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What would cause my bleb to enlarge? | If you are talking about a bleb resulting from glaucoma surgery then this is certainly a possible occurrence. The wall of the bleb can become thinned and stretched over time. This could result in discomfort, foreign body sensation or even loss of vision if the bleb encroaches on the cornea. If the bleb is enlarging but not causing any problems it can be observed. However, if you develop any of the above issues then a bleb revision surgery may be required. It is also important not to rub (or put pressure on) the eye containing a glaucoma bleb. | Given your profession as an ophthalmologist, please provide a detailed and comprehensive response to the question. | AAO |
I’ve suffered from dry eye for many years. Do cosmetic eyelash extensions applied with surgical glue aggravate dry eye? | Eyelash extensions do not specifically worsen a dry eye, however the glue can cause irritation and can aggravate an already irritated eye. | Given your profession as an ophthalmologist, please provide a detailed and comprehensive response to the question. | AAO |
How long post-scleral buckle surgery should I wait to get new prescription glasses? | Typically we wait between one or two months after scleral buckle surgery to recommend the change of glasses and refraction. | Given your profession as an ophthalmologist, please provide a detailed and comprehensive response to the question. | AAO |
I am both nearsighted and farsighted and began wearing my glasses full time about five years ago, at age 48. Is there any chance that my vision can get worse if I wear my glasses all the time? Do my eyes get more dependent on the prescription in the glasses? | The terms "nearsighted" and "farsighted" are confusing. Significantly nearsighted persons of any age can read without glasses, but vision of distant objects is blurred without glasses. Farsighted persons first need glasses to read and then, as they age, also need glasses for clear distance vision. Wearing glasses full time will not weaken your eyes or make your eyes physically more dependent on eyeglasses. We humans become somewhat psychologically dependent on our eyeglasses simply because we feel better and we function better when our vision is clear. | Given your profession as an ophthalmologist, please provide a detailed and comprehensive response to the question. | AAO |
Why do I have severe headaches with Fuchs’? | If you have Fuchs' heterochromic iridocyclitis (or Fuchs’ uveitis syndrome, an inflammatory disease affecting the front of the eye, where eyes also happen to have differently colored irises), you can get a headache when you have a flare-up of inflammation inside of the eye. During one of these episodes, inflammatory cells are circulating in front of the eye and it can be very painful for the iris to expand and contract in response to light. Sometimes, ophthalmologists prescribe medications to keep the eye dilated to help reduce the pain.If you have Fuchs' Corneal Dystrophy (a condition where cells in the front of the eye die prematurely, causing swelling and blurry vision) you can get associated eye pain, but it should not be a headache. In this condition, the cornea can swell and form bubbles on the surface that can rupture. This can feel similar to when someone suffers a corneal abrasion (scratches their eye). | Given your profession as an ophthalmologist, please provide a detailed and comprehensive response to the question. | AAO |
I would like to know where I can purchase prescription goggles for judo.Many of the better optical shops offer specialty eyewear that includes protective prescription lenses. | They are commonly used in ball sports like racquetball and handball. Judo is somewhat different than ball sports with regard to protection issues and may require special safety considerations, devices or both to keep the protective eyewear from being dislodged from your face during judo. I do not know where you live, but I am certain that if you begin calling the better optical shops in your area or speak with your ophthalmologist you will not have too much trouble finding suitable protective eyewear. | Given your profession as an ophthalmologist, please provide a detailed and comprehensive response to the question. | AAO |
What is staphyloma? | Staphyloma is the term for a thinning of the outer, white coat of the eye (the sclera) in which the underlying pigmented tissue then adds its color to the thinned sclera, giving an appearance of bluish to almost black color.Staphyloma occur in the front of the eye mostly as a response to trauma or infection in which the scleral architecture has been disturbed and the internal pressure of the eye stretches the weak point causing the protrusion and typical appearance. Rarely staphylomas can be caused by surgical weakening of the sclera at some point.Posterior staphylomas are more commonly congenital (at birth) or as a manifestation of more extreme myopia (nearsightedness). The congenital staphylomas occur near the optic disc which is commonly of normal size, but frequently the vision is substantially lowered in these cases.When related to myopia, the vision correction or disturbance is usually from the myopia alone although the staphylomatous protrusion in the back of the eye can contribute to visual distortion.There is no specific treatment for this condition but some have applied banked sclera to reinforce anterior staphylomas that appear threatening to erode into the eye.This question was originally answered on Apr. 19, 2012. | Given your profession as an ophthalmologist, please provide a detailed and comprehensive response to the question. | AAO |
What eye specialist would I see if I am experiencing temporary blindness in one eye or sometime both eyes? The blindness lasts one to two minutes and occurs about 20 times per year. Also, I have pressure sometimes at the same time as the blindness (feels similar to my eye being squeezed). | You need a comprehensive eye exam as soon as possible. Decreased vision can be a serious warning sign of eye disease. A comprehensive ophthalmologist can give you a thorough exam and recommend a specialist, if needed. | Given your profession as an ophthalmologist, please provide a detailed and comprehensive response to the question. | AAO |
How many types of glaucoma are there? I've been told I may have a more rare type of it. My only symptoms are loss of peripheral vision. | There are over a hundred types of glaucoma. Almost all of them begin with loss of peripheral vision, rather than central vision. An evaluation by an ophthalmologist can help to determine if you have glaucoma. | Given your profession as an ophthalmologist, please provide a detailed and comprehensive response to the question. | AAO |
Are there activities that make glaucoma worse? | If you have glaucoma, talk to your ophthalmologist about what you should and shouldn't do to get the most out of your glaucoma treatment. Your doctor can make recommendations that are specific to you and your lifestyle. But there are a few things that everyone with glaucoma should be careful about. Andrew Iwach, MD, tells you what lifestyle choices should go along with a glaucoma diagnosis. | Given your profession as an ophthalmologist, please provide a detailed and comprehensive response to the question. | AAO |
If you have limbal relaxing incisions for astigmatism with cataract surgery, does it change the recovery process of the surgery? | While a normal cornea has the shape of a slightly peaked dome, similar to the smaller end of an egg, we often talk about the cornea as a round sphere like a basketball. Astigmatism is the name we give to a cornea that looks more like a football than a basketball. For example, if you picture a football lying on a clock face with the long axis running from 3:00 to 9:00, the curvature is steeper in the axis at 12:00 on the clock face and flatter in the axis at 3:00, 90 degrees away. This is called “regular” astigmatism.This difference in the curvature produces two or more focus points on the retina which creates blurred vision. Eyeglasses and contact lenses are used to correct astigmatism and can produce excellent vision. There are times when a person might wish to correct his/her astigmatism with surgery to remove this astigmatism and it is common to do this at the time of cataract surgery, either with a toric implant lens or with limbal reading incisions. However, if the axis of astigmatism does not line up to make a perfect cross (perpendicular lines) then it is called “irregular” astigmatism and may require a hard contact lens or corneal surgery to correct.Limbal relaxing incisions correct regular astigmatism by flattening the overly steep curves in the cornea. The ophthalmologist can make these incisions by hand with a tiny blade or with a laser. Since relaxing incisions are an elective procedure, most insurance programs consider them to be cosmetic in nature and do not cover the added cost of this procedure.There are really two different aspects to recovering after cataract surgery: one that deals with the healing of the eye and the other deals with the final clearness of vision. The “recovery” from surgery is not prolonged with the relaxing incisions. There can be a mild scratchy feeling for a few days, but this seldom causes any recovery issue. The final visual sharpness you will have after cataract surgery can take a bit longer with astigmatism-correcting incisions. The cornea takes a little more time to stabilize after relaxing incisions, but this usually happens within a few weeks, depending on the degree of astigmatism. | Given your profession as an ophthalmologist, please provide a detailed and comprehensive response to the question. | AAO |
I put colored contacts in my eyes that I bought from a store and have put them in a few times. I wore them for two days and now my eyes are burning and I can hardly keep them open. Should I see a doctor or will this go away on its own? | Contact lenses should be fit only by licensed professionals. Stores, beauty salons, flea markets are usually breaking the law and endangering the public when they sell lenses which are not fit by doctors. See an ophthalmologist right away. Do not wear the lenses unless the doctor says it is safe after examining you. Unlike skilled professionals, stores do not have the skills to properly fit the lenses and often do not train the users in proper removal and insertion techniques and sterilization techniques. They exist to make sales, whereas doctors are primarily interested in your health. Please report the people who placed you in jeopardy to the police and health department in your area and alert your friends (since that is where you probably got this bad advice) to the dangers. Many serious eye injuries and infections occur in this country every year due to unlicensed sales of contact lenses, and you can help prevent this form of unnecessary blindness by reporting the perpetrators and warning your friends. We see a lot of this around Halloween! | Given your profession as an ophthalmologist, please provide a detailed and comprehensive response to the question. | AAO |
