You Want to Do WHAT to 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 "You Want to Do WHAT to 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 can be […]

2020-10-27T04:00:00+00:00October 27th, 2020|Blog|

You Want to Do WHAT to My Eye? Part 1

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 […]

2020-10-20T04:00:00+00:00October 20th, 2020|Blog|

The Scary Cost of Cheap Costume Lenses

Fall brings a lot of fun, with Halloween bringing loads of it.

But did you know that some Halloween practices could harm your vision? Take Halloween contacts, for instance. They vary widely, with everything from monster eyes to goblin eyes to cat eyes to sci-fi or a glamour look. They can be just the added touch you need for that perfect costume. However, some people do not realize that the FDA classifies contact lenses as a medical device that can alter cells of the eye and that damage can occur if they are not fit properly.

Infection, redness, corneal ulcers, hypoxia (lack of oxygen to the eye) and permanent blindness can occur if the proper fit is not ensured. The ICE, FTC, and FDA are concerned about costume contacts from the illegal black market because they are often unsafe and unsanitary. Proper safety regulations are strictly adhered to by conventional contact lens companies to ensure that the contact lenses are sterile and packaged properly and accurately.

Health concerns arise whenever unregulated black-market contacts come into the […]

2020-10-13T04:00:00+00:00October 13th, 2020|Blog|

Pregnancy and Your Eyes

We all know that during pregnancy, a woman's body goes through a great deal of change hormonally and physiologically.  But did you know her eyes change as well?  Below are some of the most common effects pregnancy can have on the eye.

  • Corneal changes. In some cases, pregnancy can cause the cornea, the front window of the eye, to change curvature and even swell, leading to shifts in glasses and contact lens prescriptions. In addition, changes in the chemistry of the tear film can lead to dry eyes and contact lens intolerance. It is for these reasons that it is generally not recommended to have any new contact lens fitting or new glasses prescription checks until several months postpartum. We want to get the most accurate measurements possible.
  • Retinal changes.  Many different conditions can affect the retina during pregnancy. If the pregnant woman has diabetes, diabetic eye disease can progress by 50%. In women with preeclampsia, a condition where blood pressure rises significantly, over 40% of women can show changes in the retinal blood vessels, […]
2020-10-06T04:00:00+00:00October 6th, 2020|Blog|

Top 4 Reasons Every Older Adult Needs Regular Eye Exams

The American Academy of Ophthalmology has recommendations for how often adults need to get their eyes examined and those recommendations vary according to the level of risk you have for eye disease.

For people who are not at elevated risk the recommendations are:

  • Baseline eye exam at age 40.
  • Ages 40-54 every 2-4 years.
  • Ages 55-64 every 1-3 years.
  • Ages 65 and older every 1-2 years.

Those recommendations are just for people who have NO added risk factors. If you are diabetic or have a family history of certain eye diseases then you need exams more frequently.  

As you can see, the guidelines recommend more frequent exams as you get older. Here are the TOP 4 REASONS why you need your eyes examined more frequently as you get older:

1. Glaucoma

Glaucoma is the second leading cause of blindness in the United States. It has no noticeable symptoms when it begins and the only way to detect glaucoma is through a thorough eye exam. Glaucoma gets more and more common as you get […]

2020-09-29T04:00:00+00:00September 29th, 2020|Blog|

What Are These Floating Things?

"What are these weird floating things I started seeing?"

The spots, strings, or cobwebs that drift in and out of your vision are called “floaters,” and they are more prominent if you’re looking against a white background.

These floaters are tiny clumps of material floating inside the vitreous (jelly-like substance) that fills the inside of your eye. Floaters cast a shadow on the retina, which is the inner lining of the back of the eye that relays images to the brain.

As you get older, the vitreous gel pulls away from the retina and the traction on the retina causes flashing lights. These flashes can then occur for months. Once the vitreous gel completely separates from the back wall of the eye, you then have a posterior vitreous detachment (PVD), which is a common cause of new onset of floaters.

This condition is more common in people who:

  • Are nearsighted.
  • Are aphakic (absence of the lens of the eye).
  • Have past trauma to the eye.
  • Have had inflammation in the eye.

