Eye Problems From New Antidepressant Viibryd

June 23, 2011 By 1 Comment

New Antidepressant Viibryd Hits Shelves And May Hit Eyes

 

A new potentially lock buster drug for depression has started showing up in pharmacies recently. Viibryd (vilazodone hydrochloride) improves mood disorders by decreasing the transport of seratonin for reuptake, thus leaving more of the feel good chemical to act on nerve synapses. At the same time it exerts a stimulating effect on the cells that serve as receptors for promulgation of the effect into the emotional regions of the brain. The reported lack of sexual side effects have held high hopes for an enormous  success with its introduction.

One area of concern with Viibryd is ocular side effects

Opacities on the cornea were observed in early clinical trials. There were small reductions in the tear film levels with a small increase in dry eye symptoms. The dryness may be causing some mild corneal opacitites. Some cases of cataracts were noted worsening during the trial period. Of note, no cataracts were seen developing after the study had started.

Antidepressant Eye Side Effects Appear Mild For Now

The final answers will take some time with viibryd being used in larger numbers in the general population. Presumably, there will be a low incidence of dry eye complication in some patients. Hopefully this will be mild enough to not result in anyone dropping out of treatment. Cataract progression is a bit more tricky. Since most cataracts are related with age and do progress over time there will need to be very robust studies to determine if Viibryd has any influence on changes in cataracts. Until then, lets hope this is a great  new product without many significant side effects!

 

Filed Under: Dry Eyes, Fort Collins Eye Doctor, Stinging Eyes Tagged With: , , , , , , , , , , , , , , , , , , , ,

Keratoconus Eye Doctors Treatments Today

August 1, 2010 By 2 Comments

Keratoconus | Eye Doctors Contact Lenses And New Options For Treatment

Kerataconus in the Human EyeKeratoconus is an eye disease that causes vision to gradually worsen over time, as the transparent corneal tissue that covers the front of the eye thins and bulges forward, forming the cone shape that keratoconus is named for.

Eye Doctors find rapid increases in nearsightedness and astigmatism are common with frequent changes in your eyeglass prescription. Scarring of the cornea can also occur in some cases resulting in significant vision loss.


Fort Collins Keratoconus Cases Probably Effect At Least 200-400 Individuals |Tell Your Eye Doctor If You Notice These Symptoms:

  • The appearance of long light streaks in your eyesight at night
  • Visual Glare and halos around lights, especially car headlights and taillights at night
  • Double Vision
  • Distorted Vision
  • Blurry Vision making it difficult to read
  • Ghost like images of white light surrounding objects you are viewing
  • Eye sensitivity to light

    • Eye Doctors Agree Keratoconus usually shows up most commonly between the teenage years of 16 up to age 30

    When this corneal eye disease manifests at earlier ages optometrists often find a more aggressive form with ongoing, frequent changes in your eyeglass or contact lens prescription. The best guess is the occurrence rate is about 1 in 2000 people.

    Optometrist And Eye Research Institutes Know Surprisingly Little About Keratoconus But Knowledge Is Starting To Grow

    It is hard for eye doctors to pin down the exact rate of this eye disease because it can be very mild and remain undiagnosed, especially when it burns out early (form fruste), or stops progressing after several years. Corneal Keratoconus creates irregular astigmatism, causing curvatures on the cornea tissue that are not nice smooth curves. Instead the eye curvature resembles the surface of a potato with dips and valleys on a very irregular shape. This type of shape makes it very difficult for your optometrist to provide a prescription for eyeglasses that results in clear vision. The lenses would have to be made in very strange shapes to result in clear vision. Even lenses that have been designed in this manner are rendered ineffective the moment your eyes look off the center of the lens. Irregular astigmatism also occurs without keratoconus, but it does not tend to progress and result in the characteristic steepening of the cornea resembling a cone shaped area. Usually keratoconus presents in one eye and over time well over half of the eye patients will have both eyes involved.

    In the past, much speculation centered around eye rubbing and ocular allergies. Some eye physicians have speculated that Keratoconus is triggered by eye rubbing that starts an inflammatory cascade in the cornea. Frequent eye rubbing also could cause mechanical tissue breakdown in areas of the cornea that are already compromised. Research by eye doctors has shown between 6-8% of patients with keratoconus have a family history, indicating there can be strong genetic components in a small percentage of families. Over 90% of the time if you have Keratoconus it is unlikly to be passed on to your children. Several areas of chromosomes have been identified as potential genetic markers and are being investigated further.

    Also, certain eye diseases such as retinitis pigmentosa, retinopathy of prematurely (damage to the retina tissue in the back of the eye from premature birth), Leber’s congenital amaurosis (a degenerative disease of the optic nerve), and vernal keratoconjunctivitis (a type of allergic eye disease) appear to occur more frequently in conjunction  with Keratonus.

    Some disease of the body also have a degree of co-occurrence with Kerataconus- Ehlers-Danlos syndrome, Down syndrome, osteogenesis imperfecta, pseuodoxanthoma elasticum), mitral valve prolapse in the heart, Laurence-Moon-Biedl syndrome, Rieger’s syndrome and neurofibromatosis. Several of these diseases interfere with normal collagen development and may precipitate kerataconus by disrupting collagen development in the cornea.

