Dry eye syndrome (DES) is a multifactorial chronic condition when your eyes do not have enough tears or has poor quality tears to keep the eye surface lubricated. Without a healthy tear film, it can result in multiple symptoms with wide variability causing discomfort and vision problems, and in severe cases can even damage your corneas.

Symptoms of Dry Eye

Dryness, itching, or irritation

Burning or stinging

Sandy or grittiness, feeling like something is in the eye

Watery eyes

Redness

Blurred vision, glare, haloes

 

Nearly half of all adults experience dry eye symptoms. Dry eyes can occur due to aging, inflammatory or autoimmune conditions, hormonal changes, medications, environmental or lifestyle factors, and much more. It may also be concurrent with other ocular surface diseases including blepharitis or meibomian gland dysfunction (MGD).

Typically, dry eye syndrome can be diagnosed through a comprehensive eye exam, however there is further testing available for a complete dry eye work up in order to determine treatment options.

Treatment options include artificial tears to lubricate the eyes, ointments, prescription eye drops, nutritional therapy, punctal plugs, heated hot compress masks, and eyelid scrubs, and much more

It’s important to realize DES is a chronic disease and needs long term consistent treatment. Ask our doctors about your dry eye and we will work with you to create a successful strategy for the comfort and health of your eyes.

Myopia is becoming an epidemic of our children’s generation. Studies show that nearsightedness is occurring at a younger age and to higher refractive errors. While the direct cause of myopia is still unknown, studies show links to extensive near work, lack of sunlight, and family history. Now, with evidence-based support, there are ways to control the progression of myopia.

What is Myopia?

Myopia, or nearsightedness, is a refractive condition where the natural focus point of clear vision is up close, causing distance blur. This is due to a physiologically long eyeball or a strong curvature of the front surface of the eye, causing the light rays to not focus on the retina.  Symptoms of myopia are blur at the distance and can cause squinting and headaches. As the eyeball is long or stretched, this also comes with risks of retina conditions. Myopia naturally progresses as children age and the eyes naturally grow.

Myopia Control Options

It is difficult to answer the parent’s and patient’s questions of “how high will the prescription get?” There is no definite answer, and for myopia unfortunately there is no cure. However, the goal of myopia control is to slow down or ideally stop it at the current state.

There are four main ways to control the progression of myopia:

Corneal reshaping therapy i.e. orthokeratology

Ortho-K are FDA approved customized rigid lenses that are worn at night and gently reshape the cornea and removed in the morning – similar to a dental retainer. As the cornea adapts to the reshaping therapy within a few weeks, the patient’s vision is corrected to see without glasses or contact lenses during the day. The reshaping therapy is nonsurgical and is completely reversible for when the time comes to finish ortho-K.

Multifocal soft contact lenses

Multifocal soft contact lenses are soft lenses specifically designed to reduce hyperopic defocus to inhibit the elongation growth of progressive myopia. These are meant to be worn like normal soft lenses throughout the day.

Atropine pharmacological eyedrops

Low dose Atropine 0.01% eyedrops once daily has been showed to reduce myopia progression without limited side effects of near vision blur or light sensitivity. While it is an off-label use, it is well studied and there is significant evidence to show its safety and efficacy by reducing accommodative tone and inhibiting the receptors that cause eye growth.

It does not correct vision, so glasses or contacts must be used for clear vision. It can be used for children for whom other myopia control options may not be suitable, or it can be used in combination for an additive effect to other myopia control therapy.

Bifocal or multifocal progressive eyeglasses

While less effective, if contacts or eye drops are not an option, rather than default to the single vision glasses, there is some reduction of myopia progression through bifocal or progressive lens eyeglasses by decreasing the accommodative demand.

 

Myopia control is a marathon. We are happy to guide you through the journey for the health and safety of your child’s eyes.

Ask your doctor for options and what might be best for your case.

FAQ

How bad is the myopia actually?

For example, a -3.00 D refractive error means one can’t see past 30 cm clearly without any correction. Anything higher, functionally is not only a nuisance, but also comes with a 9x increased risk of retinal conditions and other eye diseases.

What kind of eye disease risk comes with myopia?

Retinal detachments or tears, degenerative macular changes such as bleeding or breaks, cataracts, and glaucoma.

How old does my child have to be?

Myopia control is most effective when myopia onset and progression occurs, typically age 7 to mid-late teenage years. Typically, we may expect myopia to naturally progress approximately 0.50 D/year. Trends have shown that this rate is aggressively increasing, depending on genetic and environmental factors, and are seeing progression 1.00 D+/year. Therefore, earlier the intervention, the better.

Can I do orthokeratology if I’m not a child and my myopia is stable?

Yes! Ortho K for adults is absolutely an option to become independent of glasses or contacts during the day, as long as you are an adequate candidate.

Specialty contact lenses are highly customized lenses for corneal conditions that cannot be corrected by conventional glasses or soft lenses.

Common corneal conditions that require specialty lenses are keratoconus or post-surgical irregular astigmatism. Severe dry eye can also benefit from specialty scleral contact lenses.

Keratoconus is a progressive condition where the cornea becomes thinner and cone shaped, causing glare and blur, and sometimes corneal breaks or scarring that may require a corneal transplant.

Standard rigid gas permeable (RGP) lenses are traditionally used in early cases of keratoconus or minimal irregular astigmatism. The rigid lens creates a new smooth spherical surface for light rays to refract accurately for clear vision, however RGPs can move excessively and cause discomfort, and switching to a large diameter scleral lens may improve comfort.

