Blepharitis is a very common problem causing gritty burning eyes and itching of the eyelash margins. The eyelids can be stuck together in the morning. Blepharitis is basically dandruff in the eyelashes which can wax and wane with time.
When systematic, the patient must scrub the eyelid margins, where the lashes enter the lid with baby shampoo and water (50/50) or a product called “Lid Care” which can be bought over the counter at pharmacies. This should be done nightly before going to bed. Artificial tears can be used during the day. Adjuncts to the treatment include; scrubbing the lid margins with erythromycin ointment after the lid care has been applied; and an oral course of doxycycline antibiotic. Warm compresses applied directly to the eyelid margin also help loosen the debris on the lashes.
Our Surgeons perform a minimally invasive, no-stitch cataract surgery called phaco surgery. A tiny incision (2.5 mm or less) is made in the eye and a small ultrasonic probe is inserted. This probe breaks up, or emulsifies, the cloudy lens into tiny pieces and gently sucks, or aspirates, those pieces out of the eye. Then a new artificial lens called an IOL is implanted in the eye.
Unfortunately, the eyelid area seems to be an area where numerous cosmetic blemishes can occur. Chalazions are the most common of these. Each lid has approximately twenty meibomian glands. When a gland is blocked, it develops a chalazion. The first treatment for a chalazion is frequent warm water compresses for about two weeks. Drops and ointments don’t seem to help. We then give the body three months to resolve the chalazion. If it is still there after three months, then surgery is required. The surgery takes fifteen minutes with no potential for scarring.
Other blemishes include moles, papillomas, syringomas, etc. These are all surgically removable with minimal chance for scarring. All the above are deemed as cosmetic surgery and can be removed at our surgicentre.
Basal cell carcinomas and cysts are deemed non-cosmetic by our government and these are removed in the same fashion paid by OHIP at the Riverside Eye Care Centre.
Diabetic retinopathy is a complication of diabetes that weakens the blood vessels that supply nourishment to the retina. When these weak vessels leak, swell or develop thin branches, vision loss occurs. In its advanced stages, the disease can cause blurred or cloudy vision, floaters and blind spots – and, eventually, blindness.The most important preventative measure that can be taken to prevent visual loss is to have a yearly examination by an ophthalmologist. Studies have shown that a yearly exam prevents visual damage by catching retinopathy changes in a timely manner and treating effectively with laser and intravitreal injection therapy. If a patient misses their yearly exam they risk retinopathy presenting itself years later with damage that is too severe to be corrected with laser.
Dry eye is a very common problem. As we age, our eyes produce fewer tears. Various other causes also come into play. Symptoms of dry eye include:
- Irritated, scratchy, dry, uncomfortable or red eyes
- A burning sensation or feeling of something foreign in your eyes
- Blurred vision
Non-surgical treatments for dry eye include blinking exercises, increasing humidity at home or work, and use of artificial tears or gels and medicating tears. If these methods fail, small “punctal” plugs may be inserted in the corners of the eyes to limit tear drainage, or the drainage tubes in the eyes may be surgically closed.
Eyelids can develop various abnormalities as we age. The height of the upper lid can drop (ptosis) or move up (retraction). The lower lids can turn in (entropion) or turn out (ectropion). The oculoplastic surgeon has a surgical answer to these problems. The surgeries are of an out-patient nature performed under local anesthetic, usually within one hour.
The eye is filled with a clear jelly like substance called the vitreous. The vitreous is loosely attached to the inner wall of the eye, the retina. As we age the jelly (vitreous) becomes less solid and more liquified. This can cause traction at the vitreous’s attachments to the retina stimulating the retina, causing flashing lights. The liquefaction also causes particle formation in the clear jelly (vitreous) that we see as floaters. This common phenomena is called a posterior vitreous detachment. Rarely a retinal detachment can occur during the process. Thus when these symptoms occur one must contact their eye care professional or go to the emergency room.
Glaucoma is a group of eye diseases that lead to slowly progressive optic nerve damage with characteristic pattern visual field loss. Glaucoma occurs when the pressure inside the eye rises high enough to damage the optic nerve. Glaucoma can be classified to open angle versus closed angle, also primary versus secondary glaucoma, with the most common by far being open angle. Primary open angle glaucoma is often asymptomatic which develops over many years without causing central vision loss or pain – so you may not experience vision loss until the disease has progressed. Left untreated, glaucoma can cause blindness. Regular eye exams and early detection are critical.
Symptoms include blurred vision, loss of peripheral vision, halo effects around lights and painful or reddened eyes. Risk factors include family history, high myopia, diabetes, thyroid disease, previous trauma to the eye and ocular hypertension, which is when the pressure inside the eye is above it’s normal level.
Treatments to lower pressure in the eye include prescription eye drops, medications, laser therapy, SLT, LPI and surgery. At our eye care centre we routinely dilate the eye, do contact and non-contact tonometry, and visual field testing, all to detect glaucoma.
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https://www.hopkinsmedicine.org/wilmer/services/glaucoma/book/index.html
Macular degeneration occurs when the macula — the central part of the retina that ensures that our vision is clear and sharp — starts to fail, causing a loss of central vision. When central vision is lost, you cannot see fine details whether they are close or far away from you. It can be quite debilitating, as central vision is needed to see faces, to read and to drive. One does not go blind as peripheral vision will remain intact, which means that vision on the sides will be normal.
Risk factors for macular degeneration include diets that are high in saturated fat, being overweight, cigarette smoking, hypertension (high blood pressure), age over 50, and a family history of AMD. Having a heart disease associated with high cholesterol is another risk factor, as well as being Caucasian.
Symptoms include:
- A gradual loss of ability to see objects clearly
- A gradual loss of color vision
- Distorted vision
- A dark or empty area appearing in the center of vision
There are two types of Age-Related Macular Degeneration (AMD); Dry AMD and Wet AMD.
To screen for any macular discrepancies, please visit our Amsler Grid page to monitor your vision at home.
Posterior Capsule Opacification
When we do cataract surgery we leave the membrane that used to surround the old lens in place. This membrane is clear like cellophane and acts as a container for the new implant. Months to years after cataract surgery, this membrane can get cloudy and blur vision. This problem is easily corrected with a 15-second nonpainful procedure by making an opening in the membrane with a YAG laser. This is called a YAG capsulotomy.
Refractive lensectomy is a surgical procedure to free patients of distance glasses for those with refractive errors greater than -9 or +4 diopters. Corneal laser refractive surgery cannot help these patients. The procedure is exactly the same as cataract surgery with the same risks, risks similar to corneal laser refractive surgery.
Excessive tearing is a common problem as we all get older. Various problems can occur to the tear drainage system. The oculoplastic surgeon evaluates where in the tear drainage system the problem is and addresses it surgically. The procedures are of an out-patient nature.
