Dry Eye

Dry eye is a condition in which there are insufficient tears to lubricate and nourish the eye. Tears are necessary for maintaining the health of the front surface of the eye and for providing clear vision. People with dry eyes either do not produce enough tears or have a poor quality of tears. Dry eye is a common and often chronic problem, particularly in older adults.

With each blink of the eyelids, tears are spread across the front surface of the eye, known as the cornea. Tears provide lubrication, reduce the risk of eye infection, wash away foreign matter in the eye, and keep the surface of the eyes smooth and clear. Excess tears in the eyes flow into small drainage ducts, in the inner corners of the eyelids, which drain in the back of the nose.

Dry eyes can result from an improper balance of tear production and drainage.

• Inadequate amount of tears – Tears are produced by several glands in and around the eyelids. Tear production tends to diminish with age, with various medical conditions, or as a side effect of certain medicines. Environmental conditions such as wind and dry climates can also affect tear volume by increasing tear evaporation. When the normal amount of tear production decreases or tears evaporate too quickly from the eyes, symptoms of dry eye can develop.
• Poor quality of tears – Tears are made up of three layers: oil, water, and mucus. Each component serves a function in protecting and nourishing the front surface of the eye. A smooth oil layer helps to prevent evaporation of the water layer, while the mucin layer functions in spreading the tears evenly over the surface of the eye. If the tears evaporate too quickly or do not spread evenly over the cornea due to deficiencies with any of the three tear layers, dry eye symptoms can develop.

The most common form of dry eyes is due to an inadequate amount of the water layer of tears. This condition, called keratoconjunctivitis sicca (KCS), is also referred to as dry eye syndrome.

People with dry eyes may experience symptoms of irritated, gritty, scratchy, or burning eyes, a feeling of something in their eyes, excess watering, and blurred vision. Advanced dry eyes may damage the front surface of the eye and impair vision.

Treatments for dry eyes aim to restore or maintain the normal amount of tears in the eye to minimize dryness and related discomfort and to maintain eye health.

What causes dry eyes?

The majority of people over the age of 65 experience some symptoms of dry eyes.

The development of dry eyes can have many causes. They include:

• Age – dry eye is a part of the natural aging process. The majority of people over age 65 experience some symptoms of dry eyes.
• Gender – women are more likely to develop dry eyes due to hormonal changes caused by pregnancy, the use of oral contraceptives, and menopause.
• Medications – certain medicines, including antihistamines, decongestants, blood pressure medications and antidepressants, can reduce the amount of tears produced in the eyes.
• Medical conditions – persons with rheumatoid arthritis, diabetes and thyroid problems are more likely to have symptoms of dry eyes. Also, problems with inflammation of the eyelids (blepharitis), inflammation of the surfaces of the eye, or the inward or outward turning of eyelids can cause dry eyes to develop.
• Environmental conditions – exposure to smoke, wind and dry climates can increase tear evaporation resulting in dry eye symptoms. Failure to blink regularly, such as when staring at a computer screen for long periods of time, can also contribute to drying of the eyes.
• Other factors – long term use of contact lenses can be a factor in the development of dry eyes. Refractive eye surgeries, such as LASIK, can cause decreased tear production and dry eyes.

How are dry eyes diagnosed?

Dry eyes can be diagnosed through a comprehensive eye examination. Testing, with special emphasis on the evaluation of the quantity and quality of tears produced by the eyes, may include:

• Patient history to determine any symptoms the patient is experiencing and the presence of any general health problems, medications taken, or environmental factors that may be contributing to the dry eye problem.
• External examination of the eye, including lid structure and blink dynamics.
• Evaluation of the eyelids and cornea using bright light and magnification.
• Measurement of the quantity and quality of tears for any abnormalities. Special dyes may be instilled in the eyes to better observe tear flow and to highlight any changes to the outer surface of the eye caused by insufficient tears.

Using the information obtained from testing, your optometrist can determine if you have dry eyes and advise you on treatment options.

How are dry eyes treated?

One of the primary approaches used to manage and treat mild cases of dry eyes is adding tears using over-the-counter artificial tear solutions.

Dry eyes can be a chronic condition, but your optometrist can prescribe treatment to keep your eyes healthy, more comfortable, and prevent your vision from being affected. The primary approaches used to manage and treat dry eyes include adding tears, conserving tears, increasing tear production, and treating the inflammation of the eyelids or eye surface that contributes to the dry eyes.

