Uveitis

Overview

Uveitis is a form of eye inflammation. It affects the middle layer of tissue in the eye wall (uvea).

Uveitis (u-vee-I-tis) warning signs often come on suddenly and get worse quickly. They include eye redness, pain and blurred vision. The condition can affect one or both eyes, and it can affect people of all ages, even children.

Possible causes of uveitis are infection, injury, or an autoimmune or inflammatory disease. Many times a cause can’t be identified.

Uveitis can be serious, leading to permanent vision loss. Early diagnosis and treatment are important to prevent complications and preserve your vision.

Symptoms

Uvea where uveitis occurs Eye with uveaOpen pop-up dialog box

The signs, symptoms and characteristics of uveitis may include:

Eye redness
Eye pain
Light sensitivity
Blurred vision
Dark, floating spots in your field of vision (floaters)
Decreased vision

Symptoms may occur suddenly and get worse quickly, though in some cases, they develop gradually. They may affect one or both eyes. Occasionally, there are no symptoms, and signs of uveitis are observed on a routine eye exam.

The uvea is the middle layer of tissue in the wall of the eye. It consists of the iris, the ciliary body and the choroid. When you look at your eye in the mirror, you will see the white part of the eye (sclera) and the colored part of the eye (iris).

The iris is located inside the front of the eye. The ciliary body is a structure behind the iris. The choroid is a layer of blood vessels between the retina and the sclera. The retina lines the inside of the back of the eye, like wallpaper. The inside of the back of the eye is filled with a gel-like liquid called vitreous.

The type of uveitis you have depends on which part or parts of the eye are inflamed:

Anterior uveitis affects the inside of the front of your eye (between the cornea and the iris) and the ciliary body. It is also called iritis and is the most common type of uveitis.
Intermediate uveitis affects the retina and blood vessels just behind the lens (pars plana) as well as the gel in the center of the eye (vitreous).
Posterior uveitis affects a layer on the inside of the back of your eye, either the retina or the choroid.
Panuveitis occurs when all layers of the uvea are inflamed, from the front to the back of your eye.

When to seek medical advice

Contact your doctor if you think you have the warning signs of uveitis. He or she may refer you to an eye specialist (ophthalmologist). If you’re having significant eye pain and unexpected vision problems, seek immediate medical attention.

Causes

In about half of all cases, the specific cause of uveitis isn’t clear, and the disorder may be considered an autoimmune disease that only affects the eye or eyes. If a cause can be determined, it may be one of the following:

An autoimmune or inflammatory disorder that affects other parts of the body, such as sarcoidosis, ankylosing spondylitis, systemic lupus erythematosus or Crohn’s disease
An infection, such as cat-scratch disease, herpes zoster, syphilis, toxoplasmosis or tuberculosis
Medication side effect
Eye injury or surgery
Very rarely, a cancer that affects the eye, such as lymphoma

Risk factors

People with changes in certain genes may be more likely to develop uveitis. Cigarette smoking has been associated with more difficult to control uveitis.

Complications

Left untreated, uveitis can cause complications, including:

Retinal swelling (macular edema)
Retina scarring
Glaucoma
Cataracts
Optic nerve damage
Retinal detachment
Permanent vision loss

July 19, 2021

Prosthetic Contact Lenses

Prosthetic contact lenses are prescribed to mask flaws and improve the appearance of an eye disfigured from a birth defect, trauma, or eye disease.

If certain structures of the injured or disfigured eye also fail to function properly, special prosthetic lenses can be designed to block excess light from reaching the back of the eye to reduce glare and increase comfort.

Your eye care practitioner can match prosthetic contact lenses to the appearance of a healthy eye by using a pre-made trial set or by ordering custom-painted contact lenses.

Like regular contact lenses, prosthetic contacts can be made of gas permeable or soft lens materials. And most prosthetic lenses can be cleaned and disinfected using the same multipurpose contact lens solutions recommended for conventional soft or gas permeable lenses.

