Dry eye syndrome: Causes, symptoms, treatment, and prevention
What causes dry eyes?
An adequate and consistent layer of tears on the surface of the eye is essential to keep your eyes healthy, comfortable and well. Dry eye syndrome is caused by a chronic lack of sufficient lubrication and moisture on the surface of the eye. Consequences of dry eyes range from subtle but constant eye irritation to significant inflammation and even scarring of the front surface of the eye.
Dry eyes can become red and irritated, causing a feeling of scratchiness.
Dry eye symptoms
Symptoms of dry eyes and dry eye syndrome include:
- Burning sensation
- Itchy eyes
- Aching sensations
- Heavy eyes
- Fatigued eyes
- Sore eyes
- Dryness sensation
- Red eyes
- Photophobia
- Blurred vision
Another common symptom is a foreign body sensation — the feeling that grit or some other object or material is “in” your eye.
And as odd as it may sound, watery eyes also can be a symptom of dry eye syndrome. This is because dryness on the eye’s surface sometimes will over-stimulate production of the watery component of your tears as a protective mechanism. But this “reflex tearing” does not stay on the eye long enough to correct the underlying dry eye condition.
In addition to these symptoms, dry eyes can cause inflammation and (sometimes permanent) damage to the surface of the eye.
Dry eye syndrome also can affect the outcomes of LASIK and cataract surgery.
Dry eye treatment and prevention
Thankfully, there are effective treatment options if you suffer from chronic dry eye.
In many cases, routine use of artificial tears and minor behavioral modifications (taking frequent breaks during computer use, for example) can significantly reduce dry eye symptoms.
In other cases, your eye doctor might recommend prescription eye medications to help your body create and secrete more tears and to decrease eye irritation and inflammation.
Types of conjunctivitis: Bacterial, viral, allergic and others
A closeup of an eye with conjunctivitis.
Conjunctivitis (or pink eye) is the inflammation of the conjunctiva – the transparent mucous membrane which covers the white part of the eye. Infectious causes of an inflamed eye and conjunctivitis include bacteria, viruses and fungi. Non-infectious causes include allergies, foreign bodies, and chemicals.
The phrase “pink eye” is commonly used to refer to conjunctivitis, because pinkness or redness of the conjunctiva is one of the most noticeable symptoms.
Types of conjunctivitis
Bacterial conjunctivitis is a common type of pink eye, caused by bacteria that infect the eye through various sources of contamination. The bacteria can be spread through contact with an infected individual, exposure to contaminated surfaces or through other means such as sinus or ear infections.
Allergic conjunctivitis can result when your eyes encounter a substance to which they are overly sensitive, such as pollen in the air.
The most common types of bacteria that causes bacterial conjunctivitis includes Staphylococcus aureus, Haemophiles influenzae, Streptococcus pneumoniae and Pseudomonas aeruginosa. Bacterial conjunctivitis usually produces a thick eye discharge or pus and can affect one or both eyes.
Just like in any bacterial infection, antibiotics are required to eliminate the bacteria. Treatment of bacterial conjunctivitis is typically accomplished with topical antibiotic eye drops and/or eye ointments. The treatment usually takes from one to two weeks, depending on the severity of the infection.
Viral conjunctivitis is another common type of pink eye that is highly contagious as airborne viruses can be spread through sneezing and coughing. Viral conjunctivitis can also accompany common viral upper respiratory infections such as measles, the flu or the common cold.
Viral conjunctivitis usually produces a watery discharge. Typically, the infection starts in one eye and quickly spreads to the other eye.
Unlike with bacterial infections, antibiotics will not work against viruses. No eye drops or ointments are effective against the common viruses that cause viral conjunctivitis. But viral conjunctivitis is self-limited, which means it will go away by itself after a short time.
Typically, with viral conjunctivitis, the third to the fifth days are the worst. After that, eyes begin to improve on their own.
Treatment of viral conjunctivitis usually involves supportive therapies, such as eye drops, that help reduce the symptoms: for example, vasoconstrictors to whiten the eye, decongestants to reduce the surface swelling and antihistamines to reduce occasional itching.
