symptoms of dry eye melbourne

Symptoms of Dry Eye – Understanding Dry Eye Disease

Many people will encounter at least one of the symptoms of dry eye in their lifetime. For some, dry eye may be a mild, transient irritation, while for others it can be a significant, debilitating condition that interferes with daily tasks and can only be controlled with targeted dry eye treatment

The condition of dry eyes has now been recognised as a real disease with real impact, sometimes called dry eye disease or dry eye syndrome. The global prevalence of dry eye disease varies, with some studies reporting up to 50% of the population suffers from some degree of the condition. As the symptoms of dry eye disease and its effects vary across such a wide range, dry eye is thought to be significantly under-diagnosed. Many people with only a mild case of dryness may opt to self-manage rather than seek the care of an eye care professional for dry eye treatment

 

What is Dry Eye Disease?

Dry eye syndrome, or dry eye disease, is a little more complex than simply being eyes that feel dry. A healthy eye’s surface is covered by a stable layer of tears, known as the tear film. This tear film is composed of many different components, such as proteins, lipids, and antibodies, that work together to keep the surface of the eye well lubricated, protected, and nourished. The main bulk of the tear film is produced by three types of glands around the eye:

  • The lacrimal gland is located above the upper eyelid, producing the watery, or aqueous, component of the tear film
  • Goblet cells of the conjunctiva secrete a mucous layer which helps the tear film to adhere to the eye
  • The meibomian glands line the upper and lower eyelids, secreting an oil which sits at the outer surface of the whole tear film, reducing evaporation of the aqueous component

treatment symptoms of dry eye melbourneThere are a multitude of factors that can contribute to dry eye disease. Experts have divided the condition into two broad classifications – evaporative dry eye and aqueous deficiency dry eye. Evaporative dry eye occurs when the tear film is unstable and evaporates too quickly from the surface of the eye.

The majority of evaporative dry eye conditions are a result of a dysfunction of the meibomian glands mentioned earlier but can also be caused by blepharitis (accumulation of irritants around the eyelashes and subsequent inflammation of the eyelids), eye allergies, preservatives in eye drop medications, or contact lens wear. Most cases of dry eye disease are evaporative in nature.  Aqueous deficiency dry eye comprises a much smaller percentage of dry eye disease but includes underlying causes such as autoimmune disease, systemic medications, laser eye surgery, or dysfunction of the lacrimal gland. Identifying the type of dry eye and the contributing factors is important for effective dry eye treatment

 

What Are the Symptoms of Dry Eye? 

The symptoms of dry eye are not always obvious, and some may be mistaken for other conditions, resulting in inappropriate treatments which are ineffective. 

Symptoms of dry eye can include:

  • The sensation of dryness: not everyone with dry eye will identify the eyes as actually feeling dry, though this is the most obvious symptom. The feeling of dryness can range in severity from person to person. 
  • Grittiness, stinging, or burning: these are also common sensations associated with dry eye. Some people may describe the feeling of having a foreign object, like an eyelash or speck of dust, stuck in the eye that can’t be washed out. The irritation felt by a dry eye is due to the underlying inflammation associated with dry eye disease, as well as the surface of the eye becoming exposed to the environment as the protective tear layer evaporates.
  • Red eyes: while this is a common symptom of dry eye disease, the presence of a red or pink tinge to the whites of the eye or the rims of the eyelids can cause some people to seek inappropriate treatments, such as antihistamines or antibiotics, when there is no allergy or infection involved. Although the added moisture from these eye drops may help alleviate some of the redness, they are not an effective dry eye treatment
  • Blurry vision: because the tear film is the first refractive surface that light passes through in order to reach the back of the eye for vision, if this tear layer is uneven or unstable, it can cause vision to appear blurry. People with dry eye may find their vision is quite variable, especially between blinks. 
  • Glare sensitivity: light scattered by an uneven tear film may cause the eyes to feel more uncomfortable and sensitive to light sources, whether it be the sun outdoors or the light from a screen. 
  • Watery eyes: counterintuitively, watery eyes may in fact be a symptom of dryness. As the eye’s surface feels dehydrated, biological feedback mechanisms trigger a reflex to produce more tears, which can end up with the eye feeling watery instead. 

