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Q and A Archives

Please read the following two paragraphs to find a possible answer to your question.

You should always consult with an Ophthalmologist or Optometrist about eye disease or eye problems.  It is recommended that children receive a professional eye exam by an eye doctor at birth, 6 months, 3 years and before entering school.  In general, older children and adults should receive a complete eye exam every 1 - 2 years.

This section contains answers to questions compiled from 1999 to 2003.  Also see the dictionary for terms and further information and review the past featured articles.   This information is provided for personal use only and is not meant to be "medical advice." 

To help you find a specific word or topic, at the top of the page under Edit click-on "Find" within your browser  and then type in the word or topic to search.  If the Find stops at one of the hyperlinks below, click on the hyperlink to go to the topic.  Please note that topics may have been discussed several times, so you may need to do several "Finds"  to collect all the available information on the topic within this web page.

If you find this information helpful, please consider a tax deductible donation to the Ohio LIONS Eye Research Foundation.  Thank You

 

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Topics:

Cone-rod degeneration     Retinal Detachment    Turning-in of Eyes    Stye

Bright red spots    Red eye    Best's Disease     Optic Atrophy    Pink eye

Conjunctivitis    Floaters    Toxoplasmosis    Anterior Chamber Dysgenesis    Dry eye

CRVO    Corneal abrasion    Blind spot    Esophoria vs Esotropia    Ozone treatment

Macular hole    Halos    Spot on iris     Back-and-forth eye movements

Swollen eye lids    Optometrist vs Ophthalmologist    Sharp pain in eye   

Wine and Macular Degeneration    Cysticercosis    Toxocara Canis   

Patches of light in both eyes     Amblyopia in an older child    

Niacin and blurred vision    Normal pressure and glaucoma surgery   

Eye removal in glaucoma    Color blindness    Needs     Dyslexia   

Vision therapy for Amblyopia     Dilated pupils    Choroideremia vs Chorioretinitis

Flashing light(s)    Computer Eye strain    Histoplasmosis     Dark circles under eyes

Recurrent corneal abrasion     Chronic Blepharitis     Photophobia

Delayed Visual Maturation    Cortical Visual Impairment    Vitamin A and Floaters

Retinitis Pigmentosa    Half of Eye Red    Swollen Eyes and Feet

Broken blood vessel in eye     Coats' Disease    Wife's swollen eye    Yellow Eyes

Why Eye Tests?    Stationary Black Spots in Eye    Twitching Eye(s)    Watering Eyes

Sclera scar    Uveitis     Tan Spot on Eye    Best    Pterygium     Viagra    Eye Clinic

Rod-Cone Specialist    Blepharospasm    Scotoma     Eye Color and Vision

Synesthesia(Mixing-up of Sensory info)     Episcleritis    Bi-focals and Burning Eyes

MSG    Scleritis     REM(Nystagmus)    Double Vision    Color Blindness   

Unequal Pupils    Contacts    Cataract Surgery and Floaters    Optic Nerve Drusen

Central Serous Retinopathy    Niemann-Pick Disease    Pseudophakia

Seeing Dots    Head Trauma and Diplopia    Blocked Tear Duct   

Watery Eyes and Upper Lid Swelling     Something in Eye(s)    Blurry Streaks

Constantly Red Eye    Strings in Eye    Prones      Loss of Side Vision in Histo   

Bubbles on Lid Margin    Busted Vein in Eye    Holes in the Macula

Flashes in Eye    Best Patterns for Seniors    PIC Disease    Pars Planitis   

Blufferitis (see Blepharitis)     Blood in Eye    Stinging Eye    Distorted Vision  

Grave's Disease    Adie's Pupil    Diplopia     Mucus in Eye    Lazy eye

Lights Dimmer than Normal    1/2 Red Eye    Herbal Products    Tunnel Vision

Stargardt's Disease    Different Pupil Size    Upper Eye Lid Swelling   

Sensitivity to Light     Heal Macular Degeneration     Transplant Worries

Dark Circles and Bags Under Eye    Florescent Lights    Eyelid Cysts   

Jumping or Twitching Eye       Poor Side Vision and Nausea    Red Hue   

Black Spots    Fuch's Dystrophy    Adie's Syndrome    Glasses to Correct Color Vision

Blind Spots in Visual Field     Film-like Growth on Eye     Lightening Bolts   

Blood Spots on Eye    Lights hurt at Night    Iritis and Autoimmune Disorders

Retinoschisis    Pengweckula(Pterygium)    Retinitis Pigmentosa (RP)     Scales

Holme-Adie Disease    Can't Open Eyes    Sparkly Wavy Lines    Rolling Eyes   

Central Serous Retinopathy     Bubbles    Stargard (Stargardt's) disease   

Post Chiasmal Vision Loss     Nightlights and Vision Problems    

Painful Burning Eyes   Pin Prick in Eye    Thyroid Eye problem    Red Itchy Eye Lids   

Treatment for Older Amblyopic Child     Test Your Eyes for Floaters     Sty (Stye)

Blindness at Night    Itchy, Red Eyes    Looking Through Curtain    Sore Eyes

Floopy Eyelid Syndrome     Wandering Eye   High Blood Pressure and Floaters

Small Triangular Area of Flashing Prisms in Periphery    Meniere's disease

Serpiginous Choroiditis     Vogt-Koyanagi-Harada (VKH) disease    

Epiretinal Membrane     Pavement Stone or Paving Stone degeneration

Laurence-Moon-Bardet-Biedl Syndrome    ERVAN'S [Eales] Disease

Nearsightedness    Steroid use in a Child    Pseudotumor Cerebri and Papilledema

Stigmatism (Astigmatism)    Retinal Implants    Diabetic Eye or Retinopathy

Congenital Hypertrophy of the Retinal Pigment Epithelium    Eye Disease vs Defect

Wearing a Patch to Avoid Diplopia    Rings Around Lights    Marcus Gun (Gunn) Pupil

Birdshot Retinochoroidopathy    Lattice Degeneration    Loss of the Ability to Focus

Fuchs' Heterochromic Iridocyclitis    Eye Replacement in Coats  Nystagmus

Broken Glass Blind Spots     Floaters, Halos and Dark Flashes     Large Pupils

Floaters, Halos and Dark Flashes Reply    Gray Oval in Eye    Congenital Cataract

Correction for Eyes that are not Straight    Seeing Tracers or Trails    Lesion in Eye

Funds for Surgery    Scerlitis (See Scleritis)       Bumps along Lid Margin and Floaters

Eyeritis (Iritis)     Parafoveolar Telangiectasia    Blood in Eye     Blurry Eye at Night

Fugndris Flarvinoculations (Fundus Flavimaculatus)    Yellowness in Corner of Eyes

Thrust and Blurry Vision    Droopy Eyelid    Neurologist     What an Amblyope Sees

Chalazion     Ceratocome (Keratoconus)    Pass Ishihara Test    Stargartz (Stargardt's)

Eye Higher Than Other    VDU Eye Problems     Panuvitus (Panuveitis)    Walleye

Sulzmann's (Salzmann's) Nodular Degeneration    Yellow Pupils (Iris)   

% of People Who need Glasses    Young Child not Dilating    Contacts and Red Ring

Radiculopathy, Steroids and Central Serous Retinopathy    Oscillatory Potentials

Corneal Transplant in Elderly    Screen Reader (Text-to-Speech Program)    

Floating Eye    Temporal Field Loss    OD and OS     Visual Aftereffect Phenomenon

Pneumatic Retinoscopy (retinopexy)    RP or Usher's Syndrome   Eyeritis (see Iritis)

Bilateral Reholental Fibvoplasin (Retrolental Fibroplasia)    Iristis (see iritis)

Mavular Degeneration (see Macular Degeneration)       Pale Nerves

Celinder Glasses (see astigmatism)         Treatment for nystagmus   

TV and Computer Screen Effect on Eyes    Slanted (abnormal shaped) pupil

Transient Blurred Vision in One Eye    Double Vision in One Eye    Thygeson's

Duane's Syndrome         Bright Spot when Shifting Gaze     Crusty and Itchy Eye Lids

Exercise-Induced Vision Problem    Protruding eyes     Pseudomyopia   

Unable to move eye     Seeing Squiggly Lines    Constant Watering Eyes   

Swollen Upper Eye Lid    Accutane and Floaters    Eyes Focus at Different Points

   Star guards (see Stargardt's)    Eye Hemorrhaging     Blisters/Ulsers on Eye

    Droopy Eyelid    Eye Muscle Surgery for Crossed-eyes     TV and Eye Problems    

Losing Sight in One Eye    Eyes Feel Pressure and Irritated    Eye Dominance

Map-Dot-Fingerprint Dystrophy         Krukenberg (Spindle)     Optic Nerve Atrophy

Dark Circles Under Eyes    Spelling of a Rare Eye Disease    Excessive Blinking

Double Vision in the Elderly    Red Glasses and Well Being    Orbital Cellulitis

Blepharitis and Permanent Vision Problem      Nevus   Tunnel Vision    Adie Eye

Holm's Adie (Holmes Adie)    Torn Retina    Diabetic Eye Disease

Seeing Flashing Lights when Moving Eyes    White Ring Around Iris    Seeing an Arc

Bump on White Part of Eye     Recurrent Swelling of Eyelids and Blepharochalasis

Papilledema    Flashlight and Eye Damage     Treatment for Blepharochalasis

Twitching Eye    Conjunctival Cyst     Amblyopia and No Depth Perception

    Extreme Myopia and Cataract Surgery    Blister on Bottom Lash  

Fuch's Dystrophy and Corneal Transplant    Blind Spot in Right Eye   

Black and White Spots in Eyes    Eyes Feel Pressured and Irritated        Eyes Tester

Laser Operation for Astigmatism and Myopia     Imagry    Angioid Streaks

Sore Eyes and Inflamed Lids    Black Spots and Lines    Retrobulbar Neuritis

Eyes Swelling    Watery Right Eye     LIONS Knights for the Blind    Oscillopsia

Mineral/Herb for Lazy eye    L-dopa for Older Child with Amblyopia    

Myasthenia Gravis and Eye Problems    Dry, Crusty Eye Lids   

Carataconis (Keratoconus)    Crescent Scotoma     Freckle on Back of Eye

Coat's Disease    Seeing World as a Series of Slides    Eye Sight Changing Too Fast

Strabismus and Need for Surgery    Spot on Left Eye     White Blur in Left Eye    

Iritis, Why and How to Prevent    Macula Degeneration    Epiretinal Membrane

Choroidal Nevus and Vision Loss    Type 2 Diabetes and Eye Problems

Cellophane Retinopathy/Maculopathy    Halos in Eyes    Itchy Eyes   

Stargartz (Stargardt's)    Blurred Vision     Different Colored Blubs    

Blood Spot on Eye    Seeing Lines and Circles     Bumps on Eye    Myopia

Loss of Top Visual Field    Sty     Posterior Vitreous Detachment    Lens Surgery

Financal Help or Assistance    Seeing White Objects as Yellow     Fuch's and PTK

Dark Spot and Pain/Pressure    Flashing Lights at Corner of Eyes    Isochromatic

Krrytoconus(Keratoconus)    Work and Office Lighting    Contact Cut Eye

Eyes Itch, Burn and Bump on Upper Lid   Anisometropia and Vertical Deviation

Myopia and Reduced Acuity   Nevus     Acute Episodic Events  

Puffy Eye and Sinusitis    Red Spots on Iris    Devic's Disease    

Diabetes and (More) Laser     Lightening Flashes    Floaters    Eyeritis (see Iritis)

Lattice Degeneration in Child    Reinarts (Reiter's) Disease    Bumps on the Eye

Costs of Esotropia Surgery    Rod Cone Dystrophy     Night Lights and Myopia

Bloodshot Eyes in Morning and Evening    Donate Eye Glasses    Pale Optic Nerve

Small Knot on White of Eye    Sudden Los of Visual Field   Inocular Degeneration

lymphatic anjectasia (Lymphangiectasias)    Pingueculoe (Pinguecula)

Dry Eye(s) and Floater    Car Accident and Pupil Response     Surgery for Glaucoma

Adult Amblyopia     Stargardt's Why No Cure     MRI and ?    Subretinal Fibrosis

Drivers License for Blind    More Simulations     Infant with Black Pigment

   Double vision    Synechia (Synesthesia)   

Hyperlinks not available for Q and A Archives after August 1, 2000.  Use Find, under Edit on your browser, for your search.

Answers:

Q.    My husband/wife has a cone rod degeneration or dystrophy.  Is there any treatment for this disease?

There is no known treatment for cone-rod degeneration or dystrophy. Nevertheless, there are certain things that you/your husband or wife with cone rod degeneration should consider:

  1. Avoid or minimize exposure to excessive light levels by wearing a hat and dark sun glasses outside and limiting internal light levels. Some scientists/doctors believe in the "use it and lose it" hypothesis – if you’re exposed to excessive lights it will tend to aggravate the condition and lead to worsening sight.
  2. Eat a diet rich in antioxidants. Some animal research suggests that antioxidants my protect the (remaining) retina from damage, including damage from excessive light exposure. As an alternative, take vitamin supplements.
  3. Any diagnosis of a serious vision loss due to a retinal degeneration should be followed by genetic counseling. Because about 70% of retinal degenerations are autosomal recessive, there is a low probability that children of a person with a retinal degeneration will have the disease. In an autosomal disease, there is a 25% chance that the patient’s brothers and sisters from the same mother and father will also have the disease.
  4. A person with a retinal degeneration should be seen by the local Bureau for Services for the Blind and Visually Impaired (BSVI) and, if available, a Low Vision clinic. These sites provide services and equipment such as low vision devices, optical aides, scanning and computer devices, etc. Through the use of certain low vision aides such as a bioptic lens, visually impaired and even legally blind patients can obtain a drivers license in some states, including Ohio.

Q.    What causes small red spots on the white part of the eye?

Bright red spot(s) on the white part of the eye are probably subconjunctival hemorrhage(s).  These are caused by a number of things including injury or may develop spontaneously in older adults.  You should see an Ophthalmologist for a diagnosis and treatment if applicable.

Q.    What causes red eye?

Red eye is caused when the blood vessels of the eye swell with more blood than usual.  Red eye may be associated with:

  1. Infection, including AIDS
  2. Allergic or chemical reaction
  3. Glaucoma
  4. Fatigue
  5. More serious disease
  6. Need for glasses

A person with red eye should see an Eye Doctor if:

  1. There is pain
  2. See floaters
  3. Loss of vision
  4. Caused by injury
  5. There is discharge from the eye
  6. Swelling or redness of the eye lid(s)
  7. Cloudy cornea
  8. Unequal pupil size
  9. Presence of bright red blood in the eye, between the cornea and iris

Q.    What causes black floating spots in my vision?

Floaters are condensations of cells in the gel part of the eye, known as the vitreous.  Floaters appear as dark spots, as web-like objects, as a dot with arms, or strings.  Floaters are often associated with high myopia (very nearsightedness) and with aging.  A lot of floaters my be a sign of serious eye disease such as a retinal break, tear, or retinal detachment.  If you see a lot of floaters, suddenly, or see bright dots or flashing lights, you need to see an Ophthalmologist immediately.  There is no treatment available for typical, nonpathologic, floaters.  Also see Vitamin A and Floaters in this section.

Q.    What causes a retinal detachment?

A retinal detachment usually occurs when fluid accumulates between the retina, that part of the eye that contains the photoreceptors, and the underlying layer of cells, called the retinal pigment epithelium (RPE).  A retinal detachment can also occur because of abnormal bonding between the retina and vitreous by bands of fibrous tissue.  A retinal detachment my be the result of injury to the eye such as blunt trauma (remember Sugar Rae, the boxer), penetrating injury, or it may result from other things like high myopia or age-related macular degeneration.  In certain diseases, retinal breaks and tears occur and these may lead to a retinal detachment.  Early warning signs include bright dots or lights or some of your side vision may appear dark.   A retinal detachment may be treatable if detected early, so see your Ophthalmologist, immediately.

Q.    My child's eyes appear to really turn-in when he looks at close objects.

Your child may have an accommodative esotropia - this condition occurs when a child looks at near objects and the eyes turn-in too far, making their child appear cross-eyed (esotopic).  This may be a sign that your child needs glasses for seeing things close-up.  If left untreated the child may develop a lazy-eye.  You should see a Pediatric Eye doctor for evaluation and treatment.

Q.   What is Best's Disease?

Best's (not Best) disease, also called Vitelliform macular dystrophy, is an autosomal dominant (i.e., 50% of family members have it) form of generalized retinal pigment epithelium (RPE) dystrophy.  The RPE is a layer of cells in the back of the eye that provides nourishment to the retina and photoreceptors.   Clinically, Best's disease is characterized by one or more lesions in the back of the eye that sometimes takes on the appearance of a "sunny-side-up egg yolk" in the early stages of the disease and later appears as a "scrambled egg."   Depending on the locus of the lesion(s) it may or may not affect vision.  If it does not affect vision, then the patient is an asymptomatic carrier of the disease.   When it does affect vision, visual acuity may range from 20/30 to 20/200 (legal blindness).  There is no treatment available for Best's disease.  The diagnostic test for Best's disease is the electro-oculogram (EOG), which takes about one hour to perform, and a complete dilated eye exam.  All members of the family should be tested with the EOG to identify carriers of the disease, even if they are asymptomatic. 

Q.    What is optic atrophy?

The optic nerve is composed of mostly axons from the millions of ganglion cells within the inner layer of the retina.  The optic nerve goes from the eye, crosses at the optic chiasm, ( after which it is called the optic radiation) and innervates the vision centers of the brain.  In optic atrophy, some of the ganglion cell axons that make-up the optic nerve have died or are dying.  When the eye doctor looks into the eye, the optic nerve looks white or pale instead of the normal pink, healthy color.   A large number of things can cause optic atrophy, either things within the eye or things within the brain.  Sometimes optic atrophy can occur by itself, but most of the time its associated with or a symptom of another serious disease.  Optic atrophy is never a good sign, and often requires a through work-up to identify the cause.   Optic atrophy can lead to varying degrees of vision loss; from normal to near-normal vision to complete blindness.  Vision can decrease rapidly in some cases.   If you're diagnosed with optic atrophy, it is very important to follow-up on all doctor appointments with you Ophthalmologists, Neurologists, etc., your life may depend upon it!

Q.   What is Toxoplasmosis and how did I/my child get it?

Toxoplasmosis is a parasitic infection that humans get from contaminated soil or cat litter, or can get from eating undercooked contaminated meat.  From 15% to 30% of North Americans are infected by Toxoplasmosis.  Toxoplasmosis can be transmitted from an infected mother to her unborn child, in 30 to 40% of cases, where it can severely affect the infant - called congenital Toxoplasmosis.  If it is active, it is called symptomatic congenital Toxoplasmosis.  In unborn and new infants Toxoplasmosis can cause numerous vision and neurological problems including; retinochorioditis (inflammation within the eye), seizures, hydrocephalus, microcephaly (small head), fever, glaucoma and ocular palsies. Visually, Toxoplasmosis can lead to retinal tears, retinal detachments and retinal bleeding and blindness.  To minimize infection, particularly of pregnant women, meat and eggs should be well heated and contact with cat stools, including cat litter, should be avoided. 

Q.   What is "Anterior Chamber Dysgenesis?"

The anterior chamber is the front part of the eye from the cornea to the iris - the color part of the eye.  Dysgenesis means underdeveloped or maldeveloped, in other words the anterior chamber did not form completely.  If the iris is involved there is a high probability that glaucoma may develop and cause serious vision loss.   Sometimes, anterior chamber dysgenesis is associated with other systemic or whole body problems including dental defects, abnormal development of the skull and skeleton, and certain growth problems in the child.  The treatment of glaucoma in patients with anterior chamber dysgenesis is very difficult, requiring lots of surgery and eye exams.   Because of the serious nature of glaucoma, the patient MUST be seen regularly by an Ophthalmologist.

Q.    I have a Stye (or Sty) in my eye, why?

A Stye (external hordeolum) is caused by bacterial infection, typically Staphylococcus aureus.  There is usually painful swelling of the eye lid, that usually becomes localized with outbreaks  along the eyelash line.  Styes usually respond well to hot moist compresses ( 4 times/day for 15 minutes).  Removal of eye lashes in the affected area may promote drainage.  Topical ophthalmic antibiotics my be needed.  If there are other sites of infection, oral antibiotics may be necessary.   In general, styes are caused by poor hygiene whereby the patient goes to the bathroom, changes a diaper, for example, and then touches the eye area thus infecting the eye lid margin.  Proper hygiene and washing your hands with soap and water after going to the bathroom, for example, my reduce the chances of future infections.  See your eye doctor.

Q. What is "pink eye"?

Pink eye is a conjunctivitis caused by Koch-Weeks bacillus - a bacterial infection.  It is very contagious and causes wide spread epidemics, particularly in warm climates.  Once infected, the incubation period is 24 to 48 hours and is followed by an acute onset of inflamed, redness, and discharge of mucus and pus from the eye.  The patient often complains, if old enough, of scratchy, burning and pain of the eye and eye lid.  Subconjunctival hemorrhages are common and in some cases corneal ulcers may appear.  The infection reaches its peak in 3 to 4 days.  If you or your child has pink eye, immediate medical attention is needed.  Untreated patients often have recurrences of the disease.  Attention to personal hygiene is recommended.  See your eye doctor.

Q.    My eyes are very dry.

Dry eye disease (Keroconjunctivitis sicca) is a common and very frustrating disease to deal with in the aging population.  It typically affects women and symptoms include a dry, gritty sensation as well as foreign body sensation in the eye(s).   There are many causes of dry eye disease including the decrease in hormones with advancing age and reduction in eye tear production, sometimes associated with other disease.  Unfortunately, treatment options are limited, in part, because of the number of diverse factors that cause the disease.  Artificial tears and ointments provide temporary relief.  Better treatments will become available through research, some of which is being undertaken at the College of Optometry at The Ohio State University with support from the Ohio LIONS Eye Research Foundation.  See funded research.

Q.    What is CRVO and what can be done about it?

CRVO stands for Central Retinal Vein Occlusion.   CRVO as well as occlusion of one or more of the central vein branches causes various degrees of vision loss depending on the extent and locus of the occlusion.    Upstream from the occlusion venous dilation and mild hemorrhages may be observed by the eye doctor.  There also may be swelling and so-called "cotton-wool" spots in the back of the eye (retina).  A percentage of patients will also develop neovascularization (i.e., growth of abnormal blood vessels) of the iris and, as a result,  develop glaucoma.  Most patients with CRVO are elderly and their eye problems are associated with arteriosclerosis.  Recovery of vision is dependent on the extent and location of retinal hemorrhages.  If glaucoma develops, the eye may have to be enucleated (removed).

Although there is no effective cure for CRVO, depending on conditions the eye doctor may use steroids to control edema (swelling) of the central retina (macula).   Anticoagulants have also been employed to reduce/prevent the chance of iris neovascularization and associated glaucoma.  However, it appears that the use of anticoagulants are no longer considered effective for treatment/prevention.  Finally, photocoagulation (i.e., laser surgery) may be used to treat the abnormal blood vessel growth in the retina and to prevent retinal edema and subsequent loss of central vision.  The eye doctor may also run certain blood, urine and stool tests tests while the patient is taking anticoagulants.   Because of the dangers and seriousness of CRVO, the patient must been seen regularly by the eye doctor and must keep all of his or her appointments.

Q.   I have a Corneal abrasion (scratched cornea) and it hurts like ...., what can I do about it?

A corneal abrasion can be caused by a number of factors and is associated with severe pain, photophobia (light sensitivity), tearing and twitching/closure of the eye.   If there is penetration of the eye by a foreign object, very serious complications include cataract, hemorrhages and possible loss of the eye.  A person that has a corneal abrasion should by closely examined by their eye doctor for foreign objects.   Assessment usually includes the use of fluorescein stain of the cornea to localize the abrasion.  Topical antibiotic ointments are often given and patching of the eye may be recommended.  Topical corticosteroids and topical anesthetics are not recommended.  For severe abrasions the patient is usually reexamined in 24 to 36 hours.  Early treatment is essential for a corneal laceration or for penetrating injuries. 

 

Q.    We all have a blind spot in our visual field where the optic nerve leaves the eye, yet we don't usually see it.   Why don't people that have macular degeneration also compensate for the blind spot in their central vision?

A natural blind spot occurs in our visual field because there are no photoreceptors where the optic nerve head is located in the back of the eye or retina.   Yet, we are not typically aware of the blind spot in our vision.  To demonstrate the normal blind spot do the following;

On a piece of paper draw two small dots, separated horizontally by two inches.   Close your right eye and fixate on the right dot with your left eye.  Now hold the paper about 12 inches from your nose and move the piece of paper slowly straight towards your nose while maintaining fixation of the right dot with your left eye (no peaking).  Watch what happens to the LEFT dot when the piece of paper is about 6 inches from your nose - the left dot will actually disappear.  This is where your natural blind spot is located or observed.

Why don't we "see" the natural blind spot in daily vision?    Anatomical and electrophysiological studies on animals have revealed that the   visual areas of the brain corresponding to the optic nerve head (and thus the natural blind spot)  is filled-in so that there is no brain site that corresponds to the natural blind spot.  Anatomically, the brain sort of covers over the natural blind spot in our vision and, as a consequence, we do not see the blind spot in daily living.  In other words, there is no brain space devoted to the natural blind spot.   People with macular degeneration do not form such an anatomical filling-in process, possibly because the brain is no longer "plastic" or amenable to change in later life (i.e., beyond the critical period of vision development).

Important:  If you or someone you know actually sees one or more "blind spots" if your vision (other than the natural blind spot as described above), see an Ophthalmologist immediately!  The presence of blind spots in vision may be a sign of a very serious eye or/and neurological disease.  See Simulations for a few examples of diseases that cause blind spots, also called scotomas.

Q.   What is the difference between an "esophoria" and an "esotropia"?

"Eso" is a prefix meaning that the eyes turn-in toward the nose, as opposed to an "exo" meaning that the eyes appear to turn-out).  A "phoria" means that the eyes are misaligned a little (usually defined  as less than 10 prism diopters).  A "tropia" means that the eyes turn-in a lot (10 prism diopters or more) and is very noticeable.  So, an esophoria is a small turning-in of the eyes and an esotropia is a large turning-in of the eyes.  [Although we refer to "eyes", usually only one eye turns-in]  A person with an esophoria may get along fine; use both eyes together and have normal visual acuity in each eye.  Depending on the circumstances, a child with an esophoria may need to have some prism in one or both of his or her glasses.  A person with an esotropia typically will not use both eyes together and may have a lazy-eye (amblyopia).  If the child has a lazy-eye, the standard treatment is patching the good eye and forcing the child to use the lazy-eye until vision becomes normal.  Often, a child with an esotropia will need corrective eye muscle surgery to align the eyes - ideally after the lazy-eye is cured and vision in both eyes is similar.  Sometimes the child with an esotropia may need glasses and the glasses may correct the esotropia - a condition called accommodative esotropia. 

Q.    I have retinitis pigmentosa (RP) and I recently heard about "ozone" treatment for RP.  Does it work?

No.  There is no valid scientific evidence that shows that ozone treatment works in patients with RP.  A few studies have been published showing that ozone treatment improves some aspects of vision in RP patients; however, the ozone studies that we have reviewed were poorly designed, lacked appropriate control groups and were based on very few subjects.  For more information about RP and valid research, go to the Web site for The Foundation Fighting Blindness at  http://www.blindness.org/

 

Q.    What is a macular hole?

A macular hole is a lesion in the fovea - that part of the macula or central part of the retina used for reading.   To the eye doctor a macular hole looks like a hole or depressed circular or oval area that typically is reddish in appearance.  To the patient a macular hole looks like a dark area or scotoma in which the patient can't see through (see simulations).   Prior to a full-blown macular hole, a "pre-macular hole lesion" may be present and these have been referred to by various names including macular cyst, involutional macular thinning or impending macular hole.  Depending on the severity, size and location of the macular hole, the patient may have from about 20/50 to 20/400 visual acuity in the affected eye.  Some macular holes, about 10%, partially resolve or improve, but the majority are permanent as is the loss of vision. Usually only one eye is affected and  women are affected much more than men.  Trauma to the eye accounts for about 15% of macular holes, while the rest are typically associated with aging (50 and older).  Because a macular hole is difficult to diagnose, some tests that the eye doctor may order include a fluorescein angiogram and a biomicroscopy with a contact lens.  A retinal detachment may result from a macular hole and surgery may be needed.  Ophthalmologists have tried a number of treatments for macular holes with varying degrees of success.  A patient with a macular hole must see the eye doctor on a regular basis.

 

Q.    Halos around lights.

Halos are usually caused by light scatter.  Light scatter is typically caused by problems with the anterior (front) portions of the eye, such as the cornea, lens or/and lens capsule.  People that typically see halos include people with cataracts (or with the early beginnings of a cataract), people that have had "refractive surgery" and people that have had cataract surgery.  When a person has a cataract (clouding of the lens of the eye), the cataract scatters light and, as a consequence, when the person looks at on-coming head lights, for example, he or she experiences halos.  When a person has had cataract surgery, the lens of the eye has been replaced with an intraocular (inside the eye) lens; however, the lens capsule remains in the eye.  Sometimes the lens capsule will become cloudy and will cause light scatter and thus halos.  Halos are a common complaint of people that have had refractive surgery - surgery to correct a refractive error and remove the need for corrective lenses.

 

Q.    Small white spot on iris, what is it?

The white spot may actually be a foreign body on or in the cornea.  If so, you should see your eye doctor immediately, particularly if your eye is red and painful.  If you are convinced that it is part of the iris, it is unclear what it could be and you should also see your eye doctor immediately.

 

Q.    I have a 3 month old whose eyes move back-and-forth constantly.  Why is she doing this?

The technical name for eyes moving back-and-forth constantly is "nystagmus".  In an infant, nystagmus may be caused by a number of things - some very serious.  Therefore, you should take your infant immediately to a pediatric Ophthalmologist, who will probably have a number of diagnostic tests performed to determine the cause of the nystagmus.  Sometimes nystagmus is present at birth, or first noticed in the first few months of life, and occurs by itself. This is called congenital nystagmus (CN).  An infant with CN will sometimes be able to slow-down the size and frequency of the nystagmus by looking in a certain direction or turning the head a certain way (i.e., null point).  As the infant ages, the CN usually gets smaller in size, but may increase in frequency.  CN often gets worse (larger size and more noticeable) when the infant is tired or not feeling well.  Children with CN will show some degree of vision loss, and usually have visual acuity in the range of about 20/70 (visually impaired) to 20/200 (legal blindness).  Sometimes nystagmus in an infant is a sign of a more serious eye disease, such as a retinal degeneration, that can cause blindness.  Other times nystagmus may be a sign of another neurological problem with the brain or/and optic nerve(s).  So it is very important that a child with nystagmus be seen by a pediatric Ophthalmologist who is able to have a host of diagnostic tests done to determine the cause of the nystagmus.

 

Q   Swollen eyes.

Eye lid swelling may be caused by a number of factors including ocular allergies, infections, neurological disorders and trauma.  The eye lids are the most common sites for ocular allergies which may be triggered by drugs, cosmetics, insect bites and even sun light.  Even if cosmetics are not applied directly to the eye lids, they may nevertheless cause eye lid inflammation (called Eczema) because of indirect contact via rubbing of the eye lids or during sleep when cosmetics are rubbed-off of the face onto the pillow and onto the lids.  Contact allergies are usually caused by cosmetics and drugs.  The eye lids reflect diseases which primarily affect the skin, including Psoriasis.  More serious neurological problems associated with lid swelling include hyperthyroidism (Graves disease), orbital cellulitis, orbital tumors and syphilis.  Individuals may also simply have a predisposition for swollen eye lids which may worsen with sleep, when the head is in a sublime position and blood flow is increased to the facial area.  See your eye doctor if you are concerned about swollen eye lids, particularly if the swelling is associated with any other symptom such as redness, pain, double vision, reduced vision or if you feel a lump on the eye lid.  Also see Stye in this section.

 

Q.    What is the difference between an Optometrist and an Ophthalmologist?

An Optometrist (designated as an O.D.) is an eye doctor whose is trained in the optical correction of the eyes with contacts or glasses, diagnosis and treatment of eye problems and eye diseases, and who may be trained and certified in the use of diagnostic and therapeutic drugs.  To become an Optometrist, you need a 4-year bachelors degree and three to four years of post graduate work at a college or department of Optometry.  An Ophthalmologist is a medical doctor (designated as an M.D.) or Osteopathic doctor (designated as a D.O.) whose is trained in the optical correction of the eyes with contacts or glasses or surgery, diagnosis and treatment of diseases of the eye and body, uses diagnostic and therapeutic drugs, and performs surgery.  To become an Ophthalmologist, you need a 4-year bachelors degree,  4-year medical degree, 1-year internship and three to four years of residency training specifically in Ophthalmology.  Optometrists and Ophthalmologists may have additional year(s) of training in a specialty area such as pediatrics.

 

Q.    My father complains periodically of   sharp pains in his eye, almost like that caused by a needle.  Can you explain?

Sharp pains in the eye may be an early sign of glaucoma - abnormally increased pressure in the eye that can lead to blindness.  The presence of glaucoma increases with age.  Your father should see an eye doctor ASAP for a complete eye exam which should include the measurement of the pressure of the eye.   If caught early, medicines and/or surgery may prolong sight.

 

Q.    Does drinking a glass of wine every day slowdown macular degeneration?

We are not aware of any scientific evidence that drinking a glass of wine every day slows any type of macular degeneration.  However, the is some evidence of a relation between antioxidants (related to those nasty free radicals) and age-related macular degeneration; the higher the level of antioxidants in the blood the lower the risk of macular degeneration.  Excessive alcohol consumption (and cigarette smoking) appear to decrease the amount of antioxidants in the blood.  Therefore, drinking (too much) wine may actually make the macular degeneration worse!  So, if you have macular degeneration DON'T SMOKE and LIMIT ALCOHOL CONSUMPTION.  For a great booklet on age-related macular degeneration and the dos and don'ts, go to Cool Links and the Web site for the Alliance for Aging Research.

 

Q.    What is cysticercosis?

Cysticercosis (Cysticercus cellulosae) is a larva of pork tapeworm.   The parasite is usually ingested by eating raw or undercooked pork, vegetables or even water that is infected by the larva.  The parasite is easily found in Africa, Central and South America and Eastern Europe as well as southeast Asia.   In humans the parasite seems to prefer the eye and/or brain.  In the eye the parasite mostly affects the rectus muscles of the eye, but other eye sites include the retina, usually the macula, and sometimes even the anterior chamber (just behind the cornea) where the eye doctor can sometimes see the parasite.  Not all patients infected with the parasite show eye damage.  Early in the course of the infection the patient may have no symptoms.  Later in the course of the infection the patient may experience floaters, blind spots in central vision (scotomas), wide spread inflammation of the eye (panuveitis) and permanent loss of vision.  In rare cases, in which the parasites invade the brain, coma and even death occur.  If a patient is infected by the parasite, there are medical measures that can be taken to remove (via surgery), or kill (via photocoagulation or antiparasitic drugs), the parasite and to control the inflammation.

 

Q.    What is Toxocara canis and how the heck did [my kid] get it?

Toxocara canis is a roundworm parasite that lives in the intestines of puppies.   Parasites and their eggs are excreted into the soil or anywhere that the puppy "goes."  Patients can become infected by the parasite by ingesting the eggs in soil (eating with dirty hands) or from direct contact with the infected puppies.  The parasite can travel to the many parts of the body including the eye, where it causes inflammation and possible loss of sight.  Toxocara canis is described as "self limiting"; meaning that most people have limited problems with being infected.  Some doctors caution that trying to "kill" the parasite may actually cause more damage because of the toxins that are released into the body or eye when the parasites die. 

 

Q.    Every once-in-a-while I see a type of kaleidoscope effect of moving streaks of light that temporarily block-out my vision.  Sometimes it is directly in front and at other times it is off to the side.  I see the patches of light with both eyes at the same time and even see the lights with my eyes closed.  Otherwise my vision is 20/20.  Any ideas?

    Regarding your question about binocular (seen with both eyes) patches of light, we would recommend that you see a Neuro-ophthalmologist. Because you see the patches of light with both eyes at the same time means that the site of the effect is probably cortical – in the brain. That the patches of light cover parts of your visual field is analogous to what are medically referred to as "scotomas." The most common cause of transitory scotomas made-up of so-called flashing lights (fortification phenomena) is migraines. Typically, migraines that cause scotomas are also associated with subsequent headaches, but not always. Migraines can also be associated with other symptoms including ringing in the ears, loss of balance, light headedness, sensitivity to lights and other body sensations. However, temporary scotomas may be due to other, more serious, medical problems and this is why you really need to be evaluated by a Neuro-ophthalmologist; a medical doctor trained in both Ophthalmology and Neurology.

 

Q.    My 15 yr old son was just diagnosed with refractive amblyopia, even though he had previously passed all his eye tests.  The Ophthalmologist said that nothing could be done [since he is too old].  Is there any new treatment that could correct this?

We generally agree with your Ophthalmologist that your son is too old to be effectively treated, by conventional means, for his amblyopia.   By the age of 15 yrs the brain is no longer plastic or adaptive to change by, for example, occlusion of the dominant eye - the standard treatment for amblyopia.   Nevertheless, your son should be prescribed corrective lenses to correct the refractive error and, more importantly, to protect his remaining good eye.  And, he'll need to actually wear the glasses - no easy task for a teenager.

Scientists at Children's Hospital in Columbus, Ohio as well as other sites around the World have been studying the use of L-dopa (Levodopa/Carbidopa) in combination with part-time occlusion of the dominant eye in older children such as your son.  The results show that a 4 to 7 week treatment with L-dopa and part-time occlusion improves vision by about 1.5 lines on the eye chart or about 25% or so.  However, this is still an experimental treatment and requires further work.   See recent breakthroughs for additional information.

 

Q.    I've been taking a lot of iron [Niacin] tablets for ... and I've noticed lately that my vision is blurred.  Any connection?

Yes, there my be a connection between your blurred vision and Niacin.  About 10 years ago several case reports were published (Millay et al, 1988 in the journal Ophthalmology) about patients who were on large (3 - 4.5 grams per day) amounts of Niacin and complained about blurred vision.  Most of the patients were found to have swelling of the central part of the retina - the macula.  Stopping the Niacin cleared-up the vision problem.  If you are taking large amounts of Niacin and experience any vision problems, please see your eye doctor. 

 

Q.    I've had glaucoma for five years and although my pressures have been normal [ with medicine], my Ophthalmologist wants to do a trabeculectomy.  Is this really of any use with normal pressures?

Yes.  Even though your intraocular pressures may be normal (defined as below 22 mm Hg), there may be continuing damage occurring to the eye; for example, further loss of visual field or/and further damage (cupping) to the optic nerve head.  There is also a condition called "normal pressure glaucoma" - where the pressures are in the normal range even without medicine and, yet, there is damage to the eye.  So, even though your pressures are in the normal range, say 16 mm Hg, you may need to have your pressures lowered further, say 8 or 9 mm Hg, and this is probably why your Ophthalmologist wants to do the surgery.  A trabeculectomy. is one of several filtering operations and is preferred because of the chance for less complications.

 

Q.    Why is the eye sometimes removed in glaucoma?

An eye is sometimes removed (enucleated) in glaucoma because there is little or no vision remaining in the eye (the eye is "shot") AND the eye is very painful.  The eye is enucleated only as a last resort and, typically, to alleviate the pain.

 

  1. My son’s teacher recently reported that my son is colorblind. How did he get that way and can anything be done to correct it?

Normal color vision requires three types of cones (i.e., daylight photoreceptors) and each contains a different type of pigment to capture light. The three types of cones are: red cones, green cones and blue cones. These three types of cones are then wired together in such a way as to yield all the colors of the rainbow. When a person has the correct number and type of cones then their mixture will result in correct, normal color vision.

So called "color blindness" occurs when one or more of the cone types contain the wrong pigment, or contains a mixture of pigments. So when the three different types of cones mix their signals together to form all the colors in the rainbow, the result is defective color vision if one of the pigments is the wrong one. In reality, very few people are colorblind (so-called achromats – only black - white vision): rather, they are color deficient. For example, deuteranomaly refers to a color deficiency in which the green cone pigment is replaced with red cone pigment. As a consequence, deuteranopes have a hard time telling the difference between green and red-purple colors. Protanomaly refers to people that have their red cone pigment replaced with green cone pigment. Protanopes have a hard time telling the difference between red and blue-green. There are levels to the color deficiencies ("-anomaly" means partial and "-anopia" means complete); some color deficient people may be able to correctly identify a certain color if it is really intense or "pure", but may not be able to identify the color if it is more mild or subtle or if the lighting is low. Due to the similarities between the different kinds of color deficiencies and the fact that special tests are required to differentiate between them, most people simply refer to the about types of color deficiencies as "red-green" deficiencies.

Red and green color deficiencies are usually male problems – occurring in about 6 – 8% (1 in 15) of male children and about .25 - .5% (1 in 300) of female children. This is why schools will often test for color deficiencies in male but not female students. Typically, color deficiencies are caused by a defect in the X-chromosome that is passed along from the mother to the son. Because the mother has two X-chromosomes that sort-of compensate for one another, she won’t experience any color problems or have only very subtle color problems. The son, on the other hand, has only the defective X chromosome (the other sex chromosome is a Y) and, as a consequence, manifests the color deficiency. Sometimes the mother’s father (son’s maternal grandfather) will also have the same type of color deficiency and thus will pin-down the X-linked nature of the color deficiency. If one son has a color deficiency there is a 50-50 chance that other sons from the same mother will also have a color deficiency.

Color deficiencies cause particular problems for children starting school – when the color deficiency is not yet identified and the child is having problems coloring certain scenes the right color (e.g., green grass or blue skies). Such children and their parents may become frustrated in trying to teach the child his colors or the child may even be labeled "slow" in school because he just can’t get his colors right. Early identification is important for the child’s learning and to prevent unwanted labels on the child. In addition, the above discussion assumes that the child with the color deficiency has normal visual acuity, is not real sensitive to lights (i.e., not photophobic) and does not have nystagmus (e.g., eyes do not constantly move back-and-forth). If the child does have one or more of these symptoms then the child may have a more serious retinal disease called a "cone dystrophy" or "macular degeneration."

Although there are no treatments or cures for children with color deficiencies, parents and teachers can minimize the adverse impact of a color deficiency on the developing child by "working around" the deficiency; for example, by labeling crayons and the scenes to be colored with the appropriate color names. Early detection will also help prevent failing or poor grades in certain school subjects.

 

Q.    "This @*#@ sucks u don't have what I need!!!!

If you describe exactly what you need and if it is of general interest to our Web site visitors, we will attempt to address your needs.

 

Q.    What is dyslexia and can anything be done about it?

See Past Featured Article on Dyslexia.

 

Q.   My 6 year old daughter's amblyopia has not fully responded to patching, although we have been patching full time for a year.  I am considering vision therapy for her.  Are there any scientific studies validating the use of vision therapy (eye exercises)?

"Vision therapy" is a highly controversial issue that pits Ophthalmologists with Optometrists.  On the one hand, Ophthalmologists argue that vision therapy is appropriate for very few things and Optometrists, for the most part, swear that vision therapy is good for a wide range of problems from learning disabilities to amblyopia.  One underlying problem is that 'vision therapy' is a catch-all phrase that has no specific meaning.  Depending on the practitioner, vision therapy may refer to orthoptics, which has been shown to be beneficial for certain eye coordination problems (e.g., double vision, eye strain), or it may refer to watching flashing lights through colored filters, which has no scientific basis. 

If you search some of our cool links sites, compare what the American Academy of Ophthalmology says about vision therapy and what the American Optometric Association says about vision therapy.  For example, the AAO states that vision therapy should not be confused with orthoptics while the AOA states that vision therapy includes orthoptics.

Back to your question however, yes there are a host of studies that have reported that vision therapy works to improve visual acuity in children who do not respond well to conventional patching therapy.  Unfortunately, most of the studies have been poorly designed, lack appropriate controls or are simply case reports that this or that type of vision therapy worked for this or that kind of amblyope.  The lack of valid and reliable studies on vision therapy and the fact that vision therapy is not a clearly definable treatment modality is probably why there is such controversy in the area and also why most insurance companies do not pay for "vision therapy."

Before one considers vision therapy for a 6 year old you must ask if the child AND you have been good about the patching therapy.  A major reason why patching does not work in amblyopic children is because of noncompliance.  Also, ask your eye doctor what he/she thinks about vision therapy.  Also review the AAO and AOA Web sites about "vision therapy".  If you decide to do vision therapy watch out for the following warning signs:

  • Does the vision therapy practitioner say, up front, that the vision therapy will be for, say, 12 weeks or for so many sessions?  No one can tell you before hand how long it will take for vision to be maximized with any type of therapy, including vision therapy.
  • What are the goals of the vision therapy?  In amblyopia it should be to: 1. improve visual acuity in the amblyopic eye; 2. improve depth perception (stereopsis), 3. decrease suppression of the amblyopic eye, and 4. improve binocular eye movements, if applicable.  All of these tests yield numbers that can be compared from one session to the other.  If the practitioner simply performs some type of vision therapy WITHOUT assessing the child's performance on the above types of tests at each visit or at least periodically - run for the door.
  • Use the common sense rule.  Ask the practitioner before hand what exactly is the vision therapy?  Does the vision therapy make sense?  For example, does the vision therapy involve things that your child may do everyday like play video games or watch a bouncing ball?  If so, why would such everyday things improve vision and why, then, do you even need the practitioner?
  • Does the practitioner do the same type of vision therapy for different problems?   For example, is the same type of vision therapy used for amblyopia and learning problems and reading problems and sports problems?  There is an old saying; when you only have a hammer everything starts to look like a nail.  Head for the door.
  • Ask the practitioner for published articles that support the particular type of vision therapy to be used.  If he/she cannot offer published studies or simply states that "we don't need such studies - we know that it works."  Head for the door.

Whatever you decide to do for your daughter remember that the success of accepted forms of therapy, including patching and penalization therapy (e.g., dilating eye drops in  the stronger eye), is dependant on age:  The younger the child the more plastic and adaptive the brain and the more rapid the improvement with appropriate therapy.  If you delay effective therapy for amblyopia the harder it will become to cure it and the greater the chance that she will have a permanent loss of vision in the lazy eye.  One must always be careful not to delay a proven treatment method by undertaking a less than proven method.

 

Q.    I am a 21 year old male and for the past week or so my eyes have been dilated even during the light of day.  I don't do drugs or alcohol but I do smoke cigarettes.  I'll probably go to see an eye doctor, but what do you think?

Dilated pupils is most commonly the result of legal or illegal drug use.   Any of a large number of drugs that you take by mouth or inhale or inject can have a side-effect of dilating the pupils.  We are not aware of any relation between cigarette smoking and dilated pupils.  A less likely possibility includes closed-angle glaucoma, in which the pupils are sometimes "fixed" in a mid position, say about 4-5mm.  If you have any pain or redness in one or both eyes you see an eye doctor immediately because if you have closed-angle glaucoma you could permanently loss your vision real fast.  Whatever the cause for your dilated pupils, we suggest an immediate eye exam - ASAP.

 

Q.    What is the difference between Choroideremia and Chorioretinitis - symptoms, causes,diagnosis, prognosis and treatments?

Choroideremia is a progressive retinal degeneration that males get from their mothers, who are the carriers of this X-linked disease.  The mothers who carry this gene may show mild signs of the disease.  Because Choroideremia is an X-linked disease, it will appear to skip generations and will affect 50% of the male off-spring of the carrier mother.  The signs of Choroideremia include poor night vision, visual field constriction and loss of visual acuity.  There are no known treatments for Choroideremia and the vision loss progresses to light perception by about 50 years of age.   Choroideremia is diagnosed based on the dilated eye exam, and special tests include the electroretinogram, electro-oculogram and fluorescein angiogram.

Chorioretinitis implies an inflammation of the choroid - that layer of cells between the sclera (white part of the eye) and neural retina that contains the photoreceptors.  Chorioretinitis may be caused by a number of factors including blunt trauma to the eye (Chorioretinitis sclopetaria), fungal infections (e.g., candidiasis), or due to a congenital infection such as Rubella.  Chorioretinitis sclopetaria may be due to a high velocity projectile, such as a BB, hitting the eye and causing internal bleeding and retinal tears.   Chorioretinitis may be due to a fungal infection or due to other types of infections the involve the whole body (systemic) such as viral or bacterial infections.  Vision loss will vary depending on the site of the inflammation in the eye and whether the inflammation includes the macula - the central reading part of the eye.  The presence of Chorioretinitis may be a sign or the result of immunosuppression, although the literature is divided on this point.  The treatment for Chorioretinitis depends on the cause and type of Chorioretinitis.   Vision loss, whether permanent or temporary, also depends on the type and cause of the chorioretinitis.  Chorioretinitis is usually diagnosed by a dilated comprehensive eye exam and medical history.  Special blood work and other tests may be required depending on the specifics of the case.

 

Q.    I see flashing lights in my right eye when I walk into a dark room.  What is this?

Q.    Occasionally I get flashes of light like lightening bolts...they subside after a while...what causes this?

You are probably having flashing lights in your right eye all the time but only "see" them when you go into a dark room.  In older persons, zigzag flashes of light in one eye that occur in darkness may be associated with vitreous tags.   These flashes of light have been named "Moore's lighting streaks."

Flashing lights also may be a sign of a serious eye problem, possibly involving the retina or optic nerve of the eye.   Retinal holes, tears and retinal detachments can cause a person to see flashing light(s).  Certain optic nerve diseases also can cause flashing lights.  If you see flashing lights, streaks of light or a bunch of little dots that are bright and moving through your field of vision you need to see an eye doctor for a complete dilated eye exam ASAP.  If the flashing lights are due to a retinal problem such as a retinal tear, it may be treatable if caught early.  If you wait to late you could have a permanent loss of vision in the affected eye.  Play it safe and see your eye doctor.

 

Q.    My son surfs the internet for 4 hrs/day.  Now he complains of eye problems.  What's the problem and can anything be done?

Q.    I would like to know it TV or computers will make my eyes bad?

Extended close viewing of a computer monitor (or TV) can cause eye strain and fatigue as reflected by neck and shoulder problems, headache, blurred vision, double vision, red or watery or dry eyes and pain around the eyes and face.  Extended close work can also cause a person to become more near-sighted (myopic), requiring the need for stronger corrective lenses.  Problems are usually two-fold; due to poor ergonomics and due to extended accommodation and convergence to a near object, in this case a computer screen.   Ergonomics can be improved by having the top of the monitor screen close to eye level - don't look down or up at the monitor, have the monitor straight-ahead.  The monitor should also be at arms length, or about 62cm (about 25 inches) from the face.  At 62 cm, the eyes are close to their resting (ideal) state of accommodation and convergence - minimizing both eye eye muscle strain as well as accommodative strain.  If you use glasses, the monitor should be positioned to minimize eye strain and your eye doctor may be able to tell you your ideal monitor viewing distance.  Avoid glare or light reflections of the screen - if this is not possible use a screen filter (neutral density filter or Polaroid filter or micromesh filter) to reduce glare.  Don't tilt the screen up - it will create more glare problems.   Take frequent rest breaks, say about 15 minutes per 45 minutes of work and, importantly, during the rest break try to look at objects in the distance - 20 ft or more.  Finally, have your eye doctor evaluate you/your son for corrective lenses that may be required for only near work.

 

Q.    Can a person have ocular histoplasmosis but have no symptoms of chronic or acute histoplasmosis, like lung problems?  Can ocular histoplasmosis be treated?

Go to Past Featured Article #2 for answer

 

Q.    I've been working with the computer a lot for the past three years and now I have dark circles under my eyes.   What can I do about them?

Dark circles under the eyes or darker appearing skin under the eyes can be due to a number of factors.  The lack of adequate sleep will cause the eyes to appear swollen or puffy and darker than normal.  In women, hormonal changes can cause the skin under the eyes to darken.  As part of the aging process, small wrinkles under the eyes will also cause the appearance of dark skin under the eyes.  Finally, the skin under the eyes will appear dark because of shadow. 

What can you do about it?  See an Ophthalmologist that specializes in cosmetic surgery or reconstruction surgery for an opinion.  Although surgery is not typically an option, the Ophthalmologist will diagnose the problem.  If the skin is indeed darker than normal certain bleaching agents can be used to lighten the skin.   If the eyes appear darker because of wrinkling of the skin, certain laser surgery can be used to remove the wrinkles.  Certain cosmetics, even for men, can be used to cover-up the darker appearing skin.  Finally, be sure to get enough sleep and take regular rest breaks every hour when using the computer.

 

Q.    My cornea was scratched two months ago and it healed after a few days.  Since then, however, it has recurred several times, always in the late evening or early morning.  Can you give me more information?

Corneal abrasions, typically caused by fingernails or twigs, can cause pain, photophobia, reduced vision, watering of the eye and blepharospasm (twitching).   Corneal abrasions usually heal after a few days; however, some patients may experience recurrences for up to a year.  The patient often reports that he/she awakens in the morning with a painful eye that is difficult to open.  The problem is that the epithelium, the very front of the cornea, has been more or less rubbed-off (debrided) during the night.  Recurrent erosions of the epithelium may be due to dry eyes and this is why it recurs in the late evening and during the night.  To reduce the chance of recurrence of the corneal abrasion some eye doctors will suggest an eye ointment applied in the evening or before bedtime.  For more serious corneal abrasions, the excimer laser has also been used for treatment.  If you have a corneal abrasion it is very important to keep your eye doctor appointments to ensure that the wound heals properly.

 

Q.    After months of burning in my eyes and not being able to wear my contacts, a doctor finally told me that I have chronic bletharitis [blepharitis].  I know there isn't a cure but is there anything that can be done so that I can wear contacts again?

Blepharitis is a common condition that can be controlled but not cured.   Blepharitis is caused by several things including Staphylococcal infection and Seborrhea (excessive secretion of lipid from glands). Blepharitis may also be associated with dandruff, eczema, allergy, drugs and Acne rosacea.  Signs of Blepharitis include scales on the lashes, red swollen lids, burning and itchy eyes and discharge (e.g., serum-like or mucus like) from the eyes.

Staphylococcal blepharitis typically is an acute inflammation and occurs mostly in females.  It is also associated with Dry eye.  Seborrhea blepharitis is reflected by oily,greasy scales around the lashes and there may be excessive secretions or the glands may become plugged.

Treatment often includes the following:

  • Use a clean and warm (the warmer the better) cloth and hold over the closed eyes for 5 to 10 minutes.  Resoak the cloth to keep it warm as needed.
  • Once the lids are warmed and softened, clean the lid margin and lashes with diluted baby shampoo twice a day.  Continue to do this even if you don't feel that it is working.  Sooner or later things will improve.
  • If applicable, apply an antibiotic ointment to the lid margin as indicated.
  • If you have dandruff, use an antidandruff shampoo...forever.
  • If you're a woman, or a man for that matter, try changing the brand of make-up that you use or, better yet, don't use make-up.  Even if you don't use make-up near the eyes, the eyes can still become contaminated by indirect contact; for example, by your hands touching your face and then your eyes or by rubbing the make-up off onto a pillow and then into or near the eyes.
  • If you have eczema, ask your doctor about a steroid ointment to treat it.
  • If you are using drugs, ask your doctor if the drug(s) are associated with blepharitis.  If necessary discontinue or change drugs.
  • Most importantly, practice proper hygiene.  Wash you hands every time you use the bathroom, wash your face and shampoo daily.
  • If you use contacts, you must follow proper cleaning instructions for the contacts and be sure that your hands are clean before touching the contacts or your eyes.
  • Never rub your eyes with your fingers.  If necessary, use the back of your hand or knuckle which is less likely to be contaminated.

Will you be able to wear contacts again?  That is a good question for your eye doctor.  Blepharitis waxes and wanes over the years and if you're able to control the outbreaks by following the above recommendations you may be able to wear contacts again.  Unfortunately, since blepharitis is associated with dry eye in some cases, be careful - blepharitis can lead to complications including corneal ulcers and conjunctivitis.  See an eye doctor for diagnosis and possible treatment.  Good luck

 

Q.    I am looking for information on photophobia with bilateral vision loss.  Any help?

Photophobia is defined as a severe aversion to light.  Photophobia would include problems with glare, including glare aversion and glare disability.  A normal person experiences photophobia when, for example, one exits a movie theater into bright sunlight.  The eyes hurt, you squint and cover your eyes until you get used-to the light.  A person with photophobia always experiences the pain and discomfort with bright lights but they never "adapt" to the light.

Photophobia is associated with certain retinal diseases that may be progressive or stationary.  Photophobia is also associated with a cataract, even before the cataract "ripens."  If the photophobia is associated with decreased vision, typically defined as decreased visual acuity, in a younger person then we're probably talking about a retinal disease that is either stationary or progressive.  If the photophobia is stationary; that is, has been steady and has not been getting worse, the patient may have albinism, Leber's congenital amaurosis or monochromatism (rod or blue cone).  These conditions are present from birth and can be distinguished with the electroretinogram (ERG).  In these patients, visual acuity is usually 20/200 or worse.  Visual acuity is more or less stationary in patients with albinism and monochromatism and gradually worsens in patient's with Leber's.

If the photophobia is associated with decreasing visual acuity and the patient does not have cataracts, then we're probably looking at a progressive retinal disease such as a cone dystrophy or cone-rod degeneration.  Patients with cone dystrophies have visual acuities that decrease over time and stabilize around 20/200 - legal blindness.   They also may have nystagmus (eyes move back-and-forth), color vision defects and retinal changes, depending on the stage and specific type of cone dystrophy.   Patients with cone-rod degenerations or dystrophies have visual acuities that decrease significantly, often worse than 20/200.  They may also show visual field losses and have poor night vision (late in the disease process).   Finally, some patients with macular degeneration, such as Stargardt's disease, may also have photophobia, decreased visual acuity in the range of 20/30 - 20/200 and a central scotoma or blind spot in central vision.  Most cone dystrophies and cone-rod degenerations start to appear before the age of 20 years or so.

Although the vast majority of retinal diseases have no treatment, photophobia can be reduced by the use of sunglasses or special light filters such as the Corning Photochromic filters (CPF 511, 527, 550).  Wearing a hat with a brim also decreases photophobia.  A person with a retinal disease should be assessed by a retinal specialist who can also perform or refer the patient for specialized testing (e.g., ERG, EOG) as well as for genetic counseling.

 

Q.    What is Delayed Visual Maturation?

See Featured Article or past featured articles.

 

Q.    What is Cortical Visual Impairment?

See Past Featured Articles.

 

Q.    I've been wanting to tell someone about my experience with floaters in my eyes.  I was taking vitamins and eating a healthy diet, dried fruit and vegetables and fruit juices.  The skin on my feet started to crack, my skin became dry and I developed floaters in both eyes so bad that the nurse sent me to a specialist....I was consuming three to four times the recommended vitamin A.  I stopped taking vitamins.  It's taken two years and the floaters are gone.  I seriously believe the vitamin A was to blame.   I would like to see a study done on this, since so many drinks are adding vitamin A to fruit drinks our children are consuming.

Vitamin A is the active principle in carotene which has three types; alpha, beta and gamma.  Beta carotene is about twice as strong as alpha and gamma.   Vitamin A is essential in retinal function since the rod photoreceptors are made-up of vitamin A (retinene, retinal) and a protein substance called opsin.  A vitamin A deficiency can cause nightblindness and xerophthalmia (drying of the conjunctiva and cornea).  Deficiencies of vitamin A are rare, and usually occur as a result of malabsorption (due to intestinal surgery for Chrone's disease or Cystic fibrosis), liver disease (alcohol cirrhosis) or excessive intake of vitamins C or E.  Too much vitamin A, called hypervitaminosis A, causes symptoms similar to a brain tumor including increased intracranial pressure, blurred vision and swelling of the optic nerve (papilladema), headaches, dizziness, vomiting, diarrhea and a protruding of the front of the head.  Hypervitaminosis A occurs when daily intake exceeds about 50,000 IUs/day.    However, the dosage that causes hypervitaminosis A depends on body weight and may be substantially less if you're a female, child or are of small stature. 

Can hypervitaminosis A cause floaters?  We were unable to uncover any scientific evidence about such a link.  However, since hypervitaminosis A can cause papilledema it is possible that it could also cause excessive floaters.  Also, it is interesting that it took almost two years for the floaters to disappear.  Since vitamin A is stored in the liver in relatively large amounts, it can take years for excessive amounts of vitamin A to leave the body or, conversely, for a vitamin A deficiency to develop after absorption is reduced.  For example, in Crohn's disease large amounts of the intestines are removed and about 7 - 9 years later patients sometimes develop nightblindness due to vitamin A deficiency.  So the time frame of a few years for the elimination of excessive amounts of vitamin A to leave the body and for the floaters to disappear is the ball park.

Can hypervitaminosis A cause cracked feet?  The scientific literature is also moot on this point.  Vitamin A is essential for epithelial (skin) function so we would not eliminate the possibility that excessive amounts of vitamin A could cause epithelial dysfunction - including cracking feet and dry skin.  We do agree that more research is needed in the adverse consequences of excessive vitamin intake, particularly since Americans consume large amounts of vitamins.

Web site visitors, if you have any personal experiences with problems associated with supplemental vitamins please send us your comments and we'll tabulate the comments in a future Featured Article on the subject of supplemental vitamins and your vision.

 

Q.    I would like to know whether there is a cure for retinitis pigmentosa (RP).

There is no cure for RP.  There is a controversial treatment for RP, vitamin A palmitate therapy,  that may slow the progression of the disease.   However, there is much controversy over this treatment, which involves taking 15,000 IUs of vitamin A palmitate (a special form of vitamin A) per day.    Pregnant women or women that may become pregnant should NOT take vitamin A.   Treatments that have not been proven effective include panretinal laser photocoagulation, Encad, Ozone and "the Cuba cure."

 

Q.    What could cause half of my eye to [become] red?  No itchiness, soreness or irritation.

If you wear contacts you could have contact lens induced keratopathy, which may first involve the upper part of the eye.  If so, you need to stop wearing contacts immediately and see an eye doctor.  If left untreated or/and you continue to wear contacts you could permanently loss vision in the affected eye.  See an eye doctor.

 

Q.    I have painful, itchy, swollen eyes.  Also, probably unrelated, swollen, itchy feet.

The two are, in fact, possibly related and may be signs of an allergic reaction.  If you are taking medicine(s), ask your doctor if the medicine(s) can cause an allergic reaction.  Cosmetics, environmental irritants, dyes, certain foods, etc., can cause an allergic reaction as you described.  Whenever there is pain involved see your eye doctor ASAP.  Also see "Swollen eyes" in this section.

 

Q.    Is there anything you can do for a broken blood vessel in the eye?

Go to small red spots.  Also, if the broken blood vessel causes blood to accumulate in the front of the eye, between the cornea and pupil/iris, this condition is called a hyphema and warrants immediate medical attention.   If the broken blood vessel is inside the eye, for example related to diabetes (diabetic retinopathy) or to another retinal condition such as age-related macular degeneration, treatment may be available and immediate medical attention needed so see your eye doctor ASAP.

 

Q.    I have recently been through a divorce and haven't been able to eat or sleep for the past four months...  Now I am seeing tracers - trails after moving objects.  Have you ever heard of anybody seeing tracers before?  Do you think that this is a permanent condition or do you think that it may correct itself after I take better care of myself?  Any references or Web sites about tracers...?

So-called tracers are not discussed at any great length in the medical literature.  Tracers may be thought of as a series of afterimages to a moving object and, as a consequence, appear to trail the real image.  Certain prescribed drugs as well as hallucinogens (e.g., LSD), are known to cause visual disturbances including tracers.  The elderly and sometimes patients with psychiatric problems complain of afterimages interfering with their vision and peace of mind.  Given your physical and mental exhaustion, the tracers that you are experiencing may be more psychological than physiological.  Rest and recuperation may go a long way in alleviating the tracers.  Also, see your general practitioner or internist for his/her opinion.

 

Q.    My 3 year old son has recently had his right eye removed due to retinal detachment, the cause of this has been diagnosed as "Coats" disease.  I am seeking further information on this disease and any related effects, as he also has behavioral problems, poor coordination, obsessive tendencies and is very clumsy.  We are having difficulty finding any information and any help would be appreciated.

Coats' disease, either congenital retinal telangiectasia or Leber's military aneurysms, is a developmental abnormality of the retinal blood vessels and is associated with lipid (fat) deposits within and beneath the retina.  Although most common in preteenage boys, Coats' disease has been found in infants as young as four months and in adults in their 70s.  Coats' disease usually involves only one eye of otherwise healthy patients.  No hereditary pattern has been found and it does not appear to be in specific ethnic or racial lines.  Therefore, the cause of Coat's disease is not known.

Coats' disease is usually progressive and leads to lipid accumulation in or/and underneath the retina, the development of subretinal masses, retinal hemorrhages and detachment, neovascular glaucoma, cataract formation and uveitis.  Enucleation or removal of the eye may be indicated if there is pain associated with the glaucoma.   An early sign of Coats' disease may be the turning-in of the affected eye (esotropia), particularly in preverbal children.

Coats' disease is an ocular, usually monocular, problem.  As a consequence, other problems or conditions may not be directly associated with the Coats' disease, per se.  Nevertheless, the loss of one eye will cause a patient to be clumsy and have poor coordination because of the loss of binocular vision and loss of depth perception.  When a patient has one eye it is very important that the patient wear protective glasses with polycarbonate lenses to protect the remaining eye.

Psychological and behavioral problems are common in patients that have experienced a loss - in this case a loss of an eye.  Whole family psychological counseling may be necessary for THE WHOLE FAMILY to deal with the loss (as well as with the guilt).  Children are very adaptive; however, the affected child will react to how his/her parent(s) and sibs handle the loss.  If the parents and sibs avoid the issue or are repulsed by the sight of the child, particularly before a prosthesis (artificial eye) is fitted, the child will have a difficult time with adjustment.   Also, lack of knowledge about Coats' disease may cause parents to attribute other problems to the disease or for the parents to become too analytical and attribute normal childhood behaviors as pathological and associated with the disease.

 

Q.    One of my wife's eyes is swollen, and pulling down the eyelid revealed a small clear cylindrical substance inside the lid.  Using a cotton swab, I removed it carefully and some bleeding is also present.  I have done this twice, and she has rinsed her eye, but the substance returns.  What could it be?

DO NOT MESS WITH YOUR WIFE'S EYES.  She should be seen by an eye doctor for the problem ASAP, particularly since bleeding is involved.  See the previous question about swollen eyes.  A swollen eye may be a sign of an allergic reaction, typically to cosmetics, a reaction to a foreign body or a sign of a more serious problem.   The substance inside the lid may be drainage and an attempt by the eye to decrease the irritant.  Don't mess with it - you could make the problem a lot worse.

 

Q.    The whites of my eyes are a very yellow color.  What's the cause?

Yellow eyes and/or skin may be a sign of jaundice and the deposition of excessive bilirubin in those tissues.  If the white parts of your eyes are yellow, it may be a sign of jaundice and associated liver disease.  You should see a medical doctor (Ophthalmologist, internist or general practitioner) ASAP to evaluate you for liver disease ( a simple blood test).  Numerous diseases can cause jaundice in adults including hepatitis and alcohol cirrhosis.

 

Q.    Why is it recommended that you get an eye test?

For infants and children, it is very important to have periodic eye tests in order to detect treatable eye diseases such as lazy-eye (amblyopia) or large refractive errors.  If caught early, many eye problems can be corrected.  If parents wait too long, until the child has problems with reading for example, much harm will have been done.  Eye problems can lead to other problems, including developmental problems, learning problems and behavioral problems.  Also, children do not know what they're suppose to see and can go for years without knowing that they can't see as well as others of their age.

For adults, periodic eye exams, say every two or three years, are necessary to detect eye disease that also could be treatable.  There are numerous eye diseases, including glaucoma, that an adult is not aware of until it is too late and the disease has caused irreversible harm.  The eyes are also a window into the brain and central nervous system.  A comprehensive eye exam, including pupil dilation, can also uncover other diseases of the body and brain, such as diabetes.  If you think that you only need an eye exam when you experience an eye problem - you could be in for the shock of your life.

 

Q.    I have black spots in my right eye and they are not floaters since they are in a constant pattern.  I've seen an eye doctor and he thinks they are caused by cholesterol.  They are increasing in number and I'm afraid I will lose total vision in that eye.  Please comment.

Numerous things can enter the vasculature of the eye and block blood flow (ischemia) and result in sudden loss of vision.  If the block only lasts a few minutes vision usually returns to normal.  However, if the block lasts longer then permanent loss of vision will result.  The most common blockers are small crystals of cholesterol, which are usually thrown off by the carotid artery.  These usually don't cause permanent damage.  The cholesterol crystals, however, are accompanied by adhesive white emboli made-up of fibrin and platelets - these do cause permanent blockage and vision loss as in your case.  Other things within the body that can cause occlusion include calcium, bacteria, parasites and tumors, among others.

Retinal vasculature occlusion is often seen in the elderly, who also suffer from arteriosclerosis.  Since your doctor has diagnosed cholesterol as the problem, you need to ask him/her about ways to reduce the impact of others occlusive episodes; for example, use of finger massage of the globe to dislodge the cholesterol crystals/fibrin-platelet emboli when they first occur.  Also, one must be aware that these emboli may also be occurring in the brain and/or heart.  You should ask your internist about evaluating your carotid arteries for excessive blockage - if present, you may need surgery to clean-out the carotid on the affected side.  Finally, you should ask your eye doctor about possible surgical or nonsurgical options to manage your condition.  Be sure to write-down all your questions before you see  your doctor.  Good luck

 

Q    I'm having trouble with my eyes twitching.   Several years ago it was only the left eye, but now it is both.  Can you tell me what this is?  I had my eyes tested last time and nothing was detected.

Q.    My eye appears to be jumping or twitching and it is driving me crazy.  What is it and can anything be done?

Q.    My right eye keeps twitching every few minutes.   This has been going on for 5 days, what's wrong?

Lid twitching of one eye or the corner of an eye, as well as facial tics, is a common complaint in patients and seems to be exacerbated by mental or physical stressful situations, lack of sleep and possibly by stimulates such as caffeine/coffee.  The literature is sparse on this topic, however, as it appears to be a benign and fleeting problem.  Only rarely does eye twitching reflect a more serious neurological problem.   If the eye twitching is more like a facial spasm such that the eyes close, you may have blepharospasm.

Blepharospasm is an involuntary contraction of the muscles around the eyes.   It is a progressive disorder that sometimes starts with one eye but almost always involves both eyes as the disorder progresses.  Interestingly, the spasms do not occur during sleep and are exacerbated by stress and fatigue.  The cause of blepharospasm is not known and treatments are limited.  If the eye twitching is possibly a blepharospasm, see an Ophthalmologist since there are some surgical treatments that may be considered.  Sometimes, but rarely, facial spasms may be a sign of a more serious condition and need to be evaluated by a Neuro-Ophthalmologist.

 

Q.    My eyes water quite a bit, especially when I first wake up, or while I'm going to sleep.  If I'm indoors for quite a while and go outside on a sunny day, my eyes really water and I need to close my eyes for a while.  What causes this?

Excessive tearing is sometimes a way for the eyes to "flush-out" irritants, including cold, light, cosmetics and foreign bodies.  Particular attention should be placed on anything that can cause corneal irritation, including foreign bodies and even eye lashes that turn inward.   Excessive tearing is sometimes also caused by certain drugs, such as pilocarpine.   Finally, patients with anterior uveitis sometimes complain about excessive tearing, particularly when exposed to bright lights - like going from indoors to the outdoors.   See an eye doctor to rule-out a potentially treatable problem.

 

Q.    Several years ago I was poked in the eye and a scar developed on the white part.  Lately, the scar has grown more red (blood vessels are larger and more pronounced).  Should I be concerned?

We assume that you had medical intervention for the ocular trauma/scar and that you are in no pain or that there is no vision loss in that eye.  It thus appears that the scar is simply needing more blood supply and this is why it appears more red, so you probably need not be too concerned.  However, to be on the safe side (why take any chances?), see an eye doctor for further evaluation and reassurance.

 

Q.    I have uveitis.  I know traditional ways of curing this disease with corticosteroids, but I wanted to avoid side effects.  Do you know any alternative ways to cure uveitis?

Uveitis is a generic term that covers inflammation of any part of the uveal tract - iris, ciliary body and choroid.  Depending on the exact site of the inflammation, the name given to the disease will vary.  For example, if the inflammation is localized to the iris it is referred to as iritis, to the ciliary body and vitreous - cyclitis, to the anterior chamber and anterior vitreous - iridocyclitis, and to the choroid - choroiditis.  If all parts are involved - panuveitis.  Symptoms depend on what part of the eye is affected and may include red eye, watery discharge, sensitivity to light, decreased vision, floaters, pain and even abnormal pupils.  The causes of uveitis are numerous, and include sources within the eye itself as well as sources from other parts of the body (e.g., fungal , viral and bacterial infections).   The purpose of treatment is to eliminate the cause of the inflammation, suppress the inflammation and, hopefully, avoid complications of treatment. 

In general, the earlier the treatment the better.  Unfortunately, due to the multifactorial nature of uveitis, the specific type of treatment depends on the cause.   This is why a through medical history is probably one of the most important parts of the diagnostic evaluation.  As you suggest, corticosteroids, which can be considered a type of nonspecific anti-inflammatory therapy, have numerous and sometimes very serious complications.  As a consequence, new therapies are being developed which involve focused anti-inflammatory therapies as well as specific antimicrobial therapies - again, depending on the cause.  There is an ongoing clinical trial on the effects of cyclosporine on noninfectious uveitis (for further information see the NIH Web site: http://www.nei.nih.gov/neitrials_script/studydtl.asp?ID=69).   Also, there has been a clinical trial on the use of  acetazolamide (but with significant side effects) for uveitis associated with cystoid macular edema (for more information see NIH Web site:  http://www.nei.nih.gov/neitrials_script/studydtl.asp?ID=11 ).

Due to the complex nature of uveitis - your eye doctor would know the best and most prudent therapy for your type of  uveitis.  Ask your eye doctor if there are alternatives to corticosteroids but remember; uveitis can be a real nasty disease, don't avoid therapy -  your sight may depend upon it.

 

Q.    I am a 26 yr old male and I have a light tan spot on the white part of my right eye with the diameter about the size of a small pea.  It has been there for 10+ years.  I have never given it much thought but my wife seems to think that it is getting bigger.  What could this be?

You've had this spot on the sclera for 10+ years and you've never seen an eye doctor in that time?  Well, it's about time you saw one, don't you think?

The spot may be several things; most likely a dermoid cyst.  A dermoid cyst is a noncancerous tumor about the size of a pea that is usually present since birth.   A dermoid typically looks yellowish-white (tan would be in the ball park) and is usually on the white part of the eye - sclera.  Dermoids do tend to increase in size during puberty.  So the size, color and the increasing (?) size appear to fit the picture.  Removal of a dermoid is usually done in the first 5 or so years of life.

Another possibility is that the spot is a nevis - a collection of darker pigment on the sclera.  However, a nevis is usually darker in appearance than that which you describe, although a nevis can be  caused by a thinning of the sclera which allows the darker choroid to show through.  Depending on your complexion, the choroid can be tan to darker tan.  A nevis, however, does not increase in size.  You need to see an ophthalmologist, who can evaluate the spot and perform surgery, if needed.   Less likely, but always possible, the spot could be something worse so see the ophthalmologist and let us know what it turns-out to be.  [Turned-out to be a pterygium, see next Q.]

 

Q.    I submitted a question about a tan spot on my sclera... I saw a doctor and he told me it was a [pterygium].  I tried to look this up on the internet but found nothing.  Do you have any additional information you could give?

A pterygium, after the Greek word meaning "wing", is a triangle shaped spot on the conjunctiva (thin membrane that covers the exposed area of the sclera) and it usually, but not always, occurs on the side of the eye near the nose.   Pterygiums often occur in people who work outside in dusty, windy climates.   Sometimes they can increase in size and affect the cornea and vision.  If so, it can be surgically removed under local anesthesia.  If not affecting vision it is best to just leave it alone.

 

Q.    Does Viagra cause any vision problems?

Yes.  Viagra is known to cause color vision (blue-green) problems, including objects taking-on a bluish tinge.  Some patients have also noted an increased sensitivity to bright lights.  Overall minor vision disturbances compared to the benefits...

 

Q.    My mother-in-law has glaucoma and is rapidly losing her sight.  She has asked me to find a site on the internet that could give her information on eye clinics in the USA.  Can you help?

We cannot give you information about all the eye clinics in the USA.   However, if you have a particular city/state in mind we can offer a particular eye clinic in the general area.

 

Q.    Who is the specialist on rod-cone dystrophy?

The is no ONE specialist in the USA on rod-cone dystrophy.  There are numerous Retinal Specialists, who are Ophthalmologists, who diagnose and treat, if possible, retinal diseases including rod-cone dystrophy.  Look for a Retinal Specialist in your area who has available  diagnostic testing (e.g., ERGs, EOGs, Fluorescien Angiography) and who works with Rehabilitation Specialists in vision (or at least can refer you to the appropriate sites).  If you have a rod-cone dystrophy, you should also see a geneticist to determine whether your children can be affected.   Note; there are a lot of different types of rod-cone dystrophies.  An accurate diagnosis will help you in knowing how bad it can get and whether or not your children might be affected.

Q.    What is a scotoma?

A scotoma is an area of visual field in which the patient cannot see objects.   A scotoma may be absolute, such that you can't see anything  within the area of the scotoma, or it can be an area of reduced vision sensation such that only dimmer or low contrast objects are not seen.  A "central" scotoma is one that affects the very center of vision, such that when you look at a person's face only the outside edges are seen.  Scotomas can also affect only half of your visual field (hemianopsia) or multiple scotomas may be present throughout the visual field.  In general, scotomas are a sign of a very serious medical condition and warrant immediate medical attention.  See Simulations for several examples of scotomas.

 

Q.    Is there a specific eye color that sees better?

Eye color typically refers to the color of the iris - blue, green, brown and even red.  There is no evidence that people with certain eye colors see better than others, at least in terms of visual function tests such as visual acuity.  However, eye color is associated with other variables associated with vision or ophthalmology.   For example, in general, people with lighter eye colors (e.g., blue) have been shown to have a higher incidence of age-related macular degeneration than people with darker eye color.  Also, sensitivity of the cornea and ones' tolerance with contacts for example, appears related to eye color - lighter eyes appear to be more sensitive than darker eyes. 

 

Q.    I have a question about a condition I heard about a few years ago.  The condition consisted of people seeing things normally perceived by other senses.  For example, when a door bell goes off the person seeing a distinct pattern of colors.  Or, if the person detected the smell of chicken a different set of colors would appear to him.  What is the name of this condition?

The condition is called "Synesthesia" and is as you describe.   Synesthesia is the mixing-up of sensory information such that a person sees what others hear and hears what others see.  It can involve any of the six senses and their combinations.  See the December, 1999 issue of Discover magazine for a great article on the subject.

 

Questions and Answers, Aug 1.- Dec 30, 2000

Q.    For the past month or so my eyes, particularly the left eye, has been very red.  I wear disposable toric contact lenses and when I put the lenses in the redness was sharply increased.   My eye was alarmingly red... I went to the eye doctor and she dilated my eyes with something that constricted the blood vessels in my eyes and they became perfectly white.  She told me I have episcleritis... She said that this usually corrects itself and if it doesn't she will prescribe a mild steroid.  I don't see any improvement and I was wondering if you have any additional information?

As you describe, episcleritis. is an inflammation of the episclera - the outer most layers of the sclera, or white part of the eye.  In addition to redness and discomfort there is sometimes a nodule present in the area of redness.  Episcleritis is sometimes associated with rheumatoid arthritis, ulcerative colitis and gout, but most of the time the cause is unknown.  Wearing contacts will aggravate the condition and make the eye more red and painful.  The reason the eye is red is because of the swelling of the blood vessels and this is why certain eye drops will constrict the blood vessels and the eye will appear white, at least while the eye drops are still working.   Given that you've had the condition for a month and you're in pain, you may want to ask the eye doctor for the steroid eye drops, which is the usual treatment for the condition.  Until your eyes clear, wearing contacts will only aggravate the condition. 

 

Q.    I have been wearing bi-focals for 3 years, my most recent pair purchased just one year ago.  Lately, I have been finding my eyes to be terribly tired and burning by mid afternoon.  Is it possible that my vision can deteriorate this quickly and that I could require a new and stronger prescription already?

Most people over the age of 40 or so will develop presbyopia - or a decreasing ability of the lens of the eye to change (accommodate) for near viewing.  As a consequence, the person requires bi-focals to see clearly near and distant objects.   Presbyopia has a gradual onset and progression, so over the course of a year or more the eyes may require different corrective lenses in order to see clearly.

Bi-focals are very difficult to fit and there are large variations in the ability of people to adjust to bi-focals.  Some people never do adjust and this is way you may see people wearing (on their head or neck) several pairs of glasses - one for near computer work and one for distance viewing.  One question you'll have to ask yourself is whether the bi-focals are the problem.  Burning eyes may actually be a sign of dry eye disease or other eye problem other than a wrong prescription.  Your work environment may also be the cause of your burning eyes; for example, do you work near a fan or blower that can cause your eyes to become dry?  Do you still have the tired eyes or burning sensation when you don't wear the bi-focals?  Does the eye problems only occur at work, during the week, and not on the weekend?

Before you pay-out hundreds of dollars for another prescription, you may want to try a cheap pair (only about $5.00 each) of over-the-counter "reading" glasses ( try several different strengths) for your near work.  If you experiment a little with your working conditions, different reading glasses and when and where, exactly, your eyes burn, you may uncover the reason for the burning eyes.  Also, eye pain is a warning sign - so if you continue to have burning eyes and you can't discover the cause, see another eye doctor for his/her opinion.

