Check Yourself For Dry Eye Syndrome Symptoms

Optometrists Find High Incidence of Eye Growths and Bumps on White of Eyes in Northern Colorado are Benign & Often Pinguecula

A large number of people in the Fort Collins show up at the optometrists office with benign growths on the white part of their eye referred to as pingueculas. Actually they develop on the conjunctiva, the clear tissue that covers the white part of the eye (the sclera). Often they appear as mildly elevated yellowish bumps, visible to the patient or a family member with a urgent rush to the eye doctor. Often people are reluctant to discuss their concerns hoping it will be found during an eye exam. You should not hesitate to mention this at the beginning of you visit to the optometrists office. Because they are so common, you eye doctor may not mention the presence of a pinguecula on your eye unless you ask. While most optometrists find pingueculas developing in patients eyes who are over the age of 40, it is becoming more common to see them by the mid twenties. They are presumed to be caused by a UV radiation from the sun and low level irritants like dust and small particles in the wind. The incidence increases closer to the equator. Fort Collins East of I-25 they are extremely common due to the farming industry with people spending larger amounts of time outdoors and in dusty environments. People who spend their leisure time on motorcycles are also more at risk due to the ultraviolet exposure and particles from the blowing wind.

What Causes Eye Growths of Pingucula

Just as skin loses is capacity to stretch with age, so does the conjunctival tissue when it is exposed to sunlight and irritation over a cumulative period of years. In Northern Colorado people frequently visit doctors for skin changes that are essentially occurring from the the same as the eye conjuntival changes.

Eye Doctors have found the elastosis, or the capacity of the tissue to smoothly stretch and return to normal is compromised from changes to the conjunctival tissue. Collagen forms the framework, but elastin protein fibers around the collagen fibers provide the stretching capacity. The UV radiation in Fort Collins is higher due to the altitude, reflections from snow, and the amount of time we spend outdoors. With close to 300 days a year of sunshine the UV exposure is higher than most areas at a similar latitude. Altitude increases the UV dosage by 4-5% /1000 feet of elevation gain. Compared to sea level this adds approximately 25% above sea level exposures.

First there is an accumulation of abnormal cells that are altered elastin and / or collagen.  Eventually the area starts to lose cells and becomes more of a deposit of protein materials often referred to as hyaline deposits. Calcification can occur over time also. Several theories have been proposed by eye research clinics for the changes seen in the tissues that form the pinguecula.  This UV radiation and low level chronic irritation causes changes that may be:

1. An increase in the production of elastin fibers by the fibroblast cells and changes to the elastin nature into a more twisted form as they replace some of the collagen fibers. This may induce degenerative changes to the collagen fibers.
2. A interference with the natural cycle of cell programmed cell death of elastin resulting in an overproduction that takes on the abnormalities.
3. A degradation of the collagen fibers into a compromised form resembling elastin.
4. A combination of the above

Other factors may make the conjunctival tissue more susceptible to forming pinguecula.

1. Since the conjunctiva tissue does not have the tough keratin layer like the skin it is damaged faster by UV radiation.
2. The clear conjunctiva tissue is also transparent and the solar radiation that is not absorbed passes through to the sclera. We know from science that color of the surface being irradiated has a large bearing on the amount of back reflected radiation including UV.[1]   It is a very thin tissue, and the white scleral tissue underneath it with it’s white coloration should have an albedo in the range of 80-90% similar to the reflectance of snow. Measured animal studies of conjunctival tissue reflectivity across the 440 to 1000+nm range shows a steady reflectance of above 40%. Somewhere between 40 to 80 percent of the UV radiation is being added to the initial dose as it passes through. This extra back reflection of UV into the conjunctiva tissue also increases the exposure and ages the tissue faster than skin.
3. Eye conditions that increase the size of the fissure, or how wide your eye stays open, also will increase the incidence of pinguecula. Thyroid eye disease and eyes that are not as deeply recessed (the beady eyed individual with a protruding eyebrow to shadow the eye) or more likely to develop pinguecula. Studies have shown an increase in pinguecula in patients with Thyroid Orbitopathy (hyperthyroid or an overactive thyroid gland that effects the eye) that is only significant with the widened eye fissure or amount of the eye normally exposed when open). Increased dry eyes was not correlated further suggesting UV exposure as a causative factor. [5]
4. The nose acts to reflect more light onto the eye somewhat like a dull mirror, and pinguecula are more commonly found on the white side closest to the eyes, but they are also found on the temporal side.
5. The deeper, or basal layers of the superior nasal conjunctival tissue contain more dendritic cells. Dendritic cells are a type of antigen-presenting cell (APC). Antigens are molecules or molecular fragments that bind to a site on on the surface of cells, and except for autoimmune diseases they are the molecules from outside the body. Dendritic cells present them to the T helper cells that increase the immune response and that cause an increase in inflammatory cells. The tears flow towards the nose by slight eyelid horizontal movements that accompany each blink. This ensures a continuous flushing of debris and antigens from the tear film, Since the tears flow in this direction logically their would be more dendritic cells to help remove the excess antigens. Due to the density of the dendritic cells and the propensity to create more inflammation, it has been postulated this may increase the overall likelihood of pinguecula forming in the nasal region.
6. Psoralen plus ultraviolet A (PUVA) treatment has been used widely in the past for various dermatoligic conditions. It has seen a reduction in use due to other methods. PUVA uses a photosensitizing agent (8-methoxypsoralen, Oxsoralen®) taken orally or applied to the effected area before exposure to ultraviolet A  light (320-400 nm).  At least one case of pinguecula associated with PUVA has been reported. (the patient was in poor in compliance with eye protection)