Dry eye disease is a very common condition. In most cases it can be managed with simple remedies such as lubricant eye drops or home therapies such as warm compresses. In some cases, a comprehensive eye examination with an eyecare professional may be necessary to formulate a more intensive, targeted treatment plan.

explained difference between long and short sightedness melbourne

The Difference Between Long and Short Sightedness

Many people believe long sightedness to be the straightforward opposite of short sightedness. While to a certain extent this is true, the difference between long and short sightedness is a little more complex than long sightedness simply being able to see in the distance and not up close, and short sightedness being vice versa. To further complicate things, an additional condition known as presbyopia is often confused for long sightedness as people with presbyopia find an increasing difficulty with their near vision. 

 

Refractive Error and Eye Anatomy

In simple terms, refractive error refers to the mismatch of the eye’s focusing power to the length of the eyeball. Refractive error includes both long and short sightedness, as well as another condition known as astigmatism, and the previously mentioned presbyopia.

There are several points in the eye that light must pass through in order for us to see. These anatomical points serve as surfaces to bend light rays such that the rays come to a sharp point on the retina at the back of the eye, thereby providing a clear image. It’s when the refractive (focusing) power of these anatomical components doesn’t quite manage to bring the rays of light to a sharp focus on the right spot that we experience blurry vision. 

Light first passes through the tear film, which covers the cornea, before then passing through the cornea itself. The cornea is the transparent dome at the front of the eye; together with the tear film it accounts for about two-thirds of the focusing power of the eye. The crystalline lens, which sits behind the coloured iris, is responsible for the remaining one-third. The lens is suspended in place with fibres attached to a ring of muscle and can adjust its shape to bring forward the focal point of the eye to focus on closer objects in an action known as accommodation – this is particularly important for understanding long sightedness

The length of the eyeball, known as the axial length, plays a significant role in the presence of refractive error. As mentioned earlier, light must be refracted, or focused, through the tear film, cornea, and crystalline lens, to come to a sharp point right on the retina in order for us to perceive clear vision. If this focal point of light falls short of the retina, or falls behind the retina, we end up with blurred sight. 

explained difference between long and short sightedness melbourneThe main difference between long and short sightedness, and the only straightforward part of this explanation, is that long sightedness, also known as hyperopia or hypermetropia, occurs when the eyeball is too short for the focusing power of the eye – that is, the focal point of light falls behind the retina. Short sightedness, also called myopia or nearsightedness, occurs when the length of the eyeball is too long for its focusing power, and the focal point of light falls short of the retina. Both long and short sightedness may occur in conjunction with astigmatism, which is commonly caused by an uneven cornea.

Presbyopia refers to the age-related decline in the flexibility of the crystalline lens and reduced accommodative ability, resulting in an increasing difficulty at focusing up close such as during reading. Many people confuse this with long sightedness, believing both to simply refer to an inability to see at near, but these are two different conditions. Presbyopia occurs to everyone with age, and can occur alongside both long and short sightedness

 

The Difference Between the Long and Short Sightedness Experience 

Here we come to the complicated part. 

People with long sightedness, can be quite content at both far and near distance viewing without the need for glasses or conversely, experience blurred sight for both distant and near objects, and require corrective lenses all the time. This is typically dependent on two factors – the age of the person (and therefore their ability to accommodate) and the magnitude of their hyperopia. In a young person with a flexible crystalline lens and active accommodation, a hyperopic refractive error may be compensated through accommodation, meaning the lens is able to change its shape enough to provide clear vision at both distance and near. However, the nature of hyperopia is such that the crystalline lens is working to focus even far distance objects. This means a young person who is very long sighted may find the effort to see clearly even in the distance is too great, with this effort increasing as the viewing distance comes closer, and will therefore need glasses for both long and short distances. 

On the other hand, people with short sightedness, or myopia, will always find their long-distance vision to be clearer through their corrective lenses, regardless of age. A young person with short sightedness will also be able to read clearly at near through their glasses for myopia, due to active accommodation, but may find that removing their spectacles for reading is just as clear and possibly more comfortable. An older patient with myopia and reduced accommodative ability will find they will have difficulty seeing at near unless they remove their distance optical correction or wear lenses such as multifocals or bifocals with an integrated reading prescription.  

 

Refractive error can be a complicated topic but the good news is that there are a multitude of options for correcting both long and short sightedness, including glasses, contacts, and laser eye surgery. Call us today at (03) 9070 3580.

corneal infection melbourne

All About Corneal Infection And What Should You Do About It

A corneal infection is no laughing matter. While some corneal infections cause only a mildly irritated eye, other cases can present as a serious eye health concern with the potential to cause permanent vision loss. A corneal infection may arise due to a number of reasons, including bacterial or viral infections, or even due to fungi or parasites. 

