My eye hurts

Subepithelial infiltrates (SEI). SEIs generally occur after viral keratitis, but are also found in blepharitis and contact lens-related hypersensitivity.   White blood cells from the limbal vasculature are drawn into the avascular cornea.

What is Inflammation?
Inflammation is the body’s response to protect tissues and organs. It is an efficient response caused by injury, infection, autoimmune processes or idiopathic conditions. During this process, the body’s white blood cells and other immune factors protect against foreign pathogens such as bacteria and viruses. In certain conditions, there are symptoms such as redness, warmth, swelling and pain.   Inflammation is best treated with a short course of steroids.

Contact Lens Overwear

Overwearing your contact lens can cause serious problems with corneal health.   Note the blood vessels growing onto the cornea, caused by lack of oxygen.  The white areas represent inflammation.     Contact lens wear must be discontinued and medications prescribed.    Contact lens wear can cause serious damage and injury to your eyes.   Annual examinations and appropriate follow-up care are required for safe contact lens wear.

A Lasik Complication

The total incidence of epithelial ingrowth was 4.7%. The incidence after primary treatment was 3.9%. The incidence after enhancement was 12.8%.

Epithelial cells may be implanted in the interface either during flap creation or may migrate under the flap after surgery. Epithelial ingrowth is the term for cells growing under the LASIK flap.   Most cases do not affect vision

What Contact Lenses Can Do to Your Eye

ulcer

If you over-wear your contact lenses or don’t properly clean and disinfect them, this is what can happen!    An episode of pain and light sensitivity due to inflammation, with the risk of serious bacterial infection.   This must be promptly treated and can result in a permanent scar.   Changing to DAILY DISPOSABLE contact lenses (thrown away after one day) is highly recommended.   Weekly or monthly wear increases your risk of this type of infection, 12.5 times over daily disposable wear.

What Shiny Yellow Spots Can Mean

By Dr. Yvonne Alomia

liverfailureRecently, I saw a 16 year old girl for a routine eye examination.  Last exam had been 2-3 years ago.   Her medical history was negative for everything.  Picture of her right eye’s retina is above.   Blood work by primary care physician shows she has HIGH LIVER ENZYMES but they don’t know why.    The shiny, yellow spots in the retina are called hard exudates. They are the lipid residues of serous leakage from damaged capillaries.   Causes are diabetes, retinal vein occlusion, angiomas (Von Hippel-Lindau Disease), other vascular dysplasias, and radiation-induced retinal vasculopathy.

More common causes of elevated liver enzymes include:

  1. Certain prescription medications, including statin drugs used to control cholesterol
  2. Drinking alcohol
  3. Heart failure
  4. Hepatitis A
  5. Hepatitis B
  6. Hepatitis C
  7. Nonalcoholic fatty liver disease
  8. Obesity
  9. Over-the-counter pain medications, including acetaminophen (Tylenol, others)

Branch Retinal Vein Occlusion: What You Should Know

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Your eyes are a direct reflection of your overall health. A dilation enables your doctor to see the optic nerve, the retina, and the blood vessels. Early diagnosis and treatment are important in glaucoma, which causes damage to your optic nerve and retinal nerves. Conditions such as diabetes and hypertension can affect the blood vessels, resulting in bleeding and leakage.

Last year, a patient came in for her annual exam, with no complaints or problems, but reported “good vision with glasses.” Peripheral vision testing revealed an unusual defect. Upon dilation, I found out that the defect was due to a branch retinal vein occlusion (BRVO).  This is a retinal vacular disease often linked to atherosclerosis, because the hardened retinal arteries cross over and put pressure on a retinal vein. When blood flow is blocked, retinal nerve cells die, resulting in loss of vision.

BRVOs are seen most commonly in patients whose blood vessel health is less than ideal.  In these patients, atherosclerosis (hardening of the arteries) leads to a thickening of the wall of retinal arteries and makes it more likely that an artery will push on a vein leading to an obstruction.  Factors that increase the risk for BRVO include high cholesterol, being overweight, and especially high blood pressure.

She required a full cardiovascular work-up, blood tests, and prompt attention by her primary care physician. Thankfully, the condition resolved, but she has lost some of her peripheral vision, and is followed closely by me, the retinal specialist, and primary care physician.

Contact Lens Overwear

Many enjoy the convenience and vision of contact lens wear.   However, contact lenses can cause lack of adequate oxygen to the cornea.    Symptoms include light sensitivity, tearing, feeling sand in your eyes, and blurred vision.   Contact lens overwear can cause abnormal blood vessels, shown below, onto the cornea, as well as abnormal corneal cells’ size and shape.   I recommend either changing contact lens material or decreasing the number of hours of contact lens wear.  Overwear can ultimately cause contact lens intolerance, where you will no longer be able to wear contact lenses.

hypoxia2

When Contact Lenses Cause Inflammation

infiltrateSometimes contact lenses can cause inflammation of the cornea, with an accompanying bacterial infection.  The white dot shown on the cornea above is an infiltrate, caused by bacterial inflammation.  Symptoms can range from mild discomfort, feeling like there’s something in your eye, tearing, and redness, to severe pain, light sensitivity, and decreased vision.  Corneal infiltrates must be treated right away to prevent corneal ulceration, which results in permanent scarring and vision loss.   Proper care of contact lenses is very important for the health of your eyes.

When Contact Lenses Harm Your Eyes

Q:   How can contact lens wear be a risk?

A:  Contact lenses are considered a medical device, which can put you at risk for serious eye infections 

Q:  Why does a contact lens prescription have a specified expiration date?

A:  Because the doctor must evaluate the health of your eye, to make sure that contact lens wear is safe for you.  If your eye health is being compromised by contact lens wear, then the doctor can’t give you the prescription or must set the expiration date accordingly.

Q:  How would the health of my eyes be compromised?

A:  If your eye doesn’t breathe properly due to the contact lens, blood vessels can grow onto the cornea.  Other complications are alternations in your corneal cells, inflammation of the cornea, thinning of the cornea, and reduced corneal sensitivity.  With any of these problems, you must discontinue or decrease contact lens wear.   The doctor may find another contact lens that will minimize these complications.   Eventually, these problems can lead to contact lens intolerance, where you will not be able to wear your contact lenses any longer.

Q:   How can I know if my eyes are being compromised by contact lens wear?

A:  By a physical examination of your eyes.   Just because you are an established contact lens wearer or do not have symptoms does not mean contact lenses are safe to wear!   And a “selfie” of your eye is not enough to determine whether your eye health is being compromised by contact lens wear.

when your eye has an allergic reaction to the contact lenses

when your eye has an allergic reaction to the contact lenses

Bausch & Lomb:   inflammation of the cornea

Bausch & Lomb: inflammation of the cornea

complications due to contact lens wear

blood vessels growing onto the cornea