Treatments usually are continued for one to two weeks, depending on the severity of the infection.
You can get pink eye from infections from sexually transmitted diseases including gonorrhea and chlamydia. Newborn babies may be exposed when they pass through the birth canal of an infected mother.
Trachoma is a form of chlamydial infection that causes scarring on the eye’s surface. Trachoma is the world’s leading cause of preventable blindness. If you are pregnant and suspect you may have a sexually transmitted disease, you need to be checked and treated for any infection before the birth of your baby.
This pink eye caused by eye allergies is very common. Eye allergies, like other types, can be triggered by allergens including pollen, animal dander and dust mites.
The most common symptom of allergic conjunctivitis is itchy eyes, which may be relieved with special eye drops containing antihistamines to control allergic reactions.
Avoiding the allergen is also important in the treatment of allergic conjunctivitis. Allergic conjunctivitis can be seasonal or perennial (year-round), depending on the allergen causing the reaction.
This pink eye usually impacts both eyes and often affects soft contact lens wearers. This condition may cause contact lens intolerance, itching, a heavy discharge, tearing and red bumps on the underside of the eyelids.
You’ll need to stop wearing your contact lenses, at least for a little while. Your eye doctor may also recommend that you switch to a different type of contact lens, to reduce the chance of the conjunctivitis coming back.
This conjunctivitis from eye irritation causing pink eye symptoms that can result from many sources, including smoke, diesel exhaust, perfumes and certain chemicals. Some forms of conjunctivitis also result from sensitivity to certain ingested substances, including herbs such as eyebright and turmeric.
Certain forms of pink eye, including giant papillary conjunctivitis, can be caused by the eye’s immune responses, such as a reaction to wearing contact lenses or ocular prosthetics (artificial eyes). A reaction to preservatives in eye drops or ointments also can cause toxic conjunctivitis.
Cataracts: The causes, symptoms, and treatment of 3 common types
Cataract is the clouding of the eye’s natural lens. It is the most common cause of vision loss in people over age 40 and is also the principal cause of blindness in the world. Types of cataracts include:
A subcapsular cataract occurs at the back of the lens. People with diabetes or those taking high doses of steroid medications have a greater risk of developing a subcapsular cataract.
A nuclear cataract forms deep in the central zone (nucleus) of the lens. Nuclear cataracts usually are associated with aging.
A cortical cataract is characterized by white, wedge-like opacities that start in the periphery of the lens and work their way to the center in a spoke-like fashion. This type of cataract occurs in the lens cortex, which is the part of the lens that surrounds the central nucleus.
Cataract symptoms and signs
At first, a cataract has little effect on your vision. You may notice that your vision is blurred a little, like looking through a cloudy piece of glass or viewing an impressionist painting.
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Hazy, blurred vision may mean you have a cataract.
A cataract may make light from the sun or a lamp seem too bright or glaring. Or you may notice when you drive at night that the oncoming headlights cause more glare than before. Colors may not appear as bright as they once did.
The type of cataract you have will affect exactly which symptoms you experience and how soon they will occur. When a nuclear cataract first develops, it can bring about a temporary improvement in your near vision, called “second sight.”
Unfortunately, the improved vision is short-lived and will disappear as the cataract worsens. On the other hand, a subcapsular cataract may not produce any symptoms until it’s well-developed.
If you think you have a cataract, see an eye doctor for an exam to find out for sure.
What causes cataracts?
The lens inside the eye works much like a camera lens, focusing light onto the retina for clear vision. It also adjusts the eye’s focus, letting us see things clearly both up close and far away.
The lens is mostly made of water and protein. The protein is arranged in a precise way that keeps the lens clear and lets light pass through it.
But as we age, some of the protein may clump together and start to cloud a small area of the lens. This is a cataract, and over time, it may grow larger and cloud more of the lens, making it harder to see.
No one knows for sure why the eye’s lens changes as we age, forming cataracts. But researchers worldwide have identified factors that may cause cataracts or are associated with cataract development.
