Education

Eye Diseases

The macula is the central region in the back of the eye responsible for our sharpest vision (used for reading and seeing fine detail). Macular degeneration is a disease process affecting layers in the back of the eye that causes a decrease or loss of this central vision. There are two forms of ARMD. The most common is the dry form. This type is less severe and makes up 90% of patients with ARMD. The wet form is more aggressive with more vision loss. Here, abnormal vessels grow and leak fluid under the retina. Research has found that antioxidant vitamins and zinc decrease the progression of ARMD in some patients. The wet form is treated with laser surgery or injection of a medication to stop the abnormal blood vessel growth.

This is a progressive loss of vision due to a disease process affecting a structure in the back of the eye known as the optic nerve. This structure is responsible for carrying visual information to the brain. Vision loss starts in the periphery and if left untreated can result in total blindness. Treatment for glaucoma includes lowering the pressure inside the eye. This can be done with daily use of eye drops, a laser, or surgery. Early detection and treatment is crucial for preserving vision. The American Academy of Ophthalmology recommends screening visits for glaucoma for anyone over 55 years of age, or anyone with a family history of glaucoma.

Diabetes attacks the small blood vessels of the entire body. When the blood sugar is not well controlled it can damage blood vessels in the back of the eye (the retina). These blood vessels can leak fluid and cause swelling. They can also become too weak to supply the proper amount of oxygen and nutrients to the retina. There are two types of diabetic retinopathy. The most common is nonproliferative diabetic retinopathy. This form ranges from mild to severe and can progress into proliferative diabetic retinopathy. This form involves new blood vessel growth (neovascularization) of the retina. These vessels are extremely weak and grow in irregular patterns. The blood vessels leak and produce scar tissue that has the potential to cause severe vision loss. Excellent blood glucose control has been proven to lower the chance of diabetic retinopathy.

This is an extremely common condition affecting over 20 million Americans. With this condition the eyes usually feel tired, gritty, and irritated. Another symptom can be excess tearing due to an imbalance in the composition of the tear film. There are many causes such as aging, hormone changes, certain medications, autoimmune diseases, smoking, and environmental factors (extended computer use, dust, wind, and air conditioners). Treatments include artificial tears, prescription eye drops, and punctual occlusion. Punctal occlusion is a simple procedure where the doctor inserts a very tiny plug into the area where the tears drain. This keeps more tears on the surface of the eye.

A cataract is a clouding of the lens (a clear structure inside the eye). It usually develops as a normal aging process. There are several different types of cataracts depending on which part of the lens is affected. Some of the first symptoms of cataracts include glare and poor night vision (often noticed while driving). As the cataract progresses vision gets worse and reading and driving can become difficult. Treatment involves removing the cataract and placing a clear lens (intraocular lens) in its place. There are many different lens options available depending on your visual needs. The newer technology lenses can even let people see certain zones of vision without glasses after cataract surgery! –

Lipid signaling is dysregulated in many diseases with vascular pathology, including cancer, diabetic retinopathy, retinopathy of prematurity, and age-related macular degeneration. We have previously demonstrated that diets enriched in ω-3 polyunsaturated fatty acids (PUFAs) effectively reduce pathological retinal neovascularization in a mouse model of oxygen-induced retinopathy, in part through metabolic products that suppress microglial-derived tumor necrosis factor-α. To better understand the protective effects of ω-3 PUFAs, we examined the relative importance of major lipid metabolic pathways and their products in contributing to this effect. ω-3 PUFA diets were fed to four lines of mice deficient in each key lipid-processing enzyme (cyclooxygenase 1 or 2, or lipoxygenase 5 or 12/15), retinopathy was induced by oxygen exposure; only loss of 5-lipoxygenase (5-LOX) abrogated the protection against retinopathy of dietary ω-3 PUFAs. This protective effect was due to 5-LOX oxidation of the ω-3 PUFA lipid docosahexaenoic acid to 4-hydroxy-docosahexaenoic acid (4-HDHA). 4-HDHA directly inhibited endothelial cell proliferation and sprouting angiogenesis via peroxisome proliferator-activated receptor γ (PPARγ), independent of 4-HDHA’s anti-inflammatory effects. Our study suggests that ω-3 PUFAs may be profitably used as an alternative or supplement to current anti-vascular endothelial growth factor (VEGF) treatment for proliferative retinopathy and points to the therapeutic potential of ω-3 PUFAs and metabolites in other diseases of vasoproliferation. It also suggests that cyclooxygenase inhibitors such as aspirin and ibuprofen (but not lipoxygenase inhibitors such as zileuton) might be used without losing the beneficial effect of dietary ω-3 PUFA.

FAQ

The examiner will begin with reviewing your medical history as well as discussing any eye or vision problems you may be experiencing. You will read letters off the chart to assess your vision. The doctor will examine the health of your eyes with a high powered microscope (called a ‘slit lamp’). This will involve using bright lights to examine the front of your eyes and structures inside your eyes. The doctor will conclude by discussing the findings, making recommendations, and answering any questions you may have.

Dilation involves the use of eye drops to make your pupils large so that the doctor can look at structures inside of your eyes. Here, the doctor can look for diseases such as glaucoma, macular degeneration, diabetic retinopathy, and hypertensive retinopathy (to name a few). Side effects of dilation include light sensitivity and blurry vision for up-close reading.

Refraction is the process to determine which combination of lenses helps you see the clearest. The numbers are used for your glasses and contact lenses, and are also important to assess for any problems in your eye.

20/20 means that at 20 feet you can read the same as a person with perfect vision. If the number on the bottom is larger this means the vision is worse than 20/20. For example, 20/40 means that you have to stand 20 feet away from an object that someone with perfect vision can see at 40 feet.

You are legally blind when your best corrected vision is worse than 20/200 or your side vision is narrowed to 20 degrees or less in your better seeing eye.

Yes. There are now many types of multifocal contacts that correct vision for distance and for reading up-close. This is a great option if you don’t want to wear glasses. The doctor takes measurements during the contact lens exam to see which lens will work best for you.

It depends on what intraocular lens is placed inside the eye. There are now several lens options to decrease your need for glasses after cataract surgery. These lenses are known as premium intraocular lenses (IOLs). Your doctor will discuss the best lens options for you after evaluating your eyes.

These are specialty lens designs used during cataract surgery. They are a great option for patients that want to decrease their dependence on glasses. They can treat astigmatism, distance, and reading vision.

This is when the surgeon uses a laser to make a temporary flap on the front part of the eye (cornea) rather than a blade. The laser is more accurate than the blade giving better results and fewer complications. A second laser is then used to reshape the cornea, then the flap is laid back down.

There are some specific recommendations on who should have screening eye exams. The state of Missouri recently mandated that all children have an eye exam before kindergarten age. As the child grows up, they should have eye exams regularly if they have a family history of glaucoma, retinal disease, or any non-traumatic blindness. They should also be seen if they have any complaints of blurred vision. The American Academy of Ophthalmology recommends eye exams for adults if they have medical conditions that could cause eye problems, such as Diabetes, High Blood Pressure, and Arthritis to name a few. Additionally, adults over 50 years of age, or adults with a family history of glaucoma or macular degeneration, should have annual eye exams.

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