 

Q.    What is this information about MSG [monosodium glutamate] and retinal lesions...diabetes?  I know MSG, a neuro toxin, is being put in many foods under other names for flavor.  But what about our eyes and health?  I found this information on NOMSG.com and truthinlabeling.org.

A review of the Web sites that you mentioned say that MSG is the cause or contributing factor in a LOT of health problems, including glaucoma, diabetes and macular degeneration - we take these claims very seriously.  The web sites, however, lacked any scientific evidence for their claims that MSG causes or is associated with any human eye disease.  A review of the medical and scientific data related to  MSG and any eye disease or condition failed to uncover any association between MSG and eye disease IN HUMANS (see below about animal research on MSG).  Our review, however, is continuing.  If any reader can cite a reference about MSG and any human eye disease, please let us know and we'll evaluate the evidence. 

A review of the animal literature on the effects of MSG has made it quite clear that MSG is associated with retinal, optic nerve and lens abnormalities - particularly in the developing animal (rats and mice).  AND some of the abnormal findings in animals of the adverse effects of MSG do seem to have parallels to human conditions. For example, it has been shown that  MSG can cause abnormally small optic nerves in developing animals.  Interestingly, a leading cause of vision loss and blindness in newborn human infants is optic nerve hypoplasia - A condition that has been increasing in incidence since the 1970s.  Optic nerve hypoplasia now accounts for about 25% of blindness in newborn infants and the cause or reason is unknown.  In addition, MSG has been shown to cause cataracts in young animals - Again, hundreds of human infants are born every year with congenital cataracts, of unknown cause, that must be removed soon after birth or else blindness will result.

Until more is known about the adverse effects of MSG on the developing human - it would seem prudent to avoid foods with MSG, particularly if you are pregnant or about to get pregnant.  Unfortunately, as the question states, many foods contain MSG but are not labeled as such and, instead, list other names for "flavor."   Check-out the  Web sites noted above for additional information about MSG and how it is "hidden" in many foods.

 

Q.     What is scleritis and how does one get it and what is the cure?

Q.    I have a bump on the white part of my eye.    What is it?

Q.   I have a clear bubble like formation on the white part of my left eye. It does’nt hurt or bleed or impair my sight, and some day’s i don’t even notice it and others it rubs my top eyelid making my eye itch. What could it be?

A bump on the white (sclera) part of the eye is usually either (nodular) scleritis, episcleritis or conjunctivitis. 

Scleritis, or inflammation of the sclera (white part of the eye) is a condition that mostly affects women and is fairly rare.  It can affect the front of the eye, making the eye look red and it can be very painful.  It can also be restricted to the back part of the eye, so the eye appears white but it is still very painful.  In about half of the cases it is related to other diseases including rheumatoid arthritis, ankylosing spondylitis, acute herpes, and connective tissue disease.  The other half of the time the cause is unknown.  Scleritis can also be associated with uveitis, cataracts and glaucoma.  If you have the scleritis that affects the front of the eye steroid eye drops are prescribed for treatment.  If you have the scleritis that affects the back of the eye, oral medicines are prescribed, including ibuprofen.

For information on episcleritis, go to Episcleritis.   For information about conjunctivitis, go to Conjunctivitis.   Note: all three conditions may respond to topical or sometimes systemic (e.g., taken by mouth) steroids.  However, all three conditions require a visit to the eye doctor.

 

Q.    What is pseudophakia?

Pseudophakia refers to an eye that has an artificial, intraocular lens.   When the natural lens is removed because of a cataract, typically, an artificial lens is put into the eye so the patient can see.

 

Q.    I have an eye problem, I'm not sure of the name.   Basically, it is REM [Rapid Eye Movements] but I get it when my eyes are open.  I would like to know if there is any corrective surgery for this?

REM is a particular sleep state in which the eyes make rapid movements and is associated with dreaming.  I suspect that you're trying to describe "nystagmus" - a condition in which the eyes make rapid back-and-forth movements (if horizontal nystagmus).  Such a condition is often present since birth and is referred to as "congenital nystagmus".  Nystagmus is also associated with other eye (e.g., retinal degeneration) problems and neurological problems.  A person with nystagmus almost always has reduced vision.  We assume that you've had the nystagmus since birth or since you were very young.  If you just developed nystagmus you need to see an ophthalmologist or neurologist ASAP.

A person with nystagmus will sometimes be able to stop the eyes from beating by looking in a certain direction, such as to the left or right.  If the person is able to stop his/her eyes from beating by looking a certain way this is called a "null point".  If the eyes slowdown but don't completely stop - this is called a "semi null point".  If you have a null point, you might benefit from eye muscle surgery.  The ophthalmologist can move your eye muscles (and the eyes) so that your brain, more or less, thinks that you're looking in the direction of the null point when, in fact, you're looking straight-ahead.  With such surgery your eyes will not beat as long as your looking straight-ahead.  However, your eyes will still beat if you look to the sides. 

 

Q.    I have double vision.   If I close one eye things look fine but with both eyes open there are two images, one over the other.

Double vision, or diplopia, is sometimes associated with an eye misalignment or strabismus.  If one image looks like it is above the other than the eyes would have a vertical misalignment or vertical strabismus.  Sometimes diplopia is the result of the eyes failing to maintain alignment (and binocular single vision) due to fatigue or/and age factors; when the person was younger he/she was able to maintain single vision with some effort and eye strain.  Diplopia is also sometimes caused by an inability to converge the eyes for close work (accommodative insufficiency) resulting in double vision for close objects.  Diplopia is also a sign of a possible serious eye or neurological problem.  You should see an eye doctor about the diplopia ASAP, particularly if it is a recent development.

 

Q.    Is there a test or way to tell if my 3 year old is color blind?

The standard test for color blindness is the Ishihara color plates that require the patient to read numbers embedded in a set of colored dots.  So, if your 3 year old knows his numbers your eye doctor could use the Ishihara plates.  If your 3 year old doesn't read yet, sometimes color vision can be tested in 3 and 4 year olds with a color vision test called the Farnsworth Panel 15 test - a color test that requires the patient to arrange colored caps in a certain way.  About 8% of boys are color deficient, particularly for red-green colors.  Only about 0.5% of females have color vision problems.  And, because color blindness does run in families, if the boy's father is color blind for particular colors then the chances are increased that the boy will have color vision problems.  It is rare for a person to be totally color blind or achromatic.  Patients that are achromatic (achromatopia) also have reduced visual acuity and often nystagmus.

 

Q.    What does it mean if one pupil is smaller than the other one?

One pupil smaller (larger) than the other is called anisocoria.  Some people have different pupil sizes since birth and it is a congenital problem that means only that you have different pupil sizes, nothing more.  If the pupils recently became different in size then this could be a sign of a more serious eye problem or neurological problem.  Damage to the eye can also result in different pupil sizes and even differently shaped pupils, although the cause would be obvious.  If your pupils recently became unequal in size, see your eye doctor ASAP as you may need a medical work-up to uncover the cause and obtain treatment, if necessary.

 

Q.    Are contact lenses harmful to the eyes?

As long as you follow the directions for proper use of the contact lenses and follow your doctor's orders then contacts are very safe.  Problems arise when patients do not follow proper use and care directions for the contacts and when they ignore the doctor's orders.  Because the corneas need to breath and have oxygen, some problems arise when patients wear contacts for too long.  Problems also arise when patients do not follow proper cleaning and sanitary instructions and infections develop.   These can be nasty infections that cause permanent loss of sight.  DO NOT put contacts in your month to clean them and DO NOT remove contacts from your eyes and then put them back in unless they have been cleaned.  Also, always wash your hands before handling your contacts.  Finally, not everybody can wear contacts; particularly people with dry eye disease.

Q.    [Why do I have] floaters in eye that make cataract operation almost worthless?

If you have had a cataract operation recently and have floaters so bad that it seems that the cataract operation was worthless, you need to see your ophthalmologist ASAP.  Although some floaters are common in the elderly and in people with high refractive errors, sometimes a lot of floaters are a sign of a serious eye problem.   Cataract surgery can result in retinal tears and retinal detachments and one sign of these conditions are a lot of floaters.  If you have a retinal tear or retinal detachment you may need eye surgery to prevent the condition from getting worse and causing a permanent loss of vision.  Cataract surgery is very traumatic for the eye and sometimes the surgery will generate quite a bit of floaters, but these should clear-up after a while.

 

Q.    My friend has drusen of the optic nerve.  She has been having regular headaches and is fatigued a lot.   She is 34 years old and does not have a family history of genetic eye problems.   What can she do to help this condition?

Nothing.  Drusen of the optic nerve are little whitish or translucent bodies of various size that are in the nonmyelinated part of the optic nerve head.   Both eyes are usually affected.  In general they are not associated with any systemic or eye conditions, so your friend's headaches and fatigue are probably unrelated.   Typically, drusen of the optic nerve cause no problems unless they're big and/or start to interfere with blood flow or compress the optic nerve fibers (rare conditions).   Their size tends to increase with age.  Since no one knows what causes drusen of the optic nerve or how they occur, your friend can probably do nothing to help the condition.

 

Q.    I am a 50 year old female and have been recently diagnosed with Central Serous Retinopathy. My doctor seems to think cause is long term use of topical steroids. I have suffered from psoriasis for more than 20 years and have always used various creams and ointments containing steroids. I have seen very little of this problem. Can you offer me more info?

Central Serious Retinopathy, also called Central Serious Chorioretinopathy (CSC), usually occurs in  women between 20 and 45 years of age.  Visual symptoms include decreased vision, objects appearing smaller than usual, color vision changes, poor vision for low contrast objects, poor night vision and blind spots (scotoma) just outside of one's central vision.  Patients with CSC generally have a good prognosis and most recover from any vision loss in about 3 - 12 months, although episodes can reoccur.   However, about 25% may have serious vision loss in the range of legal blindness (20/200 or worse visual acuity).  Patients that seem to do worse are those with retinal detachments, macular swelling and choroidal neovascularization (abnormal blood vessel growth). 

Sometimes, particularly in patients over the age of 50 years, it is difficult to differentiate between CSC and age-related macular degeneration (ARMD).  The typical tests for CSC are a dilated eye exam and fluorescein angiography.  In both diseases however, there are choroidal neovascularization and detachment of the retinal pigment epithelium.  It appears that stress and psychological variables of the patient may play a role in CSC.  Finally, we are not aware of any published data on the relation between topical steroids and CSC.

 

Q.    Do you have any information on Neimann-Pick disease?

Niemann-Pic disease is a characterized by an excessive accumulation of lecithin and sphingomyelin in cells of the spleen, liver, bone marrow and lymph nodes.  Vision is significantly reduced by progressive optic atrophy and degenerative changes in the macula with the occurrence, sometimes, of a cherry-red spot in the macula.  Niemann-Pic disease is associated with skin pigmentation, deafness, mental retardation and epileptic seizures.  There is progressive physical deterioration and death usually occurs in the first few years of life.  Patients often are seen in the hospital, first, because of a failure to thrive.  There are also variants of Niemann-Pic disease in which there is progressive mental deterioration and cerebellar ataxia, but the eye exam is usually normal except for paralysis of the vertical gaze (patients can't look down).  Patients with Niemann-Pic variants usually survive longer and do not show degenerative changes until two to eight years of age.

 

Q.    My cousin was in a car accident recently and most likely hit her head on the steering wheel.  Ever since the accident she has had double vision.  She can see fine if she turns her head to either side.   The problem occurs when she looks straight ahead.  The doctors have beat-around-the-bush.  Do you have any suggestions on how severe this is or how it can be fixed?

Head trauma can lead to damage to the nerves that innervate the eye muscles and result in an inability for the eyes to move together or point in the same direction.   As a consequence, patients will complain, sometimes, of double vision (diplopia) when they look in a certain direction, like straight ahead.  If you look closely at your cousin's eyes when she says she sees double - you'll probably notice that the eyes are not pointed in the same direction (point a small flashlight at the eyes and notice the reflection on the two corneas - they will not strike the same part of each eye).  The most common type of nerve damage is to the sixth nerve (sixth nerve palsy) and the patient will have one eye that turns in toward the nose.  Often, after about 3 - 6 months, the damaged nerve(s) will regenerate and lead to single vision in all directions of gaze.   Sometimes, however, eye muscle surgery is needed to correct the problem or, at the very least, to allow the patient to see single in straight ahead gaze.  If the problem does not fix itself in about 6 months or so, have your cousin see an ophthalmologist (an eye doctor that can perform eye muscle surgery - often a pediatric ophthalmologist will have the most experience in eye muscle surgery) about the diplopia and recommendations for treatment.

 

Q.    On the bottom eye lid nearest the nose in the corner where the eye lashes end, there is a small, very small bump.  On my right eye this bump became large and swollen.  It's been there so long now that it's become hard.  What is it and how can I get rid of it?

You describe what appears to be a blocked tear duct.  These occur often in young infants, but anybody can get them.  In infants, usually a warm compress applied 2-3 times per day for about 15 minutes will fix the problem.  Rewarm the compress as needed.  Also, gently massage the lump during and immediately after the warm compresses may help the tear duct to open.  If the tear duct does not reopen after a week or two, the infant may need to see an ophthalmologist for a tear duct probe (minor surgery where a wire is inserted into the tear duct to clean it out).  In older children and adults, however, a tear duct probe is usually required.  A tear duct probe can be done in the doctor's office.  Because a blocked tear duct is often the result of infection, antibiotics may be needed.  Less likely, the lump may be a sign of a more serious condition.  So if the problem doesn't get fixed with the compresses and massage, if an infant, or if your an adult please visit an ophthalmologist for further evaluation and treatment.

 

Q.    My eyes are always watery and the top lid is also swollen.

The eyes often water because of irritants and eye lid swelling may be a sign of an allergic reaction - typically to cosmetics.  So, if you avoid cosmetics or at least change brands, the watery eyes and lid swelling may disappear.  However, if only the upper lid(s) swell AND the swelling is off to the side a little bit toward the side of the face, you may have an acute or chronic inflammation of the lacrimal gland(s) - a condition called dacryocystitis. (A more rare,but similar in terms of symptoms, condition is called dacryoadenitis and is sometimes associated with TB and Gonorrhea, for example).  Dacryocysitis is sometimes caused by certain infections (staphylococci), trauma to the lacrimal gland and is associated with conjunctivitis, but most of the time the cause is unknown.  Symptoms include swelling of the lacrimal sac, which is located underneath the upper eye lids toward the side of the face and  watering eyes.   Sometimes pus may be seen and conjunctivitis may be present.  See an eye doctor for evaluation and treatment.

 

 

Q.    What causes the feeling of bugs in the eye?

Q.    For the past two months, on and off, I have the feeling in my left eye that there is something in it.    Sometimes it is really bad and goes on all day and sometimes it lasts just a couple of hours.  I have tried to use clear eyes solution, but it doesn't work.   My eyes water a lot when I get this and it is very irritating.  Is there a name for this and is there anything that I can do?

When the eyes are dryer than normal, they will feel like something is in the eyes like sand, or I guess bugs, and sometimes the eyes will water a lot - a condition called hyperlacrimation.  Patients with trichiasis, blepharitis, chronic conjunctivitis and iritis also frequently have hyperlacrimation.  You need to see an eye doctor to evaluate your condition since it my be treatable.

 

Q.    I see blurry streaks across my field of vision when I move my eyes from side-to-side, or when I turn my eyes to look at something.  The level of blurry areas has increased rapidly...  I went to the eye doctor and he said that it was probably protein build-up and nothing could be done.  He also said that he wanted me to return for a check-up for glaucoma in my left eye...  What are these blurry streaks?

Since an eye doctor has examined you and believes that the streaks are the result of protein build-up, we will not second guess someone who has actually examined you.  Another possibility for the streaks, however, is that they are an early sign of glaucoma since he also suspects glaucoma in your left eye.  The following test may help clarify whether the streaks are a sign of glaucoma.

As you stated, first get a feeling about where in your visual field you see the streaks when you more your eyes back-and-forth.   Are the streaks only in the left eye or in both eyes?  Once you have an idea of where in your visual field the steaks are do the following:  Tune a large (27 inch or larger is ideal) TV to an empty channel that only contains "snow".  It will appear that the snow is moving in all directions.  View the TV from about 2 feet and with each eye (i.e., close one eye) fixate on the middle of the screen and pay attention to the rest of the TV; that is, pay attention to your side vision in all directions.  When you pay attention to the sides of the screen DO NOT MOVE YOUR EYES.  Do you notice any area of the TV screen that looks different than the rest of the screen?  Are there areas on snow that don't seem to be present or "moving"?  If yes, do the blank or different areas match the location of the streaks?

The snow test is very sensitive and very specific for glaucoma.  If the steaks are in the general area of any missing or blank parts of the TV snow pattern then it is very likely that the streaks are in fact early signs of a visual field loss - probably due to the glaucoma.  To evaluate or test for damage related to glaucoma, in addition to measuring the pressure of your eyes, your eye doctor will also probably do a visual field test to discover any loss of side vision - an early sign of glaucoma damage and also an indication that medicine or/and surgery may be needed.  By all means, follow-up with your eye doctor and follow his/her directions for treatment, if necessary.    If the streaks are in the right rather then the left eye, or if the location of the streaks does not match at all the location of any missing parts of the TV snow pattern, or if you do not notice any missing parts of the snow pattern then the streaks are most likely protein accumulation and nothing can be done about them.

 

Q.    My eyes are constantly red in the outer corners.  I have dry eye, but have been told its not that bad.  I don't wear my contacts often anymore but my eyes remain red.  I have been to 3 doctors and they say my eyes are healthy and that I basically have to live with the redness.  I feel that there must be some cause for the redness.  Do you have any suggestions?

Red eye is one of the symptoms of dry eye disease.  Since you've seen 3 eye doctors and all of them say the same thing - you can at least take comfort in knowing that the diagnosis is correct.  If you have not already tried ways to reduce the symptoms of dry eye disease then you may want to start now.  Standard suggestions include the use of artificial tears, lubricating ointments at night, avoidance of irritants including smoke and contact lenses.  The home and work place should have high humidity, if possible, and avoid drafts or blowing wind.  New treatments and drugs to fight dry eye disease are in the works, so keep regular eye check-ups and someday a medicine will become available to alleviate your red eye problem.

 

Q.    When I dig into the corner of my eyes, near the nose, (or pull down the lower lid) I pull-out what looks like string.  Can you tell me what it is?

You may suffer from what is referred to as "mucus fishing syndrome".    Some patients will actually cause eye irritation by digging into the conjunctival cul-de-sac with their fingers and "go fishing" and pullout strings of mucus.   By repeating the procedure the eyes become more irritated, more mucus is produced, more fishing is done and the cycle repeats itself.  If you DO NOT mess with your eyes the irritation will stop and the excessive mucus will go away.   So don't mess with your eyes and the problem will resolve.

Q.    My brother was diagnosed with prones and told he would go blind...

We could find no reference to "prones".  The closest thing that we could think of is Crohn's disease - but you don't go blind from it.  Another possibility is the the doctor said "cone" disease, such as a cone dystrophy.    Cone dystrophy is similar to macular degeneration in which the day time vision (e.g., color vision, fine detailed vision, central vision) part of the retina deteriorates.  Cone dystrophy does result in legal blindness or about 20/200 visual acuity (only see the top line on the eye chart)in most cases, but it does not lead to total blindness.  If you can get the actual name/diagnosis, we would be happy to supply additional information.

 

Q.    Can histoplasmosis cause a loss of peripheral vision?   Should I be tested for histo?

Histoplasmosis can affect any and all parts of the retina/eye and so it can cause a loss of peripheral vision.  However, because patient's don't use peripheral vision for much, patients will often be unaware of the loss of peripheral vision until they have a visual field test done, for example.  Patients readily notice losses of central vision so this is why histoplasmosis is usually referred to in the context of affecting central vision.  Should you be tested?  Like most people, you will probably test positive for histo, particularly if you live in a high incidence area or worked around chickens.  So I'm not sure if it would provide any worthwhile data.   Ask your eye doctor and review the past featured article section about histoplasmosis.

Q.    I get small bubbles of serous fluid on the rim around my eye - between lashes and eye.  Is this normal?

Probably not.  Serous or serum-like fluid and drainage is one symptom of blepharitis.  The tiny bubbles are probably the result of blinking action and the generation of pockets of air.  Go to the Q and A question about blepharitis, symptoms and method of treatment.

 

Q.    My father became blind two weeks ago for the reason that one of the veins in his right eye busted.  The doctors keep telling him that he has to wait for the blood to go away.  Can you tell me what his problem is? - sweet

The eye contains a large number of blood vessels and sometimes, typically because of disease or injury, the blood vessels rupture and leak into the fluid part of the eye - the vitreous.  When the vitreous fills with blood it blocks-out light from reaching the retina and therefore the patient becomes almost instantly blind, at least temporarily.  In order for the eye doctors to see the site of the leak and the damage it has caused, the blood needs to clear through the normal draining action of the eye.   Depending on the severity of the leak it could take a long time for the eye to clear-up enough for the eye doctor to assess the damage.  If the leak was off to the side of the eye, and only affected peripheral vision,  then your father might make a full recovery, more or less.  If the leak involved blood vessels in his central vision (macula) then the prognosis is poor for visual recovery and it would be likely that he will be legally blind or visually impaired in the affected eye.  Sometimes an ultrasound will be performed on the affected eye to make sure that the retina is attached.   Also, sometimes a bright flash ERG will be performed on the eye to make sure that the retina is still functioning - depending on the circumstances.

Blood vessels in the eye leak or hemorrhage for a variety of reasons including diabetes, age-related macular degeneration, hypertension or high blood pressure, among others.  So, at the very least, your father should be screened for diabetes and for high blood pressure and any other reason(s) the his doctor may suspect as the cause of the hemorrhage.  Sometimes examination of the unaffected eye will provide a clue as to the reason why the other eye hemorrhaged.

 

Q.    What is cyclophoria?

A phoria is a small deviation in the alignment of the two eyes, such that the eyes don't point exactly in the same direction.  Typical phorias are esophoria (one eye turns-in slightly), exophoria (one eye turns-out slightly) and vertical phorias in which on eye is slightly above (hyper) or below(hypo) the other eye.  A cyclophoria is not typically discussed in the literature but would involve the slight rotation along the line of sight of one eye compared to the other eye, and would be detected when one eye is suddenly covered, for instance.  As with all phorias, they do not typically cause problems and are often not noticeable except by the eye doctor during an exam.

 

Q.    What colors or patterns are appealing to senior citizens or individuals with diminishing sight?

Research has demonstrated that high contrast (difference between the light and dark parts of an object), black and white patterns including stripes and checkered boards, are most easily seen by everybody including infants as well as adults with vision problems.  The higher the contrast the better.  Regarding size, in general, the larger the pattern the better.  For example, people with reduced vision would see better a large print book than a book with print the size of news print.  In general, colored patterns are not seen very well by people with reduced vision or by infants who have a "natural" reduced vision, at least compared to adults.  [Some brain damaged patients, with cortical visual impairment, will see certain colors better than black and white.]  If you know of someone with vision problems regardless of age, they should be evaluated at the Bureau for Services for the Visually Impaired (BSVI), where professionals can evaluate they're visual potential and offer visual aides and further evaluation.

 

Q.    What is [ punctate inner chorioretinopathy] sometimes called PIC disease?

Punctate inner chorioretinopathy (PIC) has also been referred to as "multifocal choroiditis and panuveitis" and "recurrent multifocal inner choroiditis", depending on the authors.  These names seem to refer to early stages of an advancing disease.  Later in the disease process authors have referred to it as "progressive subretinal fibrosis", "multifocal choroiditis with disciform macular degeneration", "progressive subretinal fibrosis and uveitis" and "chorioretinopathy with anterior uveitis."  Patients with PIC are often young, healthy females with mild nearsightedness or myopia. Patients often have a sudden vision loss, multiple scotomas (blind spots) and photophobia.   Typically both eyes are affected and recurrences do occur.   Prognosis is noted to be poor, and most patients have visual acuities as the disease progresses to 20/200 visual acuity - legal blindness.  The cause of the disease is not known; however, it is believed to be related to a localized (eyes only) autoimmune antibody inflammation.  In other words, it seems that the body turns on itself and attacks cells within the eye at the level of the retinal pigment epithelium.  Treatment seems to be limited to the early "acute" phase and involves anti inflammatory drugs such as corticosteroids.

 

Q.    Do you have any current medical information about [ Pars

Planitis ]?

Pars Planitis refers to a type of intermediate uveitis (see Uveitis) in which an uveitic type disease creates exudates (clumps of what look like fatty deposits or "fluffy snow") as well as membrane formation over the inferior pars plana - the middle part of the eye including the peripheral choroid and ciliary body (far side vision).  Some patients will develop swelling of the optic nerve and/or macula.   Patients with Pars Planitis usually don't complain of much pain or redness or sensitivity to light.  Often they may not even have symptoms and the disease may be discovered on routine exam.  Symptoms do include blurred vision, floaters and sometimes, although rarely, bleeding within the eye (vitreous).  About 10% of patients with uveitis have Pars Planitis, males and females are equally affected and usually both eyes are affected.  Pars Planitis "goes away" in some patients but in many patients it reoccurs over time.  Severe complications in advanced cases include cataracts, bleeding in the eye, development of abnormal blood vessels and retinal detachment.  However, in the majority of cases the disease is mild and requires no treatment.  Patients that smoke, have emotional distress and patients that "hold things in" without ventilating emotions appear to have increased risk for the disease.  Pars Planitis is one of those eye diseases in which it is VERY IMPORTANT to make all eye doctor appointments on a regular bases.

 

Q.    Blood in eye.

Blood in the front part of the eye between the cornea and the pupil/iris is called a hyphema and warrants immediate medical attention.  A hyphema can lead to the sudden onset of glaucoma and permanent loss of vision in the eye.

 

Q.    A stinging sensation in one eye causing tears, wear glasses at present.

Whenever there is pain in the eye the person should see an eye doctor ASAP.   Stinging may be caused by a number of factors including an allergic reaction, foreign body in the eye, etc.  A number of diseases can also cause stinging, such as conjunctivitis and uveitis (see previous Q and A comments).

 

Q.    Why would an older person see print straight on but the news paper appears slopped?

You describe what appears to be spatial distortions in your vision.   Spatial distortions in an older person may be a sign of age-related macular degeneration or other, sometimes serious, retinal problems.  Less likely but possible, spatial distortions are sometimes associated with the optics of the eye; for example, if you have an intraocular lens (have had cataract surgery and a new lens implanted in the eye), a change in the position of the lens can also cause some distortions in vision.  If you have a piece of graph paper (cress-crossing lines) or, better yet, an Amsler grid, look in the center of the graph paper with each eye alone and do you see some of the lines as wavy or distorted?  See an eye doctor ASAP for further evaluation and treatment, if appropriate.

 

Q.    I have red veins surrounded by yellow in the whites of my eyes from the iris to the inner edge.  I have Grave's disease and Fibromyalgia.  These veins have been there for two years now.   Some days they get real bad and my vision gets fussy for a few hours.  I am amblyopic and my good eye is worse than my lazy eye.  What causes this?

We assume that you're being regularly seen by your eye doctor, if not you should be.  Patients with Grave's disease show varying degrees of exophthalmos or protruding eyes.  Because the eyes protrude outward there is increased surface area of the eye exposed to air and, as a consequence, the eyes tend to dry-out as in dry eye disease.  A sign of dry eye disease is red appearing eyes.  The redness is cause by irritation resulting in the blood vessels being gorged with blood and then become more noticeable.  If your vision is temporarily being affected as you indicate, this may be due to the excessive drying of the cornea but may also be related to the pressure placed on the eyes by the Grave's disease.  See your eye doctor about these problems, particularly about the periods fuzzy vision.

 

Q.   I am a twenty-one year old female. Last Christmas my right pupil became fixed and dilated. I visited two optometrist and two ophthamologists. After many tests including CAT scans and MRI’s of my brain, it was agreed that I had what is called an Adie’s pupil. My question is, what exactly is this condition? The only information I received from my Dr’s was that this condition is common in 20-40 year old females and that it is caused by damage to the optic nerve. The exact pathophysiology is not known and the duration can vary from 1 month to 10 years. Now I am a nursing student getting my BSN, and this is not much information for me to go by. It is very difficult to find any information on Adie’s pupil. I was wondering if you had any more information for me. Thanks.

Adie's pupil (or Adie's syndrome), also called tonic pupil syndrome, is a benign condition in which the pupil in one eye is typically larger than the other pupil in light.  In darkness the affected pupil may be small than the other, nonaffected, pupil.  Usually one eye is affected, although you have about a 4% chance of the other pupil being affected in any given year.  Adie's pupil affects more women then men, and the women are often in their 20s.  As you stated, the condition can last for years.  If you look real close at the affected pupil in a mirror and shine light in the pupil, you might actually see sections of the pupil try to contract while other segments move less or not at all - called worm-like undulations.  If you look back and forth at near and distance targets, you may also notice that your vision is also momentarily blurred because accommodation is also slowed in Adie's pupil.

The reason for Adie's pupil is unclear, although some evidence suggests that, following injury or disease, nerve fibers that are supposed to innervate the lens of the eye actually end-up innervating the muscles that control the pupil.  It is important to note that the diagnosis of Adie's pupil is, in part, a matter of elimination of other potential causes of different pupil sizes (anisocoria.), such as syphilis, Charcot-Marie-Tooth disease to name a few.  So it appears that your doctors screened-out those and other causes of asymmetric pupils.  A good source of information about Adie's pupil, see Miller's edition of Walsh and Hoyt's Clinical Neuro-Ophthalmology (Vol. 2).

 

Q.    My wife has migraines and she has recently been complaining about light in the room not being bright enough.  Even when all the room lights are on, she complains that the room is too dark... Her eye doctor says that her eye pressures are higher than normal.  Is there anything that can be done for her?

Migraines are most often associated with sensitivity to light (photophobia) and thus her dim vision is most probably not related to migraines.  However, glaucoma or abnormally high pressure in the eye(s) will cause vision to dim and glaucoma may be the problem with your wife.  We would strongly recommend that your wife's eye pressures be checked AND that she have a visual field test performed to evaluate her side vision, which is first affected in glaucoma - ASAP.  Also, try the glaucoma test mentioned in an earlier Q and A answer (Go to Blurry streaks).

 

Q.     Information on lazy eye.

Amblyopia, commonly called "lazy-eye", affects about 3% of the childhood population. Amblyopia is the leading cause of vision loss in children. The major causes for amblyopia are; 1. difference in refractive error between the eyes (anisometropia.), 2. crossed-eyes (esotropia), 3. deprivation due to cataract or anything that can disrupt vision to one eye (e.g., a droopy eye lid, matting of an eye during the first year of life).  Amblyopia causes decreased visual acuity, distorted vision and produces poor vision for objects that have low contrast. If detected early, say by 4 or 5 years of age, amblyopia can be treated and cured in most cases IF THE PATIENT AND PARENTS ARE COMPLIANT WITH TREATMENT.   The standard treatment for amblyopia is to patch the good eye and to force the child to use the amblyopic eye. Through use, the amblyopic eye becomes "stronger" and eventually visual acuity returns to 20/20 – normal vision.  Parents must NOT let the child decide if he/she wants to wear the eye patch - he/she will not wear the patch.  Parents must give the child NO ALTERNATIVES - he/she must wear the patch.  Wearing the patch is NOT an option. 

When parents and the child are not compliant with occlusion therapy, sometimes the eye doctor will try "penalization" therapy in which the stronger eye is blurred by the use of lenses or certain eye drops.  Penalization works, somewhat, if the vision in the amblyopic eye isn't too bad (20/100 or better).   Although other treatments have been tried to correct amblyopia, nothing has been found better than occlusion of the dominant eye.  Recent research funded by the Ohio LIONS Eye Research Foundation has shown the L-dopa may facilitate occlusion therapy - once the occlusion-only therapy has run its course (See L-dopa under Funded Research).  Also see discussion about vision therapy for amblyopia ( Go to vision therapy).

 

Q.    Can herbal medicines taken in large doses cause glaucoma?  In particular St. John's Wort and Ginko Biloba?

Very little is know about all herbal "medicines", they are not approved by the FDA and one should always be cautious about taking anything in "large doses" no matter the hype surrounding the herb.  That said, St. John's Wort (Hypericum Perforatum) has a number of active ingredients that can produce numerous "side-effects".  It should not be taken if you're on antipsychotic drugs or CNS depressants or placed on the skin if you're also using an ache product like vitamin A acid.  Note that the FDA lists St. John's Wort as UNSAFE.  It has a hypotensive action in humans so we doubt that it could cause glaucoma.  Any herbal product should be taken with great caution, even in the recommended dose, and as a general rule never take any herbal product if you're on any approved, standard medicine.

 

Q.    I have a very red eye for the last few days.  I can see red veins very strong on one side.   Can you tell me what to do?

Yes, see an eye doctor for diagnosis and treatment.   Redness on one side of the eye can be due to a number of disorders. See previous Q and A discussions about red eye.

 

Q.    My left eye is seeing tunnel [vision].  Could this be a detached retina or something more serious?

A detached retina is a very serious problem, but it is probably not the problem causing tunnel vision.  Several serious eye diseases cause tunnel vision including glaucoma, the most likely, and retinal degenerations such as Retinitis Pigmentosa (RP).  You need to see an eye doctor ASAP about the problem.  If glaucoma, it may be treatable and it is likely that your other eye is also being affected, just not as bad as the left eye...yet.

Q.    Is there any possible help for a patient with Stargardt's [disease]?

Stargardt's disease is a retina degeneration (focal RPE dystrophy) that causes a loss of central vision, produces a central scotoma or blind spot, abnormal color vision and possible photophobia.  Visual acuity usually decreases to 20/200 - legal blindness and then stabilizes.  Currently, there is no known treatment for Stargardt's disease.  A person with Stargardt's disease should be seen by the Bureau of Services for the Visually Impaired (BSVI), where the person can obtain certain rehabilitation services including visual aides such as magnifiers and telescopic devices.

 

Q.    My right pupil just recently became two times larger than the left one and [my vision] is kind of blurry.   What's wrong?

You need to see an ophthalmologist ASAP.  A difference in pupil size may be an indication of a very serious eye disease or neurological problem.   Also, go to Adie's disease also go to Unequal pupils.

 

Q.    I woke up and my eye lid hurt like I got hit in the eye.  Later in the day it got a little swollen and now it is more closed than the other eye.  It bothers me and I got a headache.   I was wondering what is wrong?

If your eye hurts and there is swelling of the upper lid of one eye, you may have an inflammation of the lacrimal gland.  The lacrimal gland sits underneath the upper eye lid, just off center toward the side of the face. Some conditions, like dacryoadenitis, are more serious than others, like dacryocystitis.   You need to see an eye doctor for evaluation and treatment.  Also see More Info.

 

Q.    My optometrist diagnosed me with posterior vitreous detachment in my right eye.  Could you tell me all there is to know about this disease and if Lutein can be taken to prevent any further damage to the eye?

No and probably not.   Although time and space prevent us from discussing all the aspects of a posterior vitreous detachment (PVD), we can tell you that a PVD is caused when the gel in the eye or vitreous liquefies and collapses and pulls away from the back of the eye and retina.  This usually occurs when the patient is in his/her 50s and 60s or even younger if you are very nearsighted (myopic).  The patient will often complain of floaters as the first sign that something is wrong.   PVD is associated with flashes of light, particularly in a darken environment or when making saccadic (i.e., rapid) eye movements, and vitreous bleeding which, in turn, causes more floaters.  Treatment is not indicated unless there is a tear of the retina or bleeding requiring surgery.  A patient with a PVD needs to be aware that   both eyes may become affected and that a retinal tear can occur at any time.   If the patient experiences a sudden appearance of a lot of floaters or loss of vision, prompt medical attention is required.  We are aware of no scientific evidence that Lutein or anything else helps prevent further damage or the prevention of PVD.

 

Q.    What causes a person to become sensitive to light?

Q.    Lights hurt my eyes at night.   Why?

Sensitivity to light or photophobia is caused by a number of factors including the early formation of cataracts or glaucoma, to name a few.  Any disease process that affects the front part of the eye; for example, either the cornea or the lens of the eye can cause photophobia.  Certain retinal conditions also cause photophobia.  See an eye doctor for evaluation and treatment, if applicable.

 

Q.    What can be done to heal macular degeneration?

There are many types of macular degeneration.   The most common type that mostly affects the elderly (over the age of 50) is age-related macular degeneration (ARMD).  Depending on the type of ARMD, dry form or wet form, certain treatments are available although nothing will cure or heal ARMD. Laser surgery and other types of surgery, such as photodynamic therapy, may be indicated.  Since surgery is only done by ophthalmologists (MDs), you need to see an ophthalmologist for evaluation and to see if anything can be done.  Also see macular degeneration under Dictionary and under Simulations.

 

Q.    Do florescent lights affect the eyes?

Yes.  Florescent lights flicker at 60 Hz and when the lights become old or the ballast becomes less efficient or old florescent lights will be seen to flicker.  Florescent lights can cause eye strain, particularly if you have cataracts or other eye problems.  Although florescent lights will not harm the eyes per se, they can cause eye strain and fatigue.  There is some question about the frequency of light emitted by florescent lights, and certain special florescent lights can be bought to provide the full daylight spectrum.

 

Q.    Is there a cure for cysts on the eyelid?

Yes.  There are different types of cysts that can affect the eyelids and surgery can usually be done to remove the cysts.  Also, although less common, certain types of tumors can also occur on the eyelids so medical evaluation by an ophthalmologist is necessary.  See an ophthalmologist for evaluation and treatment.

 

Q.    I've had this problem with my right eye ball for a year now and it seems to be jumping or twitching in an up and down motion.  It comes and goes.  I can stop it by closing my eyes and moving them rapidly back-and-forth.  I have gone to an eye doctor but he says there is nothing wrong.  This is really starting to get on my nerves.  Can you tell me what it is?

Most likely you're experiencing eye twitching.  Go to Twitching Eyes for more information.  When you say that its seems that your eye appears to be jumping, do you also experience the visual world as jumping around?  For example, close one eye and with the other, open eye take a finger and gently push, back-and-forth, on the corner of the eye (actually on the corner of the eye lid) and you'll notice that the visual world appears to jump around.  Is this jumping the same as when you experience your eye jumping?   If you experience the visual world as jumping when you have this jumping eye, you're describing a condition called oscillopsia.  If yes, you should see a Neuro-ophthalmologist immediately since the oscillopsia may be a sign of a serious neurological condition. Oscillopsia is also sometimes  associated with down-beat nystagmus.  If your visual world does not jump around when you experience your eye jumping then it is likely that it is a twitching eye.

 

Q.    What should a patient worry about if he is having a transplant?

It depends on what type of transplant the patient is having.   Everything that you might worry about is usually in the consent for surgery form that you sign before the surgery.  The most common eye surgery that involves a transplant is cataract surgery in which an artificial lens is "transplanted" in the eye.  Risks include those related to the anesthesia and possible infections.   Surgery always carries risks, including the risk of death, although this is extremely rare.  Other risks involve the loss of the eye or permanent loss of vision in the eye, but again, these are rare occurrences.  Before surgery, ask your doctor to describe all the possible risks and the likelihood of their occurrence.  Finally, chose an eye surgeon that has plenty of experience in the type of transplant the you're planning to have - the more experience the better.

 

Q.    In the last year or so my eyes become blurry.  I can focus on small objects but the periphery appears blurry and washed-out.  It makes it hard to see and can be nauseating some times.  What do you think?

We think that you need to see an eye doctor ASAP.  The symptoms you describe including poor peripheral vision and bouts of nausea are symptoms of glaucoma.  How well do you see at night?  Other serious eye diseases can also cause a loss of peripheral vision, including retinitis pigmentosa (RP), although RP patients don't complain of nausea.  See an eye doctor - at least if the exam comes out normal you can have peace of mind.

 

Q.    I have normal vision during the day and eye sight is excellent.  From the evening on until the next day my left eye sees everything in a very red hue.  Artificial light is extremely bad and covering the good eye, the light looks blood red.  Eye doctor can't find anything and has recommended blood work, EKG and other blood vessel exams.  I an 81 in excellent health and not on any prescriptions...  Any thoughts?

Since it is affecting only one eye it is likely a condition specific to the eye or visual system related to that eye.  Your doctor may be on the right track in testing your circulatory, blood vessel, system.  Patents with arteriosclerosis or decreased blood supply to an eye or the optic nerve of that eye will complain sometimes of the vision in one eye taking-on a different appearance such as a certain hue.  Keep your doctor appointments and if you get the chance let us know what they find-out and we'll pass it on to our Web site visitors.  Good Luck

 

Q.    I am 22 and have been having floaters for about a year and a half.  My eye doctor felt that it is not serious.  I am know seeing pulsating light and dark spots that stretch across the center line of my vision.  I see then especially after driving awhile - usually for an hour or so.   Is this a symptom of a specific disease?

Floaters are very common and usually are not a cause of concern.  However floaters, particularly lots of them or when they're present with flashes of light, can be a sign of more serious eye disease.  Since you have seen an eye doctor and he/she thinks that the floaters are not serious, it is unlikely that the pulsating light and dark spots are related to the floaters.  Patients that have migraines do complain about "pulsating" lights in their central vision.  Do you have a headache or other symptoms like ringing in the ears about the same time or within about 30 minutes following the pulsating lights?  If so, you may be experiencing migraines.  However, please note that headaches do not always occur with migraines.  You should consider returning to your eye doctor for a dilated eye exam just to be sure that the floaters and pulsating lights are not related.

 

Q.    I have black spots that look like floaters and are cobwebby.  Up close they look like circles outlined in black that connect to form lines and groups.  They are in both eyes.   It looks like looking through a dirty window.  I have been to 8 eye doctors but they say my eyes look healthy and they don't see any floaters.  I have had them four 4 years, I'm 33 yr old female in relatively good health.  Do you have any idea what is wrong?

What you describe, very well by the way, are classic floaters.   The question then becomes; are they associated with anything serious?  Since you're seen 8 doctors and they all agree that there is nothing seriously wrong with your eyes we must conclude that there is nothing seriously wrong with your eyes.  (It is not surprising that the doctors could not see the floaters since they're often difficult to see anyways).  It is obvious, though, that these floaters are causing a great deal of stress for you; else way would you see so many doctors and even search the WWW?   Patients with certain personality characteristics (e.g., obsessive - compulsive) will tend to focus on certain things in their lives.  Unfortunately, as we grow older and older, there are more and more things, healthwise, that occur with us and that we have little control over...such as floaters.  Try accepting what your doctors have said and learn to live with your floaters as many of us do.

 

Q.    What is Fuch's Dystrophy?

Fuch's dystrophy is a disease of the cornea in which the inner lining of the cornea (endothelium) changes structure and function and results in swelling, pain and loss of vision.  Although the cause of Fuch's dystrophy is unknown, there is a hereditary component (dominant trait, mostly affecting females) and the disease usually starts in the patient's 40s and progresses over the course of 25 years or so.   Usually both eyes are affected and early in the disease process there is the formation of "drop-like" particles on the endothelium in the absence of swelling.  In the middle portion of the disease there is corneal swelling, in which the cornea thickens to about twice its normal thickness, and the patient experiences halos around lights, glare problems and blurred vision.  The patient may complain of a foreign body sensation in the eyes, small corneal ulcers or blisters and pain.  The final stage of the disease process involves the further deterioration of the cornea, significantly reduced vision and possible growth of blood vessels in the side of the cornea, although the pain sensation decreases.  Treatment sometimes starts with techniques to dry-out the cornea as well as the decreasing of the humidity in the environment, lubricants, occlusion or/and a soft contact lens bandage.  Finally, penetrating keratoplasty is usually the treatment that provides the most relief for the patient.  In penetrating keratoplasty a large section of the cornea is transplanted.

 

Q.    My boss has a form of color deficiency. He recently heard about corrective lenses that allows one to see true colors but we have been unable to find more information on the Web. He saw information about these lenses from reliable sources (a national morning news program and a local news show). However, reliable information seems to be lacking, even his own Ophthalmologist had not heard of these lenses. He was able to track down a clinic in Boston that provides them and to make an appointment, but they canceled and will not reschedule until Spring. Do you have any information or know where we can get it? Thank you.

The glasses in question don't work.   The FDA, we believe, recently ruled that the glasses do not allow patients with color blindness for certain colors to actually see colors; but rather, simply improves the color discrimination that they already have.  Indeed, color vision is based on the presence and ability for three different types of cone photoreceptors in the retina to interact in a very specific way.  Color blindness for particular colors involves the loss of certain cones or the miswiring of theses cones; either way, glasses in-of-themselves cannot (read: impossible) cause a patient to see colors.  We'll try to uncover more information on this topic in the near future.

 

Q.    I noticed about a year ago that my ability to see objects close up was getting very bad quickly. I had my eyes checked and ended up with progressive lenses. What is still bothering me is that my right eye, which has always been my ‘good’ eye (I’ve had glasses for nearly 30 years, and am 41 now), has ‘blind spots.’ As I close my left eye, I can see much of what there is to see, but in many random places there are blank spots. If I refocus my eyes and look directly at a blank spot, it becomes clear.   It is starting to affect my ability to drive, especially in any rain or fog. Can you point me in a direction to investigate?

Given your age, it is common to become presbyopic – or need progressive lenses. As for your blind spots, you need to see an eye doctor ASAP. There are numerous conditions that have as a symptom blind spots (scotomas) in the visual field and ALL of the conditions are very serious. Some of the conditions are treatable. See the SIMULATIONS section/page of the web site for a few examples of what can cause blind spots in vision.

 

Q.    My wife’s eye turns red due to this thin film-like growth that has been growing from the small round flesh at end corner of the (near nostrils). I would just like to know what this is and what is the cure for this.  The growth has now occupied approx. 35% of the eyeball moving towards the lens. Which as of now has reached a very small portion of the lens. I am really worried of this growth as I don’t want to see my wife suffer from vision impairment.

As to the growth in your wife’s eye, she really needs to see an Ophthalmologist for diagnosis and treatment. It is unclear from your description what the growth might be. One possibility is that your wife has episcleritis.   (Go to MORE INFO on Episcleritis).  Another possibility is that she has a Pterygium - a triangular membrane that has blood vessels which grow from the sclera towards and sometimes into the cornea, causing sensitivity to light and discomfort. It usually occurs on the nasal (nose) side of the eye and is common in dusty and windy climates. Surgery is often necessary.

There are several benign tumors that also affect the white part of the eye and can invade the front part of the eye including the lens area. Some of these tumors can be removed by surgery, if necessary. Another concern is that if the disease affects the front of the eye near the colored part of the eye, the iris, that the disease may cause an onset of glaucoma which could lead to blindness in the affected eye very quickly. So take your wife to an ophthalmologist now – kicking and screaming if necessary, she may thank you later. If the ophthalmologist finds that the condition is nothing to worry about, then at least you’ll feel better and have peace of mind.

 

Q.    The doctor recently told me that I should have a physical by my general practitioner because I have iritis and iritis is related to an autoimmune disorder.  Is this right?

Iritis is a form of uveitis and, yes, iritis is sometimes associated with an autoimmune disorder (as well as trauma).  For example, iritis sometimes occurs in rheumatoid arthritis, rheumatoid spondylitis, Reiter's syndrome and herpes simplex, among others.  Also, autoimmune suppressive drugs are sometimes employed to fight iritis/uveitis.  You doctor is on-the-ball and follow his instructions.

 

Q.    Recently a relative was diagnosed with something called [retinoschisis].  Since I can't locate any information about the disease I can only assume that it is not very common.  The physician claims that this causes blindness and there is no cure.  Do you have any info?

Retinoschisis refers to a splitting of the neural retina -a thin layer of cells in the back of the eye necessary for vision.  There are several different kinds of retinoschisis; senile, congenital (from or in early infancy),  and secondary to trauma or disease.  The senile type is common in the elderly, over the age of 40, and occurs in about 10% or so of the population.  The senile form is usually stable for many years and often does not lead to a significant loss of vision.   In one study, over 200 eyes with retinoschisis were followed for about 9 years and NO eyes became blind.  Congenital retinoschisis, however, is worse and can lead to legal blindness because the splitting of the retina involves the macula - central vision.   Infants with retinoschisis that have macular involvement may develop nystagmus (eyes constantly move back-and-forth), eye misalignment (strabismus) and generally poor vision.  Often an electroretinogram (ERG) is useful for diagnosis of congenital retinoschisis.  Also, it is often necessary to put the infant to sleep to perform a detailed retina exam (EUA).  Congenital retinoschisis is often progressive during the first decade of life and usually stabilizes in the third decade.

 

Q.    What is ratinities pignentosa [retinitis pigmentosa], it recovery and form, and where I can get help about this disease?

Retinitis Pigmentosa (RP) is an hereditary retinal degeneration that has no proven treatment.  Symptoms include night blindness, loss of visual field leading to tunnel vision, cataracts, poor transition for light to dark and vise versa, reduced contrast vision, decreased visual acuity and eventual blindness.  Patients often become legally blind from the loss of side vision- when you have only about 10% of visual field remaining (20 degrees of visual angle of field).  About nine genetic variants have been identified and they fall into three main categories: recessive, dominant and x-linked.  RP usually is autosomal recessive (often no family history and 25% of sibs from the same mother and father are affected), autosomal dominant (50% of all family members are affected) and x-linked (females are carriers and are not affected or are affected only mildly and male offspring have a 50% chance of being affected).   There is a controversial treatment that may slow down the progression of the vision loss and the treatment involves vitamin A palmitate - a special form of vitamin A, taken by mouth once per day.  If female of child bearing age, the woman MUST be on effective birth control since vitamin A can cause birth defects.  For more information about RP, see the LINKS page and go to the Foundation Fighting Blindness web site.

Q.    What is Holmes-Adie Disease?

Holmes-Adie syndrome or disease is a tonic pupil combined with reduced deep tendon reflexes.  A tonic pupil is one that does not chance very much with changes with brightness or illumination.  Typically, the pupils constrict in brightness and dilate or grow larger in darkness.  In Holmes-Adie syndrome, the pupil(s) don't react to changes in illumination.  There may also be problems with accommodation - close-up objects may appear blurry.  Also see Adie's disease.

 

Q.    What causes my eyes to scale?

A common cause of crusting and scaling eye lid margins is blepharitis.  blepharitis is usually caused by staphylococcal infection.  For more info go to Blepharitis.

 

Q.    When I wake up I can't open my eyes for about two hours.  My eyes are red and they hurt.

You should see an eye doctor whenever there is pain associated with any eye condition.  Your symptoms relate to a number of eye problems, from allergies to dry eye disease.  See an eye doctor for evaluation and treatment.

 

Q.    Should I be concerned about sparkly wavy lines that occur in my peripheral vision occasionally?

Yes.  Sparkly wavy lines can be a sign of serious retinal or optic nerve problems.  Migraines can also cause people to see sparkly wavy like lines in peripheral vision.  See an eye doctor for a dilated eye exam.  Also, see other questions in this section that address such problems.

 

Q.    What is a detached retina and how does it occur?

The back of the eye contains a number of different layers of cells or membranes about the thickness of a layer of skin.  These layers include the sclera, the white part of the eye, choroid, retinal pigment epithelium and neural retina.   When a retinal detachment occurs, a part of the retinal layer separates from the other layers of the eye.  A retinal detachment can occur for a number of reasons including age-related macular degeneration, high myopia, blunt trauma or injury to name a few.  A retinal detachment is a serious condition and requires surgery to correct.   For more information go to retinal detachment.

 

Q.    Can subretinal neovascular membrane be caused by straining heavy lifting, etc., if you already have central serous retinopathy active?

Central serous retinopathy refers to a problem with the central (e.g., macular  or reading part of the eye) vs peripheral part of the eye.  Serous refers to serum-like fluid and retinopathy means a disease or pathology involving the retina.  So if you have central serous retinopathy you have a disease that causes serum-like fluid to build up underneath the retina layer of the eye.

A subretinal neovascular membrane is a membrane that has a lot of abnormal blood vessels in it and that is located underneath the retina.  These occur a lot in older people when the different layers or membranes in the back of the eye start to breakdown - causing blood vessels to grow from one layer to another layer.   Can straining or heavy lifting cause subretinal neovascular membranes?   Probably not, but then again no one really knows since such research has never been undertaken.  We are not aware of any studies that have found a link between heavy lifting, for example, and development of subretinal neovascular membranes.  For more information  go to Central Serous Retinopathy.

 

Q.    I am seeing a cluster of little clear bubbles in my left eye.  What is it?

If you think that these bubbles are inside the eye then they're probably floaters - collections of cells in the fluid part of the eye.  Go to Floaters.  If the bubbles on the outside of the eye then they may be a sign of blepharitis.  Go to small bubbles.

 

Q.    What is stargard eye disease?

Go to Stargardt's Disease.

 

Q.    My six week old nephew has been diagnosed with post chiasmal vision loss and they think that he is blind.  What could have caused this?

A post chiasmal vision loss refers to a loss of vision due to something that occurs after the optic chiasm - that area in the brain where the optic nerves from the left and right eyes cross to go, in part, to the other side of the brain.   This is a general term and often applies to vision loss that is of a cortical nature (i.e., involves the surface or cortex of the brain).  Another term that is sometimes used is cortical visual impairment or cortical blindness.

Unfortunately, the reason(s) for a post chiasmal vision loss is often unknown.  However, given the age of your nephew, there is hope that he will gain significant vision.  Sometimes at that age infants can be misdiagnosed and, instead, have a condition called delayed visual maturation.  This assumes that your nephew does not have any other medical condition such as a seizure disorder or other neurological problems.  If your nephew has delayed visual maturation he should start to better use his vision by about 6 months of age.  If by 6 months he still doesn't fix and follow objects than your concerns are well founded.  At the very least, your nephew should have a test called a visual evoked potential (VEP) or also called a visual evoked response (VER) that can evaluate the potential for visual function.

Regardless of your nephews condition, he should be referred to an early infant vision stimulation program and rehabilitation services for visually impaired children. - e.g., BSVI.  Good luck

 

Q.    Rolling eyes.

Rolling eyes is typically a habit that people with certain personality types develop.  It is under voluntary control.  Although rare, patients with seizure activity also are known to roll their eyes during the seizure.

 

Q.    I heard that the use of certain night lights in young children can lead to vision problems.   Any info?

A study was published last year (1998 or 1999) that claimed that sleeping with a night light resulted in the development of myopia or nearsightedness.   The study was not well controlled however, and the results have been called into question.  There is no clear scientific evidence for such a relationship.

Recently (3/2000), two scientific studies have been published that refute the claim that night lights cause myopia.  As a consequence, it is fairly safe to say that night lights do not cause the development or progression of myopia.

 

 

Q.    I have been having problems with floaters in both eyes and painful burning in both eyes.   Lately, my skin has become real itchy as well.  I have seen three eye doctors and they tell me that my vision is normal and so are floaters.  Do you have any information on this?

Floaters are normal in that as we age and as we become more myopic the more likely it is that we'll develop a few floaters.  Burning eyes, however, is not normal.  Burning eyes or the sensation that there is a foreign body in the eyes may be a sign of dry eye disease.  The fact that your skin has become real itchy my be a sign of an allergic reaction to certain drugs or cosmetics, creams, etc.  Thus the burning eyes and itchy skin should be checked-out.  If you wear makeup, try another brand or go without for a week or more and see if that helps with the burning eyes and itchy skin.  Even if the makeup is not applied to the eye area, when you sleep the makeup can be rubbed-off onto a pillow and then make contact with the eye area.  Certain environmental factors can also lead to dry, itchy skin and burning eyes.  If you work outside or under conditions in which there is lots of air movement and the humidity is too low can also lead to the conditions that you describe.

 

Q.    I get a pin prick sensation in my eyes - sometimes so severe that it feels as if there's a toothpick actually stuck in my eye.  Also, on moving my eyes it feels as if there is something clamped on them around with it.  This happens in both eyes and strikes unexpectedly.

Whenever pain is involved you should see an eye doctor to have it checked-out.   Sharp pain as you describe is one sign of glaucoma, among other things.  Less likely, your symptoms also could be a sign of dry eye disease, although the symptoms are usually more constant.  See an eye doctor.

 

Q.    My left eye lid has been swollen for 5 months.   The area toward the nose is most swollen. I have double vision when I look the least amount toward the left.  My left eye vision is very blurry...My eye doctor sent me for a thyroid test.  Help, I have already spent $4,000 and still no help.  Lately the swelling has gone to the under eye area.  My right eye is fine.

You describe a potentially very serious condition.  The last thing that you should do is stop seeing your ophthalmologist because of costs.  First, the development of double vision when you look to the left suggests a restriction of some of your eye muscles.  As a consequence, when you try to look to the left your left eye does not move as it should.  This causes the eyes to point in different directions and that is why you see double on leftward gaze.  Your eye doctors are headed in the right direction in suspecting a thyroid eye disease in which the tissues around the eye(s) swell causing the eyes to look swollen and at the same time restricting the eye movements.  

Another problem is the blurred vision in the left eye.  The blurred vision may be due to several things related to the thyroid eye disease, if that is what you have.   The swollen tissue may be putting pressure on the optic nerve - the nerve that runs from the eye to the brain. This is another reason for continuing to see your eye doctor.   Finally, there are a number of rather serious eye and neurological or systemic diseases that can cause tissue around the eye to swell. So, don't be surprised if your doctors want to do additional blood, tissue or scan type tests on you as they try to figure-out  your problem.

 

Q.    What causes red itchy eye lids?

Red itchy eye lids is usually a sign of an allergic reaction to cosmetics, drugs, detergents, soaps, etc.  The eye lids are very sensitive and are often the first place where an allergic reaction shows-up.  Try changing whatever you put on your face area, even if it is not near the eyes.  Cosmetics, for example, can be rubbed-off one part of the face during sleep onto the eye lids via a pillow.  For further informetion go to Red itchy eyes.

 

Q.    Please tell me what can be done when a lazy-eye is detected too late.  My daughter is 13 years old and I don't want to just give up.

Lazy eye is best treated before about 9 years of age.  Most expects agree that by, say, 13 years the brain is more-or-less hard wired and less likely to change or improve with generally accepted therapies for lazy eye such as occlusion or penalization therapy.  Some optometrists will recommend "vision therapy" to treat lazy eye even in older children and adults; however, the scientific basis for such treatment is absent.  Go to Vision Therapy for more information about this type of therapy.  Finally, some scientists have found that L-dopa therapy combined with part time occlusion of the dominant eye can lead to some improvement in visual acuity in the lazy eye of older children and adults.  However, the improvement is usually about a line or so, probably not significant enough to warrant consideration at this time.  Sorry, but until the National Eye Institute - National Institues of Health (NEI-NIH) takes the treatment of amblyopia seriously and funds more research into amblyopia, not much is available or will become available for older children with lazy eye.

 

Q.     How can I be tested for floaters?

Floaters are most easily seen when looking at a homogeneous field such the open blue sky without the presence of clouds (away from the sun!).  A large white wall, well illuminated, without anything on it will also work.  You can test both eyes open then with individual eyes.  Because floaters come and go, you must realize that you may not see any floaters at one time and be able to see floaters at another time.  If you see a "floater" all the time in the same location that is bigger than a dot or piece of hair, it may not be a floater, but rather, it could be a sign of a retinal/vitreous hemmhorage (if so see an eye doctor ASAP to be on the safe side).

To test yourself for floaters, look up at the sky (or wall) and rapidly move your eyes all the way to the left and then all the way to the right, back-and-forth, repeatedly, for about 15 seconds.  If you have floaters, as you move your eyes back-and-forth you'll see something that moves with your eyes as the eyes move.  If you think that you see a floater then try to look directly at it.  What should happen is that as you try to look directly at it the floater will appear to move in the same direction as your eyes and you'll never really be able to look at the floater "dead-on".  This is because the floater is inside the eye and, as a consequence, as you move your eyes the floater will also move at the same speed and in the same direction as the eye movements.  If you look real closely, you may notice that when you stop moving your eyes the floater(s) actually continues to move, for a little while, in the same direction as the original eye movement.

What do you look for and what do floaters look like?  Floaters can take-on a number of appearances.  If the cells that compose the floater are in focus, then the floater will appear as a well defined single circle or small ring or group of circles stuck together.  If the cells that make-up the floater are out-of-focus, the floater may look like a shadow of a small object, a blob, a dull or dark string, or even look like a bug with one or two arms.

It is common for people to see floaters particularly older people, over the age of 30 or so.  People that have a high refractive error (need thick glasses) are also more prone to floaters earlier in life.  In general, floaters come and go and nothing can be done about them - just learn to live with them.  However, if you all of a sudden see a lot of floaters or/and have a large dark "shadow" in part of your visual field, you should consult with your eye doctor.

 

Q.     What is blindness at night?

Blindness at night is called nyctalopia.  It can be due to a number of factors and diseases including retinitis pigmentosa (RP) and other conditions that interfere with storage of vitamin A in the liver (liver disease, alcoholism) or the absorption of vitamin A from the gut (e.g., Chrone's disease, Cystic Fibrosis, jejunum bypass surgery for obesity).  True night blindness means that the patient simply cannot see under very low light levels.  If there is a street light or a night light or some other light(s) on, the patient can "get by".  If you have night blindness see your eye doctor. 

If you can drive at night you are not night blind.  Some patients have "night myopia" - a condition that causes objects to be more blurred than usual at night.  Night myopia is caused by the dilation of the pupil at night which, in turn, changes the patient's refractive error.  If you notice things are more blurry at night you may need slightly stronger corrective lenses, particularly if you're already myopic (nearsighted).

 

Q.    At once, my eyes started itching and became blood shot.  What's the problem?

One of the most common causes for itchy eyes, and then them becoming blood shot, is due to allergies or an allergic reaction to cosmetics, drugs, perfume, etc.   See earlier questions about itchy eyes, swllon eyes or/and red eyes in this section.

 

Q.    Curtain in front of eye?

Sometimes patients will describe their vision as though they're looking through a curtain - things will appear washed-out, slightly blurred and "just not clear".  This may be a sign of several eye diseases including cataracts, cloudy corneas, and could even be a sign of glaucoma.  See an eye doctor for his/her opinion.

 

Q.    I have been diagnosed with "floppy eye lid syndrome" and I'm looking for any articles about it.  Any help?

Floppy eyelid syndrome is characterized by very loose, even rubbery, eyelids that often lose contact with the eyeball during sleep, and all-of-a-sudden the upper lid can evolve or turn inside-out.  Because of increased exposure to air and irritants, a patient with floppy eyelid syndrome can develop chronic conjunctivitis and meibomian gland (tear gland) dysfunction.  It usually affects older, obese men and is sometimes associated with hyperglycemia or sleep apnea.  Treatments include the use of eye patches at night to control the conjunctivitis, and surgery to tighten the upper eyelid to prevent loss of eyelid to eyeball contact at night.

 

Q.    My six year old daughter has esotropia (crossed-eyes), that I noticed at two years of age.  At four months of age she had a head injury.  Is her esotropia caused by a head injury?

If the head injury caused the esotropia it would have been evident shortly after the head injury.  Since the two events were 1 1/2 years apart it seems very unlikely that the two are related.  It is common for children to become esotropic.   The age of two years suggests that the condition my be related to accommodation (accommodative esotropia), which is sometimes fixed with glasses.

 

Q.    Reasons for having sore eyes, the whole eyeball is sore, dull ache when the eyes are moved left-to-right or up-and-down.

Irritants (e.g., dust, pollen, pollutants) and anything that causes the eyes to become dry (e.g., blowing air) can cause the sore, achy eyes during movement.  Your symptoms also match dry eye disease.  Since pain and discomfort are involved you should see an eye doctor for evaluation and treatment.

 

Q.    Any information on wandering eye?

Wandering eye is a popular term often used to describe an eye that does not maintain alignment with the fellow eye, it wanders.  A wandering eye can be caused by a number of conditions including an eye muscle imbalance, lazy eye or if the wandering eye has very poor vision due to a number of diseases and conditions.  In a child, a wandering eye is a warning sign and the child should see an eye doctor ASAP for evaluation and treatment. 

 

Q.    All of a sudden, last couple of days, I am seeing flashing prisms of the whole color spectrum on the left side of my visual field... No headache, vision loss or blurryness.  Just a smallish triangular or sometimes star shaped flashing prism.  This will last a few minutes and then go away, several times per day...  I am going to see about this but thought that you might have some info?

You may have a potentially serious condition and we're very glad that you have plans to see an eye doctor.  We would recommend a neuro ophthalmologist.  Your description is similar to what is referred to as a "pie-in-the-sky" scotoma.   Sometimes these may be associated with a neurological or "brain" problem on the right side of the brain.  Good luck.

 

Q.    About a year ago I was diagnosed with high blood pressure.  At the time I also experienced flashing lights when in the dark and bright dots and flashes.  I also developed floaters in both eyes.  My doctor thought that I may have a small hemorrhage from the retina...Could the flashing lights be the result of high blood pressure or is a detached retina a possibility?

A retinal hemorrhage can cause the flashing lights and floaters that you are experiencing.  High blood pressure can also lead to a retinal hemorrhage, although you should also be checked for diabetes.  A retinal hemorrhage can also lead to a retinal detachment so all of your conditions warrant close medical supervision.

 

Q.    Do you have any information on serpiginous choroiditis?  I am a 39 yr old female and I've been told that there is no treatment.  Is this correct?

Serpiginous choroiditis is a disease that usually affects both eyes, reoccurs over time (several months or even years) and is considered a chronic, noncureable, condition.  Patients usually complain of blurring of vision with no pain or discomfort.  Blurred vision may occur suddenly and reach the level of only being able to count fingers; that is, not even see the big E on the top of the eye chart.   Scotomas or blind spots in vision occur and patients often have a lot of floaters.Patients may also develop anterior uveitis or inflammation on the front parts of the eyes.  A number of treatments for serpiginous choroiditis have been tried with very limited success, although some authors believe that maintenance on steroids may reduce the number of recurrences.  Some of the complications associated with the disease are amenable to treatment including retinal detachments and retinal hemorrhages.  To monitor the disease an Amsler grid is usually employed to map the blind spots in vision and to assess the success of treatment.

 

Q.    I had a meniere's disease attack two weeks ago, was sensitive to light... and see peripheral flashing lights.   What could be the problem?

Meniere's disease is a rather rare condition in which patients have episodes of balance problems and hearing problems.  Patients complain of dizziness and loss of balance, ringing in the ears and even fluctuating deafness.  Pateints are usually in their 40s or 50s when they first experience the attacks which can last for up to 24 hours.   Headaches with stomach nausea and vomiting have been reported, and several authors believe that there is a link between Meniere's disease and migraines.  Therefore, your sensitivity to light and flashing lights in the periphery may indeed be related to migraines since both  are classic symptoms of a migraine.  It has been reported that a low salt diet and certain drugs can reduce the occurance and severity of attacks.

 

Q.    What can you tell me about Amniotic Membrane Transplantation.  The doctor recommended this for my mother who is 78 and has an infection in both eyes that won't clear up.  She is in poor health and I was wondering if this type of surgery is stressful and difficult?

Amniotic Membrane Transplantation is a procedure to help in the reconstruction of the cornea of the eye.  Amniotic membrane transplantation allows for a substrate for new cells to migrate and adhere to the membrane in order to provide a clear cornea for seeing.  This is a rather long recovery process.   All surgeries carry risks and are stressful for the patient and family.  Even though your mother is old and in poor health, the surgery is probably necessary for her to regain useful vision.   Please discuss your concerns with the doctor. 

 

Q.    My wife has been diagnosed as having Vogt-Koyanagi-Harada disease.  Do you have any info or advice?

Vogt-Koyanagi-Harada (VKH) disease is a whole body inflammatory disease that also involves the eyes.  VKH often affects people in their 20s through 50s.  The disease may affect the eyes as well as the ear and skin and also includes neck stiffness, headache, ringing in the ears and balance problems.  Early in the disease patients may be very sensitive to the touching of their skin or hair.  Unfortunately, there are a number of potentially serious complications with VKH including cataracts, glaucoma, development of abnormal blood vessels in the iris,uveitis, and retinal detachment.   Although it should be noted that patients usually have a favorable outcome, in terms of vision, with therapy.  The main treatment includes the use of steroids to control the inflammation and other immunosuppressive drugs if steroids are counterindicated.

 

Q.    What is Epi Retinal Membrane?

An epiretinal membrane is a thin layer of scar tissue that can develop on top of the retina and/or macula - the reading part of the retina.  It leads to reduced visual acuity and can cause distortions in vision.  There are a number of causes of epiretinal membrane, but it usually occurs in very nearsighted patients that have what is called a posterior vitrious detactment.  If vision is only mildly reduced it is best to leave the epiretinal membrane alone.  If vision is significantly affected, surgery can be performed to remove the membrane, although there are always risks with surgery particularly when the surgeon has to go inside the eye.  There is also a possibility that the membrane will grow back and lead to vision loss.

 

Q.    What is pavementstone?

Pavement stone or, more precisely, paving stone degeneration of the retina is a very common condition in the elderly population.  To the eye doctor, it appears as well defined, yellowish-whitish spots (lesions) inside the eye along the periphery of the retina.  The loss of some photoreceptors and thinning of the retina causes the blood vessels in the back of the eye to become easily visible, thus the name.  Paving stone degeneration usually does not affect vision and never requires treatment.  In fact, some evidence suggests that the paving stone actually can prevent or reduce the size and extent of a retinal detachment. 

 

Q.    What is Laurence-Moon-Bardet-Biedl Syndrome?

Laurence-Moon-Bardet-Biedl Syndrome is a rare genetic syndrome characterized by mental retardation, blindness due to retinitis pigmentosa (usually described as the inverse type of RP), polydactyly (more than 5 fingers) obesity, and hypogonadism.   Some patients may have the disease without mental retardation or/and multiple fingers.  Pateints may also be affected by renal disease.  There is a 25% chance that other sibling from the SAME PARENTS will also have the disease.

 

Q.    I was diagnosed with ERVAN'S [Eales] disease seven years ago (UK)) but have been unable to find anyone with the same disease or any information.  It causes inflammation behind the veins in the eye that lead to aneurysms which then burst leaking fluid.  I have lost all central vision in the left eye.  London specialists offers no hope but learn Braille now - blind in about 18 months - any help?

We could find no disease called "Ervan's" disease but a similar disease to what you describe is called Eales disease. In Eales disease there is focal inflammation and occlusion or blocking in mostly peripheral retinal vessels leading to large areas of nonperfusion and loss of tissue.  As the disease progresses, the disease moves toward the central (macular) part of the eye.  There is a large amount of neovascularization (development of abnormal blood vessels) which, in turn, cause repeated vitreous hemorrhages and further loss of vision.  Severe vision loss usually results from repeated vitreous hemorrhages, macular edema, macular holes, retinal detachment and the development of glaucoma.  It appears that the treatment of choice for the neovascularization is peripheral scatter photocoagulation ("laser surgery") of the ischemic retina - a procedure similar to that used in diabetic eye disease.  A vitrectomy is also performed on patients with Eales disease to remove blood and dead tissue from the vitreous, and has been proven successful.Interestingly, one set of investigators have found that about 25% of patient's with Eales disease having a hearing loss and many more suffer from balance problems.  Another report notes that almost 50% of Eales patients have, had or have been exposed to tuberculosis.   Unfortunately, very little is known about this complex disease.

 

Q.    Where can I find information on nearsightedness?

HERE.  Nearsightedness is the common name for myopia.  Myopia gradually develops over time as the person ages and has been shown to have a genetic and an environmental component.  If your parents are nearsighted you're more likely to be nearsighted.  If you do a lot of close work, like reading, you're also more likely to become nearsighted.  Although there are a number of anatomical reasons why a person becomes nearsighted or myopic, the most common reason is that the eye becomes too oblong and as a result the eye focuses images in front of the retina and thus you see a blurred image.  So-called minus lenses are used to correct myopia and the newest surgical procedure is Lasik surgery (Go to Past Featured Articles).

 

Q.    My daughter had a stye in her eye.  The stye has almost cleared now but the inflammation has spread inside her right eye.  She is on steroids and antibiotics for the last two years.  Is it safe to take steroids for such a long time?  She is three years old.

Our medical experts seriously question the use of topical steroids for such a long time and in such a young child.  Although you should never just stop steroid use, we would advise that it is time for a second opinion, preferably from a pediatric ophthalmologist.  Your child should be checked for glaucoma; a condition that can be caused by long term steroid use.

 

Q.    I am a 24 year old female and was just told about a month ago that I have pseudo tumors on my eyes. I believe one doctor called it a papilladema. Can you tell me what this is and how it is treated?

Regarding your question, there are a number of confusing ideas…papilledema refers to swelling of the optic nerves (actually the optic nerve heads) in each eye and the papilledema can be a sign of Pseudotumor cerebri. – The patient appears to have a brain tumor, in terms of symptoms such as swelling of the optic nerves, but there is no evidence found for the brain tumor. A doctor cannot make the diagnosis of Pseudotumor cerebri by the presence of papilledema alone. The patient would also, probably, need an MRI or CAT scan or/and a spinal tap to determine that a tumor is not present.

If you have papilledema and some vision complaints, and if your doctor said you have pseudotumor cerebri WITHOUT additional testing, you should go to another doctor, an ophthalmologist, for a second opinion ASAP.

 

Q.    What is a stigmatism?

The correct spelling is astigmatism.  An astigmatism occurs when the front of the eye, the cornea, is not perfectly shaped.   The astigmatism results in a blurred image along only one axis; for example, along the horizontal axis.  It might help to think of the visual world as being 360 degrees (top is 0, right is 90 degrees, left is 270 degrees, etc.).  So an astigmatism involves just one axis or a line along a certain degree.  An astigmatism does not usually cause problems with seeing unless it is large.  If an infant has an astigmatism that is very large, he/she could develop a lazy eye due to the astigmatism - a condition called meridianal amblyopia.

 

Q.    Our son has been diagnosed with RP [Retinitis Pigmentosa] and our eye doctor said that there is something experimental that may come up in the next few years for RP . I believe he said in Chicago. Something to do with retinal implants. Have you heard anything about this. If so what exactly are the details?

There are several types of retinal implants under development in animal studies and in limited human clinical trials. One type of retinal implant involves the placement of stem cells, cells that can grow into different types of cells, into the retina. It is hoped that these cells grow and develop into new cells to replace the RP damage.

Another type of retinal implant involves the placement of a device (a computer chip) that essentially replaces the function of the retina – the device gathers light and image information and converts it into nerve impulses that directly stimulate the optic nerve (ganglion cells) of the eye. These studies are in the very early stages of development. Both types of research are being undertaken at several sites in the US.

 

Q.    Can you tell me something about diabetic retinopathy?

Q.    What is diabetic eye?

Diabetic eye and diabetic retinopathy refer to the effects that diabetes has on the eye.  Diabetes can have several adverse effects on the eye.  For example, diabetes leads to the development of abnormal growth of blood vessels in the retina that can leak and cause an immediate loss of vision (See Simulations).  If this occurs, the ophthalmologist my do "laser surgery" (pan retinal photocoagulation) to try and halt the development of more blood vessels and their leaking. 

Diabetes also leads to the formation of cataracts.   If cataracts develop the ophthalmologist can do cataract surgery to remove the cloudy lens and replace it with an artificial intraocular lens.  If a person has diabetes, it is absolutely essential that the person see an eye doctor on a regular basis.

 

Q.    What is congenital hypertrophy of the retinal pigment epithelium?  Is it dangerous?

Congenital hypertrophy of the retinal pigment epithelium means that the condition is present at birth (congenital), involves hypertrophy (something that has been damaged and recovers or changes) and affects the retinal pigment epithelium - a layer of cells underneath the retina of the eye.  Congenital hypertrophy of the retinal pigment epithelium does not usually cause much of a problem and is usually of a very localized, limited nature.  Patients are usually not having vision problems and it is often found on routine eye exam.   Patients can have some loss of visual acuity if the area of hypertrophy involves the macula of the eye - that part of the eye used for reading.  Usually the hypertrophy is off to the side.   Patients may have some problems being able to see with that part of the eye where the hypertrophy is located - known as a scotoma or blind spot.  The condition is not dangerous, unless it is in both eyes in several spots.  If so, the patient may have a condition called Gardner's syndrome - a dominant cancer syndrome that 50% of family members would have, but this is very rare and unlikely.

 

Q.    What is the difference between an eye disease and an eye defect?

The terms are sometimes used interchangeably, but in general an eye disease usually refers to an ongoing disease process which starts with a normal eye and then the eye becomes abnormal because of a genetic problem or acquired disease (virus, bacteria).  An eye defect sometimes refers to an eye problem that the person is born with or has as a result of damage or accident.  However, sometimes one can lead to another.  For example, in closed angle glaucoma there is an anatomical defect in which the lens of the eye is too far forward in the eye and presses against the iris or colored part of the eye.  This defect can lead to glaucoma or abnormal increased pressure in the eye and glaucoma is considered a disease.

 

Q.    I have been wearing a patch on one eye for 10 years now due to uncorrectable double vision.  Will this cause my stronger eye to over work and make my other eye weaken more?  I am 39 and worried.

No.  At your age, wearing a patch over one eye to avoid diplopia (double vision) will not make the covered eye weaker or cause the seeing eye to overwork.  Nevertheless, we would question the practice of wearing an eye patch to correct diplopia, particularly for such a long time.  Have you ever seen an ophthalmologist about eye muscle surgery to correct the eye misalignment or, possibly, an optometrist or orthoptists for ways to work toward getting the eyes to achieve single vision?

 

Q.    What does it mean if a person sees rings around lights when you drive at night?

Seeing rings around lights at night usually means that there are some changes taking place with either the cornea or lens of the eye that creates light scatter.   Anything that causes the cornea or lens to become even slightly cloudy will cause the person to see rings around lights.  Typically, older people will often complain of rings around lights because of some changes taking place with the lens - typically the early beginnings of a cataract.  This leads to problems with seeing lights at night and also leads to glare problems and photophobia.

 

Q.    I was told that I had a Marcus Gunn pupil.   What is it and what are the symptoms and are there any complications from having it?

A Marcus Gunn pupil is a pupil that does not respond very well to light when the light is shined that eye.  For example,   when light is shined in one normal eye (only), both pupils will constrict or get smaller.   If the light is then moved rapidly to the affected, Marcus Gunn, eye even though the light is shining in the affected eye BOTH pupils dilated or get larger.   The patient usually does not know that he/she has a Marcus Gunn pupil.

Some people are born with a Marcus Gunn pupil and other people may acquire one without any other problems.  However, sometimes a Marcus Gunn pupil may be a sign of a serious eye problem or neurological problem, sometimes restricted to the optic nerve of the affected eye.   Therefore, if the eye doctor detects a Marcus Gunn pupil  AND you've never had one before, the doctor may perform additional testing to make sure that you don't have something that is causing the Marcus Gunn pupil.  So, if you've been recently diagnosed with a Marcus Gunn pupil be sure to follow-up on all the testing that the doctor may want to perform - It may be VERY IMPORTANT.

 

Q.    What is birdshot retinochoroidopathy?

Birdshot retinochoroidopathy, also called birdshot retinochoroiditis, is an autoimmune disease in which the person's immune system appears to turn on itself and, specifically, the retina and choroid.  It is a chronic inflammatory process.  It usually occurs in middle-aged patients (35 - 70).   When the eye doctor looks in the back of the eye he/she sees multiple whitish dots that appear like a shotgun blast, thus the name.  Dye studies show that the disease involves a breakdown of the blood-eye barrier and involves inflammation of several parts of the eye including the retina, its blood vessels and the vitreous.  Patients often complain of floaters (dots, lines with strings and cobwebs), blurred vision of both eyes, color vision problems and problems with dark-light or light-dark transitions.  Later in the course of the disease, optic nerve atrophy, subretinal neovascularization (growth of abnormal blood vessels) and hemorrhages can develop and lead to further vision loss.   Initially, prednisone and cyclosporine are used to control the inflammation, but long-term treatment is very difficult and it is usually best to be regularly seen by doctor that has experience in immunosuppressive agents, since several potential serious side effects from treatment  can result.  

 

Q.    What is lattice degeneration?

Lattice degeneration is a rather common disease in patients with myopia (nearsightedness).  It is characterized by well defined elongated areas of retinal thinning of the peripheral retina (extreme side vision).   Pigmentation is abnormal and there may be whitish-yellowish dots, ovals and lines that make-up the disease.  Retinal tears and holes and excessive floaters are common.   There may be a posterior vitreous detachment and eventual retinal detachment.   Patients with myopia in the range of -6 to -10 diopters appear to have a particular susceptibility to the disease.  If you have high myopia (greater than 5 diopters), you should have a regular, yearly, dilated eye exam to check for retinal holes, tears and detachments that are amenable to treatment.

 

Q.    I have a rapid loss of the ability to focus.  Any information?

As we age, the lens of the eye gradually loses its ability to focus or accommodate - a condition known as presbyopia.  It is common in patients over the age of 40 or so.  Often the first sign is that close-up objects appear blurred and the patient often has to have reading material at arms length in order to see it.  Sometimes the patient will comment that their arms "aren't long enough".  At other times the patient will complain that after reading for a while that objects in the distance appear blurred and that the patient can't focus on distant objects.  Usually at this point the eye doctor will prescribe bifocals - eye glasses that have a different strength of lens on the top and bottom for distance vision and near vision, accordingly.

 

Q.    What is Fuch's disease?

Fuchs' heterochromic iridocyclitis is an unusual disease and accounts for about 3 - 4% of patients with uveitis.  Patients complain about floaters, problems with glare and blurred vision due to cataracts, although often patients have no specific complaints, at least initially.  Sometimes patients are seen because of some color changes of the iris associated with the disease.  In Fuchs' the iris partly becomes depigmented and appears white, such that parts of the iris look of normal color and other parts look almost white.  Clinically, small deposits or so-called precipitates are seen in the back part of the cornea - almost looking like fine particles of sand.  Unfortunately, a large percentage of patients develop glaucoma and almost all patients develop cataracts.  There is no cure for Fuchs', although the complications of the disease are often treatable.  If you have Fuchs' it is essential that you maintain regular eye exams, as the doctor will check you for the development of glaucoma, cataracts, and inflammation.