I have had myopia since I was 8 years old. I have annual eye exams by ophthalmologists and wear contacts most of the time, but at home I wear glasses. I am 35 years old and my prescription is -11 and still has not stabilized. I am concerned since myopia usually stabilizes by the 20s or early 30s. Is there a specialist I should go see? | Myopia, or nearsightedness, is caused by the power of the eye being too strong, where the light rays that enter the eye focus before reaching the retina. It is caused by either a long eyeball (called axial myopia) or excessively curved cornea.Myopia is divided into pathologic and non-pathologic myopia. In non-pathologic myopia, the power of the eye is too strong but without any significant abnormalities in corneal shape or eyeball length. In pathological myopia, there may be abnormalities causing excessive stretching of tissues of the eye resulting in abnormalities in corneal shape or length of the eye. A dilated eye exam is needed to look for outpouchings of the retina (known as a posterior staphyloma) and for breaks in the retinal tissue indicative of myopic degeneration. In addition, patients that have high levels of myopia are at increased risk for developing retinal tears and glaucoma.You should see your ophthalmologist to determine if you have any signs of conditions associated with pathological myopia. They may also refer you to your primary care physician to screen for certain disorders that are associated with high myopia, such as Marfan or Ehlers-Danlos Syndrome. | Given your profession as an ophthalmologist, please provide a detailed and comprehensive response to the question. | AAO |
My sister, who has been told she will need cataract surgery, was informed that she would need an allergy test first. Is this a required test that can be conducted by an eye doctor? | Cataract surgery is a procedure in which a clouded lens is removed from the eye and replaced with an artificial intraocular lens to restore clear vision. I am not sure of the reason for the test unless she has shown possible allergies to some of the drugs or equipment used for the surgery. An allergist or an eye doctor should be able to perform these tests as long as they know what they are testing for. An allergist would need access to the drugs or items that the ophthalmologist will be using for the surgery and these would not be something that they would have access to for typical testing. | Given your profession as an ophthalmologist, please provide a detailed and comprehensive response to the question. | AAO |
I have cataracts, dry eyes, and astigmatism. I am confused as to whether laser or traditional cataract surgery is best for me with my dry eyes. Is there a significant difference between them in regard to post-operative vision and dry eye symptoms? | Some physicians prefer laser–assisted cataract surgery, and some do not.The data do not yet show a clear benefit of one over the other. More important here is that you identify your goals and if you want better uncorrected distance vision you may consider a toric IOL to correct astigmatism. If you would like to possibly be much freer from glasses and read without glasses, then a toric IOL that is also a multifocal or extended depth of focus toric lens may be able to accomplish this.Once you decide on your IOL, then laser assisted or conventional surgery are both fine and you can decide with your surgeon. | Given your profession as an ophthalmologist, please provide a detailed and comprehensive response to the question. | AAO |
How easy is it to spread genital herpes to the eyes? I accidentally touched a sore and then my eye without rinsing first, and I have been panicking since. The only symptoms I have had is some eye pain. No red eye, discharge, or blurred vision. What are the chances this happened? I have an annual eye exam in early October. Am I fine to wait to express concerns? | The chance of transmitting the herpes simplex virus (HSV) from physical contact with an active flare-up in one site of the body to infect another site of the body is very low.After someone has been first infected with HSV, called the primary infection, the body creates an immune response against the virus that prevents another primary infection at another site. Antibodies against the virus are found circulating in the blood years after the initial infection. Even after the primary infection is treated, the virus itself is not gone. It stays in a latent state within the nerve supplying the area of the body where the primary infection occurred.Thus, reactivations are usually in the same part of the body. Sometimes, reactivations of the virus occur in a different region, but are still supplied by the same nerve (for example patients with a history of cold sores around their lips get a reactivation in their eye).In any case, while it is difficult to externally transmit the herpes virus from one place in your body to another, one can easily transmit the virus to another person so appropriate precautions must be followed. Even if someone already has one strain of the virus, they can again be infected with another strain and thus can have both genital and oral herpes.Although unlikely, they only way to know if you did spread the virus would be to see your ophthalmologist sooner.This question was originally answered on Aug. 10, 2017. | Given your profession as an ophthalmologist, please provide a detailed and comprehensive response to the question. | AAO |
I recently had cataract surgery with wonderful crisp, clear vision after the first cataract extraction. However, the second surgery has resulted in blurry vision. Could the postsurgical complications in my second eye be caused by my pseudoexfoliation glaucoma (which I treat with Timolol eyedrops)? I am returning for a postsurgical checkup on this second eye in one week. I hope I do not have a secondary cataract. | It is unlikely that the glaucoma is directly responsible for the blurring. There are a multitude of reasons that postoperative vision may be blurry, and many of these resolve spontaneously. I am confident that your ophthalmologist will evaluate you thoroughly on your return visit. Should your vision continue to deteriorate significantly, you should return earlier. | Given your profession as an ophthalmologist, please provide a detailed and comprehensive response to the question. | AAO |
I just had cataract surgery on my left eye, which was set for distance. My doctor said if I got both eyes done for distance I will just need glasses to read. However, I am unable to focus on a computer screen with my corrected eye. The doctor now tells me I will lose my close vision to 6 feet out. I am considering having monovision to have the other eye corrected for near vision. I am not sure if they corrected my dominant or non-dominant eye for my distant vision. When I test for the dominate eye my left eye is dominate. Is this eye really dominant or is it now because I had it set for distance vision? I am confused. | This is one of those questions that does not lend itself well to email answers. You need a comprehensive examination by your ophthalmologist and the opportunity to ask all of your questions, but I will try to help you learn more about this complicated question. There are basically three distances of vision: far, intermediate (computer) and near. There is no intraocular lens made that gives excellent vision at all 3 distances. It sounds like you now have good distance vision in your left eye. The question seems to be what would be the wisest course for your right eye and how does that relate to your dominant eye. The notion of setting one eye for distance and the other for near is called monovision. Some of us prefer to do a mini-monovision, whereby a person has good distance vision in one eye and intermediate (computer) vision in the other. Glasses might still be needed for small print. We prefer to set the dominant eye for distance, but sometimes it gets reversed for one reason or another. As long as the difference between the two eyes is slight, most people can adapt to the subtle difference between the two eyes either way. You need to thoroughly discuss this issue with your ophthalmologist. He/she can easily determine your dominant eye and can do a contact lens "test drive" to allow you to see what monovision and mini-monovision would be like. | Given your profession as an ophthalmologist, please provide a detailed and comprehensive response to the question. | AAO |
I recently had a contact lens biomicroscopy exam which resulted in my eyes being very red and painful for an hour or two. Shortly afterwards I developed my first eye floaters. Could this exam have caused an anterior inflammation that in turn caused the floaters in my eyes? I am under 30 and otherwise do not have any vision problems. | There are times that your ophthalmologist will need to place a lens directly on the surface of the eye to examine particular structures. Although rare, a small corneal abrasion or scratch can occur. This can occur more commonly if you have preexisting dry eyes or other corneal abnormalities. Floaters are not associated with this type of examination. Floaters generally appear after a vitreous detachment, or retinal detachment. In younger people, who are not nearsighted, floaters may occur due to severe inflammation in the vitreous, vitreous detachment, or retinal detachment. Inflammation of the vitreous is generally painless, but associated inflammation of the choroid or iris (the pigmented parts of the middle layer of the eye) may cause pain and redness and decreased vision—this will not resolve spontaneously. A vitreous detachment is a spontaneous separation of the vitreous (the gel substance in the eye that is attached to the retina) from the retina. A retinal detachment is when the retina separates from the eye. I suggest a dilated eye examination by your ophthalmologist to evaluate the vitreous and retina. | Given your profession as an ophthalmologist, please provide a detailed and comprehensive response to the question. | AAO |
Once the IOL measurements are taken for cataract surgery, can I wear my contacts while waiting for the actual surgery? | Yes, you can wear your contact lenses after the measurements have been taken. | Given your profession as an ophthalmologist, please provide a detailed and comprehensive response to the question. | AAO |
My wife cannot have any sedation. Can she have cataract surgery without sedation? She has had other eye procedures performed with only local anesthesia. | Cataract surgery is usually done with local/topical (eye drops) anesthesia. She may have some slight discomfort at the beginning of the surgery, but many patients decide to have no intravenous (given into the vein) sedating medications. | Given your profession as an ophthalmologist, please provide a detailed and comprehensive response to the question. | AAO |
Can all lens implants be removed and replaced or are there some types that cannot? | Most, but not all, intraocular lens implants can be removed and replaced if it is medically necessary. Most insurances will only cover the cost of such an exchange in the event of a very compelling medical or optical necessity, not for convenience or small improvement in sharpness of focus. Every operation has risks and an implant exchange can be somewhat more risky if the implant is scarred into place, has had a YAG laser treatment, or some other concerns. I suggest you proceed only with the greatest of thought and consultation with your ophthalmologist. | Given your profession as an ophthalmologist, please provide a detailed and comprehensive response to the question. | AAO |
What does it mean when an eye doctor says he cannot see the back of your eye? | The eye is like a camera and has a front part and a back part. The front part is what you see when you look at a person’s eye. The back part is inside the eye and your ophthalmologist uses special instruments to see these structures. Think of it like looking through a window into a room of a house. If the window is very dirty or even blocked by a curtain, you will be unable to see the inside of the room. If there is no light inside the room you will not be able to see inside the room. Eye conditions such as cloudy cornea, cataract, and blood inside the eye are but a few of the conditions an ophthalmologist might encounter that would make a complete examination of the eye difficult. I urge you to discuss this problem more fully with your ophthalmologist. | Given your profession as an ophthalmologist, please provide a detailed and comprehensive response to the question. | AAO |