Custom prosthetic lenses can be made in a wide variety of lens powers to correct nearsightedness, farsightedness and/or astigmatism, or they can be produced without corrective power to simply provide a more natural appearance to a blind or disfigured eye.

Eye Conditions That May Benefit From Prosthetic Contact Lenses

Many injuries, conditions and infections can lead to disfigurement of an eye and make an individual feel self-conscious about his or her appearance. Prosthetic lenses can be specially designed to match the appearance of the unaffected eye as closely as possible and make the disfigured eye less conspicuous.

Disfiguring conditions frequently treated with prosthetic contact lenses include incomplete formation of the pupil (aniridia), lack of pigment or color in the eye (albinism) and damage to the cornea from trauma.

People with albinism or other eye conditions creating light sensitivity (photophobia) can benefit from prosthetic lenses that reduce the amount of light entering the eye. Prosthetic lenses also are sometimes used to eliminate double vision (diplopia) caused by certain eye conditions.

Special prosthetic colored contact lenses sometimes are used to improve vision in cases of childhood amblyopia. Two identical-appearing colored contacts are worn, but one lens has an opaque pupil painted on it to block (occlude) light from entering the eye. This lens is worn on the eye with normal sight, forcing greater use of the amblyopic eye to improve vision development in the affected eye.

Occlusion therapy with prosthetic contact lenses can be more effective for treating amblyopia than the use of an eye patch, which children often resist or remove due to embarrassment. But amblyopia treatment with contacts is more expensive due to the cost of the prosthetic lenses.

How Prosthetic Contact Lenses Are Prescribed

The first step in being fit with prosthetic contact lenses is to have a comprehensive eye exam. During this exam, your optometrist or ophthalmologist will thoroughly examine your eyes to rule out conditions that might interfere with successful prosthetic contact lens wear.

The second step is to undergo a contact lens fitting. In addition to performing the steps in a normal contact lens exam and fitting, your eye doctor may also take close-up photographs of your eyes. These color photos are sent to the prosthetic contact lens manufacturer to help the company create a prosthetic lens that matches your natural eye color and appearance as closely as possible.

Some eye doctors who specialize in contacts for hard-to-fit eyes also may have fitting sets of sample prosthetic lenses on hand so you can get an immediate idea of how effectively the lenses can restore a natural appearance to your affected eye(s).

July 15, 2021

How to Maintain Your Eyeglasses

Though many of us wear glasses, very few of us realize the maintenance they actually need to keep our vision clear. Maintaining your eyewear isn’t difficult, but it does require special care. Read some of our tips for taking care of your eyeglasses

Tips for Maintaining Your Glasses

Avoid Chemical Contact

Your glasses can be very fragile depending on how they were made. Some lenses have films on them to provide UV protection, scratch or shatter resistance, or even to enhance your prescription. These films are the most fragile part of your glasses, and they can easily be destroyed by contact with certain abrasive chemicals.

While it’s obvious that you shouldn’t scrub your glasses with, say, bathroom cleaner, it’s much less obvious that everyday things we put on our skin, like lotions and sunscreen, can be nearly as bad for our sensitive glasses as the bathroom cleaner we all know we should never use.

These products can contain mild abrasives that do not harm (and sometimes can even help!) our skin but may harm the film on our glasses, especially with exposure over time.

Wash Your Hands

The only way to be certain that you are avoiding any chemical contact with your glasses is to wash your hands before handling them. Lotions and sunscreens are just two of the many things we can have on our hands; often our hands have all sorts of random things on them that we don’t notice or can’t see.

A simple hand washing before you handle your glasses can help to keep the abrasives from getting onto your lenses and can help keep everything clean.

Rinse Your Lenses

While you’re at the sink, run your glasses under a gentle stream of warm water. This will help to carefully remove any loose dirt or other debris that could scratch the lenses when you wipe your lenses.

If you were to omit this step, you might end up scratching your lenses with invisible debris. While the damage might not be visible immediately, it will degrade your lenses more quickly.

