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|Question from Maryland |
I suffer from the ability to see my white blood cells swimming through my retinal blood vessels. It is seen mostly when looking towards the sky or against white walls etc...although I do see them occasionally in dimly lit areas. My question is, once you see this will it be with you always or will it eventually settle down? I also suffer from floaters. Is there a connection between the two?
The small rapidly moving spots, which can be seen in the eye under certain circumstances, can be due to the movement of white blood cells in the retinal blood vessels. Floaters are a similar phenomenon, but are usually caused by densities in the vitreous jelly within the eye that cast a shadow on the retina in certain lighting conditions. It is not uncommon that people may notice both of these phenomena and occasionally it may be difficult to distinguish between the two. Unfortunately there is no way to eliminate the ability to see these things and they usually do not signal any eye problem. However, a comprehensive eye examination would be able to determine whether there is any eye condition that is making these more apparent to you, or if there is any treatment that might help to alleviate your situation.
Question from Texas
Most optical illusions involve the brain's interpretation of what is seen. Therefore, they do not reflect any incorrect visualization by the retina or the optic nerve. For example, many optical illusions that involve an object appearing to be larger or smaller than it actually is, occur because the brain is comparing it to something nearby which makes it appear a different size. When the object is isolated the eye sees it normally and the brain can determine its accurate size.
One exception to this is the eye seeing a complimentary color when looking at a white surface after extended viewing of a single color. This does occur because the cones in the retina that perceive color are "overloaded" by viewing an intense color for an extended period of time, and thus they are unable to respond effectively when looking at a white surface and the brain sees the complimentary color.
Most neuropsychology textbooks will be able to give much more detail on optical illusions. The best of luck.
Question from Wisconsin
The first use of lasers in eye surgery occurred in the 1960s. The lasers available then were much different than they are now and only a limited amount of success was achieved. However, as lasers developed further, they became applicable to many many eye conditions as well as other health conditions. At present there are about a dozen different lasers that are used in ophthalmology for different conditions, ranging from glaucoma and diabetes to eyelid surgery and elimination of the need for glasses. One of the pioneers in laser eye surgery was Dr. Frances L'Esperance. Any reference on the development of lasers and Dr. L'Esperance. should be able to give you details about the early history of the use of lasers. The best of luck.
Question about an Individual in Belarus
Thank you very much for forwarding the records regarding your friend's son. While I cannot be sure that I can interpret all of these correctly due to the language, terminology and testing differences, it appears that the disease referred to is Stargardt's disease, also known as fundus flavimaculatus. Unfortunately if this is correct, there is no known therapy for this retinal problem, which is genetic in origin. This would explain why two children in the same family appear to be affected. A retinal specialist with expertise in genetic diseases could give more information, but unfortunately I doubt that any curative therapy could be recommended. If he wishes to travel to a particular city for further evaluation, I would be happy to attempt to determine the best specialist to consult.
Question from India
It appears that your doctor's advice is very appropriate for this situation. Laser surgery to change the eye's focusing ability generally should not be done on people under the age of 21, due to the changes that usually occur as children grow. Furthermore, it would be very difficult to correct the amount of focusing difficulty that results when the natural lens of the eye is removed by laser surgery alone. Contact lenses and eventually lens implants should provide a good solution for your son.
Question from Brazil
Some people have more prominent blood vessels in the conjunctiva, the clear membrane that covers the eye, thus their eyes may always appear redder than is typical for most people. However, if you have increased redness in certain situations, as you described, it is likely that your eyes are particularly sensitive and tend to become dry and inflamed quite easily. Lubricating drops such as you are using can be very helpful, but should be used on a regular basis, such as four times a day, rather than waiting until your eyes have already become irritated. It is also possible that you may have some problem with the oil glands that produce oil for your tears. If this creates inflammation on your eye, you may need some prescription medication to help to alleviate that problem. Please contact us if you have further questions.
Question from Singapore
It appears that you are susceptible to dryness in your eyes, both overnight and when wearing contact lenses. This may be the result of your contact lenses being old or poorly fitting. However, it may also be that your eyes are quite sensitive and that removal of the contacts or the dryness that develops overnight create pain in your eyes. Lubricating eye drops would be the first choice for attempting to improve your problem. Your eye doctor can suggest a drop that can be used both with your contact lenses or at night and in the morning to decrease your symptoms.