Pinguecula Are Always Benign Growths

Once a Pingueclua has been properly diagnosed by your optometrist you can rest assured. Pinguecula are always benign growths and never develop into any form of eye cancer. They can start to grow across the clear cornea tissue on the front of the eye at which point they are referred to as pterygium. Pterygium need to be followed as they need to be removed by an eye surgeon if they approach to close to the line of sight. While the surgical removal is fairly simple, they tend to recur and leave a scar. That leaves a wait and follow choice by your eye doctor. Because they are so slow to develop it is fairly easy to manage. New technology is reducing the recurrence, but remember, the majority of pingueculas don’t develop into pterygiums. In our Fort Collins Eye Clinic we occasionally see patients with symptoms related to pinguecula.

Pinguecula Symptoms and Signs

The elevation may disrupt the normal tear resurfacing on the eye and create an area of dryness and discomfort. It can also result in the edges of soft contact lenses settling poorly on the eye and leaving a gap between the soft contact lens and the conjunctiva. This often results in the lens drying out and the peripheral contact lens edge curling away from the conjunctiva.  Contact lens patients will blink and subsequently the eyelid movement can eject the contact lens. Rigid gas permeable lenses may leave a gap over the conjunctiva and edges of the cornea that dies out and damages the peripheral cornea epithelium surface cells and the conjunctival cells. The edge of the gas permeable lens may also irritate the pinguecula and result in a chronic red eye when contact lenses are worn. This can often be resolved by changing the diameter or size of the gas permeable contact lens.   A test used in research facilities called “tear ferning” evaluates the mucous layer of tears by allowing a  sample to dry on a slide and crystallize. This is often abnormal around pinguecula indicating a mucous irregularity inducing dry eyes. Occasionally pinguecula become inflamed and need prescription eyedrops to restore comfort. The incidence of problems is low and treatable so eye doctors almost never remove a pinguecula.

Optometrists Prevetative Steps For Pinguecula

UV prescription eyeglasses (or non prescription quality sunwear) is the most important preventive step you can take.  Not only will it help prevent pinguecula, but also a number of other eye diseases associated with sunlight exposure. Do a favor for your children and teenagers eye health, start them in prescription sunglasses (transition lenses that lighten and darken also offer UV protection). When you think of sunscreen think of sunscreen for the eyes. The more time you spend in the sun, the more you should think of sunwear that wraps around your face and protects the sides. Up to 40% of the UV exposure can still enter from the unprotected side of a normal pair of eye glasses. Special motorcycle eyeglass frames have become very popular in our Ft Collins Eye Care Center due to the side protection from UV and wind & dust. Wearing a hat with a brow helps reduce UV exposure. Limiting midday sun exposure is very useful when possible. The morning and afternoon sun is lower on the horizon and has a much longer path to travel through the atmosphere which filters out more UV. Don’t avoid the sun totally. While there is much controversy at this point, it does appear that some sun exposure is good for your health, reducing some forms of cancer and possibly decreasing the incidence of multiple sclerosis. While vitamin D may be the protective factor some studies indicate their may be other factors and biochemical involved.  Keep your eyes posted for more eye updates as we learn more about the fascinating world of vision!