    The changes to the cornea from Kerataconus are mostly unknown. The cornea consists of 5 layers and is about 1/2 mm thick (550 microns or about the width of 5 human hairs). The epithelium layer is the surface layers of cells. Underneath the eyes epithelium layers is a thin basement membrane sitting on the anterior limiting membrane, also know as bowman’s membrane. The bulk of the corneal thickness is in the stromal layer, where the collagen protein fibers run across the cornea, adding the tensile strength. Tensile strength is the degree a material can be stressed and still return to it’s original state and shape. Collagen is the memory material of the cornea. The structure of collagen changes in the center area of the cornea with shorter fibers, that cross more, run at different angles, run though each other, form connections to Bowmans membrane, and also form connections originating from Bowman’s membrane. It has been suggested from research by Jan P.G. Bergmanson, OD, PhD, PhD h.c, DSc, & Jessica H. Mathew, OD that this alteration in structure near the central cornea may help explain the nature of Keratoconus in the future, With shorter fibers running in differing directions with various connections the central cornea would seem to be more prone to breakdown of the normal collagen structure. Optometrists have found the bulging cone area characteristic of Keratoconus cones usually form close to the central cornea, slightly inferior, which seems to substantiate the altered central corneal tissues may play a part in the eye condition. Early changes may occur in the surface epithelial cells disrupting the basement membrane. When keratoconus begins, whatever the cause may be, protein damaging enzymes called proteases increase and start damaging the epithelial basement membrane. This is the membrane formed underneath the lowest level of epithelial cells. Subsequent breaks in the corneal anterior limiting membrane occur and the cornea starts to thin centrally, probably due to the susceptibility of the different surface anatomy of the collagen fibers under lying Bowman’s membrane. As these breaks occur the surface epithelial cells can contact the stromal level of the cornea where most of the structural framework of this eye tissue is located. Small proteins called cytokines are released and alter the fluids around the cells, leading to scarring of the cornea.  Stromal fibers may move through the anterior limiting membrane. Whatever the cause, a disruption of the normal collagen structure causes the memory shape to lose its capacity and irregular shaped corneas to subsequently develop. There are indications of changes in the different enzymes that degrade proteins and induce changes in the collagen and the spaces surrounding the cells in the cornea. Cathepsins are one type of protein that increase as kerataconus starts to occur. These could lead to destruction of the so called extra cellular matrix, the substances surrounding the cells and lead to degenerative effects in the cornea.
    They may also indirectly cause a reduction in the antioxidants and increase oxidative damage to the cornea, another theory that has been proposed. Matrix metalloproteinase-2 is also activated and changes the extra cellular matrix surrounding the corneal cells. Keratocytes are numerous cells in the cornea that produce the collagen for the fibers and the extracellular matrix components, turning mostly dormant by birth. In Kerataconus they have been observed to have increased apoptosis (increased programmed cellular death). There is a reduction in the number of collagen fiber and they also reduce in diameter. While there is little indication of dry eye causing Keratoconus, at our Dry Eye Institute of Northern Colorado, we do seem to see a possible correlation. Dry Eye Syndrome increases inflammatory compounds in the tear film that do cause cellular damage in the epithelium layers. It is possible this could start the cycle of damage that  helps initiate damage to the eye that optometry eye exams have found over the years. While this has not been suggested yet, there is a reasonably high level of floppy eyelid syndrome associated with obstructive sleep apnea and Keratoconus. Eye researchers Cintia S De Paiva, Lindsey D Harris, and Stephen C Pflugfelder have demonstrated it is possible that eyes exposed at night by staying partially open can create Keratoconus like change in the cornea. Most likely, keratoconus will be found to be several different disease processes and also multifactoral. Multifactoral eye diseases have multiple factors that combine to create the eye condition. For instance, the different collagen structure in the central cornea makes the eye susceptible, changes in enzymes may alter the tissues and start causing minor breakdowns in the epithelial surface cells, enzyme changes may lead to increased oxidative stress further weakening the eye tissue, and constant rubbing of the eyes may push the eyes over the edge by inducing mechanical damage to the eye tissues that could only occur with a compromised cornea. A genetic alteration of the cornea could make the cornea of the eye more susceptible to the entire chain of events.

    Your eye doctor will initially treat Kerataconus with contact lenses. Treatment of Kerataconus usually begins with a rigid gas permeable contact lens when vision can no longer be maintained clearly with spectacle lenses. Sometimes, a gas permeable lens will be fit over the top of a soft contact lens in a piggyback contact lens fitting, with a soft contact lens and a rigid gas permeable contact lens on top of it. While used years ago, piggyback contact lens fittings fell out of favor due to the complications from reduced oxygen flow with older soft contact lenses. With the new super oxygen permeable silicone hydrogel soft contact lenses, it is enjoying a small resurgence. It is primarily used to increase eye comfort for the keratoconic eye patient. There are also combination contact lenses available today, such as the SynergEyes contact lens that is a rigid contact lens with a soft skirt attached surrounding the lens. The primary issue with Kerataconic contact lens fittings is matching the steeply curved cone with the surrounding flatter eye tissue, while dealing with the irregularities of curvature that are present. While custom mapping technology is highly touted as the way to achieve the required fit, the truth is observation of contact lenses on a keratoconic eye by an optometrist and adjustments based on how dyes accumulate under the contact lenses is still the most accurate method to achieve an excellent final fit. Due to the drastic changes in curvature the contact lenses require multiple different curves as you move toward the edge of the lens. While many different lenses have been developed with special names as the ultimate Keratoconus contact lens, they are all variations on the basic concept of a steep contact lens center and a gradient of changing curvatures to the edge. Rigid contact lenses work because the light bending capacity of the tears is very close to the light bending capacity of the cornea. The tears fill in between the irregular eye surface and the smooth surface on the back of the lens. This essentially removes the irregular astigmatism and nearsightedness by utilizing the back contact lens surface as a new regular surface where light is altered, and often restores the corrected eyesight close to 20/20. Eye glasses may only achieve 20/40 vision or much worse because the irregular surface remains. Occasionally Scleral rigid gas permeable lenses are used. These are gas permeable lenses larger than normal that extend out onto the white part of the eye. All contact lenses today are gas permeable, or designed to let air pass through to keep the cornea healthy. Soft contact lenses are usually not referred to as gas permeable because of historical changes. Hard lenses were the first contact lenses and they were made of a material that passed no oxygen through the lens. When changes were made to the polymers used to make hard contact lenses that allowed them to breathe or pass needed air to the underlying cornea, they were renamed rigid gas permeable contact lenses. Rigid because they are still a hard material with only 1-2% water, and gas permeable because unlike the older hard contact lenses they now transmitted air to the eyes. Soon they became called by the acronym of RGP’s to save a few words (even prior to the texting era). With time they also came to be referred to as gas perms, in spite of the fact that all soft contact lenses are also gas permeable. Soft contact lenses are never rigid however, as they normally are composed of about 50% water. This softness comes at the price of increased flexibility and they drape across the eye, imitating the irregularities of a Keratoconic cornea and do not correct the vision back to optimum levels. Once your eye doctor has achieved an excellent fit and optimized your contact lens prescription, there may be frequent changes in your contact lens prescription as the Keratoconus goes through progressive changes.