Question from Florida
A chalazion is a blocked oil gland in the eyelid. Usually this appears as a small bump in the lid, which is not painful or red. In many cases, these bumps will go away with no treatment. However, if they do not, hot compresses on the eye can help to drain the clogged oil gland. If this is not successful, an eye doctor should evaluate the situation to determine whether medication or other treatment is necessary.
Question from Texas
When an eye has extremely narrow angles in the anterior chamber, it is at risk for an attack of acute angle closure glaucoma. While some people may never have such an attack, it is usually wise to do preventative treatment in order to avoid the possibility. If intraocular pressure is normal and no attacks have occurred, it is very unlikely that any damage has been done thus far. However, visual field testing prior to making a final decision about treatment may be helpful in confirming that situation.
Usually a relatively simple and safe laser treatment can provide almost complete protection against future problems. Because an attack, if it occurs, can be so rapid and severe, you may wish to discuss with your doctors whether preventative treatment would be beneficial in your case.
Please contact us if you have further questions.
Question from the United States
LASIK surgery varies in price depending on the surgeon and the area of the country involved. However, most price surveys have indicated a cost of $2,000 to $3,000 per eye in the United States.
Question from the Dominican Republic
Fatigue after reading for long hours is not abnormal. The eye uses a muscle to focus on reading material and when that muscle is used for extended periods, it can become quite fatigued. Usually taking breaks from reading or using simple measures like a cold compress or lubricating drops to soothe the eye are helpful. However, with the reading schedule you have described it is not unusual that your eyes should become tired.
Question from New Jersey
The condition you described is likely due to clogged or inflamed glands in the eyelid. Occasionally this can develop into what people call a sty, if a gland becomes blocked and infected. However, if an area of the eyelid has partial blockage of the oil glands without established infection, it can feel and appear as you describe.
Hot compresses help to open up these clogged oil glands and are usually the first treatment. Antibiotic drops or ointment can be beneficial in more severe cases, and occasionally anti-inflammatory medications are necessary if the condition does not improve. If the symptoms do not resolve promptly it would be wise to be examined by an eye doctor.
Question from California
When dry eye symptoms are most prominent in the morning, and do not occur to any great extent at other times of day, treatment overnight is the best way to alleviate symptoms. While it can be helpful to put drops in in the morning, a lubricating ointment applied at night usually lasts overnight and prevents the "stickiness" of the eyes upon awakening. If dry eye symptoms occur during the day as well, additional eye drops can be used to alleviate those symptoms.
While air filters and/or humidifiers can help to prevent the environment from being as dry, they are generally insufficient by themselves to prevent the symptoms you described. The best choice for lubricating ointments are nonprescription ocular ointments without preservatives. Your pharmacist can usually help you in choosing one. The amount of ointment used may vary for different individuals, but the ideal dose will prevent dryness and stickiness in the morning without leaving significant oily residue. If you have any questions, please do not hesitate to contact us.
Question from Ireland
Amblyopia usually signifies that one eye is unable to see as well as the other even with the use of the best possible glasses. When an eye drifts from its normal position, surgery usually can adjust the eye muscles to allow it to assume a straighter position. However, if the drifting eye does not have vision that is as good as the other eye, surgery will not help the quality of vision when it is performed in adulthood.
Please contact us if you have further questions.
Question from Illinois
If you have been told that there are calcium deposits on your lenses, your ophthalmologist is almost certainly referring to your contact lenses. Calcium deposits can often develop on contact lenses, especially when they are getting to the end of their usual lifespan. While excellent care and cleaning of the lenses can help to prevent calcium deposits, some people develop them more quickly, simply because of the constituents of their tears. Usually if you develop calcium deposits in your contact lenses, it is wise to replace them. If you need to replace contact lenses more frequently than you would expect, disposable or frequent replacement contacts may be a worthwhile option. Please contact us if you have any further questions.
Question from Turkey
Let me address each of your questions briefly.