 

Q.   My son has Coats Disease. The retina is detached and cannot be fixed by surgery. Do you have any information on eye replacement for a child and if there are any new research out there for me. My son is 2 ½ and is currently blind in his left eye.

Coats disease usually affects one eye only and, unfortunately, little can be done about it.  We cannot do eye transplants yet or in the distant future.  Sometimes there is a need to remove the eye and an artificial eye can be put into the eye socket.  The newer artificial eye can  even move with the unaffected eye. Also go to COATS for more information.

Q.   I am a 17 year old male, and I am having trouble with my vision. I see floaters all the time, I see halos around all lights at night time, and during broad daylight I see dark flashes all the time. It is really disturbing and scary. Can you tell me what is wrong?

You need to see an eye doctor ASAP.  Unless you are real nearsighted (myopic) you should not be seeing floaters.  Lots of floaters may be a sign of a retinal tear, detachment or/and bleeding in the eye.  Are you diabetic?  Sometimes a retinal hemorrhage as a result of diabetes will cause some of your symptoms.  You may have a serious eye problem and need to see an eye doctor NOW.

 

Q.    I am 52 years old. In the last 2 years I have experienced this problem. I get blind spots in both my eyes and also its like a broken glass in both eyes—like a jagged edge with colors in it. This happens in both eyes. It has happened twice now in the last month so now I am more concerned about what’s going on. I experience no pain. What are these symptoms of?

If the vision problem happens in both eyes at the same time then it is probably a brain or cortical problem involving the visual areas of the brain.  Your description is similar to that experienced by patients with migraines - even though you don't have the classic migraine headache.  What about loss of balance, ringing in the ears or strange body sensations.  You should consult with an eye doctor about the problem and for peace of mind.

 

Q.    I sent the question about floaters, halos, and dark flashes. I was wondering if you could give me some more feedback on my problem. You asked if I was a diabetic and I'm not, but I do wear glasses (I can see close, but I can’t see far away, without glasses). So I think that means I'm nearsighted. I'm 17 years old and I have had glasses since I was about 7. So I don't think I have severe nearsightedness. Also, I don't have any other medical problems. Basically, my floaters are really bad, they are there constantly, and there are a lot of them. The shapes range from wavy lines, circles, and dark patches of the floaters, pretty much any shape imaginable. Also, the halos around lights are terrible too. I see them all the time in the night. But the worst thing is The dark flashes that I see out in broad daylight. They are there all the time, the dark flashes are all over my eyes. Just if your wondering I’m, 6 foot 5 and I've been growing a lot in the past 3 years, but all the problems in my eyes seem to be getting worse.

We urge you to talk to your parents and tell them of your eye problems. You need to see an eye doctor for a dilated exam NOW. Please see an eye doctor today or at the earliest moment. DO NOT schedule a regular eye exam (it may take them several weeks or months to see you). Tell the receptionist at the doctors office the problems that you are experiencing and they should see you ASAP.

Yes, you are nearsighted (myopic) but that is probably your problem. You are not experiencing eye problems because you are growing. The symptoms that you describe can be caused by a number of things including several different types of retinal (back of the eye) problems as well as eye diseases. Sometimes real active boys can have eye injuries related to sports and just rough play (for example a retina detachment or bleeding   inside the eye). A lot of the eye problems are treatable IF THEY ARE CAUGHT   EARLY! So see the eye doctor NOW. 

 

Q.    Is nystagmus correctable with surgery?

This is a complicated question.  Nystagmus is not correctable with surgery; however, if you have nystagmus AND a null point then eye muscle surgery might enable you to not have nystagmus in primary gaze (when you look straight ahead).

When a person is born with nystagmus sometimes if the person looks in a certain direction, for example to the right, the nystagmus will stop.  The direction of gaze where the nystagmus stops is called the null point.  Some patients do not have a null point and their eyes will beat when they look in any and all directions.  If you have a null point, an ophthalmologist can sometimes perform eye muscle surgery in which the eye muscles are moved so that the null point is changed to the straight ahead position.  So, you don't have nystagmus when you look straight ahead.   However, such patients will still have nystagmus in the other gaze directions. This is an excellent question to ask your eye doctor.

 

Q.    What are large pupils a sign of?

Larger than normal pupils can be a sign of a number of things.   Most common, larger than normal pupils are a sign of the ingestion of certain legal and illegal drugs.  Large pupils can also be a sign that the person is excited.   In patients, sometimes larger than normal pupils can be a sign of a retinal disease, although this is rare.

 

Q.    Three days ago I started seeing a gray oval in my right eye, top right side.  Today it is smaller and has moved closer to the center of my vision and is more of a flash of light and sometimes a light gray circular spark.

The fact that the gray oval is only seen in your right eye suggests that it is located in the right eye.  If you see it all the time then it probably is not just a floater.  Your description suggests the presence of a small retinal/vitreous hemorrhage in your right eye.  The spark may be a sign of a retinal tear or break.  You need to seen an ophthalmologist ASAP.

 

Q.    Our daughter has recently been diagnosed with a congenital cataract.  She will be 8 in three weeks.  Will having cataract surgery be advisable at this stage?  Will regaining some of her eye sight in the limited time she has be beneficial?

A cataract is simply a opacity of the lens and a congenital cataract is one present from birth.  Congenital cataracts come in all shapes and sizes including small discrete dots and white plaque type opacities.  Some congenital cataracts rarely interfere with vision and do not cause amblyopia or lazy eye.   Others can interfere with vision and create deep amblyopia.  There are a number of causes of congenital cataracts including gestational infections, the most common being rubella.  Sometimes a congenital cataract is one symptom of a more complex disease or syndrome.  As the lens grows as we age, depending on the precise location of the cataract, the cataract may start to affect more central vision.  Because of their individual and complex nature, without examining your daughter it would not be possible to give a valid answer to your questions.  However, given the thrust of your questions, it is apparent that your daughter has amblyopia due to the cataract.   Sometimes the eye doctor will try occlusion therapy even at 8 to see if the patient will respond and gain improved vision in the amblyopic eye even with the cataract present.   If your eye doctor thinks that the cataract is significantly affecting vision, he/she may advise that surgery is necessary, in which case you should proceed with surgery.  Sometimes it is surprising how much vision can be saved or/and regained even at 8 years of age.  Finally, a cataract, even in just one eye, can cause severe problems with glare as well as sensitivity to lights (photophobia) and, as a consequence, are further reasons why it may be necessary to have the cataract operation.

 

Q.    Is there a way to correct eyes that are not level?  I have to turn my head sideways to see straight.

Yes.  If a patient has an eye misalignment he/she will sometimes compensate with a head tilt.  This achieves several things; single binocular vision and apparent eye alignment.  In addition, sometimes a head tilt can lead to neck, shoulder and back pain and discomfort.  You should see an ophthalmologist that does eye muscle surgery (for strabismus)for an opinion.

 

Q.    While pregnant with my second child I began to see trails or tracers after moving objects...I have never used drugs, which I understand can cause a similar sensation.  I recently had a complete dilated eye exam which revealed nothing.  Should I see an eye doctor again or a neurologist?

Probably neither.  Trails or tracers is one of those symptoms that is nearly impossible to quantify or measure since only the patient can see them.   Everybody can see tracers or trails after objects since they are actually a series of short lived afterimages of the object as it passes through one's visual field.  The difference is that most people do not concentrate on them or get them much thought.  When a patient complains of seeing tracers or trails, it is often the case that the patient has certain psychological issues that are unresolved, or that the patient has an obsessive-compulsive type tendency or personality.  In turn, stress (e.g., having a child) can aggravate any underlying psychological issues and make symptoms worse.

 

Q.    Are there any funds or assistance available to people who do not have vision insurance, but need surgery to correct their vision?

Not through the research foundation but try the following:

  1. Contact your local LIONS club to inquire if they fund such surgery.
  2. The Kiwanas also fund surgeries depending on circumstances.   Check out your local Kiwanas club.
  3. Depending on your income, you may qualify for either Medicare or Medicaid.  Check with your local health department.

 

Q.    My small daughter has a lesion in her eye.  What causes the lesion and what is the best treatment?

A lesion is defined as "any pathological or traumatic discontinuity of tissue or loss of function of a part".  Lesions come in all shapes and sizes and for hundreds of reasons - some serious and some benign.  Sorry, but more information is needed to address your question further. 

Seeing a doctor is always a traumatic event and everybody forgets to ask important questions during the visit.  Before seeing your eye doctor again, please be sure to write down all your questions for him/her to answer.  Also, you can contact your doctor's office and get additional information such as "What is it?" "Is it serious?" and "What is the prognosis?".

 

Q.    Have you ever heard of bumps under and along the eyelid filled with yellow wax-like substance? And what about floaters that are blocking my vision seriously (they are like having absolutely filthy glasses that someone has put some Vaseline on the viewing portion, making it extremely frustrating to see.

Regarding the bumps along the lid margin, go to Stye.   The presence of severe floaters may be a sign of serious eye disease so you should see an eye doctor ASAP.  There is also a possibility that the styes and floaters are symptoms of a more generalized, systemic, disease so you really need to see an ophthalmologist.

 

Q.   What is Eyeritis?

Correct spelling is Iritis.  See Iritis under Uveitis.   Also go to Iritis, as it related to autoimmune disorders.

 

Q.    Can you provide information on Parafoveal Telangiectasia in an otherwise healthy 64 year old female?

Parafoveolar telangiectasia may be present from birth or acquired in later life. Parafoveolar telangiectasia can affect one or both eyes (more common).  Given your gender and age, you probably have the type that affects both eyes and that is acquired.   The cause of parafoveolar telangiectasia is not known.  Initial symptoms include mild blurring and some loss of visual acuity.  The loss of visual acuity slowly progresses.

 

Q.    Blood in eye?

Patients have blood in the eye either because of injury or disease.  If the blood is in the front part of the eye, in front of and partially blocking the iris (colored part of the eye that makes the pupil), it is referred to as a hyphema.  A hyphema requires immediate medical attention and if left untreated could lead to an onset of glaucoma and blindness in the eye.  Blood in the back part of the eye, where the retina is, is usually caused by disease, such as diabetes, although trauma (e.g., shaken baby syndrome) can also cause retinal/vitreous bleeding.  Whatever the cause, blood in the eye requires immediate medical attention.  If there is blood inside the eye, depending on the situation, the eye doctor may wait for it to clear or may need to undertake surgery (vitrectomy) to remove the blood.

 

Q.    Do you have any information on the eye disease called "Fugndris Flarvinoculations" [Fundus Flavimaculatus]?

Fundus Flavimaculatus is also called Stargardt's disease.  Go to Stargardt's Disease.

 

Q.   For about the last six months I have noticed that my left eye is very blurry after I turn out the lights to go to bed. My right eye seems to pick up light, but my left eye seems completely dark. If I switch the lamp on, there’s no difference. I’ve always had 20/20 vision and I’m 34 years old. I read alot and wonder if I’ve strained my left eye.

Straining an eye will not cause the symptom you describe.  Poor night vision is sometimes a sign of serious eye disease.  You need to see an eye doctor about the problem and he/she may want to perform a visual field test and an electroretinogram (ERG) to rule-out the possibility of a serious eye disease.

 

Q.     Why do I have a little yellowness on the inner white part of my eye?

Not sure.  Could be several things including conjunctivitis, allergic reaction, jaundice or normal anatomy.  In the very corner of the eye, near the nose, is a structure called the caruncle which is triangular and where tears accumulate.  But the caruncle is not part of the sclera or white part of the eye.

 

Q.     My mother has had blurry vision for a week now, with no other symptoms except thirst.   She is waiting to see her doctor some time next week.  Any ideas?

Thrust is sometimes a symptom of diabetes.   Diabetic patients may experience blurry vision associated with the early formation of a cataract or as a result of a retinal hemorrhage.  Most probably, however, the blurry vision is not related to the thrust and all your mother has is the start of presbyopia - close things are hard to focus on.

 

Q.    I have a droopy eyelid which has developed, the doctor has advised it is probably a lesion.  Please advise best possible treatments and/or remedies?

A droopy eyelid is called a ptosis.  A ptosis can develop because of a lesion or damage to certain parts of the brain or due to damage to the nerves that innervate the eyelid(s).  A ptosis can also be related to certain neurological diseases such as myasthenia gravis.  You may need to have an exam and work-up by a neuro ophthalmologist to find the reason for the ptosis.

 

Q.    What is a neurologist and what kind of tests do they run when you go to see them?

A neurologist is a medical doctor that specializes in neurological problems, usually problems with the brain and central nervous system.   They can "run" or order a large number of tests depending on the problem or disease at hand, including blood work, imaging of the body or/and brain (e.g., MRI, CAT scan. X-rays) and physical exam.

 

Q.    If an adult has amblyopia are they able to see (have vision) out of the lazy eye?  Or, do they have vision out of the good eye and blind in the other eye?

Both and neither.  A person with amblyopia, and it doesn't matter if it is a child or an adult, can have anywhere from near normal vision in the amblyopic eye to almost no vision in the amblyopic eye - it depends on the severity of the amblyopia.  In general, the earlier the onset of the amblyopia there more severe the vision loss.  For example, if a child is born with a cataract in one eye and the cataract is not detected until, say, age 8, then the child/adult would probably only have light perception in the amblyopic eye.  If the child develops a cataract at, say, age 5 and the cataract is removed later and the child has appropriate therapy, the child may have normal or near normal vision in the amblyopic eye.  To complicate matters, some amblyopes may have normal side vision in the amblyopic eye but almost no central vision in the amblyopic eye.

 

Q.    Is there any way to cure Chalazion?

A chalazion is solid lump (tumor) usually located away from the lid margin and is a chronic inflammation of the meibomian gland.   Chalazions can involve all four lids and usually occur in adults and are usually associated with chronic blepharitis, seborrhea and acne.  Often, a chalazion will disappear after a few months and some will disappear with the help of warm packs and topical antibiotics.  Sometimes surgery (removal, incision and drainage) may be required.

 

Q.    "Ceratocone (Keratoconus)?"  What is involved in a corneal surgery?

Keratoconus is an abnormally shaped cornea - often described as "cone" shaped or pointed outward.  It is usually a progressive condition and leads to visual impairment and loss.  Often contact lenses are tried in order to reshape the cornea.  A cornea transplant is also utilized to cure the condition.  In a cornea transplant, the patient's cornea is removed and a donor cornea, often received from a LIONS Eye Bank, is sutured onto the eye.  Because the cornea is an immune privileged tissue, no immune suppressive drugs are needed.

 

Q.    Is there any way to beat the Ishihara test?  I am having trouble passing it.   I need to pass it for a job and I'm slightly deficit.

The Ishihara test is a color vision test that is composed of numerous pictures composed of different colored dots.  The patient is required to detect a number or numbers embedded in each picture.  Although there is no way to "beat" the test, except for memorizing all the correct answers, a person could improve their chances of passing the test by blurring the pictured that compose the test.  An interesting aspect of the Ishihara test is that the sharp borders that make-up the individual dots of each picture actually can interfere with a person being able to see the larger number or numbers that are embedded in each picture.   In scientist terms, the high spatial frequencies that make-up the sharp lines/contours "mask" the lower spatial frequencies that determine the number(s) to be identified by the test taker.  Thus, if a patient can focus close-in while viewing each test picture and thus blur the picture, he/she may be able to improve their test score, particularly if the person doesn't quite pass the test.  If the test taker is unable to voluntarily blur an object, than an alternative would be to buy a cheap pair of reading glasses, say with +3 diopter lenses, and to take the color test only with the glasses on.  If you're myopic or nearsighted, you might improve your test score by taking your glasses off while taking the color test only.  It is important to note that we do not condone people trying to cheat on any vision test.  However, some of us believe that the Ishihara test itself is flawed, because of the masking issue.

 

Q.    I am an adult whose left eye is higher than the right.  Can this be fixed?

It is unclear what you mean by one eye higher than the other.  Sometimes a patient will have what appears to be one eye higher than the other by actually it is the eye lid that is higher or lower and not the eye itself.   Nevertheless, you should consult with an ophthalmologist that specializes in plastic surgery for his/her opinion.

 

Q.    At 51 years old my eyesight is expected to deteriorate, however it seems to be progressing far too rapidly. It definitely started at the time I started using a PC, at work and home (about 5 years ago). Does any have information that relates to VDU eye problems. Is a liquid display monitor safer? Can the refresh rates/radiation of the standard VDU effect or impair eyesight over a long period with excessive use?

The juxtaposition of your age at the time of increased computer use and the standard age of the onset and worsening of presbyopia is probably the reason, in part,  why you feel that the computer use has lead to a worsening of your eye sight.  Presbyopia involves the loss of the ability of the lens of the eye to change shape and accommodate to near images.  As a result, to achieve a clear image the person has to hold material further and further away as they age.  In addition, as the lens of the eye decreases in its ability to focus, it becomes more difficult for the person to relax accommodation to distant objects after one is involved in near work for an extended period of time.  As a consequence, after working on the computer for a while, distant objects appear blurred.  Presbyopia can start as early as about 40 and last into the 50s so you're in the ball park.  To complicate matters, it is also well known that close work can lead to the further progression of myopia or nearsightedness, although this is usually a problem in younger individuals.

Eye fatigue is a problem with computer users and can be exacerbated by they type of computer monitor, viewing distance and glare.  The faster the refreshment rate the better and users should avoid any monitors that have an interlaced scan pattern.  Viewing distance is seldom mentioned as a problem, but the ideal viewing distance is about at arms length - or about one meter, which is the natural resting point of accommodation of the eye.  Finally, glare is a real problem for computer users and antiglare screens or filters should be used and room lighting should be arranged to eliminate any glare on the monitor.

Ergonomics is also a real problem for computer users and incorrect positioning of the operator to the computer screen and keyboard can cause numerous problems - shoulder, back or/and neck pain are common problems operators experience when they are not positioned correctly with the computer components.  We are not aware of any information that a liquid display monitor is any better than a CRT type monitor in regards to safety or eye strain.  Go to Computer Eye Problems  for more information on computer use and the eye.

 

Q.     I have been recently diagnosed with Sulzmann's (Salzmann's) Nodular Degeneration.   What exactly is this and can you point me in the direction of further information?

Salzmann's nodular degeneration is a noninflammatory degeneration of the outer parts of the cornea.  The disease is characterized by nodules in the midperiphery of the cornea that appear bluish-white.   These nodules sometimes are the result of contact lens wear (and possible previous inflammation), keratoconus and even after surgery on the cornea.  Usually, the disease does not affect vision; however, if there are recurrent episodes vision may become blurred.  Treatment includes removing the nodules by minor surgery.

 

Q.    Why would the pupils of my eyes be yellow?

The pupil of the eye is the dark center part or hole that is shaped by the iris and that allows light to enter the eye.  If the pupil appears yellow it may be a sign of a cataract or tumor inside the eye; however, these would affect your vision.  More likely, you mean the iris of the eye in which case it could be the result of certain oral medicines or a sign of Wilson's disease.   Wilson's disease is usually diagnosed in patient's between the ages of 8 - 20 years. Wilson's is a type of liver disease and the yellow color is a sign of excessive copper in the liver and is similar to early cirrhosis.  It is possible that you also have some other form of liver disease.  Because Wilson's disease is treatable and treatment may slow down or stop the progression of the disease, you need to see a medical doctor (pediatrician, neurologist) ASAP.  They'll probably want to run several liver tests and possibly take a liver biopsy to diagnose the problem.  See a doctor today!

 

Q.    What percentage of Americans need glasses/contact lenses?

In the early 70s it was estimated that approximately 25% of Americans between the ages of 12 and 54 needed optical correction for myopia or nearsightedness.  In a more recent study (1994), it was estimated that 43% of Americans between the ages of 43 and 54 were myopic, but that the prevalence of myopia decreased to only 14% over the age of 75 year. [So it appears that if you're myopic you have a greater chance of dying before the age of 75! Just kidding] About 30 million Americans wear contact lenses.  About 2 million Americans have had "laser surgery" to correct their refractive error.  Statistics for hyperopia or farsightedness or any other condition that would require glasses have not been found but would represent a small percentage compared to myopia.

 

Q.    Pupil dilation not happening in young child.

Dilation means that the pupils of the eyes do not get bigger when the child is placed from a lighted room, for example, into a darker room.   Because of several factors (e.g., smaller eyes and pupils) it can be difficult to tell that a child's eyes are dilating.  More worrisome; if the child's pupils remain dilated in the dark and in the light then this could be a sign of a serious problem.   Since all children should have a comprehensive eye exam by an eye doctor, why don't you see an eye doctor just for piece of mind and to make sure that everything is ok.

 

Q.    I experienced a very serious episode of pain in the neck from radiculopathy and muscle strain which prevented me from sleeping, moving my neck, etc., for a couple of weeks. During the first four days of the acute pain in my neck, my right eye started to flash when I looked at bright windows and subsequently looked back into a room; or if I walked outside the door during the day, my right eye would sparkle or flash briefly as I walked back into the house. On the seventh day of the acute neck pain, I received an injection of steriods into the muscle in my neck. The next morning I suddenly noticed a significant decrease in visual acuity with a yellowish discoloration overlaying the blurred vision. I was diagnosed the next day with central serous retinopathy. I subsequently read it has been determined that steriods (which previosly had been used to treat central serous retinopathy) have been shown to complicate and worsen symptoms of central serous retinopathy. Have you ever seen a link between acute pain from radiculopathy in the neck and the development of central serous retinopathy, and is it true that the use of steriods during episodes of central serous retinopathy has a negative effect on the course of the disease?

We could find no references showing a relation between radiculopathy and central serous retinopathy.  However, there appears to be an association with steroids exacerbating the symptoms of central serous retinopathy (see references cited below).  Whether steroid use can actually cause central serous retinopathy is not so clear.  So, there appears to be no association, at least documented, between radiculopathy and central serous retinopathy.  Apparently, you probably had central serous retinopathy (based on your earlier visual symptoms) when you had the steroid injection for the radiculopathy, which aggravated the eye condition.

J. D. Glass and H. Little.  Bilateral bullous exudative retinal detachment complicating idiopathic central serous chorioretinopathy during systemic corticosteroid therapy.
Ophthalmology. 1995 May;102(5):737-47.
E. Zarnir.  Central serous retinopathy associated with adrenocorticotrophic hormone therapy. A case report and a hypothesis.  Graefes Arch Clin Exp Ophthalmol. 1997 Jun;235(6):339-44. Review.

Q.    What is Walleye?

Walleye is a layperson's term for exotropia - one or both eyes of the person appear to point outward.  Conversely, cross-eyed or esotropia refers to a condition in which one or both eyes appear to turn inward toward the nose.  Both conditions might be correctable, depending on the situation, with eye muscle surgery performed by an ophthalmologist.

 

Q.    There is redness forming around the center of my eye, and eye drops don't help.  I wear contacts.  What is the problem?

You may have contact lens induced keratopathy in which case you need to see your eye doctor for possible treatment.  Stop wearing your contacts until you see your eye doctor.  You may also have poor fitting contact lenses, in which case you should stop wearing your contacts and also see your eye doctor.   If you ignore the problem and end up with a serious case of corneal infection, you could develop a permanent loss of vision.  So, see your eye doctor.

 

Q.    My mother is 80 years old and she is suffering from degenerative cornea in her left eye.  The eye doctor said that a corneal transplant can give her vision.   What should we do?  Is a corneal transplant done on old people?

Corneal disease can cause severe problems with glare and cause severe, disabling photophobia, not to mention pain and discomfort.   You should follow your doctors suggestions.  The age of the patient should not be an issue when it comes to the need for corrective surgery.  Yes, corneal transplants are done on people of all ages.  A women of 80 can expect to live another 7 years or there abouts.  If you were your mother, would you want to be able to see in the last 5 -10 years of your life?  Please discuss your concerns with your mother's doctor AND with your mother.

 

Q.    What are oscillatory potentials?  This is not recordable under lighting conditions in either eye.  Can you tell me what it means?

Oscillatory potentials are high frequency responses that are part of the b-wave of the electroretinogram (ERG). Oscillatory potentials are sensitive to circulatory problems of the retina and are often abnormal or absent in diabetic eye disease, or other diseases of the eye that involve the retina and its blood circulation.

 

Q.    Can you direct me towards where I could look into getting a text to speech program?

You are looking for what is called a screen reader.   Regarding a text to speech program, go to www.gwmicro.com for information about their screen reader. Also, go to afb.org the web site for the American Federation for the Blind for further information about screen readers and for information about Access World – a publication that evaluates assistive technology, including screen readers.

Please note that the Ohio LIONS Eye Research Foundation does not recommend or support any particular services or products and that this information is being provided to you simply as a response to your question. Thanks.

Q.     What is the name for a floating eye?

Don't know what you mean.  Could you give more detail as to exactly what the eye does?  You may be referring to a "wandering" eye.  In some patients with lazy eye, or reduced vision in one eye for a number of reasons, the one eye will wander or, in other words, not always   be in alignment with the fellow, stronger eye.  It looks like the one eye drifts-off of alignment and then returns.

 

Q.    I have a field loss in the temporal area of 20%.   Is this serious and could an airbag deployment be a causative factor?

Yes.  Any field loss is very serious and warrants a full work-up to determine the cause.  Can a field loss be due to an airbag deployment?  Probably yes.  Blunt trauma can cause a field loss in several ways.   If the deployed airbag hit the eye itself, it could cause a retinal detachment and, thus, a field loss; but this would be evident by the eye doctor.  However, a field loss could also result if the deployed airbag caused optic nerve damage.  The later would be more difficult to assess by regular eye exam alone.  Nevertheless, follow your doctor's advice.  If he/she wants to undertake additional tests, such as an MRI, CAT scan, retinal tests, etc., do it.  Although a field loss could be due to an airbag deployment, numerous other things can also cause a field loss, including a brain tumor, retinal degeneration, optic nerve disease, glaucoma, etc.

Q.    What do OD and OS mean?

OD stands for the latin o'culus dex'ter meaning right eye and OS stands for  the latin o'culus sinis'ter meaning left eye.

Q.    Can you provide any information about an in-office procedure for a detached retina that sounds like "pneumatic retinoscopy"?

You are referring to a procedure called "pneumatic retinopexy", a term coined by Drs. Hilton and Grizzard.  In pneumatic retinopexy first the surgeon treats the outside of the eye, where the retinal break/detachment is located, with cryoapplications (freezing) or photocoagulation (laser "welding").   This is followed by an injection of expanding gas inside the eye and then the patient is positioned so that the gas bubble pushes on the retinal break/detachment to close it.  It is a highly successful procedure in select patients.

Q.    What does "BILATERAL REHOLENTAL FIBVOPLASIN" mean?

You are referring to "bilateral retrolental fibroplasia" (RFP).  The newer term is referred to as "retinopathy of prematurity" (ROP).  Bilateral means that both eyes are affected.  ROP usually occurs in premature infants and has been associated with the use of oxygen.   However, the exact role that oxygen plays in ROP is not known.  In ROP, there is dilation of the blood vessels which develop abnormal growth, toruosity,swelling and possible retinal detachment in the more severe cases.  Patients with ROP may have normal vision if the ROP is mild or may have no light perception if there is bilateral retinal detachments.  Interestingly, in some patients with ROP, the ROP will actually disappear leaving the patient with noraml appearing eyes and normal vision.

 

Q.    I was reading a report (black ink on white paper) outside in the bright light of the mid afternoon sun - for about 10 minutes. When I came inside and looked at the report, it appeared to be written with green ink, rather than black. As the seconds passed, there were times when the color seemed to flit between black and green, and then after a couple of minutes, the print was entirely black again. I would like to understand the mechanism behind this phenomenom. Another version of this I have heard about is a friend’s father who, when he is looking at something on a computer screen (black on white), sees various lines in black and others in red. Do either of these instances suggest a trip to the opthalmologist?

Probably not.  The phenomenon that you experienced is most likely an afterimage effect.  Afterimages of colors are complimentary (e.g., blue - yellow, green - red) and also depends on the color of the background .  Although you and your friend thought that you were reading something black on white, most likely the black ink contained a significant amount of the complimentary color to the afterimage; in your case the ink probably contained a large amount of red pigment.  In addition, afterimages will also fad and reoccur for a while when, for example, the patient blinks or looks away from the background for a moment.  Finally, afterimages are best seen when the "adapting" stimulus is real bright; for example, something seen in bright sunlight.  Also, computer monitors are well known to contain a green phosphor, even though the screen appears white, and thus the afterimage would appear red.

Q.   Hi.  I have retinitis pigmentosa, and it maybe an usher's syndrome, cause I was born with a hearing loss. I'm 27 years old. I'm going to Emory medical for more testing (ERG and a field test). Would you know if this could affect my brain if all of this causing by some nerve problems if you know respond please, I will ask Emory tomorrow as well, I just wanted to see if I get both answers to match. Thank you for your time.

Retinitis Pigmentosa (RP) is a retinal degeneration that affects 1 in 4000 people.  The photoreceptors in the retina die - off and, as a consequence, the signals from the eye to the brain become "distorted" and the patient experiences reduced vision during the night and day.  Sometimes the optic nerve, the major nerve from the eye to the brain, will look pale, suggesting some involvement of the optic nerve (probably the ganglion cells in the retina).  In general, however, the nerves in the brain are not affected in RP.

Usher's syndrome is the leading cause of deaf-blindness in the United States.  Patients with Usher's syndrome are born with a sensori-neural hearing loss of varying degree and later develop RP.  Interestingly, patients with Usher's syndrome also have abnormal looking sperm.  Again, neither RP nor Usher's syndrome affect the brain, per se.  Although both affect the signals from the eyes to the visual centers of brain .

Q.    Went to eye doctor today and was told my son's (optic) nerve was pale.  Doctor could not explain why this was.  Need to go to neurologist.  What could it be?  What are the number of things that I need to look for?

Pale optic nerve(s), referred to as optic nerve pallor, can be a sign of a serious neurological or/and ophthalmological condition.  A host of things can cause a pale optic nerve.  It is real important that you/your son keep all appointments will all the doctors.  Don't be surprised it your son has a lot of tests done to try to find out why he has a pale optic nerve.  Some of the tests might include imaging tests of the brain (CAT scan, MRI), electrophysiological tests such as the visual evoked response (VER, VEP), and certain blood tests.  If your son is young, he may have been born with the condition, or it could be a sign of a progressive, worsening condition so keep your doctor appointments. 

Q.    My one year old son has one eye where the pupil is slanted instead of round.  Why and what is that?

You may be describing several things,some of which can be serious.  In aniridia, there may be a near complete absence of a pupil and is sometimes associated with nystagmus, sensitivity to light, glaucoma and reduced vision.  Iris coloboma is a developmental defect in the pupil and may include a sector of the iris being missing, hole(s) or a notch in the iris. Iris dyscoria is an abnormal shaped pupil and iris corectopia is a pupil in an abnormal position.  Some pupil abnormalities may be a sign of other complex conditions or associated with certain syndromes.  You need to take your son to an ophthalmologist ASAP, since the condition could be very serious and vision threatening. 

Q.    I have blurred vision in one eye which has occurred recently (two weeks).  This has happened before and faded away.  It usually takes a few weeks.  The sensation is that my cornea has a spot or scratch in the middle.  Is this something that I should be concerned with?

Yes.  You describe not a scratch on the cornea but a possible problem with the macula - the central vision part of the eye.  If you are older, say past the age of 55 or so, you may be describing the early stages of age-related macular degeneration, as well as other possible conditions.  To be on the safe side see an eye doctor for a dilated exam, where they will look in the back of your eyes and examine the retina for possible problems.

Q.    What causes one eye to have double vision?

Double vision in one eye (while the other eye is closed) is usually a sign of a dislocated lens (natural or artificial lens), a defect in the media of the eye or a problem with the macula - the central vision part of the eye.   If you recently developed monocular diplopia, see an eye doctor for evaluation and possible treatment, if applicable.

Q.    What is Axenfeld anomaly?

Axenfeld's anomaly is an abnormal development of the front part of the eye, including the cornea and iris.  In Axenfeld's anomaly, there are strands of iris, that are not supposed to be there, that cross from the iris to the cornea.  Sometimes there is also glucoma that develops because of the disruption of the flow of fluid in the eye, due to the abnormal  shaped iris, this later condition is referred to as "Axenfeld's syndrome."

Q.    At six months of age my son was diagnosed with Dwayne's (Duane's) syndrome.  When he looks to the left, his left eye remains stationary and the right eye turns in toward the nose, giving him the appearance of being crossed eyed.  The doctor has told us that there is nothing that can be done for this.  Do you have any information?

You give a great discription of Duane's syndrome and your doctor is probably right.  As long as your son has straight eyes when looking straight ahead and does not have too much of a head tilt, then no surgical correction is indicated.  If, however, he has a significant head tilt or/and his eyes are not straight in front gaze, then he could have eye muscle surgery to try to straighten the eyes in front (primary) gaze.  In general, if the condition is minor leave it alone.  In addition, the success of eye muscle surgery is not guarenteed and could actually make the condition worse.

Q.    My wife has a recurring problem called Tigesons (Thygeson's).  She has recurring scratches on her cornea.  Her doctor is treating her with steroids.  What is the disease and can she pass it on to the kids or me?

Thygeson's superficial punctate keratitis is a recurring inflammation of the cornea (keratitis) consisting of discrete spots (punctate) of inflammation.  These are not scratches, per se.  Symptoms include tearing, sensitivity to light, pain, and a feeling like there is a foreign body in the eye.   The cause of Thygeson's is unknown and it is unlikely that the kids or you will be affected.  Patients usually have Thygeson's for 2 to 3 years, and patients are usually in the 20s or 30s.  The disease comes and goes and patient's can have spontaneous recurrences or it could go away completely.  Treatment usually includes the use of artificial tears, ointments and certain types of soft contact lenses.   Steroids have been shown to be effective at resolving the keratitis, but not a cure per se.  This disease is different from chronic follicular conjunctivitis of Thygeson, which can be highly contagious and vision threatening.

Q.    I know that flashing lights can be a sign of a retinal detachment.  What I am experiencing is a bright spot whenever I shift my focus quickly.  So, if I'm at a stop light and look left and right real fast, I see a bright spot in the upper left quadrant of my field of vision.  It is rather annoying, but not painful, and I don't see it when my eyes are steady.  Should I be concerned about this?Is this the type of light one sees with a retina detachment?

Yes and No.  You should be concerned and should see a neuro ophthalmologist (you may have to be referred to one by your eye doctor) about the problem.  He/she will probably do a visual field test to quantify the problem and may want to do additional testing to find the cause of the "scotoma".  The problem is probably not with the retina or eye, but rather, with the brain.  It is not what people typically see with a retinal detachment.   Also go to small triangular bright spot in side vision.

Q.    I spilled iodine down my arm.  It stained all of it. Since then, my eyelids have been crusty and itchy.  Could this be the reason?

Probably not.  Crusty and itchy eye lids are   signs of blepharitis.

Q.    I have a quite abnormal problem, I think.  After physical activity like basketball, running, lifting weights, etc., my eyes become red and irritated within 15 minutes.  The left eye will begin to swell and the white part of the eye becomes extremely red/pink.  It will get so bad that the redness will actually overlap the lens part of the eye....I have seen several optometrists , 2 physicians and some ophthalmologists.  They all said that this is unique, and have resorted to only giving me eye drops... If there is anything that could help with the problem I would extremely appreciate it.

A  search of the medical literature and several discussions with our ophthalmologists suggest that you may be experiencing an exercise induced pigmentary dispersion phenomenon.  This is an eye disease that is difficult to diagnose and is often missed on routine eye exam. It also usually occurs in older individuals and not teenagers.   In pigmentary dispersion, cells in the anterior part of the eye are "stirred-up" by exercise and cause a blockage of the drainage part of the eye (trabecular meshwork).  This, in turn, causes pressure in the eye to increase leading to transient glaucoma and red, painful eyes and could affect your vision such that you think that the redness is blocking the pupil of the eye.   You need to see an ophthalmologist and have a good eye exam that includes iris transillumination.  You should also have your eye pressure checked and be examined immediately after exercise.  If this hypothysis turns-out to be true, you'll need minor "laser surgery" to correct the problem of exercise induced glaucoma caused by the pigment dispersion.  If this is true, if the condition is not corrected you could have a sudden attack AND possibly loss vision.  So, it is very important for you to see an ophthalmologist ASAP.  At a minimum, call the eye doctors that have examined you and have them check their records to see if they performed iris transillumination during your exam and that your concern is with exercise induced pigmentary dispersion glaucoma.

Q.    What causes protruding eyes?

Protruding eyes can be caused by a number of diseases, some very serious.  Probably the most common reason is thyroid eye disease, in which the eyes appear to buldge-out.  If the condition worsens, in some patieints with thyroid eye disease the eyes may become misaligned and even stop moving.  If your eyes were normal appearing and now appear to protrude-out, see an eye doctor ASAP.

Q.    I have just been told that I have a condition called pseudomyopia in my left eye... Do you have any information that could enlighten me on the condition.  I am only 18, and told that I will grow out of it in 10 to 15 years.

In so-called pseudomyopia, a patient who is slightly hyperopic (slighty farsighted) can appear to be slightly myopic (nearsighted) on examination.  This benign condition is usually identified on cyclopegic evaluation (i.e., with the pupils are dilated and accommodation is fixed with eye drops) and usually is seen in young adults and older children.  It is sometimes associated with an accommodative spasm, in whichthe eyes focus too close in when the patient tries to lok at near objects.  Pseudomyopia really nothing to worry about.

Q.    I am unable to move my eye.  What causes this?

If you all of a sudden or over a short period of time are unable to move an eye, you need to see an ophthalmologist ASAP.  Several very serious conditions can cause a persaon to not be able to move an eye, the most common reason is probably thyroid eye disease.  Tumors behind the eye as well as other diseases that cause the tissue around the eye to swell can also cause a patient to lose the ability to move an eye.  See an ophthalmologist or neurologist ASAP.

Q.    Why am I seeing squiggly lines?

Seeing squiggly lines may be an early sign of age-related macular degeneration (ARMD).  ARMD usually occurs in caucasians older than about 45.  See Dictionary and Simulations for additional information.  If you see squigggly lines or see straight lines that appear distorted, wavey, or there are missing parts of visual objects, you need to see an ophthalmologist ASAP for evaluation and treatment, if applicable.

Q.    I recently came from India.   For the past week I have been getting a pain in my eye.  Now there is swelling in my eye lid toward the nose.   What is it and is there any treatment?

Whenever there is pain, you should see an eye doctor.  Go to Swollen upper eye lid for more information.

Q.    Vitamin A and Isotretinoin and floaters?  I took isotretinoin (13 cis-retinoic acid) for acne and it gave me floaters...

Isotretinoin, commonly called Accutane can cause a number of vision problems including poor vision at night, corneal opacities and "visual disturbances", possibly including floaters.  Women who are pregnant or who may become pregnant SHOULD NEVER use Accutane because it can cause birth defects.  Accutane can also cause a condition called pseudotumor cerebri - the symptoms include headache, nausea, vomiting and visual disturbances.  If you have these symptoms and are taking Accutane, you should stop the drug immediately and see an ophthalmologist.  Also go to Vitamin A and Floaters.

Q.    One eye focuses at a different point than the other.

When the eyes are aligned but focus at different points in space, the condition is referred to as anisometropia ( a difference in refractive error between the eyes).  For example, one eye may be nearsighted and the other eye may be farsighted.  This is rather a common condition and, in children, if left untreated (with glasses) anisometropia can lead to amblyopia (lazy eye).

Q.    Eye all red inside, eye hemorrhaging.

Several eye diseases can cause the eye to hemorrhage inside including diabetic eye disease and age-related macular degeneration.   A patient that experiences bleeding inside the eye needs to see an ophthalmologist ASAP for treatment, which may include certain types of "laser surgery".

Q.    Blisters/ulcers on eye.  What is the cause?

Ulcers on the cornea can be caused by a numbers of factors and the signs usually include localized Haas and swelling of the cornea, swelling of the eye lid(s), sensitivity to light, pain, tearing and involuntary "twitching" of the eye.  Often trauma, sometimes due to the over wearing of contacts, can cause serious and vision threatening corneal ulcers.  Herpes simplex and other infectious diseases such as tuberculosis and syphilis can also cause corneal blisters/ulcers (referred to as interstitial keratitis).  All these conditions require prompt and immediate medical attention, so if you have a corneal blister/ulcer see a doctor ASAP.

Q.    Droopy eyelid.

A droopy eye lid is referred to as a "ptosis".  Go to ptosis for more information.

Q.    My granddaughter has an eye that turns-in badly and they are talking about eye surgery for her, can you give more details about this type of surgery?

When the eyes turn-in the condition is called esotropia.  A young infant whose eye(s) has turned-in since birth or thereabouts is referred to as congenital esotropia.  The standard treatment of esotropia is corrective eye muscle surgery, unless the patient has a type of esotropia called accommodative esotropia which can be corrected with glasses.  When an eye turns-in, it usually means that there is a problem with one or both eye muscles that control left and right gaze.  When an eye moves toward the side of the head, for example the right eye, the eye muscle near the side of the head (lateral rectus muscle) contracts and the eye muscle near the nose (medial rectus muscle) relaxes and stretches. 

In eye muscle surgery to correct esotropia, the eye doctor will put the patient asleep and then make a small incision in one or both eyes to gain access to one or more of the eye muscles.  Depending on the circumstances, the eye doctor may cut the medial rectus muscle, move and reattach the muscle further back in the eye.  Sometimes the surgeon will cut-out a small piece of the lateral rectus muscle to make the muscle shorter.  In either case, the goal is to surgically move the eye(s) via muscle shortening or by repositioning the eye muscles such that the eyes end-up straight.  In general, there is about a 70% chance that the surgery will be successful.  Some patients require a second and sometimes a third surgery to straighten the eyes.  In general, the earlier the eye muscle surgery the better, for eye alignment and the development of normal binocular vision.  Also, there is a chance for a patient with esotropia to develop amblyopia (lazy-eye).  Ideally, eye muscle surgery should be performed when there is no evidence of amblyopia; otherwise, the success of the eye muscle surgery will be less.

Q.    Sudden loss of sight in one eye.

A sudden loss of sight in one eye can be caused by a number of things, most of which are very serious.  Transient ischemia attacks(TIA), hemorrhage inside an eye due to diabetic eye disease or age-related macular degeneration, retinal detachment and transient glaucoma among others can cause a sudden loss of vision in one eye.  If you have a sudden loss of vision in one eye, even if the vision returns after a short while, you should see an eye doctor ASAP for evaluation and treatment, if applicable.

Q.    Can your eye sight really be affected by watching your television too close?

Yes.  Watching television , or for that matter watching anything, too close can cause a number of eye problems.  Nearsightedness can be worsened and eye strain (dry and red eyes, double vision, blurred vision, eye discomfort) can become a problem by viewing objects, including the television, too close or/and for too long of a time.

Q.    Have you heard of someone slowly loosing sight in one eye and then its supposed to come back in maybe a couple of weeks?  I'm not sure what they call this?

The word here is MAYBE.  Sometimes patients with optic neuritis will experience a loss of vision in one eye and SOMETIMES vision will return to "normal" in a few weeks or months.  The cause of the optic neuritis must be investigated.  Sometimes patients with nonorganic vision loss (usually a vision loss due to psychological problems) may experience vision in one eye that comes-and-goes.  We suggest that you talk to your doctor for further information about the condition.

Q.    My eyes feel pressured and irritated.  I feel like I have to blink constantly.  I've been to the eye doctor three times and one doctor told me my eyes were very dry and the other told me that my eyes were fine.   However, my eyes certainly don't feel fine.  Any suggestions?

You may have dry eye disease.  A common symptom of dry eye disease is that it waxes and wanes such that at one time the eyes may appear normal and at another time the eyes will appear more typical of patients with dry eye disease.  As a consequence, both eye doctors may be right.  Dry eye disease is a chronic problem, particularly for the elderly (over the age of 40).  One of the first things to do is to make sure that the dry eyes are not due to environmental conditions, such as air circulation or low humidity in the home or work place.  Also, certain medicines will cause the eyes to become very dry and irritated.  See other questions about dry eye disease and stay-tuned for a featured article, shortly, about dry eye disease.

Q.    My doctor performed cataract surgery on my left eye and cannot correct it with glasses.  He says that I have dot map fingerprint dystrophy????

Map-dot-fingerprint dystrophy gets it name from the visible description of the condition which includes very small cysts or "dots", irregular ridges of material ("fingerprints") and localized opaque areas or "maps" on or actually inside the cornea.  The cornea is composed of a series of layers of cells including the epithelium (very front of the corneal) and a "basement membrane" that holds the epithelium to another deeper layer called "Bowman's layer".  The problem in map-dot-fingerprint dystrophy is that waste material accumulates between the basement membrane and epithelium such that the epithelium cannot attach to Bowman's membrane.  This, in turn,  causes the further development and accumulation of debris.  This material accumulates until it actually breaks through the epithelium or front part of the cornea causing a very irritated eye, swelling, pain and  distortion.  Because there is a distortion of the refractive parts of the eye (i.e., cornea), patients sometime complain of glare problems at night with oncoming headlights, reduced visual acuity and ghost images.   Trauma, including cataract surgery, can exacerbate the problem.  Some believe that map-dot-fingerprint dystrophy is a hereditary problem that 50% of family members have or can develop to varying degree.  Treatment sometimes includes the use of lubricants and ointments, patching, and the use of certain types of soft contact lenses.  The eye doctor may also need to scrape-off, very carefully, the debris to try to promote healing.  Unfortunately, map-dot-fingerprint dystrophy is a chronic, incurable condition that waxes-and-wanes over time.

Q.    I just found out that I am left eye dominate.  First, is there a cure?   Second, if not what can I do to strengthen my right eye?  I have recently taken up archery...

There are a number of different kinds of eye dominance and, unfortunately, they all seem to measure of reflect different things.   One type of eye dominance is sighting dominance, as in your case sighting a target with a bow and arrow.  Eye dominance is nothing that can be "cured" since it is not a disease, per se.  Much like hand dominance, some people are right eye dominant and some are left eye dominant.  There is nothing that can strengthen the right eye, except possibly extensive practice .  We suggest that you talk to other archery enthusiasts and find-out what others have done with a similar problem. 

Q.    Kruckenburg.   What is it?

You are probably referring to Krukenberg (spindle), which occurs in pigment dispersion syndrome and pigmentary glaucoma.  In Krukenberg spindle, there is a vertical accumulation of pigment inside the eye, on the central and inner side of the cornea (corneal endothelium).  

Q.    Why does one have dark circles under the eyes?  This condition is not related to sleep, I've always had them and now my son has them.  What can I do?

You can probably do nothing for your dark circles, but it might be worthwhile to consult with an ophthalmologist who specializes in cosmetic surgery.  Go to dark circles for more information.

Q.    How do I find the spelling of a rare eye disease?

First, ask your eye doctor.  Otherwise, submit a comment to this site and spell the rare eye disease the best you can and ALSO describe the condition or disease the best you can.  We'll do our best to inform you of the correct spelling and give a brief explanation of the condition or disease.

Q.    Is there anything to be done to reverse the atrophy of the optic nerve which prompted the loss of sight in one eye?

Nothing will reverse optic atrophy.  If the condition/disease that caused the optic atrophy is identified and corrected, if possible, then the optic atrophy and associated vision loss may not worsen.  Whenever a patient is identified with optic atrophy, it is very important that the cause of the atrophy be identified.  Often, extensive laboratory tests and imaging tests (MRI, CT scan) are used to help identify the reason for the optic atrophy and associated loss of vision.   Unfortunately, particularly in infants and young children, the cause of the optic atrophy is sometimes never identified.

Q.    What causes double vision in older adults?

Is the double vision in one eye?  If yes, go to monocular diplopia.  If the double vision is present only when both eyes are open, then this suggests that the eyes are not pointing in the same direction.  There are a number of reasons why an elderly adult may develop double vision or diplopia, some causes of double vision may be very serious.   There may be problems with one or more of the eye muscles.  Or there may have been a tendency for the eyes to be misaligned all along but that age has caused the eyes to no longer be aligned.  Certain disease of the orbits and of the brain can also cause diplopia.  Because double vision may be a sign of a serious disease, see an eye doctor ASAP about the problem.

Q.   I have been wearing Red (vermilion) sunglasses for 15 years now. I heard that the red causes a stimulating effect in the mind and body (some how) and would agree. What I think I feel and what is real, however may be another story. I am sure there has to be studies on this. I am looking for articles which might shed some light on this subject. Can it be true and can you help me find some?

We could not find any studies related to your observations.  This would fall under "alternative medicine", which typically has no scientific basis.  From an anatomical perspective, red glasses would screen-out the blue and green wavelengths that typically stimulate the rod photoreceptors that are used for night vision.  So, as it gets dark outside you could probably see a little better after wearing red filters than if you had not been wearing red filters.   But to have a stimulating effect on the body and mind?  There is no scientific basis.  If any reader comes across such a study, please send us the reference and we'll check it out.

Q.    I have a problem, somebody told me that I blink a lot and I became self conscious about it and now I find myself blinking like a maniac. I am blinking like every two seconds and I can’t stop because my eye will burn and I have to blink. Is there anything I can do to try and stop blinking so much?

Excessive blinking is one sign of dry eye disease as well as a sign of irritants in the eyes.  Also, do you notice the excessive blinking during certain times of the day or under certain work conditions?  If so, environmental irritants (cold, wind, blowing air) can be causing the excessive blinking.   Also, contact lens wearers often blink a lot to maintain moisture of the lenses (the contact lens is an irritant).  See an eye doctor and describe your problem to him/her for evaluation and treatment, if applicable.

I have orbital cellulitis.  How did I get it and what can be done about it?

Orbital cellulitis is an inflammation of the tissues on the orbit (eye socket) and typical symptoms include the eye(s) appearing to stick-out, limitation of the ability to move the eye(s), inflammation of the eye lids and some swelling of the eye itself (chemosis).  Patients complain of sometimes double vision, pain and discomfort.  Orbital cellulitis can be cause by several factors including direct damage to the eye or/and orbit from a would, whole body bacterial infection, spread of an infection from the eye lids or sinuses or lacrimal glands to thew orbit, for example.  At least in children, the most common cause of orbital cellulitis is from a paranasal sinusitis (sinus infection).  Complications from orbital cellulitis or from what caused the orbital cellulitis may be significant and could include the spread of the infection into the brain.  Prompt and immediate medical treatment is necessary.  Most of the time, hospitalization and treatment of the whole body with antibiotics is necessary. 

Q.    Can blepharitis cause permanent eye problems and what are some of the causes of the problem?

Blepharitis is an inflammation of the eye lid margins with crusting and scaling (sometimes oily scales) and causing the patient to have irritation, red lids, burning and itching of the eye lids and area.  This may be a chronic, ongoing condition, more or less permanent, or may come and go.  Blepharitis is often associated with conjunctivitis and superficial keratitis.  Go to blepharitis and conjunctivitis for more information.

Q.    What is a nevus of the retina?

A nevus is a benign tumor that develops from abnormal melanocytes - a certain type of cell that produces melanin which, in turn, produces pigmentation of  skin and certain eye structures.   Typically, a patient will have a nevus (or nevi - more than one nevus) involving the choroid - a layer of cells in the back of the eye that produces most of the pigmentation in the back of the eye "behind" the retina.  A nevus typically is dark gray (because of excessive melanin) and is star-shaped.  The cause of a nevus or nevi is not known, and patients are usually not aware they they even have a nevus (asymptomatic).   However, some patients can develop  loss of visual field and some loss of visual acuity, as well as macular detachment and growth of abnormal blood vessels in the back of the eye due to a nevus in the affected eye.  Patient's with nevi should be closely monitored yearly or even sooner, particularly with photodocumentation of the size and extent of the nevi.  Because of the similarity between a nevus and more serious disease (melanoma), the eye doctor may watch you closely to make sure that it is indeed a nevis and also to watch out for the complications of a nevus (e.g., macular detachment, neovascularization). 

Q.    How can you tell if you have tunnel vision?  If you have tunnel vision is it inevitable that it will get worse?

As the name implies, tunnel vision means that you only have central vision: if a visual object is presented off to the side you won't see it.  Patients with tunnel vision describe it as looking through a tube (like a toilet paper tube) that blocks-out all objects on the side of your vision.  The standard test for tunnel vision is a visual field test, in which the patient maintains fixation on a point and is required to push a button when the patient sees a small light presented in the patient's visual field.  Patients with tunnel vision only report seeing the small flash of light when it is presented near the person's central vision (that part of vision or part of the eye you read with).  If the small flash of light is presented off to one side, a patient with tunnel vision will not report seeing the light.  If the tunnel vision is real bad and only allows the patient to see with about 10% of their visual field, the patient could actually be considered legally blind (a visual field of 20 degrees of visual angle or less).

In some retinal diseases like RP (retinitis pigmentosa), the patient will first have tunnel vision at night or under very dim light levels.  As the RP progresses, the patient may develop tunnel vision during the day.   Whether the tunnel vision progresses depends on the reason for the tunnel vision.   A host of retinal diseases, optic nerve diseases and brain problems (e.g., tumors) can lead to tunnel vision.  If, for example, the tunnel vision is due to a retinal disease like RP, then the tunnel vision will get worse and start to affect central vision later in the course of the disease.  Sometimes, however, tunnel vision is  due to stationary, nonprogressive visual problem such as optic nerve hypoplasia (small nerves).  In optic nerve hypoplasia, the optic nerve fibers from the patient's peripheral visual field are abnormal or absent at birth while the patient's optic nerve fibers from the central vision part of the eye are not affected.  In this case, the patient with a visual field loss may have a stationary tunnel vision, due to the optic nerve hypoplasia, that will not get worse over time.

Q.    What is Adie eye?

Go to Adie's pupil.

Q.    I need any information available about a torn retina.

The retina is a very thin membrane inside of the eye that contains a number of different cells, including the photoreceptors, necessary for vision.  A number of conditions as well as trauma to the eye(s) can  lead to the development of tears, holes, wrinkles and even detachment of the retina.  For example, in patients that are very nearsighted (high myopia), the eye becomes elongated and the retina stretches and becomes very thin.  In high myopes, the retina becomes so thin that it sometimes develops tears because of the forces that the vitreous places on the retina, requiring surgery to fix the problem.  In general, any tear, hole or detachment of the retina is a serious condition.  Symptoms of a retinal tear often include seeing flashes of light and the sudden onset of a lot of floaters - small dark objects inside the eye that can take-on a number of appearances.  A retinal tear can cause fluid/gel to accumulate under the retina and can lead to a retinal detachment.  For more information, go to retinal detachment and floaters

Q.    I see flashing lights only when I move my eyes far from the left-to-the-right, back and forth.  What can cause this?

A patient with a posterior vitreous detachment will sometimes report that they see flashing lights only when they move their eyes.  It is easier to see the flashing lights in the dark.  In normal eyes, the vitreous is a gel that fills the eye ball.  In various conditions, including aging, the vitreous gel will liquefy and collapse, causing the vitreous to detach from the back of the eye; thus, a posterior vitreous detachment.   Because a posterior vitreous detachment can lead to a retinal tear and a retinal tear can lead to a retinal detachment, you should see an eye doctor for evaluation and treatment, if applicable.

Q.    What are the signs of diabetic eye disease?

Q.    What are the symptoms of diabetic retinopathy?

The two main body parts that are affected by diabetes are the kidneys and the eyes.  In diabetic retinopathy, the retinal blood vessels increase in permeability, allowing the swelling of the retina and closure of small blood vessels.  This, in turn, leads to a reduced level of oxygen in localized areas of the retina which, in turn, leads to the development of abnormal blood vessels.   These abnormal blood vessels leak/hemorrhage resulting in the loss of vision in the areas of the hemorrhage (see Simulations for diabetic eye disease).  Other vision problems that develop in diabetic patients, particularly in those patients will poorly maintained blood pressure and poor glycemic control, include the development of swelling of the macula (central vision), numerous flare-shaped hemorrhages, and so-called cotton-wool spots.  Finally, diabetics with end-staged renal disease will develop cataracts.

Q.    What does a white ring around the iris of the eye mean?

It means that you need to see an eye doctor ASAP.   It is unclear what the white ring may signify or what it could be a symptom of; however, any change in iris warrants a trip to the eye doctor.  Because changes in the iris, either its shape or color, may also alter the filtering properties of the eye and lead to glaucoma, it is essential that any patient that experiences a change in the iris (or pupil) should see an eye doctor for a through examination.

Q.    I had a problem with my left eye that lasted about 15 minutes.  I saw an arc shape with points on it.  The arc was white and the points were different colors...any info would be appreciated.

It is unclear what the problem could have been.   One possibility is that you experienced a retinal tear - the most common type of retinal tear is the horseshoe tear that would take-on the appearance of an arc.  As the visual system adapted to the constant image of the tear, the tear would quickly disappear, but could reappear it the visual scene changed.  Since a retinal tear can lead to a retinal detachment, you should see an eye doctor for evaluation and treatment, if applicable.

Q.    My boyfriend (24 y.o.) has had a condition for approximately four years and it has gone undiagnosed thus far. (FYI he had a disorder when he was youndger and took steroids for an extended length of time.)   Approximately once a month, his eye swells up. He feels the swelling begin and within a couple of hours his lower eyelid and upper eyelid swell up so much that they close over his eye. This is very painful for him - especially to touch. He has been a casualty numerous times and had his sinuses X-rayed and his tear ducts unblocked so many times, but each time the doctors find nothing.  Finally today he went to an eye specialist who told him he has a condition called blepharochalasis. We have researched this condition and think he was wrong - the definitions say it is sagging of the eye lid which obscures vision. This is not the case. When he is not suffering from the swelling, his eye looks totally normal.   Any idea what this might be?? or if not where to look for further info?

We agree with your specialist and with additional information about blepharochasis you may also agree.  Blepharochalasis is described as recurrent episodes of severe swelling of the eye lids (one or both eyes can be affected), redness (gorging of the blood vessels in the lids), accompanied by discomfort/pain.  SOMETIMES, the lid edema will result in ptosis - drooping of the upper eye lid. The ptosis becomes more pronounced  and permanent as the person ages and has repeated attacks.  It is a rare condition that often starts with young people, like your boy friend.  Over time, and repeated attacks, the eye lids become thinner, more wrinkles develop and the eye lid skin becomes discolored.  Surgery may be indicated in advanced cases to repair the ptosis, reconstruct other parts of the eye lids and surrounding tissues/glands.  The cause is unknown, although in some very rare cases blepharochalasis of the upper lids has been associated with leprocy.

Q.   what is papilladema (papilledema)?

Papilledema, also called chocked disk, is a swelling (edema) of the optic nerve disk - that part of the optic nerve that the eye doctor can see when looking in the back of the eye.  The optic nerve runs from the eye to the early visual centers of the brain.  Papilledema is usually caused by an increase in intracranial pressure (pressure inside the head/brain), obstruction of the central retinal vein or malignant hypertension.  The presence of papilledema is never a good sign and often requires extensive testing to determine the exact cause.   Sometimes the cause of the papilledema is never found.  Also go to pseudo tumor for more information.

Q.    Can a flashlight pointed straight in to the eye cause permanent damage?

A regular flashlight as found in most stores is not of sufficient "strength" to cause a permanent eye problem.  Also, so-called spotlights, like that found in police cars, are not of sufficient energy to cause damage, unless it is with very close viewing for an extended time.  Light damage to the eye is most often caused by looking at the sun (solar retinopathy) and by welding torches (so-called welder burn retinopathy).

Q.    Thank you so much for your information on Blepharochalasis. I wonder if there is any treatment for Blepharochalasis? and how long might he suffer from it?

Because the cause of blepharochalasis is unknown, there is no known treatment or cure for the disease.  At present, it appears to be a life-long problem.  The damage caused by the disease, such as ptosis, is treatable.   However, with the advent of new therapies based on better knowledge of the immune system and genetics, there is hope that in the future the disease with be treatable/cureable.

Q.   I believe I have a conjunctival cyst.(A small transparent growth on the white of the eye which looks as if it has fluid in it) Is there a treatment for this ?

Probably, you need to see an ophthalmologist, a doctor that can perform surgery.  However, it is likely that you have scleritis or episcleritis.  Go to those links on this page for more information.

Q.    As a child I had several corrective eye surgeries and wore patches and corrective lenses for most of my childhood. Recently a doctor told me that I had no depth perception. What causes this and does it affect things like driving or raquet sports?

Most probably you have or had a lazy eye (amblyopia).  Lazy eye causes a loss (actually a reduction) of vision in one eye and disrupts depth perception.  But this is a special type of depth perception - one that capitalizes on the slightly different images received from the two eyes (called binocular disparity).  For example, you'll never be able to see those Magic Eye 3D images, or really see the depth in 3D movies.  However, although the depth perception deficit that you have is permanent, it is a very minor problem.  This type of depth perception loss may prevent you from putting in a golf game very well or from seeing subtle changes in a golf course green.  Also, it may limit some of your career possibilities. While it should not affect your driving it probably does affect your raquet ball game, since it will cause you to be less certain about the exact location of the ball in 3D space.

Q.    I am 51 and have been diagnosed with cataracts. I have extreme myopia (minus 25 in the left eye and a minus 19 in the right). The cataracts seem to be progressing rather rapidly. I have seen a retinal specialist and he reports that both retinas are perfect and there is no latticing or signs of disease. I know I need to have something done because I am having trouble getting a contact lens which will correct the left eye adequately. My concern is retinal detachment. What would you advise given the information provided? The surgeon is suggesting putting a lens in that has little or no power. I just don’t understand how vision will be improved so greatly since I have never had good vision. Any info from you would be greatly appreciated.

There is a significant possibility of a retinal detachment in any patient with high myopia and the chance of a retinal detachment will be increased by the cataract surgery.  But, if the cataracts get too bad your choices are limited.  If the surgeon puts in an intraocular len with little power, then you'll need very thick glasses and/or contacts to return your vision to where it was before surgery.   You may also need regular contacts as well as glasses in order to see well. 

Q.    What can you use in your eye when a little blister like comes up inside the bottom lash?

You can use an eye doctor.  DO NOT MESS with the "blister".  Go to your eye doctor for an evaluation and the APPROPRIATE treatment.  Please note that the appropriate treatment depends on exactly what the problem is and you won't know that until you see an eye doctor.

Q.    I have recently been diagnosed as having Fuch’s dystrophy. I am a male 67 years of age. I have been informed that I am a candidate for a corneal transplant. I understand that a complication in corneal transplants arises when the stitches used to secure the new cornea are not precisely alike. If the stitches are not alike, astigmatism develops and the uneven stitches have to be removed. Is there any research group working on improved methods of corneal transplants. I control a charitable foundation and would like to make a contribution to such a research group. Would you kindly put me in touch. Many thanks in advance.

Yes.  Applied research into the exact topic that you discuss is being carried-out at the Ohio State University by Dr. Cindy Roberts in the Department of Ophthalmology (Ph: 614-293-70399).  The research is being funded by the Ohio LIONS Eye Research Foundation.  Not only is Dr. Roberts doing the research into corneal topography and corneal transplants, but in collaboration with corneal surgeons they're using the new techniques to perform the corneal surgery and to prevent the very issue that you raise.   In a nut shell, the research/surgical team removes and replaces the cornea in advanced cases of keratoconus, for example, and when the new cornea is sutured into place Dr. Roberts does a corneal topography scan of the corneal surface to detect any irregular/abnormal areas during the surgery.  If so, the surgeon is advised to adjust the sutures in question - another scan is performed, etc., until everything looks fine.  Doing the corneal topography scans in the operating room while the surgery is being performed reduces the potential for complications afterwards.  Please note: e-mail inquiries via the present web site are anonymous; we have no way to reply directly to your e-mail request since we do not record the address of the e-mail sender.  For more information about Fuch's dystrophy go to Fuch's.

Q.   I have a blind spot in my right eye, for a year or so it was real bad for about 3 months and then I guess I got used to it and it didn't slow me done much I was tested for just about everything you can think of m.s and other things but after all the test result came back everything was negative.It has been a year or so since I was tested and the problem is getting worse, the doctor is positive that I have m.s or something along those lines but said it is to early to diagnosis the disease.  I am 30 yrs old and need to know what to do next.

If you had a brain scan (CT or MRI) and it can out normal and you had a Visual Evoked Response/Potential and it also can out normal then the possibility of MS (multiple sclerosis) is small, but still possible.  Since the scotoma is only in the right eye then the problem is at the retinal level or early along the optic nerve (before the optic chiasm) in the right eye.  Given your age it is unlikely to be a circulatory/blood supply problem in the eye or optic nerve.  You may need to have an ERG (electroretinogram) and an EOG (electro-oculogram) to rule-out a retinal disease.   Also, if the scotoma comes and goes, it could be related to an ocular migraine.

Q.    What causes black and white spots in eyes.  I am pregnant?

It is unclear from your description what the problem could be.  Please provide additional information.  For example, are the spots on the front part of the eye or something that you perceive in your vision?

Q.    My eyes have felt pressured and irritated for the past two months. I have to blink hard all the time. I am a 23 year old male. I recently went to the eye doctor and he immediately supposed that dry eyes were the problem. He did a tear test on me though and he said that my tears were normal. However, he did not have any answer for why my eyes still feel irritated or dry all the time. Any help?

The tear test is not very reliable or valid, but it is about the only thing available to assess dry eyes. Given your age, please consider environmental factors for the dry eyes.  Also, contact lens wearers often complain about dry eyes, so if you wear contacts consider an alternative.  Seasonal effects also come into play this time of year (i.e., alergies).

Q.    Operation laser stigmatism myoia.

We assume that your interested in information about laser surgery for correcting an astigmatism with myopia.  Go to Past Featured Articles for information about LASIK laser surgery.

Q.    What does imagry mean?

It depends somewhat on the context in which the word is used.  In general, in terms of ophthalmology and vision science it means a mental representation of a visual object.  For example, a dream  would include a visual image of a scene or  visual imagry.

Q.    Sore eyes, inflamed lids.  I don't know it I have an infection or an allergy?

Sounds like an allergy or an allergic reaction.   See an eye doctor for evaluation and treatment.  Go to Swollen Eyes for more information.

Q.    What causes redness around the eyes?

If you mean that the white part of the eyes is red, then it may be caused by a number of factors, most likely an irritant, allergies or dry eye disease.

Q.    Why do I get black spots and black lines on my eyes?

Q.    Blurry spots in one eye.

Go to information about floaters.

Q.    I am having a terrible time with my eyes swelling, especially the corners next to the nose.  I have changed make-up several times, I have allergy tests and don't have any particular allergies.  The swelling occurs when I go to sleep and wake-up in the morning.  The swelling goes down somewhat during the day...Help please it is very bad looking.

It sounds like you're having an allergic reaction.   Unfortunately, allergy testing is very limited and it can test only for very common irritants.  Do you have cats?  Do you use hair spray or anything else that could be rubbed-off of your body and onto the pillow while you sleep?  Is your bedroom dusty (dust mites)?  What detergents do you use wash your pillow cases?  Try isolating the irritant by sleeping in another room or some place else for a few days and see if that helps.  Sorry, but you'll have to act like a detective to figure this one out.  We assume that you've already been to one or more eye doctors for evaluation.   If not, seeing an eye doctor should be on the top of the list of things to consider.  Go to Swollen Eyes for more information.

Q.    WHAT INFORMATION CAN YOU TELL ME ABOUT THE DIFFERENT TREATMENTS FOR ANGLOID (Angioid) STREAKS.  I CAN'T FIND ANY INFORMATION ANYWHERE AND I NEED ANSWERS.

Exact spelling really helps.  Angioid Streaks are reddish-darkish, curved lines or streaks the lay between the peripheral retina and choroid vasculature and branch-out in all directions, usually in both eyes.   While about 50% of patients with angioid streaks have the pathology only, about 50% of patents that have angioid streaks have an associated disease such as pseudoxanthoma (affects the eyes, skin, heart and GI tract), Paget's disease(a connective tissue disorder) or hemoglobinopathy(abnormal red blood cells, for example, in sickle cell disease).   Angioid streaks often lead to a loss of vision in one or both eyes, usually due to macular degeneration or choroidal neovascularization (development of abnormal blood vessels that subsequently hemorrhage).  Also, patients with angioid streaks can develop a retinal detachment as a consequence of rather minor trauma to the eye or face area.  As a consequence, patients with angioid streaks should not play contact sports and also should wear safety (polycarbonate) glasses.  Unfortunately, treatment is rather limited and confined to the effects of the disease or associated disease.  Sometimes "laser surgery"(laser photocoagulation) is performed to treat the choroidal neovascularization, but reoccurrence can occur.  Please note that because angioid streaks are often misdiagnosed, you should consider a visit to a retinal specialist to confirm the diagnosis and get a second opinion.

Q.    What is the treatment for retro bulbous neuritis (retrobulbar neuritis)?

Retrobulbar neuritis is an inflammation behind the eye of the optic nerve.  It is essentially an optic (nerve) neuritis which does not show-up in the eye itself.  Treatment depends on the cause of the optic neuritis.   However, in the majority cases the optic neuritis is associated with multiple sclerosis (MS).  The treatment for optic neuritis is limited. 

Q.   I have a problem with a watery right eye. I have no lumps or anything to speak of in that eye and the optician has already tested for a blocked tear duct, which proved negative. This manifests itself most noticably, with streaming tears, when I ride a motorcycle (full face helmet). Any ideas what the problem could be ?

Wind can act as an eye irritant, so it is possible that the watery eye is a normal response to wind in your eye.  Also go to Watery Eyes for more information.

Q.    Could you tell me how the Lions got involved with "Knights of the Blind" When and how. Would like to include in our Newsletter.

In 1925 at the International LIONS club meeting heald at Ceder Point OH, Helen Keller gave the keynote address.  In her address she challenged the LIONS to become the Knights for the Blind.  LIONS members throughout the world accepted her challenge and have, ever since, worked to help the blind and also help prevent blindness through advocacy work and through research.  Toward these goals, in the early 1950s the Ohio LIONS Eye Research Foundation was established.   Research centers throughout Ohio have been funded by the Ohio LIONS Eye Research Foundation since 1952.

Q.    Is there such a thing as arthritis of the eye?

Yes and no.  In juvenile rheumatoid arthritis, anywhere from 10 - 50% of patients can develop a potentially blinding eye disease called iridocyclitis.  Iridocyclitis involves redness of the eye(s), pain, sensitivity to light and decreased visual acuity.  If not detected or treated early enough (and sometimes despite agressive treatment) the eye disease can lead to an abnormal shaped pupil, cataract, glaucoma and a general degeneration of the eye ball and blindness.   It is essential that a child with JRA have an eye exam, specifically a slit lamp exam, by an eye doctor three to four times per year to look for the very early signs of the eye disease.  Also, if the patient ever complains of an eye hurting, or seems sensitive to light, the patient should been seen by an eye doctor ASAP for evaluation and treatment.

Q.    My son has a lazy eye.   What mineral/herb can he take instead of using glasses?

None.  A lazy eye is an eye with reduced vision, typically because of crossed eyes (esotropia) or a difference in refractive error between the eyes (anisometropia) or because of a problem with how the eyes turn-in as the child fixates on close objects (accommodative esotropia).  So sometimes a child will need glasses to prevent an eye from turning in or to correct an refractive error, but this is not the same as a lazy eye.  The standard treatment for a lazy eye is patching the stronger eye and forcing the child to use the lazy eye.   Glasses will help the eyes keep straight or correct a refractive error, depending on the circumstances.   Under NO CIRCUMSTANCES should you give a child any herbs or any minerals.   Consult with an eye doctor.

Q.    I am a 16yr high school student with amblyopia.  I am wondering if the use of L-dopa would work on me since I am older?

Some studies on older children and adults with amblyopia have shown that L-dopa can improve vision in the lazy eye.  However, the improvements in vision and, specifically, visual acuity has been on the order of about one line on the visual acuity chart.  So, the improvement in visual acuity from taking L-dopa has been small. 

Q.    What are the eye complications of having myasthenia gravis?

Myasthenia gravis is a disease of the muscles, specifically a disease of the junction between the nerve and muscle fibers that utilize acetylcoline, a neural transmitter.  The eyes are usually the first to be affected by the disease and, specifically the eye lids and eye muscles.  The primary symptoms of myasthenia gravis include a drooping eye lid (ptosis) and double vision (diplopia).   Double vision is caused by misaligned eyes because the eye muscles are affected.   Also, since the eye muscles are affected, the patient my have difficulty in looking rapidly at different objects in the environment.  Symptoms usually get worse with fatigue, or even after a "long day".  The patient may appear normal during the morning hours and develop more and more, worse and worse symptoms as the day progresses.  Sometimes associated with the ptosis is a retraction of the other eye lid, which makes the patient look "bug-eyed".

Q.    Would like information on Oscillopsia.

A patient with oscillopsia experiences the visual world as constantly moving or jiggling whenever he/she moves the eyes or/and head.   The symptoms may vary depending on the circumstances, and things like riding a bike or driving a car over a rough road can aggravate the condition.  Oscillopsia is caused by a loss of ocular stabilization by the vestibular system typically through disease or injury.  For more information and demonstration of oscillopia go to Jumping eye.

Q.   I have been to an optomologist twice in the last month for my eyes. My eye lids are really dry, almost crusty, where they meet my eyelashes. The Doctor told me that it was similar to scalp dandruff, but on the eye. He prescribed two different medications and neither seemed to work. They are both still itchy and sore. I have been told that boric acid would probably help them. Any thoughts on that? Or what this may possibly be? Any advice is greatly appreciated.

Absolutely NOT! Do not put anything in your eyes that is not prescribed by your doctor.  You probably have blepharitis.   Go to Chronic Blepharitis for more information.

Q.    What is a cresent (crescent) scotoma?

A scotoma is an area of reduced vision in one or both eyes.  A scotoma can take-on almost any appearance, and the shape sometimes reflects the disease or cause of the scotoma (see Simulations).  In your case, the scotoma is shaped like a crescent - something like a crescent of the moon.  It is likely off to the side - in your peripheral visual field.  A crescent scotoma is sometimes seen in retinal diseases.  As a rule-of-thumb, if you see the scotoma only in one eye then the cause of the scotoma or disease process is within the affected eye (retina) or along the early part of the optic nerve (before the optic chiasm) in the affected eye.  If the scotoma is present in both eyes and looks very similar in each eye, then it is likely that the cause or disease process is in the brain at the optic chiasm or further back along the visual pathways.  [Note: the optic chiasm is where the optic nerves from the two eyes cross and, more or less, join together.  Thus, anything that happens to the visual system that occurs at or after the optic chiasm almost always affects both eyes to more or less the same extent.  Conversely, anything that happens along the visual pathways before the optic chiasm most likely affects one eye.]  However, as the disease process progresses, like in a retinal degeneration that affects both eyes, eventually both eyes will become affected, even though the disease process is at the retinal or eye level on the visual system.

Q.    My consultant said I have a freckle on the back of my eye, and has taken a photo of it.What is it , and should I be concerned as I have not heard of this before I have had my eyes tested lots of times and this has never shown up.

An eye doctor will sometimes tell a patient that they have a "freckle" on the back of their eye when referring to an area of (changed) pigmentation.  Much like the skin, the back of the eye should have a particular color.  And, much like the skin, the back of the eye can change color, sometimes reflecting a disease process.  You probably have a choroidal nevus or change in pigmentation at the level of the choroid (a layer of cells under the retina layer and that gives the back of the eye most of its color).  This is usually a benign condition.  Your doctor did the right thing in photograping it - this is an excellent way to watch it and determine that it is nothing to worry about.  On follow-up, just make sure that you return to the same doctor so he/she can compare photos of the freckle over time.  See follow-up question and response.

Q.    My sister-in-law, who lives in the UK, developed Coats’ disease approximately 15 years ago. After unsuccessful laser treatment at Moorfield’s Eye Hospital she eventually lost the sight in the affected eye. Unfortunately she lost the sight in her other eye at an early age and is now registered as totally blind. On questioning her it would appear that she does not know the reason why she lost the sight in one eye at an early age (some 45 years ago). Apparently she had a cast in her eye (not the one with coats’) and gradually lost the sight in it. Over the last 12 years she has also developed a cataract on this eye. My question is whether it is worth taking her to a specialist here in the USA to see if anything can be done to regain some sight in the eye unaffected by Coats’ disease.

There is nothing special about eye care in the USA vs UK.  Your sister-in-law should find-out from her current eye doctors what happened to the other eye.  It should be noted that while most of the time (about 90%) Coat's disease affects only one eye, in about 10% of patients the disease affects both eyes.   In addition, Coat's disease often causes vision problems before the age of 10 years, which would match the age when your sister-in-law lost vision in the one eye.   Thus, without additional information it is likely that your sister-in-law may have Coat's disease in both eyes. 

Unfortunately, the prognosis is not good simply because she is registered as "totally blind".  Total blindness usually refers to a patient with no light perception (NLP), so even removing the cataract would not help.  However, if she is registered as "legally blind", then there may be hope for her, particularly if she does have some vision such as for lights and possibly large objects.   [Please note that there may be some language or terminology differences between the USA and UK.]  If she does have some vision, a bright flash VER (visual evoked response) is sometimes used to assess vision through a cataract and to determine the visual prognosis in the event that the cataract is removed.

Q.    A week ago, my husband began to experience some strange symptoms. First, when he moves his head, instead of getting a clear, scanning image, he gets a series of frames, as if he were viewing the world as a rapidly moving series of slides instead of a smooth image like you might see in a movie. Second, he feels pressure behind his eyes, which he thinks could be from a sinus infection. He gets frequent sinus infections and has allergies. Third, he has been experiencing a little bit of vertigo, although not serious enough to make him dizzy and cause him to lean against a wall, or anything. It seems kind of mild. He went to his GP (we are with an HMO and must go to a GP before we can see a specialist). The GP looked in his eyes and said his retinas were not detached and that he did not see symptoms of MS. He said my husband’s problems could be caused by an inner ear virus that would clear up in "a week or two," and told him to come back then if it did not. This worried me as I am concerned that we might be sitting on a serious eye problem that needs to be taken care of right away. The doctor did not check him for a sinus infection or look in his ears. Can you tell me what might cause this strange frame-like vision? It’s like one of those flipbooks with pictures that animate when you turn the pages quickly. My husband is 31 years old. He does use eye drops as his eyes often get red, possibly from working for long hours every day in front of the computer. Sometimes he uses Ocuhist because of his allergies. Can you help?

We agree with your doctor that it is probably some type of inner ear infection with possible involvement  of the vestibular system.   Follow-up with the GP if it doesn't get any better.  Although possible, it is unlikely to be related to MS.  Go to Oscillopsia for more information about a similar subject regarding misperceiving the world as jerking or jumping as you describe.

Q.    My 14 year old daughters eye sight changes every 6 months her vision is now -7.00 sphere and -1.25 cylinder axis 19 she is very worried that she will one day be blind. What if anything can be said or done to her the doctor said she will probably be in her twenties before her eyes stabilize and she does have an astigmatism that also gets worse each time.

She will not go blind because of a refractive error or because of a need for thick glasses.  However, because she is considered a "high myope" she should be seen yearly for a dilated eye exam.  She is more likely then others to have some complications of high myopia such as a retinal tear or/and detachment which are treatable.  Floaters are also common in high myopes.

While most myopes stabilize, in terms of the progression of their refractive error, in the late teens or early twenties, about 15 - 20 % continue to progress.  Close work (e.g., reading, computer work) may aggravate the condition and lead to faster progression of the myopia.  There is also a strong hereditary component to the myopia.  We would not advise her to have laser surgery (e.g., LASIK) to correct the refractive error at this time simply because she will probably progress further and again have the need for corrective lenses.

Q.    My child has strabismus.  Is surgery necessary?  My child is 5 years old.

It depends on the cause and type of the strabismus.    Most kids that develop strabismus at about 5 years of age have accomodative esotropia - a strabismus where the eyes appear to turn-in toward the nose and the child appears crossed-eyed.  Accomodative esotropia is due to a mismatch between the eyes ability to turn-in together and the accomdative process of the eyes to focus-in on near objects. Basically, when the eyes try to focus on a near object the eyes overcompensate and turn-in too far.   Accomodative esotropia is usualy correctable with glasses and does not require surgery.  A child with any type of strabismus should be checked for a lazy eye.

If one eye appears to point outward, the strabismus is called exotropia and the layperson name for the condition is wall-eyed.  This type of strabismus does usually require surgery, but then again it depends on the circumstances and the extent of turning-out.  If an eye simply appears to "drift" in any direction, it is likely that the child has reduced vision in one eye.  In any and all cases, a child with misaligned eyes should see an eye doctor ASAP, in order to rule-out a serious eye or neurological problem and to check for amblyopia (lazy eye).

Q.    Is there a data base on health histories of uveitis patients, prior to uveitis onset?

If your asking if there are studies about uveitis patients and their prior medical histories (their health before the onset of uveitis) then you would probably have to search individual studies on uveitis and see if prior medical histories are given.  Off hand we do not know of any detailed studies on this specific topic.  We will search the literature on uveitis and report back here at a later date if something comes up.

Q.   I have noticed a spot on my left eye.It moves when I move the eye . It has been there for a month now. What could it be?

It is most likely a floater.  Go to Floater for more information.

Q.   I am a 19 year old male. I have a lazy left eye, which was discovered at around 10 years of age. The Optician said that it was too late to be corrected with an eye patch. The sight in my left eye isn’t that good, but recently I have noticed a shiny/white blur kind of thing in front of it. A few days ago, when I woke up, the eyelids of both my eyes were "stuck" together. When I opened them they were both bloodshot. Since then they have been VERY crusty in the mornings. I think this is Blepharitis. I am more worried about the white blur in my left eye. I also have two yellow/brown rings around my pupils even though I don’t smoke,drink alcohol or coffee,or do drugs.Can you help?

Yes, you probably have blepharitis which causes crusty eyes.  The blurry spot is probably a floater.  The yellow brown rings are probably normal variation in iris color.  Go to an eye doctor for your vision complaints, for treatment if applicable and for peace of mind.