• Adding tears – Mild cases of dry eyes can often be managed using over-the-counter artificial tear solutions. These can be used as often as needed to supplement natural tear production. Preservative-free artificial tear solutions are recommended because they contain fewer additives that could further irritate the eyes. However, some people may have persistent dry eyes that don’t respond to artificial tears alone. Additional steps need to be taken to treat their dry eyes.
• Conserving tears – An additional approach to reducing the symptoms of dry eyes is to keep natural tears in the eyes longer. This can be done by blocking the tear ducts through which the tears normally drain. The tear ducts can be blocked with tiny silicone or gel-like plugs that can be removed, if needed. A surgical procedure to permanently close tear ducts can also be used. In either case, the goal is to keep the available tears in the eye longer to reduce problems related to dry eyes.
• Increasing tear production – Prescription eye drops that help to increase production of tears can be recommended by your optometrist, as well as omega-3 fatty acid nutritional supplements.
• Treatment of the contributing eyelid or ocular surface inflammation – Prescription eye drops or ointments, warm compresses and lid massage, or eyelid cleaners may be recommended to help decrease inflammation around the surface of the eyes.

Self Care

Steps you can take to reduce symptoms of dry eyes include:

• Remembering to blink regularly when reading or staring at a computer screen for long periods of time.
• Increasing the level of humidity in the air at work and at home.
• Wearing sunglasses outdoors, particularly those with wrap around frame design, to reduce exposure to drying winds and sun.
• Using nutritional supplements containing essential fatty acids may help decrease dry eye symptoms in some people. Ask your optometrist if the use of dietary supplements could be of help for your dry eye problems.

Avoiding becoming dehydrated by drinking plenty of water (8 to 10 glasses) each day.

Keep an Eye on Harmful UV Rays

Ultraviolet (UV) radiation is a concern for many Americans, but most people are thinking about protecting their skin, not their eyes. Whether it’s a cloudy or sunny day, summer or winter, the American Optometric Association (AOA) reminds Americans to take specific measures to protect their eyes from the sun’s UV rays in order to decrease the risk of vision disorders.

The sun’s primary danger is in the form of UV radiation. UV radiation is a component of solar radiation, but can be given off by artificial sources like tanning beds.

According to the AOA’s 2008 American Eye-Q® survey, which identified Americans’ attitudes and behaviors regarding eye care and related issues, only 49 percent of Americans said UV protection was the most important factor when purchasing sunglasses. Respondents said that the price and style of sunglasses were among the most important factors to them.

“Overexposure to UV rays has been linked to a variety of problems, including age-related cataracts and degeneration of the cornea,” said Gregory W. Good, O.D., PhD, optometrist and AOA’s UV Protection Expert. “Other disorders that can occur are abnormal growths on the eye’s surface and even sunburn of the eyes. These conditions can cause blurred vision, irritation, redness, tearing, temporary vision loss and, in some instances, blindness.”

According to Dr. Good, the effects of solar radiation are cumulative; therefore optometrists recommend parents purchase proper eyewear for young children and teenagers. The longer the eyes are exposed to solar radiation, the greater risk a person has for developing conditions later in life such as cataracts or macular degeneration.

It is not clear how much exposure to solar radiation will cause damage, so the AOA recommends wearing quality sunglasses that offer proper UV protection and a wide-brimmed hat whenever people spend time outdoors. Also, certain contact lenses incorporate an ultraviolet blocker in the lens, which helps further reduce exposure to UV light that eventually can cause cataracts and other eye problems. Patients can ask their optometrist for additional information about these contact lenses.

The following top five tips from the American Optometric Association can help prevent eye damage from exposure to UV radiation:

1. Wear protective eyewear any time the eyes are exposed to UV rays, even on cloudy days and during the winter.
2. Look for quality sunglasses or contact lenses that offer good protection. Sunglasses or protective contact lenses should block out 99 to 100 percent of UV-A and UV-B radiation and screen out 75 to 90 percent of visible light.
3. Check to make sure sunglass lenses are perfectly matched in color and free of distortions or imperfections.
4. Purchase gray-colored lenses because they reduce light intensity without altering the color of objects to provide the most natural color vision.
5. Don’t forget protection for young children and teenagers, who typically spend more time in the sun than adults and thus are at greater risk for damage.

Additionally, be sure to schedule periodic comprehensive eye exams with an eye doctor. It’s a good way to monitor eye health, maintain good vision, and keep up-to-date on the latest in UV radiation protection.