Use a Lens Cloth

Once your hands are clean and you’ve run your glasses under warm water, you can wipe the lenses off to remove any leftover oils and grime. Back away from that T-shirt and put down the paper towels! You should only use a cloth specially designed for lenses. Your local Eyeglass World will sell these as either lens cloths or microfiber cloths. Using a material that was not intended to clean glasses can and will do more damage than the little bits of dirt you’re trying to remove.

Use a Cleaning Solution

Usually, a simple rinse and wipe is enough to get your frames back to top condition. However, there are always cases where we end up with grime that just won’t come off easily.

In these cases, you should only use a cleaning solution that you get from your optometrist. These cleaners are specially formulated to be very gentle on your glasses, whereas cleaners that might work on other forms of glass could be harsh and cause damage.

Store Them Correctly

Remember, when you’ve cleaned your eyeglasses, you need to be sure to store them properly to avoid having them collect more dirt, causing you to have to repeat the process more often than necessary.

Use the case your eyewear came in to store them. Hard cases generally provide more protection than soft cases. Even though they tend to be bulkier – they’re the safer choice.

If you have any questions, stop by any of our branches

July 10, 2021

Anti reflective lenses

Glasses with anti-reflective coating have grown in popularity as more jobs demand that employees spend time behind a computer. Everyday use of smartphones, TV viewing, and other gadgets with screens can strain the eyes even further.

In the past, AR coating was a nuisance because it would easily peel off, scratch, and get dirty easily. Today’s AR-coated lenses have improved. Their anti-reflective capabilities are “seared” into the lens.

Anti-reflective coating, also called AR coating, is created to:

Block UV rays to enhance eye protection.
Block blue light, which can help with eye strain, blurry vision, and dry eyes.
Resist smudges and scratches.
Stop water damage.

Brands such as Crizal are major purveyors of these lenses. They specialize in lenses for children and have a variety of lenses with these features. Some of their offerings are expensive.

In addition to helping you see better, AR-coated glasses are more aesthetically pleasing if you are a person who is often photographed. They let light enter more easily, allowing people to see your eyes better beneath your lenses.

June 28, 2021

Contact Lens Prescription Calculator

Click to convert your eyeglasses prescription to contact Lens prescription

May 27, 2021

After 40 years of blindness, injection of light-sensitive protein restores a man’s vision

The first successful clinical test of a technique called optogenetics has allowed a 58-year-old man to see for the first time in decades.

The man was able to see with the help of image-enhancing goggles after 40 years of blindness, thanks to an injection of light-sensitive proteins into his retina.

According to a study published by Nature Medicine on May 24, this is the first successful clinical application of optogenetics, a technique in which flashes of light are used to control gene expression and neuron firing.

The study revealed that the technique is widely used in laboratories to probe neural circuitry and is being investigated as a potential treatment for pain, blindness and brain disorders.

The clinical trial, run by the company GenSight Biologics, based in Paris, enrolls people with retinitis pigmentosa — a degenerative disease that kills off the eye’s photoreceptor cells, which are the first step in the visual pathway.

In a healthy retina, photoreceptors detect light and send electrical signals to retinal ganglion cells, which then transmit the signal to the brain.

GenSight’s optogenetic therapy skips the damaged photoreceptor cells entirely by using a virus to deliver light-sensitive bacterial proteins into the RGCs, allowing them to detect images directly.

GenSight is one of several companies developing optogenetics as a treatment for RP and other disorders of the retina.

In March, Nirenberg’s company Bionic Sight announced that four of the five people with RP it had treated with a similar optogenetic therapy and a virtual-reality headset had recovered some level of vision, although the full trial results have not yet been published.

Also, Swiss pharma giant Novartis is developing a therapy based on a different protein that is so light-sensitive that goggles might not be needed. That therapy has not yet entered clinical trials.

The researchers injected the virus into the eye of a man with RP, then waited four months for protein production by the RGCs to stabilise before testing his vision, the Nature Medicine reported.

José-Alain Sahel, an ophthalmologist at the University of Pittsburgh Medical Center in Pennsylvania and leader of the study, says that one of the challenges was regulating the amount and type of light entering the eye, because a healthy retina uses a variety of cells and light-sensitive proteins to see a wide range of light.

