About Cynthia Kiernan

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So far Cynthia Kiernan has created 414 blog entries.

Laser Treatments Might Help Floaters

Do you have floaters in your vision?

Floaters are caused by thick areas in the gel-like fluid that fills the back cavity of your eye, called the vitreous.

Many people, especially highly near-sighted people, often see some degree of floaters for a good portion of their lives. Often, these floaters are in the periphery of your vision and may only be visible in certain lighting conditions. The most frequent conditions are when you are in bright sunlight and are looking toward the clear blue sky. This I know from personal experience as I have a floater in my left eye that I most often see when swimming outdoors. Every time I turn my head to the left to breathe I see this floater moving in my peripheral vision.

This is totally harmless other than when I’m swimming in the ocean and swear that sudden object in my peripheral vision is a shark bearing down on me. Some people who have floaters are not as lucky and the floater can be very central and almost constantly annoying, […]

2018-10-16T04:00:00+00:00October 16th, 2018|Blog|

Seeing one of the 3 F’s

If you are seeing the 3 F’s, you might have a retinal tear or detachment and you should have an eye exam quickly.

The 3 F’s are:

  • Flashes – flashing lights.
  • Floaters – dozens of dark spots that persist in the center of your vision.
  • Field cut – a curtain or shadow that usually starts in peripheral vision that may move to involve the center of vision.

The retina is the nerve tissue that lines the inside back wall of the eye and if there is a break in the retina, fluid can track underneath the retina and separate it from the eye wall. Depending on the location and degree of retinal detachment, there can be very serious vision loss.

If you have a new onset of any of the three symptoms above, you need to get in for an appointment fairly quickly (very quickly if there are two or more symptoms).

If you have just new flashes or new floaters you should be seen in the next few days. If you have both […]

2018-10-10T04:00:00+00:00October 10th, 2018|Blog|

What Happened To Reversal Drops For Eye Dilation

Getting your eyes dilated can be inconvenient – including making the eyes light sensitive and having difficulty reading for a couple of hours.

So wouldn’t it be great to have another drop to reverse the effects of dilation?

On Dec. 31, 1990, Dapiprazole, under the trade name Rev-Eyes, was approved by the FDA and thought to be the answer to all the post-dilation problems. It was marketed for treatment of medically induced dilation by stimulating pupillary constriction and restoration of accommodative function for reading.

In clinical practice, Dapiprazole took between one to two hours to return pupils to pre-dilation size.

Side effects such as stinging upon instillation, conjunctival hyperemia (redness of eye), headache, and a few instances of ptosis (lid drooping), with a possible additional dollar cost to patients, appear to lessen Dapiprazole’s overall clinical benefit.

Reading ability returned in approximately 43 minutes with dapiprazole vs 66 minutes without dapiprazole (Optom Vis Sci 1994 May; 71(5):319-22). The main complaint that people had after using dapiprazole was the conjunctival hyperemia, which lasted more than three hours. The […]

2018-10-02T04:00:00+00:00October 2nd, 2018|Blog|

Are Reading Glasses Making My Eyes Worse?

Will reading glasses make your eyes worse? The short answer is ‘No.’

Although we don’t know the exact mechanism by which humans have a decreased ability to focus up close as we age (a process called presbyopia), the fact remains that it will happen to all of us.

The leading theory of how this occurs is that the lenses in our eyes get stiffer and thicker as we age such that one of the muscles in the eye that contracts to change the shape of the lens does so less and less effectively because the lens itself gets less pliable.

The process of changing the focus of the lens from far away objects to up-close objects is called accommodation. If you have normal distance vision without glasses, then your eyes’ natural focus spot is far off in the distance. In order to focus on an object close to you, the lens in your eye has to alter its shape. The ability of your lens to do that is at its best when you are born and […]

2018-09-25T04:00:00+00:00September 25th, 2018|Blog|

What does ‘20/20 vision’ actually mean?

One of the most commonly asked questions in an eye exam comes right after the refraction, or glasses prescription check: “What is my vision?”

Almost invariably, people know the term “20/20”. In fact, it’s a measure of pride for many people. “My doctor says I have 20/20 vision.” Or, on the other side of that same coin, having vision that is less than 20/20, say 20/400, can be a cause of great concern and anxiety. In this discussion I will describe what these terms actually mean.

To lay the foundation, let’s discuss some common terms. Visual acuity (VA) is clarity or sharpness of vision. Vision can be measured both corrected (with glasses or contact lenses) and uncorrected (without glasses or contact lenses) during the course of an eye exam. The result of an eye exam boils down to two different but related sets of numbers: your VA and your actual glasses prescription.

The notation that doctors use to measure VA is based off of a 20-foot distance. This is where the first 20 in 20/20 comes […]

2018-09-19T04:00:00+00:00September 19th, 2018|Blog|

Drug Allergy or Side Effect? Knowing the difference could save your life

There is a common misconception that any adverse reaction to a drug is an allergy. That is definitely not the case.