Other interesting facts from the American Eye-Q® survey include:

• 46 percent of survey respondents have worn lenses (contacts lenses or regular glasses) that provide UV protection.
• 35 percent of respondents wear prescription sunglasses.
• Some respondents understand that dry eye (32 percent), temporary blindness (30 percent), and sunburn (29 percent) can result from overexposure to UV rays.
• By comparison, fewer respondents link eye diseases such as cataracts (24 percent), eye cancer (24 percent), macular degeneration (19 percent); and glaucoma (17 percent) to overexposure to solar rays. (17 percent) to overexposure to solar rays.
• 67 percent of parents purchase sunglasses for their children; however, 13 percent of parents do not check to make sure the glasses protect against UV rays.

For additional information on UV protection, please visit: http://www.aoa.org/x4735.xml. Or to view a copy of the AOA’s Shopping Guide for Sunglasses, please visit: http://aoa.org/documents/SunglassShoppingGuide0810.pdf.

HALLOWEEN SAFETY BASED ON GOOD VISIBILITY

On Halloween, an assortment of ballerinas, clowns, ghosts, and other goblins will have their eyes on just one thing—candy. Roaming dimly lit neighborhoods is part of the fun for children in pursuit of treats, but it can also be dangerous.

Trick-or-treaters and parents need to remember that on Halloween, to be safe, you must be seen. Studies have shown that a child’s risk of injury or death as a result of being hit by a car doubles around Halloween.

Incorporate these simple precautions into the evening’s festivities to ensure Halloween safety:

• Dress children in light-colored costumes or adhere reflective tape to the costume’s fabric and accessories. Make sure children and adults are visible to passing cars.
• Eliminate masks from among the costume’s accessories. Masks can get in the way of clear vision and can increase the chances of tripping or running into objects.
• Hypoallergenic make-up is a safer alternative. Take care in keeping make-up away from the eyes.
• No trick-or-treater should go in search of treats alone. Children move through darkened neighborhoods more safely if accompanied by an adult.
• Approach only doorsteps that have a porch light lit. Similarly, if you plan to pass out treats, be sure to turn on your light.
• Pedestrians think they are more visible to drivers than they actually are, so remind trick-or-treaters to look both ways before crossing streets and to stay with the group.
• If cosmetic contact lenses are part of your costume, make sure you obtain them from your doctor of optometry to ensure that the lenses that fit your eyes properly, and to learn ways to care for them.

Prevent Eye Strain and Eye Injury at Work

Whether using a computer or a sledge hammer to get the job done, POA reports that visual discomfort, eye strain and eye injuries in the workplace are not only common, but cost billions in lost productivity each year. And, research indicates that 2,000 workers each day in the United States sustain job-related eye injuries requiring medical treatment, yet safety experts and doctors of optometry agree that 90 percent of all eye and vision injuries could be prevented with simple safety steps such as wearing properly designed and fitted protective eyewear.

While most people think of construction or manufacturing as high-risk occupations where eye injuries are prevalent, even jobs requiring “smart phones,” laptops and desktop computers can cause vision problems if not used properly.

Go Easy on the PDA
According to the American Optometric Association or,AOA’s, American Eye-Q® survey, nearly half of all Americans (46 percent) spend five or more hours per day using a computer or a PDA (personal digital assistant). And while technology can easily improve the efficiencies of one’s life, prolonged use of electronic devices may lead to symptoms of Computer Vision Syndrome (CVS) such as eye strain, dry eyes, headaches, fatigue, blurred vision and loss of focus.

CVS can be a serious problem for those who spend hours in front of a computer or hand-held electronic device on a daily basis. However, small steps can make big changes to ease vision strain.

The AOA encourages all tech users to follow the recommendations below, which will go a long way in keeping productivity up and discomfort down while surfing the Web, editing a document or sending an e-mail.

* Give It A Rest: Remember the 20-20-20 rule. At least every 20 minutes, take a 20-second break and look at something 20 feet away. The Eye-Q® survey found that the majority of Americans don’t follow this rule; more than half (59 percent) take breaks every hour, or less frequently.
* Size Up: Smaller screens on hand-held devices usually favor tiny type that challenges your vision. Instead of bringing the screen closer to the eyes, increase the font size so the device can be used at a distance that is more comfortable for your eyes.
* Sharpen Up: Better resolution offers greater clarity and usually more comfort. Adjust the brightness of the screen to a comfortable intensity, neither too bright nor too dim.
* Reduce Glare: Hand-held devices present challenges in various lighting conditions. When possible, try to make sure lighting is not directly behind the head or in front. Reducing glare may ease reading and can make a bigger difference than increasing the font size.
* Look Down: It’s easier on the eyes to focus on reading material that is below eye level; therefore, position a computer monitor or hand-held device slightly below eye level.