“No protein can replicate what the system can do,” he says. So the researchers engineered a set of goggles that captured the visual information around the man and optimised it for detection by the bacterial proteins.

Using a camera, the goggles analyse changes in contrast and brightness and convert them in real-time into what Sahel describes as a ‘starry sky’ of amber-coloured dots. When the light from these dots enters a person’s eye, it activates the proteins and causes the RGCs to send a signal to the brain, which then resolves these patterns into an image.

The trial participant had to train with the goggles for several months before his brain adjusted to interpret the dots correctly. “He was like an experimentalist, a scientist trying to understand what he was seeing and make sense of it,” Sahel says.

Eventually, he was able to make out high-contrast images, including objects on a table and the white stripes in a crosswalk. When the researchers recorded his brain activity, they found that his visual cortex reacted to the image in the same way as it would have if he had normal sight.

The man still can’t see without the goggles, but Sahel says that he wears them for several hours per day and that his vision has continued to improve in the two years since his injection.

Sahel says six other people were injected with the same light-sensitive proteins last year, but the COVID-19 pandemic delayed their training with the goggles.

A neurobiologist at the University of California, John Flannery says the study “is a big step for the field.

“The most important thing is that it seems to be safe and permanent, which is really encouraging.”

Flannery said while the image may never be as good as natural vision, it is exciting that the brain can interpret images accurately.

Other researchers are, however, calling for more studies.

Sheila Nirenberg, a neuroscientist at Weill Cornell Medical College in New York City says she looks forward to seeing whether the other people in the trial, including some who were injected with higher doses of the protein, have similar results.

“It’s interesting, but it’s an N of 1,” she says.

Karl Deisseroth, a neuroscientist at Stanford University in California who co-developed optogenetics as a lab technique, says the study is important because it is the first time that the technique’s effects have been shown in people.

“It will be interesting to try this with more light-sensitive opsins” that might not require goggles, he says. But he expects optogenetics to be most useful as a research tool that leads to therapies, rather than a therapy itself.

“What we hope to see even more of is optogenetics-guided human and clinical studies,” he says.

May 24, 2021

How to maintain health eyes

Good vision helps you perform well—at home, at work, or behind the wheel. That’s why it’s important to take a few simple steps to make sure you help keep your eyesight at its best. A regular eye exam is the best way to protect your eyesight – and an easy precaution to take. Here are some tips to help maintain eye health as you age.

Eat a Balanced Diet

fruit vegetables As part of your healthy diet, choose foods rich in antioxidants, like Vitamins A and C; foods like leafy, green vegetables and fish. Many foods – especially fatty fish, such as salmon – contain essential omega-3 fatty acids that are important to the health of the macula, the part of the eye responsible for central vision.

An inadequate intake of antioxidants, consumption of alcohol or saturated fats may create free-radical reactions that can harm the macula – the central part of the retina. High-fat diets can also cause deposits that constrict blood flow in the arteries. The eyes are especially sensitive to this, given the small size of the blood vessels that feed them.

Your eyes are unique, and have their own set of nutritional needs. Ocuvite eye vitamins are specially designed to provide a balanced combination of nutrients dedicated to the health of your eyes.* Visit Ocuvite.com to learn more.

Exercise

Exercise improves blood circulation, which improves oxygen levels to the eyes and the removal of toxins.

Get a good night’s sleep

You’ll feel the difference when you get the sleep you need. You’ll look great, you’ll perform at home or work—and good rest will support the health of your eyes.

Wash your hands

Keeping your hands clean is so important when it comes to your eyes, especially if you’re a contact lens wearer. Before you touch your eye—and before you put in or remove a contact lens—wash your hands with a mild soap and dry with a lint-free towel. Some germs and bacteria that come from your hands can cause eye infections, like bacterial conjunctivitis (pink eye). When you touch your eye, whatever is on your fingers goes right onto your eye’s surface. This is one way that people catch colds—rubbing their eyes while they have cold virus germs on their hands.