    Your Eye Doctor May Be Able to Avoid Corneal Transplants

    While only 10-20% of eyes will undergo ongoing serious changes, they do present challenges to fitting contact lenses on eyes with Kerataconus. At some point, scarring of the cornea can start to occur and patients become intolerant to contact lenses. In years past, the only remaining option was a corneal transplant. While corneal transplants enjoy a relatively high success rate, there are still risks and problems. Recently there have been some new exciting options starting to evolve.

    Permanent Contact Lenses-Intacs

    Intacs are small rigid half rings similar to portions of a gas permeable contact lens that are implanted in the cornea. They were originally developed to reverse nearsightedness, but did not prove as effective as originally thought and were replaced by LASIK eye correction procedures. A few years ago they found a new use in stabilizing Kerataconus. They are not a cure for Kerataconus, but can restore some more regularity and allow some patients to continue contact lens wear while avoiding a corneal transplant. They also appear to have some effect in decreasing the rate of change in Kerataconus. While they are promoted as being completely removable and reversible if patients have problems, this is not entirely true. About 10-15% of Intacs cause some complications and issues that cannot be resolved if they are removed. Still, it is often a better option than jumping straight to a corneal transplant.

    Kerataconus Corneal collagen cross-linking therapy

    Corneal collagen cross-linking therapy (CXL) is intended to stabilize the tissue by forming more bonds between the existing collagen fibers and also increasing the size of the fibers, making the cornea much firmer and less likely to continue deforming. It involves pretreatment the cornea with riboflavin (Vitamin B2) for 30 minutes then using radiation from the ultraviolet A band light spectrum (normally around 370 nanometers) to increase the cross links over about a 30 minute period. While it has been more extensively in Europe, it is starting to enter the U.S. market. The riboflavin acts to keep the UVA from completely passing through the cornea so the UV can act to create more cross links. Riboflavin also may have a photo reactive effect that further increases cross linking of the collagen bands. Questions still surround this treatment. It is not an FDA approved treatment in the United States but is undergoing clinical trials, and currently is used off label as a treatment for Keratoconus. The FDA (Food and Drug Administration) regulates drugs and medical devices but not eye doctors. Any procedure that uses drugs or medical devices can be performed by an eye doctor if you are properly informed, share in the decision, and it has an acceptable possibility of helping. The riboflavin still allows a significant amount of UVA to pass through the cornea. This could potentially increase future risks for cataract development. UVA with riboflavin is cytotoxic (damaging to cells) and can damage the endothelial cells that line the back of the cornea and are vital for its long term health. Corneal thickness needs to be factored in to keep this type of damage far enough away from the endothelium cells of the cornea. A minimum corneal thickness of 400 microns has been suggested but a better choice would be 450 to 500 microns. Cellular damage to the keratocytes, changes to the matrix of the cornea, and changes to the epithelium do occur in the cornea after the procedure. Normally they regenerate over the next 6 months. Riboflavin has poor penetration into the cornea so the surface layers of epithelium cells need to be removed. It is unknown if the effect of increased rigidity created by this treatment will last indefinitely, or if there are any other long term problems from increasing the cross linking and rigidity of the cornea. Some cases of persistent haze, infections, and increased eye pressure reading have been noted. The increased eye pressures may be partially due to an artifact since we know thicker (more firm) corneas read artificially high with most current glaucoma instruments. With careful consideration about the stage of Keratoconus and treatment of the eye at the appropriate stage, cross linking of collagen fibers in the cornea appears to be a great addition to eye doctors armetarium in treating keratoconus. While it may improve the condition mildly in many patients, it should always be considered as a stabilizing treatment and not a curative treatment.

    New treatments for Keratoconus and other eye diseases are improving at a rapid rate. If you are a family members have concerns about Keratoconus, feel free to contact Dr David Kisling in Fort Collins, Colorado at (970) 225-0959.

Filed Under: Contact Lenses, Corneal Transplants, double vision, Eye Surgery, Eye Symptoms, Keratitis, Uncategorized Tagged With: , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , ,

Kerataconus New Treatments

May 16, 2010 By Leave a Comment

Keratoconus | Eye Doctors Contact Lenses and New Options for Treatment

Keratoconus Courtesy of Indiana University Department of Ophthalmology

Keratoconus is an eye disease that causes vision to gradually worsen over time, as the transparent corneal tissue that covers the front of the eye thins and bulges forward, forming the cone shape that keratoconus is named for. Rapid increases in nearsightedness and astigmatism are common with frequent changes in your eyeglass prescription. Scarring of the cornea can also occur resulting in significant vision loss.

Keratoconus Symptoms Your Optometrist may discuss

  • The appearance of long linear light streaks in your eyesight at night
  • Visual Glare and halos around lights, especially car headlights and taillights at night
  • Double Vision
  • Distorted Vision
  • Blurry Vision making it difficult to read
  • Ghost like eye images of white light surrounding objects you are viewing, sometimes noticed as multiple dots when viewing on small light image-can be seen with one eye
  • Eye Sensitivity to light
  • Eye Doctors Agree Keratoconus usually show up most commonly between the teenage years of 16 up to age 30

When this corneal eye disease manifests at earlier ages optometrists often find a more aggressive form with ongoing, frequent changes in your eyeglass or contact lens prescription. The best guess is the occurrence rate is about 1 in 2000 people. It is hard for eye doctors to pin down the exact rate of this eye disease because it can be very mild and remain undiagnosed, especially when it burns out early (form fruste), or stops progressing after several years. Corneal Keratoconus creates irregular astigmatism, causing curvatures on the cornea tissue that are not nice smooth curves. Instead the eye curvature resembles the surface of a potato with dips and valleys on a very irregular shape. This type of shape makes it very difficult for your optometrist to prescribe an eye prescription for eyeglasses that results in clear vision. The lenses would have to be made in very strange shapes to result in clear vision. Even lenses that have been designed in this manner are rendered ineffective the moment your eyes look off the center of the lens. Irregular astigmatism also occurs without kerataconus, but it does not tend to progress and result in the characteristic steepening of the cornea resembling a cone shaped area. Usually kerataconus presents in one eye and over time well over half of the eye patients will have both eyes involved.

