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Wednesday, March 23, 2011


A chalazion is a bump on the lid that is non-tender and non-infectious.  It arises because of stagnation of secretions from a clogged meibomian glands.  It is initially treated with aggressive hot compresses and steroid drops.  Sometimes steroid is injected into it.  Often, if these measures don't work, it has to be removed surgically.  This is not painful as the surgeon numbs the eye. 

Tuesday, March 22, 2011


A person who spends  a lot of time in the sun should definitely use sunglasses.  One of the things that can happen is that scar tissue extends onto the cornea because of UV light exposure.  This scar tissue will continue to grow until it covers the whole eye.  It can be surgically removed before it does so.  This lesion is called a pterygium (pronounced "tuh-RIG-ee-um")

Saturday, March 19, 2011

Crusts in The Eyes in the Mornings

The picture below is the eyelid of an 18 year old boy.  He has crusts at the base of his lashes.  These crusts are produced from bacteria in the eyelash follicles.  This condition is chronic and called blepharitis.  It can cause a foreign body sensation, redness, and irritation of the eyes in the mornings.  It can be controlled with lid scrubs and occasional antibiotics, but is never eradicated completely. 

Friday, March 18, 2011

Red and Irritated Eyes

Sometimes the eyes feel are red in the mornings and they feel irritated.  In the picture below the patient has a lot of debris in their tear film, the eyes are a little red, and there are clogged glands on the lid margin.  This is called meibomianitis.  This is a chronic condition that comes from overpopulation of the normal bacteria in the eyelid because of glands having a tendency to clog.  Treatment ranges from hot compresses (rubbing the eyes well with a very hot cloth a few times a day) to doxycycline pills on a long term basis.  Omega-3 fatty acid supplementation may also help. When the eye becomes very inflammed to where it causes light sensitivity and pain, we have to use combination antibiotic/steroid drops. 

Thursday, March 17, 2011

Dry Eyes

The eye below is dry.  Instead of a nice smooth tear film it is broken up quickly.  You can also see some damage to some corneal surface cells. 

Thursday, March 10, 2011


About 35% of patients that have cataract surgery can develop a film on the implant during the first year after surgery.  Sometimes this film can be so bad that it decreases the vision and the patient feels like the cataract is back.  Patients feel like they're looking through a film. 

These cloudy capsules can be easily cleared with a painless laser procedure called a YAG Capsulotomy.  Usually the film never grows back again. 

Wednesday, March 9, 2011


If you don't replace your lenses when you're supposed to, usually monthly, deposits form on them.  These deposits eventually cause the contacts to feel rough.  Then inflammatory bumps begin to form under the eyelids that make it rough even with the contacts out of the eye.  Follow the doctors prescribed disposable schedule.  If you can't afford to wear contacts properly, don't wear contacts.  If it's just a matter of forgetting to change them, set your cell phone to alert you on the 30th of every month in the evening to throw your contacts out.

Tuesday, March 8, 2011


So the eye doctor is looking at your eye with the slit lamp microscope and exclames "Oh, you have Kruckenberg's Spindle!".  To which you reply "What?".   

Kruckenberg's Spindle is when pigment cells congregate on the backside of the cornea.  They are there because of lens zonules scrape pigment cells off the back of the iris and those cells float to the front and become attached to the back of the cornea.  Many of these cells can also clog up the drain of the eye causing pressure to rise in the eye.  This then can cause damage to the optic nerve and subsequent loss of vision.  At that point it is call pigmentary glaucoma.  Until then it is called pigmentary dispersion.  No need to be alarmed.  The patient is just followed once or twice a year depending on his risk. 

Saturday, March 5, 2011


Can you see the difference between the top and the bottom picture?  The bottom two show a cataract in the left eye. .  The top  is the patient's right eye.   The bottom one is the left eye two years prior than in the middle picture. 

Wednesday, March 2, 2011


The little dots on the cornea below are damaged cells from contact lens overwear.  These can grow into much higher concentration until it becomes too irritating and blurry. 

Tuesday, March 1, 2011

Fish Oil Good for Vision

Fish Oil: Good For Vision | Medical News and Health Information

Researchers fed mice a diet high in omega-3 fatty acids, and found it prevented abnormal blood vessel growth in the retina. That means omega 3’s could help prevent eye diseases like retinopathy, which are caused by an overgrowth of leaky blood vessels in the eyes

Irritated Eyes with Contact Lens Wear

Below shows redness of the top part of the eye.  This is called Superior Limbic Keratoconjunctivitis (SLK).  In middle-aged women who don't wear contact lenses it can be due to hyperthyroid.  In younger patients it is often due to irritation and inflammation stemming from contact lens wear.  It can sometimes be difficult to manage with a combination of lubricants, steroids, anti-allergy drops, contact lens and solution change, cylosporin and others.