References

[1] http://geography.about.com/od/physicalgeography/a/solarradiation.htm

[2} http://www3.interscience.wiley.com/journal/112130369/abstract?CRETRY=1&SRETRY=0

[3] Hoang-Xuan,Thanh;  Baudouin, Christophe     Inflammatory Diseases of the Conjunctiva,  Catherine Creuzot-Garcher

[4] Journal of the American Academy of Dermatology
Volume 57, Issue 1, Pages 177-178 (July 2007)
Pinguecula following psoralen and ultraviolet A therapy
Amit Garg, Michael Loosemore, BAb

[5] Cornea:
June 2010 – Volume 29 – Issue 6 – pp 659-663
doi: 10.1097/ICO.0b013e3181c296ab
Clinical Science
Prevalence of Pinguecula and Pterygium in Patients With Thyroid Orbitopathy
Ozer, Pnar Altiaylik MD; Altiparmak, Ugur E MD; Yalniz, Zuleyha MD; Kasim, Remzi MD; Duman, Sunay MD

Eye Doctors Dry Eye Secret Treatment

Dry eyes can be a very debilitating condition. It is very common in low humidity climates like the Fort Collins area, and it can interfere with contact lens wear and comfort. It can also be a severe problem after LASIK corrective eye surgery. Optometrists have a number of different options to treat dry eye syndrome  and contact lens intolerance today, and TheraTears non preserved artificial tears have proven very useful to eye doctors. TheraTears has some unique properties that can actually help restore the eye tissues instead of just treating the symptoms of burning eyes, gritty eyes, and general discomfort.

The tear film covering the front of the eye has been the subject of extensive study by eye doctors over the last decade. It is composed of a water component, a mucous component, and a lipid component. Every time you blink, your eyes experience a resurfacing of the tear film. When things go right, the new film has adequate water and retains its integrity until your normal blink reflex recurs. When things go wrong comfort and cells that produce the tear components are compromised.

The water component of tears has a normal value for osmolarity which is related to how much the salt concentration is in your tears. When the water levels decrease, the same amount of salt is present so the relative percentage of salt in the tears increases. This draws more water out of the corneal tissue on the front of the eye and can damage the surface cells known as the epithelium layer. The high osmolarity levels also decrease the amount of goblet cells. These are the cells that produce the mucous component of the tear film that makes the tear layer slide out across the eye surface. There are electrolytes like sodium and chloride in the tear film that are essential to keep the osmolarity in a normal range and also help the proteins like lactoferrin dissolve in the tears. Lactoferrin is a protein that fights against bacterial and fungal eye infections. It also serves to reduce eye inflammation. Because the cornea tissue on the front of the eye has no direct blood supply, a healthy tear function is vital to maintain good eye health and vision. Even from this brief view of the tear film, you can see how important it is to your optometrist that this complex system is functioning normally.

So now one of the best kept secrets of eye doctors in treating dry eye disorders and contact lens discomfort-TheraTears

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And there is a little known way of using TheraTears to achieve the correct effects called saturation dosing. Saturation dosing involves taking one vial of TheraTears and emptying it into the eyes over a five minute period for times a day for at least a few weeks. It helps restore the salt content levels back to normal and allows goblet cells to regenerate. It is specially formulated to stay on the eye for about 30 minutes. The electrolyte content is similar to what a normal eye would be so it helps readjust this also. After a few weeks your optometrist can decide when you can discontinue the saturation dosing and start a single drop several times per day. Often the tear film regains a significant amount of its integrity and the burning, dry eye discomfort stops. Sometimes the simple things work best.

There is a new epidemic that is running rampant across the United States. Fortunately it is not contagious and not life threatening like the Swine Flu, but there is a tremendous cost in terms of loss of quality of life and vision. This epidemic is often referred to as Dry Eye Syndrome and effects millions of people with symptoms ranging from mild, vague discomfort to completely disabling pain and chronic blurred eyesight.The Dry Rye Epidemic has multiple causes.