The cause of Kerataconus and the changes in the cornea are surprisingly not well known by the optometric research clinics at this time. In the past, much speculation centered around eye rubbing and ocular allergies. Some eye physicians have speculated that Keratoconus is triggered by eye rubbing that starts an inflammatory cascade in the cornea. Frequent eye rubbing also could cause mechanical tissue breakdown in areas of the cornea that are already compromised. Research by eye doctors has shown between 6-8% of patients with kerataconus have a family history, indicating there is a genetic component in some cases. Several areas of chromosomes have been identified as potential genetic markers and are being investigated further. Also, certain eye diseases such as retinitis pigmentosa, retinopathy of prematurely (damage to the retina tissue in the back of the eye from premature birth), Leber’s congenital amaurosis (a degenerative disease of the optic nerve), and vernal keratoconjunctivitis (a type of allergic eye disease which creates itchy eyes and frequent) appear to have some correlation. Some disease of the body also have a degree of co-occurrence with Keratoconus- Ehlers-Danlos syndrome, Down syndrome, osteogenesis imperfecta, pseuodoxanthoma elasticum), mitral valve prolapse in the heart, Laurence-Moon-Biedl syndrome, Rieger’s syndrome and neurofibromatosis. Several of these diseases interfere with normal collagen development and may precipitate kerataconus by disrupting collagen development in the cornea.

The changes to the cornea from Keratoconus are mostly unknown. The cornea consists of 5 layers and is about 1/2 mm thick (550 microns or about the width of 5 human hairs). The epithelium layer is the surface layers of cells. Underneath the eyes epithelium layers is a thin basement membrane sitting on the anterior limiting membrane, also know as bowman’s membrane. The bulk of the corneal thickness is in the stromal layer, where the collagen protein fibers run across the cornea, adding the tensile strength. Tensile strength is the degree a material can be stressed and still return to it’s original state and shape. Collagen is the memory material of the cornea. The structure of collagen changes in the center area of the cornea with shorter fibers, that cross more, run at different angles, run though each other, form connections to Bowmans membrane, and also form connections originating from Bowman’s membrane. It has been suggested from research by Jan P.G. Bergmanson, OD, PhD, PhD h.c, DSc, & Jessica H. Mathew, OD that this alteration in structure near the central cornea may help explain the nature of Keratoconus in the future, With shorter fibers running in differing directions with various connections the central cornea would seem to be more prone to breakdown of the normal collagen structure. Optometrists have found the bulging cone area characteristic of Keratoconus cones usually form close to the central cornea, slightly inferior, which seems to substantiate the altered central corneal tissues may play a part in the eye condition. Early changes may occur in the surface epithelial cells disrupting the basement membrane. When keratoconus begins, whatever the cause may be, enzymes increase and start damaging the epithelial basement membrane. This is the membrane formed underneath the lowest level of epithelial cells. Subsequent breaks in the corneal anterior limiting membrane occur and the cornea starts to thin centrally, probably due to the susceptibility of the different surface anatomy of the collagen fibers under lying Bowman’s membrane. As these breaks occur the surface epithelial cells can contact the stromal level of the cornea where most of the structural framework of this eye tissue is located. Small proteins called cytokines are released and alter the fluids around the cells, leading to scarring of the cornea.  Stromal fibers may move through the anterior limiting membrane. Whatever the cause, a disruption of the normal collagen structure causes the memory shape to lose its capacity and irregular shaped corneas to subsequently develop. There are indications of changes in the different enzymes that degrade proteins and induce changes in the collagen and the spaces surrounding the cells in the cornea. Cathepsins are one type of protein that increase as kerataconus starts to occur. These could lead to destruction of the so called extra cellular matrix, the substances surrounding the cells and lead to degenerative effects in the cornea.
They may also indirectly cause a reduction in the antioxidants and increase oxidative damage to the cornea, another theory that has been proposed. Matrix metalloproteinase-2 is also activated and changes the extra cellular matrix surrounding the corneal cells. Keratocytes are numerous cells in the cornea that produce the collagen for the fibers and the extracllular matrix components, turning mostly dormant by birth. In Keratoconus they have been observed to have increased apoptosis (increased programmed cellular death). There us a reduction in the number of collagen fiber and they also reduce in diameter. Most likely, keratoconus will be found to be several different disease processes and also multifactoral. Multifactoral eye diseases have multiple factors that combine to create the eye condition. For instance, the different collagen structure in the central cornea makes the eye susceptible, changes in enzymes may alter the tissues and start causing minor breakdowns in the epithelial surface cells, enzyme changes may lead to increased oxidative stress further weakening the eye tissue, and constant rubbing of the eyes may push the eyes over the edge by inducing mechanical damage to the eye tissues that could only occur with a compromised cornea. A genetic alteration of the cornea could make the cornea of the eye more susceptible to the entire chain of events.

