Eye Care Associates of Nevada Blog
By Rachel Murphy
What is a pterygium?
A pterygium is a wedge-shaped bump on the white part of the eye (the sclera) that can invade the cornea. It is sometimes called “surfer’s eye.” Pterygia are benign growths meaning they are not cancerous. They are more common on the inside corner of the eye closest to the nose, but can occur on the outside corner as well. It can occur in one or both eyes. A pterygium typically grows very slowly and does not affect vision, but in severe cases it can grow across the cornea and block vision. The most common symptoms are burning, grittiness, itching, a foreign body sensation, and blurred vision. It can lead to increased dryness and irritation. Occasionally it can become red and inflamed which can cause mild pain.
What causes a pterygium?
A pterygium is basically a callus that develops from exposure to sunlight, wind, and dust. Pterygia are more common in individuals with dry eye and can also increase the severity of the dryness. The exact cause of the growth is unknown. They are more common in farmers, fishermen, and people living near the equator. They are also more common in younger individuals age 20 to 40 and seems to be more prevalent in men than women.
How is a pterygium treated?
In many cases of mild pterygium there may be no symptoms and no need for treatment. The most common complication associated with a pterygium is increased dryness, which may be relieved using artificial tears. If a pterygium becomes irritated or inflamed, it can be treated with topical medication such as a steroid drop for short periods of time. Artificial tears and topical medications will help with irritation, but they do not shrink the size of the pterygium. The only way to remove a pterygium is through surgery. This can be done for cosmetic reasons or to improve vision if the pterygium begins to block vision.
What can I expect during a pterygium removal surgery?
The surgery is typically about 30 minutes and usually requires wearing a patch for one to two days after surgery. During the surgery, the callused patch is skin is removed and a graft placed over the area. The graft can come from another part of the conjunctiva (the clear tissue overlying the sclera) or from a graft made from amniotic tissue. Full recovery may take several weeks, but the patient should be able to return to work and normal activity after a few days. Swimming and rubbing the eye should be avoided during the recovery period. The most common side effects of surgery are redness, swelling, and soreness. Your doctor will typically prescribe a steroid drop to use for up to a few weeks after the surgery.
Will my pterygium return after having it removed?
It is possible for a pterygium to return after surgery particularly if no graft is used the surgery. If a graft is used, recurrence rate is about 5-10%. Recurrence is most common in the first year after surgery. It is very important to protect your eyes from sunlight using UV blocking sunglasses and a hat with a brim. This also helps reduce exposure from wind and dust. In some cases, pterygium removal may also change the shape of the cornea resulting in astigmatism.
By: Kellen Robertson
How do I know if I have Dry Eye Disease?
Dry Eye Disease (DED), also known as Ocular Surface Disease (OSD), has many signs and symptoms. Dry Eye Disease is a chronic and progressive disease. Symptoms you may experience include: dryness, grittiness, scratchiness, foreign body sensation, burning, stinging, redness, fluctuations in vision that clear with blinking, eye fatigue, and excessive tearing. There are many tests Eye Care Associates of Nevada will perform to determine if your symptoms can be contributed to DED.
My eyes water, how can I have dry eyes?
Excessive tearing is a common sign of dry eye disease. Your tear film is made of three layers: a mucin (mucous) layer, an aqueous (water) layer, and a lipid (oil) layer. If your oil layer is deficient, your tears evaporate faster and you experience dryness, which results in excessive tearing. Unfortunately, these reflex tears are not healthy tears and do not have the nutritional components to keep your eye feeling moist and healthy. Other causes of reflex tears are inflammation on the surface of your eyes as well as high tear osmolarity (salt content). At Eye Care Associates of Nevada we perform tests that will assess eye surface inflammation and tear osmolarity.
What causes dry eye disease?
There are many potential causes of dry eye disease. It has been reported that the prevalence of dry eyes is 5-35%. That means as high as 1 in 3 people will have some level of Dry Eye Disease. Women and those over the age of 50 are at higher risk for DED. Other causes of DED are meibomian gland dysfunction and blepharitis, two common eye diseases that can cause evaporative DED. Certain medications can cause dryness, these include: birth control, anti-depressants, and medications for allergy, acne, and high blood pressure. Systemic diseases can increase risk for DED, these include: diabetes, rheumatoid arthritis, lupus, thyroid disease, and Sjogren’s syndrome. Make sure to tell your doctor if you have dry eyes accompanied by dry mouth. Environmental factors such as smoking, extreme heat or cold, air conditioning/heating, and air pollutants can also cause dry eye symptoms. Prolonged reading or computer/phone use decreases your blink rate which can lead to dry eyes. Other things that can cause dryness are wearing contact lenses and refractive surgery, such as LASIK.