Don’t Smoke

Smoking exposes your eyes to high levels of oxidative stress. While the connection has not been clearly identified, it is known that smoking increases your risk for a variety of health conditions affecting the eye. To help you quit, visit the American Lung Association’s free online smoking cessation program – Freedom From Smoking Online – at www.ffsonline.org.

Wear Sunglasses

To protect your eyes from harmful ultraviolet (UV) light, choose sunglasses with both UVA and UVB protection. Also, wearing a hat with a brim will greatly reduce the amount of UV radiation slipping around the side of your sunglasses.

Devices and Blue Light

You’re probably using digital devices for hours each day at work and at home. These devices are exposing your eyes to high energy blue light. It’s called blue light because the wavelengths emitted are near the bluer part of the spectrum. Lutein & Zeaxanthin are eye nutrients that are concentrated in the macula and help eyes filter blue light.* Lutein and Zeaxanthin cannot be produced by our bodies on their own, so they must be obtained through diet and/or supplements. If you don’t think you’re getting enough in your diet, visit Ocuvite.com to learn more.

Here are some other tips to help when you’re on your computer:

Keep your computer screen within 20″-24″ of your eye.
Keep the top of your computer screen slightly below eye level.
Adjust lighting to minimize glare on the screen.
Blink frequently.
Take a break every 20 minutes to focus on an object 20 feet away for 20 seconds.
Use lubricating eye drops to soothe irritated, dry eyes.

August 22, 2020

Glaucoma

Glaucoma is a condition that damages your eye‘s optic nerve. It gets worse over time. It’s often linked to a buildup of pressure inside your eye. Glaucoma tends to run in families. You usually don’t get it until later in life.

The increased pressure in your eye, called intraocular pressure, can damage your optic nerve, which sends images to your brain. If the damage worsens, glaucoma can cause permanent vision loss or even total blindness within a few years.

Most people with glaucoma have no early symptoms or pain. Visit your eye doctor regularly so they can diagnose and treat glaucoma before you have long-term vision loss.

If you lose vision, it can’t be brought back. But lowering eye pressure can help you keep the sight you have. Most people with glaucoma who follow their treatment plan and have regular eye exams are able to keep their vision.

Glaucoma Causes

The fluid inside your eye, called aqueous humor, usually flows out of your eye through a mesh-like channel. If this channel gets blocked, the liquid builds up. Sometimes, experts don’t know what causes this blockage. But it can be inherited, meaning it’s passed from parents to children.

Less-common causes of glaucoma include a blunt or chemical injury to your eye, severe eye infection, blocked blood vessels inside your eye, and inflammatory conditions. It’s rare, but eye surgery to correct another condition can sometimes bring it on. It usually affects both eyes, but it may be worse in one than the other.

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Glaucoma Risk Factors

It mostly affects adults over 40, but young adults, children, and even infants can have it. African Americans tend to get it more often, when they’re younger, and with more vision loss.

You’re more likely to get it if you:

Are of African American, Irish, Russian, Japanese, Hispanic, Inuit, or Scandinavian descent
Are over 40
Have a family history of glaucoma
Have poor vision
Have diabetes
Take certain steroid medications such as prednisone
Have had an injury to your eye or eyes
Have corneas that are thinner than usual
Have high blood pressure, heart disease, diabetes, or sickle cell anemia
Have high eye pressure
Are nearsighted or farsighted

Types of Glaucoma

There are two main kinds:

Open-angle glaucoma. This is the most common type. Your doctor may also call it wide-angle glaucoma. The drain structure in your eye (called the trabecular meshwork) looks fine, but fluid doesn’t flow out like it should.

Angle-closure glaucoma. This is more common in Asia. You may also hear it called acute or chronic angle-closure or narrow-angle glaucoma. Your eye doesn’t drain like it should because the drain space between your iris and cornea becomes too narrow. This can cause a sudden buildup of pressure in your eye. It’s also linked to farsightedness and cataracts, a clouding of the lens inside your eye.