Safer Sight On-Site
Many professions – from auto repair to health care – require protective eyewear to help reduce the risk of eye injuries. AOA advises that with proper eye protection, like safety glasses, goggles, face shields and helmets, thousands of injuries could be prevented. Yet the Bureau of Labor Statistics found that in approximately 60 percent of eye injury cases, workers failed to wear proper protective eyewear.

While working around the house, it seems an even greater percentage fail to protect their sight. The Eye-Q® survey found that nearly two-thirds of Americans do not wear safety glasses or goggles when working on home improvement projects.

Eye safety – whether at home or in the work place – is proven to prevent vision loss. The two main reasons workers experience eye injuries are either because they are not wearing eye protection or they are wearing the wrong kind of protection for the job.

The AOA recommends four key elements to protect eyes from injury:

* Know the eye safety dangers.
* Eliminate hazards before starting work such as using machine guards, work screens or other engineering controls.
* Wear the proper eye protection and make sure it is correctly fitted.
* Keep safety eyewear in good condition and replace it if it is damaged.

Visit Your Optometrist
While it’s important to practice good eye health habits at work, the best line of defense is to visit a doctor of optometry on a regular basis for comprehensive eye exams to help ensure healthy vision.

AOA recommends adults age 60 and under have a comprehensive eye exam every two years and then annually thereafter. Based on an individual’s eye health, the eye doctor may recommend more frequent visits.

3-D Movies: Not Everyone Can ‘See’ What All the Hype is About

As Hollywood prepares for a summer filled with 3-D blockbuster hopefuls and cable networks launch 3-D networks and programming for newly-released 3-D televisions, the trend towards this new technology is hard to miss—except for the millions of Americans who literally can’t see it.

Movies including “Avatar” and “Alice in Wonderland” have already left their impression on the 3-D screen and new movies using the technology are making their way into theaters across the country. Meanwhile, ESPN and the Discovery Channel are preparing to broadcast in 3-D. This new technology is catching the eyes of fans nationwide, but some people may not be able to enjoy the 3-D experience because of vision problems.

“Quite simply, people who have even a small vision misalignment or those who don’t have equal vision in both eyes may not be able to see 3-D images properly,” said Dr. Leonard Press, chair of the American Optometric Association’s (AOA) Pediatrics and Binocular Vision Committee. “Individuals with unstable focusing or difficulty in coordinating vision with other senses can experience headaches and other uncomfortable side effects from viewing 3-D movies.”

According to the American Optometric Association, anywhere from three to nine million people have problems with binocular vision prohibiting them from watching 3-D TV and movies. Binocular vision is the ability to align both eyes accurately on an object and combine the visual images from each eye into a single, in-depth perception. The problem comes from fatigue caused when 3-D technology forces the eyes to make adjustments to focus simultaneously on images that are near and far away.

Symptoms indicating a potential problem with the ability to see images in 3-D vary from person to person. According to the results of the AOA’s American Eye-Q® survey, the majority of individuals who suffer from 3-D vision complications most often experience headaches (13 percent), blurred vision (12 percent) and dizziness (11 percent).
The AOA recommends seeing a doctor of optometry for further evaluation if consumers answer yes to any of the following questions:

* Is the 3-D viewing experience not as vivid as it is for others watching the same picture?
* Do you experience eyestrain or headaches during or after viewing?
* Do you feel nauseous or dizzy during or after viewing?
* Are you more comfortable viewing 2-D TV or movies instead of 3-D TV/movies?
* Is it difficult for your eyes to adjust back to normal after watching 3-D TV/movies?

“Watching 3-D programming can unmask issues such as lazy eye, convergence insufficiency, poor focusing skills and other visual problems consumers might not have previously known existed,” said Dr. Dominick Maino, a Professor of Pediatrics/Binocular Vision at the Illinois College of Optometry’s Illinois Eye Institute. “Research shows that up to 56 percent of those ages 18 to 38 have symptoms related to a binocular vision problem. It is important to know that studies also show optometric vision therapy can help alleviate these problems and make the experience of watching these movies more enjoyable.”

Optometric vision therapy is a sequence of therapeutic procedures individually prescribed and monitored by an optometrist to develop efficient visual skills and processing. Following a comprehensive eye examination, the optometrist may prescribe vision therapy if the results of the exam indicate a need and if it is determined an appropriate treatment option for the patient. The vision therapy program is based on the results of standardized tests, the needs of the patient, and the patient's signs and symptoms. Optometric vision therapy re-educates the brain to achieve single, clear, comfortable, two-eyed vision that improves eye coordination, focusing and eye movement, ultimately enhancing the 3-D viewing experience.