1. Unfortunately, in degenerative myopia, there is no predictable time at which the myopia stops increasing. However, the rate of increase tends to be less in the 30s and 40s than it is in people of your age.
2. In general, eye muscle surgery should not have any negative effect on the retina.
3. It would be very difficult to assign a percentage chance to the possibility of your children having degenerative myopia. While their risk is increased over that in the general population, there is certainly a very high likelihood that they may be spared. Or there is a large amount of ongoing research on degenerative conditions of the retina, and new experimental treatments are being tested. If you make plans to visit the U.S., we can offer you some options of centers that have expertise in this area.
Question from Ohio
If your infection is not resolved with antibiotic treatments, it should definitely be re-evaluated by an ophthalmologist. Some infections may be resistant to one or several antibiotics, and some problems that appear to be an infection alone may have other inflammatory components that may require anti-inflammatory or oral medications. Despite your persistent symptoms, it is likely that there will be therapy available to help your condition. Please contact us if you have any further questions.
Question from Washington, DC
Monovision can be an excellent option for visual correction after LASIK surgery. In particular, it can help to avoid the occasional situation in which reading glasses become necessary sooner than anticipated after laser correction of near sightedness. However, it is most advantageous for people who have an aversion to wearing reading glasses. If you do not feel that wearing reading glasses, even in the relatively near future, would be a major disadvantage, then distance correction in both eyes may be preferable for you. If you do choose this latter option, it does enhance your depth perception and subjective clarity for distant objects over that provided by monovision.
It would be worthwhile to consult your ophthalmologist regarding any specific reasons he or she has for recommending monovision in your case. You might want to emphasize that you don't have an objection to the use of reading glasses and are interested in the possibility of distance correction in both eyes in order to see if this affects your ophthalmologist's advice. Please contact us if you have further questions.
Question from Mississippi
It appears that you have developed some variety of chronic inflammation in your eyes. There are several possible causes and it may well be worth having your eyes re-examined at this stage, now that contact lens wear has aggravated them again. However, it is possible that you are feeling the effects of having used so many medications over a long period of time. This can make your eyes more sensitive for sometime thereafter. It is also possible that your contact lenses are either in poor condition or no longer fit well. Finally, it may be that you have developed a variety of allergic reaction to either the contact lenses or some of your contact lens solutions. If your symptoms did improve substantially or resolve when you were not wearing your contact lenses, it is likely that they are at least part of the problem.
Please contact us if you have any further questions, or further information about your problem becomes available.
Question from the USA
What you describe sounds most like a localized area of inflammation on the white part of your eye. This may be located at the exact site where your previous injury was, or it may be coincidental that this is in the same location. There are several causes of these inflammatory conditions, but they almost invariably require medication in order to alleviate the problem. I would recommend that you consult an ophthalmologist for an examination to determine the most appropriate type of treatment for your condition. Please contact us if you have any further questions.
Question from Oregon
Plugged tear ducts can often be improved with hot compresses and antibiotics. Depending on the exact location of the blockage, either local medication or oral medication may be necessary. Often this may take several days to a week or more to resolve, but fortunately it is not usually a serious condition. However, if it worsens or does not improve promptly it would be wise to consult an eye doctor with regard to further evaluation or treatment. Please contact us if you have any further questions.
Question from New Jersey
Orthokeratology intentionally changes the shape of the cornea. When the new shape is slightly irregular or slightly variable it is common to notice some distortion of bright lights, particularly at night. The symptoms you describe are likely to be related to this phenomenon. If it is bothersome you could consider returning to standard contact lens correction, but if you consult an expert in orthokeratology you should be able to get advice on whether additional treatment would be safe and beneficial.
Question from Texas
Paxil and related medications can change vision in some people by altering the focusing mechanism of the eye. The most common description involves difficulty focusing on near objects, but the delayed focusing or "pulling" sensation you described can be a variant of this symptom. While your symptoms may be due to Paxil the only certain way to confirm this would be a comprehensive eye examination by your eye doctor. However, even if Paxil is responsible, your symptoms may not disappear for several weeks after discontinuing the medication.