Your eye doctor will initially treat Keratoconus with contact lenses

Treatment of Keratoconus usually begins with a rigid gas permeable contact lens when vision can no longer be maintained clearly with spectacle lenses. Sometimes, a gas permeable lens will be fit over the top of a soft contact lens in a piggyback contact lens fitting, with a soft contact lens and a rigid gas permeable contact lens on top of it. While used years ago, piggyback contact lens fittings fell out of favor due to the complications from reduced oxygen flow with older soft contact lenses. With the new super oxygen permeable silicone hydrogel soft contact lenses, it is enjoying a small resurgence. It is primarily used to increase eye comfort for the keratoconic eye patient. There are also combination contact lenses available today, such as the SynergEyes contact lens that is a rigid contact lens with a soft skirt attached surrounding the lens. The primary issue with Keratoconic contact lens fittings is matching the steeply curved cone with the surrounding flatter eye tissue, while dealing with the irregularities of curvature that are present. While custom mapping technology is highly touted as the way to achieve the required fit, the truth is observation of contact lenses on a keratoconic eye by an optometrist and adjustments based on how dyes accumulate under the contact lenses is still the most accurate method to achieve an excellent final fit. Due to the drastic changes in curvature the contact lenses require multiple different curves as you move toward the edge of the lens. While many different lenses have been developed with special names as the ultimate Keratoconus contact lens, they are all variations on the basic concept of a steep contact lens center and a gradient of changing curvatures to the edge. Rigid contact lenses work because the light bending capacity of the tears is very close to the light bending capacity of the cornea. The tears fill in between the irregular eye surface and the smooth surface on the back of the lens. This essentially removes the irregular astigmatism and nearsightedness by utilizing the back contact lens surface as a new regular surface where light is altered, and often restores the corrected eyesight close to 20/20. Eye glasses may only achieve 20/40 vision or much worse because the irregular surface remains. Occasionally Scleral rigid gas permeable lenses are used. These are gas permeable lenses larger than normal that extend out onto the white part of the eye. All contact lenses today are gas permeable, or designed to let air pass through to keep the cornea healthy. Soft contact lenses are usually not referred to as gas permeable because of historical changes. Hard lenses were the first contact lenses and they were made of a material that passed no oxygen through the lens. When changes were made to the polymers used to make hard contact lenses that allowed them to breathe or pass needed air to the underlying cornea, they were renamed rigid gas permeable contact lenses. Rigid because they are still a hard material with only 1-2% water, and gas permeable because unlike the older hard contact lenses they now transmitted air to the eyes. Soon they became called by the acronym of RGP’s to save a few words (even prior to the texting era). With time they also came to be referred to as gas perms, in spite of the fact that all soft contact lenses are also gas permeable. Soft contact lenses are never rigid however, as they normally are composed of about 50% water. This softness comes at the price of increased flexibility and they drape across the eye, imitating the irregularities of a Keratoconic cornea and do not correct the vision back to optimum levels. Once your eye doctor has achieved an excellent fit and optimized your contact lens prescription, there may be frequent changes in your contact lens prescription as the Keratoconus goes through progressive changes.

Your Eye Doctor May Be Able to Avoid Corneal Transplants

While only 10-20% of eyes will undergo ongoing serious changes, they do present challenges to fitting contact lenses on eyes with Keratoconus. At some point, scarring of the cornea can start to occur and patients become intolerant to contact lenses. In years past, the only remaining option was a corneal transplant. While corneal transplants enjoy a relatively high success rate, there are still risks and problems. Recently there have been some new exciting options starting to evolve.

Permanent Contact Lenses-Intacs

Intacs are small rigid half rings similar to portions of a gas permeable contact lens that are implanted in the cornea. They were originally developed to reverse nearsightedness, but did not prove as effective as originally thought and were replaced by LASIK eye correction procedures. A few years ago they found a new use in stabilizing Kerataconus. They are not a cure for Keratoconus, but can restore some more regularity and allow some patients to continue contact lens wear while avoiding a corneal transplant. They also appear to have some effect in decreasing the rate of change in Keratoconus. While they are promoted as being completely removable and reversible if patients have problems, this is not entirely true. About 10-15% of Intacs cause some complications and issues that cannot be resolved if they are removed. Still, it is a better option than jumping straight to a corneal transplant.

Keratoconus Corneal collagen cross-linking therapy

Corneal collagen cross-linking therapy (CXL) is intended to stabilize the tissue by forming more bonds between the existing collagen fibers and also increasing the size of the fibers, making the cornea much firmer and less likely to continue deforming. It involves pretreatment the cornea with riboflavin (Vitamin B2) for 30 minutes then using radiation from the ultraviolet A band light spectrum (normally around 370 nanometers) to increase the cross links over about a 30 minute period. While it has been more extensively in Europe, it is starting to enter the U.S. market. The riboflavin acts to keep the UVA from completely passing through the cornea so the UV can act to create more cross links. Riboflavin also may have a photo reactive effect that further increases cross linking of the collagen bands. Questions still surround this treatment. It is not an FDA approved treatment in the United States but is undergoing clinical trials, and currently is used off label as a treatment for Keratoconus. The FDA (Food and Drug Administration) regulates drugs and medical devices but not doctors. Any procedure that uses drugs or medical devices can be performed by a doctor if you are properly informed, share in the decision, and it has an acceptable possibility of helping. The riboflavin still allows a significant amount of UVA to pass through the cornea. This could potentially increase future risks for cataract development. UVA with riboflavin is cytotoxic (damaging to cells) and can damage the endothelial cells that line the back of the cornea and are vital for its long term health. Corneal thickness needs to be factored to keep this type of damage far enough away from the endothelium cells of the cornea. A minimum corneal thickness of 400 microns has been suggested but a better choice would be 450 to 500 microns. Cellular damage to the keratocytes, changes to the matrix of the cornea, and changes to the epithelium do occur in the cornea after the procedure. Normally they regenerate over the next 6 months. Riboflavin has poor penetration into the cornea so the surface layers of epithelium cells need to be removed. It is unknown if the effect of increased rigidity created by this treatment will last indefinitely, or if there are any other long term problems from increasing the cross linking and rigidity of the cornea. Some cases of persistent haze, infections, and increased eye pressure reading have been noted. The increased eye pressures are presumably an artifact since we know thicker (more firm) corneas read artificially high with most current glaucoma instruments. With careful consideration about the stage of Keratoconus and treatment of the eye at the appropriate stage, cross linking of collagen fibers in the cornea appears to be a great addition to eye doctors armetarium in treating keratoconus. While it may improve the condition mildly in many patients, it should always be considered as a stabilizing treatment and not a curative treatment.

Future therapies will evolve. Cross linking collagen therapy is still in its infancy. Stem cell and genetic treatments may be seen at some time. Someday we will no longer be treating Keratoconus but acting to prevent it from ever distorting peoples vision and lives.

Filed Under: Contact Lenses, double vision, Eye Diseases, Kerataconus, Vision Service Plan -VSP Tagged With: , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , ,

Eye Signs of Sexual Abuse

April 15, 2010 By Leave a Comment

The eyes have been referred to the gateway to the soul. Sometimes they are reflective of psychological problems such as physical and sexual abuse or post traumatic stress syndrome. They are one more thing to observe when abuse is suspected.

