UNUSUAL CORNEAL ABRASION

This patient woke up with pain the eye a few days ago and now doesn't feel better. On examination it looked like an abrasion that was trying to re-epithelialize, but was unable to completely do it because of the constant motion of the eyelid across it. So I put a bandage lens on it and used Vigamox every four hours. We'll follow-up with him daily until I see progress.

FUCH'S CORNEAL DYSTROPHY

The small granules in this photo are "guttata", little excrescences or damaged cells on the endothelial layer of the cornea. When these are damaged it can cause problems in maintaining the proper amount of fluid, and therefore thickness and clearnness of the cornea.

EPIPHORA

This is the same patient below with conjunctivochalasis. Fluorescein dye was placed in the eye and it causes the tears to fluoresce when a blue light is shined on it. You can see how the tears are leaking onto the corner of the face. This chronic leaking can cause irritation and inflammation of the skin at the corner. In this case the patient was given some as needed anti-inflammatory drop, called Alrex, when the skin is irritated, and while we are working on a solution to the underlying problem.

CONJUNCTIVOCHALASIS

While this may appear as excessive tears, it's actually redundant conjunctiva. The eyeball is covered with a layer of clear, moveable tissue called the conjunctiva. It's like Saran Wrap over the eye. If fluid gets under that layer or the conjunctiva is redundant, it can cause it to bunch up at the lower lid. This is called conjunctivochalasis. Because it makes less room for the tears and can often plug up the drainage of tears, the patient can complain of excessive tears or tears falling out onto the face, as this patient did. Treatment may be a snip procedure at the drainage opening to allow tears to drain more, but only after a good investigation to determine the underlying cause is undertaken. In this case the patient was on Visine every day for a long time and this has caused chonic dilated blood vessels that may leak serum under the conjunctiva. Cold turkey was indicated for the Visine "addiction", warning that it might get a little worse before it gets better.

INGROWN EYELASH

This is an ingrown lash from a patient. The patient complained of irritation on the left eyelid. It was taken out much like an epilation and should cause no ill effects.

CHALAZION

This is a chalazion, which is a pocket of pus-filled fluid and inflammatory material. Sometimes it responds to aggressive hot compresses with massage and antibiotic/steroid ointment, but oftentimes it needs to be incised and removed surgically. Steroid injection is also an option.

Amazingly enough, this chalazion totally disappeared with aggressive hot compresses and Tobradex use after about two weeks!

CORNEA ULCER

This is a bacterial cornea ulcer in a teenage patient who wears standard disposable contact lenses. The patient will likely be refitted into a silicone hydrogel lens after this ulcer heals completely.