I contracted viral meningitis four weeks ago and was hospitalized for a week. The pain and swelling in my skull and neck still remain with constant pain in my eyes. I have light sensitivity, wear sunglasses everywhere and cannot watch TV without having flashes of black or white light. Can this be a sign of permanent eye injury from the virus? | If this is happening at the same time in both eyes, or even in each eye separately, the likelihood is that the source is in the brain, not the eyes, given your history. For simplicity, consider the eyes to be cameras (which take pictures) and the brain to be the screen or monitor on which the images appear and are interpreted. The “meninges” are the coverings of the brain and have been inflamed and irritated by the viral infection which you suffered. Just as a cough can last for weeks after a viral infection, the visual areas of the brain can be irritated for quite a while after the infection has resolved. Please keep in touch with your neurologist during this period.On the other hand, viruses can affect the eye either through the bloodstream or by travelling along the meninges, which cover the optic nerve. If only one eye is affected, it should be checked by your ophthalmologist, especially if there is pain, redness, or blurred vision. | Given your profession as an ophthalmologist, please provide a detailed and comprehensive response to the question. | AAO |
Can toenail fungus cause a fungal infection in the eye if you get a toenail clipping in your eye? | Introduction of bacteria, fungi, and viruses can all cause corneal infections if they are able to bypass the initial defenses of the corneal epithelium (the outermost layer of the cornea). The epithelium can be compromised in many situations, including severe dry eyes, a corneal abrasion, or contact lenses,. The corneal epithelial cells are bound together very tightly to help prevent foreign organisms from gaining access to the deeper parts of the cornea. In addition, our tear film contains protective enzymes that help break down organisms before they cause trouble.In other words, generally, exposure to a foreign organism alone is not enough to cause a corneal infection, but the eye's natural defenses would also need to be compromised. However, if you do have an exposure of your eye to bacteria or fungi, you should see your ophthalmologist to confirm that your eye is not at risk. | Given your profession as an ophthalmologist, please provide a detailed and comprehensive response to the question. | AAO |
I had an accommodative lens placed in one eye. What are the ramifications if I opt to have a monofocal lens placed in the other eye? | It depends on which type of accommodative lens you had placed and if you are happy with your vision in that eye.In the U.S., we currently have the Tecnis multifocal lens, the Restor multifocal lens and the Crystalens. If you have a Crystalens implant, a monofocal lens placed in the other eye is fine because it uses pseudo-accommodating effects which do not have a negative impact on vision if a monofocal lens is placed in the opposite eye.The other two multifocal lenses provide better quality of vision when they are implanted in both eyes since they both use diffractive optics where light is bent in different ways to provide near and distance correction. A monofocal lens in one eye and multifocal in the other eye can be performed but it sacrifices the advantages of both lenses and you run the risk of decreasing visual quality since each eye now uses a different optical system for vision correction. If you are not happy with the accommodative lens because of poor contrast sensitivity or decreased visual acuity, you may want to consider an intraocular lens exchange for a monofocal lens and then the second eye can easily have a monofocal lens. If you are happy with vision in the accommodative lens, it will give you better optics, better contrast and allow the eyes to work better if each eye has the same type of optical lens in place by having an accommodative lens placed in the second eye. | Given your profession as an ophthalmologist, please provide a detailed and comprehensive response to the question. | AAO |
I need some information on frontalis sling: When is this done and how comfortable is it? What is the success rate? What are the advantages and disadvantages of having this done? | Frontalis slings are one surgical approach to the repair of a droopy eyelid or ptosis (TOE-sis). Ptosis occurs when the muscles that lift the eye are diseased or stretched out. The vast majority of people with ptosis develop it as adults as part of the natural aging process. In these individuals, the muscle still works, but because it has stretched out with age, the lid is lower at rest and it takes more effort to keep the lid high enough to see out your eye. Surgery to fix this condition involves tightening or shortening this muscle in order to raise the lid's resting position.In cases where the muscle is diseased (usually children born with it or adults who develop degenerative nerve or muscle disease), not only is the lid lower, but the muscle is unable to lift the lid very much at all. People whose lid muscles are diseased in this way find that they can lift the lids somewhat by using their forehead muscle (the frontalis muscle) to lift the brows which in turn lifts the lid a little bit as well. These are the people for whom frontalis slings are a good surgical choice. A sling is a loop of material that is threaded beneath the skin between the eyebrow and the lid skin just above the lashes. When this loop is tightened, like a purse string, it makes it easier for the forehead muscle to lift the lid. The loop can be made of sutures, artificial strips, donor tendon, or even tendons obtained from the thigh of the patient him or herself!Success of this procedure is defined by an improvement in the lid's resting position but this will depend entirely on the patient's ability and willingness to use the forehead or frontalis muscle. Without this effort, the lid will, in most cases, still look droopy. In most cases, patients who have slings performed will, at least initially, have trouble closing the lid and will have a limited spontaneous blink. It is important to keep the eye moist during this time with over the counter eye drops and moisturizing ointments. These lid movement limitations typically improve with time but when needed on only one eye, a certain amount of imbalance between the two upper lids is usually unavoidable after a sling procedure.People who need frontalis slings have the most complicated and severe types of droopy lids. Ophthalmologists who perform this type of complex ptosis repair typically have specialized training in plastic and reconstructive surgery of the eye, eyelids, tear system and eye socket. You can get more information by consulting with this type of oculoplastic specialist for particular answers to your individual concerns. | Given your profession as an ophthalmologist, please provide a detailed and comprehensive response to the question. | AAO |
Do babies need 50 times more light or 50 times less light to see what an adult sees? Also, do babies see color at birth? | Babies need just about the same level of light you require. Keeping them in a very bright environment sounds dangerous to the eyes, while too dark means they cannot see what is going on in their environment. The system for detection of color is present at birth and although they cannot tell you what color they see they do have an appreciation of it. | Given your profession as an ophthalmologist, please provide a detailed and comprehensive response to the question. | AAO |
I was just prescribed erythromycin ophthalmic ointment and wanted to know if it is safe to put in a pair of my daily disposable contact lenses 15-plus minutes after using the drops. I currently don’t have a pair of glasses in my prescription and I need to be able to see for work. Is it safe to do this? | Generally, ointments and contact lenses don’t work well together. The ointment may cause the contact lens to not position or move correctly. It may also coat the lens in such a way as to cause blurring. I wouldn’t say it is not safe though—and that is your question. However, I would want to know what the condition is that is being treated by the ointment. The underlying condition may be aggravated by contact lens use and that may cause complications or be “unsafe.” Ask your ophthalmologist or other physician for guidance regarding contact lens use alongside your prescribed medication. | Given your profession as an ophthalmologist, please provide a detailed and comprehensive response to the question. | AAO |
Can exposure to chemicals used to clean aircraft cause damage to the meibomian gland? | Some chemicals can harm the eye. Chemical exposures to the cornea and the conjunctiva (such as during a splash injury or through the air) can cause irritation, redness, tearing, and blurred vision. Commonly-used preservatives such as thimerosal or benzalkonium chloride have been found to be harmful to the surface of the eye.There are certain chemicals, like polychlorinated biphenyls (PCBs), that have been found to cause dysfunction of the meibomian glands (an oil gland in the eyelid that keeps the eye from becoming too dry) themselves. PCBs were used as coolants or lubricants for electrical equipment until they were banned in the United States in 1977. Toxaphene was used in insecticides until it was banned in 1990. It was also found to cause meibomian gland dysfunction along with other health side effects.There are likely many other chemicals that can cause meibomian gland damage but are not yet known. Without knowing what chemical you were exposed to, it’s difficult to say if it was harmful. If you are concerned, please see your eye care professional for an evaluation. | Given your profession as an ophthalmologist, please provide a detailed and comprehensive response to the question. | AAO |
I have a high myopia (nearsightedness) of -22 in my right eye and -24 in my left. I’m 21 years old and I have been using thick glasses. Are contact lenses available with this prescription? | There are stock soft lenses available in powers of up to 20.0 diopters that I know of. That may work because the glasses prescription in this case will be significantly higher than the contact lens prescription. Above that, power custom soft lenses or rigid gas permeable lenses can be fabricated. | Given your profession as an ophthalmologist, please provide a detailed and comprehensive response to the question. | AAO |
I developed flashes and floaters. I went to an eye specialist and had a complete exam of my eye after it was dilated. Do you think it is usually safe to fly if the retina is not detached, but you are still getting flashes? | Yes, you can fly in an airplane. The only time flying isn’t safe is when you have a gas bubble or air bubble in your eye after retina surgery. That is because rapid changes in air pressure during flying can cause problems with the bubble. | Given your profession as an ophthalmologist, please provide a detailed and comprehensive response to the question. | AAO |
I had cataract surgery on my right eye 2 days ago. The first day after I could see everything—close up and at a distance. Now on day three, that seems to have diminished, and although the "cloudiness" is gone, vision doesn't seem as good either up close or far away as it was the day after. Is this normal? | As the new lens implants settles into position, your vision will naturally change somewhat. As inflammatory cells subside and edema (swelling) resolves, your vision should stabilize and your surgeon will be able to judge whether fine tuning with glasses or additional surgery is necessary. | Given your profession as an ophthalmologist, please provide a detailed and comprehensive response to the question. | AAO |