Children who have been abused have over stimulation of the amygdala that often becomes a permanent state and results in a state of hypervigilance and agitation. As a result of living in an unpredictable environment that is often harmful they need to be constantly alert for signs of danger. Some characteristic vision behaviors are seen.

Darting eye movements are common in an effort to constantly scan the environment for danger in preparation for fight or flight from the danger. Sometimes children will  become completely still with few eye movements, in an effort to avoid attraction form a sexual predator. Direct eye contact may be avoided and become a habitual behavior.Adults often misinterpret this lack of eye contact  as evidence of deceit or lying. Pupils are often large reflecting a high level of fear and arousal. Dilated pupils also allow greater awareness of peripheral movement and threats. Sometimes victims of abuse will use a direct aggressive, staring behavior as a challenge to try and ward of an attack, even when no real danger is present.

Children who have been abused may show signs of severe post traumatic stress disorder. This can present at times as  glazed unfocused eyes with the “thousand yard stare” off into nowhere. They do not exhibit normal behaviors such as turning towards you when spoken to or reflexive moments to sound or motion.

No specific visual behavior indicates abuse, but these can be indicators when a suspicion of abuse is present.

Filed Under: Uncategorized, Visual Signs of Abuse Tagged With: , , , , , , , , , , , , , , , , , , ,

Prism Eyeglasses-Eye Doctors Treatment For Double Vision

April 13, 2010 By 51 Comments

Optometrists in Fort Collins Usually Prescribe Prism Eyeglasses For Double Vision

Has your eye doctor prescribed prism eyeglasses for you or your child in a new eyeglass prescription? It could be due to crossed eyes, lazy eye, or some diseases of the eyes or body.

Prisms are thin pieces of the optical material that is used in prescription eyeglasses. You may remember them from high school physics. They have a base that is thicker and an apex that is thinner. Due to the light bending properties of the lens material, the thicker lens base slows light down as it passes through. Since the prism is thicker at the bottom base it slows light down longer than the top apex, and light changes direction down towards the base as it exits the prism. If the lens were equally thick throughout, it would slow the light down but the direction would remain unchanged. The amount of direction change is determined by the index of refraction of the material compared to the index of refraction of air. Lenses with higher indexes of refraction allow optometrists to make the ultra thin lenses that have drastically improved eye comfort and cosmetic appearances in recent years. The light bending capacity of a lens material is referred to as the index of refraction. The value in space in a vacuum is 1.0, essentially the same as in the earth’s atmosphere which is 1.0003.  Eye glass lenses now have indexes of refraction from 1.5 to 1.7, with the higher numbers being the thinnest.

Eyes that cross can turn in or out, and also one eye can turn up or down. Strabismus is the technical term for a turned eye. Eyes that turn out are referred to as exotropic while eyes that turn in are called esotropic. An eye that turns up is hypotropic and one that turns down is hypotropic. These are all considered as cases of strabismus, or eyes that actually do cross. Often they are mistakenly called “Lazy Eyes.”  A lazy eye is a different condition but it may result in a crossed eye. A combination of eyes turning laterally and vertically is common. When this results in double vision, it can be completely disruptive to mobility and lifestyle of the affected person. If the eye turns are present at birth, there may be no double vision present. The brain has the capacity to suppress or turn off the area of vision that results in the eyes perceiving double at early ages. When a person sees double, prisms, eye exercises known as vision therapy, and surgery are the three options eye doctors have to try and restore normal visual functioning. Prisms do not appear as a strange looking triangle in the lens. They usually show up as thicker and thinner edges on the eyeglass lenses. Normally they are ground into the shape of the lenses, but because of optical properties, some lenses can have the optical center repositioned to induce prism. There can be an adjustment to prism added to a prescription while the brain relearns how to interpret the eyes seeing single. When diseases such as strokes and diabetes cause double vision there can be some fluctuation over time, and frequent eyeglass prescriptions changes to adjust the amount of prism may be required. Temporary press on prisms known as Fresnel lenses may be used in some cases when change is expected but their optical quality tends to be very poor.

Your eye  doctor may prescribe prism in your eyeglasses for other reasons

Some people will only have a tendency for an eye to turn, and while it may not actually turn it will result in eyestrain, fatigue with reading, headaches from using your eyes, and other symptoms. These are referred to as heterophorias instead of strabismus. Instead of exotropia your optometrist would call it exophoria. Any term ending in phoria means a tendency to turn while tropia indicates an eye that is turned. To complicate matters, sometimes eyes will cross at one distance and not another, or when viewing in only certain fields of gaze. In cases of traumatic head injuries yoked prisms may be used to help retrain a disrupted visual system by altering spatial perception.

Some serious health problems can cause double vision, and any new onset or increasing condition of double vision should be thoroughly examined by your optometrist

When double vision occurs after the age of fifty, common causes are thyroid conditions, high blood pressure and diabetes. Try to notice when it occurs and what makes it worse to help your optometrist in treating your eye condition with the best methods possible. In the case of a brain tumor inducing double vision, a trip to the eye doctor could save your life.

Filed Under: binocular vision, computer vision syndrome, double vision, Eye Symptoms, Eyestrain, FEATURED, strabismus, Uncategorized Tagged With: , ,

Eye Doctors Dry Eye Secret

March 8, 2010 By Leave a Comment

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

.

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.

Filed Under: Central Fort Collins, Contact Lens Problems, Contact Lenses, Dry Eye Syndrome, Dry Eyes, Stinging Eyes Tagged With: , , , , , , , , , , , , , ,

Peripheral Side Vision Loss Retinitis Pigmentosa

September 18, 2009 By 1 Comment
retinal disease

retinal disease

Incredible images of a normal retina on the left and a damaged retina (tissue lining the back of the eye) courtesy of Robert N. Fariss, Ph.D., chief of the NEI Biological Imaging Core, and Ann H. Milam, Ph.D., former professor in the Department of Ophthalmology at the University of Washington.

