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Patient Education

Astigmatistm	Dry Eye	Ocular Migraine
Blepharitis	Floater and Flashes	Optic Neuritis
Cataracts	Glaucoma	PRK
Color Vision	Hyperopia	Ptosis
Conjunctivitis	IOLs	Posterior Capsulotomy
Corneal Abrasion	LASIK	Presbyopia
Detached Retinas	Macular Degeneration	Retinitis Pegmentosa
Diabetic Retinopathy	Myopia	RK and AK

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Blepharitis

Blepharitis is an infection of the eyelids. It is very common, and it is a permanent condition. Once it is present, it will always be present, but the severity may change over time. In some cases, the symptoms can disappear for long time periods, months or years, before returning.

Blepharitis can be controlled by careful cleaning of your eye lashes every day. This can be accomplished with warm water and mild shampoo (such as baby shampoo). Once the redness and soreness are under control, this cleaning may be decreased from daily to twice weekly. However, if the symptoms return, daily cleansing must be resumed immediately. Medication is of secondary importance in the treatment. In some cases eye drops or ointment will be prescribed to be used along with the daily cleansing.

However, medication alone is not sufficient; keeping the eyelids clean is essential. Warm, moist compresses can also help relieve the symptoms of blepharitis when used in conjunction with regular eyelid cleansing.

There are two main causes of blepharitis: staphylococcus bacteria and seborrhea. Staphylococcus bacteria commonly begins in childhood and continues throughout adulthood. Common symptoms include collar scales on lashes, crusting, and chronic redness at the lid margin. Dilated blood vessels, loss of lashes, sties, and chalazia also occur. Treatment is very important. In addition to eliminating the redness and soreness, treatment can prevent potential infection and scarring of the cornea and conjunctiva.

Seborrhea is secondary to overactive glands causing greasy, waxy scales to accumulate along the eyelid margins. Seborrhea may be a part of an overall skin disorder that affects other areas. Hormones, nutrition, general physical condition and stress are factors in seborrhea. Patient Education Library reprinted with permission of Einstein Medical, Inc. (c) 2000

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Color Vision

The human eye has receptors that are sensitive to three primary colors, red, green and blue. The brain is able to blend these three primary colors so that the eye is able to discriminate very slight differences. A person with normal color vision can see approximately 8,000 colors in nearly 8 million different shades and tints.

The retina is made up of 10 layers of different kinds of cells. These cells are connected to the brain by approximately 1 million tiny nerve fibers. When stimulated by light, these nerve fibers transmit electrical impulses from the eye to the brain, where the signals are interpreted to give vision. The retina is the focus of our "color receptors".

The very back layer of cells in the retina is called the photoreceptors. There are two types of these cells; rod and cones. Rod function well in dimly lit situations and can perceive only black, white and shades of gray. Rods are located in the outer parts of the retina, away from central vision. Cones are the second type of receptor and they are located primarily in the central part of the retina. This type of receptor functions to provide daytime vision and the important central detail vision, such used for reading small print. There are three types of cones; red, green and blue cones. These three types of cones combine to provide for the wide range in color vision. There are only about 1/3 as many cones as rods.

Color vision testing can be used to identify color defects in your vision. There are many types of color vision tests, from the general screening methods that test your gross perception of color, to other more sensitive tests, which are much more time consuming. The most common type of color vision loss is inherited and occurs from birth. But several diseases are also known to cause color vision losses later in life.

Patient Education Library reprinted with permission of Einstein Medical, Inc. (c) 2000

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Conjuctivitis (Bacterial)

The conjunctiva is a clear membrane that is the tough, leathery outer coat of the eye. The white of the eye actually lies behind the conjunctiva. The conjuctiva has many small blood vessels and it serves to lubricate and protect the eye while the eye moves in its socket.

When the conjunctiva becomes inflamed, this is called CONJUNCTIVITIS. Conjunctivitis can have many causes, such as bacteria (as in "pink eye"), viruses, chemicals, allergies, and more. In many cases it is difficult to determine the primary cause for the inflammation. One of the most common is

BACTERIAL CONJUNCTIVITIS.BACTERIAL CONJUNCTIVITIS is associated with swelling of the lid and a yellowish discharge. Sometimes it causes the eye to itch and a mattering of the eyelids, particularly upon waking. The conjunctiva appears red and sometimes thickened. Often both eyes are involved.

The bacteria most commonly at fault are the Staphylococcus, the Streptococcus, and H. Influenza. This disease is very contagious, and can be easily transmitted by rubbing the eye and then infecting household items, such as towels or handkerchiefs. It is common that entire families become infected.

Conjunctivitis can be directly cured with treatment. Usually antibiotic drops and compresses ease the discomfort and clear up the infection in just a few days. In a few cases, the inflammation does not respond well to the initial treatment with eye drops. In those rare cases a second visit to the office should be made and other measures undertaken. In severe infection, oral antibiotics are necessary. Covering the eye is not a good idea because a cover provides protection for the germs causing the infection. If left untreated, conjunctivitis can create serious complications, such as infections in the cornea, lids, and tear ducts.