Reporting to your doctors that you have an allergy to a medication when what you really had was a side effect could potentially create a substantial alteration to your medical care in the future. And this could mean a physician may avoid using a drug that could possibly save your life because of the fear of an allergic reaction.

An anaphylactic allergic reaction generally produces a very specific set of symptoms, including difficulty breathing due to constriction of windpipe, swelling of your tongue and/or a rash and hives that break out over your entire body. While an allergic reaction can present in other ways, these are the most frequent reactions that occur when you have a true allergy to something.

If that is not the type of reaction you had then it probably isn’t an allergy. If you are uncertain if your reaction to a medication is an allergy or not, testing by an allergist […]

2018-09-11T04:00:00+00:00September 11th, 2018|Blog|

Why am I having Difficulty Adjusting to My New Glasses?

Eye doctors typically pride themselves on being able to improve someone’s vision through either glasses or contact lens prescriptions. Whether it’s a first-time glasses wearer, or someone having either a small or large change in their prescription, we like to aim for that goal of 20/20 vision.

Despite our best efforts, however, correcting vision to 20/20 is not always a positive outcome for the patient. Whether someone will be able to tolerate their new prescription is based on something called neuroplasticity, which is what allows our brains to adapt to changes in our vision.

You or someone you know may have had this happen: Your vision is blurry, so you go to the eye doctor. The doctor improves the vision, but when you get your new glasses, things seem “off.”

Common complaints include that the prescription feels too strong (or even too clear!) or that they make the wearer feel dizzy or faint. This is especially true with older patients who have had large changes in prescription, since neuroplasticity decreases with age. It is also more […]

2018-09-04T04:00:00+00:00September 4th, 2018|Blog|

Are My Cosmetics Making My Dry Eye Worse

Dry Eye Disease affects more than 5 million people in the United States, with 3.3 million being women and most of those being age 50 or over. And as people live longer, dry eye will continue to be a growing problem.

Although treatment options for dry eyes have improved recently, one of the most effective treatments is avoidance of dry eye triggers.

For some that might mean protecting your eyes from environmental triggers. To do that experts recommend using a humidifier in your home, especially if you have forced hot-air heat; wearing sunglasses when outside to help protect your eyes from the sun and wind that may make your tears evaporate faster; or being sure to direct any fans  – such as the air vents in your car – from blowing directly on your face. For others, it may mean avoiding medications that can cause dry eyes.

There is one other trigger that may need to be avoided that doesn’t get as much notice: The potentially harmful ingredients in cosmetics.

Cosmetics do not need to prove […]

2018-08-28T04:00:00+00:00August 28th, 2018|Blog|

Why Do I Need an Injection in My Eye? Part 2

There are certain eye conditions where an injection into your eye might be recommended.

Injections into the eye, specifically into the vitreous or gel-filled cavity of the eye, are called intravitreal injections.

In Part 1 of ‘Why Do I Need an Injection in my Eye?’ we talked mostly about anti-vascular endothelial growth factor (anti-VEGF) injections. Anti-VEGF injections are probably the most commonly injected agents and they are used to treat wet age-related macular degeneration (ARMD), diabetic retinopathy, and retinal vein occlusion.  

But there are other injections that may be used as treatment.

Another injected medication used in combination with Anti-VEGF agents to treat wet macular degeneration, diabetic retinopathy and retinal vein occlusion are steroids. Additionally, steroids can be used to treat inflammation, or uveitis, in the eye. There is a steroid implant called Ozurdex, that looks like a white pellet and can last up to 3 months in the eye. The downside of steroids is that they can increase eye pressure and cause progression of cataracts.  

Antibiotics are another type of medication that is […]

2018-08-20T04:00:00+00:00August 20th, 2018|Blog|

Why Do I Need an Injection in My Eye?

There are some eye conditions where your doctor might recommend an eye injection as a treatment option.

Injections into the eye, specifically into the vitreous or gel-filled cavity of the eye, are called intravitreal injections.

Anti-vascular endothelial growth factors (anti-VEGF) are probably the most commonly injected agents. They are used to treat wet age-related macular degeneration (ARMD), diabetic retinopathy, and retinal vein occlusion.

In these conditions, there are abnormal leaky blood vessels that cause fluid and blood to accumulate in and under the retina. This accumulation of fluid results in loss of central vision. The role of anti-VEGF agents is to shrink these abnormal vessels and restore the normal architecture of the retina.

There are three anti-VEGF agents widely administered: Lucentis, Avastin, and Eylea.

Lucentis (Ranibizumab) is FDA approved for treatment of wet ARMD, diabetic retinopathy, and vein occlusion. It is specially designed for injection into the eye and is a smaller molecule than Avastin so it may have better penetration into the retina.

Avastin (Bevacizumab) was originally approved by FDA for treating colorectal cancer. It […]

2018-08-14T04:00:00+00:00August 14th, 2018|Blog|