Q.    I have iritis in both eyes and having treatment.  How can I stop it from happening again and how did I get it in the first place?

Go to Iritis and Uveitis for more information.  These are good questions that, unfortunately have no easy, or difficult for that matter, answers.

Q.    Further to the question about the freckle behind the eye.  How likely is a choroidal nevus to become dangerous or cause blindness?  Other sites on the net seem to suggest that it is quite likely to become malignant.

A nevus, by definition, is a benign tumor due to abnormal/atypical melanocytes.  Melanocytes are mature melanin producing cells and it is the melanin that gives skin as well as the back of the eye most of its color or actually pigmentation.  As a consequence, nevi are usually slate gray, reflecting the increased amount of melanin.  Choroidal nevi are fairly common in the general population; depending on the patient population tested, primarily in terms of age, a good estimate is 5% of the population.  In general, patients with choroidal nevi are asymptomatic (i.e., do not experience any visual complaints).  Sometimes, but rarely, choroidal nevi can lead to the build-up of fluid underneath the retina leading to a "serous" retinal detachment that is treatable.  In about 20% of patients, in the area of the nevi there may be some loss of visual field but this is usually limited.  Overall, the vision loss due to nevi or their secondary complications is small.  In terms of a choroidal nevus becoming malignant, in one study it was estimated that 1 patient in 500 will become malignant, and that was over a 10 year period.   However, the biggest concern is that a large nevus may actually turn-out to be a small melanoma (cancer).  Although the two can usually be differentiated based on size, thickness, visual symptoms, whether there is serous retinal detachment and whether there is an orange pigment present.  Bottom line, this is precisely why your eye doctor will take photographs of the nevus and follow it with periodic exams and photos.   If there are no or little concern, eye exams can be spaced a year apart.  If there are some questions or concerns then the patient may be seen every six months and require additional testing (e.g., visual fields, fluorescein angiography).

Type 2 diabetes and eye problems?

A person with type 2 diabetes (adult onset diabetes) can develop the same eye problems as a person with type 1 diabetes (childhood onset diabetes).  These include cataracts, diabetic retinopathy, hemorrhages, retinal detachment and sudden loss of vision.  In general though, type two diabetic patients are usually better controlled and have milder symptoms and complications.  A big factor is that patients with type 1 diabetes have diabetes for a longer time, run into more serious complications and have more difficult to control glucose levels.  All of this leads to worse vision complications and loss than compared to patients with type 2 diabetes.  Whatever type of diabetes you have, regular eye exams by an eye doctor are essential. 

What is cellophane retinopathy?  Is it a serious condition and is there a treatment?

Cellophane retinopathy (maculopathy) is a term applied to a wrinkling of the retina due to epiretinal membranes.  Epiretinal membranes are caused by a number of factors and are composed of an accumulation of cells and collagen on the retina.  Depending on the thickness, location and other factors, patients with epiretinal membranes can be asymptomatic or have a significant vision loss in the range of legal blindness (20/200 or worse visual acuity, in about 5% of patients).  If the epiretinal membrane does not involve the macula (reading part of the eye) the patient may not have any symptoms.   If the epiretinal membrane involves the macula and causes traction on the retina and is thicker and causes other problems, then significant vision loss could result.   Most patients with epiretinal membranes will have or will develop a posterior vitreous detachment  and increased number of floaters.  In general, epiretinal membranes are slowly progressive and cause mild visual symptoms.  If symptoms or vision loss is severe, surgery (vitrectomy) can be undertaken and result in a significant improvement of vision in the majority of patients.  If the epiretinal membranes cause no or mild symptoms, it is best just to leave them alone.

Q.    What are halos in the eyes?

You are referring to halos that people see around lights.  For example, looking at oncoming automobile headlights at night will cause some people to see halos around the lights.  Halos are usually the result of light scatter caused by changes/disease of the front part of the eye including the cornea and lens.  People with cataracts or people that have had laser surgery for correcting a refractive error (e.g., LASIK) sometimes see halos around lights. 

Q.    Itchy eyes.  Our eight year old son has for a year now had a problem with his eyes being constantly irritated, itchy, having to rub them.  We have seen a couple of specialists in allergies and they have found no sign of any specific allergy problem...Nothing seems to explain the itchiness in his eyes...It seems to present [everywhere] and year round.  Looking for suggestions and help.

Given that you've seen several specialists in allergies and they found no allergy problem then lets assume that there is no allergy problem, per se.  Since he seems to have an eye problem, has he seen an ophthalmologist?  If not, then this should be your next stop.  A number of eye diseases will cause dry, itchy, irritated eyes.  Just some of these include blepharitis, pink eye, infections and problems with of the tear generation and drainage parts of the eyes.

Q.   I HAVE RECENTLY (LAST COUPLE OF MONTHS) EXPERIENCED OCCASIONAL BLURRED VISION. IT ONLY LASTS FOR A SHORT TIME, BUT IT SORTA SCARES ME. IT COMES WITH NO WARNING BUT OFTEN WHEN I CHANGE MY LIGHTING. IT IS AS IF I AM SEEING WHITE SPOTS. IT IS HARD TO FOCUS AND MY PUPILS GET VERY SMALL. IT IS USUALLY IN JUST ONE EYE. I DO HAVE SINUS AND ALLERGY PROBLEMS AND I FIGURE IT IS RELATED TO THIS. WHAT DO YOU THINK? I ALSO HAVE A LOT OF STRESS RIGHT NOW, GETTING MARRIED, NEW JOB, AND MOVING. COULD STRESS ALSO BE A FACTOR?

It is not clear what the problem may be.   Sinus and allergy problems are probably unrelated.  Stress, and you're under a lot of it, can precipitate and aggravate any underlying physical and psychological issues in a person.  We would suggest that you see an eye doctor for a complete dilated eye exam, just to be on the safe side and to put your mind to rest.  You don't need any more stress in your life so let's eliminate any potential eye problems.

Q.   I am seeing different colored blobs, not necessarily lights or flashes, it just looks like spots I guess you would call it. Sometimes they’re orange, sometimes yellow and sometimes blue. Anyone have suggestions?

One of the most common complaints as well as questions asked on this web site are related to floaters.  However, every patient describes floaters as dark, gray or like a shadow; never as having any color.  One possibility is that you're experiencing a visual "afterimage".  If a person looks at a certain color for a period of time or if the colored object is very bright when the person looks away or looks at a white wall, for example, they'll see a complimentary color.  For example, if you look at a blue object and then look at a white wall you could momentarily see an image of the object in the complimentary color, in this case the object would take-on a yellowish color .

Q.   My sister has a blood spot on her eye, right next to the pupil. What is this? She did’t poke or hurt herself, it just developed overnight.

If it is on the white part of the eye it is probably a subconjunctival hemorrhage.  Go to subconjunctival hemorrhage for more information.  Also see Pink Eye.   If the blood is actually in the front of the iris or colored part of the eye and appears to be a puddle of blood sitting in the front of the iris and pupil, then you have a hyphema which warrants immediate medical attention - See an eye doctor ASAP.

Q.    In the last few months my eyesight has been deteriorating. What I am now seeing are elongated parallel wavy lines with lots of circles in between. This is in both eyes. Neither G.P nor neurologist know what is happening. I am 20 years old. Please help.

Since you're seeing the lines and bubbles in both eyes, (we assume that you see them in both eyes at the same time and  that they also look very similar in each eye) then the problem must be located in the visual parts of the brain.  Unfortunately it is not clear what the problem might be given the limited amount of information.  Are these things that you see always present or do they come and go?  If they come and go, are they associated with anything like a headache afterwards (possible migraine with visual fortification phenomenon)?  Since they are visually related, you really need to see an ophthalmologist for further evaluation.

Q.    Bumps in eyeball.

Bumps on the white part of the eye ball can be caused by a number of things including episcleritis., scleritis, scar tissue, as well as signs of other types of eye disease and some neurological problems.  See an eye doctor for evaluation and treatment, if applicable.

Q.    What is myopia and it's symptoms?

Myopia is also called nearsightedness - you can see close objects  and can't see distant objects.  Objects up close are seen in all their detail and distant objects appear blurry.  Nearsightedness can be easily corrected with glasses.  If you are about 40 years old or older, and objects are only clear and in focus when you hold them further (and further) away, then you have a condition called presbyopia.  See the dictionary on this web site for further information about myopia, presbyopia and hyperopia (can only see things clear that are far away).

Q.   The vision in my father’s left eye top half is black. He can see out of the bottom half. This started about 6 months ago in both eyes and within a couple of days the right eye had cleared up. Any suggestions on what this might be?

We assume that your father has seen an ophthalmologist or/and a neurologist (medical doctors) about this condition.  If not, your father should seen one ASAP [NOW].  In older adults, sudden loss of vision in one or both eyes is sometimes related to some type of circulatory (blood supply) problem in the brain or optic nerve(s) or the eye(s).  Your father may have has a stroke, in which the blood supply to his brain and/or eyes was interrupted.  Strokes occur when the blood vessels are suddenly clogged (by clotted blood, calcium fragments or other material) thus preventing the blood and needed oxygen from reaching the brain and/or eyes.   Sometimes the embolus (the thing that clogged-up the blood vessel) will clear and blood supply will be restored.  The embolus appears to have cleared, at least in the right eye.  By now, the damage and loss of vision in the left eye is probably permanent.  Of great concern, if he has not received treatment for the  original cause of the loss of vision, he is at great risk of having another stroke so HE REALLY NEEDS TO SEE A MEDICAL DOCTOR TODAY.

Q.    My eyelids get real tired.   I have to make an effort to keep them open.  It is not out of sleepiness.   Can you help?

Probably not.  Need more information.   Are your eyelids fine in the morning and then as the day progresses they get harder to keep open?  Also, is it both eyelids or really one eye lid?  Have you ever had any damage/injury to  the upper face area?

If your eyelids are fine in the morning and as the day progresses they are harded to keep open, particularly if it is only one eye, then you may have the early signs of myasthenia gravis.  If you answer no to the first question, then a number of things can cause the eye lids to be difficult to keep open including nerve damage (either through disease or injury) that controls the eyelids .   See an eye doctor for evaluation and treatment.

Q.   We discovered that my mom’s natural eye lens has slipped due to which reason we dont know (she is a thyroid patient & was on the border line for high blood presure)...she was’nt hurt in the eye or anything of the sort...what i need to know how safe is the surgery in order to replace the natural ?? what will be the cost of the surgery???

The removal of the natural lens and replacement with an intraocular lens is now performed several hundred thousand times a year in the US alone and is a generally safe outpatient surgical procedure. It is the same surgical procedure as when a person with a cataract has a cataract operation with the placement of a intraocular lens. However, as with all surgical procedures there are risks involved including infection, retinal detachment, misplaced/mislocated lens, as well as post surgical complications.  The eye surgeon will go over all the risks of the operation with you/your mother before the operation.  We don't deal with costs of things; however, this type of surgery is usually covered by insurance.

Q.   Where can I get Financal help or Assistance.  I have RP Disease paired with Cataracts and no insurance, but i also work. Any suggestions will be greatly Appreciated.

Although the Ohio LIONS Eye Research Foundation does not provide individuals with financial help or assistance, individual LIONS clubs in each city do sometimes provide individuals in their area with assistance for particular reasons.  So one possibility is to contact your local LIONS club (usually ask around and find out who a member is and when the club meets).  Go to the local BSVI (Bureau of Services for the Visually Impaired) for help on the job, if applicable.  Contact the Department of Health in your state to see what they can provide for help with the surgery to remove/replace the cataracts.  Also look into applying for Medicaid/Medicare for assistance with your health related needs. 

Q.    When looking at white objects it is all yellow or just part of it will be bright yellow.   What could cause this problem?

Seeing yellow is referred to as xanthopsia.   Xanthopsia is caused by a number of things including certain drugs and chemicals such as barbiturates, bromides, DDT, digitalis, Hydro Diuril (Hydrochlorthiazide), methyl salicylate, Metrazol, phenacetin, picric acid, santonin streptomycin and sulfathiazole.  Other drugs and chemical reactions also can surely cause a patient's vision to appear yellow when looking at white objects.  A warning is that digitalis and digitoxin poisoning can cause xanthopsia.  You should make a list of all the medications that you are taking or have taken before the development of the xanthopsia and go over the list with your doctor or/and pharmacist to determine which drug or drug interactions may have a side effect of xanthropsia.  If they have no success in finding out why you see yellow you should also see an ophthalmologist for further evaluation.

Q.    Can phototherapeutic keratectomy [PTK] be used to treat Fuch's dystrophy and is there any research study on the application of PTK to Fuch's dystrophy?

No.  Because Fuch's dystrophy involves a problem with the corneal  edothelium and basement membrane, PTK would not help in Fuch's.  PTK, almost identical to PRK (photorefractive keratectomy) but without the concern for changing refractive error, is limited to the epithelium - the front most part of the cornea.  As to your second question, Waring et al (1997, J. Refractive Surgery May - June Issue, p308-310) published a case report on PTK and Fuch's dystrophy and stated "A 63 year old female with Fuch's ...was inappropriately treated with [PTK], leading to a central focal circular corneal scar and decreased visual acuity that required penetrating keratoplasty" (cornea transplant).

Q.    I wear contacts, and lately my contact cut my eye.  Now my eye is becoming very red and sensitive to light.   What is that?

When you say that your contact "cut your eye", we assume that  you mean that your cornea was scratched.  A scratched cornea or corneal abrassion is very painful and also leads to sensitivity to light (photophobia).  Since your eye is very red, you may now also have an infection of the cornea, and some of these infections can be very serious.  You need to see an eye doctor ASAP for treatment and should not wear your contacts again until you're examined by the doctor.

Q.    Yesterday my husband started complaining of seeing a dark spot & pain/pressure in his eye - I think he needs to see a doctor, but he doesn't think its serious.  What are some of the problems this could be indicative of?

Your husband's symptoms could be a sign of a serious eye disease including, but not limited to, glaucoma, retinal detachment or hole, diabetic eye disease and age-related macular degeneration among others.  If caught early, many of these eye diseases are treatable.  If he waits too long and has one of these problems he could become legally blind for the rest of his life.  If it turns out to be something more minor, then both of you can have peace of mind for the price of a simple eye exam.  Have him see an eye doctor today.

Q.    Seeing flashing lights at corner of eyes.

We assume that you mean that you see flashing lights off to the side in your peripheral vision.  Flashing lights can be a sign of several retinal problems so you do need to see an eye doctor about the problem.   Flashing lights are a symptom of a retinal tear or detachment, vitreous tags, posterior vitreous detachment, among others.   See other questions about flashing lights for more information.

Q.    Isochromatic?

Means one color or same color.

Q.    Are there any articles on work lighting or office lighting?

It would seem that OSHA (osha.gov) would have information on this topic, but a search of their site lead nowhere.  We did find an interesting, although rather technical article at http://www.nrc.ca/irc/light/lq_project/publications/LQ1.html.

This article/site gave some interesting background on the topic of work and office lighting - a topic much more complicated then it would seem at first glance.

Q.    My eye itches and burns and its a little swollen and i feel a lump in my upper lid closest to my nose.

A lump on the upper eye lid toward the nose may indicate a lacrimal gland inflammation and disease.   As a result, secretion of the gland is decreased and your eyes become dry, itchy and burn (called keratoconjunctivitis sicca).  See an eye doctor for evaluation and treatment.

Q.   My eyes is diagnosed with Anisometripia plus Vertical Muscular Imbalance, so what is the effect on the person’s ability to live, learn and digest information if either or both of the disease are not discovered? ie: education wise?

Probably none.  Anisometropia is simply a difference in refractive error between the two eyes, such that one eye may be a little more nearsighted than the other eye.  If you are under the age of 10 years or so, anisometropia can cause a lazy eye.   So, in children it is very important to correct the anisometropia and to check for lazy eye (amblyopia).  Anisometropia is easily corrected with glasses.  A vertical muscle imbalance is also probably a minor problem that, if not too large, can be corrected with some prism in the glasses or needs no correction at all. Together, in an adult, anisometropia and a small vertical muscle deviation are minor problems that should not affect knowledge acquisition and education.

Q.    Please, I have a question regarding to myopia which I have not seen in Q/A section. My son has a myopia since the age of 10 year. Now he is 18 years. His power is constant for the last five year at -3.5 but his vision never comes to 6/6. It is always 6/9. Doctor say nothing to worry. I would like the probable cause for it.

Good question but with a difficult answer.  As you are aware, normal visual acuity is said to be 6/6 or 20/20 (Snellen).  In reality however, most patients will have better than 6/6 (20/20) and a few will have, as in your son's case, 6/9 (20/30) or worse visual acuity.  In general we get concerned when a patient cannot be corrected to 6/6 (20/20).  Sometimes the patient may have a mild case of amblyopia (lazy eye) in BOTH eyes, or a mild case of optic nerve hypoplasia (small optic nerves) that causes the patient to have mildly reduced vision.  Sometimes the reason for the mild loss of visual acuity is never known.  As long as the patient has no other complaints then there is nothing else to be done or concerned about.   However, if vision starts to decline (say to 6/12 (20/40)) or worse then there is a real problem.  So as long as your son maintains 6/9 (20/30) visual acuity it will have to be just something that he, and you, will have to live with.  The fact that your son is myopic (- 3.5) and has a stable refractive error probably has nothing to do with his reduced visual acuity.

Q.    What is a nevus?

A nevus is any lesion or abnormal tissue, either excessive or a deficiency of, that is congenital (i.e., born with).  A nevus is a stable condition. A nevus can involve any body part or component.  Regarding the eye, the most common nevus is probably a conjunctival nevus (on the white part of the eye) which is a benign, small elevated bump that can range in color from a pale to dark brown.   A large nevus on the skin is referred to as a mole.

Q.    I’d like to know if you or anyone else has any information regarding acute episodic events where a patient’s vision has the following presentation:  1. It starts as a small wavering non-focusing field that overlays the true image. A small peripheral blotch.  2. After a few seconds, the image starts to grow as a circular wavering field where the center of the image gains focus as the circle grows. It’s almost like a smoke ring and the patient is stepping through the ring. 3. Patient noted that closing either eye does not effect the image malformation. It just seems to be in the vision field.  4. Typically, the acute episode occurs after a direct exposure to an extremely bright light but not always.  5. Patient’s eyes were check for Glaucoma with negative results.   6. The average occurrence lasts several minutes with the patient feels a slight headache and nausea because of the object’s motion.  7. There were 5 acute attack about a month apart and then 3 attacks with about six months apart. With no additional attacks since. Patient has suffered no addition attacks for one year.  Noted that there has been a slight loss of vision over the last two to three years but was noted as normal for age group. Was evaluated by Ophthalmologist one year ago with nothing else stated nor a referral.  Patient History / Physical: Caucasian, Male, 45 yrs. old, 5 ft 11 inches tall, 230 lbs, Slightly Elevated BP, No major surgery or illness, Patient had normal adolescent illnesses (Measles, Mumps, Glandular Fever, and Pneumonia).

You describe the classic symptoms of a migraine, with the associated scotoma and fortification phenomenon.  In such a migraine, the scotoma or blind spot starts out small and looks like wavering lines on the edges.   As the scotoma grows, the patient can see through the center of the scotoma but can't see the edges because of the wavering lines of light (this is the fortification phenomenon).  The scotoma spreads outward and can sometimes involve the entire half of the visual field.  When the visual phenomenon subsides, the migraine sufferer may experience headache, nausea, loss of balance and others symptoms.  Often, a migraine will be brought about by, you guessed it, bright lights - particularly if the patient goes from a dark area (e.g., inside) into bright sunlight or vise versa.  There are some very good prescription medicines available now for migraine sufferers and, if your one, see your GP or Internist for an evaluation and treatment, if applicable.

Q.    My daughter has one puffy eye her doctor says is from the sinuses draining through her eye. but when i looked up sinusitis, that was not listed as a problem. She has been referred to an ENT specialist in the meantime. Do you have any information on this condition?

Based on your description, it is not possible to determine the problem.   Given that a doctor has actually examined your daughter, we'll agree with him/her.   In chronic sinusitis, the symptoms are wide ranging and may include postnasal drip or discharge, headache, pain and sensitivity when touching the area of inflammation, sneezing attacks, mouth breathing, and the patient may easily fatigue, have mental concentration problems and may not even want to eat.  Also go to blocked tear duct and Swollen eyes for related topics.

Q.    What causes the color of the eye to gather in spots in the iris it is red?

If your iris has red spots it is unlikely that it is pigment.  More likely the red spots are small blood vessels or/and small hemorrhages.  You really need to see an ophthalmologist ASAP because red spots on the iris could be a sign of serious eye or/and neurological disease.  For example, iris blood vessels (iris neovascularization) and/or iris hemorrhages can be a sign of uncontrolled diabetes (e.g., if you don't even know that you're diabetic).   Other diseases that could cause such changes in the iris include long standing anterior uveitis, occlusion of the blood vessels to the eye, acute iritis, acute glaucoma, hyperemia with red iris nodules, among others.  Because of the way the iris just covers the lens of the eye and the drainage of the eye, a common worry when changes take place with the iris, such as a change in color, always warrants a trip to the eye doctor because of the worry about sudden onset glaucoma.  So you need to see an ophthalmologist now.

Q.    I am searching for information on Devic's Syndrome.  I need some lay material regarding it.   HELP.

Devic's disease or syndrome is a disease that causes the demyelination of the optic nerves, those nerves that go from the eyes to the vision centers of the brain, and demyelination of the spinal cord.  The nerves have a fatty "insulation' surrounding them that allows them to carry nerve impulses.  When a disease process starts to destroy the myelin (demyelination) the nerves start to "short circuit" and reduces their ability to conduct nerve impulses.  Many doctors believe that Devic's disease is a special form of Multiple Sclerosis (MS).  Devic's disease usually starts suddenly, without warning, and usually starts with the eyes with pain followed by loss of vision in one or both eyes.  When the spinal cord becomes involved, there may also be a sudden onset of back pain, fever and loss of some ability to walk.  The legs may feel weak, difficult to control and floppy.  There may also be swelling of the spinal cord and loss of bladder control.  While vision usually returns to near normal levels, there may be persistent problems with mobility and bladder control.  The disease waxes and wanes over time and is slowly progressive.

Q.   My mother is a diabetic and has had both lens replacement as well as laser for Diabetic Retinopathy. The doctor now wants to do more laser. Will this help? Is there anything else that can be done to stop further eye loss or better still, improve her vision?

Yes, continued "laser surgery" is needed and required to help control the proliferation of abnormal blood vessels and to control bleeding and further loss of sight.  Unfortunately, treatment for diabetic retinopathy is far from ideal but treatment options are very limited.  If applicable, the patient does have some control over the situation.  In general, patients do better if they lose weight and keep within general weight guideline for their gender and height, don't smoke, eat right, exercise, maintain good glucose (sugar) levels, and take their medicine(s) religiously.  Also, it is extremely important to follow the doctor orders and have regular dilated eye exams.  

Q.    What causes lightening flashes of light in the outside corner of the eyes? Noticed at night in the dark.

Go to Flashing Lights in the corner of the eyes.

Q.   Floaters.

Questions about floaters, specks in front of the eyes, strings, blobs, etc., are the most sought after questions/concerns with visitors of this web site.  For information about floaters, go to FLOATERS.   Also see Vitamin A and Floaters.  And Test Your Eyes for Floaters.

Q.    What is lattice degeneration? My daughter who is 11 has been know to have this in her Left eye since her eyes were first dilated 3 years ago what should we do?

You should continue to see your eye doctor on a regular basis.  Lattice degeneration is usually detected in patients within the second decade of life, so your eye doctor was/is on top of things to have detected it at 8 years of age.  In general, it is not something to get overly concerned about AS LONG AS YOUR DAUGHTER HAS REGULAR EYE EXAMS.  These are needed because about 2% of patients will develop retinal tears which can lead to retinal detachment, and retinal detachments require surgery to repair.  Also, about 25% of pateints with lattice degeneration develop retinal holes which may or may not require treatment.  On average, about 8% or more of patients have lattice degeneration, so it is a fairly common finding.  Also, about 55% of patients have it only in one eye.  Go to Lattice degeneration for more information.

Q.    I was told that I have reinarts disease but can't find any information on it.   Is this a real condition, how long does it last?

Sorry, but we could not identify the disease or syndrome with either a spelling or similar sounding name as "reinarts".   This is probably why you can't find any information on it.  If you describe the condition it might help us find-out what it is.  The closest that we could even think of is Reiter's syndrome or disease.  Reiter's is a syndrome with three main components; urethritis (inflammation of the lining of the ureter - tube from the kidney to the bladder), conjunctivitis and arthritis (all the itises), with the most dominant feature being arthritis.  The cause of Reiter's syndrome is unknown, but most probably involves something to do with the immune system not working properly.  The syndrome affects more young adult males than females, is self limiting but with reoccurrence.  It is sometimes associated with venereal or postvenereal disease, particularly with Clamydia or Ureaplasma urealyticum.

Q.    Bumps on the eye?

A number of diseases can cause "bump(s)" on the eye, particularly on the white part of the eye (sclera).  Some of these include scleritis, episcleritis, pterygium, allergic reactions,  conjunctivitis, nevus and tumors(rare).  Any bumps on the eye warrants a trip to the eye doctor for evaluation and treatment, if necessary.

Q.    How much does an average surgery for esotropia cost?

We do not deal with the costs of surgical procedures.  However, in addition to the surgeon's operating costs, there would also be costs associated with the surgical room, anesthesia, recovery room and misc costs.   Esotropia surgery is now usually done on an outpatient basis; that is, in and out of the hospital the same day.  

Q.    What is rod cone dystrophy?

A rod cone dystrophy is a retinal degeneration the affects both the day light part of the eye (cones) and the night vision part of the eye (rods).  In a rod cone dystrophy, first the rods (night vision and side vision) are affected and later in the course of the disease the cones (day vision) start to be affected.  The most common rod cone dystrophy is retinitis pigmentosa (RP).   Go to cone rod dystrophy/degeneration for more general information about a related topic.

Q.   Hi, I have this problem where my eyes are constantly bloodshot. I don’t have particularly dry eys. They are the worst when I wake up and before I go to bed. I use over the counter eye drops which only mildly help for a few hours. What could be causing this? I have had this problem for quite sometime. There is nothing foreign (i.e. not conjuctivitus) in my eyes and it is equally bad in both eyes. Please help!

Very few dry eye disorders cause a daily variation that you describe that is also associated with bloodshot eyes, except meibomitis and meibomian gland dysfunction.  Patients with meibomitis often complain of burning, bloodshot eyes in the morning.  This is because there is decreased tear secretion at night and inflammatory processes serve to create eye irruption on awaking.  As the disease progresses, there is increased tear evaporation during the day which causes the symptoms to again appear in the evening hours.  Thus the morning and evening problems with the eyes.  And, as in your case, lubricating eye drops only provide temporary relief.  Because you've had this problem for some time, there may be continuing damage to the meibomian gland.   See an eye doctor, preferably one that specializes in dry eye disorders for evaluation and treatment, if applicable.  Go to Meibomian gland for more info.

Q.    Where can I donate eye glasses?

The LIONS collect used eye glasses for use in third world countries.  Many local libraries have donation boxes for used eye glasses.   Some eye glass/optician shops and Eye Clinics and Ophthalmology or Optometry departments also collect used eye glasses.  If you know someone that is a LIONS member, he/she would probably be happy to take the glasses.  

Q.    My father has just been in a car crash and as a result is blind at present. The doctors seem to think he has a pale optic nerve. What is this and is this treatable.

Pale optic nerve(s) after a car crash could be a sign of optic atrophy - or abnormal changes to the optic nerves due to trauma.  In layperson terms, optic atrophy means that the optic nerves, those nerves that run from the eyes to the visual parts of the brain, are degenerating or dying.  If your father has optic atrophy, treatment options are very limited and the prognosis for significant return of vision is poor.  Optic atrophy or pale optic nerves is never a good sign and, in general, is not a treatable condition particularly given that it was the result of trauma.   If your father regains some vision it may take place in the next year (a year after the accident).  Usually after trauma it can take about one year for whatever vision recovery there will be to take place.  If the doctors are not sure about the pale nerves, hopefully they'll refer your father to an ophthalmologist for further evaluation.

Q.    My father has a lesion or small knot on the white part of his eye. His optician has sent him to a specialist. What could this be?

Go to Bumps on Eye for information.

Q.    I do not think this falls into the "floaters" category. A few weeks ago, while 38 weeks pregnant, I all of a sudden lost a section of my vision in my left eye. It was like a "blank" in the visual field that would move with my eye. For instance, if I were looking at an object in the "right" way, he would disappear. Very scary...So I called my midwife who said she heard of this phenomenon several years ago, and it was not pregnancy related. She said I should rest and my vision should return to normal in a few hours. It did. It has not recurred. The "blank" spot was not like anything in the "holes" simulation, but was more of a rectangle in shape. Do you have any info on this? Thanks!

It is unclear what the problem could be.  The most common cause of temporary field loss is due to migraines.   Other conditions that can lead to temporary field loss include transient ischemic attack (TIA).  To be on the safe side, you should see an ophthalmologist, perferably a neuro ophthalmologist (an eye doctor that specializes in the eyes and in neurological problems) for evaluation.

Q.    Could someone please give me some information "lymphatic anjectasia" (the spelling must be incorect, as I can’t find it anywhere. It is bubblewrap like blisters on the surface of the eye. Thank you.

The correct spelling of the condition is lymphangiectasias.  Lymphangiectasias causes localized swelling of the lymphatic vessels - tortuous dilatations of conjunctival lymphatics that wax and wane over time.  These do look sometimes like "bubbles" as you describe

Q.   I am 58 -years ,for the last one and a half years,i have developed inocular-degeneration..it is more in left eye and is also developing in right eye as well,as a result of this there is dimness of vision and the vision also gets blurred in day light.  As such there is no pain or any visible sympton.i am using eye site glasses for the last 30-years.

Given your age, you may have age related macular degeneration (ARM), the leading cause of significant vision loss in people over the age of 60.  There are several types of ARM and some of these types are treatable.   Also, there has been new developments in the treatment of patients with ARM that can reduce the probability of vision loss in the future.  We hope that you're under the care of an ophthalomlogist who can perform the necessary treatment, if applicable.   If not, you need to see an ophthalmologist ASAP - your future sight may depend upon it!

Q.    What is Pingueculoe?

The correct spelling is pinguecula - a yellowish colored spot on the white part of the eye near the cornea and usually on the side of the eye near the nose.  These are commonly seen in the elderly, who have had lots of exposure to the sun (exposure to UV light), wind and warmer climates.  Many believe that a pinguecula is an early version of a pterygium.  

Q.    My husband, age 67 and a Type II diabetic, went to the eye doctor on 7/11 complaining of dry eyes, particularly in one eye. He had a complete eye exam and the doctor found no evidence of disease and recommended soothing eye drops which my husband is taking. On 7/14, he suddenly developed a floater in one eye, having never had them before. In addition, both eyes are bothering him more than ever—they are extremely dry and red. Could there be a connection with the exam or with the eye drops? How long do floaters typically last? It is very bothersome to him and our doctor has said he could have it "forever". Thank you in advance for your response.

Sounds like your doctor is on top of things.   A real problem in patients over the age of 50 is dry eye disease (see Featured Article).  The symptoms and your description match the disease.  Also, your doctor is more or less right about floaters, although they come and go, once you have them they just keep coming and coming (although technically it isn't the same floater you see forever).  Your husband's symptoms are probably not related to the exam or use of eye drops, although one should be careful in the use of lubricating eye drops - too much of a good thing (used extensively over a long period of time) can cause problems in of itself.  If your husband continues to have problems and particularly if he all of a sudden sees a LOT of floaters, please see your eye doctor again for further evaluation.

Q.   I recently asked a question regarding my father who was blinded in a car crash. it was originally stated that his optic nerve had died, but further tests have shown that his left eye is responding to light, even he still states it is completely dark. is there any hope of his eyesight returning or is this just a false hope?

It is always a positive sign that the pupil(s) dilate to light.   Whether your father's sight returns or whether he may have some residual vision is unknown.  As noted earlier, it may take several months, up to a year, recovery before you and he know how much vision there is remaining.

Q.    What is the procedure for glaucoma?

The surgical procedure for glaucoma depends on the type of glaucoma.  Basically, there are three types of glaucoma; primary open-angle glaucoma, primary closed-angle glaucoma and normal pressure glaucoma (a variant of primary open-angle glaucoma).

In primary open-angle glaucoma, surgery may include laser trabecular surgery in which a laser (argon) is used to repeatedly "stimulate" the trabecular meshwork (located near the outer part of the iris) which, in turn, causes increased flow of aqueous fluid out of the eye and thus decreased pressure in the eye.   Nobody really knows HOW laser trabecular surgery really works.  In general, repeated laser trabecular surgery is less and less effective when repeated on the same eye.  In open-angle glaucoma surgery may also include so-called "filtering surgery" - where the surgeon may perform one of a number of different surgical procedures (trabeculectomy, trephination, thermal sclerostomy, posterior or anterior lip sclerectomy) with the goal of increasing aqueous flow out of the eye.  In very advanced cases the surgeon may even place a tube in the eye to facilitate drainage.   Typically certain medicines are also used to control either the glaucoma or improve the chances of the surgery.

In closed-angle glaucoma, the surgery is usually laser iridotomy - where a laser is used to "burn" holes through the iris (colored part of the eye that forms the pupil).  These holes help aqueous fluid to pass from the inner part of the eye to the front part of the eye where it can drain out of the eye and thus reduce pressure inside the eye.  All surgeries may have complications, so your eye doctor will go over the possible complications with you before the surgery.  The surgeon is also the one to ask about the chances of a successful surgery and what medicines you may have to take following the surgery as well as the number of follow-up exams.

Q.    Is there a treatment for adults with amblyopia that failed correction at a young age?

In general the answer is no.  However, if you have a certain type of amblyopia, called anisometropia or refractive amblyopia, you could benefit from wearing your corrective eye glasses. Also, recent research has shown the L-dopa (levodopa) can improve your visual acuity in the amblyopic eye by about one line on the eye chart (see recent breakthroughs for more info on L-dopa).   Finally, ALL amblyopic adults should wear protective glasses with polycarbonate lenses to protect the remaining good eye.

Q.    I have stargardt's...I don't fully understand that with today's technology we can't create/make a new replacement to fix this problem.  What's stopping us?

A number of things are preventing us from curing and/or developing (eye) replacements for Stargardt's disease.  Some of the roadblocks include lack of funding for basic and applied research into the problem, lack of knowledge of the disease as well as so-called animal rights groups that think, wrongly, that the use of animals (mostly rats and mice) in research is not important for medical discoveries.   However, with developments based on the human genome project and with advances in scientific knowledge including knowledge gained from animal research, a cure is predicted in 10 - 20 years.  Most likely the cure will be based on gene therapy whereby the defective gene(s) that cause Stargardt's disease will be replaced with correctly working genes.

Q.    I am scheduled for an MRI next week to find out why my optic nerves are swollen (papilladema).  What are the scenarios and treatments for what might be discovered?  It will be a week before I have the MRI, is this too long to wait?

There is no way all the possibilities of what might be found on the MRI can be discussed.  Likewise for the treatments.  There is also a good possibility that they'll find nothing.  Waiting a week seems actually fast given that some MRI facilities, depending on location, are booked for several weeks in advance.

Q.    My father has had multiple procedures related to the treatment of ARMD.  The latest was the photo laser dye treatment and since that procedure has developed subretinal fibrosis; a term widely used but not described.  Please explain what this is and what can be done.

Fibrosis refers to the formation of fibrous tissue, usually as a result of inflammation or as a result of a loss of tissue and subsequent replacement of that tissue with fibrous tissue.  Subretinal fibrosis thus means that the fibrous tissue is developing underneath the retina, possibly related to the ARMD or the treatment(s).  In general nothing can be done about subretinal fibrosis.  As the ARMD progresses, there is more and more damage or/and inflammation to the retina and to the other layers of cells in the back of the eye, and the fibrosis is the body's response to this damage or inflammation.

Q.    I am legally blind and I was wondering if there is any possible way I could get a drivers license?   I want to know all of the options I could consider.

In several states, including Ohio, a legally blind person MIGHT be able to obtain a drivers license if they can pass a lengthy vision evaluation and complete a very detailed and comprehensive driving test with a bioptic telescopic device.   The program costs several thousand dollars and there is no guarantees that you will actually get a drivers license.  Call 614-292-1104 to reach the Low Vision Rehabilitation Services section of the College of Optometry for more information about the low vision drivers program.

Q.   In the Web page, the first image is not the image of normal view, it is the same image as "Ring or Donut Scotoma" image. I like this page and I would be pleasing you updated the page with images of more eye diseases. Thank you.

Thanks for the input and correction.  We have added more to Simulations and we'll continue to do so as time permits.

Q.    I have an 11 month old son and the optician said that he has black pigments in the back of his eye on the retina.  What is this?

Pigmentary changes in the back of the eyes, or retina, can be a host of different things, some not serious and some very serious.  You son needs to be seen by a pediatric eye doctor ASAP.  Once you have a diagnosis, we can help you with additional information.

Q.    I had each eye seeing the same object seperately, what causes that?

If your eyes are not pointing in the same direction, you will experience double vision or diplopia.  Some patients can do this voluntarily and in some patients diplopia is caused by something that causes the eyes not to point in the same direction (eye muscle weekness, damage to the nerves that run to the eye muscles, for example).

Q.    One of my girlfriends has ever since her pregnancy been suffering of something called subretinal neofaxulanisation.  A severe eye condition which started during her second trimester.  Her baby is now almost 3 months old and the desease / fungus (???) is starting to effect her other eye.  The specialists can't tell her much about the cause or possible cure. She has now undergone surgery two times, sees 20 - 40 % and has no idea what to expect next.  She's 32 years old.   Are there any other people out there who might be suffering form the same thing and know more about it?  Thanks in advance for your time.

Your friend probably has subretinal neovascularization, probably as a result of diabetes.  The diabetes and associated proliferative retinopathy was probably aggravated by her pregnancy which, in turn, caused the further neovascularization and possible subsequent retinal hemorrhages.  [Although diabetes can develop during pregnancy, gestational diabetes does not lead to diabetic retinopathy and subretinal neovascularization]  Subretinal neovascularization refers to the development of abnormal blood vessels underneath the retina.  These blood vessels tend to leak and where they leak vision is lost (See Simulations of diabetic retinopathy).  Laser scatter photocoagulation ("laser surgery") is the treatment of choice for retinal problems associated with diabetic retinopathy.   It sounds like your friend is receiving appropriate care; unfortunately, the condition is a serious one with guarded prognosis. 

 

August 2000

Q.    I have recently had two separate incidents where it suddenly appeared as though I was looking either through water or through a prism. The first occasion the prism effect was only in the outer area of my field of vision. The second occurrence the prism effect was in the center of my field of vision. I was recently told I have high blood pressure and put on Tenormin. The prescription was made without any further exam, just my blood pressure reading at the time I went in for a sore throat and cough. I am a 49 yr old female in relatively good health, but I do suffer from allergies and asthma.

At first glance, your visual experiences are similar to those experienced by migraine suffers.  See Migraine in the Q and A Archives section for more information.  However, your visual symptoms could be related to high blood pressure.   You should be examined by an eye doctor to rule-out any eye problem, per se.

Q.    I want to thank you that you paid attention to my previous e-mail and you fixed the wrong image in the simulations web page and you had published more simulations about others pathologies. I think that this page can help people to understand visual impairments viewing.  Nice work

Thank you.  We'll add more simulations as time permits.

Q.   What is "PIC"?

Click on PIC  in the Q and A Archives for information.  Or, do a Find (under Edit) for PIC in the Q and A Archives.

Q.    Thank you for answering my two previous questions regarding my father who was involved in the car crash. Since the last question he is now seeing light in his left eye, but only for periods of upto a hour then it goes dark again. Could you give me some indication of his condition and is his chances getting better of recovering some vision.

It is impossible to give an impression of his condition or his chances of gaining/recovering vision.  His doctors are in the position to answer these types of questions.  In general, the regaining of any sight is always a good sign and, of course, the more he regains the better the prognosis.  But the recovery process will be a long one and sometimes takes a year for most vision recovery to take place. 

Q.    I heard about braces for the eyes.  It is when you wear contacts while you sleep and during the day you take them off and you can see without them.   Have you heard about this?  I think they cost about $2,000 for both eyes.

The use of contact lenses to reshape the cornea of the eye has been tried for a long time with only modest success.  The effect is short lasting and used only on patients with mild refractive errors.  Why a patient would want to wear contacts at night so they don't have to wear them during the day is not clear.   However, there are serious problems with wearing contacts at night, particularly if the patient also wears them all day long.  Serious corneal infections can occur with any extended wear contacts.  

Q.    Hi.  This doesn't have anything to do about a disease but please don't pass this off as nothing.  I am seriously considering a career as an eye doctor and I was wondering how many years of schooling it takes to be an eye doctor.   And what classes and how much money?

There are two types of eye doctors; optometrist and ophthalmologist.  To become an optometrist requires a four year bachelors degree and three or four years of optometry school.  Sometimes an optometrist will also do a one or two year specialty fellowship (e.g., glaucoma) or research fellowship after completing the OD degree.  An ophthalmologist is a MD (medical doctor) or DO (osteopath) with a specialty in ophthalmology.  The ophthalmologist needs a four year bachelors degree and four years of medical  or osteopathic school, usually followed by a one year internship and then followed by a three or four year residency in ophthalmology.   Following the completion of the ophthalmology program, the ophthalmologist may take one to three years in a specialty (e.g., pediatrics).  Although things are changing to blur the distinction between an optometrist and an ophthalmologist, one of the big differences is that an optometrist cannot perform surgery.  The types of classes one takes to become an optometrist or an ophthalmologist is beyond the scope of this web site - suffice it to say there are a great deal of courses related to anatomy, physiology, chemistry, optics, and disease.  Costs? A lot!

Q.    Weepy Eyes.

Eyes that water excessively either have a problem with excessive tear production or a problem with proper tear drainage.  Both warrant a trip to the eye doctor for evaluation and treatment, if applicable.  In general, patients that only complain of weeping eyes usually have a problem with epiphora - tear drainage.   Warning: some serious eye diseases do have as a symptom watery or weeping eyes (e.g., glaucoma), so please see an eye doctor.

Q.    Was there another disease concerning the eyes named after a man other than Graves (disease)?

Yes.  A wild guess would be about 200 diseases.

Q.    A What is bletharitis (Blepharitis)?

Blepharitis is a common condition that can be controlled but not cured.   Blepharitis is caused by several things including Staphylococcal infection and Seborrhea (excessive secretion of lipid from glands). Blepharitis may also be associated with dandruff, eczema, allergy, drugs and Acne rosacea.  Signs of Blepharitis include scales on the lashes, red swollen lids, burning and itchy eyes and discharge (e.g., serum-like or mucus like) from the eyes.

Staphylococcal blepharitis typically is an acute inflammation and occurs mostly in females.  It is also associated with Dry eye.  Seborrhea blepharitis is reflected by oily,greasy scales around the lashes and there may be excessive secretions or the glands may become plugged.

Treatment often includes the following:

  • Use a clean and warm (the warmer the better) cloth and hold over the closed eyes for 5 to 10 minutes.  Resoak the cloth to keep it warm as needed.
  • Once the lids are warmed and softened, clean the lid margin and lashes with diluted baby shampoo twice a day.  Continue to do this even if you don't feel that it is working.  Sooner or later things will improve.
  • If applicable, apply an antibiotic ointment to the lid margin as indicated.
  • If you have dandruff, use an antidandruff shampoo...forever.
  • If you're a woman, or a man for that matter, try changing the brand of make-up that you use or, better yet, don't use make-up.  Even if you don't use make-up near the eyes, the eyes can still become contaminated by indirect contact; for example, by your hands touching your face and then your eyes or by rubbing the make-up off onto a pillow and then into or near the eyes.
  • If you have eczema, ask your doctor about a steroid ointment to treat it.
  • If you are using drugs, ask your doctor if the drug(s) are associated with blepharitis.  If necessary discontinue or change drugs.
  • Most importantly, practice proper hygiene.  Wash you hands every time you use the bathroom, wash your face and shampoo daily.
  • If you use contacts, you must follow proper cleaning instructions for the contacts and be sure that your hands are clean before touching the contacts or your eyes.
  • Never rub your eyes with your fingers.  If necessary, use the back of your hand or knuckle which is less likely to be contaminated.

Will you be able to wear contacts again?  That is a good question for your eye doctor.  Blepharitis waxes and wanes over the years and if you're able to control the outbreaks by following the above recommendations you may be able to wear contacts again.  Unfortunately, since blepharitis is associated with dry eye in some cases, be careful - blepharitis can lead to complications including corneal ulcers and conjunctivitis.  See an eye doctor for diagnosis and possible treatment.  Good luck

Q.    How do I address the public on eye donations?

The most important thing is to have EVERYONE sign the Anatomical Gift card as part of the driver's license renewal form AND to carry the anatomical gift card with them at all times.  Ideally, donors should check the box "any needed organs or parts." As an alternative, if you just want to donate the eyes, make the box "The following part(s) _______" and write-in "eyes."  The people in charge of procuring body parts will do the rest.

Q.    Bulging Eye.

A bulging eye is a sign of a potentially serious eye or neurological problem (the most common problem is Graves disease, thyroid eye disease).  You should see an ophthalmologist ASAP for evaluation and treatment, if applicable.

Q.    What is it when you see stars when you close your eyes at night?

Its time to go see an eye doctor.  Seeing stars or bright specks of light or flashes of light are all indications of a possible retinal or vitreous problem.   Some of these problems include retinal tears, detachments, vitreous detachment (posterior vitreous detachment), among others.  Less likely but also possible are disease of the optic nerve.  See an eye doctor for evaluation and peace of mind.

Q.    I see a blurry bit in both eyes and when I do I get a real bad headache.

Go to Q and A Archives and do a Find (under Edite) for Migraine or/and fortification phenomenon.  Just to be on the safe side, you also should see an eye doctor or an internist for evaluation and treatment, if applicable.

Q.   Macular Hole.

A macular hole is a lesion in the fovea - that part of the macula or central part of the retina used for reading.   To the eye doctor a macular hole looks like a hole or depressed circular or oval area that typically is reddish in appearance.  To the patient a macular hole looks like a dark area or scotoma in which the patient can't see through (see simulations).   Prior to a full-blown macular hole, a "pre-macular hole lesion" may be present and these have been referred to by various names including macular cyst, involutional macular thinning or impending macular hole.  Depending on the severity, size and location of the macular hole, the patient may have from about 20/50 to 20/400 visual acuity in the affected eye.  Some macular holes, about 10%, partially resolve or improve, but the majority are permanent as is the loss of vision. Usually only one eye is affected and  women are affected much more than men.  Trauma to the eye accounts for about 15% of macular holes, while the rest are typically associated with aging (50 and older).  Because a macular hole is difficult to diagnose, some tests that the eye doctor may order include a fluorescein angiogram and a biomicroscopy with a contact lens.  A retinal detachment may result from a macular hole and surgery may be needed.  Ophthalmologists have tried a number of treatments for macular holes with varying degrees of success.  A patient with a macular hole must see the eye doctor on a regular basis.

Q.    I seen dark spots in my field of vision.. These spots are of various shapes and sizes and move back and forth as I look around a room. I have been told they are called floaters. I have seen them for years and have become accustom to them. They become very clear on bright days or against white backgrounds. They appear to be nerve endings or even cells. can you tell me more about them?

Go to Simulations for a view of floaters.  Also, go to Q and A Archives, follow the directions for doing a search with your browser for floater or floaters.

Q.    Our son is 5 yrs old with amblyopia. Dxd at 4 and 1/2 yr old at routine eye check--20/200 in affected eye(secondary to esotropia with minus 5 diopters). After 9 mos patching, mostly 8-10 hours daily, max improvement is 20/60, but now also has more strabismus. Would l-dopa and eye exercises help to get more improvement?

These are both good questions and your eye doctor is the best person to answer these questions.  Why not ask him or her?  In general, L-dopa will improve vision in the amblyopic eye by 1 - 2 lines.  At present, we recommend L-dopa plus occlusion therapy AFTER all other attempts/treatments have run their course.   After you son's vision has improved to some stable point, his eye alignment must be addressed/treated with surgery, glasses, or/and orthoptics, depending on the situation.   Your eye doctor may also consider penalization therapy, whereby eye drops are placed in the stronger, dominant eye to blur the image and help the amblyopic eye gain vision.  Unfortunately, treatment for amblyopia is a long one.  If you live in Ohio, there is a new program for amblyopic children and their families.  The program is called the Ohio Amblyope Registry, and more information about amblyopia can be found at their web site; ohioamblyoperegistry.com.

Q.    Every time I turn my head, in either direction, I see what looks like a flash of light in the far right hand corner of my right eye. what could have happened?

Flashing lights can be a sign of several retinal problems so you do need to see an eye doctor about the problem.   Flashing lights are a symptom of a retinal tear or detachment, vitreous tags, posterior vitreous detachment, among others.   See other questions in the Q and A Archives about flashing lights for more information.

Q.   Twitching eye.

Lid twitching of one eye or the corner of an eye, as well as facial tics, is a common complaint in patients and seems to be exacerbated by mental or physical stressful situations, lack of sleep and possibly by stimulates such as caffeine/coffee.  The literature is sparse on this topic, however, as it appears to be a benign and fleeting problem.  Only rarely does eye twitching reflect a more serious neurological problem.   If the eye twitching is more like a facial spasm such that the eyes close, you may have blepharospasm.

Blepharospasm is an involuntary contraction of the muscles around the eyes.   It is a progressive disorder that sometimes starts with one eye but almost always involves both eyes as the disorder progresses.  Interestingly, the spasms do not occur during sleep and are exacerbated by stress and fatigue.  The cause of blepharospasm is not known and treatments are limited.  If the eye twitching is possibly a blepharospasm, see an Ophthalmologist since there are some surgical treatments that may be considered.  Sometimes, but rarely, facial spasms may be a sign of a more serious condition and need to be evaluated by a Neuro-Ophthalmologist.  Go to the Q and A Archives and use your browser to do a Find (under Edit) for twitching for more information on a twitching eye.

Q.   Hi I am 16, and over the past year or two I have developed purple bags underneath my eyes. I don't do drugs or drink a lot, I get the proper amount of sleep and vitamins and drink a lot of water. I was just wondering does this have anything to do with my actual eye and if you have any ideas on what's causing this please tell me??? thank you!

 

Dark circles under the eyes or darker appearing skin under the eyes can be due to a number of factors.  The lack of adequate sleep will cause the eyes to appear swollen or puffy and darker than normal.  In women, hormonal changes can cause the skin under the eyes to darken.  As part of the aging process, small wrinkles under the eyes will also cause the appearance of dark skin under the eyes.  Finally, the skin under the eyes will appear dark because of shadow. 

What can you do about it?  See an Ophthalmologist that specializes in cosmetic surgery or reconstruction surgery for an opinion.  Although surgery is not typically an option, the Ophthalmologist will diagnose the problem.  If the skin is indeed darker than normal certain bleaching agents can be used to lighten the skin.   If the eyes appear darker because of wrinkling of the skin, certain laser surgery can be used to remove the wrinkles.  Certain cosmetics, even for men, can be used to cover-up the darker appearing skin.  Finally, be sure to get enough sleep and take regular rest breaks every hour when using the computer.  Go to the Q and A Archives and do a Find (under Edit) for dark circles for more info on bags and dark circles under the eyes.

Q.   What is posterior vitreous detachment?

Go to the Q and A archives and do a Find (under Edit on your browser) for posterior vitreous detachment for info on this topic.

Q.   What is a growth on the white area of the eye?

The spot may be several things.  A number of diseases can cause "bump(s)" on the eye, particularly on the white part of the eye (sclera).  Some of these include scleritis, episcleritis, pterygium, allergic reactions,  conjunctivitis, nevus and tumors(rare).  Any bumps on the eye warrants a trip to the eye doctor for evaluation and treatment, if necessary.

  A dermoid cyst is a noncancerous tumor about the size of a pea that is usually present since birth.   A dermoid typically looks yellowish-white (tan would be in the ball park) and is usually on the white part of the eye - sclera.  Dermoids do tend to increase in size during puberty.  Removal of a dermoid is usually done in the first 5 or so years of life.

Another possibility is that the spot is a nevis - a collection of darker pigment on the sclera.  However, a nevis is usually darker in appearance than that which you describe, although a nevis can be  caused by a thinning of the sclera which allows the darker choroid to show through.  Depending on your complexion, the choroid can be tan to darker tan.  A nevis, however, does not increase in size. 

A pterygium, after the Greek word meaning "wing", is a triangle shaped spot on the conjunctiva (thin membrane that covers the exposed area of the sclera) and it usually, but not always, occurs on the side of the eye near the nose.   Pterygiums often occur in people who work outside in dusty, windy climates.   Sometimes they can increase in size and affect the cornea and vision.  If so, it can be surgically removed under local anesthesia.  If not affecting vision it is best to just leave it alone.

Episcleritis. is an inflammation of the episclera - the outer most layers of the sclera, or white part of the eye.  In addition to redness and discomfort there is sometimes a nodule present in the area of redness.  Episcleritis is sometimes associated with rheumatoid arthritis, ulcerative colitis and gout, but most of the time the cause is unknown.  Wearing contacts will aggravate the condition and make the eye more red and painful.  The reason the eye is red is because of the swelling of the blood vessels and this is why certain eye drops will constrict the blood vessels and the eye will appear white, at least while the eye drops are still working.

Scleritis, or inflammation of the sclera (white part of the eye) is a condition that mostly affects women and is fairly rare.  It can affect the front of the eye, making the eye look red and it can be very painful.  It can also be restricted to the back part of the eye, so the eye appears white but it is still very painful.  In about half of the cases it is related to other diseases including rheumatoid arthritis, ankylosing spondylitis, acute herpes, and connective tissue disease.  The other half of the time the cause is unknown.  Scleritis can also be associated with uveitis, cataracts and glaucoma.  If you have the scleritis that affects the front of the eye steroid eye drops are prescribed for treatment.  If you have the scleritis that affects the back of the eye, oral medicines are prescribed, including ibuprofen.  Whatever the bump is, you should be seen by an eye doctor for evaluation and treatment, if applicable.

Q.   My daughter is having a Cat Scan because she has pale optic nerves and has been suffering from migraines. What would they be looking for in a CAt scan?

A CT scan is a technique for examining intracranial (within the head) structures.  A CT scan is great for looking at brain tissue vs cerebrospinal filled spaces (ventricles), as such, a CT scan is often used to search for or evaluate ventricular size or/and displacement, subdural accumulation of fluid and mass lesions.  A CT scan is often used to look for brain swelling, contusions, hemorrhages,solid tumors and vascular tumors, calcifications, vascular malformations, and brain abscess.  

Q.    What is a prism?

A prism refracts or bends light.  A prism is usually placed in corrective lenses or glasses to correct for small eye misalignments.

Q.    How is a sty caused?

Go to Q and A Archives and do a Find (under Edit on your browser) for Stye or/and sty for an answer.

Q.    Is there any way to correct my vision after they were burnt with oxygen when I was a baby?

You probably have Retinopathy of Prematurity (ROP) or what was in earlier years (1950s) called Retrolental Fibroplasia.  Go to Q and A Archives and do a Find (under Edit) for Retinopathy of Prematurity.  Because ROP is a developmental problem with the retina, there is no treatment for adults with ROP.

Q.   I have a broken blood vessel in my right eye. The lid hurts. Should I be worried?

Whenever there is pain associated with an eye condition, you should see an eye doctor for evaluation and treatment, if applicable.

Q.    WHAT DOES IT MEAN WHEN VERY OCCASSIONALLY I SEE LIKE FLICKERING IN BOTH EYES, KINDA LIKE A KALIADSCOPE U R LOOKING AT THAN IT PASSE. THANKS VERY MUCH

The most common cause of the phenomenon you describe is migraines (so-called fortification phenomenon).  Go to the Q and A Archives and do a Find (under Edit) for migraine for more information.  However, other ischemic (reduced blood flow or reduced oxygen delivery) to the brain can also cause the phenomenon that you describe, so you should see an eye doctor just to be on the safe side.

Q.    I am a 14 year old girl and i have a cyst on the bottom of my left eye. I have had this problem for at least 6 months and i have had the cyst drained 2 times which was extremely painful for me. The cyst keeps coming back again and again. I would appreciate it if you have any advice if you would give it to me. Please. I do not want to have my eye drained again.

If the cyst is a sty, go to the Q and A Archives and do a Find (under Edit) for sty or/and stye for more information.  However, you should talk with your eye doctor about other possible forms of treatment, if applicable.

Q.    I have a baby boy who is now 1 year and 3 months old. On 10th July 2000 he had his MMR immunization without any high fever after that. How ever a day or two after the injection, I realised his eye closed shut on the left once he woke up from sleep in a morning. The eyes only widely open after 2 hours and so but swollen.The next day I saw another eyes on the right shows the same problem but not too serious like the left eye. The next day the swollen becoming very big at the left eye and I touched the eye lid and it was soft. My son seems did not feel any pain. I look into his eye ball but there is no reddish or simptoms that the eye was being infected. I brought him to see a local doctor and he prescribed fucithalmic, and I applied to my son's eyes two times daily. For the first two days the swollen subsided but then it swollen again even though I applied the eye-drops.

4 days ago I make appointment to see a pedetrician, and he suspected my son is having a kidney problem. However he prescribed another eye-drops called sofradex containing framycetin sulphate, gramicidin , and dexamethasone. He asked me to collect the urine if the situation do not improve. I apply the eye-drops and the swollen shrink drastically but my son crying everytime I put the eyedrops which I suspect due to the pain. Still the eyeball is white-blue and looks normal to me. No reddish or infection-like to the eye. However the swollen grows again two or three hours after I put the eyedrops, but the swollen is not too big like before. Tomorrow I will bring the urine for urine test. To describe further, the stomach of my baby is bigger than usual now, but I do not see a problem as he has a good appetite.  Lastly, my house is clean and wellkept.

It is unlikely that the MMR (measles-mumps-rubella) immunization caused the lid swelling, although it is always possible, although unlikely, that the MMR caused an allergic or hypersensitivity reaction resulting in kidney damage or disease.   Facial swelling is one of the signs of kidney disease.  However, the most common cause of lid swelling is due to an allergic reaction to something in the environment or ingested.  Since the swelling appears in the morning, check/change anything and everything that contacts the baby's body while he/she is sleeping (blankets, pillows, clothing) as well as any soaps and shampoos and see if this has any effect on the lid swelling.  Also, check/change what the infant is eating and drinking.   [Important note:  NEVER GIVE YOUR CHILD ANY HERDS, TONICS, LOTIONS, ETC!]   One of the more serious diseases that we worry about in infants and young children that has lid swelling as a symptom is orbital cellulitis, most often associated or caused by paranasal sinusitis.  Be sure to keep a close watch on your child for any other symptoms such as the eyes appearing to bulge-out or lack of ability of the child to move his/her eyes.  Also watch closely for any other "unusual" behaviors.   Be sure to keep all your doctor appoints, it sounds like your child is receiving appropriate care.  Good luck and let us know what happens.

Q.   What can cause redness in eyes and vision disturbance?

Numerous things, the most common are the "itises" including iritis and conjunctivitis and uveitis.  Go to the Q and A Archives and do a Find (under Edit) to receive info on these diseases.  Because there is visual disturbance, you need to see an eye doctor ASAP for evaluation and treatment, if applicable.  Don't delay, the longer you wait the worse it could become.

Q.    My boyfriend has recently gone semi-blind in his left eye started 5 days ago he couldn't see out of it and now all vision out of the eye is blurry and is unable to see clearly.  The doctors have said it may be eyeitis and linked to the arthiritis in his legs. Could you please help and tell me what you think it could be?

Iritis can cause vision loss/disturbances and is sometimes associated with arthritis.  If so, your boyfriend needs prompt medical attention.   For example, in juvenile rheumatoid arthritis, anywhere from 10 - 50% of patients can develop a potentially blinding eye disease called iridocyclitis.  Iridocyclitis involves redness of the eye(s), pain, sensitivity to light and decreased visual acuity.  If not detected or treated early enough (and sometimes despite aggressive treatment) the eye disease can lead to an abnormal shaped pupil, cataract, glaucoma and a general degeneration of the eye ball and blindness.   It is essential that a child/teenager with JRA have an eye exam, specifically a slit lamp exam, by an eye doctor three to four times per year to look for the very early signs of the eye disease.  Also, if the patient ever complains of an eye hurting, or seems sensitive to light, the patient should been seen by an eye doctor ASAP for evaluation and treatment.

Q.    My daughter is 4 months old. I've noticed that her eyes are not properly aligned, i.e. her eye-balls are non-aligned slightly. Could this be a serious problem or will it get rectified on its own, as my daughter gets a little older.

Usually by three months of age an infant will maintain straight eye alignment.  However, between about 3 months and 6 months of age the infant may occasionally and momentarily have misaligned eyes.  If your daughter is 4 months old and has constantly misaligned eyes, you should take her to an eye doctor for evaluation.   Some children with large, wide bridges of the nose will sometimes appear to have crossed eyes (pseudostrabismus), as in Asian-Americans.  Misaligned eyes may be due to several reasons; for example, simply eye muscle alignment problems, a sign of amblyopia (lazy eye), and sometimes because of more serious problems with one or more eyes or the brain.  Since almost everyone (American Academy of Pediatrics, American Ophthalmological Association, American Optometric Association) recommend that an infant have an eye exam at about 6 months of age, take your daughter to an eye doctor for evaluation and peace of mind.

Q.    Would like to discuss a problem and I await a decent response. During a treatment, due to absence of oxygen to the brain at some point of time the cells related to the vision were affected and now the patient has an improper vision. Is there a solution available to treat and let the patient lead a normal life. We have tried all the possible treatment (in allopathic, homeopathic). Your response would be a great help to us.

It is not possible for us to figure-out what the problem is.   If the patient is a child, lack of oxygen to the brain can cause brain damage and affect the visual parts of the brain.  Many of these patients have cortical visual impairment or cortical blindness.  Early intervention services including early infant visual stimulation is suggested for these patients.  If the patient is an older child or an adult that has had a stroke, for example, treatment options for vision recovery are limited.  Usually it can take up to a year for vision and visual function to recover (as much as it will).

Q.    This is a follow-up to a question that I asked recently and is posted on your site in the Q&A archives as "Bloodshot eyes in the morning and evening". I went to the eye doctor and was thoroughly checked over. She could not find the cause of my constantly bloodshot eyes. She said that I did not suffer from dry eye syndrome and the surface of the eyes looks fine. I was wondering if there were any surgeries (i.e. laser surgery, etc..) that could remedy the redness or any other treatments that would work on a long-term or permanent basis. Like I said earlier, I have no other symptoms and it is a basically a HUGE annoyance.....

We're glad that you went to the eye doctor and that she count not find any serious problems with your eyes.  Unfortunately, this doesn't help you because you still have bloodshot eyes.  There are no surgeries, per se, that will fix bloodshot eyes and we DO NOT recommend that you use over the counter eye drops since excessive use of such eye drops can cause problems in of itself.  A possible clue to your problem may be that you only have bloodshot eyes in the morning and in the evening and not during the middle of the day.  Patients with meibomitis or with advanced meibomian gland dysfunction do complain of a chronic sandy-gritty burning sensation of the eyes with red eyes in the morning and the evening.  The meibomian gland provides a lipid (greasy film) for the eye to control tear evaporation.  Decreased lipid release, as in the case of meibomian gland dysfunction, thus causes increased tear evaporation and red, irritated eyes.  Go to the Q and A Archives and do a Find (under Edit) for meibomian gland for further information.

Q.    How to minimize risk to eye sight.

  • Always wear protective glasses/goggles made with polycarbonate when working, if there is a chance that an object can travel at high speed and cause injury.  This includes when working with sanders, grinders, lawn mowers, weed whackers, hammering, etc.  Also wear protective goggles when playing sports if there is any chance of eye injury.
  • In general, avoid guns and toys that shoot projectiles, like BB guns, darts, etc.
  • As a general rule, always wear a hat with a wide brim and sunglasses when outside in daylight to limit sun light exposure and damage to the eye.    It is believed that excessive exposure to sun light can lead to cataracts and age-related macular degeneration (as well as skin cancer). 
  • Rather than undergoing refractive surgery (e.g., PRK or Lasik) for a refractive error, which can lead to vision loss or vision disability, wear eye glasses instead.  You avoid the chance of complications due to refractive surgery and, at the same time, have eye protection all day long.
  • If you or a child has a lazy eye, be sure to wear protective glasses or corrective lenses made with polycarbonate to protect the remaining good eye.
  • Don't smoke and eat a diet rich in antioxidants.  This may reduce you chances of developing age related macular degeneration.
  • When using the computer, follow established guidelines for minimizing eye strain.
  • Most importantly, see an eye doctor for an eye exam every year to two - more often if you have diabetes, glaucoma or age related macular degeneration or any other eye problem.

Q.    Why does my eye hurt?   Why is it puffy and watery?  I feel pressure.

We don't have a clue.  Because your eye hurts, you need to see an eye doctor for evaluation and treatment, if applicable.

Q.   I have two very small white growths in the corner of my eye on the inner most section of the lid close to the beginning of my nose. Do you know what these growths are from and what I can do?

The small white growths on the corner of the eye lids near the nose can be a number of things.  Most likely are blocked or infected tear ducts and/or allergic reaction.  What can you do? - You can go to the eye doctor for evaluation and treatment.

Q.    Macular degeneration.

For information on macular degeneration, go to the Q and A Archives and do a Find under Edit) for macular degeneration.  Also, go to Simulations of vision loss.

Q.    I am 31 years old, for 6 months I have been seeing in my right eye a light gray/lavender spot.   It is in the upper right hand side on my eye and looks like an oval that flashes when I blink.  It is always in the same spot and I can see it with my eyes closed.   I went to the eye doctor and he said that I have very healthy eyes.  That this maybe from a migraine, which I do suffer from.  Can you give me more information?   I don't beleive that this is from migraines ands I need to know who I should see next or if this is something that will go away.

Are you sure that the spot (scotoma) is only in the right eye?   If yes, then the problem is in the eye itself (e.g., localized retinal detachment) or something to do with the optic nerve in that eye.  If it is in one eye only then it most likely is not something in the brain, per se.  Did the eye doctor perform a visual field test to quantify the spot?  If no, a visual field test ON BOTH EYES should be performed.  We agree with you that this scotoma is not related to migraines.  We suggest that you see a neuro-ophthalmologist or possibly a retinal specialist for further evaluation.  Let us know what they find, if anything.

Q.    When I look to one side, the conjunctiva appears to wrinkle up in the outer corner rather than side past my eye lid.  The problem is worse in the morning and improves as the day goes on.  What causes this?  What can I do to improve the situation?

Your description seems a bit unusual, but you may be actually suffering from, among other things, conjunctivitis, episcleritis or scleritis or possibly an allergic reaction.  What can you do about it? - You can see an eye doctor for evaluation and treatment, if applicable.  Since the problem is worse in the morning, make an eye doctor appointment in the morning so he/she can have a better appreciation of the problem.

Q    What causes floaters?

Go to the Q and A Archives and do a Find (under Edit) for floaters for an answer.  Also go to Simulations.   In general, floaters are caused by both normal aging processes in the eye and disease.

Q.    My two year old boy looks at the sun. He does it through the car windows when we are driving somewhere and he looks at the reflection of the sun in the neighbors windows. What are the risks of this behavior.

If he has normal vision and does what you describe, probably none.  Of course, no one should look directly at the sun; as this will cause burn spots on the retina and could lead to legal blindness.  However, if he is looking at a reflection off clear glass, then the light energy (both visible and nonvisible) from the sun is greatly reduced and put on top of that the fact that he is looking through a car glass window, which would further reduce energy reaching his eyes, strongly suggests that it would not cause damage.

Q.   Why do I sometimes wake up in morning and blind, briefly, in right eye only? I see flashes, lightning, and darkness gradually returning to normal but dimmer sight. Also my right iris is very white during this time but the normal blue returns later, also.

It is unclear why you are experiencing temporary blindness in one eye in the morning.  Nevertheless, you need to see a doctor ASAP for evaluation.   Go today!

Q.   I have read all your Q&A's on dark flashes but am not sure my symptoms are the same. For many years, whenever I turn my head sharply to the right or left, I see lots of black rods with flashes on the ends. They dart around and I feel a little faint until I relax my head position. Should I be concerned?

Yes.  Some patients with limited blood flow through the various arteries located in the neck will experience a change in vision and/or lightheadedness when they turn their head to the left or right, as you describe.  You should go see an internist doctor for evaluation.

Q.    One pupil is larger than the other one.

One pupil larger than the other is called anisocoria.  Go to the Q and A Archives and do a Find (under Edit) for anisocoria for an answer to your question.

Q.    Which part of eye is taken out for transplant after death?

After death, the whole eye is removed.  The cornea (very front of the eye) is used for transplantation.  Other parts of the eye may be used for research.

Q.    What is a yellowish colour appears on the white of the eye?

A number of conditions can cause the white (sclera) part of the eye to change color to yellow including jaundice (possible liver disease), leptospirosis infection (an infection spread to man by opossum, skunk, raccoon for example and causing jaundice), brucellosis (an infection caused by cattle, sheep and goats, for example that infects humans), as well as chemical compounds such as picric acid or/and nitro and aromatic amido compounds and lipid deposits.  If your eyes appear yellow you need to see a doctor ASAP.

Q.    Something strange happens to my nephews eye...symptoms start with on the top corner of the lid appears a rock hard like marble thing and then swells up so much that his eye mostly shuts and then turns into what looks like a black and blue bruise but he's had no injury at all, I think its some sort of infection but not sure. Have you heard of anything like this before?

Your nephew needs to see an eye doctor.  He may have a cyst or an inflammatory occlusion of the lacrimal gland, sometimes due to a foreign body, infection, chemical injury, burns or tumors.  He also may have blepharochalasis.  Go to the Q and A Archives and do a Find (under Edit) to learn more about blepharochalasis.

Q.    My son has a growth on his eye, its red and the doctor said it will need surgery or it will cover the cornea. What is it called?

Q.   I have a growth in my eye and I'm considering remove it. It is called Pfenygium. Do you have any information on this. It is like a clear tissue that starts groing on top on the cornea. Please reply soon. I'm doing some research on it before I have it remove.

It is probably a pterygium.  Go to the Q and A Archives and do a Find (under Edit) for pterygium for more information.

Q.    Swollen eyes.

Go to the Q and A Archives and do a Find (under Edit) for swollen eyes for information.

Q.    Good day.  My name is Mohamed and I use my computer for too long and when I finish I watch TV...about 7 hours a day..now when I am in the house my vision is normal but when I go out to the sun I start seeing like black spots and whenever I move my eye they move too...this is constantly happening to me...there is no professional eye doctor here in Africa where I am...can u give me an idea of what I am experiencing?thankyou

Possibly.  It sounds like you are experiencing floaters.   Floaters become much more visible when you're outside and looking at the clear blue sky, for example.  Go the the Q and A Archives and do a find (click Edit then Find) within your browser for floaters.  Also go to Simulations and click on Floaters for examples of what they look like.  Floaters are common as we age and in patients with nearsightedness.  A lot of floaters may be a sign of a retinal or inner eye problem.  If you are in Ghana, we have a contact that may be of help to you.  If so, supply your e-mail address and we'll forward his e-mail address to you.  Good luck.

Q.    My grandmother started having really bad problems with her eyes. She says her eyes always have moucous (mucous) around them, and it sometimes is almost like a leagon (lesion), can you help, because the doctors have no idea, and are just wasting her money on many costly eye drops and various medications.  Please help!!!!

We're sorry that you're not pleased with your mother's eye doctors; unfortunately, we are in no position to second guess her eye doctors.  Some chronic eye conditions that occur when we age include dry eye disease  as well as Blepharitis (see current 8/16/00 Featured Article or Past Featured Articles on Dry Eye Syndrome about these diseases).   Go to the Q and A Archives and do a Find for both diseases for more information.  Unfortunately, both Dry Eye Disease and Blepharitis are chronic, incurable diseases that one has to control but learn to live with, at least for now.

Q.   I was writing to find out some information on an eye diease, I'm not sur of the name of the disease but  know it is caused from bird droppings. If there is any information that you have on that disease it would be helpful. thank you

You're probably referring to Histoplasmosis.  Go to Past Featured Articles at the top of this page and read the article about histoplasmosis.  You can also go to the Q and A Archives and do a Find (under Edit on your browser) for histoplasmosis for further information.

Q.    On info re: ocular histoplasmosis, it was noted to avoid altitudes above 7000 feet.  I'm traveling to Peru - Machu Piccu and I'm now concerned.   Why should one avoid higher altitudes?

It is recommended that to avoid or reduce the chance of bleeding of macular or paramacular lesions caused by the histoplasmosis, and resultant loss of central vision, that one avoid elevations above 7000 feet (sorry, no mountain climbing or skiing in high altitudes) and avoid aspirin.  Go to Past Featured Articles for further information on histoplasmosis.  You should consult with your eye doctor to determine whether this is a concern for you given your condition.

Q.    Coat?

For information on Coat's Disease, go to the Q and A Archives and do a Find (under Edit) for Coat's.

Q.    Please tell me what old bilateral central serous retinopathy is.  Every definition that I have read says that it has to do with leakage behind the eye.  However, the doctors think that my father has it but he does not have leakage behind his eye yet he is legally blind?

Bilateral means both eyes and the leakage they're referring to is fluid ("serous") - the same fluid that causes any body part to swell (not blood).  Go to the Q and A Archives and do a Find (under Edit) for central serous retinopathy for more information.

Q.    What is Horner Syndrome?

Horner syndrome, also called Bernard - Horner syndrome, is an abnormality with the sympathetic nervous system, either partial or complete, caused by a number of conditions including congenital defects, tumor, damage/injury,  or even vascular headaches.  About half the time the cause is never discovered.    Symptoms can include partial ptosis (droopy eye lid), possible elevation of the lower lid, miotic (small) pupil and anisocoria (different pupil sizes), one eye may appear smaller than the other, eye redness, excessive tearing, and sometimes different pupil colors.  There may be facial sweating, numbness, part of the face may feel warm and it may be difficult to focus the eyes are some of the variable symptoms.    The symptoms depend on which nerve fibers are affected.  A test called the "cocaine test" (pupil does not dilate with cocaine) is often used to confirm the diagnosis of true Horner's syndrome, and additional testing may include radiologic studies (X ray, CT scans) of the chest to help determine the cause.  In infants, the presence of Horner's syndrome warrants a complete work up for the possibility of neuroblastoma.

Q.    What causes the whites of the eyes to be a faint gray or a faint blue in a 5 week old baby?

There is quite a bit of variation in the color of the sclera in infants, so it is most likely normal variation.  However, the pathology that immediately comes to mind that has bluish sclera as one of the symptoms is osteogenesis imperfecta.  Osteogenesis imperfecta is commonly known as brittle bone disease and is characterized by the triad; brittle bones, blue scleras and deafness.  This disease occurs in about 1 in 50,000 babies.  Certain connective tissue diseases also are associated with bluish sclera as a symptom.  Blue sclera is associated with numerous syndromes including; Werner, Turner, Marfan, Lowe, van der Hoeve, Folling, Crouzon, Bloch - Sulzberger, delange and Ehlers - Danlos syndromes.  Why not have peace of mind and take your baby to a pediatric eye doctor or your pediatrician for a professional evaluation.

Q.   Floaters?

Q.    What makes you see spots only in one eye?

Q.    What causes vision that has cobweb like floaters?

Q.   I have had an aterial occulsion in my left eye and I have floaters in my right eye. I have had all of the medical test for the left eye and have been told that my health is good and sometimes the occulsions cannot be explained. The floaters are my main concern and I have been told that I must live with them. Thanks for your comments

Go to the Q and A Archives and do a Find (under Edit on your browser) for floaters.  Also, for an illstration, go to the Simulations page.  Floaters sometimes look like cobwebs, but sometimes cobweb-like vision can be a sign of occlusion of eye blood vessels.   Floaters can occur in one or both eyes and once you get them you usually will always have them, although they come and go.  Floaters will move as you move your eyes; however, if you look closely, they'll continue to move slightly after you have stopped your eyes. 

Q.    Red eyes.

Go to the Q and A Archives and do a Find (under Edit) for "red" or "red eyes" for further info on what is associated with red eyes.

Q.    my question is...two years ago I had my eyes checked and my prescription then is pretty much the same as now..which I just had done again...the only difference of increase for vision was the reading from 2.00 to 2.25---which is very slight..the main increase was the axis...it went from 085 to 175 on my right eye..and the left eye which had none now has 10.....I got new glasses...and when I put them on and wore them a little..I could feel the pulling sensation on my eyes...then I became dizzy...and then I became nauseous....my head began to hurt etc.....I took them off and put my new ones on and it took awhile to feel better...the old prescription was OD + 100 sph, and OS + 100 -25 x 085...and then add +2.00----which is for the bifocal....the new prescription is...sph +1.00, CYL +0.50, Axis 175 I presume that was for the right eye...and the left eye is sph +0.75, CYL +0.50, Axis 10........add for reading +2!  .25 on both...could you tell me what the problem might be..I myself think its the axis...its to high...my old one has 085..and the new is 175----big difference...I had this problem once before..and they rechecked it and I was given a 95 at that time..could you give me some idea or what you think about my situation..remember I feel dizzy and nauseous with these new glasses..I can see..it is a little blurry with the new reading prescription...but I'm sure over time I will adjust...thankyou

Sounds like an excellent question for your eye doctor.   Patients often have difficulty in adjusting to their new glasses, particularly bifocals - causing the general symptoms that you describe.  As before, have your eye doctor recheck your prescription AND the prescription in the glasses.  Also, sometimes the optical shop does not manufacture the right glasses for the prescription.

Q.    Will the dry eye cause blindness?

No.  Dry eye disease does cause eye irritation, red eyes, etc., but not blindness.  For more information on dry eyes, see the featured article (or past featured articles) and also do a Find for dry or dry eyes in the Q and A Archives.

Q.    Could you please tell me how can I get help for adult amblyopia?  I read about a drug came out for that from Dr. David Peed is any way I can talk to this doctor thanks.

We were unable to find a "Dr. Peed" in several doctor directories.  The drug may be L-dopa.  Go to Recent Breakthroughs about L-dopa for more information.

Q.    My toddler (She'll be 3 in Nov) had a fall back in late April... Her nose became bruised and swollen over the next few hours.... Over the next couple of weeks as the hematoma resolved she developed bruising under the eyes. One eye had more bruising than the other (I don't remember which one though). After the bruises went away, we noticed her eyes weren't tracking properly. It didn't occur all the time though. We noticed it when we were sitting at the kitchen table and I was feeding her. At the same feeding session I noticed the tracking problem only occurred occasionally. We made a trip to her pediatrician and scheduled an appointment with an ophthalmologist. I was unable to get an appointment until August. Since that time we noticed the improper tracking decreased in frequency. The ophthalmologist has diagnosed esotropia and we are waiting for her bifocals to be ground. I asked if the nose trauma could be related to the appearance of the tracking problem. We had not noticed it before the fall and our seating arrangement at the table has been in place for many months prior to the fall. Her pediatrician had not mentioned any eye problem at any of her well baby visits. Is it possible that the fall traumatized the eye muscles and caused the esotropia? If so, is it likely that the glasses will help strengthen the muscles and time will resolve the tracking problem?

It is very unlikely that the fall caused the problem with tracking.  Actually, what you're probably noticing is not a tracking problem per se, but rather, a temporary misalignment of the eyes as your daughter tries to focus on the food brought to her mouth.  It is very common for children about 3 years old to develop what is called accommodative esotropia - the eyes turn-in too far  when the patient focuses on near objects, like food.  Your ophthalmologist is probably right and the corrective lenses should correct the problem, as long as she wears the glasses.   You'll probably notice that her eyes will appear normal and aligned when she has the glasses on and her eyes will become crossed when she does not wear the glasses, particularly when looking at near objects.  It is important for her to continue to wear her glasses  - if she doesn't she may develop a lazy eye; which creates all kinds of other problems.

Q.    flashing blurred vision.

If you see flashing lights and your vision is blurred, you need to see an eye doctor ASAP.

Q.    My father is 66 year old, he feels something like an ant flying 30 centimeters away from his left eye. I want to know what is the problem and what he should do? thank you very much.

Your father is probably experiencing what is referred to as a floater.  Go to Simulations for what floaters look like and go to the Q and A Archives and do a Find (under Edit on your browser) for floaters for more information.  Floaters are common in the elderly and a few probably means nothing.  A lot necessitates a trip to the eye doctor.  Also, just to be on the safe side, if your father has not had an eye exam by an eye doctor in the past year, schedule one today.

Q.    What cause the eye muscles to twitch?

Its probably not an eye muscle; but rather, an eye lid.   Eye lid twitching is a common problem and is usually caused by stress, lake of sleep and possibly too much caffeine.  Go to the Q and A Archives and do a Find for twitch or twitching eye for more information.

Q.    I have an eye problem where my vision is sort of like a bad TV reception.

It is unclear what the problem is, but our gut feeling is that you should see an eye doctor ASAP.  One possibility is glaucoma.  If so, you need treatment today!

Q.   Now I'm 18 yrs old and have been battling a progressive eye disorder I've wrote in before and was never answered and seen things on the Q and A page before that I thought were totally irrelevant so I would appreciate a simple answer what to you is astigmatism and what is outlook of a patient suffering with this disorder.

Q.   I would like to fully understand what a stigmatism is and its long term effects on a persons vision?

An astigmatism is a refractive error in which the cornea is not perfectly spherical, like a basketball, but rather shaped more like a football.  An astigmatism is almost always a minor refractive error and is usually corrected with glasses.  It is generally nothing to worry about and does not cause blindness.   There are really no long term complications.  A distantly related condition is keratoconus - in which the corneal becomes progressively misshapen - like a cone, and sometimes requires a cornea transplant.