Certain precautions can to taken to avoid the disease and stop its spread. Careful washing of the hands, the use of clean handkerchiefs, and avoiding contagious individuals are all helpful. Little children frequently get conjunctivitis because of their poor hygiene.

Patient Education Library reprinted with permission of Einstein Medical, Inc. (c) 2000

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Ocular Migraines

The classic migraine is a severe headache, which in some instances may be accompanied by nausea. Ocular migraines are visual disturbances in which visual images look gray or have a wavy appearance. They almost always occur in only one eye. Other common symptoms are loss of vision, particularly in one eye, and increased sensitivity to bright lights. The visual distortion, when it occurs, normally starts in central vision and then moves off to one side.

The ocular migraine can occur either in conjunction with the common migraine or without the corresponding headache. Generally, when it accompanies the common migraine, the visual disturbances happen before the onset of headache symptoms. In younger people with common migraine, it is typical for the ocular migraines to also occur. As people age, it becomes more common to experience ocular migraines without headache symptoms.

In general there is no serious complications caused by ocular migraine. Treatment, in most instances, is not necessary unless the ocular migraine is linked to the common migraine.

Patient Education Library reprinted with permission of Einstein Medical, Inc. (c) 2000

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Posterior Capsulotomy

What is the Capsule?

The natural lens of the eye is held in place by a thin clear membrane called the lens capsule. The capsule completely surrounds the lens and separates it from the thick fluid in the back of the eye, called the vitreous, and the thinner fluid in the front of the eye, called the aqueous.

Cataract Surgery Effects the Capsule

Cataract surgery is necessary when the natural lens become cloudy and must be removed. When cataract surgery was originally performed, surgical techniques were not as refined as today, and both the natural lens and the capsule were removed during surgery. Newer techniques allow the capsule to remain in the eye and hold the implanted lens (or intraocular lens, IOL) in place. Leaving the capsule in place during surgery is a great advancement because it allows the vision after surgery to be more stable and provides for less surgical complications.

Sometimes the posterior, or back, portion of the capsule becomes cloudy after cataract surgery. The reasons for this cloudiness are unknown. If the posterior capsule becomes so cloudy that it detrimentally effects vision, then a capsulotomy is performed.

What is a Capsulotomy?

A capsulotomy is a procedure in which an opening is created in the center of the cloudy capsule. The opening allows clear passage of the light rays and eliminates the cloudiness that was interfering with the vision. A laser beam is used to create this opening. This procedure is painless, very safe and typically the results can be seen immediately. For capsulotomy, as with any surgery, rare complications can occur, such as swelling or retinal detachment. These complications can cause loss of vision.

A cloudy capsule will may times appear the same way as the original cataract. The vision is cloudy or hazy and the patient is heavily bothered by glare. In fact, vision is so similar that some patients think that the cataract has come back or regrown. This is impossible, cataracts cannot return once the natural lens has been removed.

If your vision is getting worse after cataract surgery, it could be that your capsule is becoming cloudy. Your eye doctor should give you a thorough eye examination to determine the cause of your vision loss. If your capsule is becoming cloudy, your eye doctor can then determine whether a capsulotomy is necessary to improve your vision.

Patient Education Library reprinted with permission of Einstein Medical, Inc. (c) 2000

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Retinitis Pigmentosa

The retina lies in the back of the eye and is a multi-layered tissue which detects visual images and transmits them to the brain. Retinitis pigmentosa (RP) refers to a group of related diseases which tend to run in families and cause slow but progressive loss of vision. In retinitis pigmentosa, there is gradual destruction of some of the nervous sensors in the retina.

The first symptoms usually occur in youth or young adulthood, although it may be first seen at any age. Retinitis pigmentosa causes night blindness and loss of side vision. In normal persons, the visual system adjusts to darkness after a short period of time. People with night blindness adjust to darkness very slowly, or not at all. Due to the loss of side vision (peripheral vision) in patients with retinitis pigmentosa, mobility becomes more difficult.

Most forms of retinitis pigmentosa are inherited. Different patterns of heredity are associated with different degrees of progression. An attempt to know more about how severely the disease has affected other family members may help predict how a specific person might ultimately be afflicted, though variability exists within each family. Such knowledge is also helpful in making decisions about such things as marriage, family and occupation.

In general, there is no specific treatment. Recent research suggests that some patients may benefit from certain kinds of vitamin therapy. But these studies are not conclusive. Much research is directed toward solving this problem. Periodic examinations by an eye doctor are advised.It is important to keep in mind that patients with retinitis pigmentosa may develop other treatable disease, such as glaucoman or cataracts. Low vision aids may be prescribed. In some cases, retinitis pigmentosa may be associated with other disease processes which might need evaluation by other medical specialists.

Despite visual impairment, the many rehabilitative services that are available today allow patients with retinitis pigmentosa to live meaningful and rewarding lives.

Patient Education Library reprinted with permission of Einstein Medical, Inc. (c) 2000

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