• Time spent by adults on computers and youth on video games dramatically lowers the normal blink rate and causes the eyes to dry out faster than normal.
• Historically, before mass consumption of processed foods, for every unit of omega-3 fat we consumed in our diet we ate 1 to 4 units of omega 6. Today that ratio has shifted to 20-30 times more omega 6 fats in our diets than omega-3. This has caused an outbreak of disease of the eyelid margins and resultant poor tear film quality.
• As the population has aged there has been an increase due to normal, age related decreases in tear production.
• The large increase in prescription medication use has resulted in numerous drugs being used that contribute to dry eyes. Medications for blood pressure, depression, allergies, pain, and many other conditions can have drying effects.
• Millions of women treated with hormonal replacement therapy in the past may have increased the dry eye epidemic.
• With the shift to industrialized society, working indoors the patterns of airflow and humidity have been altered and effect the incidence of dry eyes.
• The long term shift away from water consumption towards caffeinated beverages and colas aggravates dry eyes in some individuals.
• Even the increase in obesity leads to low grade inflammation in the body which can decrease tear production.
• Many eyedrops, prescription and over the counter, can  cause or aggravate dry eyes to the point that some patients discontinue their treatment and suffer sight loss.
• Perhaps the worse culprit in the dry eye epidemic is LASIK eye surgery. The nerves that drive the eyes to blink are cut by the surgery and dryness is a frequent complaint after surgery. The dryness sometimes persists and requires long term treatment.

Fortunately we have many options today, including prescription eye  medications, new contact lens materials, glaucoma  eye drops designed for dry eyes, nutritional supplements, and even  micro-plugs implants for the tear ducts to help increase the basal level of moisture. If you feel you have symptoms of dry eyes please call and request an appointment for a dry eye evaluation. Your vision insurance service plan may provide coverage for dry eye treatment.

Symptoms could be any of the following:

1. Burning or stinging if the eyes
2. Eyes that intermittently water excessivley
3. Eye that feel griity at times
4. Vision that blurs up for brief periods of time
5. Pink or red eyes
6. Vision discomfort that gets worse as the day progresses
7. Developing intolerance to contact lenses
8. An increase in the normal level of itchy eye allergies
9. Frequent styes and eye infections

CALL: 970-226-0959

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Some of the best ideas come from listening to what patients have to say. Here is a simple contact lens tip from a patient. If you are always getting confused about which is your right or left lens there is an easy solution.

Once you receive your annual supply of contact lenses and are comfortable with the prescription, open the boxes and mark each individual lens package with a R or L. A fine tip permanent sharpie marker will adhere to the surface and leave a nice visible letter. For years we have marked the boxes right and left, but once a box is opened the individual lenses can get jumbled up if they fall out of the box. Also, you are forever having to look for which end of the box is marked. With 2-4 week disposable lenses it won’t take but a few minutes to put a large R or L on the individual containers and you are good to go for the rest of the year.

The only caveat is that an open or even marked box cannot be returned. Contact lenses are a medical device and your eye doctors office should have a no return policy on opened boxes. Like a prescription drug, you would not want to place a lens on your own eye that had been to places unknown and then dispensed to you, even if the lens is sealed. There could be bacterial contaminants on the container or it could have been exposed to extremes of heat, cold or other forms of chemical or biological contaminants and body fluids.

With the remarkable strides being made in contact lens comfort technology more people are changing to contact lenses that never would have considered them an option in the past. Don’t assume you are not a candidate for contact lenses because of dry eyes or bifocals. If your optometrist doesn’t discuss the option take the initiative and you may find yourself in the new world of contact lens comfort technology.

Vistakon is releasing a new contact lens called ACUVUE® OASYS^TMfor PRESBYOPIA under the Acuvue Brand. The original Acuvue Bifocal contact lens was made from a material called Etafilcon. It worked by the wonder trademark called Pupil Intelligent Design^TM. The Acuvue Oasys Bifocal is designed on STEREO PRECISION TECHNOLOGY^TM and HYDRACLEAR® PLUS technology.

Hydraclear^TM is a substance incorporated throughout the lens to help it remain moist. Other silicone hydrogel lenses use plasma surface treatments to help overcome the wetting problems that accompany silicone materials. Supposedly, the effect is similar in providing a wettable surface on the lenses.

