costume contacts from the illegal black market because they are often unsafe and unsanitary. Proper safety regulations are strictly adhered to by conventional contact lens companies to ensure that the contact lenses are sterile and packaged properly and accurately.

Health concerns arise whenever unregulated black-market contacts come into the US market and are sold at flea markets, thrift shops, beauty shops, malls, and convenience stores. These contacts are sold without a prescriber's prescription, and are illegal in the US. There have also been reports of damage to eyes because Halloween spook houses ask employees to share the same pair of Halloween contact lenses as they dress up for their roles.

So the take home message is, have a great time at Halloween, and enjoy the flare that decorative contacts can bring to your costume, but get them from a reputable venue and be fit by an eye care professional with a proper legal prescription. Don't gamble with your eyes for a night of Halloween fun!

 

The content of this blog cannot be reproduced or duplicated without the express written consent of Eye IQ

Your Meds = Dry Eyes?

Dry eye is a very common problem that affects women more than men and becomes more prevalent as people get older.

It can present in many ways, with symptoms that can include a foreign body sensation, burning, stinging, redness, blurred vision, and dryness. Tearing is another symptom and occurs because the eye initially becomes irritated from the lack of moisture and then there is a sudden flood of tears in response to the irritation.

Unfortunately, this flood of tears can wash out other important components of the tear film that are necessary for proper eye lubrication. Signs and symptoms can range from mild to severe.

There are medications that have the potential to worsen the symptoms of dry eye. Here are the broad categories and specific medications that have been known to potentially worsen the symptoms:

  • Blood Pressure Medications - Beta blockers such as Atenolol (Tenormin), and diuretics such as Hydrochlorothiazide.
  • GERD (gastro-esophageal reflux disorder) Medications - There have been reports of an increase in dry eye symptoms by patients on these medications, which include Cimetidine (Tagamet), Rantidine (Zantac), Omerprazole (Prilosec), Lansoprazole (Prevacid), and Esomeprazole (Nexium).
  • Antihistamines - More likely to cause dry eye: Diphenhydramine (Benadryl), loratadine (Claritin). Less likely to cause dry eye: Cetirizine (Zyrtec), Desloratadine (Clarinex) and Fexofenadine (Allegra). Many over-the-counter decongestants and cold remedies also contain antihistamines and can cause dry eye.
  • Antidepressants - Almost all of the antidepressants, antipsychotic, and anti-anxiety drugs have the propensity to worsen dry eye symptoms.
  • Acne medication - Oral Isotretinoin.
  • Hormone Replacement Therapy - The estrogen in HRT has been implicated in dry eye.
  • Parkinson's Medication - Levodopa/Carbidopa (Synamet), Benztropine (Cogentin), Procyclidine (Kemadrin).
  • Eye Drops - In addition to oral medications many eye drops can actually increase the symptoms of dry eye, especially drops with the preservative BAK.

If you are suffering from dry eye and are using any of the medications above you should discuss this with your eye doctor and medical doctor. DO NOT stop these medications on your own without consulting your doctors.

 

Article contributed by Dr. Brian Wnorowski, M.D.

Are My Eyes Changing Colors?

 

It can be common that eye doctors get patients who come in asking if the white part of their eye, the sclera, has a growth or is turning a gray color.

This is called a senile scleral plaque, which is commonly seen in people over the age of 70. It is a benign condition and more commonly seen in women.  This condition is symmetrically found on both sides of eyes and is due to age-related degeneration and calcification of the eye muscle insertion into the eye.  In one study, the size of the senile scleral plaque increased as the person ages and was not associated with any medical conditions.  People are asymptomatic, as the plaques do not affect vision and no treatment is needed.

Another commonly asked question is: Why is the colored part of my eye turning white?  

The colored part of the eye is the iris, which is covered by a clear layer called the cornea.  It is actually the edge of the cornea that attaches to the white part of the eye that becomes grey or whitish colored.

This condition is called arcus senilis, which is seen in over 60% of people over the age of 60 and approximately 100% over the age of 80.  There is no visual impairment and no treatment is needed. Sometimes when this condition is seen in younger patients, it may be related to high cholesterol so a visit to the primary care doctor may be needed.  

These are two very commonly encountered conditions that may cause distress for patients because it seems like their eyes are changing colors.

Thankfully, no treatment is needed for these two conditions, as they do not affect vision.

Article contributed by Dr. Jane Pan

Macular Mojito and Cataract Cocktails?

Did you know that nutrition plays a vital role in your ocular health?