Retinitis Pigmentosis is an eye disease that is primarily genetic and causes a slow, progressive loss of vision starting in the periphery and moving in, resulting in tunnel vision. Often eyesight will remain 20/20 until very late in the disease but with the extreme loss of side vision it can be very debilitating. Vitamin A has been used to slow the progression but doses of Vitamin A as low as twice the suggested normal dosage may increase the risk of hip fracture.

Ushers Syndrome, a combination of retinitis pigmentosa and hearing loss is common in Louisiana in the Acadian and Cajun population, French settlers that fled Canada and settled along the bayous of Louisiana. It is very uncommon to see this eye disease in Fort Collins since only a small percentage of cases result from spontaneous mutations.

If you are aware of any loss of peripheral or side vision it is important to schedule an appointment with your optometrist since other eye conditions like pituitary tumors and glaucoma can also create slowly progressive loss of side vision.

Filed Under: Eye Diseases, Eye Nutrition, Eye Symptoms, Eye Vitamins, Fort Collins Eye Doctor, Fort Collins Optometrist, Retinitis Pigmentosis, Side Vision Loss Tagged With: , , , , , , , , , , , ,

Common Causes For Childrens Headaches From Eye And Vision Disorders

August 27, 2009 By 2 Comments

Headaches come from many different sources and people often bring their child to see the eye doctor first to rule out vision problems as a cause. Headaches are the second most common reason parent bring their children in to our Fort Collins Optometrist,  Practice Usually it is not a vision related problem, but there are cases that have a direct correlation with the eyes. If headaches are related to eye problems, most of the time your optometrist will uncover a specific visual task the headaches seem to center around. It could be reading, computer use, video games or time in the sun.

Eyeglass frames can cause pressure behind the ears and on the side of the head if not properly adjusted. Frames that are tilted can alter the effective lens prescription and result in eye strain. Nickel is a common component in many metal frames (and in parts of plastic frames). Nickel allergies are fairly common and can cause discomfort, itching and possible mild headaches.

Your child’s eyeglasses prescription may cause headaches under certain conditions. Large uncorrected amounts of farsightedness are probably the most common cause in children. With farsightedness, they may have the focusing capacity to pass the eye doctors chart test with flying colors while not wearing prescription lenses. In doing so, they may be close to using all of their focusing reserve capacity. This would be like spending all day walking around carrying close to the maximum amount of weight you can hold. Because the focusing muscle is considered smooth muscle and does not fatigue like the striated muscles you use for your arms or legs, there is some disagreement on this point. It is really an academic point since the headaches do commonly occur, possibly due to variations in focusing and resultant clarity, constriction of the colored iris tissue, or other unknown factors. How much uncorrected farsightedness is required to cause headaches? We know higher amounts are more significant as age increases but with lower amounts it is not as clear what levels create eyestrain and headaches. Sometimes the only way to know is to fill an eyeglasses prescription and see if the headaches resolve.

Focusing problems in general are very hard to diagnose with precision. Eyes may over focus, under focus, have variable focusing, and on rare occasions have focusing spasms. Some prescription medications can cause focusing problems, dry eyes and sensitivity to light increasing the likelihood of headaches.

Uncorrected nearsightedness can cause a child to squint to see the blackboard and result in headaches. Usually they will be complaining about blurry vision, unlike with farsightedness. Nearsightedness has normally been corrected by an eye doctor due to blurry vision before there are complaints about headaches.

Astigmatism is a condition where the eye has two different curvatures, shaped more like half of a tennis ball squeezed on top and bottom. While astigmatism does blur vision, children frequently notice more eyestrain than blurriness. The eye is focusing for one curve then the other trying to find the clearest focus point. Moderate to high levels of astigmatism can cause headaches but usually the child has complaints that sound more like eyestrain and may be squinting to try and clear things up.

Convergence insufficiency is one of the leading causes of headaches related to vision in children. In our optometry practice in Fort Collins, we find it is one of the most common undiagnosed eye conditions. When your child reads or works up close the eyes have to perform two functions. First they have to adjust the focus for the correct distance. Secondly they must turn in both eyes (converge) to point in the exact direction of what they are looking at. Most reading is done at about 14 to 16 inches away from the face in children. Kids should be able to keep their eyes pointing at an object at least until it is within 4 to 6 inches from their nose. If they can’t, they lack enough reserve capacity to keep their eyes pointed at the object and they will have eyestrain and headaches. The severity of the problem is related to how well their brain functions in partially shutting down the image from one eye. If they lack this capacity the headaches can be severe with near work, resulting in headaches, eyestrain, blurred vision, and failing grades in school.

Muscle imbalances are similar to convergence insufficiency. Due to eye muscles or tendons that are slightly misshaped or inserted slightly abnormally, their eyes may have a tendency to turn in, out, up, or down. Constantly struggling to keep images from doubling can cause frequent headaches if the brain is not good at shutting off one of the images. Fixation disparities are very tiny eye alignment errors that can have a similar result but can only be diagnosed with appropriate testing.

Migraines are a very common cause of headaches and take many different forms. Usually there is a family history of migraines already known. Children that develop migraines at an older age often are carsick at younger ages. These headaches tend to be on one side of the head and may be associated with nausea and light sensitivity. Migraines need to be thoroughly tested and diagnosed in conjunction with your child’s pediatrician and possibly a neurologist. The only association migraines have with eyes are some people have migraines triggered by small changes in their eye glass prescription, and some migraines can cause very minor damage to the eyes over time.

Some children and adults are naturally very sensitive to small changes in their eyeglass or contact lens prescription. Every time there is a minor change they start having headaches, and learn quickly it is time for an appointment with the optometrist. Autistic children may have somewhat of an opposite type of  problem, and clearing up vision too much may contribute to sensory overload and headaches.

Rare causes of headaches around the eyes are tumors around the optic nerve or eye. Inflammation inside the eye that sometimes accompanies childhood arthritis and other autoimmune diseases can cause eye pain, headaches, and light sensitivity. Unusual light sensitivity, red eyes, headaches, abnormally small or large pupils, changes in behavior and school grades can be indicators of illicit drug usage, now common even in elementary schools. School counselors usually have a pretty good idea who is involved and it is a quick call.

A sinus infection can result in headaches around the eyes and in rare cases even sight loss.