Q.   What is bletheritis (blepharitis) and how is it treated?

For an answer, go to the Q and A Archives and do a Find (under Edite on your browser) for blepharitis.

Q.    What is and what can cause eyeritis (iritis)?

For an answer, go to the Q and A Archives and do a Find, under Edit on your browser, for iritis.

Q.    What is a stye?

To find information about a stye, please go to the Q and A Archives and do a Find (under Edit on your browser) for stye and "sty".

Q.    I have been diagnosed as having an eye infection, possibly chlamydia.  What is this and can it have been caused by swimming in an infected pool?

While chlamydia is usually associated with venereal disease, chlamydia can also infect the eyes and lead to blindness.  Chlamydia infection is actually one of the leading causes of blindness worldwide and there are three types: trachoma (the real bad type), infant or neonatal inclusion conjunctivitis and adult inclusion conjunctivitis.  Trachoma is the one that causes the most blindness worldwide and is present to a very large scale in the Middle East, India, Africa and Southeast Asia, but some cases do occur in the USA.  Trachoma is often contacted directly via direct contact with infected ocular secretions, but can also be contacted through infected materials such as towels and clothing touching the eye area.   Trachoma is characterized by development of inflammation, conjunctivitis, corneal changes, and lid deformities and scarring and blindness.  Fortunately, treatment with systemic (oral) tetracycline or doxycycline is very effective and curative.

The second type of chlamydia infection is neonatal inclusion conjunctivitis, which is contacted during birth as the infant passes through the birth canel.  Signs of the disease occur about 5 days after birth and include pus-like discharge from the eyes, inflammation, corneal changes and sometimes scarring.

Adult inclusion conjunctivitis is a sexually transmitted disease and is usually caused by direct contact of the eyes with infected genital or urinary secretions.  IMPORTANT: sometimes infection does occur in poorly chlorinated swimming pools.  Adult inclusion conjunctivitis is very common and signs include redness, mucus discharge and irritation usually occurring a few days to up to 3 weeks after infection.  Again, oral tetracycline or doxycycline is used to cure the disease (eye drops alone will not work for the whole body infection).

Q.    My friend has had a lead fragment in his eye for 30 years.  How can a surgeon locate and remove the lead?

Since your friend has had the lead in his eye for 30 years, as long as it does not cause problems it is usually advised to leave it alone.  An ultrasound could be performed to locate the fragment, if it is not visible, and surgery can be done to remove the lead; However, serious blinding eye loss could occur with surgery.  If the fragment contained iron, your friend would most likely be blind in the eye  from a condition called siderosis.

September 2000

Detached retina test?

A dilated eye exam is usually sufficient to detect a detached retina.  Sometimes, if the patient has a dense cataract or if there is blood inside the eye which prevents direct viewing of the retina, an ultrasound test can be performed to detect a larger detached retina.

Is  stargartz (Stargardt's) curable?

No.  There is no treatment or cure for Stargardt's disease.   For more info on Stargardt's disease, go to the Q and A Archives and do a Find for Stargardt's.

Is there a cure for color blindness?

In general no.  There is no cure for hereditary color blindness, which affects about 8% of boys and 0.5% of girls to varying degree.  In general, very few people are actually color blind (only see black and white).  A more appropriate term is color deficient, and if you want to be politically correct - "color challenged".  Sometimes color vision problems result from certain medicines/drugs, in which case the stopping of the medicine may relieve the color vision problems.

Is having 20/25 R and 20/25 L vision good?

In general 20/20 visual acuity is considered normal, but most normal people actually have better than 20/20 visual acuity.  However, quite a few patients have 20/25 and even 20/30 visual acuity without any other problems.  So, 20/25 vision is good but not great. 

When we refer to 20/25 or so vision, these numbers are Snellen notation numbers and an easy way of thinking about these numbers is that the numerator (top number) is what is the patient's number and the denominator (bottom number) is normal.  So, what a patient sees at, say, 20 feet away a normal patient could see at 25 feet away.  Legal blindness is 20/200 or worse visual acuity, so what a patient sees at 20 feet away a normal person could see 200 feet away.

Definition of legally blind?

In the USA, legal blindness is defined as having a visual acuity WITH BEST OPTICAL CORRECTION of 20/200 or worse in the better eye or having a visual field of less than 20 degrees of visual angle in the better eye.  Twenty degrees of visual field is about the size of your two hands side-by-side held at arms length.

Different eye color.

Different eye (iris) color is called heterochromia.   Sometimes people are born with different colored irides (iris of eye eye) and everything else is fine.  Sometimes different colored irides may be a sign of more serious disease, such as Waardenburg syndrome (and hearing loss).  Different colored irides can also be the result of trauma, uveitis, tumor in the eye, glaucoma, intraocular foreign body, and even a sign of Horner's syndrome.  Overall, a child or an adult with different colored irides should be examined by an eye doctor to rule-out any serious and sometimes treatable condition.

Q.    For over a year now I have been experiencing problems with the blood vessels in both my eyes. This has resulted in a loss of vision in both eyes along with flashes of light when I move my eyes. I was told that my blood vessels are hemorrhaging and leaking. I have consulted several doctors including retinal specialists, however, no one can find a cause for this problem. I have undergone every test they can think of (for diabetes, arthritis etc. etc) but everything comes up negative. Other than my eyes, I appear to be a healthy 20 year old. The doctors have put me on an aspirin a day to thin my blood, but other than that, they have no idea what to do. They are frustrated as am I. Is there any obscure disorder that they may have missed which would cause this problem? If so please let me know. Thank you.

A frustrating condition for some patients as well as doctors is that of retinal hemorrhages of unknown cause.  In part, the problem is due to the fact that so many things can cause retinal hemorrhages.  It helps to know what type of retinal hemorrhage is occurring in the patient as well as the location; this will sometimes help in identifying the cause.  For example, hemorrhages deep in the retina (intraretinal) are of two basic types; dot and flame. Dot (round and red) hemorrhages are deep in the retina and sometimes are a little bigger and may be referred to as blots.   Flame hemorrhages are located nearer the top (superficial) retina, appear flame-like, and are located towards the back (posterior) part of the eye.  Flame-like hemorrhages are more common in hypertension.  Intraretinal hemorrhages occur in many systemic (whole body) diseases and usually affect both eyes.   Intraretinal hemorrhages also occur in patients that have occlusions of the retinal veins.  These types of occlusions typically affect only one eye and there is venous dilatation.

Subretinal hemorrhages appear more amorphous in shape, cover the retinal blood vessels, and occur in trauma or as a result of subretinal neovascularization (development of abnormal blood vessels) due to, for example, age-related macular degeneration.

Preretinal hemorrhages, which occur on or near the inner surface, occur in several disorders including retinal neovascularization (as in diabetes, sickle cell), trauma, breaks in the retina and in vitreous detachment, and less often in leukemia.

As suggested by your letter, often a through medical history and general physical exam along with a CBC (complete Blood Count), blood glucose levels, serum protein levels (for hyperviscosity) may be performed.  Finally, fluorescein angiography may be performed to search for small changes in the retinal as well as choroidal blood vessels.

We're sorry that the response is long and not necessarily to the point, but the question and answer are both complex and not easily addressed.  The fact that both eyes are affected and that the disease appears to affect your central vision (posterior pole of the eye) suggests a possible systemic disease. Unfortunately, there are indeed a lot of obscure disorders that can cause retinal hemorrhages.

Q.    My left eye just started twitching.  It gets worse as time goes by.  What can I do?   I am so irritated.

The most common cause of twitching eye(s) is stress (and irritation!).  Ways to reduce stress such as more sleep, exercise, relaxation techniques, as well as reduced alchohol consumption seem to reduce the frequency of twitching eyes.  Look at your work and family life and identify the stressful items and try to reduce or control them.  Also, for more info on twitching eyes, go to the Q and A Archives and do a Find (under Edit) for twitching.

Q.    My left pupil is larger than the right pupil.   What is the problem?

One pupil smaller (larger) than the other is called anisocoria.  Some people have different pupil sizes since birth and it is a congenital problem that means only that you have different pupil sizes, nothing more.  If the pupils recently became different in size then this could be a sign of a more serious eye problem or neurological problem.  Damage to the eye can also result in different pupil sizes and even differently shaped pupils, although the cause would be obvious.  If your pupils recently became unequal in size, see your eye doctor ASAP as you may need a medical work-up to uncover the cause and obtain treatment, if necessary.

Q.    Aura in vision.

It is unclear what you are referring to.  The most common aura (a visual sensation that usually preceeds something else like a seizure or hysteria) in vision seems to be related to migraines.  Go to the Q and A Archives and do a Find (under Edit) for migraine for more information related to visual aura related to a migraine.

Q.    Eye and spots.

The most common reason a person sees spots is due to floaters.  Go to the Q and A Archives and do a Find (under Edit) for floaters.   Also go to Simulations for what some floaters look like.

Q.    Corneal opacity.

Corneal opacity refers to a "clouding" of the cornea, that may be limited to a small spot or the entire cornea.  Metabolic diseases, glaucoma,   trauma such as chemical burns, infections among others can cause a cloudy cornea.   All cloudy corneas warrant a trip to the eye doctor for evaluation and treatment.   IMPORTANT:  cloudy cornea(s) in an infant or child warrants immediate medical attention.

Q.    Differential diagnosis of red eye.

There are a LOT of conditions that can cause red eye.  Just to get you started, go to the Q and A Archives and do a Find (under Edit) for "red eye" or/and "red eyes".

Q.    How do I get rid of bags under the eye?

Dark circles under the eyes or darker appearing skin under the eyes or "bags" under the eyes can be due to a number of factors.  The lack of adequate sleep will cause the eyes to appear swollen or puffy and darker than normal.  In women, hormonal changes can cause the skin under the eyes to darken.  As part of the aging process, small wrinkles under the eyes will also cause the appearance of dark skin under the eyes.  Finally, the skin under the eyes will appear dark because of shadow. 

What can you do about it?  See an Ophthalmologist that specializes in cosmetic surgery or reconstruction surgery for an opinion.  Although surgery is not typically an option, the Ophthalmologist will diagnose the problem.  If the skin is indeed darker than normal certain bleaching agents can be used to lighten the skin.   If the eyes appear darker because of wrinkling of the skin, certain laser surgery can be used to remove the wrinkles.  Certain cosmetics, even for men, can be used to cover-up the darker appearing skin.  Finally, be sure to get enough sleep and take regular rest breaks every hour when using the computer.

Q.    I live in ___________ and would like to know if the Lions still accept old eye glasses...

Yes, the Lions throughout the USA and even the World collect old eye glasses for use in third World countries.  Most optical shops and most public libraries have drop-off boxes for old, complete eye glasses.  Give some optical shops in your area a call to see if they accept old glasses for the Lions.

Q.    Have previously asked questions regarding my father who was blinded in a car crash. It now appears that his eye ball, optic nerve are ok but has no response from brain to eye and his blood vessels are damaged. Can this repair itself naturally, and if not is there any surgical procedure, if so where please.

It is always good that the eye and optic nerve are ok.  It sounds like your father suffered severe brain hemorrhaging affecting some visual parts of the brain.   There are about 32 cortical visual areas of the brain that do all kinds of different things.  Two major visual pathways are referred to as the "What" pathway and the "Where" pathway.  These pathways help determine what a visual object is and where in space the object is located, respectively.  So, depending on whether one or both pathways and corresponding cortical sites were damage, a patient may not be able to "see" certain things.  In addition, patients with certain types of brain damage sometimes have large parts of the visual field missing (see hemifield hemianopsia under Simulations) and deny "seeing" objects in that part of the visual field, but they can sometimes point to or direct their fixation to the object in the "blind" part of the visual field (sometimes referred to as blind sight).

Back to your question, in general, the younger the patient the more and the faster the recovery from trauma. The brain is able, to a limited extent, to heal itself, and this healing process can take up to about a year.  Active use of vision along with motor (muscle) function may facilitate recovery.  Unfortunately, depending on the extent and site of damage, visual as well as perceptual deficits may remain.  We are aware of no surgical or medicinal treatments for brain  damage due to trauma/hemorrhage.

Q.   I am 32 and had a lazy eye as a child. Is it recommended to have Lasik surgery or a different method done to improve eye sight in that eye?

A lazy eye is a brain problem and not an eye problem per se.   So Lasik refractive surgery, which might correct a refractive error of the eyes and obviate the need for glasses or contact lenses, would not help vision in the lazy eye.   If you had Lasik refractive surgery, you may no longer need glasses but you would still have a lazy eye and poor vision in that eye.  A serious factor to consider, particularly given that you have a lazy eye, is that Lasik refractive surgery may eliminate you need for glasses, which would actually INCREASE the probability of damage to the remaining good eye, thus leading to visual impairment and even legal blindness.   Patients with only one good eye are advised to wear safety glasses made of polycarbonate.  As a consequence, a case can be made that Lasik refractive surgery should not be performed on patients with a lazy eye; but rather, the patient should wear the corrective lenses made with polycarbonate or if they do not need glasses then they should wear safety glasses made with polycarbonate.

Q.   I would like to know about amblyopia for adult could you tell me where can I get help please thanks.

There is no accepted or established treatment for adults with amblyopia.  If the patient has refractive (anisometropic) amblyopia, some improvement in vision might be gained by wearing corrective lenses/glasses.  Some research has shown that L-dopa may improve vision in the lazy eye of an adult a little bit, but not enough to really warrant treatment.

Q.    Have check your site - cannot find any thing on myoptic degeneration. Have been haveing severe photophobia for last 2 years. Opthomologist used for last ?20 years said nothing to do. Last November, after his semi-retirement, I was seen by one of his younger partners - he too said nothing to be done - come back in 1 year. This Spring my family doctor noted "lazy" eye and suggested I see my opthomologist. Called & set up app't. Saw different younger partner in practice. She was more concerned b/c I had very pale retinas. So set up follow up visit w/retinologist. Did that and after a visual exam only, he said not sure why retina pale. I asked if any meds I'm on for CFIDS could be causing, he said not. I asked if he'd seen pale retinas before, he said in a couple of lupus patients. So back to optho., who did first visual field test i've ever had (53 y/o and bifocal since age 8). Still wasn't ?comfortable w/retinologist "report" and set up 2nd retinologist consult. !

2nd retinologist did retinal algiogram w/dye and said myoptic NOT macular degeneration. Have been looking for info on myoptic degeneration but not able to find. Will see retinologist in 2 more months for 3 ? little areas on retina he may need to do surgery on NOT laser. And to see opthomologist in 3 months for followup. I will check your Q & A site for any info &/or resources you may be able to provide. Thanks so much for this terrific public service.

The correct term is myopic degeneration, although most text books refer to it as pathologic myopia.  Myopia is also called nearsightedness, and the major reason for myopia is that the eyeball elongates from front to back as the disease progresses.  A normal eye may be about 22mm long while a pathologic myopia eye may be 32mm or more long.  Refractive errors tend to be greater than -10 diopters.

As the eyeball becomes longer as the myopia progresses, the retina (which can be thought of as a very thin membrane inside the eye that contains the photoreceptors and other visual cells) as well as the choroid (that gives the back of the eye most of its color) and sclera (white part of the eye) are stretched and become even thinner.  As the retina thins, there are greater and greater chances for breaks, tears and detachments of the retina to occur.  In addition, the photoreceptors, that are usually pointed toward the middle of the pupil, become misaligned and, as a consequence, become less efficient at gathering light that enters the pupil and eye.   The choroid may become atrophic and lose color, becomes more pale, while the sclera also becomes more thin and transparent.

The fact that you're seeing flashing lights may be a sign of retinal breaks, tears or a retinal detachment.  Localized retinal problems may be treated with surgery, as your letter suggests.  As the pathologic myopia progresses, hemorrhages may occur, anterior uveitis may result and mobility of the eye may be reduced.   Severe loss of vision can occur due to the pathologic myopia or more probably due to the complications (e.g., retinal detachment), so regular and frequent eye exams are essential.

Q.   My aunt has been diagnosed with "Best Disease" and is going blind. HELP!

There is no known treatment for Best's disease.  For more information on Best's disease, go to the Q and A Archives and do a Find (under Edit on your browser) for Best's.

Q.    Degeneration of macola?

You are referring to Macular (Macula) degeneration.  Most likely, you have age related macular degeneration.  Go to the Q and A Archives and do a Find for age related macular degeneration.

Q.   My 15-yr old son, who has had a long history with ADHD, has recently been diagnosed with tunnel vision. Is there a connection between the two? The doctor had also mentioned some sort of visual therapy involving the use of colored lights to not only improve the tunnel vision, but in some cases, improve some behaviors associated with ADHD. He feels there is a connection when certain branches of the optic nerve are blocked that attribute to not only the tunnel vision, but also to certain behaviors that are exhibited when neurotransmitters and other chemicals are blocked through the optic nerve. What is your opinion?

Take your son to another eye doctor for evaluation ASAP.  There is no connection between ADHD (Attention Deficit and Hyperactivity Disorder) and tunnel vision.   It makes NO scientific or medical sense that watching colored lights will improve tunnel vision.  It makes NO sense of any relation among neurotransmitters, optic nerve function and tunnel vision and watching colored lights.

Tunnel vision can be a symptom of serious neurological and visual problems.   Sometimes patients will fake vision loss on visual field tests, used to measure and assess peripheral vision and thus check for tunnel vision.  These latter patients usually have some psychological problems or have unresolved mental issues.   Nevertheless, even these latter patients DO NOT have a condition that would warrant such vision therapy.  If the tunnel vision is due to, say malingering or hysteria, psychological and family counseling might be in order; BUT FIRST the cause of the tunnel vision must be established and this is why you need to take you son to a qualified eye doctor for evaluation.  If the tunnel vision is due to, for example, glaucoma, immediate treatment is necessary.  We have recently seen a patient about 15 years of age that had optic nerve atrophy in one eye possibly associated with a medicine (Ritalin) used to treat ADHD.  So, any loss of vision in a patient taking (any) medicine over a long period of time should be evaluated very throughly. 

Q.    Can high blood pressure affect the eyes?

Yes.  Patients with high blood pressure often complain of floaters.   Also, if left unchecked, high blood pressure can be a cause of retinal hemorrhages and loss of vision. 

Q.     Blind spots and streaks of light?

Blind spots in vision and streaks of light are some of the symptoms of a retinal detachment.  You need to see an eye doctor for a dilated eye exam and possibly other vision tests ASAP.  Some patients will describe floaters as "blind spots"; however,  floaters are seen to move a little bit when the patient moves his/her eyes.  True blind spots in vision (known as scotomas) are stationary and are in the same place in the visual field (e.g., center of vision ) and are usually larger than floaters.  Streaks of light can also be due to a number of conditions, but regardless, you really need a professional eye exam to rule-out less serious conditions than a retinal detachment.  See you eye doctor today.

Q.   What is the flashing in my eyes?

Don't know.  But one thing is certain - any flashing in an eye warrants an immediate trip to the eye doctor for a dilated eye exam.  One of the big worries about flashing lights is that it is a symptom of a retinal detachment, which could be treated successfully and prevented from getting worse, if caught early.  So see an eye doctor ASAP.

Q.   About 2 months ago, I noticed a change in long distance vision in my right eye. Since it had been a year or so since my last eye check, I went in and found that my right eye had changed quite a bit, while my left eye changed very little. After getting my new prescription filled (glasses), I noticed I was seeing a shadow or ghost image to the right of all high contrast lines. I thought it was a bad coating on the lenses, but while the glasses were being re-checked, I noticed the shadow was visible without the glasses (they checked out okay). There is no shadow in the left eye with right eye covered, and the glasses simply bring the shadow into clearer focus. Along with my right eye weakening for far vision, I now notice it is much weaker during reading (normally done without glasses). Is the shadow or ghost image of major concern? I sometimes find myself being distracted by it while driving, but other than that it's just annoying.

Shadows or double images seen with one eye (monocular diplopia) is usually due to problems with the optical properties of the eye, including the cornea, lens and/or vitreous.  It may have something to do with the changing or worsening of vision in the affected eye.  See your eye doctor (an optometrist or ophthalmologist) for further evaluation. 

Q.   What are the major causes of widespread blindness?

Some that immediately come to mind include those associated with vitamin A deficiency, River Blindness, glaucoma, diabetes and age-related macular degeneration (over the age of 65).  In children, the leading causes of legal blindness include optic nerve hypoplasia (small optic nerves), cortical visual impairment and retinopathy of prematurity.

Q.   What causes a blue haze to come over a brown eye?

If you are referring to "seeing" a blue haze and that you have brown eyes - the color of the eyes is not an issue.  However, if you see a blue haze you should see an eye doctor ASAP, since seeing any type of haze may be a sign of a serious eye problem, like glaucoma.  Haze may also be a symptom of the development of a cataract, or even due to a disease that affects the cornea.  A blue haze can also be a side-effect of certain drugs, for example Viagra.  So play it safe and go see an eye doctor today.

Q.    Date of first corneal transplant, place of first corneal transplant?

The concept of transplanting some layers of the cornea or all of the cornea has been around for about 200 years.  Early in the history of corneal transplant surgery, various types of animal tissues and even synthetic materials were tried, but without success.  Von Hippel is credited with performing the first lamellar (top layers of the cornea) corneal transplant (called  lamellar keratoplasty) surgery in 1886.  Later, Zirm performed the first successful complete corneal transplant surgery (called penetrating keratoplasty) in 1906.  However it really wasn't until 1952, when Stocker performed the first successful penetrating keratoplasty for corneal edema, that the field of penetrating keratoplasty blossomed.   Exact locations are not clear.  For a detailed history on the subject, see Rycroft (1955) Corneal Grafts.  London, Butterworth publishing.

Q.    What could be wrong with your eye if it is focusing in and out, like it is spasmusing?

The description is similar to what is referred to as accommodative spasm, caused by an inability to relax the muscles that control the curvature of the lens.   Accommodative spasm can sometimes occur in patients with an uncorrected astigmatism or hyperopia (farsighted), exophoria (eyes turn out slightly), presbyopia as well as in pateints on certain drugs (anticholesterase) for glaucoma.  Certain eye diseases (iridocyclitis) can also cause accommodative spasm and stress may also play a role in the condition.  Accommodative spasm is associated with headache, blurred vision and discomfort.  Many of the causes of accommodative spasm are treatable, so see an eye doctor for evaluation and treatment.  

Q.    Our school needs to purchase a closed curcuit TV for two of our students who have been diagnosed legally blind.  Where would I find help on this subject?

The local Bureau for Services for the Visually Impaired (BSVI) should be able to provide a list of manufacturers that produce closed-curcuit TVs for the legally blind.

Q.    I have a friend that has a problem with his eyes watering really bad after surfing in the ocean for a long time.  He's been to a local doctor here in Indonesia but they just said that his watering eyes were due to lack of sleep.  If he's in the ocean for a long time for one day, his eyes start to drain out alot of saltwater and hurts some.   Would this be because of the sun, saltwater, and in the wind for too long?  Is there any way to treat watering eyes?

Any irritants will cause the eyes to water, sometimes excessively.  All the things that you describe (saltwater, sun, wind) over an extended period of time could cause the eyes to water excessively.  It is the eyes way of trying to flush-out an irritant or dryness.  If the eyes water ONLY after extended surfing, than the problem is most likely caused by an irritant.  The best solution would be to wear swimming goggles while surfing.

Q.    What could it mean if you begin to have trouble seeing out of one of your eyes and you start to see colors....green?

It means that you need to see an eye doctor.  Seeing green is unusual.  Trouble seeing out of one eye means that the problem is usually located in the eye or the optic nerve that goes from the eye to the brain.  it is very highly recommended that if a person all-of-a-sudden starts to have blurred vision in one or both eyes that he/she see an eye doctor soon. 

Q.    In order to sleep must our eyes be closed? Why or why not?

You can sleep with your eyes open or closed.  The problem is, that if you sleep with your eyes open they'll dry-out leading to all kinds of corneal problems.  As a consequence, people must sleep with their eyes closed.  Some patients that have certain nerve/neurological problems will sleep with their eyes open or partially opened and these patients are sometimes prescribed eye drops/lubricants to use at night to prevent eye problems.

Q.    Ptergium (pterygium)?

For info on pterygium (note correct speling), go to the Q and A Archives and do a Find (under Edit on your Browser) for pterygium.

Q.    How to treat eye stye?

First, you'll need to got to the eye doctor and make-sure that it is indeed a stye.  Then go to the Q and A Archives and do a Find (under Edit on your Browser) for   Stye.  The hyperlink on the first line under Topics will also get you to the information that you have requested.

Q.   WHAT DOES IT MEAN WHEN THE EYE IS RED AND SWOLLEN AND IS VERY PAINFULL TO OPEN AND IT HURTS TO BE EXPOSED TO LIGHT.

It means that you need to see an eye doctor.  Any pain warrants an immediate trip to the eye doctor.  Your symptoms go along with numerous eye diseases, some very serious (orbital cellulitis, keratitis - see next question).   Photophobia (sensitivity to light) may suggest corneal or inner eye involvement.   See an eye doctor today.

Q.    Contact lens cysts?

Wearing contact lenses over an extended period of time or/and wearing improperly cleaned or contaminated contact lenses can lead to infections of the cornea and cysts.  A very serious, vision threatening infection is Acanthamoeba infection associated with contact lens wear and related to contaminated solutions or/and contact lenses.  Acanthamoeba keratitis (trophozoite and cyst forms) usually involves one eye and symptoms include red eye, pain, photophobia, clouding (sometimes ring shaped) of the cornea and infiltrates.  Early treatment is essential.  Late diagnosis and treatment is not good and there is a lot of controversy as to the best  treatment when the diagnosis is made late in the disease course.  In some persistent cases, in which the eye basically can't be saved, the eye is removed.  Any contact lens associated infections and cysts should be taken very seriously and adherence to the doctor's recommendations is essential for possible favorable outcome.

Q.    I have written a few times before regarding my father who was blinded in a car crash. Since i last wrote he is now starting to see shadows (outlines of door frames and people etc.) Is this a positive sign or is it just false hope?

Starting to see shadows is always a good sign.  In general, in many types of situations, including the development of vision in a baby, vision starts with large, high contrast objects (e.g., black on white) and progresses to smaller detailed objects of lower contrast.   So, your father's vision is starting to recover in an expected fashion and, hopefully, will continue to progress and improve to include smaller details and fainter objects.

Q.    Can you tell me about idiopathic juxtafoveal telangiectasia?

Idiopathic means that the cause is unknown and not associated with something else (and it is usually an acquired and isolated form).  Juxtafoveal means that it is localized to the foveal (very central vision) part of the eye and retina.   telangiectasia refers to the dilation (enlargement) of existing blood vessels in the retina and in this case in the foveal area of the retina.  These blood vessels tend to leak, creating some loss of vision.  If the telagietasia affects only one eye (usually considered a mild form of Coat's disease) the prognosis is usually good, and depending on the situation may or may not warrant laser photocoagulation.  In general, bilateral idiopathic juxtafoveal telangiectasia is worse than unilateral (one eye) disease and is sometimes associated with choriodal neovascularization (development of abnormal blood vessels that tend to hemmorrhage) and progressive loss of central vision.   Because the disease affects the very central part of the eye, it may not be possible to perform laser photocoagulation as a treatment, except in very select cases.   Some authors believe that there is an association with diabetes, so testing for diabetes may be in order.

Q.    Subconjunctival?

The conjunctiva is a thin membrane that covers the exposed areas of the eye, including the cornea and sclera (as well as the eyelids).   "Sub" means beneath, in this case, beneath the conjunctiva.

Q.   Should I worry if when seeing a light source (for example a bright window) and later closing my eyes, I still can see a bright shadow in the shape of the object (window) for a few seconds?. Also, sometimes if I sneeze very hard I see flashing dots on my peripheral vision for a few seconds.

The first experience is not of concern since you describe what is commonly referred to as a positive afterimage.  Whenever a person looks at a bright object for a few seconds and then looks away or towards a much darker object (e.g., wall) or closes one's eyes, the person will experience a momentary positive "afterimage" of the bright image for a few seconds.  Depending on the exact circumstances, the person could also experience a negative afterimage - seeing the original object as a darker image rather than a bright image of the object.

Regarding your second experience, sneezing creates very powerful forces within the body and these forces can affect the eyes and what one sees.   Although conjecture, sneezing probably creates a shearing force within the eye between the vitreous and retina.  This shearing force could create flashing dots (called phosphenes) for a few seconds, as the vitreous shears across the retina.   [Addendum:  Sneeze induced phosphenes are actually quite rare: as a consequence, you should consult with an eye doctor for further evaluation.  Further review of the literature reveals that phosphenes may sometimes be a prelude to retinal detachment or an early sign of optic nerve disease.  So see an eye doctor.]  It is always a good idea to have regular yearly or every other year eye exams to rule-out the possibility of eye disease.

Q.   Bumps on eyes?

Bumps on the eye warrant a trip to the eye doctor because some lumps and bumps can indicate a serious eye or systemic (whole body) problem.  The most common bumps on the eye are (nodular) scleritis, episcleritis or conjunctivitis. 

Scleritis, or inflammation of the sclera (white part of the eye) is a condition that mostly affects women and is fairly rare.  It can affect the front of the eye, making the eye look red and it can be very painful.  It can also be restricted to the back part of the eye, so the eye appears white but it is still very painful.  In about half of the cases it is related to other diseases including rheumatoid arthritis, ankylosing spondylitis, acute herpes, and connective tissue disease.  The other half of the time the cause is unknown.  Scleritis can also be associated with uveitis, cataracts and glaucoma.  If you have the scleritis that affects the front of the eye steroid eye drops are prescribed for treatment.  If you have the scleritis that affects the back of the eye, oral medicines are prescribed, including ibuprofen.

For information on episcleritis, go to Episcleritis.   For information about conjunctivitis, go to Conjunctivitis.   Note: all three conditions may respond to topical or sometimes systemic (e.g., taken by mouth) steroids.  However, all three conditions require a visit to the eye doctor.

Q.   Is it possible at all to restore or at least improve vision for a patient suffering from uveitis, complicated with macular edemae in both eyes and a scotoma in one eye?

That is a tough question.  Uveitis or inflammation of the uvea (vascular coat of the eye) is a difficult disease for the patient and eye doctor.   Uveitis often will wax and wane over time and, as a consequence, vision may also wax and wane with the disease.  The macular edema (swelling) may decrease and thus your vision may improve.  However, a scotoma is not a good sign and the prognosis for vision recovery related to a scotoma is poor or guarded at best.  For more information about uveitis, go to the Q and A Archives and do a Find (under Edit on your browser) for uveitis.  Good luck.

Q.    I have recently been told that I have a chorioretinal scar.  What is this and what can I expect?

Like most tissues of the body, the choroid (one of the inner linings of the eye) and the retina (inner lining of the eye that contains the photoreceptors) can develop scar tissue (dense, fibrotic tissue) as a consequence of trauma or inflammation or even neovascularization.  Chorioretinal scars can also form as a result of, for example, sarcoidosis (a chronic progressive systemic disease that affects most organs of the body including the heart) and toxoplasmosis (go to Q and A Archives and do a Find for toxoplasmosis).  The real question is why and how did you get a chorioretinal scar?  And this is the question that your eye doctor will have to figure-out.  As with any scar tissue, tractional forces can cause some complications including possible retinal detachment, so regular eye exams are in order.

Q.   My daughters vision is now at -800 &-750 ,Is she going blind? or what?

You are referring to a refractive error of -8.00 and -7.50; in other words your daughter is highly myopic (nearsighted).  Simple glasses or contacts will improve her vision to normal 20/20 vision in most cases.  Therefore, no your daughter is not going blind.  But like most of us that are really nearsighted, regular eye exams (every year) to check for things like retinal tears and detachments are in order.  As patients become more and more nearsighted, the eye becomes longer and longer which , in turns, stretches the various linings of the eye, like the retina.   Sometimes when the retina is pulled too far, small tears and even detachments can occur.  These are usually correctable if caught early, thus the need for regular eye exams.  For more information about myopia, see the current (September '00) Featured Article.

Q.    What causes double vision?

Go to the Q and A Archives and do a Find (under Edit on your browser) for double vision for an answer.

Q.    ...My son who is 6 year old who had a left eye accident in August 1st 1999 with an arrow...  He had a deep vitrectomy and lensectomy, retinal detachment repair, removal of retinal membrane...  The post operation follow-up exam showed that the retina is on, but there is a retinal scar.  The vision is 20/100 with glasses.  As a practice of his injured eye, he closes his normal eye 10 hours per day.

It sounds like your son received very good medical care for his eye injury, given that he now has 20/100 vision in that eye.  Most cases like the one that you describe result in very little vision or even removal of the eye.  In many cases of penetrating injury to the eye, the best that can be hoped for is 20/200 vision (legal blindness level).  So it sounds like your son is doing very well.  The closure (patching we assume) of the better eye for 10 hours/day is to fight against the development of amblyopia (lazy eye) in the injured eye; which could result in even worse vision in that eye.  Finally, it is very important that you son wear his corrective lenses/eye glasses (made with polycarbonate lenses we hope) to protect the good eye from future injury.

October

Q.   I have white spot in both eyes. During my last eye exam, my doctor told me they are sun spots, what does it mean, is it dangerous?

It is not clear what "sun spot" refers to in your case, as several possibilities exist.  An over exposure to sun and wind, particularly in dry climates, can lead to a pterygium - a triangular shaped spot ("sun spot") on the corners of the whites of the eyes near the nose (go to the Q and A Archives and do a Find, under Edit on your browser for pterygium).  Another possibility is an actinic keratosis, a precancerous skin lesion.  Actinic keratosis looks something like a blister on the skin near the eyes and there may be one or more of them.  They tend to come and go and change shape.  While estimates vary, as many as 20% of these pateints may develop skin cancer.  If a person is exposed to the  sun too long he/she may also develop solar lentigines - light brown to black in color spots, about 1 - 3 mm in size, on the skin around the eyes.  These are primarity cosmetic type problems.  Finally, if a person stares at the sun too long, he/she may develop solar retinopathy - basically burn spots on the retina, inside, of the eye(s) - these can lead to vision loss and sometimes blindness. 

Q.    I recently asked question about being recently diagnosed with myopia degeneration. In question I mentioned having severe photophobia - which I understood to be intolerance to "bright" light. In reply you referred to "flashing lights". What I have is very serious intoleranceto light (i.e. in house with 60 watt light bulb over head must wear wide brimmed hat and sometimes sunshades, too. I could not tell from your reply if the myopia degeneration is causing the extreme light sensitivity. For several days after you replied to my question I "searched" your site again. Or could there be another cause?

Flashing lights or/and excessive floaters refer to symptoms of a possible retinal tear, break or detachment sometimes related to high myopia.  Some patients with high myopia do complain of sensitivity to light (i.e., photophobia).   However, your description suggests that you are extremely photophobic.  We suggest that you visit your eye doctor and discuss with him or her your concerns about the photophobia.  Sometimes high myopia and photophobia can be symptoms of other eye problems.  For example, high myopes are more inclined to develop glaucoma - another eye disease that sometimes causes photophobia.

Q.    What is Steff Syndrome

Unknown.  There is a Scheie's syndrome, a variant of Hurler's syndrome, in which corneal clouding occurs (along with claw hand, heart problems, and face irregularities).  There is also a Schirmer's syndrome, in which glaucoma occurs early in the course of the disease.

Q.    Catyrac?

The correct spelling is cataract.  Go to the Q and A Archives and do a Find (under Edit on your browser) for cataract for more information.

Q.    Can Stargardt's ever be a miss diagnosis for a different disease like "battens"? If so, or if not can you explain? Our child has just been diagnosed with "Stargardt's" but my parents have informed me of another disease in our (distant) family that have had "Battens" and he is worried that our son may have this. Even though he was tested 28 years ago to make sure he did not carry the gene. Thank you

It is always possible to misdiagnose a retinal disease, particularly when retinal changes do not always occur early in the course of the disease such as in the case of Stargardt's disease.  Stargardt's disease affects central vision, vision related to the macula of the eye, and can cause a loss of visual acuity, color vision problems and sometimes photophobia.  To the eye doctor the macula may look normal early in the course of the disease and then may take-on a granular appearance or a beaten-bronze appearance.

Batten disease is a neurodegenerative disease that also affects the eyes and particularly the macula of each eye.  It is also associated with   seizure activity, loss of motor control and mental deterioration.

To answer your question, since both diseases affect the macula of the eye and since early in the course of the diseases it may be difficult to precisely make the diagnosis, it is indeed possible to misdiagnose Stargardt's disease and the macular degeneration related to Batten's disease, particularly very early in the course of Batten disease if the eyes are affected first and there is no other symptoms (until later in the course of the disease). Typically, however, other symptoms of Batten disease (e.g., seizure activity) usually precede the development of the macular degeneration.    So this latter fact would seem to make the misdiagnosis between Stargardt's and Batten unlikely.  Nevertheless, you should convey this new information about the family history to your eye doctor for his or her opinion.  It may also be important to screen for Batten disease in the child.

Q.    My son who is six years old is suffering from costs disease and retinal detachment on his left eye. He had already underwent surgery for correction but of no avail; his eye is literally blind. Kindly advise if there is any remedy to correct his eye sight. If there is any possibility we have not given up hope considering that he is still very young.

Coat's disease is a nasty disease which, thankfully, usually   affects only one eye.  It seems that most of the time vision is loss in the affected eye and sometimes the eye has to be removed.  In general, the prognosis is very poor for vision in the affected eye(s).  Sorry, but we are not aware of any new treatments available for Coat's disease.  Please go to the Q and A Archives and do a Find (under Edit on your browser) for Coat's, for more information.

Q.    Spots on white of eye?

A large number of things can cause spots on the whites of the eyes, and the most common appears to be a pterygium - a triangular shaped "spot" on the sclera near the nose (go to Q and A Archives and do a Find for pterygium).   Allergies, hemorrhages, pigmentary changes, systemic problems, etc., can cause spots on the eye.  See an eye doctor for evaluation and treatment, if applicable.

Q.  There is a seven year old boy in our town who has Stargardt's disease, and his family can't afford the CCTV to teach him how to read. Would you have any information available to me about fundraising, or funds that are available to get this young man and his family back on the right track?

Based on federal law, the school system is required to provide appropriate accommodations, including a CCD TV camera/large print system, to students that need such equipment for learning AT SCHOOL.  Thus, the first place to look to is the school system.  However, the school may not be required to provide such equipment for the student's home; therefore, other sources of obtaining such equipment may need necessary in some instances.  Local LIONS Clubs sometimes have funds available for local visually impaired students to meet their needs.  So try contacting your local LIONS club.  Knight Templars also provide funds for equipment for visually impaired students, so this is another place to look in your community. 

Q.   I have a persistent scaly spot on my eyelid at the corner of my left eye. My eyes also feel very uncomfortable at times as if they have sand or a severe sunburn on the eyeball.

The scaly spot and dry eye symptoms may be related, and one eye problem that comes to mind with those symptoms is blepharitis (go to Q and A Archives and do a Find for blepharitis).  Other eye problems are also possible.  So you should see an eye doctor for evaluation and treatment.

Q.    I SEE A CIRCLE OF LIGHTS GOING DOWNWARD IN THE CORNER OF MY LEFT EYE , IT HAPPENS MAYBE 3 OR 4 TIMES A DAY ....IS THIS A SIGN OF A SERIOUS EYE PROBLEM?

It is unclear what the problem may be.  Seeing any kind of lights that are not "there" is always an indication of the need to see an eye doctor.  The simplest explanation is that you're actually seeing floaters; but floaters are always dark in color.  Certain retinal and vitreous problems can lead to seeing lights.  See an eye doctor for evaluation and treatment, if necessary, and let us know what it turns-out to be.

Q.    Can you explain NearSightedness and Farsightedness, I have to do a oral report on them, what causes and if treatable for tommorow.

We don't want to do your homework for you, but if you go to the Dictionary page you'll have a definition of each.  Nearsightedness is primarily caused by having eyes too long (from front to back), and as a result images are focused in front of the retina and appear as blurred.  Farsightedness is caused by having eyes that are too short, and thus images are focused behind the eyes and appear also blurred.   Both conditions are corrected with either glasses (corrective lenses), contacts or refractive surgery (e.g., LASIK - see Past Features Article about Refractive Surgery).

Q.   I was told I have "2 red lines on my retina but it's nothing to worry about". What causes this and should I be concerned? Thank you.

We have no idea what the two red lines might be.  We suggest that you again talk with your eye doctor for more information.

Q.    About ten years ago I took a job for one year working with computers (CRT screens).  I suffered terrible head aches and one day "suddenly" developed numerous floaters in both eyes-something I had never experienced before in my life. Before I had no need of glasses since my vision was excellent.  Ten years on and I still suffer with head aches and have difficuulty focusing close up.  I would appreciate any advice you might be able to offer.

Your present symptoms and the computer work 10 years ago are most likely unrelated.  The probability of floaters increase as we age, so the presence of a few floaters may be age related and not related to a computer job 10 years ago.  (Note: some of our web site visitors have complained that vitamin A supplements caused them to have floaters.  Although a clear relation has not been established between the two, we are advising visitors to this web site of the possibility that vitamin A supplements may cause floaters)  Also with age, it becomes more and more difficult to focus up close - a condition called presbyopia.  Most people in their 40s eventually need reading glasses or bifocals.  The reason for your headaches is not clear, one possibility is that they may be somehow related to eye strain and eye fatigue.   Go to an eye doctor for an exam, since it is possible that you need reading glasses or other corrections for proper eye sight.

Q.    I wear contact lenses and today when I took them off, I felt as if something was in my right eye, and when I close my eye it feels as if its coming from my eyelid.. I cannot judge whether this is coming from my eyelid or not, but when I put the contact lens back in my eye feels better. I am going to go see my doctor, I was just quirious as to what you might think it was.

You may have a scratch on your cornea or lid irritation, again from the contact lens.  Until you see your eye doctor, it may be best not to wear your contacts until you are examined.

Q.    What is it called when you have one row of eye lashes?

Don't know.  Eyelashes usually are arranged in two or three irregular spaced rows.  Excessive eye lashes (hypertrichosis) may be present at birth and extend throughout life.  Sometimes hypertrichosis develops in adulthood and may be associated with serious systemic problems with the GI tract or lungs (malignancy).   Hypertrichosis may also be rather localized , due to irritation or even chemical irritation or present from birth.

An absence of eyelashes (and often eyebrows) is called alopecia, although this term is usually applied to absence of hair on the scalp.  Alopecia of the eyelashes may be due to numerous factors including congenital defects, systemic infections, endocrine problems, chemical or drug reactions, trauma, and even sometimes due to psychological problems where the patient may unknowingly pull-out the hair lashes.

Q.   If someone has been diagnosed with optic nerve atrophy due to excessive brain pressure that cut off the blood supply to the optic nerve, is there any chance (however remote) of either an optic nerve transplant or nerve regeneration. The neural ophthalmologist recommended that the patient see a neural ophthalmologist every 6 months. I was wondering if that suggestion was based on the possibility of one of those 2 scenarios. In addition, it has only been 2 months since the accident that caused the brain injury. Is it possible that there may still be a chance that some sight will return this far out? He is completely blind.

These are excellent questions to as your neural ophthalmologist.   Although there is animal research currently underway to try to transplant optic nerves, the practical use and ability to actually transplant optic nerves in humans is still a long way away.  Optic atrophy is always a bad sign with generally a poor prognosis.  In general, optic nerves do not regenerate.   However, if the intracranial pressure is now normal and no more damage is done to the brain and optic nerves, there is always a chance for some vision recovery, albeit slight.  In general, we say that it may take up to a year for vision to recover after an insult, like an auto accident.  It is also possible that other brain areas related to vision were also damaged in the accident; as a consequence, the loss of vision may have been due to several factors, including damage to the optic nerves.  As the other brain areas recover for the accident, it is possible that some vision may return.  It is important to realize, however, that brain injury is often a complex issue, an issue that is best dealt with by the doctors giving the care.    They would be the ones with the best information about the chances for some vision recovery.

Q.    What is eighties chronic pupil?

The correct spelling is Adie's (not eighties).  To learn more about Adie's pupil, go to the Q and A Archives and do a Find (under Edit on your browser) for Adie's.

Q.   I am searching for an answer to my child's tunnel vision, he is 13 years old and in good health however a visual field test revealed that he has tunnel vision, which I have always suspected but no one would listen. I am in search of any info you may have thanks.

Tunnel vision is a serious symptom of a potentially very serious condition or disease.  Tunnel vision (lack of peripheral vision) requires a through medical work-up to determine the cause.  A number of conditions and diseases cause tunnel vision including retinal diseases (e.g., RP), optic nerve abnormalities (e.g., optic nerve hypoplasia) and compression lesions (e.g., caused by a brain tumor).   Sometimes, particularly in children, tunnel vision (sometimes noted as spiral fields) is due to psychological problems, in which the patient actually fakes a loss of side vision for whatever reason(s).  Usually, the eye doctor can trick the patient into revealing if the tunnel vision is due to psychological problems.  An illustration of tunnel vision is provided on the Simulation page. 

Q.   I have read most of your question and answers but have not been able to find any info on seeing lights outside in broad daylight or when it is foggy out. I am not bothered with them in the dark or in normal light it is bad when I am outside and the sun is shinning or even if I look at a white wall.

It is unclear what the problem might be.  We suggest that you visit an eye doctor for a complete, dilated eye exam.

Q.    Explain a ptergyma.

The correct spelling is pterygium.  Go to the Q and A Archives and do a Find (under Edit on your browser) for pterygium for information on this condition.

Q.    What are the floaties I see in my vision? How do I know if it's severe? Can it be corrected? What causes them?

Information about floaters can be found in the Q and A Archives ( for floaters do a Find under Edit on your browser) and an illustration can be found on the Simulations page. 

 

Q.    Is blind spot sensitive to colour?

As the name implies, the blind spot is an area of visual field in which NOTHING is seen.  The blind spot is caused by the optic nerve, which carries information from the retina to the visual areas of the brain.  Where the optic nerve head is located in the back of the eye, there are no photoreceptors to capture and convey light into nerve impulses.  Since there are no photoreceptors there is no vision (for anything).

Q.    What can you tell me about pumpcal aclusion?

Punctal occlusion (note correct spelling) involves the occlusion of the puncta, either by the insertion of silicone or collegen punctal plugs into the canaliculus or by cauterization of the canaliculus.   Insertion of silicone plugs is reversable and cauterization involves permanent closure.  Punctal occlusion is usually done to alleviate symptoms of dry eye disease (gritty sand irritation, tear deficiency or/and increased tear film osmolarity).     Punctal occlusion appears to decrease tear film osmolarity, decrease tear drainage and increase tear volume.  Occlusion may be done on the inferior and superior puncta of each eye. 

Q.    WHAT IS STARGOTT'S DISEASE?

The correct spelling is Stargardt's disease.  Go to the Q and A Archives page and do a Find, under Edit on your browser, for Stargardt's for more information.

Q.   Over the past two months I've had my eyeglass prescription changed 4 times, 3 times by an optometrist, and once by an opthamologist. Why does the prescription change seem fine for a few days/weeks, then I start to have trouble seeing again. It's my left eye that seems to keep changing. What could it be?

Don't know.  This is a good question to ask the docs that have examined you as they should be able to answer such a question.

Q.    I am a 16 year old male. In the last 3 months or so I have noticed that my left eye has gotten worse, everything just appears blurry, while my right eye has stayed perfectly fine, everything looks sharp and defined. I do use a computer frequently, but I'm always over an arms length away, and take breaks. In the profession I want to go into, perfect vision is needed. Is there any hope for me?

We don't know what the problem could be with such limited information.  Nevertheless, you need to see an eye doctor for evaluation and treatment, if applicable.

Q.   What is fukes? I had a lens implant and just in a few months my eyes is cloudy and now I have black spots and lines in this eye, is there any cure for this and fukes?

The correct spelling is Fuch's.  Go to the Q and A Archives and do a Find, under Edit on your browser, for Fuch's for more information on this corneal disease.

Q.   Eyes close for no reason can not drive some times they close will driving.

You need to see an eye doctor or possibly a neurologist ASAP for further evaluation of the problem.

Q.    I am a healthy 20 yr old and recently I noticed a very tiny spot in my right eye.  It moves around and comes and goes, mostly when changing focus.  My sister has toxoplasmosis.  Is this a floater or should I consider toxoplasmosis as a cause?

It is most likely a floater.  Whether the floater is related to toxo or whether or not you have toxo is not clear.

Q.   What are some common eye problems people have?

Common eye problems include myopia (nearsightedness), hyperopia (farsightedness), styes, pterygiums, floaters, dry eye disease and amblyopia.  Fairly common, but more serious, eye problems include cataracts, glaucoma, age related macular degeneration and diabetic eye disease.

Q.    Which color is the first to be lost when scuba diving?

Good question; unfortunately, we don't have a clue.

Q.   Can under developed rectus and extraocular muscles in children cause learning disabilities?

In general the answer is no.  Underdeveloped eye muscles is not a well defined entity.  The phrase implies weak or small eye muscles, which cannot be easily measured, if at all.  Since the eye muscles are covered by sclera, the white part of the eyes, one cannot directly measure or observe such muscles.  One possibility would be to undertake eye movement recordings and analysis, in which the velocity of the eye movements is recorded and this eye velocity measure could possibly infer a weak (or restricted) eye muscle.

A weak or underdeveloped eye muscle would suggest the presence of an eye misalignment; for example, crossed-eyes (esotropia).  Eye misalignments can usually be corrected by glasses, orthoptics, or/and eye muscle surgery.  Research has shown that infants with very crossed eyes do perform slightly worse on visual and visual-motor tasks (e.g., reaching for a visual object) than normal infants, but the differences are slight.  Since one eyed students, students with crossed eyes, visually impaired and even blind students can do fine in school, it would appear to be a stretch to say that some type of eye muscle problem per se can cause a learning disability.  Nevertheless, it may be possible to have some problems with reading, for example,  particularly if the eyes cannot converge and focus on close objects.   This problem is referred to as convergence insufficiency.   For more information on convergence insufficiency, see the Announcement page about convergence insufficiency and the new treatment trial underway at OSU College of Optometry.  It is important, however, to note the current proposed treatment for convergence insufficiency - basically practice at looking at near objects (e.g., pencil push-ups).  Finally, it is very important to first rule-out other things that can cause a learning disability; for example dyslexia, which has nothing to do with weak eye muscles.

Q.  My eye leads are swelling?

The most common reason why eyelids swell is due to allergies.   Eyelid swelling can also be a sign of more serious eye or/and whole body (systemic) disease.  Go to the Q and A Archives and do a Find, under Edit on your browser for "swelling" and/or "eyelid swelling" and/or "eye lid swelling" for more information on this topic.

Q.    I would like to know something about Steven Johnson disease, the cause, cure and treatment?

Stevens-Johnson syndrome has been described as a "cruel" disease: It is a potentially life threatening disease involving the whole body (systemic disease), and it is believed to involve an abnormal immune response to a microbe (e.g., mycoplasma pneumonae, herpes simplex virus).   This abnormal immune response is called a hypersensitivity reaction, causing fever, tiredness, nausea and vomiting, loss of appetite, headache, blisters on the palms of the hands and soles of the feet and mouth and other mucus membranes, as well as fingernail and eye involvement.  With the eyes, Stevens - Johnson Syndrome causes conjunctivitis,   conjunctival blisters, keratopathy, abnormal eye lashes that may turn-in toward the eyes causing irritation, meibomian gland dysfunction and dry eye problems and, finally, problems with the cornea including scarring, neovascularization and ulcers.  This appears to be a life long disease.  Treatment is beyond the scope of this web site, but mainly involves treatment of the specific symptoms that arise.  Some authors argue that immunosuppressive therapy and the use of systemic corticosteroids may make the disease worse.

Q.    Cures for double vision?

The cure for double vision (diplopia) depends on the cause of the double vision.  Usually double vision, when both eyes are open, is caused by misaligned eyes.  Misaligned eyes can be corrected by glasses with prisms, orthoptics (certain eye exercises) and by surgery.  However, again, the cause of the double vision must be established.  Diplopia can be a sign of a serious eye or/and neurological problem.   So if you have diplopia an eye exam by an eye doctor is in order.

Q.    What could cause the whites of the eyes to have a dark blue/gray tint?

There is quite a bit of variation in the color of the white parts (sclera) of the eyes in people, so it may be just common variation.  However, numerous syndromes/diseases are associated with blue/gray sclera. Probably the most common cause of blue/gray scleras is Osteogenesis Imperfecta, commonly known as brittle bone disease characterized by the triad; brittle bones, blue scleras and deafness.  This disease occurs in about 1 in 50,000 babies.  Certain connective tissue diseases also are associated with bluish sclera as a symptom.  So you need to see an eye doctor about this condition.

Q.    What might cause visual disturbances in the center of the visual field?

The most common central vision TEMPORARY disturbance is probably due to migraines.  In the elderly, those over 50, the most common central vision permanent visual disturbance is due to age related macular degeneration.  However, a whole host of eye diseases that affect the fovea and/or the macula can cause central vision disturbance, so see an eye doctor about the problem and to determine whether it is treatable.

Q.   My grandmother (my mothers mother) had retinitus pigmentosa she had 3 daughters , my mother had a son and two daughters. I have a daughter and a son, where might RP turn up again? Could my son get it? or my daughter be a carrier? Is my brother likely to get it he is 45. Is there an age where it most likely is obvious. My children and my self have had our eyes checked by an optometerist. We notified hime of our RP past. Should we have a test by a more qualified eye doctor? Also can tests be done on an unborn child to see if they have the disease. My son may start a family in the next few years and is concerned if it will reoccur in his children. So many questions, Thankyou in anticipation

The answers to your questions depend on a through family history, which in turn would define the type of RP that affected your grandmother.   If you can do a through family history than the following scenarios are possible:   If the detailed family history indicates that only your grandmother had RP (and any of her sisters and brothers) than it is highly probable that your grandmother had autosomal recessive RP (AR RP).  AR RP usually affects only one generation so it would be unlikely (probability of about 1 in 3600) that any other generations/your children would be affected.  Evidence for AR RP does include the fact that no one else in the future generations has been affected.

If the through family history shows, for example, that your grandmother AND about 50% of her brothers and sisters has/had RP AND a number of family members in earlier generations (from her mother's or father's side of the family) has/had RP, than the family history would suggest that your grandmother has/had autosomal dominant RP.  In this case, about 50% of her future generations/family members would be expected to have RP.  Clearly, autosomal dominant RP does not run in your family because you did not report any other cases in the more recent generations.

The third typical type of RP is X-linked (sometimes called sex linked) in which females are carriers (possibly with a very mild form of the disease) and the RP is passed on to 50% of the male offspring and 50% of female offspring are carriers.   X-linked RP is the one that skips generations.  Since your grandmother was blinded by the RP is it very unlikely that she had the X-linked type of RP.

Regarding onset of symptoms, in general the AR RP is the worse and symptoms (e.g., night blindness, loss of side vision) start relatively early, before the age of 20 - 30 years.  X-linked RP may start very late, up to say 40 or 50 years of age and is more slowly progressive. 

Overall, based on the limited information that you provided, it would seem that your grandmother had AR RP. As a consequence, the probability of your children and relatives having RP is small, similar to that seen in the general population - about 1/3600.

Q.   I experienced seeing a spot that was somewhat round and was outlined in black jagged edges with white inside the black and the center was light gray and I could see somewhat in the center. The black and white outlines were flashing like a strobe light and it made me feel a little dizzy. It lasted for about 5 to 10 minutes and then I was fine. Could this have something to do with my contacts drying out or a more serious problem?

Nothing to do with contacts.  The most common reason for your visual symptoms is that of migraines.  The visual phenomenon that you describe is classic and called a fortification phenomenon.  Migraines do cause lightheadedness, dizziness, ringing in the ears, body sensations and headaches (but not always).  There is, however, a very small chance that something else, possibly vascular/blood supply in nature caused the symptoms.  Why not visit your GP or internist or eye doctor for further assessment just to be on the safe side.  There are some good meds now available to combat migraines.  For more info on migraines, go to the Q and A Archives and do a Find, under Edit on your browser for migraine.

Q.    How does diabetes cause blindness?

The main way that diabetes causes blindness is by hemorrhages within the eye.  Diabetes causes reduced oxygen/blood delivery to the retina and this hypoxia, in turn, causes the development of abnormal blood vessels that tend to leak or rupture.  Everywhere that the blood vessels hemorrhage, vision is lost.  If a blood vessel in or near the macula of the eye (that part of the eye used for reading) hemorrhages than central reading vision is lost and the patient can become legally blind if both eyes become affected.

Q.   In the last year, I have started developing red lines in the white part of my eye. Each one starts out very sensitive and will hurt for a few weeks, and then it becomes a permanent line in my eye. It started with one but now my eyes are full of red lines that won't go away. My eyes are constantly hurting. I have been to three different doctors and have been prescribed quite a few different remedies, but none have worked. Do you know what might be causing these lines and is there any way to remove them?

The red lines are most likely swelled blood vessels.  Since several eye doctors have actually examined you and have treated you on an ongoing bases, we cannot do better or even offer additional information.  In your case, it would be best to discuss with your doctors what might be going on.  It always helps that before the doctor exam that you write down your questions and concerns and , hopefully, your doctor will answer your questions.  If your doctor(s) can give you a diagnosis, we would be happy to provide additional information about the disease.  Good luck.

Q.    My 3 year old poodle has been getting dilated pupils.   What are the possible causes?

As with humans, dilated pupils are most often caused by drug use, both legal and illegal.  Excitation can also cause dilated pupils, but we doubt if your poodle is being overly excited.  In the case of your poodle, we would be concerned of possible poison(s) that the dog may be consuming.  Do you let the dog out, by chance, to roam the neighborhood?  Could a neighbor be poisoning your dog?   We strongly suggest that you bring this topic up with your vet.

Q.   ...recently [my grandmother] has been concerned about a crescent shaped object that she sees when laying down. She called and asked her eye doctor about it and he said it was nothing and most likely related to anxiety. Now, can you please help me? Is it possible that her eye problem could be related to anxiety? I've tried searching the internet for anxiety related eye problems but have come up with nothing.

Anxiety can cause patients to experience vision loss (e.g., hysterical blindness, conversion reactions); however, crescent shaped "objects" (most likely a form of scotoma) is not typical.  Certain retina and neurological conditions can cause patients to see crescent-shaped scotomas.  We would suggest a visit to an eye doctor for a retinal exam.

Q.    My eyes and upper part of nose felt like there were frozen underneath. Had some slight pressure feeling along with it - also had some very slight numbness under upper lip. This lasted approx. 2 hours. Has anyone had this before? Should I be concerned?

Yes, you should be concerned.  If you have had an injury to the facial area recently, the symptoms are suggestive of possible nerve damage.  If you have not had any injury than the symptoms may be suggestive of nerve damage due to an unknown entity.  Another possibility is sinusitis.  Suggest a visit to your GP or internist, and if they can't find the reason for the symptoms than visit an eye doctor experienced in neurological problems (e.g., neuroophthalmologist).

Q.    Growth on eye lid margin?

It is most likely a sty if it is located along the eye lashes.   However, other more serious diseases can also cause lumps on the lids such as basal cell carcinomas (malignant tumor) so an eye doctor should check it out.  For more info on sty, go to the Q and A Archives and do a Find, under Edit on your browser for sty or/and stye.

Q.   Puzzled... At times, in left eye only, center view is clear and round in center, with wavy lines radiating away from center....Ideas?

Sounds like an ocular migraine - a migraine that can cause temporary amblyopia or reduced vision in one eye.  The symptoms that you describe are often called fortification phenomenon.  See an eye doctor to rule out any other cause of the visual symptoms.

Q.    What is bests disease ?

For info on Best's disease, go to the Q and A Archives and do a Find, under Edit on your browser, for Best's.

Q.    I have red lines (veins) linking all the way to the outer circumference of my iris. Is there any way to make these red lines disappear? I'm assuming this is caused by eye strain, due to the no. of hours I spend on the computer each day.

You really need to see an eye doctor about your condition.   Are the red lines (gorged blood vessels) always present?  Or only seen after a long day at the computer?  If they're always present, than they may be a sign of possible serious eye disease.  See an eye doctor to be on the safe side - your vision may depend on it.  If they are related to computer work your eye doctor may be able to provide advice as to ways, including certain optical corrections to relieve the eye strain.

Q.   My left eye has been twitching periodically over the past two weeks, and now is it beginning to puzzle me. It comes and goes, sometimes not for long periods, and then it happens very frequently. I can be talking to someone and it just starts, and feel very self-conscious...what do you think could be the problem?

In classical eye twitching - look in a mirror when the eye is twitching and you'll probably not see the eye actually twitching because it is a very small movement.  If the eye twitch is more of an eye squinting or eye closure than we're talking about something else, possibly blepharospasm.   In the vast majority of cases, eye twitching can be thought of as a tick usually due to stress, fatigue, or even too much stimulants such as caffeine.  Eye twitch will involve one or both eyes and will come and go, depending on the cause or precipitating factors for the eye twitch.  For more general info on eye twitch, go to the Q and A Archives and do a Find, under Edit on your browser for twitch or/and twitching.

Q.    For the past few months now my eye has been feeling like there is a speck of dirt stuck in it which will not come out. It is not painful but is causing me a lot of irritation. Although I wear contacts, the irritation is still present with or without them. I saw an optometrist a few days ago who gave me Lotemax for lid inflammation. He says he saw no signs of infiltrates, and gave me Acuvue 2 to wear, but my eye is still feeling extremely irritated. He says the cornea looks fine. Do you have any idea what this is? I am resigned to not wearing my contacts for a few weeks.

Good.  Not wearing the contacts for several weeks may help to identify the source of the problem.  If you're in your 40s or older, you may have dry eye disease, which is sometimes difficult to diagnose because it waxes and wanes and the tests for dry eye disease are not great (see past features article on Dry Eye Syndrome or disease).  Numerous other conditions can cause your basic symptom of sand in the eye, including meibomian gland dysfunction.

Q.    What are the effects of Lupus on the eyes?

Systemic lupus erythematosus (SLE) is a chronic disease related to immune system dysfunction.  About 90% of SLE patents are female and LSE may be triggered or exasperated by sunlight.  SLE usually involves well defined, scaly lesions of the skin as well as sometimes fatigue, fever, weight loss (sometimes anorexia), gastrointestinal problems, CNS problems and more. Regarding the eyes, SLE is associated with conjunctivitis, episcleritis, occlusion of the retinal veins and loss of choroidal circulation.  Retinal ischemia may lead to neovascularization (development of abnormal blood vessels) which tend to leak causing sudden loss of vision in some cases.   Classic of SLE are so-called cotton-wool appearing spots on the retina, which relate to areas of poor circulation.  About 25% of SLE patients experience keratoconjunctivitis sicca (KCS); inflammation of the cornea and conjunctiva, thickening of the corneal epithelium, itching, burning sensations of the eyes (similar to dry eye disease) and sometimes loss of visual acuity.  There may be CNS involvement including optic neuropathy similar to optic neuritis, optic disc edema, increased intracranial pressure chiasmal lesions, cortical blindness, homonymous hemianopsia (see illustration under Simulations), migraines and double vision.  many of these problems seem associated with ischemic events.

Q.   What is wrong if I often feel a burning sensation and more recently twitching in both eyes?

A burning sensation in the eyes is often due to dry eyes (see past featured article on dry eye disease/syndrome) or allergies, but it also can be caused by other more serious eye problems.  The eye twitching (see previous question about eye twitch) is probably unrelated and due to things like stress, fatigue and too much caffeine.  See an eye doctor about the burning sensation.  Also for more info on burning eyes or dry eyes, go to the Q and A Archives and do a Find (under Edit on your browser) for burning.

Q.    I see a dark circle in my left eye.  I can see through it but it leaves a blur image, it usually goes in a couple of days.

It sounds like your experiencing a ring scotoma (see simulations for an example) in the left eye.  Your symptom may be a sign of serious eye disease.   You need to see an eye doctor for a dilated exam ASAP.

Q.    Are there any advances whatsoever in finding a cure for Best's disease?

There is a lot of basic, applied and animal research currently underway for many of the retinal diseases, including Best's disease.  The biggest advances in the next 5 - 10 years will probably come from genetic research - research into the genes that cause Best's disease.

Q.   The extrageniculostriate system.

Visual pathways include a pathway from the retina to Lateral Geniculate Nucleus (LGN) to striate cortex (occipital cortex) to higher cortical pathways, as well as from the retina to superior colliculus to inferior pulvinar to striate cortex to higher cortical pathways.  There is also a little known visual pathway from the retina to the hypothalamus and beyond (upper thoracic spinal cord, anterior pituitary).   Extrastiate usually refers to the pathway from striate cortex to the  higher cortical areas pathway, beyond striate cortex (Brodmann area 17).  At last count there were about 32 cortical areas devoted to visual information processing. 

Q.   Lebers hereditary optic atrophy.

Leber's hereditary optic atrophy/neuropathy (LHON) is characterized by a sudden vision loss in one eye followed by loss of vision in the other eye, usualy a few weeks or months later.  LHON is the first disease to be linked to an inherited , maternal, mutation in the mtDNA.  LHON usually affects males, about 90% of the time.  The vision loss ranges from mild to no light perception, with most of the cases worse than 20/200 - legal blindness.  Although there have been some cases of improvement in vision following the initial onset of vision loss, most cases show a permanent vision loss.  The diagnosis of LHON can be confirmed via blood samples and DNA sequencing.  We have seen numerous patients with LHON over the years and often the patient first notices the vision loss in one eye following an accident or head trauma.  The patient then believes that the head trauma caused the vision loss in one eye and seeks medical attention which leads to the discovery of the condition.

Q.    Can anything be done for color blindness?

No.

Q.   I am experiencing flashing light in my right eye and a web like display during my waking hours.

You need to see an eye doctor ASAP.  Flashing lights may be a sign of a retinal detachment or retinal tear.  A web like display is sometimes seen by patients with blood vessel occlusion disease.  Se an eye doctor today.

Q.    I’m 28 years old and wear glasses, strength –5.5. In my job I spend 8 hours a day behind my computer screen. I have a serious eye strain problem, which started about two years ago. At the moment I have also eye strain problems while reading from paper. First strain problems disappeared during at night and weekends. At the moment I have continuously pain around my eyes. My optician concluded constrained eye muscles one year ago. Since then I have undertaken several actions to solve the problem. 1) My eyes were checked by different opticians and were found ok. 2) I have visited an ortoptist who gave me some cross-eye exercises. I practice these exercises every day. 3) Two physiotherapists have examined my neck and shoulder to check for a strain headache, but found no abnormality. 4) I have tried weaker glasses (advice from my optician) by wearing both my contact lenses and reading glasses. Generally speaking I wear my glasses when using the computer. 5) I have increased the monitor viewing distance step by step, at the moment this distance accounts 1.2 m to reduce eyestrain. Moreover I take frequent rest break to look at objects in the distance.  All action mentioned above, however have only had small effects. When I’m preparing to sleep I first have about half an hour a lot of pain in my forehead after closing my eyes.  I hope you have a solution for my eye problems.

Sounds like you're doing everything right and still have problems.  You state that your problems started about 2 years ago.  Did anything else happen about that time or can you link the original onset of your eye strain to something that happened about the same time (e.g., new computer set-up or monitor?).   Unfortunately, often patients have too become detectives to try to uncover the reason for such eye strain.  Is your computer monitor the right height - the top of the screen about eye level?  Do you do something else besides the computer typing like turning your head towards material while typing?  What about glare on the monitor?  The best we can offer is for you to that charge and manipulate your work space until you can find the root cause of the eye/muscle strain.

Q.    As an infant, my mother noticed that when I would drink from a bottle or chew food my right eye would jump or twitch up and down. As my jaw would open, my right eye would open very wide while the left remained normal. This has always been the case as my right eye continues to enlarge when I open very wide (in the dentist's chair, or chewing food). My mother was told by a doctor 23 years ago that my eye muscle was connected incorrectly to my jaw and the term he used was "Jaw Winkens." I have been experienced TMJ problems and was wondering if one had to do w/ the  other. Also, I cannot find any information on "Jaw Winkens" and am very curious about this condition. Is there another name for it?

The correcty term is "jaw-winking"  Jaw-winking is associated with congenital ptosis - an infant born with a droopy eyelid, usually involving one eye.  The droopy eyelid retracts or opens-up when there is jaw opening like that seen when an infant sucks on a bottle, and sometimes other facial or tongue movements can induce the retraction of the droopy eyelid.  Jaw-winking and the associated ptosis can be associated with amblyopia (lazy eye), difference in refractive error between the eyes (anisometropia) and sometimes superior rectus palsy or inability to raise the eye on the affected side.  We know of no association between jaw-winking anf TMJ.  Although the exact cause of jaw-winking is unknown, it is believed that there may be an inborn misrouting of the fifth cranial nerve to the position of the third cranial nerve that controls the levator muscle for the eyelid.  Certain types of surgery may be used to correct or improve the condition. 

Q.    Eye loose focus after reading close objects what cause?

If your in your late 30s or 40s, you're probably experiencing the start of presbyopia.  As we age, the lens of the eye becomes less and less able to focus on near objects.  Also, after a period of close work, for example, the eyes have a difficult time in being able to focus at more distant objects and, as a consequence, things appear blurred.  See an eye doctor for further evaluation and to see if you need bifocals.

Q.    Blister like growth on white of the eye close to the iris?

You may have a pterygium - a rectangular shaped growth on the white of the eye near the nose and that can grow and affect the pupil.  For more info, go to the Q and A Archives and do a Find, under Edit on your browser, for pterygium.  Whatever, the problem, see an eye doctor for futher evaluation; It could be a more serious condition.

Q.    Please advise with respect to an eye ailment diagnosed as tyragium. It appears as a growth over the eye starting from the inner area going towards the pupil. It is not cataract as we were told by the doctor, but i would appreciate any additional information you can provide on this ailment.

The correct spelling is pterygium.  For more info, go to the Q and A Archives and do a Find, under Edit on your browser, for pterygium.

November

Q.    amliobia?

You probably mean amblyopia.  Go to the Q and A Archives and do a find, under Edit on your browser for amblyopia.  Also, look under past featured articles on the top of this page.  Also go to ohioamblyoperegistry.com for extensive info on amblyopia.  Don't forget to come back now!

Q.    What is Gonoreah?

The correct spelling is gonorrhea.   It is typically considered a venerial disease (a sexual disease).  However, it can also infect the eyes.  A new born can catch the disease as he/she passes through the birth canal and this is why all new borns have 1% silver nitrate placed in the eyes.   Older people can also get their eyes infected through contact with infected body fluid making contact with the eyes.

Q.    Looking for information on fuches dystrophy.

You're probably referring to Fuch's corneal dystrophy.  Go to the Q and A Archives and do a Find, under Edit on your browser, for Fuch's for more info.  Fuch's corneal dystrophy has been discussed several times in the past.

Q.    Help PLEASE. I have had red eyes for the last 20 years of my life. I have been to eye specialist and no one has been able to diagnose why. I have had drops given to me which are designed to lubricate the eyes but they do not work. My eyes are irritated all the time. They seem to get even redder when I am under stress. Does stress play a factor in eye redness. This is the most embarassing thing in my life and is making life intolerable. I'm at the point where I avoid social interaction because I am so embarassed. Please any suggestions would help. I have read your Qs and As and not found anything that I haven't heard before. I chronically look like i'm suffering from a massive hangover and my eyes always get worse when I am put under stress. Please any help would be very much appreciated. Thanks

Sorry, but since you've already seen several docs about the condition, we can offer nothing more since they actully have examined you.  Some patients simply have chronic red eyes.  Since stress seems to be related to the condition, have you tried relaxation techniques (yoga, exercise, breathing techniques?).   Sometimes a condition will stress-out a patient so much that the stress itself is the cause or major contributing factor for the problem.

Q.    what is retinal arterioles ?

An artery is a blood vessel that takes blood away from the heart.  An arteriole is a very small arterial branch, typically proximal to a capillary.  ( A capillary is a real small blood vessel that connects the arteries to the veins which carry blood back to the heart).  So a retinal arteriole is a small blood vessel in the eye.

Q.    With in the last two weeks my left eye lid twitches almost constantly. Almost to the point of not being able to keep it open.

If you can easily see the eye twitching and it is actually causing the eye to close somewhat, it is probably not the typical event that we consider an eye twitch.  It is possible that you're experiencing a blepharospasm.  A blepharospasm may or may not be associated with other problems such as a lesion of the eye's fifth cranial nerve.  See an eye doctor for futher evaluation.

Q.    I was interested in any info you might have regarding links between Accutane and permanent dry eyes. It seems well known that Accutane can cause dry eyes concurrent with usage, but in my case I developed dry eyes just a few weeks after abandoning Accutane treatment (I stopped after three months of usage due to severe dry mouth). For the last several years my eyes have gotten progressively worse and I've even had punctal plugs put in. I've heard that there are currently studies being done on the relationship between testosterone-type harmones and dry eye syndrome, and was wondering how one might get involved in a study or be a candidate for such experimental therapy (is there anything available in Canada, say, that isn't available here?). When might the fruits of such studies be borne? Thank you very much.

I just thought of an addendum to my question about Accutane and dry eyes-- have you heard anything about cylcosporine as treatment? Apparently there have have been promising results in canine treatment, but are there human clinical trials in the works? And, pray tell, what exactly is cyclosporine? Is it readily available, potentially harmful, or used for any other sort of treatment? Thanks once again.

Accutane can cause dry eyes and further, because the active drug is a form of vitamin A, the effects can be very long lasting.  Vitamin A is stored in the liver and a very large dose of vitamin A can remain in the liver stores for years.   So, having continued dry eyes for several months after treatment would not seem unusual.  It is VERY IMPORTANT that the patient on Accutane know that it can cause birth defects so women should not take Accutane unless they're on a very effective birth control.  Regarding cyclosporine, yes, there is a multicenter clinical trial curently underway to assess cyclosporine for dry eye disease.  For further info on the study, visit the NEI-NIH web site at: (This web page has been removed.  Try to find info at http://www.nei.nih.gov/).   Also see the past featured article on dry eye disease and available treatments.

Q.   I notice when I take more than 1 excedrin in a day, a blood vessel in my eye will break. Is there a relationship between aspirin and vein breakage in the eye? Any treatment necessary? The white part of one of my eyes on the outer part of the eye is filled with blood. Nothing covering the pupil.

Sounds like you have reoccuring subconjunctival hemorrhages.   These do occur in otherwise healthy patients, and any blood "thinner", such as aspirin, can make the problem worse.  However, just to be on the safe side, see an eye doctor for further evaluation of the problem

Q.   I have noticed a yellow patch on the corner of my eye. it is just outside where the color from my eye stops and the white starts. it doesn't affect my vision but i wondered if i should be concerned. i am 20 years old, wear contacts, and out in the sun alot. if you can shed any info on this for me i would greatly appriciate it.

The yellow spot is probably a pterygium.  Go to the Q and A Archives, as well as this web page, and do a Find, under Edit on your browser, for pterygium for more info.  If you don't think that it is a pterygium after reading about it, write us back and include additional information about the spot if you can.

Q.   How did retinoblastoma get It's name?

Retinoblastoma is a malignant tumor that arises from retinoblasts.  The word comes from a combination of location of the tumor, retina, and type of tumor, congenital blastoma.  A blastoma is an abnormal growth (neoplasm) that arises from a group of cells that develop into a new organ, in this case the retina in normal development.  Retinoblastoma is a very serious condition and is usually detected before the age of five years.  Typically, the pupil of the affected eye appears white.  Sometimes the infant/child will develop misaligned eyes because of decreased vision in the affected eye(s).

Q.    Do tear ducts function normally in the blind?

In general, yes.  Blindness is seldom caused by external eye factors, which might affect the drainage of the eyes and the tear ducts.   Blindness is usually caused by diseases or damage to the inside of the eye or optic nerve or brain.  This does not mean, however, that patients who are blind do not have problems with the tear ducts - their chances of a problem would be about the same as in the normal population.

Q.    What causes spots in front of an eye?

If you mean that you "see" spots, than it is most likely floaters.  Go to the Q and A Archives, as well as this web page, and do a Find, under Edit on your browser, for floaters.  Also, an illustration of floaters can be found on the Simulations page.

Q.    My wife, aged 51, has been complaining about increasing light sensitivity. She has difficulty driving at night or in bright sunlight even with sunglasses. Bright room lights, televisions and computer screens cause her pain. She has adapted to the increased sensitivity by eliminating or reducing activities that cause pain thus reducing her life quality.  She is nearsighted and wears glasses. She has complained about excessive dryness in her eyes and, as a consequence, has been unable to wear contact lenses. I would appreciate any suggestions regarding how we might treat this condition.

Your wife needs to see an eye doctor to determine the reason for her light sensitivity.  It is common for patients around 45 - 50 years of age to complain about and to have dry eyes, thus preventing the use of contact lenses.  It is also fairly common for women to complain about not seeing very well at night (we know that that sounds sexist but it simply is a fact that women more than men complain of poor night vision).  However, her complaint of sensitivity to light is unusual and may be a sign of serious eye disease such as cataracts or glaucoma.  See an eye doctor and have test(s) for dry eye disease (see past fratured article on Dry Eye Syndrome/disease), glaucoma as well as a complete dilated eye exam.

Q.   What is chrodil?

Q.    Choroidopathy?

You are probably referring to choroid.   Choroidal then relates to the choroid.  The choroid is a layer of tissue in the eye the contains pigment and is the vascular coat of the eye.  The choroid contains /conducts arteries and provides blood to the retina.  A choroidopathy is another name for choroiditis or inflammation of the choroid - or also uveitis affecting the choroid.

Q.    Retinal Pigment Degeneration?

The retinal pigment epithelium (RPE) is a thin layer of cells that provide nurishment to the retina, including vitamin A, and also gives a "charge" to the eye as measured by the electrooculogram.  Wide-spread RPE degenerations or dystrophies include Best's disease/Vitelliform degeneration and localized RPE dystrophies include Stargardt's disease, among others.

Q.    My secretary just told me that she has a eye condition, that her gel is getting hard and produces vision problems, what is the clinical name for this condition?

It is unclear what the problem might be based on your description alone.  As we age, the lens of the eye becomes fixed and unable to adjust and, in a sense, becomes hard.  As a consequence, the individual requires reading glasses for close work - a condition called presbyopia.  Also, as we age and sometimes related to pathology, the gel of the eye, called vitreous, will liquefy and end up puling away for the retina.  This condition is called posterior vitreous detachment.  Sometimes, a posterior vitreous detachment can cause vision problems and lead to other eye problems.  If you can find the name of the condition we'll be happy to add more to this discussion.

Q.    I have floopy eyelid syndrome since the 8th grade.  I'm now in the 11th grade but here lately I have been having like pains in the back of my eyelid whenever its infected, and also it will feel like my eyelid is being pushed in or pulled-out.  If you have any time, can you tell me what is causing this or what it is?

In floppy eyelid syndrome, there is a tendency for the upper eyelid(s) to evert or turn-out or/and loose contact with the eye ball.  This is what you describe as pushed-in and pulled-out.  In floppy eyelid syndrome there are common problems with chronic (papillary) conjunctivitis as well as meibomian gland dysfunction and this may be what you describe as pains in the back of the eyelid.  Patients with floppy eyelid syndrome often complain of red, irritated eyes with mucus discharge.   Sometimes taping the eyelids shut at night or patching the eyes at night may help with some of the symptoms.  Sometimes surgery is recommended to tighten the or shorten the upper eyelid. 

Q.    Eye cloudy (diabetic)?

Whenever a patient has diabetes and has any changes in vision, the patient really needs to see an ophthalmologist for possible immediate medical evaluation and treatment.  Cloudy vision may be a sign of an early cataract or a sign of serious retinal problems.  So play it safe and see your eye doctor about the problem.

Q.    blufferitis?

The correct spelling is blepharitis.  Do a Find, under Edit on your browser for blepharitis in this section and in the Q and A Archives for info.

Q.   One of my eyes will begin to hurt, water, turn red and then looks as though it has a second skin. What is this?

Whenever there is pain the patient should see an eye doctor.   It is not clear what the problem might be, some of the problems though may be serious, so see an eye doctor about the problem.  One possibility is that you have a form of conjunctivitis that results in a membranous conjunctival reaction.

Q.   What do you call the small growths on the surface of the eye?

You'll have to describe the condition in greater detail.   Numerous problems can cause "growths" on the eye, the most common is a pterygium.  For more info on pterygium, check this web page and the Q and A Archives (do a Find under your browser Edit) for pterygium.

Q.    What does CSM stand for when listed as the acuity?

CSM usually stands for Central Steady Maintained fixation.   This would be considered normal.  CSM is usually used when examining preverbal children and handicapped patients

Q.    Eye redness and pain.

Q.    Blurred vision.

Whenever there is pain or blurred vision, one should seek immediate medical attention.

Q.   My daughter,who is now 2yrs 9months old suddenly became extremely sensitive to the sunlight at age 1yr 8 months old. It effects only her left eye. She also tilts her head to the left. Her eye waters quite abit this seems to be worse in the morning. She often says she's sick or tired.Her eye looks puffy and tired when she does open it. She has had 2 eye exams and a CT scan nothing has been found. This little girl used to love to be outside now she wont go until after dark. I am desperate and would welcome any suggestions you might have. Thank you from concerned Canadian mother.

Whatever is going on with your daughter it is obvious that she is experiencing photophobia; sensitivity to light.  This is probably why she doesn't like going outside in the bright light and, possibly, the reason why the eye is watering.   Of concern, since she is either voluntarily closing one eye or one eye is closed because of "puffiness", she has a possibility of developing amblyopia or lazy eye in the affected eye.  As a consequence, it is very important that she is closely monitored for the development of amblyopia.  We assume that she is being seen by a pediatric ophthalmologist.  Talk to her eye doctor or pediatrician further about the problem and determine if they have a name for the condition.  If so, we would be happy to provide additional information.