It is not very clear what STEREO PRECISION TECHNOLOGY^TMmeans. According to VISTAKON® the addition of an aspheric curve on the back of the lens helps eliminate the problems with ghosting. Aspheric curves flatten out as you move away from the edge similar to the shape of the eye. Aspheric lenses can improve vision by more closely resembling the corrective shape the eye needs, but it is not clear how the asphericity has an impact on ghosting. Only time will tell if this is an optical enhancing improvement.The change to the senofilcon A material will be a dramatic improvement in the oxygen permeability,comfort, and eye health the lens delivers. This is a welcome addition to the growing options we have for correcting presbyopia with contact lenses today.
The real innovation the original Avuvue Bifocal Lens contributed was a soft bifocal contact lens in a disposable format at a reasonable price. The secondary advantage was a large range of near prescription powers that could be individually adjusted, a new concept at the time. The lens design has 5 concentric rings of alternating distance and near zones. Theoretically, even if the lens does not center perfectly on the eye there are always sections of distance and near zones of the lens in your line of sight. Of course the disadvantage is there are always sections of distance and near zones of the lens in your line of sight that are responsible for ghost images. Given time, some people will adapt very well to this but in my experience that equates to about 20% of the people who try this design. The new ACUVUE® OASYS^TMfor PRESBYOPIA uses the same concentric ring approach with the added back aspheric surface.

The Acuvue Oasys Bifocal^TMis being produced in the same Senofilcon-A material that has been used in the Acuvue Oasys Lens. This is a silicone hydrogel contact lens that works exceedingly well for about 25% of the patients I see. For the remaining 75% it is OK, just not the dramatic comfort improvement seen in certain individuals. The downside of the material is it tends to develop lens coatings in 10-14 days, sometimes a little shorter than the recommended 2 week replacement cycle.

Overall, this is another addition to help those of us with arms too short that want to continue enjoying the benefits of contact lenses

Welcome to Dr Kisling-Fort Collins Eye Doctors Choice Website. Our vision is to be the premier resource for answers about your eye symptoms and eye problems. You can use the search box to find answers to questions about your eyes. You will find articles on contact lenses, dry eyes, glaucoma, eye nutrition pinkeye ad other eye diseases.

There is also information about eye examinations, eyeglasses, prescription eye glasses for different conditions;nearsightedness,farsightedness, astigmatism, and presbyopia.

We carry a unique selection of eyeglasses for women, men and children with the latest lens technologies including glare free anti-reflection coatings, no line progressive 5th generation eye glass lens designs, transition sunglasses tints, thin and light hi-index prescription lenses.

We also try to make your vision insurance processing as simple as possible. We welcome most insurance including Vision Service Plan (VSP).

If there is a topic you would like more information on please feel free to leave a request in the comment box. Thank you for visiting our website and we hope we can become your partner in preventative eyecare for a lifetime of healthy eyesight!

Twitchy eye? Many people become concerned when they start having an eyelid that twitches intermittently or even constantly. This may occur for weeks, months, or even years. Typically it does not occur constantly and has been coming and going for a month or so when the patient finally show up at the eye doctors office concerned they have acquired a serious vision problem. Most of the time after a lengthy eye exam and detailed analysis an accurate diagnosis is made-benign eye twitch. Essentially that means the doctor has no idea what is causing your eye problem but has ruled out  serious diseases

Sometimes a cause for eye twitching is found. Anything that causes ongoing low grade irritation of the eye can elicit twitches. An eyelash growing in towards the eye, dry eyes, a foreign body such as small particles of vegetation, insects, metal, etc. can all be provoke twitching eye lids. Some prescription medications and serious medical problems can precipitate eye twitches.

A well kept secret today is there are effective treatments for benign eyelid twitches. Specific types of topical antihistamine prescription eye drops frequently can alleviate the twitch, even though an eye allergy is usually not the cause. Reducing stress may help in many cases. Stress reductions techniques that help can include improving your sleep cycle by eliminating caffeine, relaxation techniques, and looking for areas to reduce the areas of high stress in your life. Cool packs on you eyes for 5-10 minutes several times per day can be tried as a palliative measure. Cold compresses probably reduce the nerve transmissions responsible for the eye twitching. If cool packs don’t work, warm packs sometimes will. Artificial non preserved tears can be used several times per day; they are not harmful and if a dry eye is part of the problem they could provide needed relief. Often a placebo effect can occur with artificial tears and is beneficial even when you are aware that it is a placebo.  Medications that can evoke eye twitches include stimulant drugs for attention deficient disorder, medications for Parkinson’s disease, some cold medications, and even asthma inhalers. If the problem is severe you should discuss your medications with your physician.