Cardiologists stress lean meats, red wine, and exercise for your heart health. But what about your eyes? Well, studies show there are distinct food groups that show extreme benefit to the well being of your vision.

Macular Degeneration is a condition of the retina in the back of the eye that causes symptoms of loosing the fine detail vision we have been used to, replacing it with a central scotomas or blind spots. Your central vision gets destroyed by this disease. Macular Degeneration is an inherited disease, as well as some cataract formations, so check your family history to see if you are at greater risk. Lutein, found in green leafy vegetables such as kale, spinach, and broccoli create an added insulation in your retina against macular degeneration. Yellow vegetables and fruit (squash, yellow watermelon) and Omega III supplements (fish oil or flax seed oil) also help boost the pigment cells in the macula to promote crisp vision. As a side note, it is best to purchase molecularly distilled fish oil, and take the pills at night to prevent unwanted GI effects or “fish burp” which occurs with less expensive, non distilled fish oils. Remember, not all fish oil pills are created equally.

What about preventing cataracts, the clouding of the natural lens of the eye that causes symptoms such as dim vision, glare at night, decreased focusing, and blurred vision? Well, studies have shown that the vitamin C found in citrus fruits such as oranges, lemons, grapefruit, and kiwi can slow down cataract formation. Cutting your UV exposure by wearing sunglasses with UV-A and UV-B protection will also help, as well as smoking cessation.

It's good to be aware of these vision conditions that affect millions of people worldwide, and to do your best to incorporate preventative care such as good nutrition, regular check ups with your eye care practitioner, and sun exposure prevention.

If you don’t have time to eat all those fruits and vegetables in a day consider a fruit or vegetable smoothie and then drink to your good ocular health!  Additionally, cooked food devalues the precious live enzymes, so these foods are best eaten raw.

Remember, you can play a vital role in your ocular health. As Hippocrates, the father of medicine, said, "Let your food be your medicine and your medicine be your food."

What is a Punctal Plug and Why Would I Need One For My Eyes?

Punctal plugs are something we use to help treat Dry Eyes.  

Dry Eyes is a multifactorial problem that comes from a generalized decrease in the amount and quality of the tears you make.  There is often both a lack of tear volume and inflammation in the tear glands, which interfere with tear production and also cause the quality of the tears to not be as good.

We make tears through two different mechanisms.  One is called a basal secretion of tears, meaning a constant low flow or production of tears to keep the eye moist and comfortable.  There is a second mechanism called reflexive tear production, which is a sudden flood of tears caused by the excitation of nerves on the eye surface when they detect inflammatory conditions or foreign body sensations. It is a useful reflexive nerve loop that helps wash out any foreign body or toxic substance you might get in the eye by flooding the eye with tears.  Consider what happens when you get suntan lotion in your eye.  The nerves detect the irritation that the lotion creates, and you quickly start getting flooding of tears.

That reflex mechanism is how some people get tearing even though the underlying cause of that tearing is dry eye.  They don’t produce enough of the basal tears, the eye surface gets irritated and then the reflex tearing kicks in and floods the eye, so you tear up.  Once that reflex is gone then the eye dries out again and the whole cycle starts over.

One of the treatments for dry eyes is to put a small plug into the tear drainage duct so that whatever tears you are making stay on the eye surface longer instead of draining away from the eye into to the tear drainage duct and emptying into your nose.

There are several different types of punctal plugs.  Some are made of a material that is designed to dissolve over time.  Some materials dissolve over two weeks, while others can last as long as 6 months.  There are also plugs made out of a soft silicone material that are designed to stay in forever.  They can, however, be removed fairly easily if desired or they can fall out on their own, especially if you have a habit of rubbing near the inside corner of your eye.

One of the big advantages of punctal plugs is that they can improve symptoms fairly rapidly - sometimes as quickly as a day.

The long-term medical treatment for dry eyes such as Restasis, Xiidra or the vitamin supplement HydroEye can take weeks or months to have a good effect.

On the other hand, plugs simply make you retain your tears for a longer time; they don’t help the underlying inflammation.  That is where the medical treatment comes in.  Sometimes it is useful to use a temporary plug for more instant relief while you are waiting for the medical treatment to work.  Sometimes there is clearly just a deficiency of tears and not much inflammation and the plugs alone will improve your symptoms.

All in all, punctal plugs are a safe, effective and relatively easily inserted treatment for dry eyes.

Article contributed by Dr. Brian Wnorowski, M.D.

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