When a […]

2020-09-24T04:00:00+00:00September 24th, 2020|Blog|

Hearing That Your Driving Days Are Over

One of the hardest questions eye care professionals deal with every day is when to tell people who are having difficulty with their vision that they need to stop driving.

Giving up your driving privilege is one of the most difficult realities to come to terms with if you have a problem that leads to permanent visual decline.

The legal requirements vary from state to state. For example, in New Jersey the legal requirement to drive, based on vision, is 20/50 vision or better with best correction in one eye for a “pleasure” driving license. For a commercial driving license, the requirement is 20/40 vision or better in both eyes.

In some states there is also a requirement for a certain degree of visual field (the ability to see off to the sides).

According to the Insurance Institute for Highway Safety, the highest rate of motor vehicle deaths per mile driven is in the age group of 75 and older (yes, even higher than teenagers). Much of this increased rate could be attributable to declining vision. […]

2020-09-15T04:00:00+00:00September 15th, 2020|Blog|

Visual Hallucinations? It Could Be Charles Bonnet Syndrome.

Who is Charles Bonnet?  He was a Swiss naturalist, philosopher, and biologist (1720-1793) who first described the hallucinatory experiences of his 89-year-old grandfather, who was nearly blind in both eyes from cataracts.   Charles Bonnet Syndrome is now the term used to describe simple or complex hallucinations in people who have impaired vision.  

Symptoms

People who experience these hallucinations know they aren't real.  These hallucinations are only visual, and they don't involve any other senses. These images can be simple patterns or more complex, like faces or cartoons.  They are more common in people who have retinal conditions that impair their vision, like macular degeneration, but they can occur with any condition that damages the visual pathway.  The prevalence of Charles Bonnet Syndrome among adults 65 years and older with significant vision loss is reported to be between 10% and 40%.  This condition is probably under reported because people may be worried about being labeled as having a psychiatric condition. 

Causes

The causes of these hallucinations are controversial, but the most supported theory is deafferentation, which is the loss of signals from the […]

2020-09-08T04:00:00+00:00September 8th, 2020|Blog|

Detecting Alzheimer’s though an Eye Exam?

Alzheimer's Disease International estimates that the number of people living with dementia worldwide – nearly 44 million in 2014 – will almost double by 2030 and more than triple by 2050.

There is no single test that can show if a person has Alzheimer's, but doctors can almost always determine if a person has dementia, although it may be difficult to determine the exact cause. Diagnosing Alzheimer's requires careful medical evaluation, neurological testing, and sometimes brain imaging and blood tests to rule out other causes of dementia.

Most of the testing for early disease – MRI scans of the brain, brain PET scans looking for amyloid, and spinal taps looking for certain proteins in the spinal fluid – are not very accurate, and they are invasive and often expensive.

Researchers have now turned to findings in the eye to help with early detection and are hoping to find ways to make the diagnosis earlier when potential treatments may have a better outcome. There is also hope that these tests will be less expensive and invasive then […]

2020-09-01T04:00:00+00:00September 1st, 2020|Blog|

Dropless Cataract Surgery

Eye drops can be hard for some patients to put into their eyes. After cataract surgery, there are two main issues we are trying to control: Preventing infection and controlling inflammation.  Traditionally, we prescribed antibiotic eye drops to prevent infection, as well as steroid eye drops to control post-operative inflammation. Now we have some alternatives to using eye drops after surgery.   

There are some antibiotic solutions we can place inside the eye at the end of the cataract surgery that have been shown in most studies to do as good or better a job preventing infection as using antibiotic eye drops before and after surgery.

Just recently, the FDA approved two new steroid delivery methods to reduce post-operative inflammation that have the potential to eliminate post-op steroid eye drops in most (but not all) patients who are undergoing cataract surgery. Those two products are called Dexycu and Dextenza.

Dexycu is a white bolus of steroid medication that is injected inside the eye after cataract surgery. It will not be visible in most patients because it […]

2020-08-25T04:00:00+00:00August 25th, 2020|Blog|