Thursday, December 31, 2009

Eye Infections & Conjunctivitis

We all have heard the term "pink eye" or "red eyes" being used to describe a condition in which the eye or eyes turn a more pinkish or reddish color in response to irritation or infection. This color change is due to dilation of the blood vessels in the conjunctiva, and can also be described as conjunctivitis. The dilation of the blood vessels is the eye's way of bringing more oxygen to the area that is affected. The cause of "pink eye" can be varied. It can be due to any type of condition that can irritate the eyes. In other words, it can be due to an infection of either bacterial or viral origin. It can also be due to allergies or exposure to something in the environment that irritates the eyes, such as smoke or smog. Too much sun can cause the eyes to turn pink or red. The treatment of "pink eye" is based upon the cause of the problem. If the eyes are making lots of mucous the cause is usually bacterial. The treatment here is an antibiotic. If the discharge from the eyes is more of a watery consistency than a mucous consistency the cause can be viral or allergic in nature. If the cause is allergic in nature there are many excellent treatments available. The treatment can range from an antihistamine eye drop to a steroid. With eye allergies there is typically a certain amount of itching associated with the condition. If the cause is viral the treatments are limited. Like a cold, there is no recognized treatment for a viral infection although there are some that are being investigated. Eye infections usually start in one eye and then progress to the other eye. It is important to realize that the bacterial and viral causes of "pink eye" are contageous. It is very easy to spread these conditions to family, friends and associates. Seek the advice of an eye care professional as soon as possible and wash your hands or use a hand sanitizer regularly. Keep your fingers and hands out of your eyes and away from your face. Use a separate towel or washcloth and be careful with the use of anything that could come into contact with your eyes. Makeup products that has come into contact with the eyes should be discarded. (This always makes me very popular with my female patients when I recommend this!)

The good news is that these conditions respond well to therapy in most cases with the exception of viral conjunctivitis. In the case of viral conjunctivitis the patient must wait out the condition and treat the symptoms....much in the way we treat a "cold". Eventually, our immune system learns how to fight the virus and we get over the condition.

The best advice I can give is to seek the care of your eye doctor ASAP when you have any condition affecting the eyes that causes them to become redder or pinker than normal. Your eye doctor will determine the appropriate treatment and you will be well on your way to recovery.

Sunday, December 20, 2009

Improving Nearsightedness with Orthokeratology

There was an article in the LA Times recently showing a large increase in nearsightedness or myopia. While the cause of this is controversial, there are a lot of researchers that believe that this is due to how much time our society currently spends doing close work...especially related to the computer. So what can we do about it? Certainly glasses and contact lenses can help. Lasik surgery can correct nearsightedness as well. There is an additional procedure that can be used to treat myopia in both children and adults. It is called orthokeratology or "corneal molding". This procedure involves using special rigid contact lenses that are designed to flatten the corneal curvature and thereby reduce or eliminate myopia. These lenses can we worn at night, in a fashion similar to a retainer for the teeth. Overnight the lenses put gentle pressure upon the surface cells of the cornea and flatten the area over the front of the cornea. When the lenses are removed the nearsightedness is dramatically improved. Patients, often after just one or two days, can reverse their myopia. Using this system, patients do not need to use contact lenses or eyeglasses during the day. All they need to do is replace the lenses in the evening and repeat the process.

There is an interesting side effect that is being reported by patients and doctors that use this technique. It is often found that in addition to reversing the myopia it is being reported that there is a tendency for the myopia not to increase. In other words, using this technique not only reverses the myopia while the lenses are being used, but the tendency for the myopia to increase...especially in children.... is often controlled. There is speculation about why this occurs but it has definitely been reported.

It is also important to know that this procedure only works if the lenses are worn regularly. If a patient decides to discontinue the procedure the eyes will go back to their original myopia. The procedure is especially useful for athletes that are involved in contact sports or water sports. They can perform to their maximul level without the worry of losing a contact lens or the difficlty of attempting to wear eyeglasses while they peform their activity.

Wednesday, December 9, 2009

Surfsup!!!

The weather has turned cold and the surf is up. There were great waves this morning but I did not have enough time to take advantage of them before work. Tomorrow is my late day and I will have a go at it in the morning. Full wetsuit time. My friend told me the water, while cold, is warmer than the air. Definitely calls for booties too. This will be the first time I have been able to ride my new board in good, solid waves. I am really looking forward to it. Film at 11:00 :)



Great day at the office today. The end of the year is the busiest time of year for us due to patients taking advantage of their insurance benefits and flex dollars before the end of the year. Yea! It's nice connecting with new and old patients. Frequently I see the kids of patients that I saw when they were students at nearby UCLA. Lots of fun.

Wednesday, November 25, 2009

A visit from Kimmie

I had one of those serendipitous moments yesterday when Kimmie came back to see me. She is a delightful 11 year old that I have been seeing for several years in the office. She inherited her myopia from her dad who has a high amount of myopia. She came back in for a recheck and had another increase in her myopia. Her family had moved out of town to a far away ski /recreation area and she was back in town for the holidays. I have been thinking about her all year because when she was here on her last visit she made me a surprise drawing of herself wearing her new eyeglasses. I proudly put it on the wall in one of our exam rooms. A day does not go by without a patient commenting about the drawing. It was
a true surprise and I enjoy looking at it every day. Apparently my patients do too. I told her how popular the drawing was and she was a little embarassed yet happy to hear about it. It reminds me about how prescious my patients are to me and how much they have become a part of my life.

Thursday, November 19, 2009

Helping patients

I had one of those special moments yesterday when I saw a young five year old little girl for a follow up on her lazy eye. We were lucky to have her parents bring her in at an early age to help her with her problem. She had a lazy left eye due to the eye being very farsighted. Her eye was turning in. We prescribed glasses for her and actually had her wearing one contact lens in the affected eye for awhile. In addition, we prescribed patching the good eye which forced her to look out of the lazy one. Yesterday she showed complete reversal of the lazy eye. Her depth perception was normal. We were very excited. This is a case that could have turned into a permanent lazy eye if it was not caught early enough. Due to her alert pediatrician who made the referral and our care were able to solve her problems.

Surf warning

I went surfing this morning before work at Bay Street just south of the Santa Monica Pier and found a white piece of paper on my windshield when I returned to my car. It read: "Warning: This is a polite warning asking you to please don't surf here. This surfing spot has become extremely crowded and dangerous. We are a network of surfers who have been surfing here for years. We will no longer tolerate newbies, snakes and kooks. We kindly ask you to move south of lifeguard station # 24. Remember, this is a friendly warning. If you continue to surf north of station # 24, we will take action." I find this offensive and will report it to the Santa Monica Police. Surfing should not be restrictive. The ocean is for everybody.

Wednesday, November 18, 2009

Eye floaters

I just saw on U tube a cartoon description of eye floaters that was really pretty accurate in describing the way that they look to a patient. Check it out under the heading: "U Tube family guy peters eye floaters". In most cases floaters are very common, but they can signal a problem...especially if they are a new event. If they are the little specs and spots that have been around for a long time, they probably are not serious. If they are new and especially if they have been associated with flashes of light it is best that a patient visit their eye doctor for a dilated eye exam to make sure that the retina is OK. If the floaters are associated with a retinal tear this becomes a very serious event that needs attending to on an immediate basis.