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August 15, 2019
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.  Th...

Lyme Disease and Your Eyes

Lyme disease is an infection that is caused by a spirochete (a type of microorganism) called Borrelia burgdorferi. It is transmitted to humans by the bite of a deer tick.

The disease has a strong geographical incidence, being highly concentrated in the Northeast United States and now also has a high incidence in Minnesota and Wisconsin.

Lyme disease was first discovered in Old Lyme Connecticut in 1975. It can start with a characteristic “bull’s eye” rash, in which there is a central spot that is surrounded by clear skin that is then ringed by an expanding rash. It can also appear just as an expanding rash.

This rash usually starts within days of the tick bite. Eye problems can occur along with this rash in the first phase of the disease. This includes red eyes that can look like full-blown pink eye with eyelid swelling. It also can produce sensitivity to light and inflammation inside the eye called iritis or uveitis.

The second phase of the disease usually starts within a few weeks of the tick bite and this occurs because the spirochete gets into the blood stream. This stage often has rashes starting away from the original bite site. It can also produce joint pain, weakness, and inflammation in several organs including the heart, spleen, liver and kidneys.  

There are also several ways it can affect your eyes. It can cause inflammation in your cornea (keratitis), retina (retinitis), optic nerve (optic neuritis), uveitis, inflammation in the jelly like substance that fills the back of the eye called vitreous (vitritis) and the muscles that move your eye around (orbital myositis). It can also affect the eye if it causes problems with the nerve that controls your eyelid muscles so that your eye will not close properly (Bell’s palsy).

There is a third phase of the disease that is caused by long-term persistent infection.  This phase can create multiple neurologic problems and can appear very similar to the presentation of Multiple Sclerosis (MS). The eyes can show any of the same signs as phase two, but the most common presentation is persistent keratitis.

The diagnosis is made by observing the presenting symptoms, being in an area where there are significant number of the disease-carrying ticks, and a blood test that can confirm the diagnosis.  

The symptoms and signs of Lyme Disease can mimic many other problems so it is important to keep Lyme Disease in mind if you are having multiple problems involving different organs and you know or have any suspicion that you may have had a tick bite while you were in areas where the disease is prevalent.

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

UV Damage in Childhood

The Sixties.............War, peace, expressing yourself, the Civil Rights movement, and the Beatles. One of the biggest hits of the era was “Here Comes the Sun” by the Beatles. 

In the health care world, the sun plays a balancing role in delivering its rays to our bodies to help produce Vitamin D. Many people who work indoors are directed to take Vitamin D supplements because of lack of exposure to the sunshine, Conversely, people who are outside a lot have a risk of overexposure causing skin cancer.

The eyes are at risk as well. If sunglasses are not worn, there is a greater risk for cataracts or skin cancers of the eyelids. It is important to know that not all sunglasses are made alike. UV A, B, and C rays are the harmful rays that sunglasses need to protect us from.

However, many over the counter sunglasses do not have UV protection built into the lenses, which can actually cause more damage especially in children. 80% of sun exposure in our lives comes in childhood. Without UV protection in sunglasses, the pupil which dilates more behind a sun lens, allows more of the harmful rays of the sun in.

The whole point is for the consumer to be aware that it is vital to buy sunwear that has UV protection built into the lenses. Polarized lenses protect the eyes from the sun as well as from glare from the road and water.

Fisherman love polarized lenses because you can see the fish right through the water. People who boat also claim their vision is better because glare off the water is reduced.

So next time you hear the famous Beatles hit, remember to be educated on the best products for your eyes, to keep you healthy and prevent cataracts and cancer. Remember, UV protection in sunglasses is the way to go.

Open and Close Angle Glaucoma

90% of Glaucoma Cases are Open Angle

Glaucoma is a disease that affects the optic nerve. The disease causes the nerve cells at the front of the optic nerve to die, which leads to partial or total vision loss. The first two types of glaucoma occur with in an eye that has no structural deformities.  These two types of glaucoma both stem from a problem in the angle between the cornea and iris of the eye. They are called Narrow Angle and Closed Angle Glaucoma.

Open Angle glaucoma, also referred to as chronic glaucoma, normally develops after the age of 35 and is the most common form of glaucoma. It occurs when aqueous fluid builds up and causes the pressure inside your eye to increase. The fluid is not drained properly because of a clog in the trabecular meshwork, a sponge-like, porous tissue which drains fluid from the eye. This happens gradually, with no symptoms. It can lead to partial or total vision loss and can only be detected through routine eye examinations.