Scleral lenses are designed to vault over the sensitive cornea and rest on the white part of the eyes, called the sclera. These lenses are highly customized and comfortably fit with very minimal movement by vaulting over the cornea and are filled with a tear reservoir, to create the optimal smooth refractive surface for clear vision. The tear fluid reservoir also provides comfort for people with severe dry eyes that cannot tolerate conventional contact lenses.

Hybrid lenses exist for mild and moderate cases of keratoconus, combining the clarity of RGP lenses surrounded by the comfort of a soft lens “skirt”.

Glaucoma is a group of eye diseases that cause damage to the optic nerve and cause irreversible vision loss. There are many types of glaucoma, but essentially all cause optic nerve damage due to elevated eye pressures or when the optic nerve is vulnerable to the eye pressure. When the optic nerve is damaged, vision loss typically begins from the periphery and can progress to tunnel vision or complete blindness.

There are very little symptoms in glaucoma. Glaucoma is all about change, baseline and historical measures are very important in following progression. Because it occurs slowly, glaucoma is often called the “silent thief of sight” and many patients cannot tell their vision is changing until it is too late due to severe disease.

However, unlike most other types of glaucoma, Acute Angle Closure Glaucoma may include symptoms of headaches, severe eye pain, nausea and vomiting, excess redness/tearing/and blurred vision. Angle closure glaucoma is a medical emergency and if you experience this, see an eye professional immediately.

Those at risk of glaucoma are:

Older

Have a family history of glaucoma

African/Caribbean/Hispanic descent – for open angle glaucoma

Asian – for angle closure or normal tension glaucoma

Have a history of ocular trauma

Thinner corneas

Chronic eye inflammation

Have diabetes or blood pressure issues

 

Glaucoma is often picked up on comprehensive eye examinations. Talk with your optometrist about your risk of glaucoma.  Your doctor may decide you need a glaucoma work up to fully evaluate your ocular status and regular eye pressure follow ups. Treatments include conservative measures with topical eye drops, to laser procedures and also surgical intervention.

A cataract is a cloudiness or opacity in the normally clear crystalline lens within the eye.

Most cataracts are age related and naturally develop in people over age 50. Cataracts can also develop earlier secondary to other risk factors such as diabetes, steroids, smoking, alcohol, previous eye injury/surgery, excessive exposure to UV light.  Rarely they can also occur in children from birth, i.e congenital cataracts.

Depending on its size and location, cataracts will interfere with normal vision. Cataracts are best diagnosed through a comprehensive eye examination with dilation to evaluate the lens.

Symptoms of cataracts include

            Blurred or hazy vision, difficulty seeing in poor lighting conditions

Glare sensitivity, particularly driving at night

Lesser intensity of color perception

Changes in the eye’s refractive error or prescription

 

Treatment of cataract is based on the level of visual impairment. Early cataracts are monitored and may simply require a change in the eyeglass prescription. However, as the cataract progresses and starts to significantly impact your vision, eventually a change in prescription is not enough, and surgery may be indicated.

Cataract surgery is typically performed in an outpatient setting and the patient returns home after the procedure. The ophthalmologist removes the natural now cloudy lens that is the cataract and replaces it with a clear artificial intraocular lens implant. It is one of the safest and most common surgeries performed in the United States, and is highly effective with patients reporting better vision and improved quality of life. Regular comprehensive eye examinations allow your optometrist to monitor and optimize your vision as it changes due to cataracts and intervene with surgical referral before your vision becomes very limited.

AMD is a retinal condition where the disease affects your central vision retina called the macula, typically sparing the periphery. Early changes may be imperceptible to you but can lead to irreversible blank spots and blindness in severe disease.

There are two types of AMD: Dry and Wet.

Dry AMD makes ups 90% of all cases, where retinal deposits called drusen build up and cause dimming and defects in the vision.

Wet AMD is less common, where weak and leaky blood vessels cause bleeding in the retina. This leads to macular scarring and acute vision loss. Treatment for wet AMD typically includes intraocular injections or laser to reduce the compromised leaky blood vessels.

While there is no way to reverse the changes, regular retinal evaluations are required to monitor for progression. Nutritional changes to diet and supplements have also been shown to reduce the risk of progression in certain cases.

Diabetic retinopathy is the leading cause of vision loss for Americans. Patients with diabetes should have annual diabetic eye exams to monitor for potential changes.

The back of the eye is composed with thin layers of tissue to make up the retina. The retina is responsible for detecting light and sending our visual signals through the optic nerve to the brain. It is a highly active structure and also has small delicate blood vessels to supply the eye. Diabetic retinopathy occurs due to elevated blood sugar levels that damage these blood vessels leading to leakage, bleeding of new leaky vessels, and scar tissue which can lead to blindness. Left untreated it can cause retinal detachment and development of glaucoma.

Early to moderate diabetic retinopathy is often asymptomatic, therefore requiring regular eye examinations with your optometrist to monitor for need of potential interventions. Coordination with your primary care doctor/endocrinologist is highly important.

Treatment of diabetic retinopathy depends on the severity, and includes intraocular injections, laser, or surgery by the ophthalmologist.

We recommend updated yearly exams especially for contact lens wearers. If you need to order more supply of contact lenses, you can call our office to order and have them sent directly to you. Our current established patients with valid contact lens prescriptions can also order directly from our WEB STORE. All contact lens orders will need to have unexpired Contact Lens Prescription and will need to be verified by our office.

For our Centre Park Eye Care patients, please go on www.yourlens.com/centrepark to order.

For our Galleria Optical patients, please go on www.yourlens.com/galleriaoptical to order.