Q.    Superior Limbal Keratosis.

Keratosis refers to any horny-like growth.  The superior limbal area would refer to the top of the eye near the edge where the cornea and white part (sclera) of the eye meet.

Q.    A small flashing ring in the center of my vision appeared suddenly and over 15mins the ring grew larger and larger until it grew past my peripheral vision, returning my vision to normal. It grew in an un-uniform, organic way. I stare at a computer screen all day and haven't been eating properly. could that be the problem or is this a sign of something serious?

It sounds like a fortification phenomenon and ring-type scotoma experienced by migraine sufferers.  If so, typically migraine sufferers will experience a headache, dizziness, loss of balance, ringing in the ears or some other body sensations during or following the visual phenomenon.  Have a discussion with your GP, Internist, etc., about the problem. 

Q.   I see a jagged line. There is a beggining and an end to the line. it gradually get longer and longer. it last about 30 minutes. I get it sometimes 3 times a week and sometimes I go for months OK.

It is unclear what the problem might be.  We suggest that you discuss the problem with your eye doctor.  If you see straight lines as wavey - this may be a sign of a potentially serious eye disease like macular degeneration.   If you see a line that isn't really there, than the problem is not so straightforward.

Q.    Convergence/divergence.

In ophthalmology, convergence usually refers to the eyes turning-in toward a close object - the eyes "converge".  When a patient changes fixation from a near object to a more distant object, for example, the eyes will "diverge". 

Q.    How do I find info on "tygisines" disease?  Help with spelling, please

Q.   Information on thygersons disease.

You may be referring to Tygeson's disease, the more technical phrase being "chronic follicular conjunctivitis of Tygeson."  Phillip Thygeson first reported an epidemic of chronic (long lasting) follicular conjunctivitis in a group of teenage girls in California.  The girls were apparently sharing eye make-up and spread the disease from one to another.  Patients with Tygeson's disease complain of sensitivity to lights (photophobia with rapid onst), eye irritation and foreign body sensation, and some decreased central vision.  The disease is long lasting and estimates vary from four-to five-months to several years.

Q.   I have been seeing double for quite a while and it has gotten really bad lately. What causes this?

In general, double vision (when both eyes are open) is caused by a misalignment of the two eyes.  The real question, however, is what is causing the eye misalignment.  Because some serious problems can sometimes cause double vision, you need to be seen by an eye doctor for further evaluation.  Also go to the Q and A Archives and do a Find, under Edit of your browser, for double vision or double for more info.

Q.    Please give me some information on suedo exfloation.

Q.   My mother was told she has pseudoexfoliahon syndrome. What is psudoexfoliahon syndrome?

You're probably referring to pseudoexfoliation syndrome (note spelling).  In pseudoexfoliation syndrome, fluffy white material in the anterior chamber (front part of the eye between the cornea and lens) deposits on various structures of the eye including the lens capsule, iris conjunctiva and ciliary body.  Importantly, this material appears to have the potential to clog-up the trabecular meshwork - the sponge-like filter of the eye that , in part, controls intraocular pressure.  When the trabecular meshwork gets clogged-up, pressure increases inside the eye leading to open-angle glaucoma.  The danger in open-angle glaucoma is that the patient is often not aware that the pressure in the eye(s) has increased and the patient may suffer irreversible vision loss before seeking treatment.  So, if a patient is diagnosed with pseudoexfoliation syndrome regular eye exams are very important.

Q.    How are eyes affected with marfans syndrome?

Marfan's syndrome is associated with numerous eye problems including myopia, neovascular glaucoma, retinal detachment, abnormal development of the iris (iris coloboma) as well as the macula and optic nerve, and pigmentary retinopathy.  The most common eye condition associated with Marfan's syndrome is lens dislocation which can get worse with age and require removal of the lens and the placement of a intraocular lens.  Problems with the lens and pupil of the eye in Marfan's syndrome may be associated with glaucoma.  Regular eye exams are needed to follow the patient with Marfan's syndrome.

Q.    Long story.  I have had problems with conjunctivitis for the past 15 years.  Now however, my eyes are so bad that they have a crust like scabbing around the outer eyes and my skin around the eyes, down to my nose and cheeks is red and broken out like a rash...They both are swollen to where I look like a boxer at frequent times....I will go to another Dr, but I am getting tired of that, but anything to help would be great!!!

Your present problems do not sound like conjunctivitis; but rather, possibly seborrheic blepharitis (which is associated with conjunctivitis), with the seborrheic dermatitis affecting the facial area.  See your eye doctor for treatment.  For further information on blepharitis, go to the Q and A Archives and do a Find, under Edit on your browser, for blepharitis.  Good Luck

Q.   WHAT IS A PSEUDO TUMOR IN THE EYE?

You're probably referring to pseudo tumor cerebri.  This is a condition in which the patient appears to have a brain tumor, but does not.  One of the signs of pseudo tumor cerebri is a swelling or papilladema of the optic nerve head (disc).  However, pseudo tumor cerebri is a diagnosis of exclusion - one must make sure via a host of diagnostic tests (CT scan, spinal tap, etc.,) that the patient does not indeed have a brain tumor. 

Q.    What is Best's disease.  Is there current research going on in relation to best's disease?

For info on Best's disease, please go to the Q and A Archives page and do a Find, under Edit on your browser for best's.  The topic has been discussed several times in the past year.  Also, go to the Links page and click-on the link for the Macular Degeneration Foundation (http://www.eyesight.org/).

Q.   I have a small lump on my eye in the area of my bottom eye lid what is it?

If the bump is actually on the eyelid, there are numerous possibilities, the most likely being chalazion and sty.  Less likely but possible is a tumor.  A chalazion is usually located away from the lid margin.  It is more solid, may or may not be red and may be there for months and then disappear.  A sty is usually located along the eye lash margin where the roots are located.  A sty is usually reddish, swollen and painful to the touch.  It is soft and may spontaneously break and drain pus-like fluid.  A tumor is usually flatter, not red and will continue to grow and involve more and more of the eyelid.  For more info on sty or chalazion, go to the Q and A Archives and do a Find, under Edit on your browser for the respective word.  See an eye doctor for further evaluation and treatment.

Q.    What is ADM syndrome?

Don't know.  You may be referring to Age-related Macular Degeneration, which some refer to as AMD.  AMD is not a syndrome.  For more info on age-related macular degeneration, go to the Q and A Archives and do a Find, under Edit on your browser, for macular degeneration.

Q.   I have an extremely low tolerance to light. Possible cause and solution?

Low tolerance to light is known as photophobia.  A long list of conditions/diseases can cause photophobia and the solution/cure depends on the cause of the photophobia.  Conditions/diseases that cause photophobia include cataract, cornea problems, drugs, retina problems/degenerations and even cortical/brain problems.  See an eye doctor for evaluation and treatment.

Q.    When were glasses first worn?

We have a reference to this question...somewhere.  We'll try to uncover it in the next week or two, if possible.  We believe that it was in the 15th century, possibly Italian related.

Q.   My wife has a problem with her eyelids. Both are rather pink and swollen. Her eyes themselves are fine - but her eyelids itch like the dickens. Is this an allergic reaction? Or what is most likely the cause?

The most likely cause for swollen, pink/red and itchy eyelids is due to allergies.  In women, a common allergic reaction is to facial make-up.   For more info on this topic, go to the Q and A Archives and do a Find, under Edit on your browser, for allergies or allergy.   Have her see an eye doctor for evaluation and treatment.

Q.    Star guardts?

You're referring to Stargardt's disease; a retinal degeneration.   For more info, go to the Q and A Archives and do a Find, under Edit on your browser, for stargardt's.

Q.   Optic neuritis?

Optic neuritis is inflammation of the optic nerve - the nerve that runs from the eye to the visual parts of the brain.  Numerous things can cause optic neuritis, the most common being Multiple Sclerosis (MS).  Go to the Q and A Archives and do a Find, under Edit on your browser, for optic neuritis for more info.

Q.   I have been having episodes nearly every other day seeing zagged lights around objects that only last 15-20 mins then go away. It does disturb my vision. What is causing this and is it dangerous.

The cause is not clear, but what is clear is that you need to see an eye doctor for evaluation.  Migraines are associated with zagged lines that sort-of shimmer and the area of zagged lines tend to grow and spread-out to more side vision.  The "fortification" phenomenon lasts about 15 minutes or so and may be followed by a headache, dizziness, loss of balance and other bodily symptoms.   Go to the Q and A Archives and do a Find, under Edit on your browser, for migraine and see how others describe them.  Click-on the Simulations page for an illustration of the fortification phenomenon.  Since other things can also cause such symptoms, see an eye doctor for piece of mind.

Q.    I am 36 years old and have been seeing a lot of floaters for at least a year now..I have seen several specialists , who have all said there is nothing wrong with me..They tell me they see healthy eyes..I should say that by several , I mean several thousand.   What should I be concerned with.

It is common for patients to complain of a few floaters, particularly as we age.  To see a lot of floaters may be a sign of a serious retinal or optic nerve problem.  Since you've seen several specialists it would seem that they would have ruled-out most causes of floaters.  We assume that when you saw the specialists that they were either ophthalmologists or optometrists and, importantly, that they performed a dilated eye exam.  If not, see an eye doctor for a dilated eye exam.   If so, from a computer/web site we can't second guess someone that has actually examined you, so we have to go by the word of the docs that have.

Q.   My son, aged nearly ten, has recently started complaining of seeing differently with one eye than with the other. At first he said he saw more colour out of one eye, but on further questioning he said that the one eye sees "darker" than the other. Can you think of any reason this should be? Is it something I should follow up? He had his vision checked about a year ago and it was fine.

There are several possibilities for seeing objects darker in one eye than the other and some of the problems may be serious.  We strongly recommend that your son see an ophthalmologist for the problem.  Although children sometimes say that they can't see out of one eye in order to gain attention or for various psychological reasons, it is not at all common for children to complain of darker images in one eye.  Have him see a doctor ASAP.

Q.    What could cause parts of my vision to disappear?

Numerous conditions and diseases can cause vision or parts of vision to disappear and then reappear, the most common probably being visual symptoms associated with migraines.  Vascular problems also cause vision to wax and wane over time.  A lot of the conditions and diseases that cause vision to disappear are serious conditions so see an eye doctor about the problem ASAP.

Q.    Bright flashes.

Seeing bright flashes when there is no visual stimulus may be a sign of serious retinal or/and optic nerve disease/  So see and eye doctor about the problem and make sure that you have a dilated comprehensive eye exam.

Q.   I have a teredium (not so sure about the spelling) in both of my eyes. Want to know everything about it.

You're probably referring to a pterygium.  Do a Find, under Edit on your browser, for pterygium on this page and on the Q and A Archives page for more info.

Q.   Since having my prescription updated recently (to both my clear glasses and sunglasses), I have developed a particular sensitivity to wearing my sunglasses i.e. I develop eye aches and headaches from wearing the sunglasses. The prescription has been checked and is OK, and the prescription on my sunglasses and glasses is pretty much spot on. This has been going on for some months now with no apparent solution in sight (co-incidentally, I have also recently developed dry bloodshot eyes though my general vision is fine). I am shortsighted and my prescription is in the -3 to -4 range. Any ideas regarding this problem?

Eye problems related to corrective lenses are often difficult problems to resolve, requiring continuous collaboration among the patient, eye doctor, optician and eye glass manufacturer.  Sometimes the "problems" with corrective lenses are never uncovered.  Even the size of the glasses/lenses may be an issue - some patients cannot use or tolerate smaller or larger frames.  Additional problems develop with bifocals, trifocals,  and high refractive index plastic lenses.   Since the prescription in the two glasses are the same; consider the other variables in the equation including the type of lens material, size of the frame and even the darkness of the sun glasses.  If all else fails, try getting the same glasses/frames with and without darker lenses, if possible.

Q.    Recently I experienced a blurred vision experience that started in the center of my vision and eventually covered my entire vision. It is more of a kalaidescope effect that lasted for about an hour and was followed by a headache and nausea. I am being told it was a migrain. What do you think?

The effect that you describe, known as the "Fortification" phenomenon, is consistent with visual effects associated with a migraine.  Sometimes migraines will cause such visual phenomenon while at other times a migraine may not affect vision.  Sometimes patients will experience the fortification phenomenon during a migraine but without the headache.  Nausea is commonly associated with migraines.  For more info on migraines and vision problems, do a Find, under Edit on your browser, for migraine on this page as well as on the Q an A Archives page of this web site.  Also, sometime this week (Nov 27th, 2000) we will have a simulation of the fortification phenomenon on the Simulations page of this web site.   There are now some very effective migraine medicines available so see your eye doctor or internist or general practitioner about the problem and migraine medicines available, if applicable.

Q.    Glycoma?

The correct spelling is glaucoma.  For info on glaucoma, do a Find, under Edit on your browser, for glaucoma on this web page and on the Q and A Archives page.  Also see the simulation of advanced glaucoma on the Simualtions page.   Also, look at the Dictionary page for a general definition of glaucoma.

Q.    Two months ago, my dad began to have sort of blurred eyes on the right eye. Doctor tested and diagnosized as a macular cyst. However, he did not recommend any treatment nor medicines. Is there any medical treatment or surgery possible for that kind of disease? Any hospital recommended?

We assume that the macular cyst did not develop after cataract surgery or any other type of eye surgery.  A macular cyst is usually associated with the development of a macular hole.  In fact, many authors refer to a macular cyst as a "pre-macular hole".  In a macular cyst, the central part of vision is affected and the patient often complains of blurred vision and the presence of floaters.   Sometimes a macular cyst may spontaneously resolve (about 5 - 12%) while in about 50% to 90% of patients a macular cyst will progress to a macular hole within about two years.  If a macular hole develops, the patient is left with a visual acuity in the affected eye of about 20/200 - legal blindness.  The patient is left with normal side vision but reduced central vision (vision used for reading for example).  In about 11% of patients with a macular hole in one eye, a macular hole will also develop in the other eye.  Unfortunately, treatment options are very limited for macular cysts and for macular holes.  At present (year 2000), there is no accepted form of treatment of macular cysts/holes while several experimental treatments have been tried including laser photocoagulation and vitrectomy.

Q.   CHOROID LAYER?

The choroid (along with the ciliary body and stroma of the iris known as the uvea ) is the vascular coat of the eye, containing the blood vessels that nourish the retina.  It is also heavily pigmented, containing about the same amount of pigment and color as the skin.  From the outer white part of the eye, known as the sclera, inner layers include the choroid, retinal pigment epithelium and neural retina which contains the photoreceptors.

Q.    What is lastest technology as concerning prosthetic Ophthamology?

Good question; unfortunately, we know little of this area.   Suffice it to say though that prosthetics have come a long way and now there are artificial eyes that can be connected to the intraocular muscles such that the artificial eyes can more along with the normal eye.  In fact, in talking wirth patients with an artificial eye it is often surprising to learn that they infact  have an artificial eye.  Unfortunately, all artificial eyes are cosmetic corrections only and do not allow for any vision...yet.

Q.   I'm making an appt. with an opthamologist, but lately have been experiencing a lightening type of effect in both eyes. It's as if there is something to the right side like a distortion in water. It happens once in a while and then goes away after ten or fifteen minutes. I can still see, but the area affected is annoying. I am a male, 57 years old, quite nearsighted, and use the computer all day long. This started a few months ago. Any clues as to what I am trying to describe?

Glad to hear that you're going to see an ophthalmologist about the problem.  It is not clear what the problem might be.  Since the problem affects both eyes at the same time, the locus of the problem must be in the brain.   Since it affects the right side of your visual field, the problem must be on the left side of the brain.  The transient nature of the visual experience may hint at a possible vascular problem, possibly an ischemic event somewhat analogous to a migraine or even a transient ischemic accident (TIA).  A visual field test may detect the locus of the visual field defect even if you are not currently experiencing the visual phenomenon.  If possible, let us know what the ophthalmologist finds, if anything, and we will add an addendum on this question/answer.

Q.   My stepdaughter is complaining of a shadow above her eye that is blocking some of her vision. Is this a symtom of MS?

The description "shadow above the eye" is not clear enough to render an opinion.  Sometimes, patients with MS will complain of the vision in one eye being "darker" than images in the other eye, but other conditions and even visual aftereffects (illusions) can also cause on eye to appear dimmer than the other eye.  If you have a concern about MS, have your daughter see her eye doctor, who could run several tests to identify the problem.  If your daughter actually has MS, than the symptom may be related to the MS and be a sign of optic neuritis.  If so, she should also be seen by her eye doctor for further evaluation and possible treatment.

Q.    What is sjogrena (Sjogren) syndrome?

You're probably referring to Sjogren syndrome.  Originally, Sjogren syndrome was characterized as dry eyes, dry mouth and rheumatoid arthritis.   More recent evidence shows that it can be present in the absence of the rheumatoid arthritis.  Sjogren syndrome is believed to be an autoimmune disorder of the (lacrimal) glands of the eyes leading to dry burning eyes (keratoconjunctivitis), sensitivity to light (photophobia) and stringy discharge.  There may also be some mild blurring of vision.  The salivary glands may also be affected leading to dry mouth as well as difficulty in swallowing, chewing and even talking.  This dryness may even extend to the nasopharynx and lungs leading to chronic bronchitis and pneumonitis.  Treatment may be limited and combating the dry eye disease is of significant concern.

Q.   How would one go about requesting information about the use of L-dopa for amblyopia? We have attempted to send an E-mail but have not received the information. We continue to be interested in receiving the protocol for off-label use, clinic forms utilized (including patient signature documents) and any brochures/pamphlets that are available (the paperwork involved and an understanding of what the patient goes through / what the patient experiences).

Go to L-dopa under (click Here >>)  Funded Research 

( http://www.ohiolionseyeresearch.com/L-dopa.htm) for info on the off-label use of L-dopa for children with amblyopia.  You can also use the Ask a Question form as you did to send the above message; but remember, we do not collect any information from visitors to this web site INCLUDING e-mail return addresses so we have no way to contact you directly.  In any message sent via the Ask A Question form, please include your name, e-mail address, snail mail address, etc., and we'll send you the requested information.

December

Q.    I was hit in the eye a couple of months ago and now I am having sharp pain in this eye, also it feels like it is swollen inside (the back side of eye)- what could the problem be?

Whenever there is pain in the eye you should see an eye doctor for evaluation and treatment, if applicable.  Blunt trauma to the eye and surrounding tissues can lead to several conditions, some serious.  Trauma is sometimes associated with the development of glaucoma or increased pressure in the eye, particularly if there is blood in the front part of the eye behind the cornea (known as a hyphema)   Also, trauma can lead to or be associated with the following to name a few: cararact, double vision (diplopia), misaligned eyes (strabismus), lens dislocation and blurred vision, iris problems, loss of vision and macular hole, optic nerve damage, retinal or other hemorrhages, detached retina, and a loss of the ability to move one or both eyes.    If the trauma was severe enough, the eye socket can be ruptured and create all kinds of problems and require surgical correction. 

Q.    What is the difference between hard or soft lens implants for cataract surgery? Is one better than the other and why, please.

Intraocular lens materials continue to evolve and improve over time.  The primary "hard" intraocular lens you may be referring to would probably be made of polymethylmethacrylate (PMMA).  PMMA has been available for about 45 years and is the hard intraocular lens preferred by most surgeons.  PMMA is a very stable and light weight polymer.  It does not develop protein deposits as do silicone intraocular lenses.  About the only real drawback with PMMA intraocular lens is that it cannot be bent and, as a consequence, the incision in the eye must be the size of the lens.

Soft intraocular lenses have been made primarily with silicone and hydrogel.  Although silicone has been used as a regular contact lens material, one problem has been protein build-up on the lens.  Research is continuing to see if such build-up also occurs inside the eye with silicone intraocularlenses.  Hydrogel is the soft lens material of choice it seems and it's optical properties are good and it does not cause any reactions within the eye.  An advantage of the soft intraocular lenses is that they can be folded so that the incision in the eye can be very small, on the order of a few millimeters.  Another advantage to the hydrogel lens is that it absorbs water and, as a consequence, can be smaller during insertion and will enlarge within the eye and with water absorption.  Unlike the PMMA lens, long term follow-up is lacking for both silicone and hydrogel lenses.  A drawback with the hydrogel lens is that it may be damaged by YAG laser light, which is used for some eye "laser surgeries".

Q.    Need articles related to the loss of depth perception.

The area is too broad.  We need you to give a more specific question about depth perception or/and what type of loss you're referring to.

 

Q. I have had the following experience a few times over the past year. It occurs when I am waking in the morning. As I open my eye, I feel a sharp pain similar to that of being poked in the eye, and I find it painful to keep my eye open, and it starts to tear. The pain usually lasts for 5-10 minutes, but the last time it occurred, the pain continued intermittently for a few days. Is it possible to strain your eye by opening it too quickly? I am 35 years old.

As to your question, no one cannot open ones eyes too fast as thus cause pain and discomfort. Since you are experiencing pain, you should be seen by an eye doctor for evaluation and treatment, if applicable. Your symptoms suggest a possible association with dry eyes developing at night, while you sleep. Several conditions can lead to the symptoms and timing of the day that you describe. Importantly, if you wear contacts, the problems you’re experiencing may be related to them. If you don’t wear contacts, another possibility related to the glands that provide lubricants to your eyes or even a type of allergic reaction. See an eye doctor and let us know what they uncover.

  1. What is Haradas Disease?

Harada’s disease is a systemic, whole body, inflammatory process that affects the eyes as well as other organs. The generally accepted term now is "Vogt-Koyanagi-Harada" (VKH) syndrome for what some refer to as simply Harada’s disease. The longer term gives credit to other discoverers of the same or very similar disease. Patients with VKH syndrome may have a sudden loss of vision due to fluid build-up underneath the retina (inflammation of the choroid) leading to retinal detachment. There may be spontaneous recovery of vision with resolution of the retinal detachment. Patients with VKH syndrome may have a form of uveitis that affects the front part of the eye. Other possible vision problems include swelling of the optic nerve and optic neuritis, development of glaucoma, retinal hemorrhages, and development of abnormal blood vessels of the optic nerve head and retina which tend to hemorrhage. Often patients with VKH syndrome will complain that their skin or/and hair is sensitive to the touch. Also, patients may complain of ear or hearing problems, neck stiffness, pain around the eyes and ringing in the ears.

The cause of VKH syndrome is not known, although some scientists suspect a viral disease. Depending on conditions, treatment is usually directed at controlling the inflammation.

Q. What could be causing the loss of focus in one eye, with a grey oval area? I had a field of vision test done which showed I have loss of vision in the eye. Dye test with photos was done and showed no abnormalities. Eye pressure test done yearly have all been normal. I do have minor headaches on the side where problem is. I am going for a MRI since I am in good health. Otherwise. I am a fifty year old male and have been trying to find an answer or cause of this for at least three months any help from you would be greatly welcomed.

The gray oval that you describe is referred to as a scotoma. Given that it is located in one eye only, suggests that the locus of the problem may be the eye itself or possibly the optic nerve of that eye. It sounds like the docs are systematically trying to uncover the reason for the scotoma. The visual field would quantify the extent of the scotoma and help determine if it is in one or both eyes. The dye test (fluorescein angiography) would detect the majority, but not all, retinal conditions that can lead to such a scotoma. We suspect that the MRI will come back normal, but it is possible that the scotoma is related to optic neuritis which, in turn, may be associated with other serious problems which may be detected by the MRI. We would not be surprised that you eventually have an electroretinogram (ERG) test and possibly a Visual Evoked Potential (VEP, also called a VER) to further assess the early visual pathways. It is important to continue with the diagnostic work-up; although it is frustrating at times to not know what is going on. It does sound like the docs are systematically investigating the problem; so stick in there and sooner or later they’ll find out the problem.

Q I am supposed to find out info on an eye disease in which we believe is called "HERETAL DEMACULATION" now obviously that is not the correct spelling, could you possibly check the spelling or tell us what we possible could be looking for?

Wow, that’s a tough one. The best that we could come up with is hereditary macular degeneration. "Heretal" is probably refers to hereditary, and "demaculation" does contain the word macula (macular). Finally, "De…ation" would be consistent with the word - degeneration. Thus, hereditary macular degeneration.

There are different types of hereditary macular degeneration, but the bottom line is that they all cause a loss of central vision/visual acuity and may or may not be associated with a family history of significant vision loss. Some types affect color vision and may cause sensitivity to lights (photophobia). Typically, macular degeneration bottoms out at around 20/200 – legal blindness.

  1. What do I do about my stie?

First, you need spell it correctly – sty or stye (its spelt both ways). Next, go to the Q and A Archives and do a Find, under Edit on your browser, for sty and stye for more information. If you only think you have a stye, then you need to see an eye doctor for diagnosis of the condition. Sometimes, albeit rarely, a "stye" turns out to be something worse.

Q. What causes corneal neovascularization? Can it be cured? Will you regain your sight? Is there ANY relationship between it and cancer?

A lot of things can cause corneal neovascularization from infection to disease to injury to surgery. Even wearing contact lenses too long can eventually lead to corneal neovascularization. It is important to note that corneal neovascularization is a symptom of a disease or injury or infection and not a disease, for example, itself. Depending on the cause, it may or may not be "curable". What is important is that ANY corneal neovascularization warrants an immediate trip to the eye doctor. In general, corneal neovascularization is the result of not enough oxygen getting to the tissue, in this case the cornea. Usually an early sign of lack of or reduced oxygen delivery is swelling or edema of the tissue.

Q.   I was diagnosed with a meibomian cyst which I think is also called a chalazion. I had it drained about two weeks ago and was given eye drops for it. I went to the follow up appointment last week and was told that it is still there so I should continue with the eye drops for another week as well as the warm compresses. Just by looking at the eye you can't see it. I wear contact lens and was told that I can start to wear them again after the week is up. So my question is after using the drops for another week and if the chalazion is still there can I start back wearing my contact lens anyway?

This is a question for your eye doctor, since he/she has been examining and treating you.  In general, however, one should not wear contacts, and further irritate the condition, if the problem is still present.  Error on the side of caution.

Q.    BLETHARITIS.

The correct spelling is blepharitis.  Go to the Q and A Archives and do a Find, under Edit on your browser, for blepharitis for more info on the condition.

Q.    My father 74 is on blood pressure medicine.  He has had small heart attack month ago, but for years, sensation of looking through water running down a windshield.  He doesn't have migraine headache; rarely a head ache at all.  Please answer if this sounds like something you recognize.  Thank you he also has mild emphysema.

Patients with certain vascular problems, including migraines, ischemic events (reduced oxygen levels to the brain or eye), as well as high blood pressure report areas of reduced vision.   Sometimes these patients will report that the area of reduced vision is like looking through disturbed water (water on a windshield, through a waterfall, rippling water).  The visual phenomenon may thus be associated with your father's high blood pressure.  Have him discuss the visual phenomenon with his general practitioner/internist doctor as well as with his eye doctor.  

Q.    My Dad has cancer...it has spread to his brain and today he started seeing specs if he looks at a white wall...he can see them...what do you think this is from?

Your father may be experiencing "floaters".   Floaters are cells and debris inside the eye and are common in older patients and in patients with nearsightedness.  Sometimes, however, floaters are the result of changes in the health of the optic nerve, the nerve that connects the eye with the visual centers of the brain.  Floaters are associated with swelling of the optic nerve, known as papilladema.  Papilladema is sometimes associated with increased intracranial pressure (pressure inside the brain).  Make sure that your father's doctors, particularly his eye doctor and neurologist, are informed of the sudden onset of floaters.

Q.    Can I correct my short sided problem?

Some patients do refer to nearsightedness or myopia as being "short sided"; thus, we assume that you're referring to myopia.  Myopia is a refractive error of the eye, typically because the eye is too long, and patients with myopia can't see things clearly that are far away.  Myopia can be corrected several ways including glasses (corrective lenses), contact lenses and refractive surgery (e.g., LASIK).  However, you must see an eye doctor (ophthalmologist or optometrist) for evaluation and treatment.

Q.    What are some problems associated with contact lens wear?

As long as a patient follows directions for the use, storage and cleaning of contacts, contacts can provide a near problem free experience to the user (but see below).  Problems arise when the patient fails to follow the directions.   For example, NEVER swap contacts with other people.  If you do you could get a potentially blinding eye infection.  NEVER put contacts in your mouth to "clean them".  NEVER sleep with contacts (even if they say they're extended wear).   Always follow directions for cleaning and disinfecting.  NEVER wear contacts longer than the recommended time.  And, importantly, if your eyes are red, hurt, unusually dry, or have discharge, DON'T wear your contacts but do see your eye doctor.

Problems with contact lens wear include:

  • Sensation of dryness of eyes - most common complaint of soft contact lens wearers
  • Giant Papillary Conjunctivitis (GPC) - most common "significant" complaint of soft contact lens wearers.  Symptoms include; mucus discharge, itching, blurred vision, discomfort and increased blinking.
  • Acute red eye - complaint of overnight soft contact lens wearers, who awake to find their eyes red, painful and the contact(s) stuck to their corneas.
  • Peripheral corneal desiccation - most common complication for rigid gas permeable lens wearers.  Leads to dry eye problems, mucus accumulation and debris on lens, red eyes particularly along the lower half (3 to 9 o'clock position) of the eye.  Also causes the upper eyelid in particular to fell uncomfortable.
  • Allergic and toxic keratoconjunctivitis - may lead to discomfort, pain, sensitivity to light and reduced vision.   Usually associated with increased sensitization or allergic reaction to the preservatives found in contact lens care products.
  • Acute epithelial decompensation - a potentially serious, but rare, consequence of daily wear soft contacts.  Leads to pain and continued loss of vision even after the contacts are removed.  Believed to be due to corneal hypoxia (lack of oxygen).  Vision decreases and pain increases over a 1 - 2 day period followed by recovery in about 1 - 2 weeks.
  • Bacterial corneal ulcers (microbial keratitis) - Although rare, this condition is described as one of the most serious consequences of contact lens wear.   Contacts harbor bacteria (e.g., Pseudomonas aeruginosa) that grow and infect the cornea, leading to ulcers of the corneal, loss of vision, pain, photophobia, and discharge.  Vision maybe permanently loss.
  • Other complications include; ptosis (dropping eye lid(s), lid sensitization, corneal abrasions and dry eyes.

Q.    Is marjuana used to treat glaucoma, or just relieve pain on a temporary basis?

Smoking of marijuana causes a fall in intraocular pressure (IOP) in 60% to 65% of users.  However, there is a tight balance between getting enough THC to lower pressure and yet not too much to cause unwanted (?) side effects.  Marijuana is also used to relieve pain in certain patient populations but not, to our knowledge, in glaucoma sufferers.

Q.   My sister has not worn 2 contacts in over a year. When one contact starts irritating her eye, she leaves it out and wears just one. She now has to wear her glasses full time, because she has an irritation under her eyelid that wearing the contact hurts her eye. She is now complaining of being dizzy, sickheaded and headaches. She has gone to 3 eye doctors and they have done a complete eye exam on her and have found nothing. The doctors don't know why she is constantly dizzy .She also wakes up in the morning dizzy and it seems to get worse as the day goes by and she can't function during the day. Could she have ruined her eyes by wearing only 1 contact during those times that her eye was irritated? She is so scared that she has. This has been going on for about 2 weeks.

The dizziness probably has nothing to do with her eyes or her history of contact lens use or misuse. She should see an Internist or General Practitioner about the dizziness and headaches.

Q.   Because of a deviated septum, I sleep most of the time on my right side. I wore contact lenses (soft, disposable) for a few years. One night, I slept with one lens in my right eye because I could not take it out (couldn´t find it). The next morning, I expected it to be on the pillow case, as had happened before. It was not and it seemed to me that it had sort of melted. I continued wearing lenses, normally. For the last year or so I have had the following condition: I wake up most of the times with my right eye very red, sometimes really bloodshot. My ophthalmologist treated me as for an allergy, many medicines were used, to no avail. I changed doctors and the new one treated me for lack of lubrication (which was really present) , but also asked for pathological tests. Those showed a small piece of plastic material (minute part of a lens) in the back of the eye (which was removed successfully), plus the occurrence of staphylococus and pseudomona cepacea. A treatment with amicacin and ofloxacin did away with the bacteria. However, the redness persists, on and off, errratically. I live in Brazil. On a recent trip to New York, I saw a prominent US ophthalmologist who diagnosed my condition as follows: because of the deviated septum, which mostly blocks the drainage of my right malar sinus, during bouts of sinusitis (which I have had repeatedly) part of the infected material from the sinus, instead of going down the nose, would go up the tear duct into the eye. An otolaryngologist who I saw also in New York on the recommendation of the ophthalmologist, confirmed the diagnostic. Coming back to Brazil, I reported to both my ophtalmologist and otolaryngologist. The two said they had never heard of such an occurrence. I have been tested for floppy eyelid syndrome, having slept various nights with a tight bandage over the right eye, to prevent eyelid movement. The next morning the eye would still be red.

Have you heard of a condition like this? Is the diagnostic I got in New York possible? I plan to have my septum surgically corrected early next year and thus hope to have my right eye returned to normalcy. In the meantime, I count on some information from you that can shed some light over my problem. Thank you.

First, let us say that since you've been actually examined by several ophthalmologists you should take what they say rather than anything that you may find on the Internet (including this exchange).  That said, let's try to act like a detective and separate the various facts and conditions.

Your chief complaint is a right red, bloodshot eye in the morning.  The eye remained the same, more or less, after the piece of contact lens was removed.  It would seem improbable that the contact lens broke apart and that a part is still remaining in the eye causing irritation.  However, since the right red eye episode started following the contact lens experience AND only a piece of contact lens was recovered; although unlikely, there is a possibility (let's say 10%) that a part of the contact lens is still behind the eye causing irritation and the red eye.   However, if true, we would expert this condition to create a constant red eye and not just one in the morning.  So, we'll reduce the possibility on partial lens induced irritation and red eye to, say, 5%.

Second, you were on antibiotics which would have done away with the various types of bacteria and yet the right eye remains red.  If the eye remained red shortly after or during the antibiotic use, it would seem very unlikely that bacteria is causing the red eye.  (Is there a relationship between your bouts with sinusitis and the red eye?  If so, increase the possibility to 50%)  So for the moment, let us assume that the deviated septum and bacteria from the sinuses to the eye via the tear duct is not an issue (1%).  (It is possible, nevertheless, that such a condition could cause your right red eye.)  This leaves us with the possibility that the right red eye may be associated with floppy eyelid syndrome. 

You are not clear whether you actually have floppy eyelid syndrome, but let us assume that you do.  We do know that, in floppy eyelid syndrome, the eye on the side that the patient sleeps on is the most affected and this is the eye that will appear red (and dry) in the morning (conjunctivitis).  Sure enough, you state that you sleep on your right side most of the time.  So, there is some positive evidence that the right red eye may be the result of floppy eyelid syndrome (75%).   You also state that the right eye is not always red.  It is possible that you don't always sleep on the right side or/and that ,depending on conditions, your upper eyelid does not separate from the globe and result in red eye.  However, you state that you tried patching the right eye at night and yet still have the red eye in the morning.  This reduces the possibility, somewhat, that you have a right red eye due to floppy eyelid syndrome, but still the possibility exists, say 50%. 

Based on this discussion, it would appear that the most likely cause of the red right eye is from floppy eyelid syndrome.  Since you plan to have your deviated septum corrected, if the red eye goes away after surgery than, of course, the problem would seem to be due to the deviated septum and bacteria entering the orbit via the tear duct.  If the surgery does not correct the problem and if you indeed have floppy eye lid syndrome, you may want to consider surgery to correct the upper eyelid on the right side (or both sides) which may involve removing some tissue from the upper eyelid(s) or surgery involving an upper eyelid(s) tightening procedure.  Finally, you may want to consider the possibility, although remote, that a piece of contact lens remains in the orbit causing the irritation and the right red eye.  Overall, our best guess (and that is what it is) is that your condition is due to floppy eyelid syndrome.   Good luck

Q.    What is the clinical term for a condition where the pupil sizes are different?

The condition is called anisocoria.  Go to the Q and A Archives and do a Find, under Edit on your browser, for anisocoria for more info on the condition.

Q.   I've problem in only right eye. It pains when I read continuously for 6-7 hours.I have done convergence exercises, but it has only limited effectiveness when I have to read for 10-12 hours. convergence exercises for 10-12 times do not help to reduce the pain in this case.what to do.

You should be examined by your eye doctor to see if certain types reading glasses might help the eye strain.  Also, he/she may consider placing a prism in your current glasses/prescription to help with the close-up work.  If your in your 40s or there about and do not currently wear glasses, try using different strengths of reading glasses that are available at drug stores or even discount stores.   These usually come in different strengths, such as +1.5 to +2.5, for reading.   Finally, try taking frequent rest breaks from the close-up work and try looking in the distance (grater than 20 ft or so), ideally outside views, to reduce the eye strain.  

Q.    My mom 54years, had a branch retinal artery occlusion,she had a laser treatment a month ago.  Now her visual acuity is finger counting.  Does she comes to the normal visual acuity in the future.

Any occlusion of the retinal arteries or veins, whether partial or complete, is a devastating event for the retinal and for retinal function.  The retina (or other layers of the eye like the choroid) is very sensitive to a disruption of the blood supply, creating lack of oxygen to these vital areas.  If retinal circulation is not restored in a very short time, within hours and probably at most a day or so, the damage is usually permanent and severe.  Sometimes "laser surgery" will be undertaken to treat swelling of the central part of the retina (macula).  At other times,  the blocked blood vessels may lead to neovascular glaucoma and require "laser surgery".  Patients will sometimes recover some vision; however, most of the time the patient is left with a very serious and permanent loss of vision in the affected eye.

Q.    Do you have more information on convergence insufficiency in

female children under 10 years old?

Yes, go to Announcements under Featured Articles by clicking here http://www.ohiolionseyeresearch.com/anouncem.htm#NIH Funded Study at O.S.U College of Optometry Looking into Accommodative Insufficiency

 

Q.    What do I do to relieve dry, scratchy eyes?

What you do is go to the eye doctor and have an exam to determine WHY you have dry, scratchy eyes.  After it is determined why you have the condition than something can be done about it.  We don't mean to be flippant, but the reasons are many and the treatment depends on the reason.

 

Janurary, 2001

Q.    What do I do to relieve dry, scratchy eyes?

What you do is go to the eye doctor and have an exam to determine WHY you have dry, scratchy eyes.  After it is determined why you have the condition than something can be done about it.  We don't mean to be flippant, but the reasons are many and the treatment depends on the reason.

Q.   What is the problem with a new born when it's eye lid's won't open, some thing to do with weak muscle?

Your child should be seen by a pediatric ophthalmologist ASAP for the eye problem.  The inability to open an eye or a very droopy eye lid is called ptosis.  When ptosis affects both eyes it is called bilateral ptosis.  So called levator muscles cause the eye lids to open and close.  Although congenital (born with) ptosis usually affects only one eye, in about 20 - 25% of cases both eyes may be affected.  Congenital ptosis can be caused by a number of factors including eye muscle (superior rectus) weakness or paralysis, third nerve paralysis and sometimes, but rarely, by a condition called Horner's syndrome.  If the ptosis and droopy eye lids are mild than it is unlikely to cause lazy eye (amblyopia) in one or both eyes.  If the droopy eye lids are severe and cover most of the pupil of the eye than lazy eye may result.  Sometimes the ptosis may also be present with misaligned eyes or strabismus, which may require eye muscle surgery to correct.  Sometimes a difference in refractive error between the eyes (anisometropia) may be present.  Sometimes in infants with bilateral ptosis there may be abnormalities of the eye lids (epicanthus supraciliaris, palpebralis, tarsalis or inversus) - all of these conditions may require surgical correction.  As a consequence, due to the surgical nature of the ptosis and associated anomalies, you should have your child see a pediatric ophthalmologist for evaluation and treatment. 

Q.   If lead falls into eye what should i do?

See an eye doctor ASAP.

Q.    I am legally blind from scarred corneas. The vision in my left is 20-400, and my right eye is about 20-800. I view the internet using a WebTV (an internet receiver/transmitter) hooked to a 25 inch TV. The TV sits on a table, which I sit at. The screen is 6 to 12 inches from my eyes at any given time, depending on how close I need to be to see the text. I am on the internet anywhere from 8 to 12 hours a day, every day. Could this close of "TV viewing" cause me to develop cataracts, or any other problems that could make my vision worse? I don't suffer headaches, and I don't seem to suffer other symptoms of eye strain, other then mental fatigue.

Modern TVs and computer monitors do not pose any risks, that we are aware of, related to the development of cataracts or any other eye conditions.   However, close work is associated with the further development of myopia or nearsightedness as well as eye strain and headaches.  If you developed the corneal scars after the age of, say, 7 years or so, you may want to be examined by a cornea specialist or ophthalmologist to determine whether you're a candidate for a cornea transplant to regain your sight.

Q.    Several years ago, I had a catalog of audio tapes that could be borrowed through the mail. The postage was free. It was like using a library thought the mail service. Now that my Mother really needs this service, I don't know how to find it. Do you have any information available. She is in North Central Ohio. Thank you.

The fact that the postage was free suggests that the audio tape service was through an agency for the blind and visually impaired or possibly through the Ohio library system.  So, first I'd check with your local library to see if they provide such a service.  Next, check-out the web site for the American Printing House for the Blind via the Cool Links page on this web site.  Also, check-out the other links available to see if they have such a service.

Q.   My Boyfriend's mother had been suffering from this eye disease since the last 5 years. SHe had seek all kind of medical treatment in SIngapore. All the specialists said that there is no cure for it. It is said that there is a layer of film covering her retina which causes her eyesight to deteroriate. All doctors said that she will soon lose her vision. Please help me! Cos we care alot..

We're sorry but without more info we can offer an opinion on the disease or possible treatments.  A diagnosis would help a lot and we could provide additional info on the disease.

Q.    Please enlighten with any disease which can cause blindness and no cure for it.. sympton are eyesight are getting blurrer.. had been last for almost 5 years.

There are numberous, probably 100s, of eye diseases that can cause a person to go blind and that do not have any available treatments.  If you have a diagnosis and a specific eye disease in mind, please send a request again and we would be happy to give you more info on the disease.

Q.    I am a social worker at Sycamore Primary Care in Miamisburg, Ohio. I recently had a patient ask me to help him find someway to get eyeglasses. This patient is having problems medically and in not currently working. He has no money or insurance. Can you offer me any suggestions on where I can turn to help this man. Any help you could give will be greatly appreciated. Thank you!

There are a number of agencies that help children get eye glasses (Prevent Blindess Ohio and Vision Service Plan cooperative, local LIONS clubs, BCMH) but adult coverage is very limited.  We'll look into this issue this week (1/1/01) and if we uncover something we'll add it to this answer.    See the past featured article on agencies that help kids get eye exams and glasses.

Q.    My eye hurts alot. I've gone to the eye doctor, but he is not sure what the problem might be. My right eye is very red and sort of swollen. Can you tell me what it might be?

We suggest that you go to another eye doctor for an evaluation.   A lot of eye and whole body diseases can cause one or both eyes to become red and hurt.  See another eye doctor ASAP.

Q.    Iam having trouble getting a straight answer from eye doctors regarding my poor vision. (About 20/50 corrected, worse than 20/200 uncorrected). I went in recently to see about having lasik surgery done. After a complete dialated eye exam the doctor said that my vision should be much better than 20/50 corrected with the glasses I have. And that lasik couldn't/wouldn't achieve any better than that. But couldn't explain what the real cause was as he did not see any abnormalities in the retina or optic nerves during the dialated test. So again I get the "bump and run", ie; referal to another doctor, who does more tests and comes up with the same answer. "Umm, you should be seeing better than you are." Again no answers as to the real issue.

Ok, lets take the analogy of a video camera to human vision. I realize completely that you can have a good, perfectly focused (or in my case, focusable) lens but if your ccd is messed up, you won't get a good picture. What I have gathered from the doctors is that my lens is focusable (eye curvature is correctable with glasses, contacts, surgery, etc.)But my ccd (cones,rods,etc) are not working right or my brain is not interpreting the signals correctly.

Some background... I am a 35 yr old male in pretty good health and shape. I have been extremely nearsighted w/astigmatism as long as I can remember and have been wearing glasses since I was 4 or 5 years old. My lens prescripton got steadily stronger until I was about 28 at which point it leveled off and then actually got weaker for a few years till it leveled off again. At this point I have had the same prescription for 3 years. I was always able to maintain about 20/35 corrected up until the past two years in which I have noticed despite my glasses being the same my vision is increasingly blurred. My peripherial vision is ok, blurred but there, my color vision is ok, and my night vision is so-so but not noticebly worse than in the past.

Iam just wondering what course I should take. The reading I've done isn't very encouraging for "ccd" related problems. So should I [A] seek out another doctor?, if so, what kind? The guys I went to already were the best eye doctors in my area but were not neurologists. [B] Live with it and gradually go blind. [C] Get a brain pith.

Right now Iam leaning toward [B]. Mainly because if I throw more of my hard earned money at a doctor for another "uhh, I don't know" response, he's gonna get a [C].

And lastly being a mechanic-tech-type-o-guy. I understand very well the art of diagnosis. But we have to deal with dozens of new models every year. Doctors have been working on the same two models for over 5000 years. Why is there so much guesswork and "I don't knows"? I probably sound frustrated, and I am, If I treated my customers like that, I wouldn't have them for long.

So I guess my bottom line question is...

Is there a type of doctor that KNOWS how to diagnose and possibly treat the inner workings of the eye?

The optics and CCD analogy is a good one.  Regarding your question about the "right" type of eye doctor to see, we would suggest a Neuro - Ophthalmologist or a retinal specialist who has access to electrophysiological testing (ERGs, EOGs, VERs).  If you provide your city/state/country we'll be happy to suggest someone in your area, probably in your state or country.

However, the fact that your visual acuity is now 20/50 and deteriorating is not a good sign.  Your symptoms and age are suggestive of a retinal disease, possibly a cone dystrophy or macular degeneration.  If you're real myopic, say greater than -10 diopters or so, you may also have myopic degeneration which can cause a gradual decline in visual acuity.  This is where the electrophysiological testing may come in handy - these tests can assess function and are not limited to what the eye doctor can see (anatomy).

Also, the doc(s) that informed you that you were not a good LASIK candidate should be congratulated for their ethical approach to your problem.   We have seen several post LASIK patients similar to your situation that had the LASIK surgery, expecting to see better after the surgery, and were surprised when it didn't improve their visual acuity better than glasses.  Good luck on your search.

Q.   I am 24yrs old and have Best's. My eyesight is relatively good. What are my chances of macular degeneration to the point of visual impairment, and when would that be most likely to occur (old age/any time)?

Patients with Best's disease (Vitelliform degeneration) may remain 20/20 or may loss vision to the 20/200 level or so.  The amount of vision loss one can expect depends to a great extent on the absence or presence of a retinal lesion and location of the lesion(s) in the back of the eye (retina).  If you have an abnormal EOG (a test to screen for Best's disease) and no retinal lesion, than you'd be a carrier of the disease but your vision would remain normal.  If you have a retinal lesion (e.g., sunnyside-up egg yolk type lesion) and the lesion is off to the side than you may remain 20/20 all your life.  If, however, the lesion involves your macula or fovea in each eye than the prognosis is more guarded and an eventual visual acuity loss to about 20/200.  In general, visual acuity loss is slow, starting in the teens or early twenties and progressing until the 30s - 40s or so.  The good thing about Best's is that the visual loss is localized and patients never go totally blind from the disease.

Q.   I have blood right across the lower eye near and under the lower eye-lid. I am not tearing blood. What's wrong?

If the blood is right behind the cornea and is blocking the pupil, a conditional called hyphema, you'll need to see an eye doctor ASAP.  Hyphemas are associated with the sudden onset of glaucoma and needs medical treatment/intervention.   If the blood is below the pupil, on the white part of the eye, sclera, than it may be a subconjunctival hemorrhage.  Subconjunctival hemorrhages are rather common, but the reason for it should be investigated.  So you should also see an eye doctor to make sure that the eye(s) and the rest of the body are OK.  If you wear contacts, stop wearing your contacts and see an eye doctor about the problem.

Q.   High pressures are caused by what diseases?

We assume that you are referring to pressure inside the eyes, intraocular pressure, a condition known as glaucoma if the pressure is causing some damage to the eye.  Go to the Q and A Archives  and do a Find, under Edit on your browser, for glaucoma for more info.  In general, (closed-angle) glaucoma is the result of a structural abnormality of the eye and the reason for other types of glaucoma (open-angle glaucoma and normal pressure glaucoma) are not really known.  Trauma, hemorrhages, certain medicines and whole body diseases can cause glaucoma or increased pressure in the eyes.

Q.   I would like some information on eye ulsers.

Go to the Q and A Archives and do a Find, under Edit on your browser, for "ulcer" for general info on the topic.  If you have a specific type of disease or/and type of ulcer, please provide additional info and we'll provide additional info on the topic.

Q.   I was diagnosed with episcleritis. I've had it about 3 times with in 4 months, is this something that will reoccur for the rest of my life? Can it get worse the more I have it?  Can it cause any other problems, blindness, night blindness, etc..

Episcleritis is usually a self limited disease localized in one eye.  Episcleritis causes the eye to become red, usually in a local area, sometimes pie shaped, and there may or may not be a lump in the affected area.  After the episcleritis resolves, there may be some thinning of the sclera in the area of the nodule, if present, and the area may appear more gray than the rest of the white of the eye.    In general, episcleritis is a mild condition that does not harm the eye.   It usually responds well to topical nonsteroidal anti-inflammatory drugs, available from your eye doctor, and others have found success with, for example, ibuprofen when a nodule is present (used for patients with herpes zoster nodular scleritis).  The use of topical corticosteroids for episcleritis has been questioned - while topical steroids may quickly resolve the episcleritis, it may reappear and become more difficult to treat in subsequent episodes.  Sometimes, episcleritis may be associated with other diseases, such as glaucoma, herpes, inflammatory bowel disease, systemic lupus erythematosus and rheumatoid arthritis.

Q.    What does blurred vision come from? (I am a contact wearer)?

Blurred vision is usually the result of an uncorrected, overcorrected or undercorrected optical error of the eye(s).  It is the purpose of the cornea and lens of the eye, for the most part, to produce a sharp image for the retina.  If the retina does not receive a sharp image the patient will experience blurred vision.  Corrective glasses, contacts or refractive surgery (e.g., LASIK) are usually used to correct the focusing error of the eyes and produce a clear sharp, nonblurred vision.  So, in your case, a blurred image may be the result of not having the right contacts.  However, if you're older, say in your early 40s, you may be experiencing presbyopia - the loss of the ability of the lens of the eye to focus.   If so, it may be time for bifocals.  Bifocals, as the name implies, allow the patient to have a sharp clear image at more than one distance.  A common complaint of patients with presbyopia is that after a while of close work, like reading for example, it is difficult to see clearly more distant objects.  This later problem arises because the lens of the eye loses it's ability to change shape or focus.  AS a result, the patient eventually needs bifocals to see clearly, at least most of the time.

Q.   What is retinal glaucoma?

Retinal glaucoma is another name for simply glaucoma.   Sometimes docs will refer to retinal glaucoma to signify that there is damage to the retina or nerve fibers in the retina from the glaucoma.

Q.    Since the beginning of December I have notice that the shape of my eyes has changed. My left eye is now much larger than my right although my right eyelid is slightly swollen but has kept it's original shape. I'm forty years old and don't need to wear glasses even though I've never been able to see properly out of my left eye (there was no need - so I was told by the opticians). This eye shape difference isn't exactly unnoticable and wearing eyeshadow increases the fact.  I would be very grateful if you could give me a clue as to what it may be.

It is highly probable that the "eye shape difference" that you report is not the eyes, per se, but rather the position/shape of the eye lids.   Certain conditions will cause one or both eyes to appear to buldge-out or, conversely, for the lids to retract.  In women, particularly, we worry about thyroid eye disease or thyroid eye problems.  You need to see your eye doctor or an Internist about the problem.  As for the statement you attribute to the optician...it doesn't make ANY sense.

Q.    Over the past year, my 36 year old husband reported that with increasing frequency, he could not get both eyes to focus equally. Apparently, one eye remains more dilated than the other at the times when he has a problem focusing. He saw an eye doctor, who suspected nerve damage and offered further testing, which was not pursued. Although the focusing/dilation problem got worse for several months, he recently reported that it was no longer bothering him. However, when I saw him recently after a six week absence, I noticed immediately that his irises were a different color: not their usual clear green, but a more opaque blue-green. Do these clues add up to suggest any particular condition to you? Thank you.

Probably the most common, although still rare, cause of different pupil sizes is called Adie's pupil, related to possible nerve damage and abnormal nerve innervation to the eye and pupil of the eye.  Go to the Q and A Archives and do a Find, under Edit on your browser, for Adie's.

Different iris color is called heterochromia.   Sometimes people are born with different colored irides (iris of eye eye) and everything else is fine.   Sometimes different colored irides may be a sign of more serious disease, such as Waardenburg syndrome (and hearing loss).  Different colored irides can also be the result of trauma, uveitis, tumor in the eye, glaucoma, intraocular foreign body, and even a sign of Horner's syndrome.  Overall, a patient with different colored irides should be examined by an eye doctor to rule-out any serious and sometimes treatable condition.

Q.    Can glaucoma cause migraines?

We are aware of no study or personal experiences linking glaucoma to migraines.  However, glaucoma can cause headaches, pain and eye strain; but the headaches are not, to our knowledge, considered migraines.

Q.   My son was diagnosed with histoplasmosis 15 years ago and has been on steroid therapy since that time. Prolonged corticosteroids use has resulted in cataracts and numerous other diseases of his eyes. For the past three months he has been experiencing ruptured blood vessels on a weekly basis. I assume that this is resultant conjunctival thinning from steroid use. He has regular appointments with his ophthamologist and was recently examined and told that his eyes are otherwise stable. Any advise would be very much appreciated.

Steroids may be appropriate for acute flare-ups as well as long term use to avoid or minimize vision loss in patients with histoplasmosis (histo).  Some authors have recommended that one initially start with a large dose of steroids and then taper the dose down  over a 1 - 2 year period.  Other authors recommend the use of steroids particularly for subfoveal lesions.  In general, however, the use of steroids for histo is a controversial topic, with limited research on the topic.  It is generally agreed that during long term steroid use that serum glucose levels and blood pressure be checked regularly and that the doctor monitor the patient for systemic side effects. 

The continuous use of steroids for histo for 15 years seems long.   However, your doctor is in the best position to assess the need for the long term use of steroids in your son.  You may want to have a frank discussion with your ophthalmologist of the continued use of steroids, in part to alleviate your concerns.   Whatever the outcome, it is essential that you DO NOT stop steroid use without your doctor's very close supervision.  For more info on Histoplasmosis, go to the Past Featured Articles for an article on this topic.

Q.    When moving from a bright area/source (e.g. outside on a sunny day or after looking at a computer screen) to a dark (or much darker) area, I sometimes see flashes around the edges of my eyes. These flashes are only present around the edges of my eye, are not particularly bright and are only visible for a few seconds before disappearing completely. I'm short-sighted (-5 diopters) and I recently had an eye examination where I was told I have a small patch of lattice on either eye. I've was told to watch out for about flashes and floaters in my eye test, and just wanted to know whether these flashes are normal (i.e. eyes adapting to the dark) or not.

 

You are probably having flashing lights in your eyes all the time but only "see" them when you go into a dark room.  In older persons, zigzag flashes of light in one eye that occur in darkness may be associated with vitreous tags.   These flashes of light have been named "Moore's lighting streaks."

Flashing lights also may be a sign of a serious eye problem, possibly involving the retina or optic nerve of the eye.   Retinal holes, tears and retinal detachments can cause a person to see flashing light(s).  Certain optic nerve diseases also can cause flashing lights.  If you see flashing lights, streaks of light or a bunch of little dots that are bright and moving through your field of vision you need to see an eye doctor for a complete dilated eye exam ASAP.  If the flashing lights are due to a retinal problem such as a retinal tear, it may be treatable if caught early.  If you wait to late you could have a permanent loss of vision in the affected eye.  Patients with high myopia and, particularly, with lattice degeneration, have an increased chance of seeing floaters and light flashes as well as an increased chance of retinal detachment/tear/break.  Play it safe and see your eye doctor about the problem.

Q.    I have Type II Diabetes and glaucoma and was diagnosed by my optomologist to receive glasses. I have no means of buying them as I am on social security and do not have insurance. How can I get help in getting my glasses before my eyes get worse?

A real problem that we have is trying to get corrective lenses/glasses for adults with limited income.  There is no easy solution.  One possibility is to be seen at a "Free (eye) clinic" in the area, if possible.   Sorry, but the solution escapes us.

Q.    Ten years ago, I had an episode where there were blackened areas in my eye, almost like I had just had a flash picture taken of me. Then, it turned into a backward "C" rainbow colored crescent in my eye,and went away. I went to an eye doctor who said it was a broken blood vessel. This has happened two or three times since. Should I worry?

We assume that you experienced a retinal hemorrhage and subsequent loss of vision.  Yes, any loss of vision and any retinal hemorrhage warrants immediate medical attention and a visit to the eye doctor.  Your doctors will need to  determine, if possible, why you're having the retinal hemorrhages.   The most common reason for retinal hemorrhages is diabetes, followed by age related macular degeneration.  However, sometimes the cause of retinal hemorrhages is never known.

Q.    I am a 32 yr female with nearsightedness. For a few days in July 2000, my left pupil would occasionally dilate independently of the right when in relatively well-lit rooms. It would return to its normal size after a few moments or if I opened my eyes very wide. I was seen by a Dr at LSU eye center. She said she saw the pupil behave abnormally, but could find no cause. The problem stopped after she dilated my eye. Yesterday, during an evaluation for LASIK, the Dr discovered a small hole in my left retina, which was repaired by laser by a retinal specialist that afternoon. I notified both Drs of the July pupil episode. While the retina and pupil seem to have no direct connection, I am concerned that there could be some underlying problem that is being missed. Any ideas?

A difference in pupil size may be a sign of a serious eye or body problem/disease.  The most common cause of unequal pupil size (anisocoria) is called Adie's pupil.  Go to the Q and A Archives and do a Find, under Edit on your browser, for Adie's for more info.  Some believe that Adie's pupil is the result of damage to and then abnormal (nerve) reinnervation within the eye.  Interestingly, retinal holes are sometimes caused by trauma to the eye.   As a consequence, the abnormal pupil and retinal hole in the eye may both be the result of previous trauma to the eye.  Whatever the reason for the abnormal pupil, one thing is clear - you need to have the abnormal pupil further investigated as to cause.

Q.   What is barrick vein occlusion?

You're probably referring to branch vein occlusion.   In retinal branch vein occlusion, a section of a vein in the eye gets closed-off resulting in some loss of vision in one eye.  Branch occlusions are sometimes associated with arteriosclerosis, high cholesterol levels and other blood vessel problems.

Q.    What should we do if 5 years old kid has mirror vision problem?

We assume that you're referring to the reversal of written letters of the alphabet.  As children learn to read and write, reversing letters is a very common problem that shows-up in the learning process.  Most of the time, continued lessons in reading and writing will solve the problem.  Reversing letters is a higher order learning problem amenable to intensive practice in letter writing.   Only if the child fails to correctly write letters after intensive practice should one consider the possibility of a more serious learning problem such as dyslexia.   Seldom, if ever, is the reversing of letters considered an "eye" problem.   Although children should have a comprehensive eye exam by an eye doctor before entering school, the reversing of letters is not a problem for the eye doctor; but rather, a problem for teachers and professionals that deal with learning disabilities (if it cannot be corrected through intensive practice).  For info on dyslexia, go to Past Featured Articles for an article on dyslexia.

Q.   I was wondering if you could give me some links and/or informational areas I could research to help me with my vision problems. The case history is as follows:  In early December of 1998, I experienced a small loss of vision (a floater) in right eye within 2 hours of injection of initial Anthrax vaccine. By next morning, visual field loss extended to most of lower peripheral vision (draw a line from 2/3 up nasal side to 1/3 of outer side), light acceptance was greatly decreased, and pain was experienced with eye movement. Examined by medical officer (was currently underway on U.S. Navy vessel) with opthalmascope and was told of nerve swelling and blood. Initial dx was Optic Neuritis. Treatment was to rest eye (patching) and await movement to a location where I could be flown off ship for specialty care/dx. 6 days later, I was flown to Tripler Medical Center, Pearl Harbor, HI where consultations were held with both Neurology and Opthamology departments. Both confirmed dx of Optic Neuritis and patching was allowed to continue (reduced headaches due to visual discrepancies and allowed easier continuation of normal functions). Patching was worn for 2 mo. until visual acuity lessened due to atrophy (quickly recovered to normal level); but swelling was greatly reduced, visual field had increased by about 15-20%, and light acceptance was close to that of the unaffected eye. Within a month, visual field loss had increased and light acceptance decreased about 10-15% with increasing pain on eye movement. A short course of oral steroids was given (20mg and taper two days each) with minimal change (5-10%) of light acceptance, pain, and visual field loss and it stabilized at that point within livable limits. I opted to complete the deployment and get specialty consultation upon return in 3 mo.

In late June of 1999, I was consulting on right eye problems with Opthamology department at NRMC Balboa, San Diego, CA and noticed a floater in left eye. Workups were started and initial dx of Optic Neuritis was called into question. Within 3 weeks, I had visual field loss of 85-90% of left eye and acuity changes in right. I was hospitalized and dx'd with acute iron deficiency anemia and optic neuropathy with unknown etiology. I underwent a CT- scan, 2 MRI's, an LP, and myriad and varied blood tests with nothing but results within normal range. I was also transfused with 2 units whole blood and given high volume steroids IV. I was released within 3 days and continued on a course of oral steroids (dex(40mg daily for 5 weeks with an additional 1 month taper)). In September 1999, a bone marrow biopsy was performed that found some Leukoerythroblastic cells in peripheral blood; but these later were not to be found. I have been checked by Rheumatology, Hematology/oncology, pediatric/genetics (LHON mitochondrial tests), and a second independent workup was started after a decrease in light acceptance, increase in visual field loss, and pain was noted in both eyes. Given a short course of steroids (solumedrol IV 3 days, prednisone 60-40-20-10 taper 2 days each) which improved it back to previous levels. Iron levels still at lower edge of normal range and 2nd LP was inconclusive due to body reconfiguration (weight same, body fat from 19% in June 1999 to 29% in October 2000).  If you have any ideas, please let me know. THANK YOU.

Your complex history limits the usefulness of our impression.   If you have or had optic neuritis, a Visual Evoked Response (VER, also called a Visual Evoked Potential, VEP) could be used to confirm the presence of optic neuritis.   The presence of blood (in the eye?) does not go along with typical optic neuritis.   The field loss that you describe could be due to optic neuritis or an ischemic optic neuropathy, for example.  The clue here may be the pain on eye movement.   Pain during eye movement is typically associated with optic neuritis.  Also, optic neuritis seems to wax-and-wane over time and may affect one than the other eye, as in your case.  Given your age, an ischemic optic neuropathy that affects one than the other eye is very rare, in our opinion.  Given your age and history, it would be very unlikely that you have Leber's Hereditary Optic Neuropathy(LHON) that leads to optic atrophy and significant vision loss very suddenly.  So, our "guess" would be that you have optic neuritis. 

Q.    My daughter has a stigmatism in her right eye she also has very limited vision in this eye and now has been told she has a non malignant growth in the same eye this is being monitored,but I would like to know if it progresses what is the prognosis. I did not ask the specialist as one I was a bit shocked and two my daughter was in the room. she is 13

It all depends upon what type of nonmalignant growth you're talking about.  If you can get the name of the growth, we'll provide additional info on it.

Q.   What causes a build up of pressure behind only one eye?

It is not clear what you mean by pressure build-up behind an eye.  Glaucoma refers to, more or less, a pressure build-up inside an eye.  Do you actually mean behind the eyeball and that the eye appears to protrude forward or there is a sensation of fullness within the orbit?  If the eye appears to protrude outward several possibilities exist including orbital tumors, infections, gland disorders, and a host of other things.  Probably one of the more common conditions that leads to an eye protruding is thyroid eye disease.  Whatever the problem, you need to see an eye doctor about the problem ASAP. 

Q.    Can you get color blind with excessive usew of A VDU >?

We're not sure what you mean by a VDU or AVDU, you're possibly referring to a Visual Display Unit or some type of monitor or image generation system.   Whatever, patients are born color blind (genetics) or acquire color blindness through a disease process (e.g., retinal degeneration, optic nerve disease, rarely but possibly via brain damage or tumor).  Watching or viewing objects such as CRTs, VDUs etc., cannot cause a color blindness.  If you feel that you're recently have experienced decreased color vision (rarely are patients totally color blind; but rather, are color deficient) see an eye doctor about the problem.

Q.    What kind of vision will I have after having had a corneal laceration?

Vision following a corneal laceration depends on numerous factors including the type and extent of damage, what caused the corneal laceration, proper medical care and the healing process, among others.  In general, most corneal lacerations heal completely and leave the patient with no permanent vision loss.   Patients with corneal lacerations often complain of problems with glare, oncoming headlights and are photosensitive.  Sometimes the pain with a corneal laceration is significant.

Q.   What is palsy of the iv nerve of the eye?

Fourth nerve palsy is the most common isolated muscle palsy seen by the eye doctor.  The most common acquired cause of a fourth nerve palsy is closed head trauma, even a mild blow to the head can cause a fourth nerve palsy.  Other causes of fourth nerve palsy include brain hemorrhage, diabetes, brain tumor among others.   In about 25% of cases the cause of the fourth nerve palsy is never uncovered.   A fourth nerve palsy leads to diplopia secondary to an eye misalignment.   Often, but not always, a patient with a fourth nerve palsy will tilt his/her head to achieve single binocular vision.  A fourth nerve palsy may last for a long time and may require surgical correction. 

Q.   I am a 40-year-old female in good general health. Approximately 3-4 months ago I began to notice a small oval shape filled with diagonal lines in the center (focal point) of my vision- in both eyes. I mostly noticed it when lying down in bed at night or upon waking (still lying down) in the morning. It either was not as noticeable or did not exist at other times of the day. I saw my opthalmologist, who examined both retinas and could find no problem. More recently, the spot seems to be more of a dark gray circle, again, in both focal areas, noticeable when lying down (especially noticeable against a white wall). I do have fairly frequent migraines related to ovualtion and menstruation. These headaches have worsened considerably during the last five months. The severity and frequency of the migraines has been reduced with 20 mg. amitriptalyn (sp?). I may be entering early menopause since an ovary was removed five years ago (migraines started after that). I have noticed that the spots may be worse as I approach my period. Although I get nausea prior to some migraines, I have not particularly noticed visual symptoms.

Your description (oval with diagonal lines) is consistent with the fortification phenomenon associated with migraines.  Although the precise description, extent and severity are different among patients, for the most part you do describe the fortification phenomenon.  Go to the Simulations page and examine the simulation of the Fortification phenomenon.  A small scotoma with the diagonal lines is quite similar to what you describe.  Also, go to the Q and A Archives and do a Find, under Edit on your browser, for migraine, and see what others have to say about similar experiences.

Q.   What is a mylenated nerve?

A myelinated nerve is a nerve cell (axon) that has a myelin sheath or coating.  Myelin is mostly lipid (fat) and acts as an insulator so that cells can carry electrical signals. Without myelin, a cell would not be able to carry electrical information along its axon to other cells.  For example, in multiple sclerosis (MS) the optic nerve fibers loss their myelin coating and, as a consequence, vision decreases and the propagation of nerve electrical signals is decreased. 

Q.   What is a stigmatism, what causes it, does it get worse and can it be cured?

The correct spelling is astigmatism.  For more info, go to the Q and A Archives and do a Find, under Edit on oyur browser, for astigmatism.  Also see the Dictionary for a general definition.

Q.    What is horner's syndrome in dogs?

Damage (either born with or acquired) to the sympathetic nerves in the neck area or brain stem can result in what is termed Horner's syndrome.   Symtoms depend on whether nerve damage is partial (typical) or complete.   Symptoms include abnormal pupil size in one eye, droopy eye lid, sweating and constriction of blood vessels on one side of the face (so that one side of the face may be sweaty and cool while the other affected side is dry and warm), reduced pressure inside the eye (opposite of glaucoma) and difference in eye (iris) color.  In a dog, we can only speculate, symptoms might include different iris color, different pupil sizes particularly in dim light, and possibly a droopy eye lid.

Q.    I wore contacts until about a year ago. I got contacts when I was 12 and am now 20. Throughout the years I would get frequent eye infections. I was told I had "GPC". Basically they told me I was allergic the film that would build up on my eyes. Recently though after a year of not wearing contacts I seem to have to same symptoms in both of my eyes. My vison is a little blurry, my eyes are itcy and seem a little swollen. I have looked all over for the defination of "GPC" but have been unsuccesful. Can you please help with the this. I have an eye doctor appointment and would like to inform him of my history. Thank you.

GPC stands for Giant Papillary Conjunctivitis.  Symptoms include excessive tearing, itching, mucus accumulation sometimes with strands of mucus blocking vision, and foreign body sensation, among others.  It is believed that GPC is the result of extended contact lens wear(especially hydrogel lenses) and an autoimmune response to ????.  Onset seems to be seasonal, and patients with known allergies are more likely to be affected.  If GPC occurs with soft contact lens wear, switching to a rigid, gas permeable lens may solve the problem.  Other interventions include saline eye irrigation, lens cleaning, hygiene and picking the right lens material and even the lens design.

Q.    Thank you very much for your answer. I wonder if I were entirely clear, however, in my wording about the irises: both irises ARE currently the SAME color, but that color is different from their prior appearance. Here's the question as I submitted it before (and thank you!): Over the past year, my 36 year old husband reported that with increasing frequency, he could not get both eyes to focus equally. Apparently, one eye remains more dilated than the other at the times when he has a problem focusing. He saw an eye doctor, who suspected nerve damage and offered further testing, which was not pursued. Although the focusing/dilation problem got worse for several months, he recently reported that it was no longer bothering him. However, when I saw him recently after a six week absence, I noticed immediately that his irises were a different color: not their usual clear green, but a more opaque blue-green. Do these clues add up to suggest any particular condition to you? Thank you.

Regarding a difference in pupil size, what immediately comes to mind are Adie's pupil and Horner's syndrome - both of these are thought to be related to some type of nerve damage.  As for changing iris color, some of the things that we worry about include inflammatory processes such as iritis and uveitis, as well as glaucoma.  All of these diseases warrant a trip to the eye doctor for further evaluation.  If left untreated, some of the diseases that affect the iris, such as glaucoma, can lead to blindness.

Q.    I am a 18 years old i have the problem with my left eye the docter says your eye is totaly failed and tell me the dieases glucoma and my eye is not working.

Glaucoma is usually related to increased pressure inside the eye and causes damage inside the eye.  Once damaged, vision will not recover.  We assume that you're been placed on certain medicines to control the pressure or/and have had or planning to have surgery to try to control the pressure and future damage.   You should also be worried about the other eye - be sure to make all doctor appointments and do everything your doctor says; for example, be sure to take your medicine as recommended and NEVER miss a dose.

Q.    What is hystoplasmosis and what causes it?

Q.   WHO SPEALIZES IN HYSTPLASMOSIS, ANY INFO . pLEASE.

Go to Past Featureds Articles for an article about histoplasmosis (note correct spelling).  Also, go to the Q and A Archives for additional info on the topic.

Q   I'm interested in your answer that describes "a bunch of little dots that are bright and moving through your field of vision." I sometimes see such a phenomenon, most commonly if I turn my head as far to one side as it will go and sometimes during a warm shower, which presumably would dilate the blood vessels in my head. My eye doctor said the bright spots probably are signs of an ocular migraine. I want to be careful, however, because I am extremely myopic (-9.5 in each eye) and have large eyes. Does the ocular migraine diagnosis satisfy you, or should I be skeptical of it? Thanks.

Phosphenes, or the perception of little clusters of bright dots, are usually seen when a patient raises his/her head suddenly (e.g., bending over forward to a straight-up position) or is suddenly jarred or, as in your case, if the patient moves the head real fast and suddenly.  These types of movements cause changes in the blood vessels in the eyes and cause the patient to experience phosphenes.  Your eye doctor is basically right since ocular migraines also involve dynamic changes in the blood vessels of the eyes.  However, we would tend to reserve the definition of ocular migraine to a more significant vascular event and not one that can be initiated by the patient voluntarily.  The onset of such phosphenes is more common in high myopes such as yourself and you're right-on-the-money in wanting to be careful in avoiding head trauma or sudden blows/shifts etc. to the head.  such events could cause a retinal tear or detachment in a high myope.  As a high myope, the occurrence of phosphenes and the presence of the more common darker floaters is also common. 

One word of caution: sometimes older patients (>50 yrs) with   occlusive vascular disease/arteriosclerosis in the neck area will experience changes in vision as a result of turning their head far to the left or right.  When the patient turns his/her head the blood vessels in the neck further constrict thus causing change in vision (sometimes temporary loss of vision).  So if your over 50, have arteriosclerosis or are a heavy smoker or/and have high cholesterol, you may want to have your GP or Internist evaluate you for such a condition.

Q.    My husband, 48, was just diagnosed with non-ischemic CRVO in his left eye. He has no other health or vision problems. What is the likliehood that his vision will return and what is the average length of time it takes to return?

It is unusual for a person under the age of 50 to have CRVO.   Most, 90% or greater, are over the age of 50; indeed, most are over the age of 60.   Depending on its exact nature, patients with nonischemic central retinal vein occlusion (CRVO) usually have total or near total vision recovery over the course of several months.  Others have reported that recovery of vision depends on the visual acuity following the attack; the better the visual acuity the better the recovery.   However, it should be noted that some patients (10% or so) with nonischemic CRVO may develop ischemic CRVO with sometimes serious complications including development of glaucoma and removal of the eye.  CRVO, in general, has also been associated with other conditions including hypertension, diabetes, open-angle glaucoma and being male.   The bottom line is that if a patient is diagnosed with CRVO, particularly ischemic CRVO, the patient needs to have regular eye exams and to closely follow the eye doctor's recommendations.

Q.    Pale optic nerve.

A pale optic nerve (head) is called optic atrophy if severe enough or optic nerve pallor if more mild.  Both optic atrophy and optic nerve pallor can be a sign of a serious visual or neurological or whole body problem and warrants a full medical work-up to find the cause.

Q.   I have yellow spots on the white of my eye. what could cause this?

Don't know what it could be or the cause.  However, the most common yellowish spots on the whites of the eyes is called a pterygium - a yellowish triangle shaped patch on the sclera toward the nose.  Go to the Q and A Archives and do a Find, under Edit on your browser, for pterygium for more info.  If you can describe it (them) in greater detail we'll add to this answer.

Q.    What is the most common std between the ages of 14 and 15?

Sorry but we can't/don't answer non vision or non eye type questions.  (A guess would be human papilloma virus that is associated with cervical cancer.)

Q.    Where are most lions found?

In a Lion den.  Ha Ha... Seriously, the LIONS is an international service organization with clubs in 185 countries and with 140,000+ members.   The most lions can be found in the USA, where LIONS was founded in 1917 by Melvin Jones a Chicago business man.  More info can be found about LIONS at http://www.lionsclubs.org/.

Q.    What is the condition called when you see a "floating spot" in your eyesight?

It is called a "floater".  An illustration can be found in the Simulations page and additional info can be found in the Q and A Archives page (do a Find, under Edit on your browser for floater).

Q.    I have had a sharp shooting pain in the outer corner of my eye. It has happened about 3 times since last night. It also seemed to occur when I bent my head down, what could this be?

Don't know.  However, when pain is involved, you should see an eye doctor for evaluation just to make sure that it is not a serious condition like glaucoma.

Q.    Is there anymore information that I need for my science project optic nerve hypolasia?

We don't have a clue about your science project about optic nerve hypoplasia (note spelling).  The Featured Article this month discusses optic nerve hypoplasia.  There is also some info available in the Dictionary.

Q.    For the past couple of months my husband (age 81) awakes in the morning and is unable to see anything but the outline of my face - not the features. He went to an ophthalmologist who indicated he has an abnormal amount of fluid build up in the eyes in both the morning and evening and gave him an ointment (Muro) to help eliminate the fluid. It seems to help but he feels he is slowly loosing his sight. I read an article about glaucoma which discusses excessive fluid in the eye - his ophthalmologist tested for glaucoma and found no problem. He contends this happens to many elderly persons and it is not anything serious to worry about. Please let me know your opinion as loss of sight would be tragic for him because of his desire for reading newspapers, etc.

It is not clear what your husband's problem is with his eyes.   It is possible that the ophthalmologist is referring to dry eye disease which is common in the elderly.  A common lubricating eye drop is murine.  We don't think that the ophthalmologist was referring to glaucoma when he told you about fluid build-up.   It is possible that during the night your husband's eyes become dry, possibly due to the eyelids not completely closing at night or because of fluid build-up within the tear glands of the eyes.  This would affect his vision in the morning.   Sometimes, but rarely, patients with strokes will have a problem with not being able to recognize familiar faces (prosopagnosia), but this seems unlikely in your husband's case.  If he continues to have problems, please return to your ophthalmologist and, before hand, make sure to write down all of your husband's eye problems and the medicines that he is on so the doctor can further evaluate his vision (certain medicines will also cause the eyes to become dry). 

Q.   I have a mild cone dystrophy. Just saw a retinal specialist who says there are no contraindication for LASIK. My vision has been relatively stable for about 6 years (I'm 28). Will laser vision correction be useless -- I'm myopic. Does cone dystrophy always progress?

In general, patients with cone dystrophy tend to stabilize from 20/50 to 20/200 visual acuity.  LASIK may eliminate your need for corrective lenses or contacts but will not improve your visual acuity better than corrective lenses.   We recently saw a patient with a cone dystrophy who had LASIK, with the idea that it would somehow improve his visual acuity or correct the cone dystrophy - this is not the case.  There is not real treatment or cure for a cone dystrophy.  Recent research has shown that another complication of refractive surgery such as LASIK is the development of an eye misalignment and diplopia (double vision) and requiring corrective eye muscle surgery.  You should proceed cautiously with the idea of having LASIK to correct your refractive error.

Q.    What causes sharp eye pain?

A lot of eye diseases, some serious (e.g., MS, Glaucoma), can cause sharp eye pain.  The general recommendation is when there is pain the patient should see an eye doctor, immediately, for further evaluation.

Q.    I have a swelling right below my eyebrow and above my upper eyelid. A CT scan of orbits and sinuses showed no tumor. It showed acute hay fever and some sinus blockage. There is no sinus infection. I've tried allergy medicine, but that hasn't worked. I also had an opthmalogist check my vision, optic nerve, pressure,etc. They were all fine. The swelling is only by my left eye. Please give me suggestions as to tests,medicines, etc. that I can suggest to my doctor.

Since you've been actually examined by an ophthalmologist, we are in no position to recommend additional tests to him/her.  The symptoms that you describe may be related to meibomian gland dysfunction or inflammation.  Go to the Q and A Archives and do a Find, under Edit on your browser, for meibomian to see if any of the related discussion fits your symptoms.

Q. I have a mild cone dystrophy. Just saw a retinal specialist who says there are no contraindication for LASIK. My vision has been relatively stable for about 6 years (I'm 28). Will laser vision correction be useless -- I'm myopic. Does cone dystrophy always progress?

In general, patients with cone dystrophy tend to stabilize from 20/50 to 20/200 visual acuity. LASIK may eliminate your need for corrective lenses or contacts but will not improve your visual acuity better than corrective lenses. We recently saw a patient with a cone dystrophy who had LASIK, with the idea that it would somehow improve his visual acuity or correct the cone dystrophy - this is not the case. There is not real treatment or cure for a cone dystrophy. Recent research has shown that another complication of refractive surgery such as LASIK is the development of an eye misalignment and diplopia (double vision) and requiring corrective eye muscle surgery. You should proceed cautiously with the idea of having LASIK to correct your refractive error.

Q. What causes sharp eye pain?

A lot of eye diseases, some serious (e.g., MS, Glaucoma), can cause sharp eye pain. The general recommendation is when there is pain the patient should see an eye doctor, immediately, for further evaluation.

Q. I have a swelling right below my eyebrow and above my upper eyelid. A CT scan of orbits and sinuses showed no tumor. It showed acute hay fever and some sinus blockage. There is no sinus infection. I've tried allergy medicine, but that hasn't worked. I also had an ophthalmologist check my vision, optic nerve, pressure,etc. They were all fine. The swelling is only by my left eye. Please give me suggestions as to tests, medicines, etc. that I can suggest to my doctor.

Since you've been actually examined by an ophthalmologist, we are in no position to recommend additional tests to him/her. The symptoms that you describe may be related to meibomian gland dysfunction or inflammation. Go to the Q and A Archives and do a Find, under Edit on your browser, for meibomian to see if any of the related discussion fits your symptoms.

Q.    Is there a cure for macular degeneration?

Q. Is there a surgery for macular degeneration where you will be able to see better again?

There are many different types of macular degeneration. The most common type is age related macular degeneration (ARMD), which comes in two basic types – dry and wet. Although there is no "cure" for ARMD, several types of treatments are available depending on the type and severity. To learn more about ARMD, go to the Q and A Archives and do a "Find", under Edit on your browser, for macular degeneration.

  1. I have a cobweb effect in my right eye with a small black spot in the lower corner. What could be causing it?

The small black spot may be a floater or it could be a so-called blind spot or scotoma. If the black spot moves around and periodically disappears it is a floater. If it is always in the same place in your vision and, more or less, always present then it could be a scotoma. A floater or two is common. A scotoma is a sign to see an eye doctor ASAP. Sometimes patients (some with high cholesterol, older or/and with arteriosclerosis) with problems with blood flow, or vascular occlusive disease, sometimes report seeing a cobweb type of image. See an eye doctor for evaluation.