Besides advancing age, cataract risk factors include:
- Ultraviolet radiation
- Diabetes
- Hypertension
- Obesity
- Smoking
- Prolonged use of corticosteroid medications
- Statin medicines used to reduce cholesterol
- Previous eye injury or inflammation
- Previous eye surgery
- Hormone replacement therapy
- Significant alcohol consumption
- High myopia
- Family history
One theory of cataract formation is that many cataracts are caused by oxidative changes in the human lens. This is supported by nutrition studies that show fruits and vegetables high in antioxidants may help prevent certain types of cataracts.
Cataract prevention
Though there is significant controversy about whether cataracts can be prevented, a number of studies suggest certain nutrients and nutritional supplements may reduce your risk of cataracts.
One 10-year study of female health professionals found that higher dietary intakes of vitamin E and the carotenoids lutein and zeaxanthin from food and supplements were associated with significantly decreased risks of cataract.
Good food sources of vitamin E include sunflower seeds, almonds and spinach. Good sources of lutein and zeaxanthin include spinach, kale and other green, leafy vegetables.
Other studies have shown antioxidant vitamins such as vitamin C and foods containing omega-3 fatty acids may reduce cataract risk.
Another step you can take to reduce your risk of cataracts is to wear protective sunglasses that block 100 percent of the sun’s UV rays when you are outdoors.
Cataract treatment
When symptoms begin to appear, you may be able to improve your vision for a while using new glasses, strong bifocals, magnification, appropriate lighting or other visual aids.
Think about surgery when your cataracts have progressed enough to seriously impair your vision and affect your daily life.
Many people consider poor vision an inevitable fact of aging, but cataract surgery is a simple, relatively painless procedure to regain vision.
During surgery, the surgeon will remove your clouded lens and, in most cases, replace it with a clear, plastic intraocular lens (IOL).
New IOLs are being developed to make the surgery less complicated for surgeons and the lenses more helpful to patients. Presbyopia-correcting IOLs potentially help you see at all distances, not just one. Another new type of IOL blocks both ultraviolet and blue light rays, which research indicates may damage the retina.
Eyewear after cataract surgery
In most cases, unless you choose presbyopia correcting IOLs, you will still need reading glasses after cataract surgery. You may also need progressive lenses to correct mild residual refractive errors as well as presbyopia.
For the best vision and comfort possible with glasses prescribed after cataract surgery, ask your optician to explain the benefits of anti-reflective coating and photochromic lenses.
Presbyopia and its causes, symptoms, and treatment
presbyopia is the normal loss of near focusing ability that occurs with age. Most people begin to notice the effects of presbyopia sometime after age 40, when they start having trouble seeing small print clearly — including text messages on their phone.
You can’t escape presbyopia, even if you’ve never had a vision problem before. Even people who are nearsighted will notice that their near vision blurs when they wear their usual eyeglasses or contact lenses to correct distance vision.
The eye’s lens stiffens with age, so it is less able to focus when you view something up close.
Worldwide, an estimated 1.3 billion people had presbyopia in 2011. This number is expected to increase to 2.11 billion by 2020, according to Market Scope.
Though presbyopia is a normal change in our eyes as we age, it often is a significant and emotional event because it’s a sign of aging that’s impossible to ignore and difficult to hide.
Presbyopia symptoms
When you become presbyopic, you either have to hold your smartphone and other objects and reading material (books, magazines, menus, labels, etc.) farther from your eyes to see them more clearly.
Unfortunately, when you move things farther from your eyes they get smaller in size, so this is only a temporary and partially successful solution to presbyopia.
If you can still see close objects pretty well, presbyopia can cause headaches, eye strain and visual fatigue that makes reading and other near vision tasks less comfortable and more tiring.
What causes presbyopia?
Presbyopia is an age-related process. It is a gradual thickening and loss of flexibility of the natural lens inside your eye.
These age-related changes occur within the proteins in the lens, making the lens harder and less elastic over time. Age-related changes also take place in the muscle fibers surrounding the lens. With less elasticity, it gets difficult for the eyes to focus on close objects.
Presbyopia treatment
Eyeglasses with progressive lenses are the most popular solution for presbyopia for most people over age 40. These line-free multifocal lenses restore clear near vision and provide excellent vision at all distances.