Some limited studies have shown complimentary alternative medicine may be useful is certain patients. Acupuncture has reportedly helped some people. Most simple eye twitches are probably similar to the twitches you have from time to time in you legs and arms. These are often due to muscle fatigue and electrolyte imbalances. Make sure you are well hydrated and have adequate magnesium, potassium, calcium, and vitamin D in your diet. Some healthy food to add are bananas, raisins, apricots, cantaloupes and leafy green vegetables like spinach. Avocado lovers can benefit also. Gentle stretching of leg muscle spasms has become the accepted standard replacing gentle massaging. You might try the eye equivalent of gentle stretching by slowly closing your eye, pause briefly, then open it slightly larger than normal and pause for a second. Try doing ten repetitions ten time per day.

When eye twitches become severe and spasm the eye closed it can be caused by an over stimulation of the brain center responsible for blinking. This has a genetic predisposition so if you have other family members with similar problems that is significant information you should tell your optometrist. Usually it begins with more frequent blinking and progresses to eye closure spasms. When eyelid twitches become constant and severe, they may keep the eye closed and interfere with vision. Injections of Botox, the face lifting drug, are a tremendous asset in these rare cases. Although many people are frightened by the though of injecting something into their eyelid that is so toxic it is considered a potential terrorist weapon, the doses used resemble homeopathy and are exceedingly safe. It would probably take at least 30 to 40 thousand doses at once to be lethal. Drugs in the same class as valium have had some success in treatment. As a last resort eyelid surgery can be attempted.

Uncontrollable, progressive eye spasms that effect you eye sight need further evaluation for serious underlying neurological diseases. The majority of cases are benign and the initial visit to an eye doctor can help you on the road to recovery.

As we age so do our eyes so it is important to take precautions to avoid certain eye problems. A common eye problem that accompanies aging is  macular degeneration. This eye problem is caused by deterioration of the retinal tissues lining the back of the eye. This is a chronic eye disease with a multitude of evolving forms of treatment. It can give a person blurry vision and blind spots, and involves the central area of vision only. Unfortunately, this small area called the macula is vital for all detailed vision functions including reading. Since most of the retina remains healthy magnification aids can often be used to extend reading images onto the remaining healthy tissue. There are two different kinds of macular degeneration, the dry form and the wet form. The dry form of macular degeneration is less sight threatening and precedes development of wet macular degeneration.

Once macular degeneration transforms into the wet variety it can progress rapidly and cause serious vision complications. This can give you visual distortions such as seeing straight lines being crooked or wavy in appearance. You may notice objects looking very small or being farther away then they really are. You may notice loss of your central vision with blurry spots.

Evidence for nutritional intervention in preventing and treating macular degeneration continues to grow. Low dietary intake of the carotenids lutein and zeaxanthin are associated with an increased risk of age-related macular degeneration and may retard the development and progression of macular degeneration. Lutein and zeaxanthin have high levels   in Broccoli, corn, squash,peas,  and  green leafy vegetables like spinach and kale. Foods with a high glycemic index (sugar rich simple carbohydrate foods that raise blood sugar rapidly) also increase the risk of macular degeneration -eating oatmeal may be good for more than just your heart. Vitamin deficiencies of E,D,and C seem to increase the risk of macular degeneration but vitamin A, especially in smokers may increase your risk for macular degeneration. Omega-3 fatty acids found in cold water fish contain docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA), and may act in a preventative manner for macular degeneration.Coenzyme Q10 and acetyl-L-carnitine supplementation is a potential early intervention. UV and blue light increase risk for macular degeneration so sunwear should start early for children.

If you have dry macular degeneration you may notice blurriness in the words that you read, less color in certain objects and have a harder time recognizing peoples faces. Your vision may start to seem hazy and you will have the need for brighter light. With both kinds of macular degeneration, it may only effect one of the eyes. Sometimes people don’t realize that they have it with the eye that does not have it making up for the eye that is effected.

Another problem with your eyes as you age is cataracts. Cataracts cloud the eye and are a common type of eye problem. There are three basic types of cataracts that you should be aware of which are nuclear sclerosis, cortical and sub-capsular. The nuclear sclerosis cataract forms throughout the lens as a gradual darkening and discoloration. A sub-capsular cataract is at the back of the lens close to the line of sight and may cause vision loss much faster than other types of cataracts. Cortical cataracts start in the cortex of the lens. If you have a cataract you should not be overly concerned, they can be successfully removed by having outpatient surgery and are one of the most successful surgical procedures done today. Artificial lenses are implanted, often with no stitches involved in an outpatient procedure.

