Sun Exposure to Eyes Can Cause Potential Damage

Some research indicates sun exposure has the potential for damage to the lens and retina of the eye.

Aside from that, the white of the eye can be affected as well. The most common issues are pinguecula, pterygium and, more rarely, cancer.

Pinguecula may appear as a raised yellowish or grayish bump on the inner or outer side of the white of the eye. It may occasionally be irritated or dry out and make contact lens wear less comfortable. In and of themselves, they are not dangerous and we can treat the inflammation and drying effectively with topical eye drops. The only way to remove them is surgically, which is rarely necessary unless they become a concern cosmetically.

Pterygium is another benign growth on the inner and outer whites of the eye. They are vascularized growths that creep onto the colored portion of the eye. Pterygium may affect vision by inducing astigmatism or, if quite large, may even block vision directly. They also can be easily irritated and surgery is necessary to remove them.

Pinguecula and Pterygium are most common in people who spend a lot of time outdoors. Wearing good sunglasses with UVA, B and C protection is important to prevent them. If you develop a growth on your eye, make an appointment with your eye doctor.

Pupil Dilation Provides a More Accurate Prescription

If you have ever noticed that you can see more looking through an open doorway than you can see looking through the door’s peephole, you will understand why we dilate pupils.

When the pupil is small, we cannot see the details of the lens and the view of the retina is compromised. When we cannot see, we cannot adequately follow the progress of conditions such as diabetes, cataracts, macular degeneration, and the risk of retinal tears and detachments in the peripheral retina and we may miss important details that could lead to loss of vision.

We also dilate to understand a potential source of error in eyeglass prescriptions. Individuals with astigmatism or who are far-sighted tend to overfocus. When we dilate the pupil, we can relax that tendency and get a more accurate and comfortable prescription for eyeglasses.

We do not have anything to replace pupil dilation completely, but we have a partial substitute with the OPTOMAP — photography that gives a 210-degree view of the inside of the eye or 80% of the retina. This allows us to see somethings in better detail than a dilated exam, but there is still 20% we cannot see. At least every other year, we still need to dilate to look at the details of the lens that the OPTOMAP cannot see.

It should be noted that OPTOMAP, when used to avoid dilation, is not covered by insurance and you may pay out of pocket for the convenience of no dilation. In summary, though it may be inconvenient and a bit uncomfortable, dilation allows us to take better care of your eyes.

The Right Time to Remove Cataracts

Historically, a cataract was ready to remove when it was “ripe.” This antiquated term was used to delay surgery until the cataract was advanced. Thankfully, that era has passed. Today, wonderful improvements in both cataract surgery and lens implants, including laser cataract surgery, routinely provide excellent vision, (often without glasses, depending upon the implant).

Medicare pays for cataract surgery when vision is 20/40 or worse. If cataracts interfere with something important, such as driving or reading, Medicare may pay for surgery earlier. The key is that the symptoms must be caused by the cataract, interfere with important life activities and must not be correctable by simpler means such as new glasses.

If your vision is worse than 20/40 but meets your needs, a delay in cataract surgery usually will not harm your eye or make the surgery more difficult. Medicare has recently found that cataract surgery by itself reduces the risk of falling and breaking a hip by 20%. Do not wait so long that your cataract is visible or “ripe” in the old sense and risk breaking a hip. Instead, see your eye doctor regularly to monitor your cataract, and when the time is right, enjoy your best possible vision for the rest of your life.

Cataract Facts & Factors

The lens inside your eye is normally clear at birth and leaves the pupil dark. The lens gradually loses its transparency as we age. The increasing whiteness of the lens, visible in the pupil in advanced cases, is a cataract.

There is a genetic component to cataract formation, and there clearly is an aging component. Extensive exposure to sunlight, smoking, poor diets, and disease, such as diabetes, play a role in the growth of cataracts.

However, there are factors that might help prevent a cataract or at least slow its growth.