Question from New Jersey
It may be that your friend is suffering from a vascular tumor in the retina. This could explain his symptoms and the terms you found, although not exact, could represent this type of problem. The only way to determine the exact nature of his problem, however, is a comprehensive eye examination and it may be that the diagnosis is still somewhat in doubt. It would be helpful to know if any other tumors were found elsewhere in his body or if the problem in the eye was thought to be related to any other disease. If any other information is available, I would be happy to attempt to interpret it.
Question from Ohio
If your lazy eye is beginning to drift once again, surgery almost always will restore it to a more accurately aligned position. However, if the drift is only occasional you may wish to defer surgery at this time. In some cases, exercises can be at least partially helpful in improving the eye's position, though it depends on the position of the drift. As you are aware, glasses, either with or without prisms can also be helpful, if you wish. A comprehensive eye examination, preferably by an expert in eye muscle surgery would be the best source of information in helping to make your decision.
Question from Europe
Degeneration of the optic nerve can result from many causes. In a person over age 80, the most common sources would be abnormal blood flow or glaucoma. However, there are other less common causes as well. If it can be determined which of these causes is responsible for the degeneration of the optic nerve, then it may be possible to assess whether treatment could be beneficial. Unfortunately, many conditions that damage the optic nerve may not be reversible because optic nerve fibers usually cannot be regenerated.
Question from the United Kingdom
Damage to the optic nerve from high pressure is usually irreversible. Most treatment is directed toward preventing further damage, although in some cases reduction of pressure may result in slight changes in vision. There are many glaucoma specialists in the U.S. who may be able to offer some help if the pressure in your friend's eye remains elevated. However, if the pressure has now been reduced to normal, it may not be possible to restore the portion of his vision that has been damaged due to the previously elevated pressure. If you have a particular city in mind, I would be happy to seek out some specific names of specialists in glaucoma surgery for you.
Question from California
Depending on the location of the persistent blood vessels, they may indeed be caused by a contact lens that is old, poorly fitting or worn for excessive lengths of time. When these blood vessels appear they generally occur at the periphery of the cornea, adjacent to where the white of the eye begins. However, if the blood vessels are located entirely within the white part of your eye, they may be merely due to dryness, irritating contact lens solutions or older contact lenses.
A comprehensive eye examination by your eye doctor can determine which of these factors is most responsible for the symptoms you are noticing.
Question from India
When a 3-year-old has been determined to be myopic, the only treatment commonly accepted at present is to improve her vision with eyeglasses. There is no known cure for myopia in childhood, as it is believed to be genetically determined. Furthermore, when glasses are necessary at this young age, they generally are necessary throughout youth. As you may know, laser surgery can be performed in adulthood to reduce or eliminate nearsightedness and this may be an option for your daughter in the future. Lastly, there is no proven method of preventing further increase in myopia at this age, although a number of methods have been tried with inconsistent results.
Question from Ontario, Canada
A number of companies have now developed machinery for measuring the eyes for glasses or contact lenses using lasers and other methods. In simple terms, they work by treating the eye as a camera and determining what lens focuses light on the retina most accurately. However, this is not always a perfect prescription for glasses and for this reason eye doctors often still ask their patient's which lens looks sharpest when reading the eye chart. The general name for the device to which you refer is an auto-refractor. You may be able to find an eye doctor's office in your area, that has access to such a machine or your local Medical Society may be able to refer you to such an office.
Question from Pennsylvania
When crossed eyes develop in a 2-year-old, it may mean that the child is in need of glasses. When a child is born with crossed eyes or develops them in the first 3-6 months of life, surgery is almost always required to correct the misalignment-alignment of the eyes. However, in a child whose eyes have been straight until age 2 or thereafter, it is common for far-sightedness to lead to the development of crossed eyes. A comprehensive eye examination by an ophthalmologist, especially one who specializes in pediatric ophthalmology, would be able to determine the cause of your daughter's problem quite readily. I would recommend that you consult an ophthalmologist as soon as possible. Crossed eyes should always be treated as soon as possible and even if you do not have insurance, there may be a children's hospital, a clinic or a University in your area that could provide the services your daughter needs. Please let me know if you have any further questions.