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Less common types of glaucoma include:

Secondary glaucoma. This is when another condition, like cataracts or diabetes, causes added pressure in your eye.

Normal-tension glaucoma. This is when you have blind spots in your vision or your optic nerve is damaged even though your eye pressure is within the average range. Some experts say it’s a form of open-angle glaucoma.

Pigmentary glaucoma. With this form, tiny bits of pigment from your iris, the colored part of your eye, get into the fluid inside your eye and clog the drainage canals.

Glaucoma Symptoms

Most people with open-angle glaucoma don’t have symptoms. If symptoms do develop, it’s usually late in the disease. That’s why glaucoma is often called the “sneak thief of vision.” The main sign is usually a loss of side, or peripheral, vision.

Symptoms of angle-closure glaucoma usually come on faster and are more obvious. Damage can happen quickly. If you have any of these symptoms, get medical care right away:

Seeing halos around lights
Vision loss
Redness in your eye
Eye that looks hazy (particularly in infants)
Upset stomach or vomiting
Eye pain

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Glaucoma Diagnosis

Glaucoma tests are painless and don’t take long. Your eye doctor will test your vision. They’ll use drops to widen (dilate) your pupils and examine your eyes.

They’ll check your optic nerve for signs of glaucoma. They may take photographs so they can spot changes at your next visit. They’ll do a test called tonometry to check your eye pressure. They may also do a visual field test to see if you’ve lost peripheral vision.

Glaucoma Treatment

Your doctor may use prescription eye drops, oral medications, laser surgery, or microsurgery to lower pressure in your eye.

Eye drops. These either lower the creation of fluid in your eye or increase its flow out, lowering eye pressure. Side effects include allergies, redness, stinging, blurred vision, and irritated eyes. Some glaucoma drugs may affect your heart and lungs. Be sure to tell your doctor about any other medications you’re taking or are allergic to.

Oral medication. Your doctor might also prescribe medication for you to take by mouth, such as a beta-blocker or a carbonic anhydrase inhibitor. These drugs can improve drainage or slow the creation of fluid in your eye.

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Laser surgery. This procedure can slightly raise the flow of fluid from your eye if you have open-angle glaucoma. It can stop fluid blockage if you have angle-closure glaucoma. Procedures include:

Trabeculoplasty. This opens the drainage area.
Iridotomy. This makes a tiny hole in your iris to let fluid flow more freely.
Cyclophotocoagulation. This treats areas of the middle layer of your eye to lower fluid production.

Microsurgery. In a procedure called a trabeculectomy, your doctor creates a new channel to drain the fluid and ease eye pressure. This form of surgery may need to be done more than once. Your doctor might implant a tube to help drain fluid. This surgery can cause temporary or permanent vision loss, as well as bleeding or infection.

Open-angle glaucoma is most often treated with combinations of eye drops, laser trabeculoplasty, and microsurgery. Doctors tend to start with medications, but early laser surgery or microsurgery could work better for some people.

Infant or congenital glaucoma — meaning you are born with it — is usually treated with surgery because the cause is a problem with your drainage system.

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Glaucoma Prevention

You can’t prevent glaucoma. But if you find it early, you can lower your risk of eye damage. These steps may help protect your vision:

Have regular eye exams. The sooner your doctor spots the signs of glaucoma, the sooner you can start treatment. If you’re over age 40 and have a family history of the disease, get a complete eye exam from an eye doctor every 1 to 2 years. If you have health problems like diabetes or are at risk of other eye diseases, you may need to go more often.
Learn your family history. Ask your relatives whether any of them have been diagnosed with glaucoma.
Follow your doctor’s instructions. If they find that you have high eye pressure, they might give you eye drops to prevent glaucoma.
Exercise. Moderate activity like walking or jogging at least three times a week might help lower eye pressure.
Protect your eyes. Use protective eyewear when playing sports or working on home improvement projects

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To Be the Region’s Leading Eye Care Provider, Delivering the Most Advanced, Specialized Eye Care Services in a Compassionate, Patient-Centered Approach.

July 29, 2020

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