The second type of glaucoma affects a small percentage of people and is called Normal Tension glaucoma. It occurs with normal eye pressure and can be attributed to an unusually fragile optic nerve or reduced blood flow to the optic nerve. This trait may be inherited and can only be monitored through routine eye exams.

Narrow Angle glaucoma can develop either quickly or slowly and usually occurs in people with farsightedness. It occurs when the angle narrows causing the aqueous fluid to build up. This narrowing is caused by a bowing of the iris. Narrow Angle glaucoma can only be detected through routine eye examinations. It can cause vision loss and can also lead to an emergency condition called closed angle glaucoma.

Closed angle glaucoma, also called angle closure glaucoma, develops quickly and is a medical emergency. It occurs when the iris bows forward so much that the angle is completely closed. That means that no aqueous fluid can escape, which causes the pressure to build up rapidly. There are many symptoms associated with closed angle glaucoma such as headaches, severe pain, vision loss, redness and nausea. As stated earlier, this is a medical emergency and if not treated immediately can cause severe damage to the optic nerve.

Routine eye examinations are important to detect and monitor glaucoma early. Speak with your eye care provider if you are at risk for glaucoma.

Why do I need glasses if I wear contact lenses?

 

There is an old adage in the eye care industry: Glasses are a necessity, contact lenses are a luxury. Ninety-nine percent of the time this is absolutely true. In the absence of unusual eye disorders or very high prescriptions that don’t allow a person to wear their glasses comfortably, contact lenses should only ever be worn if there is a good, sturdy, updated set of prescription glasses. This is due to the fact that there are often emergencies where people can not wear their contact lenses.

In the 21stcentury, contact lens technology has gotten to the point where we have drastically cut down on the number of adverse events related to contact lens wear. However, human beings were not meant to wear little pieces of plastic in their eyes. Contact lenses are still considered a foreign body in the eye, and sometimes with foreign bodies, our eyes might feel the need to fight back against the “invader.” As such, things like red eyes, corneal ulcers, eyelid inflammation, dry eyes, and abnormal blood vessel growth can result from wearing contact lenses.

More often than I would like, I have patients who are longtime contact lens wearers come in, and when I inquire as to the condition of their glasses, they say they don’t own any. My next question is inevitably: “What happens if you get an eye infection and you can’t wear your contacts?” I then see the proverbial light bulb go off in their heads followed by a blank stare. Why? “Because I’ve never had a problem before.” Well, just because you maybe have never been in a car accident before, that doesn’t mean you shouldn’t wear your seat belt!

I will therefore repeat the most important takeaway here: Glasses are a necessity, contacts are a luxury. Even if you don’t want to go “all out” and get the most expensive frames or lenses in your glasses, having a reliable pair of glasses is an absolute must for any contact lens wearer.

Article contributed by Dr. Jonathan Gerard

Love is in the Air, Love is in the Eyes

 

We have all heard the term ”Love is in the Air,” but can love really be in the eyes? Actually, Science has proven it so. Certain chemicals (or endorphins) that produce the emotion of love can be emitted through emotions expressed in the eyes. Romeo and Juliet and Antony and Cleopatra all can prove that love is in the eyes of the beholder. There are physiological changes in the eyes that occur when love is expressed between two individuals. Two people in love, love shown towards a family member, child, or pet all cause the same response: the pupil (black part in the center of the eye) dilates.

The size of the pupil can be an indication of emotional responses and messages.According to Scientific American, the autonomic nervous system (our fight or flight response), causes the pupil to have a quick dilating response. The ANS is also in charge of heart rate and perspiration, and when a person is extremely interested in another person, the pupil has a dilating effect that is slightly less than the pupillary light reflex. This bounce in size is an automated response that gives scientists indication of mood or interest (or love) shown to a person or pet.

Mounting scientific evidence also shows the benefit of looking into the eyes of your pet, especially dogs. Stroking them causes you to become more healthy on all fronts, and a few minutes a day of lovingly looking at the dog and stroking the pet releases serotonin, prolactin, and oxytocin which are "feel good" hormones.

There are also studies inspired by psychologist Arthur Aron, from over 20 years ago, that show if you stare into someone's eyes for 4 minutes you can fall in love... for looking eye to eye allows you to connect and reminds you why you fell in love in the first place.

Overall health is improved and years can be added to your life when looking at something or someone with love. Your eyes and autonomic nervous system play an intricate role in the expression of love. In conclusion, science and Shakespeare have it right when it comes to the response of the pupils. Remember what Shakespeare said in A Midsummer Night’s Dream, ”Love looks not with the eyes, but with the mind.”

Source:

12/07/2012 article of Scientific American entitled:

Why Do Pupils Dilate in Response to Emotional States?

By Joss Fong

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