My wife is using Gatiquin P eye drops after cataract surgery for the last 5-6 years. Is this OK or are there other drops she should use regularly? Her eyes sometimes tear and can be a little painful. | Gataquin is an antibiotic/steroid combination drop that should not be used long-term unless there is a specific reason. In addition, an ophthalmologist should be monitoring her eye pressure regularly. Ask her ophthalmologist if there are other drops they recommend to treat her symptoms. | Given your profession as an ophthalmologist, please provide a detailed and comprehensive response to the question. | AAO |
If my prescriptions barely differ between each eye, can I buy a box of contacts for one eye and use them for both? | To get the sharpest vision in both eyes and lower the risk of eye strain, it is recommended to use the exact prescription recommended by your ophthalmologist. Wearing an incorrect prescription may impair vision, especially if you are under-correcting your dominant eye. Overcorrecting one eye can lead to symptoms of eyestrain including headache, fatigue, and blurred vision.In some cases, though, ophthalmologists intentionally give a slightly lower prescription than measured in one eye to counteract the effects of presbyopia (age-related loss of near/reading vision). You should discuss your concerns with your ophthalmologist to see if there’s an acceptable solution. | Given your profession as an ophthalmologist, please provide a detailed and comprehensive response to the question. | AAO |
I had a new eye test just one day before my retinal detachment surgery. Will the sight in my operated eye change or can I order my new glasses? | There is a reasonable chance that you will need a change in your glasses correction as a result of the retinal detachment surgery. Regardless, I would recommend holding off on ordering your new glasses until your eye has stabilized after the surgery. | Given your profession as an ophthalmologist, please provide a detailed and comprehensive response to the question. | AAO |
I’m 72 and had a hemorrhage (bleeding) behind my macula, which caused a blind spot in my eye. How can I make the blood reabsorb back into my system so that I can retain some of my vision? I cannot read due to the blind spot. I am doing the injections into my eye now but wonder if healing to regain reading vision is possible. | The best treatment for reabsorbing the blood and returning to reading vision will be injections of anti-VEGF drugs. There are no other treatments that have demonstrated significant benefit. Unfortunately, while this treatment is highly effective at preventing further vision loss, there are a limited percentage of patients that regain reading vision. | Given your profession as an ophthalmologist, please provide a detailed and comprehensive response to the question. | AAO |
Can retinal diseases affect the distance between the retina and lens and induce myopia? For example, if central serous retinopathy is "resolved" as much as possible, would you retain prior visual acuity, aside from retinal damage? | Yes. In any condition where the sensory retina (light sensitive tissue lining the back wall of the eye) is elevated, like in central serous retinopathy, the distance between the lens and the retina is altered. This changes the focusing power of the eye and can make you less nearsighted (i.e., less myopic). When the condition improves and the retina returns to its normal position, you should regain prior focusing power assuming there has been no retinal damage. Retinal diseases, including central serous retinopathy, may damage the retinal cells that generate vision, and even if the swelling goes away returning the retina to its normal position, the vision may still remain impaired. | Given your profession as an ophthalmologist, please provide a detailed and comprehensive response to the question. | AAO |
I have RGP hard contacts and am allergic to most all solutions (I use peroxide based cleaning solutions now which work great). Can I use diluted saline for eye drops for RGPs? And if so, what ratio of water to saline should I use? I am allergic to all other rewetting drops I have tried. | Rigid Gas-Permeable (RGP) contact lenses require more rigorous care than soft contact lenses since they are not disposable. For cleaning the lenses of protein deposits, follow your ophthalmologist's recommendations, but an enzymatic cleaner such as a hydrogen peroxide–based solution is a great choice. Artificial tears or rewetting drops can make RGP lenses more comfortable. A key aspect of these drops is they are made in a sterile environment and are free from bacteria. You should not try to make your own saline solution as non-sterile (i.e., tap) water can contain bacteria such as Acanthameoba. These bacteria are very resistant and can form cysts when they enter the eye. There have been multiple outbreaks of severe infections in the past 30 years from people trying to make their own saline solution. If you are allergic to a chemical in various over-the-counter drops, you should ask your ophthalmologist to recommend preservative-free formulations of artificial tears that you may not have tried. | Given your profession as an ophthalmologist, please provide a detailed and comprehensive response to the question. | AAO |
Two days ago I was diagnosed with bacterial pink eye and was prescribed Ciloxan. Am I allowed to go in the sun while having pink eye? I live in Florida and was thinking of laying out in my back yard, since I am pretty much confined to my house for the next few days until my pink eye subsides. | Yes, you can sit in the sun. The sun will not impact the pink eye. Bacterial pink eye is unusual compared to the viral form. | Given your profession as an ophthalmologist, please provide a detailed and comprehensive response to the question. | AAO |
Is it possible for me to get contacts if I only have one eye? I lost an eye to cancer. | There are no restrictions on the use of contacts for those with one eye. Many do this in your circumstance and others who have poor or no vision in one eye also do this. Having one eye places an extra burden on you to be very cautious about the care of the lens and the underlying normal eye. Be sure to clean and replace the lens as instructed by the manufacturer. Also, remove the lens if there is the least sign of redness or change in comfort. Remember also to wear safety glasses over the contact, or even when not using the contact, to protect your only working eye. | Given your profession as an ophthalmologist, please provide a detailed and comprehensive response to the question. | AAO |
After noticing a small brown patch (1 mm at most) on the white of my eye a month ago, I visited an eye doctor who said it is just a nevus (a mole-like growth on the eye) which only required observation in case it changes. Is it unusual to be diagnosed with a nevus on the sclera (white of the eye) at 27 years old? It seems I'm reading a lot are typically present at birth. | You are correct. Conjunctival nevi are areas of increased pigmentation on the surface of the eye that are present from birth. Changes in appearance of nevi are concerning and should be evaluated by your ophthalmologist. Newly arising pigmentation can also occur. One condition, Primary Acquired Melanosis (PAM), reported in up to 36 percent of light skinned individuals, is where new patches of pigmentation arise on the surface of the eye. Occasionally these lesions contain atypical cells that can progress to melanoma (cancer) and therefore should be evaluated by your ophthalmologist. Similar pigmentary changes in dark-skinned individuals almost never progress to melanoma and are known as Benign Epithelial Melanosis or Racial Melanosis. New pigmentation changes can also be due to medications, chronic ocular surface inflammation, or hormonal abnormalities such as in Addison's Disease. Your ophthalmologist will evaluate each lesion looking for any concerning characteristics that would warrant a biopsy (when a small sample of cells is removed and tested in a lab). They can be followed by serial eye exams (seeing your doctor regularly—once a year or more often) or with photographs. If you are concerned about any lesion in your eye, let your ophthalmologist know. | Given your profession as an ophthalmologist, please provide a detailed and comprehensive response to the question. | AAO |
Why would an eye chart exam be done after eye dilation? | Visual acuity (the sharpness of vision) is usually measured as the first part of an eye examination. If you normally wear glasses or contact lenses, your vision will be checked with these lenses. Your distance vision may also be checked without lenses to see if you meet the criteria in your state to drive without corrective lenses. Visual acuity is checked using the distance eye chart and a near (reading) card. A refraction may be done to see if your vision can be improved with a change in your lenses.Vision may be checked again after dilation if your pupil is extremely small or if there is cloudiness in your cornea or lens that might block your vision with a normal size pupil. A refraction may also be repeated after dilation to confirm your glasses prescription. Certain dilating drops temporarily paralyze your focusing muscles so your ophthalmologist can more accurately determine how much glasses correction you need. This is called a “cycloplegic refraction” and is frequently necessary in children and young adults. | Given your profession as an ophthalmologist, please provide a detailed and comprehensive response to the question. | AAO |
My 69-year-old sister had a corneal infection. Can this affect your brain? She is not herself and her brain isn't working right. | If the infection stays confined to the cornea, it cannot spread to the brain. If the infection spreads into the back portion of the eye, this is referred to as endophthalmitis. In rare instances, an infection in the eye can spread to the brain if it has caused endophthalmitis; however, this is very rare. A specialist should be able to keep the infection confined to the front of the eye with topical and/or systemic antibiotics depending on what has caused the infection based on cultures of the cornea. | Given your profession as an ophthalmologist, please provide a detailed and comprehensive response to the question. | AAO |
Is there any way to lower eye pressure using home remedies? | Eating a healthy diet can maintain your overall health and may be good for your eye health as well. Regular exercise has been shown to reduce the eye pressure in some individuals with open angle glaucoma. Many herbal remedies are advertised for glaucoma but none have been proven effective in treating this potentially blinding disease. Herbal supplements should never be used in place of proven therapies that are prescribed by your doctor. You should always discuss any of these types of treatments with your ophthalmologist before trying them.This question was originally answered on Dec. 11, 2013. | Given your profession as an ophthalmologist, please provide a detailed and comprehensive response to the question. | AAO |