Another presbyopia treatment option is eyeglasses with bifocal lenses, but bifocals provide a more limited range of vision for many people with presbyopia.
It’s also common for people with presbyopia to notice they are becoming more sensitive to light and glare due to aging changes in their eyes. Photochromic lenses, which darken automatically in sunlight, are a good choice for this reason.
Reading glasses are another choice. Unlike bifocals and progressive lenses, which most people wear all day, reading glasses are worn only when needed to see close objects and small print more clearly.
If you wear contact lenses, your eye doctor can prescribe reading glasses that you wear while your contact lenses are in. You may purchase reading glasses at an eyewear retail store, or you can get higher-quality versions prescribed by your eye doctor.
Regardless which type of eyeglasses you choose to correct presbyopia, definitely consider lenses that include anti-reflective coating. Anti-reflective coating eliminates reflections that can be distracting and cause eye strain. It also helps reduce glare and increase visual clarity for night driving.
People with presbyopia also can opt for multifocal contact lenses, available in gas permeable or soft lens materials.
Another type of contact lens correction for presbyopia is monovision, in which one eye wears a distance prescription, and the other wears a prescription for near vision. The brain learns to favor one eye or the other for different tasks.
While some people are delighted with this solution, others complain of reduced visual acuity and some loss of depth perception. Because the human eye change as you grow older, your presbyopia glasses or contacts prescription will need to be increased over time as well. You can expect your eye doctor to prescribe a stronger correction for near work as you need it.
If you don’t want to wear eyeglasses or contact lenses for presbyopia, a number of surgical options to treat presbyopia are available as well.
One presbyopia correction procedure that’s gaining popularity is implantation of a corneal inlay.
Typically implanted in the cornea of the eye that’s not your dominant eye, a corneal inlay increases depth of focus of the treated eye and reduces the need for reading glasses without significantly affecting the quality of your distance vision.
The first step to see if you are a good candidate for presbyopia surgery is to have a comprehensive eye exam and a consultation with a refractive surgeon who specializes in the surgical correction of presbyopia.
Presbyopia is a part of growing older
We are all getting older, and we’re all going to have to deal with the effects of presbyopia. Whichever option you choose – eyeglasses, contact lenses or surgery – you’ll be able to easily read messages on your phone or a book to your granddaughter without any trouble.
Bell’s palsy: Causes, symptoms, and treatment
Bell’s palsy is a temporary weakness or paralysis of the facial nerve known as the seventh cranial nerve. This nerve controls facial expressions, eyelid movement and the muscles of the forehead and neck.
Bell’s palsy usually occurs suddenly, affecting the greater part of one side of the face. The cause often is unknown, but the condition has been associated with certain viruses such a herpes simplex and herpes zoster (shingles). Risk factors for Bell’s palsy include diabetes, pregnancy and Lyme disease.
Statistics show that Bell’s palsy affects about one person out of 60 or 70.
After the abrupt onset of Bell’s palsy, most people develop maximum weakness within 48 hours. Prior to the onset, some people feel pain behind the ear.
While Bell’s palsy may appear similar to a stroke, no other neurological signs or symptoms are present.
How does Bell’s palsy affect eyes?
Most people with Bell’s palsy are unable to blink on the affected side of the face. At the same time, the lower eyelid may turn outward (ectropion). The face and lips on the affected side become droopy, and you have little or no control over their muscle function.
Because the muscle that opens the eye is controlled by a separate cranial nerve, you can easily open the affected eye. But you are unable to close the eyelid.
As a result, most people with Bell’s palsy suffer from an extreme form of dry eye syndrome known as exposure keratitis
Bell’s palsy treatment and recovery
Treatment for Bell’s palsy usually includes generous use of ocular lubricants, such as non-preserved artificial tears and eye ointments. Many people require the eyelid to be patched or taped shut while sleeping, to keep it moist.
If you develop an outwardly turned eyelid, you may need surgery to repair it.
Approximately 80 percent of people with Bell’s palsy recover within six months. But without proper care of the involved eye, you may suffer needless and permanent consequences such as corneal ulceration and scarring of your eye’s clear front surface.