The AOA also recommends visiting a doctor of optometry on a regular basis for comprehensive eye exams to help ensure healthy vision overall. The AOA guidelines suggest adults age 60 and under have a comprehensive eye exam every two years and then annually thereafter. Children should be evaluated every year as long as they are in school. Based on an individual’s eye health or the presence of certain risk factors, your optometrist may recommend more frequent visits.

Prevent Macular Degeneration by Eating Your Valentine's Day Chocolates

As Valentine's Day approaches those heart shaped boxes filled with chocolate are often thought of as guilty pleasures. However, those chocolates may actually good for you.

Dark Chocolate is high both in polyphenols and antioxidants, together these may prove to be beneficial in preventing macular degeneration. The darker the chocolate the better. Dark chocolate is proving to be good for for many health conditions including diabetes, hypertension, elevated cholesterol and may reduce the risk of blood clots, strokes and heart attacks. Polyphenols from Dark Chocolate may also exhibit some anti-vegf properties and may prove to be beneficial for macular degeneration. Try to eat the Dark chocolate with the highest percent of Cocoa and the least amount of sugar.

The American Journal of Clinical Nutrition reported on the effects of cocoa and dark chocolate on a study done on 23 healthy Americans. The published results were:

Cocoa powder and dark chocolate may favorably affect cardiovascular disease risk status by:

1) modestly reducing LDL oxidation susceptibility,

2) increasing serum total antioxidant capacity and

3) increasing HDL-cholesterol concentrations, and

4) not adversely affecting prostaglandins

Antioxidants combat and neutralize free radicals which cause damage to our cells, and in particular the macula where lots of oxidation takes place.

"Almost every single one of the risk factors we have for macular degeneration can be linked to free radicals."

Dr. Lylas G. Mogk, M. D., Visual Rehabilitation and Research Center of Michigan.

Dark chocolate has many more antioxidants than milk chocolate. Milk chocolate has the least amount of total antioxidant capacity. It is recommended that you select chocolates with at least 70% cocoa content. Natural cocoa powders contain the highest amount of total antioxidant capacity.

Avoid consuming your dark chocolate with a glass of cold milk since the milk interferes with absorption.

"Eating a little bit of chocolate or having a drink of hot cocoa as part of a regular diet is probably good for personal health, so long as people don't eat too much of it, and too much of the kind with lots of butter and sugar," said Diane Becker, the lead researcher of an 18 month study at Johns Hopkins in Baltimore.


References:

http://www.fortifeye.com/index.php?main_page=page&id=20

http://www.webrn-maculardegeneration.com/antioxidants-in-chocolate.html

Keep Your Eyes Safe This New Year's Eve

The countdown to New Year's Eve is a time to celebrate with family and friends. As you open that bottle of champagne in celebration, it is hard imagine it could lead to a trip to the emergency room or even permanent vision loss.

The cork from a champagne bottle can fly up to 50 mile per hour as it leaves the bottle. According to Doctor Kuldev Singh M.P.H., clinical correspondent of the American Academy of Ophthalmology and Professor of Ophthalmology of Stanford University School of Medicine, "Incorrect popping of champagne corks is one of the most common holiday-related eye hazards. Anything that travels with such force can have a dangerous effect if it strikes your eye. Eye-related cork injuries can lead to acute glaucoma, detached retina, and corneal abrasion all of which can result in decreased vision. Many champagne cork-related injures necessitate urgent surgery to prevent significant, permanent vision loss--a terrible way to spend the holidays."

Here are a few simple steps you can follow that can help prevent eye injuries this New Year's Eve.

• Make sure the champagne is chilled to at least 45 degrees Fahrenheit before opening. The cork of warm bottle is more likely to pop unexpectedly.

• Don't shake the bottle. Shaking increases the speed at which the cork leaves the bottle.

• To open the bottle safely, hold the cork down with the palm of your hand while removing the wire hood. Point the bottle at a 45 degree angle away from yourself and from any bystanders.

• Place a towel over the entire top of the bottle and grasp the cork.

• Keep the bottle at a 45 degree angle as you slowly and firmly twist the bottle while holding the cork to break the seal. Continue to hold the cork while twisting the bottle. Continue until the cork is almost out of the neck. Counter the force of the cork using slight downward pressure just as the cork breaks free from the bottle.

• Never use a corkscrew to open a bottle of champagne or sparkling wine.

Sources:
American Academy of Opthalmology.

http://www.medicalnewstoday.com/articles/174607.php