What are my treatment options?
There are many treatment options for Dry Eye Disease depending on the classification and category of DED. The standard initial treatment is artificial tear eye drops and warm compresses. Here at Eye Care Associates of Nevada we also have advanced technology treatment for meibomian gland dysfunction and blepharitis, the two most common causes of DED. These advanced technology treatment options include LipiFlow and BlephEx. We may also consider adding a supplement called HydroEye which has been proven to improve tear film quality and resolve signs and symptoms. Your doctor may also consider starting you on prescription eye drops called Restasis. Restasis is the most commonly prescribed drop for DED and has been shown to increase tear production and reduce inflammation. Your doctor will determine the best customized treatment based on your signs and symptoms.
Is there a cure for my dry eyes?
There is no cure for Dry Eye Disease. Treatment is aimed at improving the health of the surface of your eyes as well as treating symptoms. The treatment is often a stepwise approach and should be viewed as a marathon, not a sprint. Often times the signs and symptoms of DED have been causing damage to the surface of the eyes for months to years and it may require months to years of treatment before signs and symptoms are managed.
By: Kellen Robertson
What is glaucoma?
Glaucoma is defined as progressive damage to the optic nerve head, the connection between your eyes and brain. In early glaucoma there are no obvious symptoms, making it critical for regular eye exams. One of the first signs of advancing optic nerve damage and glaucoma is permanent peripheral or side vision loss. However, with regular exams by your eye care provider, your doctor can observe clinical signs before vision loss occurs. There are many different types of glaucoma, including open angle glaucoma and angle closure glaucoma. Your eye care professional will run a battery of tests to determine the correct diagnosis.
What does pressure have to do with glaucoma and what is a healthy eye pressure?
High intraocular pressure (IOP) is a known risk factor for glaucoma and currently the only treatable and modifiable risk factor. The normal range of pressures is from 12 to 22 mmHg with the national average pressure being 16mmHg. However, a diagnosis of glaucoma can still occur with pressures in this normal range. Each individual has a different acceptable range of fluctuating eye pressures. An eye care professional will determine a safe range of eye pressures for each glaucoma patient, independently.
Who is at an increased risk for glaucoma?
Factors that increase your risk for glaucoma include increasing age, African American or Hispanic race, high intraocular pressures, and poor general health. The older you become, the higher the risk for glaucoma, with 12% of people over the age of 63 having the disease. Being diagnosed with diabetes, high blood pressure, or heart disease increases your risk for glaucoma. Lastly, having a direct relative with glaucoma increases your risk for inheriting the disease by four to nine times.
Will I go blind from glaucoma?
Glaucoma is a slowly progressive disease with damage occurring over years rather than days. Central, detailed vision is preserved until end-stage glaucoma, but the risk of going blind is still a possibility. Visual loss occurs first in the periphery and spreads towards the central vision. In order to monitor your peripheral vision, your eye care professional will have you perform a visual field test, which requires you to respond to lights presented in your peripheral vision.
How is glaucoma treated?
The main treatment goal for glaucoma patients is to lower intraocular pressure. There is no cure for the condition, but maintaining healthy pressures can slow the progression of the disease. Common initial treatments include daily eye drops or laser procedures. Advanced cases may require more invasive surgical procedures. Your eye care professional will determine the best starting treatment based on each patient’s case.
By: Trish Duffield
Am I a candidate for cataract surgery?
At Eye Care Associates of Nevada, we provide a comprehensive cataract surgery evaluation prior to scheduling the cataract surgery procedure. This is a time to meet with our cataract surgeons and to answer any questions you may have.
Will I need to wear glasses after cataract surgery?
While every patient case is different, there are many lens implants available that can be utilized to potentially eliminate the need for full-time glasses wear after cataract surgery. During your cataract surgery evaluation at Eye Care Associates of Nevada these lens options will be discussed in detail.
What is the cataract surgery recovery like?
If it is determined that both of your eyes need cataract surgery, you will be scheduled for one eye at a time with 1-2 weeks in between. Most patients experience blur and halos the first day after surgery, which gradually improves over the next week of healing.
What is the protocol for follow-up care?
At Eye Care Associates of Nevada we check your visual and healing progress at 1 day, 1 week, and 1 month after surgery for either eye. Proper instillation and usage of eye drop medication is the most important factor in reducing healing time. We keep our patients on a regimen of eye drops for 1 month total.
What are the possible complications of cataract surgery?
The lens implants placed inside your eyes will last forever and the surgery has an excellent success rate. The most common issues after cataract surgery are problems with glare and mild irritation as the ocular surface heals. If present, these minor issues improve with time. As with any surgical procedure, there are more serious complications that can occur but those are extremely rare.