Never forget lack of sleep. Fatigue, poor diet, caffeine crashes, dehydration, and stress probably cause most headaches. Preventative eye exams for children always helps rule out some easily fixed causes so don’t neglect an eye check up if your child is being afflicted with headaches.

Last, but not least is the friend who just got new glasses syndrome. All of a sudden your child develops blurry vision and headaches. Fortunately, an optometrist can diagnose this case pretty easy. Sometimes you may want to consider discussing in advance with your child’s eye doctor a placebo pair of glasses  with little or no prescription. Occasionally with a strong willed child it is easier to just let them wear a pair for six months  and spend your energy on the bigger battles.

Ten Reasons To Be More Concerned About Your Child’s Headaches

1. Headaches that are continuing to get worse or becoming more frequent

2. Headaches that occur in the same area of the eye or head

3. Headaches that wake children up at night or are present at the beginning of the day

4. Headaches accompanied by double vision, blurred vision, or abnormal eye movements

5. Headaches that cause a child to cease their normal activities

6. Any headache that occurs after a fall, possible bump to the head, or after loss of consciousness or

memory, however brief

7. Any headache that is accompanied by changes in responsiveness, sluggish thinking, slurred

speech, changes in balance, different pupil sizes, severe vomiting, droopy half open eyes, altered or

unusual behavior

8. Headaches that only occur when a specific person is around (possible abuse)

9. Headaches occurring in other people present (possible carbon monoxide poisoning)

10. Severe Headaches with very rapid onset, high fever, stiff neck

If you have concerns about your child having mild or moderate headaches, starting with appointments with your optometrist and family doctor makes sense, proceeding to a neurological evaluation if needed.

Filed Under: Childrens Eye Care, FEATURED, Headaches, Migraine Tagged With: , , , ,

Migraines and Brain Retina Damage

July 17, 2009 By Leave a Comment

According to recent article in  the Journal of the American Medical Association by Scher, Ann a study in Iceland has shown evidence that women who suffer from migraines with visual auras were twice as likely to have lesions (damaged areas) in the cerebellum later in life. The cerebellum is part of the lower brain that participates in balance and movement. It is not known if these lesions have any effect or significance.

These are interesting findings in light of the evidence that some people who suffer from migraines also have effects (small areas of vision loss) in their peripheral vision. To the best of our knowledge, these defects are inconsequential on overall vision. The advent of automated testing of peripheral vision brought these defects to awareness, patients have not complained of symptoms prior to the findings. Perhaps the cerebellum damage will fall in the same category, interesting findings on MRI tests that have no effect on overall health.

The larger question is why these problems occur. Conjecture would be vascular, or blood flow changes associated with migraines but migraines are not strictly vascular changes. Hopefully understanding these complications can lead to better understanding of migraines and preventative treatments.

Any severe  headaches associated with flashing lights, loss of vision, or other vision symptoms warrant a visit to your eye doctor and family doctor, with further evaluation by a neurologist if needed.  Migraine headaches are considered a diagnosis of exclusion, meaning after every other potential cause has been ruled out they can be diagnosed. Usually there are specific characteristics that help in making the diagnosis after a complete evaluation, but occasionally they can have complications that resemble strokes or other neurological problems. Vision insurance such as Vision Service Plan often provide coverage for vision exams associated with migraine symptoms. Because other serious problems like retinal detachments can cause flashing lights you should immediately call your optometrist if this a new problem that has not been previously diagnosed.

Filed Under: Flashes Tagged With: , , , , , , , , , , , , , , , , , , , , , , , , , ,

Eye Allergy Relief

July 3, 2009 By Leave a Comment

Itchy eyes have you rubbing with the summer pollen?  As an Optometrist in Fort Collins I see the office filled with eye allergy problems every year when the cottonwood trees fill the air with summer snow. The best solution currently is usually an eyedrop prescription called Pataday. Pataday is s refined version of the older drop called Patanol. Pataday is formulated so you only need to use it once a day for maximum benefits. It has a dual acting mechanism, the first is an antihistamine effect that starts immediately to curb the effects of the histamine released from cells that have been exposed to pollen or other allergens. The second mechanism takes several days to fully function but it stabilizes the cell walls so they won’t break down and release the histamine when exposed to allergens.

Because you already have histamine released it takes several days for Pataday to stabilize the system and let the histamine already present dissipate from your system. That is why it is important to use it daily during a bad allergy stretch instead of only when your eyes are bothering you. Pataday has shown to be superior to a number of similar medications is a number of studies. It is a very safe prescription eye drop and we don’t hesitate to leave patients on it constantly if needed. Because it is the same drug in Patanol, there is a fairly long track record.  The biggest drawback to Pataday is cost, without insurance coverage it is an expensive drug and if you are uninsured you need to discuss this with your eye doctor. There are other options that are much better than continued suffering with the itching and burning that can become incapacitating and even dangerous when driving.

Alternatives such as oral antihistamines can sometimes worsen symptoms by drying the eye and resulting in relative increases in allergen concentrations and dry eye syndrome. Some over the counter eyedrops can exacerbate symptoms if used on a prolonged basis.

Pataday remains the prescriptions drop of choice for seasonal allergic conjunctivitis (SAC) ( in plain English, the itchy stinging eye symptoms that accompany the trees and grasses growing in the summer).One of the premier benefits is the once a day dosing means you can continue wearing your contact lenses. Using an eye drop first thing in the morning allows you to start wearing your lenses 15 minutes later and not have to worry about removing them for multiple doses during the day.

Cold compresses and frequent use of non preserved artificial tears also help decrease the inflammation and dilute the pollens in your tear film.

Some patients find relief in alternative treatments.  Similasan’s Allergy Eye drops are homeopathic formulations relatively easy to find over the counter.

More severe cases of allergies can be treated with the new generation of ester ophthalmic steroids that target inflammation with a unique, site-active mechanism of action. These modified steroid prescription eye drops are very safe to use without the high frequency of side effects of glaucoma and cataracts seen in older steroid drops.

Don’t delay treatment for eye allergy problemns. There are numerous options and no reason to continue suffering.

Filed Under: Stinging Eyes Tagged With: , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , ,
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