Q. My 8 year daughter has a cataract in her left eye. We recently took her to an eye clinic where they do cataract surgeries here in Edmonton, Alberta, Canada. The doctor put her through a test where they focus a laser beam through her cataract on to her retina and she was able to read from a Snellen chart that was projected through the laser beam. Her vision was 20-25 with the laser where as it would normally be about 20-80. What is this piece of equipment or test called? Is there any research being done to advance this technology towards a non-surgical treatment of cataracts?

The use of a laser is a simple way to "get around" a cataract and to determine if vision or the eye with the cataract is otherwise healthy. Given that vision "without" the cataract is about 20/20 or 20/25 and vision with the cataract is 20/80 says that it would be worthwhile to have the cataract removed (and an intraocular lens implanted) to improve vision. The laser test also says that your daughter does not have amblyopia or a lazy eye from the cataract AND that the cataract probably has not been around for a long time. The use of the laser in this instance has nothing to do in terms of the development of a nonsurgical treatment for cataracts.

  1. What is similar to a stye?

A chalazion. Both are caused by an eyelid infection. While a stye (may be red and swollen and sensitive to the touch and may contain pus) is located along the lid margin where the eye lashes are located, a chalazion (more solid and firm) is usually located away from the lid margin. Other possibilities include dermoid cyst, sebaceous cyst and dermolypomas. I believe a brief description of these latter conditions are found in the dictionary

Q. The center of my right eye has a distorted circle area. I am age 58. It looks like text has had been erased and blurred. I have had migraine headache when I was younger. I have had the visual disturbances for some time, but now this seems to be there all of the time and is worse when I am tired. The migraine disturbances would appear, move through the field of vision and be gone in 5 to 30 minutes. This seems to be here all of the time. Sometimes it seems that text is running together and it is very hard to tell what I am looking at.

You need to see and ophthalmologist ASAP – like today! Your age and symptoms are suggestive of age-related macular degeneration. You may need immediate "laser" surgery or other type of medical intervention. See an ophthalmologist now!

Q. An ophthalmologist said that I have pterygiums in both eyes. I have read your Q and A's about these growths, but I could not find anything about how to avoid or reduce the pain that occurs when they get dried out. Mine get so painful at times, due to excessive computer work or document review, that I have trouble opening my eyes. What can you suggest (other then blinking more often)?

We suggest that you return to your eye doctor and explain your situation to see what he/she recommends. Lubricating eye drops are only a temporary solution. Given that pain is involved you may qualify for surgery to have them removed, although they may return. Environmental conditions, such as moving air or excessive computer screen viewing, will aggravate the condition. You may also have another underlying condition usually referred to as dry eye disease. See the past featured article about dry eye disease.

Q. Is there such a thing as myopic degeneration or is it more likely to be macular degeneration? Any cure? What’s on the horizon?

Yes, there is a condition called myopic degeneration in which the eyes are very nearsighted (myopic). In myopia, the eyes tend to be too long or football-shaped. This causes the different layers or tissues of the eyes to be stretched to, well, a breaking point. Myopic degeneration can cause a loss of central vision, problems with seeing at night, sensitivity to lights, as well as increased chances of retinal tears, breaks and detachments. Patients with high myopia and with myopic degeneration tend to see a lot of floaters. The sudden onset of a lot of floaters, seeing flashing lights or seeing a black area in one’s visual field warrants an immediate trip to the eye doctor.

Q. If you wear eye protectors in the tanning bed is there any harm done to your eyes?

By the tanning bed lights or by the eye protectors? In general, eye protection in tanning beds is for the UV or ultraviolet light as well as for other certain parts of the light spectrum that might harm the eyes. So, such protection is needed and welcomed. Depending on what exactly is used for eye protection in such tanning beds, it is also possible to have damage to the eyes or tissue surrounding the eyes by certain eye protectors. Eye protectors should never push on the eyeball itself, since extended pressure on the eye can cause permanent blindness. Also, eye protection like swimming goggles that is too tight can cause nerve damage around the tissue around the eye

Q. How many people are blind, who wouldn't be if they received an eye donation?

Sorry, but we don’t have good statistics on that one. Nevertheless, as with all types of organ donations, there is a real shortage of donor eyes for cornea transplant surgery as well as for use in research.

  1. I have these floating dots I see through my left eye, what could it be and how do I get rid of them?

They’re probably floaters. The real question is why do you have them? Many patients will get a few floaters as they age and the floaters are just part of the aging process. Once you have them you’ll always have them. Sometimes floaters can be a symptom of a serious eye problem or associated with a certain type of eye disease. Just to be on the safe side, see an eye doctor about the problem.

Q. My 7 year old son has no problem seeing things near or far, he also passed his vision test with flying colors. My concern is when he watches TV, I see him turning his head and looking side ways. Should I be worried about this or is it just a bad habit?

Turning one’s head while attempting to watch TV, for example, may be a sign of an eye misalignment. Often, patients with an eye misalignment will have to turn their head a certain way to see things with single vision. Vision is normal in each eye; however, the eyes have a hard time working together. If he turns his head to the left or to the right (but the eyes are level with the floor) he may have an eye that turns in slightly (and you may not notice the eye misalignment). If he tilts his head such that the eyes are not level with the floor, for example, he may have an eye muscle nerve problem, one being a 4th nerve palsy. In any case, your son needs to see an ophthalmologist (not an optometrist), because, depending on the problem, may need eye muscle surgery to correct the problem. Such eye misalignments can cause other problems like eye fatigue and strain, double vision and even neck problems.

Q.    Can optical (optic) atrophy be caused by a head injury?

Optic atrophy (note correct term) can be caused by a head injury, as well as numerous other things including hydrocephalus (so-called water on the brain), inflammatory conditions, brain tumors, hereditary conditions (e.g., Leber's optic atrophy), vascular conditions, etc.

Q.    What causes high pressure on the eyes?

We are not sure what you mean.   If you mean increased pressure inside the eyes, a condition called ocular hypertension or glaucoma, numerous causes exist.  For example, structural abnormalities related to the lens and pupil of the eye sometimes cause (closed-angle) glaucoma.  Sometimes problems with the drainage part of the eye can cause (open-angle) glaucoma.  It is also possible that the eye may be susceptible to normal pressures within the eye (normal pressure glaucoma).   It is also possible that the generation of fluid within the eye may be abnormally high causing increased pressure, although some would debate this possibility.  For more info on glaucoma, go to the Q and A Archives and do a Find, under Edit on your browser, for glaucoma.

Q.    I have a problem when I wake up in the morning and look at my solid white shower wall and close one eye and look out the very very side of the other eye I see a circle that gets smaller and bigger as I turn my head leaving my eye still.I see this with both eyes when the other eye is closed.For some reason after I take a hot shower the circle goes away and it just becomes a little bit of a dark spot that only can be seen looking out the very side of my eye against a white surface.I have visited my eye doctor and been dilated and given a vision field test all which came out great,he said not to worry about it since it goes away,but it is still on my mind every morning and I thought maybe you could help.I am 30 years old.Thank you.

I asked a question last night about seeing the circle in the morning,I just needed to add that I wear contacts but only during the day and I have recently quit totally to see if this was the problem,but it hasn't made a dfference so far.And also my eye lids are a little bit puffy in the morning.

Glad you saw an eye doctor and that everything seems fine.   We also don't know what you could be observing/experiencing.   Sometimes patients with migraines will report that hot showers trigger visual sensations of circles of light.  And, as you change fixation (while moving your head) the circle will appear to expand and contract.  An afterimage of a bright object will also act in the same way - the patient will "project" the afterimage onto surfaces at different distances and the afterimage will appear to grow bigger, with farther away fixation, and smaller, with closer fixation.  (see if this is the case in the shower - i.e., see if the circle size varies with the distance from the wall.) Another, remote, possibility is that the contacts are causing some localized corneal swelling around the edges and that you're seeing this ring of corneal edema in the morning and that the moisture from the shower helps resolve the slight differences in corneal topography.  (See follow up question about 3 questions below ). 

Q.    The skin/muscle right beneath my right eye has been twitching continuously for the past 4 days. My eyelids are slightly swollen. What could that be?

Go to the Q and A Archives and do a Find, under Edit on your browser, for twitch or twitching for more info on this topic.  In general, twitching (which you basically can't see in a mirror) is due to stress, alcohol, not enough sleep, etc.

Q.    Do you have any information on bilateral atrophy of the RPE, RPE Lesions, or RPE focal degeneration that you could email to me?

There are a large number of macular, generalized as well as focal RPE (Retinal Pigment Epithelium type dystrophies.  Macular dystrophies include; Butterfly-shaped dystrophy, Reticular dystrophy of Sjogren, Spider dystrophy, and pattern dystrophy of the RPE, among others.  Generalized RPE dystrophies include Best's disease (also called Vitelliform dystrophy).  The interesting thing about Best's disease is that it looks like a localized lesion in the back of the eye; however, based on the abnormal EOG (Electro-oculogram) it is obviously a generalized condition.  Focal RPE dystrophies include Benign concentric annular macular dystrophy, Stargardt's disease, dominant Stargardt's disease, and Fenestrated sheen macular dystrophy, among others.

Due to the numerous types of RPE dystrophies, the effects on vision and long-term prognosis very.  Visual acuity may range from 20/20 to 20/200.   There may be a central scotoma, color vision loss and decreased night vision.   The best known and probably most common form of RPE dystrophy is Best's disease.   For more info on Best's, go to the Q and A Archives and do a Find, under Edit on your browser, for Best's.   Sorry, but we do not respond to e-mail send to requests.

Q.    I am the person that is seeing the circle in the morning and I just had a little more infomation I would like to add.I wanted to let you know that I don't have migraines,and also the circle that I am able to see is there as soon as I open my eyes in the morning.The shower just helps it to go away,but if I am awake for about 1 1/2 hours it goes away on its own.The possibility of the contact causing corneal swelling, how long would it take for the swelling to stop once I quit wearing the contacts.I quit Thursday and it hasn't seemed to changed yet? This corneal swelling would that mean that my contacts aren't fitting properly and I need to be refitted,because I have wore contacts for 16 years,but did get new contacts about 4 months ago.I agree about the contact swelling situation since that is the only thing that I physically do to my eye,and I was just wondering why it only occures when I don't have them in my eyes and not while I am wearing them.That kept messing up my reasoning that it could be my contacts.Thank you for the wonderful service you provide and also I have scheduled another eye exam with another ophthalmologist just to get a second opinion.My original doctor is a optometrist.   Thanks again,You help to put my mind at ease.I have never had any eye problem so this is new to me.

Go to Problems with Contacts and see if any of these are related to your problem.  If you see the ring or circle with both eyes, individually, and it looks very similar between the eyes then the problem may not be with the contacts - it would seem remote if both corneas were affected in a similar fashion.  let us know if they find anything. 

Q.    I have had recurring iristis and uveitis for the past 1.5 years. With my doctor's help, I have been treating it with Predforte Eye Drops and oral steriods. I am searching for any dietary, lifestyle, or habits that may decrease my chance for an iritis/uveitis reoccurence or flare-up?

Although we're not sure of lifestyle changes per se, there does seem to be a relation between certain personality traits/styles and flare-ups of iritis.   In general, patients that "bottle things up" inside or patients that need to have complete control of their life and surroundings (and don't or can't) are at particular risk for iritis flare-ups.  Some authors have reported a direct relation between episodes of depression in a patient and iritis.  Patients with excessive self-control also have problems in terms of "keeping things in" or even acknowledging stressful events in their lives.  Bottom line:  Patients need to develop strategies for dealing with and limiting stress in their lives.  While many of us can't avoid stressful situations at work, for example, we all can handle stress better; for example, through regular exercise and keeping in shape.  In one's personal life, try to avoid stressful situations if at all possible and know your limits.    Recognize and deal with stressful events - don't ignore them or pretend that they don't bother you when in fact they do.  Let off steam - don't keep things bottled-up inside.  Finally, don't put your body through stressful things like smoking cigarettes and drinking excessive amounts of alcohol.  Good luck.

Q.   Disease caused by hepatitis c.

We are not aware of any vision or eye problems caused by or related to Hepatitis C.  However, any disease process that affects the liver and that could lead to cirrhosis of the liver could lead to reduced Vitamin A stores in the liver thus leading to nightblindness.  Also, it is possible that Hepatitis C infection could cause flare-ups of iritis (see above question and answer).

Q.   I was just diagnosed with anterior uveitis and Birdshot Syndrome. I am finding information on uveitis, but not on Birdshot Syndrome. Do you have anything? Thank you!

Uveitis and birdshot retinochoroiditis are sometimes connected or occur in the same patient.  The reason it is called "birdshot" retinochoroiditis is because it looks like the back of the eye has been hit by a shotgun blast - there are small white spots scattered throughout the retina.  The cause of birdshot retinochoroiditis is not known.  It seems to occur in patients, mostly women, around the age of 50, with a range from about 35 - 70.  The patient may experience blurred vision, or "cobweb" vision, a number of floaters, some loss of color vision and problems with going from a lighted area to a darker area and vise versa (i.e., light transition problems).  Some patients may not have any symptoms.   Visual acuity can be affected by swelling (edema) of the retina or/and macula or/and by the development of a subretinal neovascular membrane and/or hemorrhages.   Interestingly, some patients with birdshot retinochoroiditis develop depression and have problems with sleeping.  Treatment seems directed at controlling inflammation inside the eye.

Q.   Can lasik be used to correct glucoma?If not then what other treatment is available for people suffering from glucoma?

LASIK refractive surgery is used only to correct a refractive error - i.e., an optical error of the eyes.  Nowadays LASIK does involve the use of a laser, but only to remove a thin layer of cornea.  For more info on LASIK surgery info, complications and some screening info, go to the FDA web site .  For info on glaucoma, go to the Q and A   Archives and do a Find, under Edit on your browser, for glaucoma.  Warning: LASIK surgery is now associated with the underestimation of intraocular presssure. In other words, if you have a history of glaucoma, a family history of glaucoma or have one or more glaucoma risk factors, a glaucoma screening may lead to an underestimation of your pressures IF YOU HAVE HAD LASIK surgery.  If you have had LASIK surgery, you should inform your eye doctor at each visit that you have had LASIK surgery so that he/she can compensate for potentially inaccurate (low) intraocular pressure readings.

Q.    About a year ago I started to notice a bilateral transient Achromatopsia in response to bright light lasting less than a minute. My color perception shifts to a more blue toned vision as if I were looking through sunglasses. I visited my local Ophthalmologist who could find no evidence of macular degeneration or other problems. Any thoughts on this? As like most other dentists, I utilize a high powered sub ultra- violet curing light for composite tooth bonding. I try to utilize eye protection, but enviably am exposed visually to it. Could this be a contributing factor? Would you recommend I see a neurologist?

Transient color distortions sometime occur as a side effect of certain medicines - a bluish tint is associated with Viagra, for example.  If you are on any prescription meds trying looking in a PDR for possible visual side effects.  Does the bluish tint cover your vision like a curtain?  If so, we may also be looking at an ischemic event, particularly since it only lasts a minute or so.  Patients with Transient Ischemic Attacks (TIAs) report temporary changes in vision, like a curtain covering the vision for a minute or so.  Do you have high cholesterol or cardiac problems or vascular disease?  A second opinion never hurts and it may be beneficial for peace of mind.  As for the sub ultra-violet curing light, usually light damage to the retina is more-or-less permanent and long lasting.  You may want your color vision checked periodically, we prefer a color test called the Farnsworth Panel D-100.  

Q.    Can you duplicate vision loss in a person with a pituitary lesion?

The pituitary sits right below the optic chiasm, where the optic nerves from each eye combine and cross one another.  When the pituitary expands or grows due to pathology (e.g., pituitary tumor), it pushes up against the optic chiasm and causes losses of the visual field.  The exact type of visual field loss is highly variable, however.   A hallmark of pituitary tumors is the very different types or degrees of vision loss occur in the left and right eyes.  In addition to visual field losses, a pituitary tumor can lead to reduced visual acuity in one or both eyes.   Again, vision may be much more affected in one than the other eye.  Go to the Simulations page for an ilustration.   

Q.   I have just been diagnosed with iritis. I read on this page that using steroids can have multiple side effects. My doctor has me using steroid eye drops every 30 minutes for the next week. This sounds pretty excessive but I'm sticking to the regime. What side effects should I watch out for?

This is a very good question to ask your doctor if you have concerns.

Q.   I have a friend that was diagnosed with Histoplasmosis this week. Not in her eyes, but she had a lump in her neck that was removed and found to be this disease. I was wondering if you knew anything more about a good web site or reading materials to find more information about this.

Go to past featured articles on this web site for info on histoplasmosis and effects on the eye and vision.  Sorry, we know of no web sites with additional info on noneye effects of histoplasmosis.

 

March 2001

Q.    How do you explain when your left eyelid starts to twitch for 3 days or more?

Go to the Q and A Archives section and do a Find, under Edit on your browser, for twitch or twitching for an answer.

Q.    What is hystoplasmosis?

Go to the Q and A Archives and do a Find, under Edit on your browser for histoplasmosis - note the correct spelling.  Also, click HERE for a Past Featured Article about histoplasmosis.

Q.    Do you think that there is a significant psychological/neurological component to eye floaters? By that I mean, do floaters get bigger and more noticeable, in part, because the mind learns to focus on them? If this is the case, what is the best way to condition it not to focus on them?

That's a tough question.  The only apparent association between psychological issues and floaters is that their constant presence sometimes drive people nuts!   Floaters can be very annoying and the more the patient concentrates on them and pays attention to them the worse they appear to get in terms of size and occurrence.  By far, the best thing to do for that annoying floater or two is to ignore it/them as much as possible.  Also, one can have some control over their presence, at least in terms of seeing them, by looking away from backgrounds such as the open blue sky or some other homogeneous light  field and, instead, direct one's attention to darker backgrounds or backgrounds with many different contours and colors which make fl;oaters harder to see.

In terms of a neurological component, certain neurological diseases can cause floaters to occur, such as conditions that affect the optic nerves, retina, and other inner parts of the eye.  Since the eye is an extension of the brain, in a sense, floaters are a neurological condition - although to get more specific it is usually associated with vision and possible vision problems.  For more info on floaters, go to the Q and A Archives and do a Find, under Edit on your browser, for floaters or floater.  Also, we have tried to illustrate some common types of floaters on the Simulation page.

Q.    Two days ago I started experiencing sharp prickling pain in my right eye. It did not disappear overnight. Last summer I had similar pain in my left eye. After a dilated exam the doctor informed me that I had irritation and gave me some eye drops for optional use. Do you have an advice for me? Should I see a doctor again and ask him or her to check for something specific? My other eye problems include many eye floaters in both eyes (developed a year and a half ago), and large halos around lights at night (developed half a year ago). I wonder if there is a connection between these phenomena. I am a 19 year old male.

Glad you saw an eye doctor.  The things, such as glaucoma and retinal detachment for example, that we would look for would have been covered by a comprehensive dilated eye exam.  You are somewhat young for floaters; however, if you're a high myope (real nearsighted) it would explain the floaters.  Halos are usually associated with cornea, lens or vitreous problems.  However, if you're nearsighted and wear contacts that would probably explain the floaters, haloes and eye pain.

Q.    Recently my brother was seeing wavy lines. He went to the eye doctor who shined a bright light in his eyes. It was painful, and my brother developed a high sensitivity to light. He went to an eye specialist. The doctor said his optic nerve looked fine, and he gave my brother some eye drops. The problem now is that the vertical lines are much more wavy, and a "fog rolls in" so that my brother can barely see. The specialist told him to quit using the eye drops, and come back in six months. This doesn't sound like good treatment to me. Should my brother go see another specialist?

Whenever a patient has loss of vision, he/she should see an eye doctor ASAP.  If your brother is not happy with his eye doctor and is worrying about the loss of vision than by all means get a second opinion.  One thing we do worry about is glaucoma and a healthy optic nerve would suggest that glaucoma is not an issue.   You fail to mention your brother's age, if he is 50 years or older, a prime concern is age-related macular degeneration (ARMD).  A test for ARMD is the Amsler grid, a series of vertical and horizontal lines like graph paper.  Go to (click on) the link here to go for the Amsler grid test for macular degeneration: http://www.preventblindness.org/eye_tests/mdchart.html?foo=Macular+Degeneration+Test

If your brother sees the wavy lines in the grid, he should see an ophthalmologist ASAP, since this is one symptom of ARMD.  He may need a certain type of laser surgery or other treatment.  [See follow-up question below]

Q.   I have cerabal palsy, and was placed in an oxygen incubator as a baby in 1951. Growing up, my distant vision has always been poor, but after catarac surgery my vision was corrected to 20-40. I asked for a retina examination at my last eye exam. It was a bright light that really hurt my eye. Ever since that time, my vision has been foggy. Vertical lines are now distorted. I went back twice to the eye doctor. Each time he shined a light in my eye, dialated or not, the symptons got much worse. My vision, which had been corrected to 20-40 is now to the point where I have to read with a magnifying glass. The vertical wavy distortion is much worse. The doctor told me that my cornea had fogged up, and the bright light had distorted the cornea. If this is so, would a cornea transplant correct the problem, or is there other treatment available? The doctor also said my optic nerve was fine.

The additional info helps.  Still, your eye doctor and you will have to uncover WHY your cornea(s) became cloudy?  Sometimes cloudy corneas are the result of certain metabolic and systemic diseases (e.g., mucoplysaccharidoses, syphilis) and it remains a possibility that your CP is somehow related to the cloudy corneas.  It seems extremely unlikely that the bright lights from the eye exam alone caused the cloudy corneas.  It is possible that the bright lights during the eye exam may have triggered some type of metabolic event in the cornea and thus caused the cornea to cloud, but even this seems very remote. 

You may need to be examined by a cornea specialist as to whether you're a candidate for cornea transplant surgery.  However, you should be aware that cornea transplant surgery carries the risk of several potential serious complications.   Putting your two questions together, your eye doctor probably wants you to wait for 6 months or so to see if the cornea clears-up.  It sounds like your eye doctor is being very straight forward with you so why not just ask your current eye doctor for his/her opinion regarding the cause of the cloudy cornea, about cornea transplant surgery and the prognosis for your cornea to clear in the immediate future?  Good luck.

Q.    Tabulate the hormones of the endocrine glands?

This sounds like someone's homework.  Do you have a specific question regarding one of the protein hormones?

Q.   I have noticed a rapid image flickering in my peripheral vision. It is most noticeable when turn awayfrom a computer screen or a light and look at it from the side or when I am simply in a brightly lit room. Also at night when I move my eyes across LED digits of an alarm clock or microwave I see a "trail" of these digits when they pass through my perpheral vision. Is this normal or should I visit an eye doctor and point it out to him or her? I am 19.

These are normal phenomena.  The monitor flickers at 60 Hz, depending on the type of monitor, and the flicker rate is such that you'll only see it with your peripheral vision and under certain environments.  The LEDs experience is also normal.  Nevertheless.  We recommend that everyone see an eye doctor every two years, just to check for the more common eye conditions, so if you haven't seen an eye doctor for the past two years have one check you out.

Q.   What is medically wrong if you are colorblind?

Color blindness is a wrong term since the vast majority of patients with color vision problems are not blind to all colors but, rather, may confuse certain colors and see other colors normally.  About 8% of boys and 1/2% of females have some type of color vision deficiency, a genetic problem.  More rare, certain retinal problems and, even more rare, some brain problems can cause a patient to have color vision problems.  Some medicines (e.g., Viagra) can also cause color vision problems.  The ones that we really worry about are the acquired color vision problems - where the patient had previously had normal color vision.  In the majority of cases nothing can be done for color vision problems, unless it is caused by a certain medicine.

Q.   Please provide us information about any cure avilable for central areolar choroidal dystrophy.My relative and his twin brother both are recently diagnosed with this disease.

Central areolar choroidal dystrophy (CACD) is characterized by a gradual loss of vision, that starts around 40 years of age, and may progress to "count fingers" visual acuity.   However, it should be noted that loss of vision in CACD is highly variable.  Some patients may retain very good visual acuity, but may have loss of visual field in the shape of a donut (See Simulations for annular or ring scotoma).  CACD may also cause some loss of night vision and in some patients some parts of the visual field, where parts of the back of the eye have degenerated, the patient may experience blind spots.  CACD is an autosomal dominant disease, in other words, there is a 50% chance that children will also have the disease.   Clinically, the ERG is often subnormal or mildly abnormal and light adapted and/or dark adapted ERGs may show some abnormalities.  When the eye doctor looks inside the eye, he/she can typically see large areas of loss of pigment and white looking areas.   There is no known treatment or cure for CACD (3/16/01).

Q.   What causes shimmering vision?

It is difficult to fully understand what you exactly mean.   However, taken at face value, shimmering vision can be caused by vascular insufficiencies, like that experienced during a migraine (probably the most common).   A Transient Ischemic attack (TIA) could also cause a type of shimmering vision.   If you mean that your vision is somewhat distorted you could also be referring to the early signs of age related macular degeneration.  Why not visit an eye doctor just to be on the safe side and to rule-out potentially serious conditions?

Q.   Is there a medical proceedure for stargardts disease yet?

No.

Q.    How effective is Visudyne Therapy in treating myopic degeneration in an extremely nearsighted 42 year old?

The efficacy or effectiveness of Visudyne therapy for pathologic myopia or myopic degeneration has not been established to the best of our knowledge.   There is one study out of Switzerland (Archives of Ophthalmology, March 2000) that we are aware of that showed that in a few patients Visudyne photodynamic therapy was well tolerated (did not produce serious side effects) in non macular degeneration patients with choroidal neovascularization.  This was a preliminary study on a few patients and if this line of work proves successful at actual treatment of choroidal neovascularization in patients with pathologic myopia it will probably be 3 - 5 years (2004 - 2006), as a guess, before Visudyne therapy is approved and recommended for pathologic myopia.  This does not mean, however, that patients should not enroll in experimental clinical trials to test the effectiveness and safety of Visudyne therapy - we would encourage patients to participate in such trials after fully informed signed consent outlining the benefits and risks of such studies.

April, 2001

Q.   How is Hystoplasmosis contracted?

For an article on Histoplasmosis, note correct spelling, go to Past Featured Article to answer your question.

Q.   I've had a look at your web site and I was wondering if I could make some suggestions. I suffer from hemianopia and I think your representation, though technically correct is very misleading to somebody who does not have first hand experience of the condition.  Could you let me have an e-mail address to which I can send my suggestions?

Yes, we encourage suggestions.  Just use the "Ask a Question" form to make suggestions.  Thanks for the input in advance.

Q.   I was diagnosed with Iritis about 4-5 years ago. At first, the symptoms only occurred once a year and I was perscribed Cyclogyl and Atropine Sulfate to relieve the pain. Now I am having the symptoms much more frequently (every other month, alternating eyes). I was never given a sufficient explanation of what was causing this to occur and it's terribly frustrating trying to get a referrel to an eye specialist from a GP. Any suggestions? I still have the meds from previous appointments, is it ok to continue using them on a 'as needed' basis?

For general info on iritis, go to the Q and A Archives and to the Dictionary.  We strongly suggest that you see an ophthalmologist for the iritis.   No, it is not OK to use past prescribed meds to treat current conditions. 

Q.   Retinal vein occulsion?

Go to the Q and A Archives and do a Find, under Edit on your browser, for CRVO (central retinal vein occlusion) for an answer.

Q.   Possible side effects after cataract removal?

Prior to surgery, your ophthalmologist/surgeon, should have gone over with you the potential problems associated with cataract/lens removal.  Some of the possible problems include various problems with the intraocular lens including incorrect position, and other problems like hemorrhaging, glaucoma, floaters, reduced visual acuity and/or other visual complaints, as well as optic nerve and retinal problems leading to loss of vision. 

Q.    Education suggestions for right homonymous hemianopsia?

Homonymous hemianopia is blindness in one-half the visual field of one eye. It can be caused by a variety of reasons, including a tumor of the optic nerve, optic nerve compression, or inflammation of the optic nerve (optic neuritis). Depending on the cause of the hemianopia, other physical conditions can sometimes occur with the visual field defect, such as cognitive difficulties (thinking), hearing impairment or problems with mobility. Any other physical disabilities need to be considered when adjusting an educational environment for an individual with a field defect.

The primary area of functioning affected by a visual field problem is mobility. A student with homonymous hemianopia should be acquainted with the lay out of the classroom without other students present, in order to alleviate distractions. In addition, the student should be seated so his/her remaining visual field is facing the blackboard and the instructor. The teacher should of course always be aware of movement during instruction that might occur out of the student's visual field. If leaving the student's field of vision is necessary, verbal description can be used to supplement the missing visual information. Sometimes it is beneficial to use a semi-circular seating arrangement during a class that uses frequent discussion so the student can benefit from facial communication as well as auditory. It is also helpful to call the student's attention to each new individual who is speaking, particularly if that person is out of visual range.

Magnification of reading material is usually not helpful unless there is a central vision problem in addition to the homonymous hemianopia. Making an item larger can actually make a portion of it leave the visual field, requiring the individual to scan the written material and as a result slowing down the reading process. Changing the light also will usually not improve the visual situation unless there is some other vision problem. The same good lighting that all students should experience will generally be adequate for a student with a visual field defect due to homonymous hemianopia.

Q.    My three year old son has delayed visual maturation. I need to know as much information about it (and treatment) as possible. Can you help us?

See the Past Featured Articles section for an article on delayed visual maturation (DVM).  Given your son's age of 3 years, the diagnosis of DVM does not fit.  Almost without exception, DVM is restricted to patients under one year of age.  One possibility is a diagnosis of Cortical Visual Impairment (CVI) - a past featured article on CVI is also provided in past featured Articles.  If your son was diagnosed with DVM when he was less than a year old, then we suggest that he be seen again by a pediatric ophthalmologist for evaluation.

Q.   I've located my natural blind spots with each eye closed, but the spots seem to still be there when my eyes are both open. Sometimes it feels like poor peripheral vision in that specific area. Any ideas.

Yes, you need to see an eye doctor for a comprehensive eye exam and possible visual field test ASAP.  It is rather straight forward to locate the natural blind spot in each eye while the other eye is closed.  It is not normal to still see a blind spot when both eyes are open, since the natural blind spots do not affect the same location in visual space .  A comprehensive eye exam and visual field test should help to determine if anything is going on to cause a scotoma or loss of peripheral vision in one or both eyes.

Q.    Can I develop eye allergies to certain pigments in makeup? My eyes have recently shown signs of pink eye the next morning when I wear blue or purple eyeshadow the day before). For years I have been able to wear these pigments, but the allergies developed within the last year.

Sure can.  There is a long list of "ingredients" in eye makeup and many of them can cause allergic reactions.  In addition, repeated use of certain ingredients can lead to hypersensitivity to the particular ingredient, thus leading to rather severe allergic reactions to the same eye makeup one has used for years.

Q.    My four-year-old son has been diagnosed with Best's disease. His lesions are already atrophic which was quite a surprise to find out. Right now his vision is about 20/30 but I'm concerned he will develop choroidal neovascularization. Most of the info out there concerns AMD rather than Best's. What percentage of Best's patients with Stage V atrophic lesions will develop neovascularization?

Using the Deutman classification for Best's disease (Vitelliform dystrophy), Stage IV is defined as the atrophic stage - the advanced stage usually, but not always seen in the later years (after age 20 or so).  We are aware of no specific stats as to the percent of patients that will develop neovascularization with Best's; although is is probably small, say less than 10%.  Most patients, about 90%, will retain 20/40 or better visual acuity and about 5% will have less than 20/200 visual acuity (legal blindness).  One or both eyes may be affected and patients sometimes have sensitivity to light (photophobia).  Sunglasses should be worn while outside.   The Electrooculogram (EOG) is used in older children and adults to confirm the diagnosis and to identify carriers of the dominant gene as well as to identify asymptomatic family members.  Currently (4/2001) there is no treatment for Best's disease.

Q.   I am a 20 year old female and in my right eye I have noticed a couple of small dark spots around the colored part of the eye (my eyes are dark brown and the spots are about the same color). I wear glasses because I am nearsighted, but other than that, I have no vision problems (the spots do not affect my vision). I also have allergies which makes my eyes itchy and watery at times. I've had the spots for a few years now, and so far my doctor hasn't even acknowledged them.Could stress, diet, or allergies cause the spots, or is it something more serious?

Since you've seen an eye doctor and he/she wasn't concerned about them, they're probably just pigmented spots on the iris - a common condition like freckles.  The next time you see your eye doctor ask about them.  Most likely, stress, diet and allergies do not play a role in the pigmented spots.  A concern would be if the spots are red in color - suggesting possible hemorrhages which should be checked by your eye doctor.  There are some rare conditions associated with discrete "spots" which are slightly elevated pigmented areas or discrete ball like spots on the iris such as in neurofibromatosis.  Leukemia is also associated with the accumulation of white cells in the front chamber of the eye.  But since you're had the spots for years it would seem highly unlikely that you would have any of these rare conditions.

Q.    I was in the sun yesterday and below my eyes became puffy. What can I do do shrink the swelling?

First try to keep out of the sun.  Second, the reason for the puffy eyes is not really known - it could be the result of the sun itself or an allergic reaction to sun screen or even because you were laying down, for example.   In general, puffiness is the result of an excess accumulation of fluid so sometimes a cold compress can reduce the swelling and fluid accumulation.  See your GP or eye doctor if it doesn't go away after a few days or if you are concerned about the swelling or if there are other symptoms.

Q.    My friend is loosing his sight in one eye due to veins on retina bleeding , in the uk they say there is nothing they can do to improve what sight he has his age is 70 somthing.

It all depends on the cause of the bleeding veins.  The most common causes of retinal hemorrhages in the elderly are due to age-related macular degeneration (ARMD) and diabetes.  Both may be treatable, depending on the curcomstances.  The so-called wet form of ARMD, associated with neovascularization and retinal hemorrhaging, may not be treatable again depending of the exact condition.   Once sight is loss it might not be able to be recovered.  The real issue or concern is the prevention of the other eye from being affected.  Unfortunately, we have heard of some real horror stories about the lack of health care treatment of the elderly in the UK, because of the socialized medicine.  You should find-out from your friend the exact diagnosis and with it we can tell you more about whether it is treatable, perhaps in another country. 

Again, once vision is lost it probably cannot be recovered, but there are exceptions.  For example, there is a real life story of a woman in Cleveland Ohio USA who had end stage diabetes - she lost both legs, was legally blind form retinal hemorrhages and near death.  She had a pancreas and kidney transplant and afterwards actually regained her sight and is now 20/20 or nearly so.  I wouldn't have believed it if it were not documented by her doctors and had I not actually met the women.  She has written a book about her ordeal (Sorry but we don't know the title).

Finally, even if he can't regain sight and has poor vision in both eyes, it might be worthwhile for him to go to an agency that deals with patients with low vision.  In the USA such agencies are called Bureau of Services for the Visually Impaired (BSVI), where he could try low vision devices to improve his remaining functional vision.

Q.   What if you have arthritis in both of your eyes?

A certain eye problem called iritis is associated with arthritis.  Iritis can cause vision loss/disturbances and is sometimes associated with arthritis.  For example, in juvenile rheumatoid arthritis, anywhere from 10 - 50% of patients can develop a potentially blinding eye disease called iridocyclitis.  Iridocyclitis involves redness of the eye(s), pain, sensitivity to light and decreased visual acuity.  If not detected or treated early enough (and sometimes despite aggressive treatment) the eye disease can lead to an abnormal shaped pupil, cataract, glaucoma and a general degeneration of the eye ball and blindness.   It is essential that a child/teenager with JRA have an eye exam, specifically a slit lamp exam, by an eye doctor three to four times per year to look for the very early signs of the eye disease.  Also, if the patient ever complains of an eye hurting, or seems sensitive to light, the patient should been seen by an eye doctor ASAP for evaluation and treatment.

Another eye problem associated with arthritis is episcleritis. Episcleritis is an inflammation of the episclera - the outer most layers of the sclera, or white part of the eye.  In addition to redness and discomfort there is sometimes a nodule present in the area of redness.  Episcleritis is sometimes associated with rheumatoid arthritis, ulcerative colitis and gout, but most of the time the cause is unknown.   Wearing contacts will aggravate the condition and make the eye more red and painful.  The reason the eye is red is because of the swelling of the blood vessels and this is why certain eye drops will constrict the blood vessels and the eye will appear white, at least while the eye drops are still working.

There is also a certain syndrome that is associated with both arthritis and another eye problem - conjunctivitis.  Reiter's is a syndrome with three main components; urethritis (inflammation of the lining of the ureter - tube from the kidney to the bladder), conjunctivitis and arthritis (all the itises), with the most dominant feature being arthritis.  The cause of Reiter's syndrome is unknown, but most probably involves something to do with the immune system not working properly.  The syndrome affects more young adult males than females, is self limiting but with reoccurrence.  It is sometimes associated with venereal or post venereal disease, particularly with Clamydia or Ureaplasma urealyticum.

May, 2001

Q.  My 75 year old mother has suffered from Tigeson's (Tygeson's) for decades. Only within recent years has the opthamologist been able to identify what it is. She has yearly check-ups. I read your response to another question asking if it was contagious. You said patients are usually in their 20's or 30's and it usually disappears in 2-3 years. As I mentioned she has had it for decades and suffers a great deal. She uses eyedrops, etc. but gets no relief. She has intense pain and sensitivity and basically has to rest and cannot use her eyes. In the past her episodes have lasted a few days, now they are getting longer and more frequent. She had one that lasted 6 days last week and has woken up with a new attack this morning. Do you have any information that may help her? Is their anyone doing research on this particular disease that I could contact? Do you have any additional information or recommendation where I could find some helpful information? What are the leading research centers in the world for eye diseases?

Tygeson's is a form of chronic follicular conjunctivitis (CFC).  (Original reference: P. Tygeson and M. Okumoto.  A new type of chronic follicular conjunctivitis with corneal changes.  Am J Ophthalmol. 1967 May;63(5):Suppl:1277.)  CFC can be caused by a number of infectious agents including Staphylococcus sp, Moraxella lacunata, Clamydia trachomatis and others.   Some infectious agents may require systemic (oral) antibiotics instead of topical antibiotics.  Also, some of these agents may not be detected by standard laboratory/culture tests.  To prevent reinfections, talk to her eye doctor(s) about the need to throw-away ALL eye and face make-up, creams, eye shadows...everything that makes contact with the face and eyes (even old eye drops).  There is a possibility that the disease is somehow related to an allergic reaction.  Closely follow her eye doctors recommendations as to treatment and possible referrals.  It would seem that a Ophthalmology specialist in infectious/inflammatory agents of the eyes would be your best bet.  If the eye doctor is at a lost as to a referral, try contacting the American Academy of Ophthalmology (AAO) for a possible referral (see Cool Links).   Good luck.

Q.    Exactly what is delayed visual maturation. Is it common in an otherwise neurologically healthy child? Are any other developmental problems associated with it?

For a featured article about Delayed Visual Maturation, see Past Featured Articles.  Almost by definition, it occurs in otherwise neurologically normal healthy infants.  The vast majority of patients develop normal visual function by 6 - 8 months of age.  Many of the infants appear blind and suddenly start to fix and follow like a normal infant - as though a switch has been turned-on.

Q.   Maintaining eye contact causes irritation and itchiness to the other person.  What is the name of this condition.  Is there a treatment for this diseas.

Please restate and resubmit your question.  The question is not clear.

Q.   A cure for blufferitis?

The correct spelling is blepharitis.  If you have blepharitis, you should see your eye doctor for treatment.  For some direction, go to the Q and A Archives and do a Find, under Edit on your browser, for blepharitis.

Q.    I have recently began getting a lot of very long string floaters that wrap around each other and cover most of myvisual field. I have been to an optomitrist and opthalmologist and they have found nothing that can be causing them.They continue to grow and I'm getting more of them (all have appeared in the last month) and I don't know what to do or what caused them. Here's a brief history: Eleven months ago I moved from Ohio to Pennsylvania. I started having dry eyes and went to see the doctor.  I am very myopic (-6 contacts) and was switched from accuvue 1 to accuvue 2 contacts about July of 2000. The  doctor found that I had very high cholesterol (314) and a slightly underactive thyroid. I was put on synthroid and lipitor  which I took for about 6 months (dry eyes never really went away). My cholesterol went down to around 200 but I began getting muscle pain, twitching, and sore ankles. Doctor took me off lipitor in March to see if they would go away, which they did, but my cholesterol went back up to 324 where it is now. Since going off the lipitor, I've began getting the floaters I described above. I've been to an optometrist and opthalmologist who both did dialated eye exams and said that floaters just happen, there's nothing I can do, hopefully they'll stop growing. My question is, could the high cholesterol be causing the floaters? I have done some reading on teh web and have found a few references to cholesterol causing floaters (cholesterol granuloma and synchysis scintillans). I have an appointment with a neuro-opthalmologist in mid-May but right now it looks hopeless. These floaters keep getting worse and all the docs I've seen so far say that they just happen and hopefully they'll stop getting worse and start breaking up after a while. I hate going outside any more, especially in nice weather (either sunny or even brighter cloudy days). If I could figure out what's causing these I'd stop or start doing something to keep them from getting worse. I'm clueless and very scared at this point. Please provide any suggestions you can.

At -6 diopters you're considered a high myope; very nearsighted.   Floaters are very common, particularly for high myopes.  Glad that you've seen several eye doctors and they're right - floaters are common and there is nothing that you can do to prevent them.  The possible relation between high cholesterol and the occurrence of floaters is an interesting one, but we have no evidence of such an association.

Q.    MY MOTHER HAD A BRAIN INFART ON THE LEFT PART OF HER BRAIN ABOUT EIGHT MONTHS BACK. SINCE THEN HER VISION IN THE RIGHT EYE HAS BEEN DETERIORATING .THE OPTHALMOLOGIST , AFTER LOOKING AT THE CATSCAN REPORT SAYS THAT THERE IS NO REMEDY FOR CORTICAL BLINDNESS. SHE HAS BEEN HAVING DEIBETISE FOR LAST FIFTEEN YEARS BECAUSE OF WHICH THE VISION IN HER LEFT EYE IS ALSO DETERIORATING. I WANT TO KNOW IF THERE IS ANY REMEDY OR A NEW TECHNOLOGY AVAILABLE ANYWHERE ON THE GLOBE FOR CORTICAL BLINDNESS AND THE DAMAGE DONE BY DEIBETISE? THANKS A LOT . YOU PEOPLE ARE RENDERING A WONDERFUL SERVICE. GOD BLESS YOU.

An infarct can cause cortical visual impairment (we no longer prefer the term "cortical blindness").  See Past Featured Articles for an article on Cortical Visual Impairment.  In general, it takes about a year to show maximum recovery for a brain injury or damage, so your mother still may recover some more visual function.  Since your mother suffered an infarct on the left side, it would affect both eyes more or less equally.  Thus, decreasing vision in one eye is probably not the result of the infarct, per se.  Chances are that her diabetes is causing loss of vision in both eyes, possibly as a result of diabetic retinopathy or/and damage to the optic nerves.  We are aware of no major breakthroughs in terms of technology or rehabilitation related to diabetes or cortical visual impairment.

Q.    I just noticed a small bump on the outer part of my eye "outer coat of the eye." It is located over the white part of the eyes. There is no redness but slight discumfort does occur when I blink.

Since the bump is causing you some discomfort, see your eye doctor about the problem.  For some clues as to the possible problem, go to the Q and A Archives and do a Find, under Edit on your browser, for episcleritis, ptergyium and scleritis (a Find for "bump" may also reveal clues).  The bump may also be due to inflammation due to an allergy as it is a very bad time of the year and pollen counts are going through the roof, so-to-speak.

Q.   What is hystoplasmosis?

Go to Past Featured Articles for info on histoplasmosis (note spelling).

Q.    An oftalmologist (ophthalmologist) put drops in my eyes to dilate the pupils.  Now my pupils are unequal in size. Could it be the drops?

Yes.  Depending on a patient's sensitivity to dilating eye drops (e.g., atropine), the patient's eyes may be dilated for several hours to several days (even up to a week).  The dilating medicine can wear-off differently in each eye and thus cause the pupils to be unequal in size.  Often, more dilating medicine is put in one eye than the other - resulting in one eye being dilated longer than the other.   If any concern, or particularly if there is any loss of vision (except mild blurred vision that goes along with the pupils being dilated) or pain, etc, give the ophthalmologist a call. 

Q.    I had LASIK surgery about 9 months ago. As a result I have gone from -5.5 in my right eye to -.25 and from -5 to +.5 in my left eye. As a result of the surgery my vision is actually 20/20 with both eyes however the vision in my right eye seems a little fuzzy. Why would this be? Does it have anything to do with the difference between the 2 eyes?

Q.    After having LASIK surgery I have some minor starbursts around bright lights at night. I have corrected vision of -.25 in my right eye and + .5 in my left. The starbursts seem to be worse in my right eye. Is there any reason for this? What causes starbursts? Is this something that may improve with enhancement?

A common side effects of refractive surgery, such as LASIK, are halos and so-called starbursts around lights, particularly at night, as well as blurred vision.  Sometimes these side effects diminish over time and sometimes they're permanent type side effects.  Halos and starbursts are caused by changes in the cornea as a result of the incision or removal of corneal tissue which is part of the LASIK surgery.  Blurred vision may be due to cornea changes or/and uncorrected refractive error.  So-called enhancements, just additional LASIK surgery, may improve the refractive error and lead to less blur.  After nine months it would seem that the halos and star bursts are long-term complications.

Q.   Is there a possibility of harm to the eyes from watching a TV (computer} screen in a blacked-out room?

None that we are aware of.  Depending on the situation, you may notice an occasional afterimage, but this is a natural occurrence and causes no harm.

Q.   Do chlamydia come back if treated properly?

We assume that you're referring to conjunctivitis caused by chlamydia infection, usualy occurring in a newborn.  Because of the increased incidence of chlamydia infections, an added treatment to newborns is the use of antibiotics such as tetracycline and erythromycin ointment applied to the eyes or even a single injection of penicillin.  If treated properly, chlamydia should not come back unless there is reinfections or perhaps a virulent strain of the "bug".   Another possibility is that there was  multiple infections, say chlamydia and herpes virus.  Treatment of one would not necessarily affect the other and, as a consequence, the conjunctivitis continues or appears to recur.

Q.    I have a question for your frequently asked questions section of your homepage. IF you could forward this to the appropriate person I would be most appreciative.  I usually run at night when I get home from work. More often than not, after ten to twenty minutes of running I notice two kidney bean shaped spots directly in my field of vision. THey ware white and appear to be glowing. THere is a round hole directly between them where I can see fine. I usually stop running and after two to ten minutes they fade away. When I go for walks they do not appear. My eyes were examined last year and everything looked okay. I have stigmatisms in each eye but not that severely as to warrent glasses.  THese spots are troubling since I cannot see when they are in my field of vision.

You/your friend should be examined by a  General Practioner and possible Neurologist. The symptoms may be indicative of a serious disorder, possibly involving a heart, vascular or brain disorder.  We would suggest that you not run until the condition is fully checked-out.  Although you/your friend are/is having visual symptoms, it is probably not a vision problem, per se.  See a doctor about the problem.  Sorry, we do not send direct e-mail replys.  Good luck.

Q.    Whenever I turn or rotate my eyes profoundly in darkness I can see a light blue semicircle appear and disappear quickly in each eye. These flashes are not random, I can reproduce them by repeating the eye movement. Is this a normal phenomenon? I am 20 years old, with -0.75 in both eyes and many floaters. I have seen an opthalmologist recently, but forgot to mention this. The main reason why I am concerned is because I have to perform the same eye movements in the sport that I play.

You describe a normal phenomenon.  As one moves the eyes rapidly back-and-forth, pressure is placed on the eye balls and the pressure causes visual phosphenes or appearances of lights - in your case as semicircles (the writer sees more-or-less ovals).

Q.   Pattern Dystrophy - Need to know all I can find out about this disease. Dr. ____ diagnosed this.

You're probably referring to Pattern Dystrophy of the RPE (Retinal Pigment Epithelium).  This is an autosomal dominant hereditary eye disease that has no treatment (as of 5/30/01).  Your father or mother must also have the disease.  There is a 50/50 chance of any of your children also having the disease.   Pattern dystrophy of the RPE is a very slowly progressive vision problem that starts in the second to fourth decades of life.  There is a very mild visual acuity reduction (say down to 20/30 or so - god enough to keep driving) and patients sometimes complain of sensitivity to lights (photophobia).  Many patients with this disease do not have any symptoms, so family members may be asymptomatic.  Usually, two tests (ERG and EOG) are used to help in the diagnosis of the disease.  We know of the doctor who diagnosed your disease and you're in good hands.

June, 2001

Q.    My daughter is 9 and 1/2 months old and still has not shed any tears when she cries...is this something to be concerned with?

It is sometimes difficult to tell whether an infant has normal tearing - most of the time they 're on their backs and tears don't run down the face.   As long as the eyes are not red, the infant doesn't rub his/her eyes excessively and there is no other signs of dry eyes such as crusting, scaling, etc., it is probably not a concern.  Nevertheless, the American Academy of Ophthalmology, American Optometric Association, among others recommend that a child have a comprehensive eye exam by an eye doctor at six months, three years and before entering school.  So, if your infant has not been seen by an eye doctor this is a good time to make an appointment just to make sure nothing is wrong.  Although rare, several conditions can cause a lack of or reduced tearing in an infant including the absent of the lacrimal glands, Riley-Day syndrome and ectodermal dysplasia, among others. 

Q.    What is the percentage of success with ptosis surgery?  What doctor does ptosis surgery?

The success of ptosis surgery depends on several factors including why the patient has ptosis, cause, is it unilateral or bilateral, and the experience of the doctor performing the surgery, among others.  So, the best person to ask about surgical success is the surgeon him/herself.  All surgeries are performed by an ophthalmologist, often one who does cosmetic or reconstruction surgery.

Q.   What cause black spots in vision?

You're probably referring to floaters - one of the most common problems that web surfers ask about.  Go to the Q and A Archives and do a Find, under Edit on your browser, for floater or/and floaters.   An illustration is also given under Simulations.

Q.    I have hystoplasmosis in my right eye resulting in blurred central vision. i now have a blurred spot in left eye. at what point should i stop driving and is this considered a disability?

Your eye doctor will determine when your visual acuity is too poor to drive.  Sometimes patients will fail the vision screening test as part of the   driving test  also resulting in the loss of license renewal.  In general, if your visual acuity is worse than 20/70 in the better eye, with best optical correction (glasses), you no longer qualify for a driver's license.  A significant vision loss is considered a disability, but the level of visual acuity is generally 20/200 or worse - legal blindness.  However, depending on the state or country, different guidelines exist as to the precise definition of a visual disability.  If you're in the USA, a local office that deals with disabilities, usually involving social security services will define a vision disability and corresponding benefits, if any.

Q.    Is there a source of assistance for cataract surgery for those who cannot afford it.

Depending on a patient's age Medicare/Medicaid might be one option.  Also, view the Featured Article on the eye health/eye care resources available in Ohio.  If you're in central Ohio or another area with a Children's Hospital and the patient in question is a child, many hospitals base charges on ability to pay (a sliding scale).  Does anyone else, reader or otherwise have any suggestions?   If so please forward your suggestion on this topic to the web master and we'll add to this list.

Q.   My 2 1/2 year old has been diagnosed with Congenital Fourth Nerve Palsy. I've noticed his eye going upward 3 months ago & it took two months to get an appointment with an Ophthalmologist. The doctor looked at him & told us to follow-up with his associate in 3 months. My concern is, by that time 6 months would have elapsed since the onset. Could waiting for any treatment or follow-up cause irreversable damage? Is there anything else I should do?

Fourth nerve palsy, also called trochlear nerve palsy, is the most common form of cyclovertical muscle palsy seen by the pediatric ophthalmologist.   Often, the cause of the nerve palsy is never established.  A fourth nerve palsy often results in double vision in certain directions of gaze, may cause a head tilt in the patient and also may lead to amblyopia (lazy eye) if the head tilt and residual vertical deviation do not lead to single binocular vision.  In a congenital fourth nerve palsy (compared to an acquired palsy) a vertical eye deviation often brings the patient to the attention of the ophthalmologist by 6 months of age.  In general, the pediatric ophthalmologist will want to perform surgery ASAP in order to maintain binocular vision, prevent the development of amblyopia as well as to prevent the development of permanent skeletal-muscle problems, facial asymmetry and scoliosis.  Given that your child is almost 3 years of age, and the vertical eye misalignment was only discovered recently, the ophthalmologist would have evaluated your child for amblyopia and whether the fourth nerve palsy is causing the lack of binocular vision.  Given that treatment (patching the stronger eye) for amblyopia was not instituted, we must assume that your child must be doing fine and that the ophthalmologist saw no need for concern.   Nevertheless, given that YOU ARE CONCERNED, why don't you give your ophthalmologist a call to discuss your questions and concerns.  If he/she refuses to talk to you about your concerns, perhaps it is time to seek the advice of another pediatric ophthalmologist.  Finally, if you're located in Ohio, there is a great resource for finding a pediatric ophthalmologist in that state - via the Ohio Amblyope Registry.   Visit the web site for the Ohio Amblyope registry at ohioamblyoperegistry.com and click on the Find An Eye Doctor Page on the web site.  Good luck.

Q.   What causes a person to see stars for a few moments after a very severe sneeze?

The cause of seeing stars when one sneezes is a matter of conjecture.  Most probably, sneezing causes a temporary disruption of the visual processes within the eyes - either by a sudden disturbance in ocular blood flow or by causing movement of the vitreous or sheering of the vitreous across the retina.   (Note that stars are sometimes seen when a person suddenly elevates his/her head creating  possible hypertension or drop in blood pressure within the head/eyes - supporting the disruption of blood flow hypothesis). 

Q.   I would like some information about visual field neglect and visual field cuts after a stroke. What suggestions do you have for working with these problems?

We will discuss this issue with our rehabilitation expert and get back to you at this location when we get an answer to your question.  Thanks.

Q.    Is there any cure found for stargartz (Stargardt's) yet?

Sorry, not yet.  It will be probably 10-15 years before a possible effective treatment or/and cure...hopefully.  Note correct spelling.   For additional info on Stargardt's disease, go to the Q and A Archives and do a Find, under Edit on your Browser for Stargardt's.

Q.    My sister checked my eyes the other day and noticed that there is a lot of dark spots in the white of my eyes. She described it as looking almost like a dark halo throughtout the white of the eye. I also have xanthelasma on my eyelids that has been getting worse. I am a 32 year old female and I've had the xanthelasma since my early 20's. Could these two things be related? I have also recently had attacks of a watery distortion in my peripheral vision that lasts about 10 minutes. Could all these things be related or do they sound like separate problems?

Xanthelasmas is characterized by raised lesions of yellowish color often found on the upper eye lids near the nose.  They often occur in women of middle age or older and are sometimes associated with systemic (whole body) disease, in patients with hyperlipidemia as well as in some patients as a result of, for example, diabetes.  Your sister may be describing a condition called corneal arcus marginalis - a halo around the white of the eyes - This may be a sign of hyperlipidemia.  You need to see an Opthalmologist ASAP to assess the condition, particularly since you are experiencing changes in your vision.  You may also ask the Ophthalmologist about the possibility of new laser surgery to remove the lesions, although not all patients are a candidate for surgical removal.

Q.   WHAT IS THE TREATMENT FOR KERATITIS?

As with all treatments, the treatment of keratitis depends on the cause of the keratitis; for example, viral keratitis may be treated with antiviral medications.  Chlamydia, trachoma and others infections warrant other types of treatment.  Probably the worst, yet preventable, type of keratitis is due to Acanthamoeba infection, the direct result of not taking proper care of contact lenses and their use.  Evaluation and treatment  may include the use of corneal biopsy, cultures, use of certain drugs (e.g., aromatic diamidines, neomycin, polymycin sulfate), cryotherapy, corneal scrapings, removal of infected tissue and drugs for pain management.   Penetrating keratoplasty (corneal transplant) may also be necessary.  Removal of the eye may also be needed in severe cases.  The use of steroids is highly controversial, yet steroids may be, unwisely, used in undiagnosed cases of Acanthamoeba infection - some argue that the use of steroids may simply suppress the body's natural fighting ability and prolong the course of the disease. 

Q.    When I wake up in the morning and when I drive home at night, my eyes seem to excrete some kind of "goo," oil maybe, that makes my vision around light sources hazy (and my floaters very noticeable.) I can make it go away when I rub my eyes, blinking rapidly isn't enough usually. Is this a symptom of dry eye? What should I do?

One of the basic secretors of the eyes include the oil glands.   Certain diseases as well as certain types of injuries to the glands or/and nerves could produce excessive oil secretion.  Also, there needs to be a balance between tear fluid (water and oil) secretion  and evaporation - if there is decreased secretion and the same amount of evaporation can lead to increased tear film osmolarity.    In other words, the tear film may appear more oil-like.  For information on dry eye disease, go to Past Featured Articles and see the article on Dry Eye Syndrome.  We suggest that you see an eye doctor to asses and, possibly, treat the condition. 

Q.   What is "Dwayne's Retraction Syndrome?" I am a 24 year old female with this condition and can't seem to find any info on it. Can you explain to me the causes, treatment(if any) and the chances of passing it on to my children?

First, the correct spelling is "Duane's Retraction syndrome".  Duane's is a special form of vertical eye misalignment, and most of the time affects the alignment of the left eye and affects females more than males.   Sometimes Duane's may affect both eyes (about 20% of the time).  In most cases, the inheritance of Duane's is sporadic - there is no known genetic pattern.   However, there have been a few case reports of a dominant inheritance pattern; in other words, it affects about 50% of the offspring.  So, in general, it is unlikely that your children would be affected with the same problem.  The cause of Duane's is believed to be due to abnormal innervation of the lateral rectus muscle (eye muscle on the temple side of the eye) of the affected eye.  There may also be some involment of the medial rectus muscle (eye muscle of the nose side of the eye), possible as a result of the original abnormal lateral rectus muscle.

In most cases, Duane's is not a problem when the patient looks straight ahead - the eyes maintain alignment.  However, often the patient will develop an eye deviation in which the affected eye turns in toward the nose and the patient has to turn his/her head in the direction of the deviated eye (e.g., left) in order to maintain single binocular vision while looking straight ahead.  Most of the time the patient will have great difficulty with turning the affected eye out toward the side of the head/face.  The affected eye will also move up or down depending on the patient and exact nature of the eye muscle problem and attempted direction of gaze.   Most patients adapt to the condition by learning to more their head instead of the eyes when viewing objects off to one side.  Sometimes surgery can be performed to correct an eye misalignment in primary (direct ahead) gaze when the patient has to relay on an abnormal head posture to see things with both eyes at the same time.  Because Duane's retraction syndrome is variable among patients and because it is associated with certain conditions/syndromes, it might be worthwhile for you to consult with an ophthalmologist who specializes in strabismus (eye misalignments) as to the benefit of eye muscle surgery. 

 

July, 2001

Q.   What is the most common cause (lesion) of homonymous hemianopsia?

Hmmm.  Good question.  We are not aware of any systematic study that quantified the different causes of homonymous hemianopsia (HH).   Our best guess is that vascular abnormalities (infarctions, ischemia, aneurysms, strokes,migraines (?) etc.) are the leading cause of such visual loss.  In general, retinal and optic nerve disease seldom cause HH defects.  Chiasmal abnormalities, usually the result of pituitary lesions/tumors can cause HH; however, chiasmal abnormalities usually result in different visual field losses in each eye (see Simulations).  Lesions/tumors/compression lesions/vascular abnormalities along the optic tract, optic radiation, dorsal lateral geniculate nucleus (LGNd) and visual cortex (V1 V2) account for the vast majority of HH defects.  Sometimes, although seldom, temporal lobe lesions can also cause HH defects.  Finally, we cannot dismiss nonorganic or psychological problems as a cause of HH defects.

Q.    Tell me about eyerptis.

Q.    What can be done for eyeritis?

The correct spelling is iritis.  Go to the Q and A Archives and do a Find, under Edit on your browser, for iritis (repeatedly) for available information.

Q.   What do you know about cornea ulsers?

Go to the Q and A Archives and do a Find, under Edit on your browser, for corneal ulcers (note exact spelling and click on Find repeatedly).  We would be happy to address specific questions and diseases once you review the material already available.

Q.   I had LASIK surgery approximately 10 months ago and I have noticed floaters in my vision. After doing some research I found that these floaters may be caused by the surgery itself although the jury still seems to be out on that. After looking through your archives I noticed that something similar happened to someone after having cataract surgery and part of the response was that the floaters should clear up. Can I hope/expect that as well or is this yet another complication of my surgery that I will have to learn to live with?

Whenever a patient has any complications possibly associated with eye surgery it is best to consult with the ophthalmologist that performed the surgery.  Floaters, a lot of them, may be a sign of a retinal problem (tears, holes, detachments) which can result from eye surgery or occur spontaneously as a result complications of a high refractive error.  That said, it is possible that the floaters will clear sometime after the surgery, although 10 months seems like a long time to still have any residual floaters as a result of the surgery.  If you are (were) rather nearsighted, a common complaint of such patients is the presence of floaters - these will continue to be a problem even after LASIK surgery.  Some floaters can also occur simply with age.  Finally, it is possible that you always had floaters, but never noticed them, and that having eye surgery made you more aware of your eye sight and the presence of such floaters.

Q.    YELLOW SPOT ON EYEBALL - NO PAIN BUT APPEARS TO BE SPREADING?

You may have a Pterygium.  Go to the Q and A Archives and do a Find, under Edit on your browser (multiple times) for pterygium.  If this does not appear to be the problem, describe in more detail and we'll try to add info.  Also, if you're concerned, see an eye doctor for an exam.

Q.   Have optic nerve hypoplasia and have found plenty of information on what causes it. However, I have had a lot of difficulty in finding any information on research or advances in science to help improve vision for people with this condition. Any ideas?

Go to Past Featured Articles for a short article on optic nerve hypoplasia.  Other than vision "habilitation" (e.g., use of optical aides, magnifiers, mobility devices, etc.,) there is no known (as of 6/17/01) treatment or cure for the problem.  However, one of the many projects funded by the Ohio LIONS Eye Research Fpoundation includes work on growing new optic nerves and uncovering the genetic causes of optic nerve hypoplasia.  Go to Funded Research and click-on Medical College of Ohio for a short summary of the research.  Good luck.

Q.    My son is 23 and has been diagnosed as having Stargardt's disease. I would like to know where leading research is being done (worldwide even) so I can follow it more closely as to breakthrough research.I live in France.

The Ohio LIONS Eye Research Foundation does support clinical research into the possible treatments of Stargardt's disease and the treatment of other types of cone dystrophies and macular degenerations.  Some of this research is being undertaken at Children's Hospital, Columbus, Ohio, USA.  To find the latest research into Stargardt's disease, go to http://www.ncbi.nlm.nih.gov/PubMed/ and for a key word to search type in "Stargardt".  Good luck to you and your son.

Q.    My wife recently lost most of her peripheral vision, she says it is like looking through a long paper towel tube, where the tube is semi transparent. We spent a week at a major research hopital to no avail. It has been classified as "white spot syndrome". We are now asked to sit and wait until something happens. It has been over two months, and there has been little improvement. 1 Spinal Tap, 2 MRI's, 2 Cat Scans, 15 viles of blood withdrawn, 3 photograph sessions with her eyes and meetings with some of the areas top eye specialists have given us nothing. Please offer any suggestions.

White dot syndrome is also called Multiple Evanescent White Dot Syndrome (MEWDS) and the symptoms are what your wife describes - acute onset of loss of side vision, possibly some blurred central vision, one eye affected and shimmering lights in the periphery.  MEWDS usually affects only one eye in females who are between the ages of about 15 and 50.   Sometimes the loss in vision is preceded by some viral illness or symptoms.  Although the exact cause of MEWDS is unknown, we do know that it is a disease that affects the retinal pigment epithelium (RPE) and photoreceptors of the eye(s) .  Some believe it is the result of a viral infection. 

It does sound like you received good care, although it is frustrating not to know exactly what is going on or if it might get worse.  MEWDS is sometimes misdiagnosed and it sounds like your docs performed  the necessary tests to rule-out a more serious condition.  Usually, MEWDS will resolve in about 2 - 4 months and there is no treatment available.  Some patients will have a reoccurrence of the problem, even several years later.  So, although it sounds like your docs are taking a wait and see approach and that it is frustrating to simply wait and wait, hang in there - there is a very good chance that the body will take care of itself and correct the problem.  

Q.   If the optic nerve is nicked during eye surgery on a patient with glaucoma resulting in partial loss of vision in the lower field of vision is it possible that the optic nerve can recover and the patient's vision comes back to normal?

Q.    I had eye surgery to remove a blockage in one of the veins of my eye. I also have glaucoma. after the surgery I now have a loss in my field of vision. The surgeon told me that he may have nicked my optic nerve and he hopes that the vision will come back. What are the chances that the optic nerve can heal and my full vision will return?

Surgery within the eye is very dangerous but often necessary.   First, we would like to commend your ophthalmologist for being straight with you about the possibility that he may have nicked or even touched the optic nerve during surgery.  The optic nerve is an extremely sensitive organ and even touching it may cause some damage.  No one really knows the answer to your question, only time will tell.  In general, if the nerve was, say, irritated than the chance is fair to good that most of your side vision will return eventually.  However, if the nerve was actually damaged than the prognosis is more guarded/poor.  Another consideration, particularly since you have glaucoma, is the possibility that the loss of side vision is not the result of something happening during surgery but the result of the glaucoma.   Good luck.

Q.   I recently noticed that I have a problem with my eyes. When my head is straight forward and turn my eyes to the left, I see a double vision. The thing I am looking at appears twice in my sights. 1 on top of the other. But if I look the other way (still keeping my head straight, turning JUST my eyes) my vision is fine. Im waiting for my insurance company to send me some papers to get my eyes checked out. Just wanted to research. Can u tell me what this could be???

You have a certain type of eye muscle imbalance.  The real question is WHY do you have such a muscle imbalance?  One possibility is that you may always had the eye muscle imbalance but just noticed it for the first time (you can probably answer that question); or, the muscle imbalance could be the result of injury or disease, particularly to the nerves that innervate the eye muscles.  The possibility exists that you may need a diagnostic work-up and several medical tests so you should see an ophthalmologist about the problem.  Let us know what you find out.

Q.   I see zig-sag colored lines in vision lasting 5 minutes to 20 minutes. Longer lasting causes thichness feeling above brows and at end of outside of eye.

Sounds like you need to see an eye doctor for a complete, dilated, eye exam.    Zig-zag type lines are often seen by patients with migraines (see example in Simulations), whether or not accompanied by a headache or other body symptoms.  However, to rule-out possible serious eye disease, such as a detached retina or retinal tear or other eye specific problems, you'll need to be examined by an eye doctor.

Q.    My 4 year old daughter was diagnosed with amblyopia in her left eye last March. The original diagnosis was severe high myopia with myelinated nerve fibers in the left eye. The right eye is 20/30. She was given glasses with a -8.5 for the left lens and a clear lens for the right eye. We patched the good eye for 11 hours a day. At the first 6 week follow up she went from 20/1200 to 20/200. Since then she has had two more six week checks with no more improvement. Our PO has explained that children with these two problems show little improvement after the initial improvement. He says they think it might be a problem with the retina. He wants us to decrease the patching to one hr a day to see if she can maintain the 20/200. She is to wear her glasses all day every day. I know with 20/200 she will not be using her left eye but if something ever happens to the good eye at least she will not be at the original 20/1200. Have we done all we can for her vision. I am interested in the article on L-dopa. Is this something that could work for Emily? Any response would be appreciated.

We're glad to see that your daughter responded favorably to the patching therapy for amblyopia.  Being only four years old, she is still in the early phase of the critical period for visual development and recovery of visual function with patching therapy.  After the initial improvement, and assuming that she has been wearing the patch faithfully, she might still improve in visual acuity, albeit slower.   You and your eye doctor might want to continue with full time patching for awhile and then gradually decrease patching time rather than simply going from 11 hours to one hour per day.  If you can get her visual acuity to about 20/100, then you might want to consider penalization therapy via the placement of dilating eye drops in the stronger eye to further improve visual acuity.  Only as a last resort should you consider combining patching therapy (minimum of three hours per day) with a seven week trial of L-dopa (Sinemet, levodopa/carbidopa 4:1).  Your eye doctor may also be right in that your daughter may only have the capacity to improve to the best visual acuity of about 20/200.  Also, such anisometropic amblyopes, in which there is a high myopic refractive error, tend to do worse than, say, a patient with hyperopia or a large plus correction in the worse eye.  If you live in Ohio or for more info on amblyiopia, go to the web site for the Ohio AMblyope Registry at OhioAmblyopeRegistry.com

Q.    Are illegal drug use a cause of dilated pupils'iris?

Yes.  The number one reason for dilated pupils is, legal and illegal, drug use.

Q.   I am a 23 year old female and was recently diagnosed with right homonymous hemianopsia. There is no apparent cause or accompanying symptoms. I was watching TV and when I blinked my eyesight was instantly gone. I am scheduled to go through testing within the next few days to find a cause for it. I have had no other symptoms other than the visual field cut. What are all the possible causes for this condition and is there any chance given the fact that I have no history or cause for injury that I will regain my sight?

For further info on homonymous hemianopsia do a Find, under Edit on your browser, on this page and on the Q and A Archives page for the key word(s).  Also see a simulation of HH on the Simulations page.  A sudden loss of visual field is usually caused by a vascular problem, such as a "stroke" or aneurysm.  Sometimes a patient will have had an HH for a long time but suddenly just notices it, in which case other causes may exist.  You should have an immediate full medical work-up.

Q.   Please tell me some research opportunities for cortical vision impairment in Cincinnati, ohio.

Hmmm.  As a patient/subject or as a student or?  Off hand, we don't know of anybody doing such research in the Cinci area.  You may want to contact the local BSVI office to inquire about such issues.  Readers, if you know of any possibilities let us know and we'll post at a later date.

August, 2001

Q.    What is carataconis?

The correct spelling is Keratoconus - An inherited disease where the cornea becomes progressively shaped like a cone. Wearing a contact lens may slow the progression of the disease. Corneal transplant surgery may be required.   More info may be obtained by going to the Q and A Archives and doing a Find, under Edit on your browser, for Keratoconus.

Q.   What is the vision prognosis for a 5 year-old with a penetrating eye injury? The injury did not affect the lens, but damaged the iris and cornea. His injury goes directly across his pupil.

Penetrating eye injuries are ALWAYS VERY SERIOUS.   Prognosis of a penetrating eye injury varies tremendously depending on the location, type of object, whether infection occurs, complications, etc.  In general, many penetrating eye injuries lead to a cataract and removal of the natural lens and   the need to wear thick glasses, contacts or/and artificial, intraocular lens implant.  If a serious infection occurs, there may be a need to remove the eye.   Many perpetrating eye injuries yield an ultimate visual acuity of about 20/200 (legal blindness) to about 20/70 (middle of the eye chart).  One should not expect the return of normal (20/20) visual acuity in the injured eye.  A visual acuity of better than 20/70 would be considered a very good outcome.  A possible exception would be if only the cornea (very front of the eye) was affected.  In this later case vision might return to normal.  Finally, any injury to the iris, which forms the pupil of the eye, would lead to some loss of visual acuity.

Q.    Scholarships.

The Ohio LIONS Eye Research Foundation (OLERF) provides scholarships/fellowships in eye research to graduate students, optometry students and postdoctoral fellows.  Scholarships are limited to one per approved and funded research institution.  Current research institutions funded by the the OLERF include OSU Department of Ophthalmology and College of Optometry, Columbus Children's Hospital Department of Ophthalmology, Case Western Reserve Department of Ophthalmology, Medical College of Ohio, Wright State University and University of Cincinnati.  The OLERF committee member or department Chairperson at each institution usually decides on the student who submits a student fellowship application and subsequent awardee.

Q.    When living in Florida in Feb. of 2000, I had a vitrious detachment in my right eye. I still experience the floaters, and flashes of light. My floaters have increased to include dots, circles, squiggly worms with lines, clouds etc., especially when looking at bright surfaces. In Florida I was seen by a retina specialist, and since moving from there my Opthamologist in Michigan I feel hasn't given as much serious attention to my condition as in Florida. During my last exam, he didn't even dialate my eyes. It's been over a year since the previous dialation. Since that time, (and I told my eye doctor in July,2001 that in my left eye I now have a flash of light when in a well lit area, and especially see it on a white wall. These are like arcs, but I didn't see them in the dark. I now just last night seen in the dark a flash of light in the center of my left eye. The arc are off to the left side of my left eye. Neither doctor has been able to explain to me why for years now I see dancing glitter on the pavement when I go out into the sunlight without sunglasses. I also see a shimmer of light when in a normal lit room, and glance toward a window. It lasts only a second or two, and can happen in either eye, but not simultaneously. I've searched your archives, but haven't come across anything quite like I've experienced. To what extent can an eye doctor give an eye exam without dialating the eyes? I was quite surprised that the exam was performed without dialation, and when I asked the person who did my vision test, he said the doctor could see well without my eyes being dialated, as my pupils were quite large! Thankyou for any light you may have as to my condition.

A vitreous detachment is fairly common in the elderly and in patients with high myopia/ nearsightedness.  Common symptoms include flashes of light and floaters.  Patients may also experience some distortions in vision as you describe.  Always of concern, flashing lights may also be a sign of a retinal tear or detachment that may require medical intervention.  We'll have to take your ophthalmologist at his word and assume that you have very large pupils so that he/she can get a good look in the far periphery to examine the retina.  As always, if you're not happy with your eye doctor tell him/her so or/and seek another ophthalmologist who will address your concerns.  (Also see question below.)

Q.   when I just submitted my question concerning the vitrious detachment while living in Florida, the message says I forgot to include my e-mail address. I couldn't figure out how to add that to the message after I sent it, so if this works I'll be happy.

We do not require an e-mail address and, in fact, we receive all input from the web site as from "anonymous".  We're surprised that you got such an error message.  Apparently, the error message is the result of you using   Webtv and the error message was probably generated, not by our Internet Service Provider/web site, but rather from Webtv.   Thanks for the information.

Q.   I went in for a routine eye exam and was told I had an enlarged, swollen optic nerve. A neurologist was recommended and they did several tests and a MRI. Other than a blind spot, no other problems were found (no tumor either). This was a few years ago and every time I have my eyes checked the optic nerve is still enlarged and I am referred to another doctor. Should I be worried? Any idea what could be causing this?

A swollen optic nerve (papilladema) is always a cause for concern and warrants a complete medical work-up.  It sounds like you went through the work-up and the docs could find nothing causing the papilladema.  If it has been several years and the condition has not changed (and you are otherwise healthy) is a good sign, but the reason for the papilladema remains unknown.  We would strongly recommend that you maintain your regular eye exams and do whatever is necessary (and recommended) to find the cause of the papilladema.  Your eye doctor has probably documented the papilladema with photographs and has documented any changes of visual function (e.g., visual acuity, visual field) which can be compared over time to see if it is a stationary or progressive condition.  A Visual Evoked Potentials (VEP) to patterns (e.g., checkerboards, gratings) and to flashes of light may also be used to assess optic nerve function and possibly give a clue as to the cause of the condition.

Q.   I have -5.75 spherical 1.25 cylindrical in my right eye.  I have 1.75 spherical in the left and 0.75 cylindrical.  While cutting my beard with scissors in front of a mirror I am able to see better without glasses.  I do not use glasses regularly with any noticable side effects.  Should I wear glasses regularly with my condition?  I find it difficult to see without sufficient light at night. Is it a problem?

These are good questions to ask your eye doctor.  If you have such a difference in refractive error between the eyes we would be surprised the you're not amblyopic or have a lazy eye.  If you do have a lazy eye than you should wear glasses at all times to protect your better eye.  Because of the refractive error in your right eye, being nearsighted, you don't need glasses to see things (e.g., your beard) up close.  You may, in fact, not have a lazy eye because you may be using your left eye for more distance vision, based on the type of refractive error in that eye.   You probably need glasses to see better at night because any minor refractive error causes patients to have particular problems at seeing well under dim light levels.   Finally, wearing your glasses would help seeing better at night and would allow for better depth perception and probably reduce eye strain.

Q.   How do i cure mouth ulsers?

Sorry but we only answer questions about the eyes and visual system.

Q.   I get black spots that cover approx. 1/8th of my visual range which fade in, last about 3 minutes, then fade out. This happens perhaps once every few days, after I have been doing some close work.

Black spots, known as floaters, are common (when few in number) and for further info on floaters go to the Q and A Archives and do a Find, under Edit on your browser, for floaters.  Also see Simulations for a sample of what floaters look like.  With near work, the fibers that control accommodation pull the retina forward and causes traction on surrounding tissues of the eyes.  This in turn can cause some floaters to occur or perhaps become more visible.  However, whenever a patient experiences a lot of floaters, as in your case, we would strongly suggest that you see an eye doctor for a complete dilated eye exam to see if you may have a retina detachment or tear that is causing the large amount of floaters.   [See follow-up question and answer below.]

Q.    What is a hole in the eye?

You may be referring to the hole in the middle of the iris (colored part on the front of the eye), known as the pupil.

Q.    I recently asked a question about black spots which fade in and out and you interpreted "black spots" as floaters. I am not describing floaters. These black areas are areas of vision from 1/3 to 3/4 of the area of vision in my right eye which gradually fade out and become black & through which I cannot see and then within approx. 3 minutes fade away and my vision becomes normal and clear. This happens every few days. I have no health problems and am in my mid-50's. Thanks for your help.

Given the amount of vision loss and timeframe, your symptoms appear similar to ocular migraines and, less likely, Transient Ischemic Attacks (TIAs).   TIAs usually affect both eyes.  Whatever the problem, it is probably vascular/ischemic in nature and warrants an immediate trip to the ophthalmologist.

Q.   My father(55) has been to his GP and visited a specialist about the muscles in his eye. It first started last year where his left eye just loss the use of its muscles and he lost focus in his eye and needed a lense to balance his vision until the muscle recovered which took nearly 8 months. Once his left eye had just about recovered the right eye muscles then seem to have failed and they are taking a long time to recover. He is very worried that this may spread and effect the rest of his muscles in his body. The specialist says he has something called OMG. Do you have any more information available or can you suggest somewhere we can go to get some more help and advice.

The GP may be referring to Ocular Myasthenia Gravis (OMG), which affects the extraocular muscles causing an eye misalignment and double vision, and may also cause a droopy eye lid (ptosis).  OMG usually affects male patients over the age of 40 who do not have other neurological problems.  OMG is known to be an autoimmune disorder and may be triggered by an infection or trauma.  Although Myasthenia can affect other muscles, particularly facial muscles, in about 75% of cases it initially affects the eye muscles only, thus the name.  While about 15% of patients have restricted disease to the eye muscles only, in the majority of cases MG also affects other muscles so your father's concerns are well founded.  Usually, symptoms are worse with muscle usage and fatigue.  The disease waxes and wanes over time and can affect one eye then the other.  Although OMG and MG affect the eyes, it is usually managed by a neurologist or neuro-ophthalmologist.

Q.   What body organs does hytoplasmosis (histoplasmosis) affect?

Histoplasmosis can affect all body organs including the lungs (primary site), liver, spleen, heart, bone marrow, adrenals and brain (including eyes).   For a review article on histoplasmosis, go to Past Featured Articles.

Q.   I am having "flashes" of white light on the right side of my right eye - like a flash of lightening - is this something I should be concerned about?

Yes.  You need to see an eye doctor ASAP for the condition.   The eye doctor will most likely perform a comprehensive, dilated, eye exam (so take someone with you to drive home after you're dilated).  Flashing lights are sometimes associated with serious retinal conditions such as retinal tears and retinal detachments, which sometimes require surgery to repair.  Flashing lights in one eye are sometimes also associated with an optic nerve condition (and sometimes associated with minor conditions).  Be on the safe side and see your eye doctor.

Q.   I see as black spot in the center of my vision when I blink. What is it and what causes it?

Don't know.  Numerous conditions can cause black spots in vision - some minor and some serious conditions.  Be on the safe side and see an eye doctor for a comprehensive eye exam to diagnose and treat the problem, if applicable.

Q.   I am a 36 years old female. My doctor told me that I have burns in my central vision. Can you please expand on this condition?

There is a condition called solar retinopathy where the back of the eyes are "burned" when a patient looks directly at the sun for a long time; for example, while viewing a solar eclipse.  Also, welders can acquire so-called welder's burns of the retina as a result of not taking adequate eye protection while welding.  If neither of these conditions seem to apply, the possibility also exists that your eye doctor was using the term "burns" to simply describe, in nonmedical terms, a change in the pigmentation in the back of the eyes.  Ask your eye doctor for clarification.

Q.   What is the use of eye donation ?  How are others benefitted by it?  What is the process of transplant?

Eye donations allow other patients to regain sight and allows researchers to have human eye material for research.  When eyes are donated at the time of death, the whole eye is typically removed; the cornea is used for corneal transplants and the other eye materials/cells are used by researchers to better understand diseases like RP and glaucoma, for example.  Patients with corneal abnormalities, either through disease (e.g., Fuch's corneal dystrophy) or accident (e.g., alkaline burns to the cornea), are able to receive a corneal transplant and enabled to "see" again because of the kind donation of the eyes upon death.   The remainder of the eye is used for basic and applied research.  Only the cornea of the eye is transplanted, and the operation involves removing the entire cornea from the donated eye, removing the cornea of the recipient patient and sewing/stitching on the donor cornea to the recipient eye.  The real challenge of cornea transplant surgery is to transplant the donor cornea such that there are no irregularities that could affect the recipient's ultimate vision following surgery.

Q.    If someone donates eyes, and the other person was born blind, is it possible to donate eyes to them to make them see again?

In general, no.  Donated eyes are only used for cornea transplants.  If a person was born blind from a condition other than from a cornea disease, the donated eye and cornea would not help the condition.  However, if a patient was born blind because of a cornea problem at birth, which prevented him/her from seeing clearly, an early (e.g., first few months of life) cornea transplant would allow the patient to receive a clear image to the eye and brain so that the visual system could develop normally or nearly so.  If the patient was born with a cloudy cornea and waited, say a year or more, even with a clear, transplanted cornea the patient would probably have very poor vision and see only light/darkness or just have light perception.