I use three eye drops: artificial tears, antibiotic, and corticosteroid drops. Which should be used first? | There is no strict or recommended order for instilling drops, but the artificial teas should be used last to minimize the “wash-out” effect.After instilling each drop, be sure to allow two to five minutes before using the next one, and close the eyes while applying gentle pressure to your tear ducts (where your eyelid meets nose) to make sure the drop is fully absorbed inside the eye. Also, some steroid drops need to be agitated (shaken) before using because they come in a suspension formula. Ask your doctor or pharmacist for specific instructions for using your drops. | Given your profession as an ophthalmologist, please provide a detailed and comprehensive response to the question. | AAO |
I had cataract surgery and a mono lens implant on my left eye three weeks ago. Since then I have been disoriented and nauseous. My right eye is almost 20/20 and I have not done surgery in that eye yet. I had to get stronger reading glasses after the surgery. What is making me so nauseous? After a day of working on the computer, I want to vomit. | The difference in correction from the distance eye to the now near eye may be a bit much for you to handle — about two diopters is all that most can tolerate. See where you are with your ophthalmologist and if there is too much difference, consider LASIK to bring the eyes a bit closer together (less nearsighted in the mono near eye). | Given your profession as an ophthalmologist, please provide a detailed and comprehensive response to the question. | AAO |
I have pink eye and the doctor gave me erythromycin ointment which I’ve been using for 3 days, but it is still red. How long does it take before it starts clearing up? | There are many causes of acute and chronic conjunctivitis. This question would have very different answers depending on the cause of your "pink eye." If your pink eye is caused by a common bacteria, your signs and symptoms should be self-limited and disappear within seven to 10 days. If your condition is caused by a virus and your ophthalmologist is treating any bacterial agent that might be accompanying the viral conjunctivitis, it might take a few weeks to resolve.But, this question is best asked of your ophthalmologist. He or she will understand your disease and be able to answer your questions much better. Your question has too little information for me to give you an accurate answer. | Given your profession as an ophthalmologist, please provide a detailed and comprehensive response to the question. | AAO |
What is the best way to get rid of protein deposits on hard lenses? | Protein deposits need to be periodically removed from rigid gas permeable contact lenses using an enzymatic cleaner. This cleaner is different than the normal disinfecting and storage solution. Your eye care professional will discuss with you how often to use the enzymatic cleaner depending on the amount of protein deposited on the lens. Most patients need to use the cleaner weekly or monthly but others need to use it daily. | Given your profession as an ophthalmologist, please provide a detailed and comprehensive response to the question. | AAO |
I'm going to have cataract surgery soon, and I have to make a decision about what type of lenses to have implanted. What do I need to know to make the right decision? | Intraocular lenses (IOLs) are plastic lenses that are surgically implanted in the eye to replace the eye's natural lens that has become cloudy as a result of the cataract. They are designed to help your eye regain focusing and refractive ability.Currently, there are three kinds of IOL available:Multifocal and accommodative lenses can also be used to treat myopia, hyperopia and presbyopia. In addition, they enable a person to rely less on glasses and/or contact lenses to see clearly at both near and far distances.You should discuss your options with your ophthalmologist so that you can decide together what type of lens is suitable for you. | Given your profession as an ophthalmologist, please provide a detailed and comprehensive response to the question. | AAO |
I had good far vision and bad near vision before cataract surgery. After the surgery my near vision is fine but my far vision is not as good as it used to be. Is that normal? | With modern cataract surgery, your surgeon can often set the vision at any distance. It is popular to leave older patients with good near vision in some cases and have them wear glasses for distance tasks. Ask your surgeon what the plan is or was. | Given your profession as an ophthalmologist, please provide a detailed and comprehensive response to the question. | AAO |
What is the best way to put drops into your eyes? I blink a lot and have small eyes. When I put the drops in they seem to end up on my eye lashes. | You are not alone in your difficulty in applying eye drops. I advise my patients to shake their drops vigorously for a minute or so prior to using them. Next I advise them to lean their head back and look up to some spot on the ceiling. One hand pulls the lower eyelid down as the other hand, with the drop, attempts to deposit the drop in the space between the eyeball and the lower lid. Remember, if you miss with the drop, you can always try again. You will not overdose yourself with an eye drop. Another suggestion is to put the drops in the refrigerator. It makes the drops cold and one can more easily feel the drop when it hits the eye and know that you have been successful in the placement of the eye drop. | Given your profession as an ophthalmologist, please provide a detailed and comprehensive response to the question. | AAO |
Can an immunocompromised immune system cause blurry vision? I have Lyme disease (bacterial infection causes by the bite of a tick), Morgellon's (a poorly understood skin condition) and MRSA (a bacterium that causes infections in many parts of the body). I suspect these things are contributing. | None of these diseases should have a direct effect on vision. Lyme disease can, in some circumstances, cause eye inflammation (uveitis), but the other conditions do not have an effect on the eye. I would see your ophthalmologist for a thorough dilated eye exam to see if there is a treatable diagnosis. | Given your profession as an ophthalmologist, please provide a detailed and comprehensive response to the question. | AAO |
What could cause a 6-year-old to blink hard and constantly? He reports that his vision is fine and he is not in pain. He says that his eyes are sometimes dry and wet at the same time (yes, strange). I will make an appointment for him to see a pediatric ophthalmologist, but any insight while we wait for his appointment would be helpful. | Several years ago we studied a large number of children who exhibited excessive blinking and/or excessive force of blinking. Our study was published in the journal Ophthalmology.Most children fell into one of four major categories: (1) The need for glasses or a change of glasses; (2) a habit or a psychological issue such as excessive stress; (3) misalignment of the eyes, including misalignment that is so subtle that it is not easily detected; or (4) a problem with the front part of the eyes such as dry eyes, a foreign body under the eyelids, et cetera. Often, no obvious cause can be determined. If an obvious problem is detected, it should be treated. When no problem is detected and there are no other associated signs or symptoms, observation is usually all that is warranted.This question was originally answered on Mar. 10, 2014. | Given your profession as an ophthalmologist, please provide a detailed and comprehensive response to the question. | AAO |
I read on your site that the UV coating on regular prescription glasses is equally protective as that on sunglasses. So do sunglasses have other benefits over UV-coated prescription glasses? For instance, do they protect better from corneal burns or other kinds of sun damage? Or can one just stick to regular prescription glasses with no ill effects? | Generally, the UV coating on prescription regular eyeglasses, when applied correctly, is certified for UV protection. Over-the-counter sunglasses that say they have UV prescription may vary in the percentage of UV blocking. Confirm with your optical shop before purchase that your eyeglasses or sunglasses block 99 or 100 percent of UVA and UVB rays. Good optical shops can actually measure this with a UV meter.Assuming equal UV protection, sunglasses may offer more comfort than regular eyeglasses by reducing brightness from the sun. Oversized and wraparound sunglasses block more peripheral light rays, and sunglasses with polarized lenses provide greater clarity by reducing the glare of reflected light.Corneal burns are rare and come about from excessive exposure such as that experienced by welders, those skiing at high altitude, or using tanning beds without adequate protection. Sunglasses or regular eyeglasses cannot protect your eyes from certain intense light sources. Talk to your ophthalmologist about eye protection for special situations such as those listed above. | Given your profession as an ophthalmologist, please provide a detailed and comprehensive response to the question. | AAO |
I was diagnosed with a posterior vitreous detachment (or PVD, when the gel in the middle of the eye shrinks and separates from the back of the eye) a week ago and am feeling some pain and irritation from dry eyes. Is it safe to use drops, and if so what kind? What can I expect to happen over the next few weeks? I am having a heightened state of anxiety over this and am also supposed to be traveling out of the country in 5 weeks which doesn't seem like a great idea. | PVD is a completely painless event so your discomfort is probably from your dry eyes. It is safe to use artificial tears but you should be evaluated by an ophthalmologist to determine if you have any underlying conditions that may be aggravating your dry eyes. In more than 90 percent of people, a PVD is a benign (harmless) event although the floaters can be disturbing. Typically, the floaters will improve over weeks to months. You should return to your ophthalmologist if you notice worsening of the floaters, flashing lights, or loss of vision. | Given your profession as an ophthalmologist, please provide a detailed and comprehensive response to the question. | AAO |
I had lens implants in both eyes in the mid-1990s due to taking Prednisone. Now I think one of them is failing. I'm seeing little flashes of light in my peripheral vision that are circular just like the lens. I've also noticed the eye aching from time to time. Do these lenses fail after a certain time and have to be replaced? | Lens implants don't fail and don't need to be replaced. Rarely they can move and cause visual symptoms. However it is more likely that your symptoms are unrelated to your implants. You should definitely see an ophthalmologist as soon as possible. Flashes of light in the vision may represent a more ominous event such as a tear in the retina. This should be evaluated by an ophthalmologist, who will check your retina with a dilated eye examination. | Given your profession as an ophthalmologist, please provide a detailed and comprehensive response to the question. | AAO |
I have a very healthy 13-year-old that has LCHAD (when the body cannot break down fat for energy). He has yearly heart and eye appointments and has a milder form of this genetic disorder. At this time, all eye exams have been perfect. Our eye doctor suggested a visual field test just to make sure things look okay. Is this an exam with accurate results for someone that age? I am really torn of what to do. | LCHAD tends to be progressive and appears to be mild in younger persons when it is first detected. They should be on low fat, high carbohydrate diets. Unfortunately LCHAD also affects the retina (light sensitive tissue in the back of the eye) and progression is common despite excellent management otherwise. The damage to these structures causes gradual dropout of retinal light receptor cells with reduction of vision. Nearsightedness and cataracts (cloudy lenses) are also associated over time. A visual field test will map out whether the retina in your 13-year-old has had any visual changes. Retinal examinations will show pigmentary changes before the vision is altered. A 13-year-old should easily be able to perform a visual field examination, especially in this age of electronic gadgetry. You can expect very accurate results from your child. | Given your profession as an ophthalmologist, please provide a detailed and comprehensive response to the question. | AAO |