It is not practical to try to choose your parents or not get older. But, it would be good to wear a hat and/or sunglasses outdoors, eat an ideal diet, and consider vitamin and antioxidant supplementation. Also, do not smoke or drink to excess and do control any other chronic diseases well, especially diabetes.

Most people as they age have some degree of cataract and many of these limit vision and lifestyle by creating significant glare when driving or loss of fine detail at distance or near. Fortunately, cataract surgery can restore excellent visual function and, depending upon the options chosen, can reduce the need to wear glasses at distance or near.

If you are concerned that you may have cataract, seek an evaluation by an ophthalmologist who offers the latest options. At the Eye Clinic of Austin, we seek to offer you the options that we believe will be best you and for your vision—the same that we would choose for our family or ourselves in similar circumstances.

Are Generic Eye Drops the Same as Branded Eye Drops?

The short answer is: They have the same main ingredient in the same amount and concentration. The long answer adds: Nothing else in the bottle needs to be the same. So they might be equally effective as the branded, nearly as effective, or less effective than the branded.

It's much like comparing two different brands of vanilla ice cream. To be vanilla ice cream, it must contain vanilla. But every brand has a different recipe leading to subtle changes in texture and taste. Those subtle differences might affect the most important measurement: how much you like that ice cream. Likely, you have a real favorite, maybe Blue Bell, not just any generic vanilla ice cream.

Branded eye drops must go through a very expensive FDA approval process to get on the market. The reason the generics are less expensive is that they are required only to have the same concentration of the active ingredient. They do not have to prove they are as effective as the brand name. This makes for a difference in price and probable differences in effectiveness. Less effect is important in many patients and critical in some. Because neither you nor I have control over which generic is dispensed to you, control of your problem may vary over time.

Sometimes any vanilla ice cream is OK, but usually your favorite is best. Cost is important; so is proven effectiveness. Choose wisely. If you're experiencing chronic dry eye though, then make an appointment with your ophthalmologist to determine if you have dry eye disease.

What is Laser Cataract Surgery?

For more than 15 years, a few doctors have told their patients they were having laser cataract surgery. This was a simplification to avoid explaining the complex nature of the ultrasonic vacuum device used to remove the cataract. It was not a laser.

The Eye Clinic of Austin uses the LenSx femtosecond laser in cataract surgery. This allows us to make precise and reproducible incisions in the cornea, both to enter the eye and to reduce astigmatism; as well as inside the eye to open the lens capsule and break the lens into pieces for removal.

Surgeons have good hands, but no matter how good those hands are, the laser is more precise. This degree of precision leads to more predictable results from cataract surgery because it reduces some of the variables. The laser lens fragmentation reduces the amount of ultrasonic energy required to remove the cataract with phacoemulsification, which reduces the general irritation to the eye. Both of these improvements lead to better results and an increased chance that you will get the results you and your surgeon want.

If you need cataract surgery, contact the Eye Clinic Austin for your laser cataract surgeon.

What's Causing the Flashes of Light in Eyes?

The three most common explanations for seeing flashes of light include:

1. An ocular migraine.
2. A problem with the retina such as a tear or detachment.
3. A separation of the jelly-like fluid away from the retina called a Vitreous Detachment.

Most ocular migraines involve seeing a shimmering pattern from both eyes. This will last from 10 minutes to 30 minutes and then resolve.

With a retinal tear, sparks of light will be seen and will persist for a long time along with the sudden appearance of “floaters” or little black specks in the vision. Patients sometimes describe this as seeing a gnat or a spider web. It can be a line or a dot. Retinal tears are serious. They should be diagnosed and treated immediately to prevent a retinal detachment.

In the majority of cases, however, a person experiencing flashes of light has a condition that is not dangerous called Posterior Vitreous Detachment. In this, the jelly-like fluid in the back of the eye separates from the retina. This leads to a retinal tear in less than 2 percent of cases. Most flashing will stop, and floaters will diminish slowly.

The only way to know which condition applies to you is to have an exam with an eye specialist immediately.