Another eye problem you may encounter as you grow older is called dry eye syndrome. As we age, we do not produce as many tears as before. It is known to cause discomfort and pain and can result in serious vision loss in more extreme cases. Treatment is available with a multitude of options. You do not have to suffer from the chronic burning and stinging that accompanies dry eyes. If should have your eyes dilated every one to two years by your optometrist to check for these eye problems and other diseases that can compromise your vision irreversibly. Prevention is the best gift you can give your family and yourself.

David H. Kisling, O.D., A.B.D.A.
Fort Collins Eye Doctors

Fort Collins Contact Lens

Vision Service Plan Provider

The sudden appearance of a red spot on the white of your eye can be very unnerving as it appears that the eye is bleeding. When it materializes without a history of trauma or other health problems, there is usually not a serious problem. Still, is hard to imagine anything more disturbing to look at than a blood red eye.

The Front of your eye has a mucous membrane layer called the conjunctiva. This thin transparent tissue forms a loose covering over the white part of the eye, the sclera, and extends under the eyelids. It has a thin layer of surface cells called the epithelium and a layer of connective tissue below this where small blood vessels,nerves, goblet cells (that secrete mucous) are located. The conjunctiva is extremely sensitive to inflammation because of a large number of mast cells(the cells that release histamine when you are exposed to an allergen).

Since the conjunctiva is loosely bound to the underlying sclera there is a potential space for blood to accumulate in.  The small blood vessels in the tissue are capillaries, and they have fenestration to allow fluid exchange. Because they are so small and are subject to more movement and subsequent shearing forces in the loose conjunctiva tissue, it is not uncommon for a vessel to break and bleed. This blood spreads out in the space underneath the conjunctiva and appears to be a much larger volume than it is due to the thinness of the film of blood.

A number of events can trigger a hemorrhage under the conjunctiva.  Coughing, vomiting, sneezing, straining for a bowel movement all increase blood pressure temporarily and can cause a sub-conjunctiva hemorrhage. Some  activities such as rides at amusement parks with rapid acceleration and deceleration  increase the blood pressure in the thoracic cavity and the head, which has been shown to cause  hemorrhages. Merry go rounds can have the same effect. Rubbing your eyes may also mechanically burst a capillary as can any form of trauma to the eye.

Conjunctiva  hemorrhages are not painful and do not lead to sight loss. They are equivalent to a bruise and undergo color changes over several weeks as they resolve and gradually reabsorb.

Any bleeding seen on the eye needs a thorough eye examination by your eye doctor to rule out other serious problems. Trauma could cause an unknown eye perforation that results in blindness if not treated. Any recurrent episodes warrant evaluation for underlying problems and diseases that make you more susceptible to having fragile blood vessels.

High blood pressure, arteriosclerosis (accumulation of cholesterol on your blood vessels), some types of blood cancers,diabetes,HIV and other diseases increase the frequency of conjunctiva hemorrhages. Drugs can cause hemorrhages including blood thinners (Coumadin), aspirin, ibuprofen (Advil), and even Birth Control Pills in rare instances. Some systemic diseases; flu,measles, malaria, and rare viruses similar to Ebola are factors.
Conjunctival hemorrhage has been reported as a result of embolism from breoken bones and different types of surgery.

Some viral eye infections can cause  hemorrhagic conjunctivitis. Acute hemorrhagic conjunctivitis is a specific viral disease seen more commonly in lessor developed countries and is characterized by large outbreaks of eye infections with conjuctival hemorrhages.

One other rare cause of  conjunctiva hemorrhage is referred to as Vicarious Menstruation. Little or no uterine bleeding occurs but bleeding occurs monthly and can occur almost anywhere on the body, though it is more common in the respiratory track,noes, gums, and conjunctiva. There have been patients who have eye hemorrhages every month at the time of their menstrual cycle.

Relax, Call the office and let us take a look at your eye. The odds are overwhelming it is an innocuous event that will causes you no problems other than a slightly scary looking eye.  Although occasionally a torn contact lenses edge can cause the problem, it is often not necessary to stop wearing contact lenses for the eye to heal. If you have teenagers tell them “Twilight” wasn’t really fictions after all!

The conjunctiva tissue is small but vital to keeping mucous on your eye surface for a healthy tear film, allows the eyelid to smoothly resurface the cornea on and keep your vision clear, while preventing dry eyes. It is very active in the eyes own immuine system. Make sure you keep it healthy with routine eye check ups. Most vision insurance plans like Vision Service Plan (VSP) provide well coverage visits.