I was having a shower and liquid soap entered my eyes. It was a burning sensation for 10 minutes. Now it is much better. I rinsed it with lot of water and eyewash. Pain now is very minimal and I can see properly, but my eye is a bit red. This happened 20 minutes ago. Is there anything I could do? Or is it nothing to worry about? | There are probably few events more common than getting soap in the eyes during bathing. These products have been heavily tested and contain no toxic ingredients. Soap in the eyes does cause stinging and that is why "baby shampoos" are available which allow you to bathe a child with less fear of resistance due to the pain of soap in the eyes. You did the right thing with the eye washout and you have nothing to fear.This question was originally answered on Oct. 16, 2013. | Given your profession as an ophthalmologist, please provide a detailed and comprehensive response to the question. | AAO |
I had PRK done 2 weeks ago. Is it normal to feel like there is an eyelash in my eye? I know in the beginning it can feel like that, but it just came on so suddenly. | First, sometimes an eyelash is just an eyelash. However, an unhealed area of epithelium (outermost layer of the cornea) on the surface of the cornea can feel like something in the eye is well. It is vital that you see your surgeon as soon as possible to see what the issue is. | Given your profession as an ophthalmologist, please provide a detailed and comprehensive response to the question. | AAO |
Can being in the snow for three hours cause you to see colors wrong? For example white objects look yellow, blue objects look green except on the edges were you see blue? | Yes, but your vision should return to normal in a few minutes once you are back in normal lighting. If it continues, a complete eye examination is needed. | Given your profession as an ophthalmologist, please provide a detailed and comprehensive response to the question. | AAO |
What are the disadvantages of lipid-based artificial tears? | Lipid-based tears are becoming more popular as a way to supplement the oil-based layer of the eye’s natural tear film. They are usually made as an emulsion, which means that the components can settle out over time if they have been kept on a shelf for a while. You can shake the bottles before using to make sure they are well-mixed. They also tend to have a whitish or milky consistency, which means that they are usually not approved for use with contact lenses as temporary blurring of vision can occur after using.There are also very few formulations of lipid-based tears that are preservative-free. Preservative-free drops are recommended if someone is using drops four or more times per day to limit preservative exposure. Discuss with your ophthalmologist about the right artificial tear drop for you. | Given your profession as an ophthalmologist, please provide a detailed and comprehensive response to the question. | AAO |
How common is it to get retinal detachments in both eyes? And after they have been fixed, can it happen again? I have a connective tissue disorder. | As a general rule, retinal detachment occurs in both eyes in about one in ten patients with an initial retinal detachment in one eye. The second detachment in the fellow eye may occur even years later. Patients with connective tissue disorders such as Marfan or Stickler syndromes have a higher rate of bilateral (both eyes) retinal detachment that may exceed 50 percent. Patients with connective tissue disorders should seek expert retinal care and discuss the risks and benefits of prophylactic (preventative) treatment of the fellow eye. | Given your profession as an ophthalmologist, please provide a detailed and comprehensive response to the question. | AAO |
My friend's 5-month-old baby has large angle esotropia (a large amount of misalignment, or crossing of the eyes) in both eyes. The baby’s prescription is +8.00 with astigmatism in both eyes. The doctor in his country recommended eyeglasses but my friend is worried that the baby is so little. Should my friend wait until her child is older? | A newborn’s and infant’s visual system is already developing fast so having the eyes aligned is crucial to make sure it develops as fully as it can for the best possible vision.In this situation, glasses are needed as they will improve the visual development in both eyes and possibly correct the crossed eyes (esotropia). While the thought of having such a young child in glasses may be alarming to some parents, using them is essential when there is eye misalignment and this level of visual correction for a refractive error like astigmatism. | Given your profession as an ophthalmologist, please provide a detailed and comprehensive response to the question. | AAO |
My 23-month-old had blocked tear ducts when she was born, in both eyes. The right side cleared at 4 months and the left at 6 months. But every time she gets a cold (which is often, with two older school-aged sisters), the left eye, and occasionally, also the right, will clog again, and she gets watery eyes and tears streaming down her cheeks. Her eyelashes on the bottom of her left eye also seem to grow in an upward trajectory and when she has overly watery eyes, they stick to her eyeball. She also seems to have an overly runny nose, although I'm not sure that's related. Should I consult an ophthalmologist to have her ducts probed, even if they only become clogged when she’s ill? | Tearing that is different between the two eyes is suspicious for a blockage in the nasolacrimal duct system. If the tear drain is intermittently blocked, there may be a functional obstruction. This means that while there is not a 100 percent anatomic obstruction, under the right circumstances such as clogging with mucus, debris, oil or other substances, it can become blocked.A pediatric ophthalmologist can probe and/or irrigate the tear drain to determine if there is an anatomic or functional obstruction. Having an obstruction can be bothersome due to tearing, but can also lead to an infection called dacryocystitis if there is accumulation of debris in the nasolacrimal sac. I would see your pediatric ophthalmologist for an evaluation to see if any intervention is necessary. | Given your profession as an ophthalmologist, please provide a detailed and comprehensive response to the question. | AAO |
What are the risks of leaving silicone oil in a child's (4- to 5- years old) eye indefinitely? | Silicone oil most often is put in an eye following retinal detachment surgery to help hold the retina in place. Whenever possible, we plan on removing the oil after one to three months to avoid risks such as cataract, corneal clouding, or glaucoma. Unfortunately, in some patients, the retinal detachment is severe enough that we have high concern that the retina is likely to re-detach if we removed the oil. As a result, we make the difficult risk/benefit decision to leave the oil in place indefinitely. | Given your profession as an ophthalmologist, please provide a detailed and comprehensive response to the question. | AAO |
Is it normal to have foggy vision after a posterior vitreous detachment? | Yes, many times the vision can be foggy after a posterior vitreous detachment (or PVD, when the gel that fills the eye pulls away from the back layer of the eye) and the floaters take time to dissipate and usually become less noticeable, but they usually do not go away completely. | Given your profession as an ophthalmologist, please provide a detailed and comprehensive response to the question. | AAO |
I have double vision and have long been frustrated by not being able to show people what I see. Because prisms are used to correct/stabilize double vision, would it be true they can also be used to induce double vision in normally sighted people? I see a lot of those low vision simulators online, but no one has a double vision one. | Yes, if you place an appropriate prism in front of one eye of a patient with no misalignment you can create double vision. | Given your profession as an ophthalmologist, please provide a detailed and comprehensive response to the question. | AAO |
Hello, I'm from Argentina and my son, who is 13 years old, was knocked with a soccer ball in his right eye and my ophthalmologist said that he lost the vision in 80% of his eye and there's nothing he can do!! What do you recommend? I really want to know if there's anything I can do for my son. | It sounds like the retina was damaged. If so there is usually nothing that can be done to repair that structure. This is why protection is so important. Protective eye wear is recommended for soccer (football) but is not well accepted by the public. | Given your profession as an ophthalmologist, please provide a detailed and comprehensive response to the question. | AAO |
My prescription in both eyes is -7. After cataract removal in one eye, would I be experiencing nausea and dizziness until the other one is done? Could both be done at the same time? | The issue you raise has to do with the opportunity to improve your myopic prescription at the time of cataract surgery when a new artificial lens is implanted. If the operated eye improved to (–) 0.5 for example, then it would be difficult to wear glasses long term with that much difference in the two prescriptions. If you already wear contact lenses, then it would work to wear the contact in the un-operated eye; you would not need the contact lens in the newly operated eye.If you are planning to have cataract surgery in both eyes, then doing them sequentially one after the other makes sense. Many patients might choose to space them two weeks apart. This allows time for the first eye to recover, and for the ophthalmologist to assess the refractive outcome of the first eye (e.g. what is the resulting new prescription). Although it feels odd at first (and sometimes patients remove one lens from their spectacles), after a few days, the difference becomes much more tolerable. However, that is why most patients choose to have their second eye done relatively soon after the first. Your ophthalmologist can help you with this decision. | Given your profession as an ophthalmologist, please provide a detailed and comprehensive response to the question. | AAO |
Are cerulean blue eyes a guy thing? It occurred to me the other day that I've never seen them on a woman. | Eye color does not have a gender predisposition. | Given your profession as an ophthalmologist, please provide a detailed and comprehensive response to the question. | AAO |
I have a tractional retinal detachment in my left eye. Will I have the same condition in my right eye and how many years before it happens? The tractional retinal detachment happened 8 years ago. | Traction retinal detachments can be caused by a variety of underlying conditions. In some of these cases, the fellow eye may be at risk, but other causes do not put the fellow eye at risk. I encourage you to discuss this question with your retinal physician. | Given your profession as an ophthalmologist, please provide a detailed and comprehensive response to the question. | AAO |