Q.   I have yellowish raised area on sclera between iris and inner eye. What could this be?

Q.   Pathophysiologically what is happening to the eye in ptyregium?

A pterygium is a slightly raised, triangular shaped, yellowish lesion that usually occurs between the iris and the inner eye (near the nose).   Pathophysiologically, a pterygium is a benign lesion composed of elastic and hyaline degenerative changes of the conjunctiva.  It is believed that such degenerative changes are caused by or aggravated by irritants such as sun, dust and wind.

September, 2001

Q.   IS THERE A CURE FOR EYERITIS OR ANY NATURAL MEDICATION YOU CAN TAKE OTHER THAN MAXIDEX EYE DROPS WHICH I HAVE BEEN ON FREQUINTLY FOR THE LAST TEN YEARS WHICH WORK WHEN IM ON THEM BUT WHEN I STOP THEM MY EYES BECOME INFLAMED THIS IS ONGOING HELP ME?

In chronic iritis (note spelling) there may be pain, sensitivity to lights (photophobia) and pain when light is shined in the involved and uninvolved eyes, red eye(s), some decreased vision and excessive tearing.  In about 50% of cases iritis is associated with a systemic disease (e.g., ankylosing spondylitis, Reiter's syndrome, inflammatory bowel disease, Behcet's disease, etc.,), so often an extensive medical work-up is required.  Unfortunately, as in your case, the iritis keeps reoccurring thus requiring the use of topical steroids.  Sometimes, particularly with systemic diseases, systemic steroids are indicated.  Unfortunately, there are no "natural" ways to combat iritis.  However, there does appear to be some life style or psychological components to iritis.  Go to the Q and A Archives and do a Find, under Edit on your browser, for iritis for more info.

Q.    Treating nodular scleritis the natural way?

Nodular scleritis may require a medical work-up and exam.   Typically, for nodular scleritis, nonsteroidal anti-inflammatory drugs (NSAIDs), systemic steroids or/and immunosuppressive therapy may be indicated.  We are not aware of any "natural" treatments for nodular scleritis.

Q.    Please, inform us if there is any cure for toxic optic- neuritus.  My uncle is suffering from this disease since 6 years.

In optic neuritis, there is usually a sudden loss of vision in one or both eyes.  The vision loss may be mild or severe.  Optic neuritis usually affects patients between the ages of 18 - 45 years.  Toxic optic neuritis (we prefer the name toxic or metabolic optic neuropathy) may be caused by numerous entities such as alcohol, anemia, malnutrition and toxins (e.g., chloroquine, chlorpropamide, ethambutol, isoniazid, streptomycin, lead, etc.,).  Therapy depends on the cause of the toxic optic neuropathy.  Often, the cause is never known.  We assume that your uncle is older than 6 years.  He'll need to see an ophthalmologist in order to determine whether anything can be done for his eye problems.

Q.   I am T... C...,a general physician with three years experiences in dignosis and treatment of ophthalmologic diseases.  Also, I have published research in common diseases of eye addressed to corneal graft and assessment of rate of successful cases and their mainly relative factors at Khalili hospital in Shiraz(IRAN).I am very interested in contiuing my researches and I have projects for this aim.  Would you please lead me for obtaining grant for eye researches from your organization or other referral centers in U.K (or other developed countries.

The Ohio LIONS Eye Research Foundation only funds approved research centers in Ohio, USA.Sorry, but we do not know what may be available in other countries.

Q.    Do your eyes turn yellow from smoking and if they do how do you go about treatment?

We are not aware of any association between yellow eyes and smoking.  Some benign lesions (Pingueculum, Pterygium) on the white part of the eye (as a patch or triangular shaped patch or discoloration) can be yellowish in appearance.   Sometimes diet (e.g., high intake of carrots or/and carrot juice, for example) can cause the skin and white part of the eyes to take-on a yellowish appearance.   However, yellowish skin or/and yellowish whites of the eyes can also be a sign of serious disease, including jaundice and liver disease and even be a symptom of certain syndromes.  Numerous diseases can cause jaundice in adults including hepatitis and alcohol cirrhosis.  For more info on this topic, do a Find, under Edit on your Browser, for yellow   in this section and in the Q and A Archives.    You should see an Ophthalmologist, Internist or General Practitioner about the problem. 

Q.   I experienced a jagged oval shapped bright lighted halo in one eye. This lasted about 30 min and with it I felt light headed and somewhat nausus. I have been told I have floaters in my eye, could that be a piece that has broken off.

The symptoms appear very similar to those experienced by migraine sufferers, except that the bright white halo is seen in both eyes.  See the Simulations page on this web site for an illustration of the halo, called a fortification phenomenon.  You may have experienced an ocular migraine, which can affect one eye only.  You should be examined by a Internist or GP to be sure that nothing else is going on to explain the halo. The halo has nothing to do with floaters.

Q.    What is allergic conjuctivitis and should one continue using eye drops for a long time to avoid scratching?

Allergic conjunctivitis is a common eye problem which includes a combination of allergic rhinitis (inflammation of the mucus membrane of the nose) and, typically, pollen induced hay fever.  Both eyes appear red and swollen, the eyes itch and there may be excessive tearing (watery or even pus-like).  Don't rub the eyes - it only makes things worse.  It is best to see an eye doctor about the problem.   The use of over-the-counter eye drops may provide temporary relief, but long term use can cause additional problems.

Q.   How would you treat sore and infected eyes?

You go to an eye doctor, who can diagnose and treat the condition with the correct medicines.

Q.   Multiple Evanescent White Dot.

Please do a Find, under Edit on your Browser, for Evanescent (or other key word) on this web page for an answer.  Update:  In an earlier study (Mamalis and Daily, Ophthalmology, 1987, p1209 - 1212), it was reported that 8 of 8 patients with the syndrome had "...good recovery of visual acuity with eventual fading of the white dots."

Q.   Broken blood vessel in eye?

Broken blood vessels or hemorrhages on the white part of the eye(s) are very common and usually do not require medical intervention.  Hemorrhages inside the eye, either inside the cornea such that  blood pools in front of the pupil or iris (called a hyphema) or inside the eye such that one cannot see the blood directly, can be very serious and require immediate medical intervention.  The main reason for a hemorrhage and blood between the cornea and iris or pupil is trauma.   Some of the most common reasons for hemorrhages inside the eye (the ones you can't see directly) include diabetes and age-related macular degeneration.

Q.   Corneal scratches.

OUCH.  Corneal scratches can be very, very painful.   In addition, corneal scratches cause sensitivity to light (photophobia), may lead to infection and other problems.  Depending on the circumstances, corneal scratches may take several weeks to heal and require medical intervention. 

Q.    Blurred vision left eye ringing ears.

See an eye doctor.  The two conditions may or may not be related.

Q.   I wish to know how can i threat my "drusen" condition?

Drusen are semiclear outgrowths of Bruch's membrane in the eye, cause by the aging process or pathology.  First you need to be diagnosed by an eye doctor who then can determine if anything can be done about the condition.

Q.    The other day I saw about 3 or 4, small, grayish spots in the white area -excuse my ignorance- of my sister's two eyes, she doesn't report any actual pain in her eyes but she does have a small, brief headache every once in a while, what might the reason of these spots be?

Grayish spots on the sclera, white part of the eye(s), may be a sign of minor (freckle) or serious (melanosis) conditions.  As a consequence, your sister needs to be seen by an ophthalmologist, particularly since a biopsy or surgery might have to be considered for diagnosis and treatment.

Q.   My co-worker's fourteen month old son appears to have no feeling in his right eye. He has caused so much damage to the eye by scratching it that he needs to have his eye sewn shut so that it heals. My co-worker has taken him to many doctors, even specialists in Boston. No one seems to have an answer for her as to the exact present cause and as to the long term prognosis. My co-worker would like to take her son to a pediatric cornea specialist if such a speciality exists. Any information would be greatly appreciated. Thank you.

Local disease of the cornea (e.g., herpes simplex), and sometimes eye lid abnormalities, may disrupt corneal innervation and lead to a breakdown of the corneal epithelium.    Sometimes, certain corneal diseases and their treatment require suturing the eye shut (called a tarsorrhaphy) for a short period of time for healing to take place.

We are not aware of pediatric cornea specialists, but we'll research this issue and if anything surfaces we will update this response.   Typically, cornea specialists see patients of all ages.  We assume that the child had no demonstrable eye problems before the episode as described.   Unfortunately, the parents and doctors are between a "rock and a hard place" so to speak, since total occlusion of the eye may cause deep and, possibly, irreversible amblyopia in the occluded eye.  Sometimes in cases in which the doctors do not want the patient to touch an affected eye, splints will also be placed on the patient's arms, at the level of the elbows, so that the patient cannot reach the face and eyes.

Q.    What does it mean when i see a sort of light and flashing to the side in my right eye, and when i close it, it sort of looks like a green circle, like when youve looked into a light too long, or looked at the sun?

It means that you need to see an ophthalmologist ASAP.  You may have a retinal detachment (or other retinal condition).  If so, you'll need surgery to repair it and prevent it from getting worse.  Be on the safe side and see an ophthalmologist NOW.  Describe the symptoms to the doctor's receptionist and they will see you immediately.

Q.   I am a special education teacher with a student who has been recently diagnosed with Duane's syndrome. How does the syndrome affect vision? Would the syndrome affect his letter recognition? Is there anything I should be aware of to help this child be a successful reader ? He is a grade 2 student with little letter and sound recognition.

Duane's Syndrome is a congenital oculomotor disorder, in which the patient has trouble in maintaining proper binocular eye alignment particularly in off-center gaze.  As the patient ages, the affected eye might turn-in (esotropia).   In general, it may cause double vision in certain gaze positions and thus, somewhat, affect reading.  However, the patient may compensate for the eye misalignment by turning the head to create single binocular vision and by moving the head during reading.  It should not affect letter or sound recognition.  However, Duane's is sometimes associated with other conditions or abnormalities.  About 10% of patients may also have a hearing loss, thus it would be advisable for the student to have a hearing test, particularly since it appears that he has problems with sound recognition.

Q.    Pseudoxanthoma elasticum.

Pseudoxanthoma elasticum (PE), also called nevus elasticus, is a rare hereditary disorder that usually appears after puberty.  PE affects mainly the eyes, skin, GI tract and cardiovascular system, resulting in a form of degeneration of the elastic tissues and deposition of calcium in the body .  In the eyes, angioid streaks, that look similar to blood vessels, form in the retina, chorioretinal changes occur and vision may be disturbed/blurred.  In the skin, yellowish spots, 1 - 3mm in diameter, occur which might not be noticed early in the course of the disease. Hemorrhages/lesions may occur in the GI tract, mouth/lips, rectum and/or vagina .   Blood vessel changes may lead to reduced arterial pulses, hypertension, coronary insufficiency and mitral valve prolapse.  There are different types or/and severity of the disease. 

Q.    I wonder if is any treatment yet for adults with amblyopia if its something please let me know.  I heard about l- dopa plus is this good to use ?? thanks

Except for the L-dopa research, there is nothing new on the horizon regarding the treatment of amblyopia in adults.  L-dopa has been found to improve visual acuity about one line on the visual acuity chart in adult patients.   Whether this is a temporary or permanent improvement is not known.  L-dopa therapy appears safe and might be useful in improving visual acuity in certain jobs (e.g., commercial drivers license) where the person is required to pass a visual acuity test AND the person is close to passing .  In children, recent evidence, not yet published, has shown that penalization therapy, whereby eye drops are used to dilate the pupil of the stronger eye, works about as well as patching the stronger eye.  The use of eye drops does take a longer time than patching to reach the same level as in patching, and visual acuity must be about 20/100 or better in the amblyopic eye.

Q.    Who do i go to for catarac removal?who are the top chicago

opthalmoligists?

Only ophthalmologists (MDs and DOs) can perform cataract surgery.  We don't want to play favorites, as to the best in the Chicago area.   In general, the more cataract surgeries that the Ophthalmologist performs the better your chances for a good outcome.  However, cataract surgery has come a long way in the past 30 years and the complication rates are very low.

Q.    Yellowish inside eye with a bump on the white part?

On this page and in the Q and A Archives, do a Find, under Edit on your Browser, for Pterygium and for scleritis, both are a possibility.  Also, you should be examined by an eye doctor just to be on the safe side since, although rare, other more serious conditions can cause the symptoms you describe.

Q.   After looking at PDA (Palm Pilot) for awhile, I notice I have total double vision in my left eye and can not focus for quite a long time. I do have high pressure in that eye (narrow angle) and a catarat. What is causing this focusing problem to occur and is there something I can do about it. It does not seem to occur with regular computer monitors, just the PDAs.

Monocular diplopia (double vision in one eye) is usually caused by refractive error related to the early optical pathway of the eye (cornea, lens, vitreous).  As such, given that you have an apparent early cataract in that eye, the monocular diplopia is probably due to the cataract.  The reason you see it only with the palm pilot, we would have to guess, is possibly because of the size of the object - smaller objects are more likely than larger objects to appear double.  Another possibility however, is color differences between the objects or screens; red and greenish-reds would be more likely to cause monocular diplopia than, say, more bluish colors or screens.  We assume you're in your 40s or so and probably in the early stages of presbyopia; this would cause blurred vision for more distant objects after a period of close work.  We assume that your narrow angle glaucoma has been successfully treated (i.e., pressure is below about 22) and is not an issue.   Nevertheless, there is a rare condition in undiagnosed patients with narrow angle glaucoma in which close viewing leads to an elevation in IOP and sometimes even a loss of sight.  Any concerns should be addressed by your eye doctor.  Do a Find, under Edit on your Browser, on this page and on the Q and A Archives page for diplopia or/and monocular diplopia for additional info on the subject.

Q.    Where can i find out about lighting for someone with photophobia?

We assume that the reason for the photophobia has been diagnosed, since photophobia is sometimes related to serious eye disease.  Probably the best source for practical info on photophobia and lighting conditions would be a low vision clinic, where they work with such patients on a daily basis.  Issues usually relate to type of light source (e.g., fluorescent is bad), level of lighting, the use of special light filters and lenses.  In addition, some meds can cause photophobia so be sure to ask any of your docs that have prescribed meds to you.  In patients with macular degenerations and cone dystrophies, we have found the Corning Photochromic Filter (CPF) 527 to be particularly helpful at improving vision and decreasing photophobia.   The nice thing about the CPF 527 is that the lens darkens in the light and lightens in the dark.  The drawback is that the lens is reddish in color and distorts color vision.

October, 2001

Q.   My husband who is a 41 year old was at the eye clinic today and seen the consultant where he was told he was sure he had Fuchs heterochromia uveitus I was reading an answer to your question wher you said diffrent colored irides can be caused by trama the doctor definatley said their was a diffrence in coulour. Is fuchs heterochrommia uveitis the same and can this be caused by Trauma.

No and probably not.  An acquired difference in iris color, called heterochromia., can be caused by a number of conditions including trauma with and without hemorrhage, a tumor inside the eye, glaucoma, intraocular foreign body, iris atrophy and in the case of Fuch's heterochromic iridocyclitis/uveitis (FHIU) - inflammation inside the eye (iridocyclitis, uveitis).  In fact, the diagnosis of FHIU is usually made after it has been determined that there is no history of ocular trauma.

FHIU is associated with decreased vision, photophobia, floaters, pain and discomfort, sometimes differences in iris color (about 75 - 90%), cataract (about 85%), glaucoma, inflammation, among others.  The cause of FHIU is unknown.  The need for periodic eye exams is obvious.

Q.    Symptons of detached retina?

There are different types of retinal detachments and symptoms very greatly from no apparent symptoms to excessive floaters, loss of visual field and flashing lights.  There may be an "odd" awareness that the eye doesn't feel right, but there may be absolutely no pain involved.  All retinal detachments require an immediate/emergency trip to an ophthalmologist's office for a dilated eye exam and possible surgery.

Q.    what causes eyes to go out of focus?

There is a wide variety of causes of loss of focus or blurring of the visual environment - some very common and some serious.  You need to be examined by an eye doctor to find-out the cause.  The most common cause of blurred vision in patients 40 years and older is related to presbyopia - an aging eye and the difficulty of changing focus from, say, a near object (e.g., reading a book) to a more distant object like seeing a sign far away.

Q.    What is degenerative eye disease?

A degenerative eye disease is any disease of the eyes that gets worse over time.  There are probably hundreds of degenerative eye diseases.  The most common one in the elderly, those over 50, is age-related macular degeneration (ARMD).

Q.   what is eyeitis?

The correct spelling is iritis.  On this page and on the Q and A Archives page, do a Find, under Edit on your browser, for iritis for further info.

Q.    I am 49 yrs old and this is my first pair of glasses. They are bifocals. Since recieving the glasses I have been back to the eye doctor because with the first glasses when looking at a bright light or object I would see 4 objects right on top of the other. He checked my glasses said they were exactly as he prescribed but after having me read he moved the RD in from 36 & 34 to 33 & 32. My new glasses have come and seem to be better but I still see an extra image when looking at bright lights or objects. Is this something I need to get use to or do I need to pursue this. I don't want to hurt my eyes any further.

Optical errors can cause double vision in one or both eyes, so we must assume that in both eyes you're seeing double and that both eyes or glasses have an optical error.  Such diplopia is a particular problem with smaller and brighter objects.  Although it won't "hurt" the eyes per se, such diplopia can cause eye strain, headaches, etc.  Also, bifocals are very difficult to adjust to and also difficult to prescribe/fit to the patient.  Nevertheless, if you're seeing double it means that there probably continues to be some uncorrected problems with the prescription.  Don't worry about making your eye doctor mad or hurting his/her feeling.  It is his/her job to get it right, so return and try and try again until you're happy with the outcome.  The cost of prescription glasses now-a-days means that you deserve to be a satisfied customer - and this is also what your eye doctor wants.

Q.   Can scatter photocolagation laser ever cause a hole in the retina? If so how?

Panretinal laser photocoagulation is where an Ophthalmologist "shoots" a laser into the eye and "burns" small spots on the retina, sometimes more than a 1,000, in order to treat certain eye diseases.  Probably the most common eye disease for photocoagulation treatment is diabetic retinopathy (also neovascular glaucoma, macular edema, retinal detachment, retinal ischemia, among others).  In a sense, each laser burn creates a hole in the retina.  However, we would guess that you're referring to a retinal hole as in age-related macular degeneration and in which a laser is sometimes used.  It is our strong suspicion that for whatever reason you had panretinal photocoagulation is the likely candidate as to the cause of the retinal hole.

 

Q.   What are the little patches of yellow in the whites of my eyes? They do not bother me, but a friend was concerned?

If the patch is triangular shaped and toward the nose, it may be a pterygium.  On this page and on the Q and A Archives page, do a Find, under Edit on your browser, for pterygium (and for yellow or yellowish and also Pingueculum) for more info.   However, yellow patches may also be a symptom of more serious eye disease and, as a consequence, you should be examined by an eye doctor for an accurate diagnosis and treatment if applicable.

Q.    What is a stigmitism?

The correct spelling is astigmatism.  In this section and on the Q and A Archives page, do a Find, under Edit on your Browser, for astigmatism for more information.  Also look in the Dictionary.

Q.    I am trying to find a foundation to help my sister. She is 54 years old and diognosed with macular degeneration, she is alo on total disabitily. We have found a machine that will help her to read, it is called video eye. Does your foundation help with the purchasing of these machine? I've tried my local Lions Club to no avail.

Sorry, but OLERF only funds research and fellowship grants at certain research locations in Ohio.  Many local LIONS clubs do honor such requests, and there are many LIONS clubs in many communities.  See Resources in Ohio for additional possibilities for funding the equipment you describe.

Q.   I had the Lasik procedure preformed about a year ago. Subsequently, I have developed a problem with a stray eye lash that grows towards the surface of my eye. I went to the DR several times and he just plucked it out. This seemed simple enough. I went and bought a magnafying glass and have started doing it myself. First, I take a flashlight and lay it on the table.I then take the glass and lay it on a small mirror. Then, I use tweezers to pluck out stray hairs that seem to be growing towards the surface of my eye. The problem is this: After removing the stray hairs, my pupil is dialted for a couple days from being that close to the flashlight. Is this dangerous? Could I be causing damage to my eye? Is there another solution to keep the hairs from growing back?

Trichiasis is the medical name of ingrowing eyelashes as you describe.  It makes "no sense" that your eye would be dilated after plucking your eyelashes - neither the procedure nor the light would cause your pupil to dilate.  Looking at a bright light would, in fact, make your pupil constrict and get smaller not larger.  Is it possible that you have some type of medicine (e.g., mydriacyl) on the tweezers and that the med is getting into your eye and dilating the pupil?  See your eye doctor about the dilated pupil.

Q.   What are the symptons of anthrax?

We only address questions about the eyes and visual system, as such, we'll address the symptoms of anthrax as it relates to the eyes and surrounding tissues.  Anthrax proliferates at the site of the inoculation or site of infection and initially causes a small (0.5 - 1cm) inflammatory, circumscribed, solid elevated lesion on the skin of the face or eye lid with a large amount of swelling around the lesion.  This lesion gradually enlarges and becomes pus-like (like a inch square burn with pus in the center)  and then develops into an ulcer (about the size of a piece of charcoal) of dead tissue that is dark and appears to about fall-off the skin or site.  If the eye lids are affected, there is swelling of the lids and the skin of the eye lids may slough off.  This, in turn, could lead to the eye lid turning outward and exposing the eye and cornea to dryness and additional eye problems.  In severe cases, eye lid deformities can result and require plastic surgery to repair.

Q.   What is the black spot on my iris?

It could be a number of things, some minor and some serious.  As a consequence, you'll need to be examined by an eye doctor for diagnosis.  A minor problem would be an iris freckle, for example.  However, it could also be a iridic melanocytoma, melanocytic nevus or a condition that leads to secondary glaucoma, among others.  See an eye doctor.

Q.   Please explain how the contact lenses for the color deficient work, how much do they normally cost, and how effective are they?

Sorry, but we don't have much info on the contacts that you refer to.  However, nothing will provide a color deficient patient with the ability to "see" colors that they otherwise can't see.  By the use of certain filters, one could improve on discrimination of certain colors via addition and subtraction of certain wavelengths, but this is in no way color vision per se.  We'll update this answer if we come across additional info on this topic.

Q.   I have blurred vision in one eye, what could be the problem? I do wear corrective lens.

Cound be a million things, some minor and some serious.  It is probably related to a refractive error or other optical problem (minor problem), but be on the safe side and have your eye doctor diagnose the problem.

Q.    Sometimes i see black lines or dots that seem to be more visible once im in the sun light.Is this a disease.

You're probably experiencing "floaters".   Floaters are common as we age and are common in patients that are nearsighted.   Then sudden onset of a lot of floaters can be a sign of serious eye disease or pathology.  For more info on floaters, do a Find, under Edit on your browser, for floaters on this web page and on the Q and A Archives page.  Also go to Simulations for a rough idea of what they look like to the patient.  If you're concerned or haven't had an eye exam by an eye doctor in a while, see your eye doctor for a comprehensive eye exam.

Q.   I have glaucoma and have since a very young age.  I have two sons are they at risk and what if any line of heredity does this follow usually the mothers or the fathers, I have been told it follows the fathers.

The best way to determine the inheritance pattern for any disease is to do a complete family history/ family tree for the disease, ideally with the help of a genetic expert.  As a guide whether your children are at risk, if you can do a comprehensive family history and only you (and your sisters and brothers) are affected then it is probably a recessive type of disease and the chances that your children will be affected is small.  If there is a clear family history and it seems that about 50% of one family line is affected then it is probably a dominant type of the disease and you would have a 50% chance of  each child affected.   If the disease appears to skip generations and only affects males, then it is probably an X-linked (sometimes called sex linked) form of the disease and the mothers would be the unaffected carriers and male offspring would have a 50% chance of being affected.

There have been published reports of juvenile onset open angle glaucoma occurring in an autosomal dominant inheritance pattern (GLC!A) with a mutation in the TIGR/MYOC gene.  Adult onset POAG has also been reported to occur at different gene locations (GLC1B - GLC1F) and on chromosome 3q (GLC1C locus).  Given that you have what appears to be juvenile onset open angle glaucoma, it would seem important for your children to have regular periodic eye exams.

Q.   I know this is gonna be long but here goes.  When I was 12 I was diagnosed with Glaucoma. I didn't have any problems until about 2 years ago when I started having squiggly lines of light in my periphreal vision. I went to a Retina specialist first and she found active lesions in my eye, within two weeks I came back for a check-up and they were healing. I got checked for numerous causes i.e. histoplasmosis amoung other things. Nothing was found. Well after two years and three doctors for glaucoma and follow ups watching my retina I still have the light squiggly lines and occasionally do have a orb of light open and close in my perphreal vision, although I have told all the doctors about it they don't seem concerned. I don't know if the lesions caused this or if it is the glaucoma...the doctors all tell me different things. Any suggestions on this. Maybe I should seek out yet another doctor?

Seeing squiggly lines could be a sign of several different conditions.  For example, could the squiggly lines be floaters?   Patients with glaucoma do commonly report the presence of floaters.  See the response two questions before this one.  Squiggly lines and, as you say, an orb of light opening and closing could be a symptom of migraines (either classic or ocular).   Go to Simulations to see an example of both floaters and the Fortification phenomenon (orb of light) as seen by patients with migraines.   Finally, glaucoma does result in ocular ischemia - internal elevated pressure in the eye causes a reduction in blood flow and, depending on the situation, such ischemia can cause the patient to experience the symptoms you describe.  A history/diary of when the squiggly lines occur (i.e., do they occur about the same time of the day?) may reveal an association to when during the day you take glaucoma medicine - and may suggest that a variation in IOP may be the cause of the phenomenon you describe.

Q.    What is mapping of the eyes?

You'll need to be more specific.  One can map the cornea of the eye (corneal topography) and map the inner parts of the eye through various techniques (visual field, multifocal ERGs, retinal photographs, etc.).

Q.    Delayed visual maturation?

Go to www.ohiolionseyeresearch.com/past.htm#Delayed Visual Maturation fo a past featured article on the topic.

Q.    Black spot and lines.

Probably floaters.  For more info on this topic, do a Find, under Edit on your Browser, for floaters on this web page and on the Q and A Archives page.

Q.    Is there any one out there who can give a brief decription of Trichiasis which is ingrown eyelashes on humans not a dog.  I would like to know if this is heriditery. Why is it so difficult to find easy information on this issue. What do I look forward to in the future with this silly disease. If it is a disease. How did I get it? I am 57 years old , would it be from my childhood. A doctor diagnose me this past summer and I need more information on this subject.

As you describe, trichiasis is, by definition, ingrown eyelashes that can irritate the eye.  Nowadays, it seems, that everything is hereditary although we haven't seen any study that has identified the hereditary pattern of trichiasis per se.  One can think of trichiasis as a growth abnormality of the eyelashes that may or may not develop in certain patients.  There are actually a number of diseases in which the eyelashes become misdirected including epiblepharon, acquired distichiasis and entropion.  What separates trichiasis for these other diseases is that the lid margin is normal and not misdirected or distorted.   Trichiasis is sometimes related to inflammation, possibly related to prolonged infection and sometimes related to trachoma.  Trichiasis can sometimes lead to blinding complications.  Thus, medical intervention is necessary and may include removal of misdirected eyelashes (plucking, surgically, via electrolysis, cryotherapy or freezing), use of lubricants and even use of certain types of contact lenses.  More involved surgery may also be warranted.

Q.    What is a white speck on the pupil?

The iris is a heavily pigmented structure and changes in the pigment may lead to hyperpigmentation or hypopigmentation.  A white or lighter colored iris or spot on the iris suggests a hypopigment condition.  A small white spot or patch on a brown iris, or so-called vitiligo iridis, may signify a herpes zoster.  Another possibility is an iris freckle, if the spot is tan and the iris is dark.  Yet another possibility is a condition related to a senile iris, as we age the edge of the iris thins out and loses pigment.  Because iris changes can sometimes be associated with systemic disease and diseases that affect intraocular pressure (glaucoma), any changes in iris color should be examined by an eye doctor for exanimateon.

Q.    Sunlight sensitivity.

Sensitivity to light, sunlight or otherwise, is called photophobia.  Patients with light complexions, particularly albinos who lack pigment, are prone to photophobia.  If photophobia develops in an individual, an eye exam is in order because photophobia is sometimes related to eye disease, including certain retinal degenerations, glaucoma, early cataracts and in certain metabolic diseases.

Q.    Septo optic dysplasia.

Septo-optic dysplasia (De Morsier syndrome) is usually associated with optic nerve hypoplasia.  Septo-optic dysplasia involves abnormally small optic nerves (optic nerve hypoplasia), absence of the septum pellucidum and interior pointing of the antero-inferior margins and flattening of the roofs of the frontal horns as demonstrated on brain imaging.  These structural defects sometimes lead to hormonal deficiencies which, in-turn, may lead to growth abnormalities and possibily diabetes.  For more info on optic nerve hypoplasia and septo-optic dysplasia, see the past featured article on optic nerve hypoplasia.

Q.   I am a 37 year old female in good health. I've noticed the past couple of nights driving I see these circles around lights (headlights and traffic lights). I've noticed that I don't see them on some of the softer lights like the ones on a sign or in the house. I've read some of the information in the Q & A archives so I guess the circles are called halos. The information in Q&A seems to relate this condition to people with cataracts or that have had some kind of eye surgery. I have not had any kind of eye surgery nor do I have cataracts. I am a high risk for diabetes but I just had a diabetes test 2/3 weeks ago and everything was fine. I have had iritis, which my doctor treated with steroid drops. It has not flared up in at least 4/5 years. Could the iritis be causing this? Is this a sign that I'm about to have a flare up fo iritis? What else, other than cataracts or surgery causes these halos?

Halos are primarily caused by optical errors of the eyes.  Optical errors include corneal changes including inflammation and metabolic changes, lens changes as sometimes seen in early cataracts, and in changes in the ocular media or jelly part of the eyes.  In your case, iritis and related changes could be a possibility.  Another possibility, given the history of steroid use and history of diabetes, is that you are having early changes in the lenses toward the development of cataracts due to the steroids or due to lens changes related to diabetes (?).  Let your eye doctor know about the halos.

Q.   Can sinuses cause problems for your eyes?

Not sure as to the precise question; however, there is a close relation between certain sinus problems and eye problems.  Allergic reactions are probably the most common association between the sinuses and the eyes - red, itchy and swollen eyes may go along with nasal congestion, running nose, etc.  More rarely, certain sinus conditions may involve the eyes, particularly masses or tumors of   the sinuses.  For example, there may be ocular involvement associated with adenocarcinoma, esthesioneuroblastoma and histiocytosis of the sinus and certain eye problems including optic neuritis and optic neuropathy.  Ocular inflammation can also be associate with sinus inflammation or other sinus pathology.

Q.    I have pain behind my eye, with my eyesight blurry but I still can see. I just want to know what this is?

The symptoms could be due to one of a number of serious eye problems.  Both pain and blurred vision are symptoms that neceessitate an eye exam.  See an eye doctor today!

Q.   What is the definision of enucleated?

Enucleated means to surgically remove an eye.

Q.   How many people suffer from eye disease?

This is actually a tough question.  For example, some patients may have eye conditions, such as myopia, that require glasses to correct, but myopia is not a disease, per se, it is a condition or state of the eye.   As a rough estimate, problably 20% or so of people probably have an eye disease or eye condition.  This % of people with eye problems would be greater in the elderly (primarily because of age-related macular degeneration, cataracts, diabetic eye disease) and in certain minority populations (e.g., Blacks have a higher incidence of diabetes and glaucoma).

Q.    What is the cornea? how do i know if ther is bleeding between the iris and the cornea?

The cornea is the very front of the eye, which is clear and the "window" to the eye.  You would see red blood if there was bleeding between the cornea and the iris (colored part of the eye that makes-up the pupil).  Such bleeding is called a hyphema.

Q.   WHEN PUTTING BIFOCALS ON MY RIGHT EYE FEELS LIKE A HAIR IS SHOOTING OUT, WHEN REMOVING A SIMILAR FEEING.

We're not sure as to the question.  Please resubmit the question with more detail.  Do you actually mean a bifocal contact lens?

Q.    Retrobulbar neuritis

Retrobulbar means behind the eye ball.   Neuritis typically means inflammation; in your case, inflammation of the optic nerve.  Neuritis also means or refers to demylination or degeneration of the optic nerve.  Thus, retrobulbar neuritis means inflammation of the optic nerve behind the eye ball.  Sometimes when there is inflammation of the optic nerve, the eye doctor can look inside the eye and see swelling of the optic nerve head - that part of the optic nerve that is, so-to-speak, attached to the eye.  However, sometimes the optic nerve head will appear normal (i.e., no swelling), but other tests indicate swelling of the optic nerve behind the eye ball as in your case.  Retrobulbar neuritis may affect one or both eyes and may sometimes be associated with other conditions or diseases.  It usually has a fast onset and vision is reduced.  Vision usually improves one week to one month after the attack, although sometimes vision loss is permanent.  Optic neuritis is usually associated with a systemic (whole body) disease or other neurologic problem.  Optic neuritis is sometimes associated with Multiple Sclerosis (MS), meningitis, viral infection, drugs or toxins.

Q.   I am a writer, currently working on a screenplay. One of my characters, a girl of Kindergarten age, requires glasses for a period of time to correct a problem. Is there such a problem, and what would it be? Thank you

Young children are often farsighted (hyperopic) and may require "coke-bottle" type glasses to see close-up.  These glasses make the eyes appear real big.  As children get older, their eyes may change from being farsighted (can't see things close-up) to having normal eyes (no glasses needed) to having nearsightedness (myopia, can't see things far away).  As a consequence, a child may need glasses to correct a farsightedness problem only for a few years (sometimes forever).  

In another situation, a child may have a difference in refractive error between the eyes (anisometropia), such that one eye may be nearsighted and the other eye may be farsighted or need no correction.  Some of these children may develop a lazy eye or have the potential to develop a lazy eye and, as a consequence, they are prescribed glasses to correct the optical error and to avoid the development of a lazy eye.  These children tend to always need the glasses, but only need to wear the glasses to avoid the development of a lazy eye until the age of 8 or 9 years.

Q.   I have asked several doctors (a doctor in our Urgent Care center referred me to an allergist, who referred me to an ENT) and none of them seems to know what's going on with my eyes. For the past year or so I have had a yellow discoloration of my eyelids, and this has progressed to swelling of the upper eyelids (between the top of my upper eyelid and the bottom of my eyebrow, kinda looks like I've just been punched equally on both sides). I can also feel something under my eyelids on both sides, and it runs almost the full width of my eyelids. I do not have any secretions, scaling, decreased vision or any other symptoms besides the yellow discoloration and swelling that are visible. I know I should see a doctor, but my question is, what kind of doctor? What kind of tests should I have done?

The first doctor I saw thought the yellow discoloration might be caused by a lipids problem. I had a blood test done and it came up normal for everything they tested for. The allergist thought it might be my sinuses blocking the veins which return blood from my eyes, so he referred me to an ENT. I had surgery to remove polyps and what not about 3 weeks ago. (This was needed even if I didn't have swollen eyelids). The surgery went well and I can smell again, but the swelling came right back. (The prednisone they prescribed shortly before and after the surgery helped with both the swelling and the discoloration for a short time). But, like I said in my previous message, my vision isn't being affected, besides having a hard time keeping my eyes open because of the swelling. Also, I just finished a long course of Cephalexin antibiotics as a follow up to my surgery. I'm not sure if that would help cure an eye infection, but I figured I'd include it FYI.

We're perhaps biased, but you should see an ophthalmologist for the problem.  Lid swelling can be caused by a number of diseases, some reflecting a systemic or whole body problems (e.g., cerain cancers), some reflecting certain syndromes (e.g., Melkersson-Rosenthal syndrome) , among others (e.g., conjuctival amyloidosis).   The fact that both eye lids appear affected, suggests a possible systemic disease...even allergic reactions can cause bilateral eyelid swelling.     Sometimes yellow discoloration may be a sign of liver disease (jaundice, hepatitis, hyperbilirubinemia).  We'll consult with others and if some additional info becomes available we'll update the answer to this interesting question.

Addendum:  Regarding above question, it may be bilateral xanthelasma.  Should have normal lipid metabolism.  Biopy and light microscopy should confirm diagnosis of xanthelasma (and R/O Dx of atypical lymphoid hyperplasia, Wegener's granulomatosis).

Q.    What is binocular degeneration?  Do you offer funding in Michigan for therapy, five year old.

We have never heard of "binocular degeneration".   Please double check your source of this information.  No funding is available in any state for therapy (?) from the Ohio LIONS Eye Research Foundation.

Q.   Are there optical aides for persons suffering from age-related macular degeneration?

Yes, all kinds of optical aids are availabel for age-related macular degeneration.  See your local Bureua of Services ofr the Visually Impaired (BSVI) office for more info.  Also, see recent past featured article about assistance for the visually impaired.

Q.    What is glocolma?

The correct spelling is "glaucoma."  Go to the dictionary for a definition of glaucoma.  Often associated with increased pressure in the eye, there are several types of glaucoma (closed-angle, open-angle, normal pressure).   All types affect (cells that make-up the) the optic nerve of the eye and which eventually lead to a loss of vision (typically side vision first) if left untreated.   Some believe that glaucoma is actually a blood supply problem within the eye, and that increased pressure creates ischemia and loss of visual cells within the eye (particularly ganglion cells and bipolar cells) thus leading to vision loss.  Do a Find, under Edit on the top of your browser, for glaucoma on this page and on the Q and A Archives page for more info on glaucoma.

Q.    I have currently been experiencing a recurrent "tugging" feeling in my eyes. Its like a 1-2 second "pull" and then it disappears. Can anyone tell me what it is from? Email me at...

Not clear what the symptom might refer to or be caused by.   See an eye doctor if the problem persists.  We don't respond to individual e-mail addresses.

Q.    Homomynous heminaopsia.

The correct spelling is "homonymous hemianopsia".   See dictionary and the Simulations page for more info.  Also do  Find, under Edit on your browser, for the key words for more info.

Q.    About six months ago, having had perfect eyesight since birth (40 years), my eyes started to have difficulty re-adjusting to light. For example, if I came into the house from outside, it would be black for several seconds before my eyes could adjust. I went to the optician who said my eyes were okay, but after several months the condition seemed worse and I found it difficult to focus normally during the day. I went to the optician again and was told my eyes are okay and was given low strength glasses to ease the condition. Now a month later, my eyes feel noticeably different. I went to a different optician who says I have no peripheral vision and has referred me urgently to an eye specialist. What could cause this? I am worried now that I may have a brain tumour.

Your symptoms are NOT what would be expected from a brain tumor.   Sometimes certain retinal problems will have symptoms as you describe - poor adjustment to a change in lighting, poor night vision and poor side vision.  We would expect you to have, in addition to a dilated eye exam, a visual field test as well as an electroretinogram (ERG) and an electro-oculogram (EOG) to assess retinal function.   Once the retinal specialist provides a diagnosis, we can provide additional information on the condition.

Q.   I need to know about anridra?

You're probably referring to aniridia - near or compete absence of the iris (colored part of the eye).  Aniridia is associated with poor vision, sensitivity to light and nystagmus.  Sometimes aniridia is associated with glaucoma, cataracts, progressive corneal changes and optic nerve hypoplasia.  Thus, annual eye exams may be in order.  Aniridia may run in families (dominant) and it also may occur spontaneously (no family history).  If sporadic, there is an increased chance of Wilms tumor, necessitating annual abdominal exams with ultrasound or with other techniques.

Q.   Hystoplasmosis?

The correct spelling is "histoplasmosis".  For a featured article on the topic, go to http://www.ohiolionseyeresearch.com/past.htm#Histoplasmosis.   Also, on this page and on the Q and A Archives page, do a Find, under Edit on your browser, for histoplasmosis for more info.

Q.    I have took me 9 month old to the TN. Lions Eye center.They say she has a cherry red spot in her left eye. They tell me it is a birth defcet. She has very poor vision in that eye. With glasses they say the best we can hope for is the big E on the chart. It also causes that eye to wonder, they are going to patch her good eye. They tell us it has to do with the nerves growing to much and it caused her eye to be to large. Do you know a medcial name for this or have any information on this? I can't seem to find anything.

A cherry red spot of the macula or center part of the eye used for reading can be a sign of several diseases, the most serious being Tay-Sachs disease.   A cherry red spot can also occur in Niemann-Pick disease and Sandhoff disease.   In Tay-Sachs disease, the assessment of the enzyme hexosaminidase in serum or white blood cells is used for diagnosing the disease.  Tay-Sachs disease is a very very serious disease, and we must assume that the doctors have ruled-out the disease in your child.  Assuming that your child does not have a syndrome per se, we must assume that the docs are referring to a birth defect such as a coloboma of the macula.  Thus, as you state, visual is predicted to be poor and it is common for eyes with reduced vision to "wander" and for the eyes to become misaligned.  The docs will try patching the stronger eye to see if there is any amblyopia (lazy eye) in the wandering eye. If there is some amblyopia in the wandering eye, vision should improve, somewhat, and the eye should wander less.  Check with your eye doctor for the exact name of the disease, if any, and keep all your child's eye appointments.

Q.   My eyelids, near the inside corners of my eyes, are pigmented orange. Several docs have suggested I have high cholesterol, but that comes up negative. One doctor suggested that it was a chemical reaction to make-up. I've had them about 15 years. The patches are always there, but the brightness/intensity varies. I have been unable to correlate diet/weather changes with the intensity. I am white, female, age 34. Patches appeared when I was about 17.

Q.    It may be bilateral xanthelasma.  If so, you should have normal lipid metabolism.  Biopy and light microscopy should confirm diagnosis of xanthelasma and rule-out the diagnosisx of atypical lymphoid hyperplasia or/and Wegener's granulomatosis.  Sometimes yellow discoloration may be a sign of liver disease (jaundice, hepatitis, hyperbilirubinemia). 

Q.   I have an 8 year old son, in whom I have recently noticed grayish irregular spots on the whites of the eyes above his irises, that is to say, normally out of view unless the eyelids are retracted. He does not complain of pain or vision disturbances. Can you tell me what this might be? I am not sure where to submit my e-mail address...

There is a fairly wide range of variation in sclera (white part of the eye) color.  Sometimes, the sclera will be thin and allow the darker underlying layers, such as the choroid, to show through and make the sclera darker in appearance.  So it is possible that what you're seeing is simply a normal variation in the color of the sclera.  However, some metabolic diseases are associated with changes in sclera color (e.g., blue sclera).  Also, grayish spots on the sclera may be a sign of minor (freckle) or serious (melanosis) condition.  As a consequence, you should have your child examined by a pediatric ophthalmologist just to be on the safe side.   

Q.   Can you tell me if Stargardt's syndrome is the wet or dry type of macular degeneration?

So-called wet and dry forms of macular degeneration refer specifically to age-related macular degeneration (ARMD) and NOT to other forms of macular degeneration, such as in Stargardt's disease.  It is like talking about apples and oranges.  In the case of ARMD, the wet form (exudative) refers to the form in which abnormal blood vessels grow and leak or hemorrhage and vision loss can be sudden.   The dry form (non-exudative) is the more common form and does not involve the abnormal growth of blood vessels and vision loss is more gradual.  In one sense, since Stargardt's disease does not involve the development of abnormal blood vessels, one might think of it as a dry form of macular degeneration.  However, just because an apple and an orange are both fruit, it doesn't mean that an apple is an orange.   Thinking of Stargardt's as a dry form of macular degeneration would lead to incorrect assumptions and conclusion - Stargardt's and the dry form of ARMD are totally different types of pathology, that happen to affect the same area of the retina/macula.

Q.   My right eyelid has been "jumping" quite a bit lately and there is tingling all over the face manily on that side. When it has been "jumping" alot the eye starts to tear up. Is there some possible nerve damage or spinal problem?

It is not clear what the problem might be.  We suggest that you be examined by an Internist or General Practitioner (GP) to evaluate the problem.

Q.    Does a hyperop accomodate to see in the near or in the distance? What conditions would indicate a bandage lens? ie a corneal abrasion? bullous keratopathy? What diseases would indicate a scleral lens?

A hyperope can see better in the distance than at near because the eyeball is short and has difficulty with accommodating to near objects.  Most infants and young children are hyperopes (farsighted). 

Depending on the condition and extent of disease or injury, a corneal contact lens bandage or a scleral contact lens bandage may be used - the exact type of contact lens bandage is dependent on a number of factors and dependent on the clinician's professional judgement.  There are no hard and fast rules in terms of the type of pathology one type of contact  lens bandage or the other should be used.

Q.    I have had a persistent eyelid problem for about 10 months. It started after I was hospitalized for a clogged saliva gland that almost ruptured. I was given an extensive regiment of antibiotics (cipro drip and steroid drip). About 4 weeks later, after flying to Mexico (I am an airline pilot) I noticed a film in my right eye like sleep but when I rubbed my eye it itched very bad, this happened about 4-6 times and then went away. Then I noticed my upper right eyelid rising up in the middle off my eye & twitching. So I went to an Ophthalmologist who started treating me for allergic conjunctivitis with steroids (TobraDex) after 4 weeks no improvement he said I just had to get out of what I was allergic too. I am went to an Allergist and was not having allergy problems so I went to some other Ophthalmologists all who treated me for the Allergic Conjunctivitis with no success for 6 months. I am now going to a behind the eye Ophthalmologist who has diagnosed me with a meibomian gland dysfunction. I have no other problems with my eyes i.e. blepharitis and have 20/20 vision. My upper right eyelid just is slightly swollen and seems to be slightly raised off my eye in the center where it is raised and twitches. The twitch is very slight and intermittent and does not close the eye it just raises up slightly. When I get out of the shower I can see where the upper right lid comes down slightly over the lower lid and leaves an in print on it. The eyelid seems to be swollen on the eyelash end. I have been to a Neurologist and Dermatologist, and been tested for sorgens and other arthritic conditions all came back neg. I just find it hard to believe I have some kind of chronic gland dysfunction only in one eye and on one lid. Most doctors dismiss this as not a big thing and I know it is not compared to someone going blind but being an airline pilot this could be critical. I worked 10 years flying for a lot of people and going to school before being hired by a major airline just last year and I do not want to loose my career. I am open to suggestions.

We agree with the most recent ophthalmologist that you may have a meibomian gland dysfunction.  And, if the upper eyelid is slightly separated from the eyeball this could lead to dry eye conditions (red, dry, irritated eye).   Meibomian gland dysfunction is also related to dry eye syndrome because it disrupts the oil secreting gland opening or orifices of the eyes (located along the eyelid margin).   Meibomian gland dysfunction can affect one eye only; simple allergic reactions typically affect both eyes.  Also, your episode of film over the eye fits with the early stages of meibomian gland dysfunction in which the orifices by which the meibomian gland secretes oil are blocked and causes the gland to swell with oil.  By pressing on the upper eyelid and gland, one can cause the meibomian gland to release this built-up oil and "flood" the eye with oil causing the symptom (film over the eye) as you describe.  Ask your ophthalmologist about the use of hot compresses and massage of the eyelid and eyelid margins for meibomian gland dysfunction as well as the possible use of tetracycline.  Later, one might also consider punctal occlusion to treat dry eye disorders associated with meibomian gland dysfunction.  Good luck flying the friendly skies.

Q.    Can dwains be corrected?

Duane's retraction syndrome might be treatable but it is not correctable.  Duane's is due to abnormal innervation of the eye muscles and nothing can correct the abnormal innervation.  However, depending on the patient, surgery may be performed to allow the patient to have straight eyes when looking straight ahead (and to elliminate any head turn).  If appropriate, see an ophthalmologist that performs eye muscle surgery for examination.

Q.   COULD BRANCH RETINAL VEIN OCCULSION BE CAUSED BY TRAUMA?

It is possible but not probable.  Trauma is not listed as one of the causes of branch retinal vein occlusion.  However, by definition, anything that results in a loss or significant reduction of blood flow through a branch of the retinal vein is a cause of branch retinal vein occlusion.  For example, if you suffered a trauma which resulted directly or indirectly in a blood clot, embolic material thrown off from a blood vessel wall or collapse of the blood vessel itself would lead to such an event.  However, the most likely cause of branch retinal vein occlusion is age related vascular disease sometimes associated with underlying pathology such as arteriosclerosis, high blood pressure and high cholesterol.

Q.    Can you provide more info on rod cone dystrophy. what is it? hoe does it affect sight? how does it progress? My 9 year old son has benn afflicted since birth and it appears to be a genetic defect. I also want to know if any research is being done currently. Also, how will this affect my son's ability to take math proficiency tests. Verbally, he can answer questions and has a firm grasp of numeric concepts but has difficulty with geometric shapes and shading. A recent pre-proficiency test showed a substantial deffict in this area. Where can I get more info on this disease?

On this page and on the Q and A Archives page do a Find, under Edit on your browser, for "rod cone"  for more info on the topic.   Also, go to the web site for the Foundation Fighting Blindness for more info on rod cone dystrophy (may also be referred to as a rod cone degeneration).  The rod photoreceptors work at night, black-white vision only, and are mainly used for side vision.  The cone photoreceptors work during the day, are used for central vision, color vision and for seeing fine detail.  A rod cone dystrophy means that the disease affects both types of photoreceptors - first the rods than the cones.  Patients with rod cone dystrophy generally have very poor vision, worse than 20/200 (legal blindness) visual acuity.  A lot of the expected symptoms are as you describe.  The most common rod cone degeneration is Retinitis Pigmentosa (RP).

Q.   bletharitis

The correct spelling is blepharitis.  For more info on blepharitis, on this page and on the Q and A Archives page do a Find, under Edit on your browser, for blepharitis.  Also see the Dictionary for a general definition of the term.

Q.   tracking problems.

More background info is require to answer this question.

Q.    What are other available & successful options for treatment for orbital pseudotumor myositic type besides steroids?

Symptoms of orbital psedotumor may include rapid onset of pain, lid swelling, redness, progressive vision loss, double vision and other eye lid changes.   Although reoccurrence is uncommon, at least in adults, it can reoccur even after an extended time (e.g., years).  The myositic type of ocular pseudotumor is common and double vision and pain on eye movement are classic signs of the disease.  Double vision is due to a limitation of eye movements due to inflammation.  The eye(s) may also appear to bulge-out.  Often, numerous conditions may proceed the ocular pseudotumor including sinusitis, asthma and upper respiratory infections.  Other than steroids, the most common and widely used treatment for the disease, other options might include low dose radiation, cyclosporine and even chemotherapy, depending on the specifics of the case.  More than one episode of the disease may warrant an orbital biopsy.   Closely follow your doctor's recommendations.

Q.   I have retinopathy a vitrectomy was done it rebled now I have blood and oil in my eye what is the oil is it dangerous?

The oil is probably silicone oil and it is not dangerous.   Usually, but not always, the ophthalmologist will remove the oil after 6 - 9 months.  If may also be necessary to insert more oil later in the course of treatment.

Q.   What information do you have on the cures for marcus gun syndrome?

A Marcus Gunn pupil (syndrome) is a symptom and not a disease, per se.  As a consequence, it is not treatable; however, the underlying cause of the Marcus gunn pupil might be treatable.  The presence of a Marcus Gunn pupil suggests that there is disease along the early parts of the visual pathways in the affected eye - usually a retinal or optic nerve disease.

Q.    What would cause fluid behind the retina?

A large number of diseases/conditions can cause fluid behind the retina and the precise cause may not be known.  Aging, age related macular degeneration, diabetes, certain types of retinal detachment, posterior uveitis, among others can cause such a condition.

Q.   I have Bechet's disease and uveitis in my right eye. In 1999, was having blurred vision and thhought I needed glasses. I was immediately sent to the opthalmologist,he said it was retinal vein occulision. Within a month,I developrd iristis. Even with steriod drops,it turned into uveitis. My doctor did lots of blood test and we could not find out what was causing this.Finally, I was sent to NIH where I had lots of tests and they finally said Bechet's disease. have been on presidone and cyclosporine,steriod drops, preesure drops(developed glaucomafrom sterid drops )and dialting drops.I am now on just predforte drops and cellcept 1000mgs twice a day. My doctors did not seem to know how long I will be on this drug.MY question is: what is the long term prognosis of UVeitis? Will i eventually lose the sight in my good eye? I know that the sight I lost in my right eye is gone for good bececause the retina has been damaged. Is there anything else I can do to help myself? Thanks

Behcet's disease (note correct spelling) is an autoimmune disorder and seems to affect Middle Eastern and Far Eastern populations, most often men.   In the USA, about 4 in 1,000,000 people have Behcet's.  Behcet's waxes and wanes over time and there also may be different types of Behcet's.  Dependent on the type, Behcet's may affect the mouth, eyes, skin and/or the genitals as well as the GI tract, joints (arthritis) and central nervous system.  Importantly, ocular Behcet's usually leads to legal blindness within about 4 years after the initial attack (greateer thean 50% chance), unless immunosuppressive drugs are used (there still is a 25 % chance of legal blindness).  With ocular involvement, usually one eye is affected first followed by the other eye, usually within a year or so.  With every attack vision may be premenantly lost.  As you mention, Behcet's may involve numerous parts of the eye, including the front (iritis, cataract development, development of glaucoma), back (vascular occlusive disease, vasculitis) and the whole eye (uveitis).  The patient often initially complains of pain around the eyes, redness, blurred vision and sensitivity to light.  Such attacks may last for a few weeks followed by a quiet period, with each attack causing further loss of vision.  As the disease progresses, there may be optic nerve involvement and optic nerve atrophy may develop.  As for treatment, your doctor is in the best position to recommend alternative treatments.  These may include immunosuppressive agents (the earlier the better).  Other treatments might include steroids, cytotoxic drugs (e.g., Chlorambucil, Cyclophosphamide), colchicine (an NSAID), and cyclosporine (based on 1999 reference).  Good luck

Q.   I have rings floating in front of my left eye.

The very small rings are actually individual cells (actually cell walls) that make-up some types of floaters.  See Simulations for an illustration.  On this web page and on the Q and A Archives page do a Find, under Edit on your browser, for floaters for more info on the subject.

Q.    Sometimes when I focus on something it appears to grow and diminish in size repeatedly. Almost like it is moving closer and then further back. This happened quite often as a child, especially when I was tired but had subsided until recently. I have realized that when this is happening my pupils are actually dialating and then shrinking repeatedly. Is this normal or should I be concerned?

The phenomenon that you're experiencing is probably convergence-accommodative micropsia; a common phenomenon.  As you look at close objects the eyes turn-in (converge)  and the objects appear smaller and as you look away at a more distant objects/or same objects the eyes turn out and the objects appear bigger.  Why such a phenomenon occurs is not clear but it is fairly common.   More rarely, objects may also appear to grow bigger or to shrink because of seizure activity and sometimes due to migraines (but other symptoms usually also occur during such "attacks").  Changes in pupil size probably plays no role in the phenomenon.

Q.    Can people be born blind?

Sure.  A number of blinding eye problems can occur at birth.  Some infants are even born without eyes or with eyes too small to allow for vision to occur.  Some infants are born with very small optic nerves (optic nerve hypoplasia) such that visual information cannot reach the brain from the eyes.  Some infants are born with retinal disease (e.g., Leber's congenital amaurosis) such that they will never have normal vision.  Other eye problems at birth include cortical blindness (now referred to as cortical visual impairment) - these infants look perfectly normal, have normal looking eyes, optic nerves and even normal looking brains (normal CT and MRIs); yet, don't see or don't see very well because of a problem with the visual parts of the brain. 

Q.    What information can you research on the eye disease bleb and what corrective remedy is available to a 70 year old male?

Not clear what you're referring to with your question.  Is the bleb related to glaucoma surgery for example?  Any of these types of questions is best handled by your surgeon and ophthalmologist.

Q.    HOW CAN I DONATE MY EYE WHEN I AM ALIVE AT THE AGE OF 50

PLEASE REPLY TO THE FOLLOWING...

You can donate your eyes by signing your driver's license organ donation card and specify eyes.  Also, let your family and possible care givers and decision makers know of your wishes after death.  We do not reply to individual e-mails addresses.  All answers are on this page and the Q and A Archives page.

Q.   I have always had dark brown eyes with a few flecks of green, but over the years they have turned almost completely green with only a small ring around the pupil that is still brown. My left eyelid also has started drooping and twitching with decreased clarity of vision. Is there a correlation or simply coincidence and what causes them?

The change in iris color may be part of the aging process and is probably not related to the droppy eyelid or blurred vision.  However, some iris color changes can be a symptom of a disease that also involves the maintainance of pressure in the eye and any unusual eye color changes should be assessed by an eye doctor.   Whenever a patient has either blurred vision or droppy eyes (ptosis), tyhe patient should also been examined by an eye doctor.  So our advice to you is.. you guessed it - SEE AN EYE DOCTOR about all the symptoms that you have mentioned.

Q.    Hi,my best friend has got a little problem with her eye.For the last six months her eyes have changed colour,to like maybe light brown.We have gone to alot doctors and they claim there's nothing wrong ,that with time it would return to its original colour.She doesn't feel any pain or discomfort.The doctors say it could be allergy ,but we don't know and this really bothers her,she feels so uncomfortable with them since at times people ask.She has also done all the relevant test,like the hepatitis test and a host of others,but this is Nigeria and our doctors are not experts please,help,thank you very much.

Eye (iris) color can change for a number of reasons - some related to serious conditions and some reflect things not to worry about.  Since your friend has seen several doctors about the eye color changes and evereyone says the same thing, not to worry, don't worry about it and figure that it is just one of those things that happens as we age.

Q.   I HAVE A RED BUMP IN THE LOWER LID OF MY EYE. IT IS SIMILAR TO WHAT AN OAKTAG WOULD LOOK LIKE, EXCEPT RED. WHAT CAN THIS BE?

If the bump is along the lid margin, along the roots of the lower eye lashes, it is probably a sty.  Styes are usually red, swollen and may be painful to the touch.  They appear to contain fluid and sometimes will break open and pus-like fluid will drain out.  Styes usually go away after a few weeks, but sometimes they may need to be surgically removed.  If the bump is away from the lid margin, the bump may be a chalazion; a solid lump that is hard and firm to the touch and may or may not be red.  Both a sty and a chalazion may respond to a warm compress.    Lumps on the eyelids may also be a sign of a tumor, but these are very rare.   See an eye doctor about the problem and possible treatments.

Q.    What is the procedure used to remove a Dermoid Cyst from the cornea and could I get information on one? this is on a infant.

A dermoid cyst is a noncancerous tumor that usually is present at birth and that appears yellowish white  to fleshy pink in appearance.   Dermoid cysts are usually elevated and round or oval in appearance.  Dermoid cysts usually appear on the upper and outer part of the eyeball but can also involve the cornea.  Because dermoid cysts sometimes increase in size during puberty, they are usually surgically removed in the preschool years.  If the dermoid cyst involves the cornea, to avoid the chance of the development of a lazy eye, it might be advisable to have the cyst surgically removed. 

Q.    July 2000,I got bitten by a bug(unknown) on my left eyelid, I had no itching from the bite, but alittle swelling, which just got bigger,also effected was below the eye, it got real puffy and started tearing, as if I had a cold, both eyes have swelling top & bottom now, another symptom was redding in the face which would come & go. I have been to Eye & Allergist. Eye doctor, just came in the room took one look at my face and said "you have Grave's Disease". I had my thyroid Iodined out in 1991, and have had no symtoms of thyroid problems since, thyroid specialist said he did think it was possible for me after all those years to now start developing symtoms of Graves Disease, The allgerist has found lots of things to stay away from, which I do Try, I also take allgery shots weekly, since March, The puffyness has gone down some but is still around eyes. I have also had a MRI done, Found nothing behind the eyes. Eye doctor suggested, a plastic surgeon, do you think it may be fat bags, top & bottom, or the shots just haven't been long enough to show better results? Help

First, a patient can get Graves' disease (thyroid eye disease) even if you don't have a thyroid.  Think of the thyroid  as separate from thyroid eye disease.  Graves' is a autoimmune disorder, at least that is what most investigators think, and it may occur years after the thyroid is destroyed by radioiodine.   In fact, some believe that such destruction of the thyroid may actually aggravate the autoimmune disorder and more or less trigger the Grave's disease.  Second, are you sure that you were actually bitten by a bug?  It is not unusual to first show signs of Graves' disease in one eye.  Close examination of such patients usually show that the other eye is also affected but to a lesser "subclinical" extent.   If your major symptom is swelling around the eye (eyelids), it sounds like you have a relatively mild case of Graves', at least presently.  It sounds like you are receiving good care.  Don't be so hard on your ophthalmologist because he/she spent so little time on you.  Make sure to maintain your doctor appointments and let him/her know if you have any additional symptoms like double vision in certain directions of gaze or any vision blur or vision loss.  Good luck

Q.    what causes double vision in one eye only?

So-called monocular diplopia is most commonly caused by optic problems with the eye.  These optical problems can be caused by the cornea, lens and ocular media (vitreous) of the eye.  Retinal problems can also sometimes cause monocular diplopia, but rarely.  People who have or start to develop a cataract will also sometimes see double in one eye (most common cause).  Patients that have had catarct surgery and have an artificial lens in the eye can also develop double vision.   Very rarely, monocular diplopia is also a complaint of patients with psychological issues.

Q.    What are old age fixes?

We don't have a clue.

Q.   What is Syrgrens sydrome?

You're probably referring to Sjogren's syndrome.  Sjogren's syndrome is associated with several interrelated symptoms including keratoconjunctivitis (inflammation of the cornea and conjunctiva (surface of the eyeball) with possible lacrimal gland enlargement, dry mouth with possible salivary gland enlargement, along with connective tissue disease like rheumatoid arthritis.  Sjogren's syndrome usually affects middle aged or older women and is believed to involve an abnormal immune system.

Q.   What are the problems associated with "Bleeding Retina"?

The most common problems associated with a bleeding retina include diabetic retinopathy and the wet form of age-related macular degeneration.   Any disease that causes  the growth of abnormal blood vessels in the eye or retina can lead to a bleeding retina.  A bleeding retina can lead to permanent vision loss at the site or location of the bleed.  For example, look at the Simulations page for an example of a vision loss (simulation) of diabetic retinopathy.

Q.    My eyes have been watering for the past 2 1/2 years..I had 8 differect types of suregeries, including, the crawford tubes...nothing is helping. My doctor is Dr. ... from ... Eye Institue...I heard this is suppose to be about the best palce in MIchigan...But he has not helped me..Is there posslible soemthing else he can do that he is not aware of??

You never gave the diagnosis!  Watering eyes can be a symptom of several eye diseases/conditions.  If you provide a diagnosis perhaps we can offer some suggestions or at least additional information on the specific disease.

Q.   My son, who is five years old, was recently diagnosed with COAT'S DISEASE. He recently went through laser surgery on his one eye but, I would like to know what else we could do to help him. We are from a small town and I didn't know if we should seek a pediatric opthamologist or travel to a larger city where more advance studies are being performed?

For information about Coat's disease, go to the Q and A Archives and do a Find, under Edit on your browser, for Coat's.  We may be biased but it may be necessary for a child with a serious eye disease, such as Coat's disease, to see a pediatric ophthalmologist for treatment and follow-up.  If an eye turns-in or becomes misaligned, or if the child complains of any vision problems with the affected or unaffected eye, immediate medical attention is warranted.

Q.   how does video games affect eye sight?

In general video games do not affect eye sight.  Long play can cause eye strain (blurred vision, sore eyes, double vision), but such fatigue can be cause by any excessive eye related work.  Lots of flashing lights, flashing screens or/and rapid and repetitive change can cause some patients to experience seizure like problems, as experience in Japan several years ago.

Q.    Are there any new treatments for dry macular degeneration?

See the recent breakthrough with antioxidants and ARMD (Click Here).

Q.   My eyes water and burn when I read or watch TV while lying down, especially at night. If I situp, the symptoms go away. What's the problem?

Don't know.  Environmental factors (e.g., lighting, air movement, etc.) may be playing a role.  See an eye doctor about the problem.

Q.    Has there been any research on whether the treatments for age related macular degeneration (antioxidants and zinc) may be beneficial for people with Stargardt's disease?

No research, that we are aware of, has looked at the effects of antioxidants on the progression of Stargardt's disease.  Please note that age-related macular degeneration is very very different from Stargardt's disease, although both are referred to as a "macular degeneration".

Q.    What is delayed visual maturation?

Go to Past Featured Articles (Click Here) for an article on Delayed Visual maturation.

Q.    Worsening strange visual disturbances.   2 Years ago I started developing visual disturbances. It started off with streaks/light refractions off any kind of lights, i.e street lights, it will be a refraction the width of the light that beams towards the floor from the light that fans out. I have got really bad sensitivity to light and get severe glare off light. I have developed blue cobweb like halos around white lights, e.g. car headlamps. I have a snowing effect in dim lighting where it looks like its snowing, and against bright surfaces I can see the blood rushing around the vessels in the back of my eyes. I can notice flickers in fluorescent lighting. I have trouble looking at computer screens/TV's etc because when i move my head forward and back whilst looking at the screen a series of wavy lines in my vision will form, almost as if my vision cant handle what its looking at. Series of straight lines will look wavy and swirly. I get afterimages from things i look at. I also get afterimages, e.g. if i wave my hand past my face in dim light it will leave a slow trail of my hand behind it. I have a lot of floaters in both eyes that are on the increase. I have more recently developed a double vision phenomenum (one image above the other, same in both eyes) if i am to open my eyes wide then relax them again a refraction of the image will appear above it, causing a double vision. I am getting very concerned about these problems as no-one seems to be able to diagnose them. I am only 18yrs of age, and the doctors seem to of lost interest in me, my next appt with a neuro-opthlamologist isnt for another 5 months im very scared as my vision is slowly deteriorating.

I have had an MRI and CT scan which is normal. An E.E.G which was also normal, I have had a thorough dilated eye exam and still nothing showed up. Where do I turn ? I am deseparatley searching everywhere for an answer.

Any feedback or suggestions would be very much apreciated,

Believe it or not, most of the "symptoms" that you describe are not symptoms of any disease but may be normal visual experiences.  It is normal to see afterimages, trails following moving objects (hands), even double vision when doing so-called strange things with your eyes (like opening them widely).  It is also rather common to see the blood vessels in the retina under certain conditions.   We're not surprised that all your tests have come back normal.  The way that you describe things and the things that you do describe suggest to us that you may have some mental health issues worth exploring.  Of course, thinking that you are experiencing some sort of serious vision problem(s) can cause stress and anxiety; however, you seem to be fixating on a range of different visual experiences which leads us to believe that you may need to look at psychological issues and not physical problems or vision problems, per se. 

Q.   Cross eyes?

On this web page and in the Q and A Archives page, do a Find, under Edit on your browser, for crossed eyes also known as esotropia for additional info on the subject.

Q.   When I wear my contact lenses, I sometimes have trouble focusing and experiance minor pain in my right eye only. My prescription is as follows:Sphere: -5.25, Cylinder: +0.5, Axis : 90.  This is for both eyes. I have yet to change my glasses/lenses to match. They are currently -4.25. My lenses are not torics, so do not comphensate for the cylinder and axis. Could this be the problem?  Usually I have trouble focusing, and there is a small pain in my right eye, That I do not experiance with glasses.. I've also noticed that my right eye dialates alot more then my left.   I'm mainly concerned as to whether or not I am damaging my eye, and what I can do to still wear contacts and have the same vision as I have with glasses. I have tried toric lenses and find them extremely uncomfortable. Should I use them?  Another thing. I've had my eyes checked out frequently because I have a large number of floaters in each eye. They are constantly in my peripheral vision and are very hard not to notice.. The biggest one also seems to be in my right eye.. I am 19 years old.

You need to see your eye doctor about the blurred vision, pain and difference in pupil size.  There may be a problem with the contacts not fitting right and thus the reason for the pain.  The reason for different pupil sizes is not clear.  Get the problems with the contacts worked-out before you get a new perscription for glasses.  You're a moderate level myope (nearsighted) and it is not surprising that you have a number of floaters.

Q.    I am 55 y/o female who has been seeing the same opthomologist for 25+ yrs. Last year he "semi-retired" and I had to see a junior partner who discovered very pale retinas and did the first visual field I've ever had done. Also sent me to see a retinologist who has done 3 or 4 retinal angiograms (with dye) and last one w/o dye. Because I felt like they were just giving me bits of info at each visit I went to see another opthomologist who said he could find no signs of glaucoma - junior partner said I had low pressure glaucoma and started me on drops. This second opthomologist sent me to a different retinologist who said he saw no signs of macular atrophy which first retinologist said I had. My checking into the cost of the surgery (MD, anesthesia, and out pt charges would be 24,000 -28,000 per eye!! As of 12-31-01 I will have no I have no medical insurance because premium going from 300/month to 440/month. Second retinologist said no signs of macular atrophy or anything else which would require any kind of surgery but he said I have retinitis pigmentosa. He was very assertive in his manner and said hcanges have been occurring over 30 years with definite signs for at least 10 years. Are the signs of RP that vague that my opthmologist of 25+ years would not have seen anything or his junior partner who I have seen at least 5 or 6 times over last couple of years or the first retinologist would all miss it? Have searched your site to the best of my ability and can't find information to answer this question. Where can I find more info on RP? Who do I trust the group I've seen for 25+ years or the two new guys I got a second opinion from? Or do I need a third opinion?? If so, where should I go--in my town or to a university center about 80 miles away- transportation would be a problem because I have severe photophobia (daylight and night time oncoming headlights ) so only drive to 3 or 4 locations w/n 5 mile radius of home.

It is highly unlikely, but possible, that you would be diagnosed with RP (Retinitis Pigmentosa) at your age.  The one doc is right in that signs of RP would have been around for at least 10 years and possibly 30 years or more.  For info on RP, go to the web site for the Foundation Fighting Blindness (used to be called the RP foundation), as found on the Cool Links page (Click Here).  In order to confirm the RP diagnosis, you may need an ERG (electroretinogram) and EOG (electro-oculogram) tests.  There are so many differences among the different diagnoses (RP, normal pressure glaucoma, macular atrophy) that ERG and EOG testing may be warranted to clarify the diagnosis.  You may want to go to the University center WITH ALL YOUR RECORDS FROM THE DIFFERENT DOCS for another opinion.

Q.   i would like to ask you that should i must always wear spectacle when i have astigmatism? what will happen when i rarely wear spectacle?

An astigmatism is an optical error of the eye and may cause some blurred vision particularly with lines and other objects in certain orientations or in certain angles.  In general, you wil not cause any harm by not wearing your spectacles.  You may experience some eye strain (blurred vision, red eyes, sore eyes, headaches, etc.) by not wearing the spectacles.

 

Q.    Can diplopia and cellophane maculopathy be related?

Yes and no.  If a patient has some eye misalignment but the misalignment is small, s/he may have normal single vision (i.e., no diplopia) and the eyes may appear straight.  However, in such patients, even a minor loss of vision in one or both eyes (say caused by a maculopathy) could lead to an increase in the binocular eye misalignment (one eye goes in or out) and cause binocular diplopia, particularly when the patient is sick or tired (or drunk).  Also, monocular diplopia can result from optical changes of an eye as well as retinal changes within the eye.  As a consequence, monocular diplopia (double vision in one eye while the other eye is closed) could be the result of a maculopathy.  At the same time however, strictly speaking, there is not really a direct relation between a maculopathy and diplopia but a causal one...sometimes.

Q.    I have visited this page searching information about a bunch of "points", "dots", "lines", etc... that I see since a time from now. Most of them simply are there, you don't know why and they'll simply keep being there. But I have the suspicion that direct intense sun-reflexes might somehow "burn" retinal cells, and so cause some of those "floaters". I believe that because once upon a time I got the sun reflexed onto a bus-window right into my eyes and then I had the relatively common "flashing lights" you see when you watch at a bright light; then, a car passed and the sun reflexed again, this time onto the car's window, and again right into my eyes. From then until now two years have passed, and the zone where the "flashing lights" had appeared (i.e. where the sun reflex had "hit" harder, and twice) remains distorted. I have also a lot of other floaters; I think that all of them are because of the sun. In fact, I don't remember having had those floaters until I bought a pair very transparent eyeglasses. -maybe it's because they don't filter the UV-rays at all- żIs it possible that somehow my eyeglasses favored the formation of the floaters? Thank you for reading. I hope I haven't exposed it on a too chaotic fashion. If so, sorry about that.

If light is bright enough, it could possibly cause retinal damage and lead to floaters (e.g., welder's burn retinopathy), but we doubt it in your case particularly since you are dealing with a very short duration of exposure.  Eye glasses are unrelated to floaters.  However, one thing that you have not considered is that the bright lights may have triggered a migraine which would lead to some of the symptoms that you describe.  Finally, please consider being examined by an eye doctor to evaluate the cause of your symptoms.

Q.   I was reading about Hystoplasmosis and was very interested by "blurred vision or/and blind spots in the visual field." About six months ago I went to the eye doctor because I was experiencing floating blind spots. I was told that it was protein build up which occurs normally as you age, I am 33. I accepted this answer and never gave the spots another thought.  I spent Thanksgiving in the hospital and five days later was told I had Hystoplasmosis. I would like to know if there is a difference between protein build up and the blind spots you mentioned? Do they look similar to a doctor? If Hysto. caused these spots, will they go away after taking the medication?

Some types of floaters can be considered as so-called protein build-up and are associated with aging.  However, floaters are very small and move around in and out of sight.   Once you have (these types of) floaters you always tend to have floaters.  Other types of floaters can be the result of cells, in the vitreous part of the eye, from hemorrhages and inflammatory (?) or atrophic processes, such as in histoplasmosis.  These types of floaters may disappear altogether once the histoplasmosis quiets down so-to-speak.  However, the blind spots that are referred to in the histoplasmosis Past Featured Article are not blind spots related to floaters but are the result of permanent damage to the retina (or choroid) of the eye, usually the result of a hemorrhage or possibly atrophy.  These blind spots are always there and never move - they're always the same place in the visual field.  So it is not correct, strictly speaking, to refer to "floating blind spots" (although we can see how one might think of a floater as a very small blind spot that moves).

Q.    Can Tanning Beds/ultraviolet rays be harmful to a person's eye sight?

Absolutely.  Ultraviolet (A and B) light contains a high amount of energy that can lead to potential cataract formation and even possibly damage the retina and other layers (e.g., choroid) of the eye.  It is essential to wear protective eye wear while in a tanning bed, for example.  This is an eye related web site so we will not dwell on the skin damage and skin cancer related to ultraviolet light damage.

Q.    Pituitary gland location?

In the brain, the pituitary gland is located immediately underneath the optic chiasm - where the optic nerves from each eye cross and combine to form the optic tracts.  If you were to stick your index finger in your mouth towards the roof, you would be near (1/2 inch or so) the pituitary gland.

Q.    How do you get pink eye?

Very easily.  Pink eye (acute contagious conjunctivitis) is caused by a bacterial infection that is highly contagious.  Pink eye can easily spread from one eye to the other and from one child to the other by simple hand contact with an infected source.  Pink eye is usually caused by pneumococci, staphylococci, streptococci and hemophilus influenzae.  Pink eye requires a visit to the eye doctor for examination and antibiotic eye drops.

Q.   If an Infant has one eye that is not functioning normally and the Doctors want to put an eye patch on him once a day for a certain period of time to strengthen it. Is there any activities you recommend to help strengthen and stimulate the eye? At this point not knowing where the eye is at when it comes to site.

If the patch is on the stronger eye than the condition is probably amblyopia, commonly known as lazy eye.  See the past featured articles on amblyopia (Click Here) and on the Ohio Amblyope Registry (Click Here).   While the main stay for treatment of amblyopia is patching of the better eye, what a patient should do or look at during patching to maximize the return of vision in the amblyopic eye is unclear.  Some believe that physical activity, such as playing games, sports, etc., is better than, say, passively watching TV in terms of recovery of vision.  Of course, patching will do no good if, for example, the patient is asleep during patching. (And yes, we do see parents once in a while that say that they are patching the child while he sleeps because it is easier to leave the patch on - a big mistake.)  There was a treatment called the CAM treatment that was proposed about 15 years ago suggesting that watching black and white stripes spinning around while the patient was wearing the patch was a good adjunct therapy.  However, subsequent research demonstrated that CAM was not effective at improving vision.  Finally, some eye doctors, usually optometrists, argue that so-called "Vision Therapy" should be used in combination with patching to improve vision in the lazy eye.  Such vision therapy can encompass almost anything; from watching certain computer type games to watching a bouncing ball.  Ophthalmologists, however, would argue that vision therapy is unproven and is one reason why insurance companies do not cover such vision therapy treatments.   So, without better and more science on the subject, we would say to that the patient should engage in some physical and visually demanding activity during patching may be your best bet.  During such physical activity safety may be a concern and parental supervision is recommended.

Q.    I HAVE DILATED PUPILS MOST OF THE TIME. I USED TO TAKE A LOT OF EPHEDRA BUT I HAVEN'T FOR AT LEAST 6 MONTHS NOW. COULD IT BE FROM THE DRUGS OR ADIE'S SYNDROME? ALSO MY AUNT HAS ADIE'S SYNDROME AND SHE HAS SJOGRENS. IS THERE A POSSIBLE CONNECTION? AND SHOULD I SEE AN EYE DR FOR MY PUPILS? THANKS.

You should definitely see an eye doctor about the dilated pupils.  The most common reason for dilated pupils is drug use, both legal and illegal, and this would include herbs.  It seems unlikely that you have Adie's pupil, which usually affects only one eye, or Sjogren's syndrome.  Adie's and Sjogren's are unrelated.

Q.    How can i get help with getting glasses for my son?

Schedule an appointment with an optometrist or ophthalmologist for an eye exam and to see if your son needs glasses.  For financial help in getting an eye exam or/and glasses, see the Past Featured Article (Click Here) on community resources, particularly in Ohio.  Many of these resources are also available in other states through similar named agencies.

Q.   My grandson is 15 months old and all of a sudden his left eye is turned in toward his nose at times both eyes cross. This has only happened since Christmas. He has gotten a doctors eye appointment, but I was wondering what it might be and if it is serious.

About 1% of children develop a condition called "accommodative esotropia" during the first few years of life.  In accommodative esotropia, there appears to be a mismatch between the ability of the eyes to turn-in (converge) when looking at near objects and the ability of the eyes to focus (accommodate) to near objects.  As a consequence, when a child looks at a close object s/he will turn-in the eyes too much and develop esotropia or "crossed eyes".  If the condition is left untreated the child could develop a lazy eye (amblyopia).  Treatment of accommodative esotropia usually involves glasses.

Q.    I am 23 years old and have very bad eye sight. I started wearing glasses for near sightedness at 10 and changed to contacts at 14. Since then my eyesight has went very down hill and I can hardly see without my contacts in my eyes. However, there is another problem that has been bugging me for many years. Every so often I lose the sight in my left eye. This occurs for about 5 minutes and then it goes back to normal. There is no pain, just inconvence of not being able to see out of one eye for a period of a few minutes. This occurs about every few months for many years now.  I am just wondering what could be causing this?   I have been to my eye doctor many times over the years, but he never noticed anything unusual when he examined my eyes.  Could it be a nutritional condition or is it due to my contact wearing?

Losing vision in one eye can be a symptom of a very serious, even life threatening, condition.  If you are sure that the loss of vision is only in   one eye, the chief symptom suggests a problem at the level of the left optic nerve or left eye itself.  Usually, temporary vision loss in one eye is suggestive of a vascular problem, probably the least serious being an ocular migraine or ocular transient ischemic attack.  Older individuals sometime suffer a temporary loss of vision in one eye because of a temporary blockage of the blood supply to the eye by a plaque or fatty type particle that has broken-off a blood vessel wall (sign of arteriosclerosis).  A temporary loss of vision could also be a sign of vascular/heart disease, high cholesterol and other disease processes.  It is unlikely that nutritional or contacts are the cause of the vision loss.   Suggest that you see a general practitioner (MD or DO) for a complete physical including blood work.

Q.    I have a small yellow dot on the inner corner of my eye that swells every now and again but i have 20/20 vision is it ok?

A pterygium is a common condition in which a small yellowish triangular patch of tissue, usually on the inner part of the whites of the eyes, develops and grows.  Go to the Q and A Archives and do a Find, under Edit on your Browser, for pterygium for more info on the topic.  Also, see an eye doctor about the problem to make sure that it is nothing more serious.  If it is a pterygium and it continues to grow, it could start to affect the cornea and need to be surgically removed.    

Q.    What ia EPI or retinal membrane with macular hole. And what causes this?

An epiretinal membrane is a thin layer of scar tissue that can develop on top of the retina and/or macula - the reading part of the retina.  It leads to reduced visual acuity and can cause distortions in vision.  There are a number of causes of epiretinal membrane, but it usually occurs in very nearsighted patients that have what is called a posterior vitrious detactment.  If vision is only mildly reduced it is best to leave the epiretinal membrane alone.  If vision is significantly affected, surgery can be performed to remove the membrane, although there are always risks with surgery particularly when the surgeon has to go inside the eye.  There is also a possibility that the membrane will grow back and lead to vision loss.

Q.   Is there any treatment anywhere for an eye with macular degeneration that is 2400?

You problably mean 20/400 visual acuity.  The answer depends on the type of macular degeneration (we assume it is age-related macular degeneration, but wet or dry?) and many other factors.  This is a question bet answered by your eye doctor who has all the needed information to fully address the question.

Q.   My father a young 80 year old; has over the past four years found that though his eyes focus clearly independently (he holds a hand over one eye to look at details) together the eyesight is blurred just enough to now start to be a problem. He feels that the problem probably is more to do with the messages from each eye starting to move at different speeds. Is there a name for this problem? What if anything could be done to balance the signal sending? I just spent several hours reading your wonderful archives but did not see anything which discussed this particular problem.

Your father is a smart cookie.  It is inde