There is something that appears to look like a tear in my eye near my pupil. If it is a tear what can be done? | The appearance of the pupil is governed by the shape of the iris. The iris can be damaged congenitally, from external trauma, or from intraocular surgery such as a cataract operation. Often, a torn or abnormally shaped iris will not cause any symptoms. However, since the main function of the iris is to regulate the amount of light reaching the retina by constricting in bright environments, in severe cases of iris damage patients may develop light sensitivity. In these situations, the iris can be repaired in a surgical procedure called a pupilloplasty if there is enough iris tissue remaining. Another option to regulate the amount of light entering the eye is wearing a colored contact lens.Iritis is another condition that can cause distortion of the iris, resembling a tear. In iritis, inflammation in the eye can cause adherence of the iris to the lens. If the patient becomes light sensitive, the adhesions can be released with dilating drops or a surgical procedure called a synechiolysis. | Given your profession as an ophthalmologist, please provide a detailed and comprehensive response to the question. | AAO |
I have been told I have photopsia. Can you tell me what this is and what causes it? Is it serious and can it be cured or corrected? | Photopsia is a symptom not a diagnosis. Therefore I am not sure what it means to say that you have been told you have photopsias. To answer this question one would need to know exactly what you are experiencing. Photopsias are flashes of light that are usually brief and intermittent. Many, many conditions can cause photopsias and these can be benign or problematic. They can be caused by problems with the vitreous, retina and nerve of the eye. They can also be neurological in origin and not related to any eye issue. Therefore, the causes and treatments can only be determined by a much more detailed description of your symptoms as well as a comprehensive eye exam by an ophthalmologist. | Given your profession as an ophthalmologist, please provide a detailed and comprehensive response to the question. | AAO |
Does herbal medicine for sleep, e.g. valerium, chamomile, etc. worsen dry eye? Is it safe to take them with that condition? | Some prescription and herbal medications have "anticholinergic side-effects." These side-effects block the cholinergic receptors all throughout the body. Once these receptors are blocked, the body’s ability to secrete moisture is made difficult and dryness in mucous membranes such as the mouth or eyes can develop.A number of other factors can contribute to dry eye moreso than herbal medications, such as prescription diuretics for high blood pressure, antihistamines, anti-seizure medications, and environmental factors such as air conditioners, fans, smoke, and contact lenses. An eye doctor can assess your risk factors for dry eye and help devise a treatment to make your eyes more comfortable. | Given your profession as an ophthalmologist, please provide a detailed and comprehensive response to the question. | AAO |
Sometimes when I hold my breath I lose vision in my left eye—is that normal? | Losing vision in one eye, even temporarily, is never normal. Amarosis fugax, or fleeting blindness, requires an immediate full eye exam, and usually a neurological and cardiac evaluation. Ophthalmologists often see patients who have nothing wrong with the eye itself, but have ocular symptoms of brain or heart disease.You didn't mention your age. In older people, temporary loss of vision in one eye can be a symptom of atherosclerotic disease (narrowing of the carotid artery) or inflammation of the blood vessels (temporal arteritis), which can lead to stroke. Immediate diagnosis, work-up, and treatment is important to prevent permanent loss of vision.In all age groups, transient loss of vision can be caused by hyperviscosity (increased thickness) of the blood, multiple sclerosis (a disease that disrupts the flow of information within the brain, and between the brain and the body), complex migraine, lupus (when the body attacks its own tissues), heart valve abnormalities, brain tumors, and heart arrhythmias (irregular heartbeat). High pressure inside the skull (pseudotumor cerebri) can occur in anyone, but is often seen in young, obese women. Malignant hypertension (high blood pressure) and lupus can occur at any age.Your ophthalmologist is a medical doctor who has a complete understanding of cardiac and neurological disease that can cause ocular symptoms. Schedule an appointment immediately with your ophthalmologist, who will want more detail about your symptoms—when they started, when they occur, how long the symptoms last—and also a complete past medical history, and a complete eye exam looking at your vision, visual field, color vision, and if there is any abnormality of the eye such as retinal detachment or swelling of your optic nerve (papillema) which can mean high pressure inside the skull.Depending on your eye exam, you might need further testing of your brain (MRI/spinal tap with opening pressure), or carotid arteries (carotid ultrasound), or of your heart valves (cardiac ultrasound) or heart rhythms (Holter Monitor, EKG), and blood testing for inflammation and hypercoagulability. | Given your profession as an ophthalmologist, please provide a detailed and comprehensive response to the question. | AAO |
Is it possible that the IOL implant after cataract surgery would prohibit use of progressive eyeglasses (“no-line” glasses that correct vision at more than one distance)? | My general answer is that it would be quite unusual. I would tend not to use the word prohibit, and instead say that there could be something about the way the optics of the eye and the lens interact to make the progressive eyeglasses ineffective or less comfortable. Unfortunately, it is difficult to answer your question without knowing more about the implanted lens and your refractive outcome. | Given your profession as an ophthalmologist, please provide a detailed and comprehensive response to the question. | AAO |
I'm already blind in my right eye and I need a cataract taken off that eye. Can I drive home afterwards? I already have driven for years with one eye anyway. | Due to your sedation and possible inflammation (swelling), it would be best to arrange for someone to take you home following the operation. | Given your profession as an ophthalmologist, please provide a detailed and comprehensive response to the question. | AAO |
My daughter is 7 years old and has been tested as having poor eyesight. The doctor here in China has determined to induce mydiasis (dilation of eye) by using eye drops in order to determine the cause of the eyesight problems. Is this a standard diagnostic procedure used internationally, and is it safe? The doctor says she will need to undergo a month's worth of this. | Mydriatic drops are often used to assist in diagnostic testing and examinations. They are typically used several times, but not for a month. These drops can be used long term for treatment of some eye conditions. | Given your profession as an ophthalmologist, please provide a detailed and comprehensive response to the question. | AAO |
My 16-year-old daughter has -5.00 D (diopters of myopia) and has been using glasses for 5 years. I’ve heard lot about LASIK, but is refractive lens exchange the better option? Would either or another option allow her to remove glasses permanently? | In the U.S., we generally wait until 18 years of age for LASIK, which for her amount of correction should be the perfect fix. Lens exchange is a very invasive riskier surgery and would not be recommend at her amount of correction. If her exam checks out for her being a good candidate for LASIK, she should love being glasses-free for years to come. | Given your profession as an ophthalmologist, please provide a detailed and comprehensive response to the question. | AAO |
Can corrective laser eye surgery lower the risk of retinal detachment? My son has a -13 prescription. | No, removing the nearsightedness will not make the eye anatomically different—it is still a very long eye and has more risk of detachment over time. The best thing is to have regular eye exams and to come in if any change in vision is noted. Depending on his age, an ICL (intraocular contact lens) is a possibility to treat his myopia if he wants to get out of this high prescription. | Given your profession as an ophthalmologist, please provide a detailed and comprehensive response to the question. | AAO |
My glasses prescription for my left eye is -11.25 and for my right eye it is -10.75; however, my contact prescription for both eyes is -9.50. How can my eyes be different from each other with glasses but not with contacts? | Small differences in the prescription may not be reflected in both eyeglasses and contact lenses. Sometimes I will prescribe the same power for both eyes in contact lenses because the patient will do just fine and then they don't have to keep track of right and left lenses.If you are having trouble seeing well with the contacts as compared to the glasses, then you may want to have your prescription refined and updated. | Given your profession as an ophthalmologist, please provide a detailed and comprehensive response to the question. | AAO |
I have a scratched cornea in one eye due to thyroid eye disease. If I read extensively, could it further damage my cornea? | Thyroid eye disease can cause bulging eyes, puffy lids, double vision, and in the worst scenario, loss of vision from optic nerve damage, or damage to the cornea from drying out. Lubricating the eyes with drops and ointment, patching the eye closed at night, sleeping with head elevated, and dietary salt restrictions can help, but some people require further measures such as steroids (orally, intravenously, or nasally), radiation therapy, or surgery. Reading will not harm you. But our eyes blink less when reading so a very dry cornea may cause irritation and blurred vision. Taking more frequent breaks and using frequent artificial tears should help. But it is important that you see an ophthalmologist, and follow treatment instructions. | Given your profession as an ophthalmologist, please provide a detailed and comprehensive response to the question. | AAO |
What does a sudden onset of an arc of slashing light on the periphery of one's eye indicate? Is this urgent or not? | It is urgent and you need to see your ophthalmologist very soon. The inside of an eye is filled with a thick, clear jelly called the vitreous humor. As we age, the vitreous humor loses some of its water content and shrinks. At that point it is no longer big enough to fill the entire inside of the eye and it pulls away from the retina. As it pulls away, it often tugs on the retina and that causes an arc-like flash of light in the periphery of the vision. A small number of people who undergo this normal process will develop a tear in the retina or a detachment of the retina. This can be vision threatening and could result in blindness if not treated soon enough. Anyone with the symptoms of flashes of light with or without new black spots (new vitreous floaters) in their vision must be examined by the ophthalmologist right away.This question was originally answered on Mar. 10, 2014. | Given your profession as an ophthalmologist, please provide a detailed and comprehensive response to the question. | AAO |
I just bought my glasses and I am worried about something. They are for distance (-0.50), but at the same time they have blue control. So, they are practical for any kind of blue light devices (PC, phone, etc.), which means I want to use them for reading. Is it OK to use distance glasses for reading? I read that this may worsen my near vision and I am only 27. | At your age, accommodating an extra half diopter for near is easy and will not blur your near vision. The exercise might even be good (not scientific!) and help to strengthen the ciliary muscle. In about 15 years you may notice a bit of strain and can do something about it then. This is when most people need reading glasses. | Given your profession as an ophthalmologist, please provide a detailed and comprehensive response to the question. | AAO |
Is it normal to have swelling around the eye two days after retinal tear surgery? | Yes, that would be common. Typically it will resolve within 5 to 7 days. | Given your profession as an ophthalmologist, please provide a detailed and comprehensive response to the question. | AAO |
Is it normal to have a lower reading glasses prescription after cataract surgery? My eyes are completely healed from the surgery. | The reading glasses prescription depends on the power of the lens implant (intraocular lens or IOL) that was placed inside your eye. Your reading glass power is inconsequential. What’s more important is that your reading vision is satisfactory while wearing the glasses. | Given your profession as an ophthalmologist, please provide a detailed and comprehensive response to the question. | AAO |
Does it hurt your eyes to go swimming while your eyes are dilated? | The short answer: do whatever you are comfortable doing with your pupils dilated. Swimming is fine.Having your pupils dilated at the ophthalmologist for your annual eye exam can be annoying. Fortunately, it doesn't last too long. The dilation makes you light sensitive, and your near vision is blurry for about an hour after the drops. It is a good idea to wait until your vision feels normal before you drive. Swimming is safe. I usually tell patients the effects of the dilation will last 2–4 hours so they don't call back unnecessarily. It may be longer in patients with dark brown eyes. | Given your profession as an ophthalmologist, please provide a detailed and comprehensive response to the question. | AAO |
What can cause loose ligaments in the eye? | I am presuming the questioner wishes to understand the cause of ptosis or droopy upper eyelid. Ptosis or upper eyelid drooping has a large differential. The condition may be congenital or acquired—meaning one can be born with the condition or develop the condition as they get older. An acquired ptosis may be caused by long term contact lens wear, trauma or repeated episodes of swelling. There are neurologic conditions that may lead to a droopy eyelid such as diabetes, aneurysm, or Horner's syndrome. Tumors or deposits in the tissues may lead to a droopy eyelid as well. We recommend that individuals with droopy eyelids undergo a complete eye examination to determine the health of their eyes and the cause of the eyelid droop. Once known, the eyelid position may be raised to a more normal position by an oculofacial plastic surgeon. | Given your profession as an ophthalmologist, please provide a detailed and comprehensive response to the question. | AAO |
If you have macular edema that is being treated by injections, can you drink wine? | I don’t know of any reason why you couldn’t. | Given your profession as an ophthalmologist, please provide a detailed and comprehensive response to the question. | AAO |
Are colored cosmetic lenses safe? I had an eye injury 10 years ago and now the affected eye is discolored. | There are a number of FDA-approved colored contact lenses that are safe to use on the eye. In addition to changing the color of the eye for cosmetic reasons, these can be successful in helping disguise an injury as well. Be wary of unapproved lenses that enter the U.S. through illegal channels and are purchased through unusual channels, like convenience stores, that are not safe. | Given your profession as an ophthalmologist, please provide a detailed and comprehensive response to the question. | AAO |
My 7-month-old child was diagnosed with a unilateral macular scar. A blood test for toxoplasmosis came back negative. Is it possible to evaluate the degree of vision loss and is there any treatment for this condition? Is it advisable to patch the good eye for several hours each day or to use protective glasses (to protect the good eye)? Is there any chance, given the young age, that vision will improve? | There is currently no treatment of macular scar. Toxoplasmosis is just one cause. It is advisable to protect the better eye with glasses when your child is old enough to be at risk for injury. The chance of vision improvement is hard to predict. In some cases vision will improve with patching, but this will depend on how large the area of damage is. | Given your profession as an ophthalmologist, please provide a detailed and comprehensive response to the question. | AAO |
After having cataract surgery, how long might double vision persist as a side effect? | There are different reasons that someone might experience double vision and so it is not possible to know why you are having this without an examination. You should ask your eye surgeon. | Given your profession as an ophthalmologist, please provide a detailed and comprehensive response to the question. | AAO |
I’m nearsighted and had PRK surgery a couple months ago. Before the surgery, they found retinal tears in both eyes. They told me this is more common in nearsighted eyes. The tears were repaired before the PRK surgery. Now that I’m no longer nearsighted, is there still a risk of retinal tears/detachments? Also, can you explain why nearsighted eyes have more risk for tears and detachments? Also, as I am a pilot, do high altitudes increase the risk? | Although your eyes are not optically nearsighted (myopic) after the PRK, they still behave biologically as though you were still nearsighted. This is because PRK just changes the surface of the eye similarly to a contact lens. The inside of your eye still has the features of a myopic eye. Therefore, you remain at risk for problems such as retinal tears and retinal detachment. However, the fact that you received treatment for retinal tears decreases the chance you will have further problems.Myopic eyes are bigger than normal eyes. As a result, the retina is thinner than in normal eyes. A thinner retina has a greater chance of tearing. Also, myopic eyes have a higher incidence of a condition called lattice degeneration which is a focal thinning of the retina and is a risk factor for retinal tears and retinal detachment.Changes in altitude do not increase the risk of a retinal tear or retinal detachment. | Given your profession as an ophthalmologist, please provide a detailed and comprehensive response to the question. | AAO |
Are there any ophthalmologically endorsed eye makeup brands? I've recently been diagnosed with blepharitis and wish to use only those brands that have been tested ophthalmologically. | There are many different products which are hypoallergenic and thus less likely to cause sensitivity around the eyes. The appropriate products for each patient are dependant on the patient and they should see an eye specialist for recommendations. There are many different eye creams which can be used. I recommend Lumiere by Neocutis but there are a variety. A gentle makeup remover should always be used to remove all makeup at the end of the day. | Given your profession as an ophthalmologist, please provide a detailed and comprehensive response to the question. | AAO |
I have a red bump on the inside of my eyelid. It does not hurt but I can feel it when I touch my eyelid. What is it? | There are many different types of eyelid lesions. To make a definitive diagnosis regarding the type of eyelid lesion, a physical exam with an ophthalmologist is needed.The most common cause of a red bump inside the eyelid is an area of focal inflammation called a chalazion. A chalazion results from an obstruction of the meibomian glands (oil-producing glands within the tarsal plates of the eyelids). If the gland openings on the eyelid margin become blocked, the material within the glands is released into the surrounding eyelid tissues. This initiates an inflammatory response that can cause redness and tenderness. Chalazia often evolve into chronic, cyst-like lesions as the body walls off the area of inflammation.Treatment for chalazia in the inflammatory phase includes warm compresses and lid scrubs. Drops or ointments can be used, but they are usually not effective. When chalazia are chronic and cyst-like, incision and drainage may be required for resolution. Intralesional steroid injections are also an option, but they are less effective and can result in depigmentation of the skin.Malignant lesions may be mistaken for chalazia, so it is recommended that an eye exam be performed by an ophthalmologist if you develop a persistent chalazion. Atypical and recurrent chalazia should be biopsied for a definitive diagnosis.This question was originally answered on Jul. 10, 2012. | Given your profession as an ophthalmologist, please provide a detailed and comprehensive response to the question. | AAO |
My daughter recently had a pre-school eye check and I have received a letter saying the results suggest she has an ocular movement disorder. What could this be? I am a worrier, so will overthink this until I receive some information. | There are many possible causes for this observation, along with the observation being wrong. I would recommend that a parent consider the results of the vision screening and discuss the findings with their pediatrician, but in my opinion, in most cases the child should have a complete eye examination with an ophthalmologist. | Given your profession as an ophthalmologist, please provide a detailed and comprehensive response to the question. | AAO |
I was wondering what they use to make the glasses with transition adaptive lenses work? Is it a type of glass or a tint that is installed in the lenses? | This is a new development in lenses which contain a chemical that not only changes (darkens) in brighter light but also has an alignment of the chemical which causes a polarized effect. The company would have you believe that this additional polarized light blocking effect can be helpful and is an improvement over the previous photochromic lenses which darken without the polarizing effect. The lenses are constructed so that the polarizing blockage is horizontal in orientation. Light reflecting off water, snow and certain atmospheric conditions can be blocked by this orientation and so the extra cost of these lenses might be worthwhile if these conditions are part of your lifestyle. | Given your profession as an ophthalmologist, please provide a detailed and comprehensive response to the question. | AAO |
I had a cataract removed nine days ago with astigmatism correction and a multifocal IOS lens implanted. I still have blurred vision along with glare. I started with 20/40 vision in that eye and a day after surgery I had 20/25. How long can I expect to have these symptoms? | Blurred vision can result from several factors:Glare can be present even after cataract surgery and tends to decrease over time. Glare can be seen with multifocal lenses and even non-multifocal lenses. After cataract surgery with multifocal lenses some patients may even need a pair of glasses at night and/or for reading to achieve best vision. The duration of these symptoms can vary greatly depending on each patient’s unique circumstance. Speak with your ophthalmologist for more information. | Given your profession as an ophthalmologist, please provide a detailed and comprehensive response to the question. | AAO |
My eyes are very bad, and I have cataracts. I do not want to change my visual acuity with a lens implant. Is this possible? | If what you want is the same amount of myopia or hyperopia as you had prior to cataract surgery, yes, this can be done. | Given your profession as an ophthalmologist, please provide a detailed and comprehensive response to the question. | AAO |