The cornea is the transparent dome of tissue at the very front surface of the eye. This anatomical structure is the first surface that light passes through in order to reach the back of the eye and form what we call vision; disruption to the clarity of this tissue can be a real problem for your sight. The cornea is also the most sensitive structure, something that becomes apparent when even the finest eyelash falls into your eye.

You may come across the word “keratitis” when reading about corneal infections – keratitis technically refers to any inflammatory condition of the cornea and may or may not involve an active infection. However, all corneal infections involve some degree of inflammation at some stage of the disease, and so will often include keratitis in its medical naming.  

 

Causes of Corneal Infection 

Infectious causes of keratitis include:

 

Viral infections

The most common viruses involved in viral infections of the cornea are herpes viruses and adenoviruses – viruses that are often responsible for conditions beyond eye health. Type 1 herpes simplex is the same strain that causes cold sores and also has the ability to cause an eye infection known as herpes simplex keratitis.

Another virus of the herpes family is varicella zoster virus, which is also the virus behind conditions like chickenpox and shingles. Unfortunately, both these viruses are never cleared from the body but instead lie dormant; reactivation of the virus from various triggers can cause recurrent infection and inflammation, which can be sight-threatening. Adenoviruses are very common viruses often responsible for symptoms such as sore throat, pneumonia, and the common cold. Viral infections of the eye associated with adenoviruses are highly contagious, so much so that an eye infection caused by adenoviruses is called “epidemic keratoconjunctivitis”. 

causes corneal infection melbourneViral corneal infections often present as a sore, watery, red eye. There is also often glare sensitivity and blurred vision in the affected eye. The infection may be present only on one side, however, due to the highly contagious nature of the adenovirus, it can be expected to soon spread to the other eye. Patients with herpes-associated keratitis may have a history of cold sores while patients with adenoviral keratoconjunctivitis may report having had a recent cold or been in contact with someone else with a cold. Unlike herpes keratitis, which is treated with antiviral medication, there is no consensus on effective treatment for adenoviral keratitis, which will often self-resolve over a couple of weeks. 

 

Bacterial infections

Bacteria are the most common culprits of corneal infections, typically staphylococcus aureus and pseudomonas aeruginosa. Bacterial keratitis should never be ignored as it can have serious consequences for eye health, including permanent scarring and loss of vision. People who wear contact lenses, especially those with contact lens habits contrary to the recommendations of their eyecare practitioner, are at a greater risk of bacterial keratitis; additional risk factors include other causes of compromised eye health such as chronic dry eye, recent eye surgery, or eye trauma.  

Similar to a viral corneal infection, bacterial keratitis will also present with a painful, red eye but the discharge will often be of a pus or mucous consistency rather than watery. Depending on the site and severity of the infection, your vision may be significantly impaired from a large, central corneal ulcer, or perhaps only slightly blurry from the mucous discharge. 

 

Fungal infections

Corneal infections due to fungi can be more difficult to identify as it develops slowly, often presenting symptoms only days after the initial infection. However, the effect on eye health and vision can be devastating if not treated appropriately. Many cases of fungal keratitis are preceded with some sort of vegetation-related trauma to the eye, such as plant matter flicking into the eye during gardening or being scratched in the eye by a tree branch or leaf while outdoors. Contact lens wearers are also at a higher risk of contracting fungal keratitis, as are people who are immunocompromised, such as those using steroid medications. Common fungal pathogens include Candida, Aspergillus, and Fusarium. It’s been noted that the likelihood of specific fungal infections can vary by geography and climate. 

A fungal keratitis can present with the typical eye infection symptoms of pain, redness, glare sensitivity, tearing, and decreased vision. However, some cases actually present with very little pain or discomfort in the eye, which can delay diagnosis and prompt treatment. 

 

Parasitic infections

Luckily, parasitic keratitis is rare. The most common parasite to cause keratitis is acanthamoeba, a common, hardy protozoa found in water, soil, and even air. Similar to other types of infectious keratitis, contact lens wearers are at an increased risk of contracting acanthamoeba keratitis, particularly when proper lens disinfection and hygiene is disregarded. 

The distinguishing symptom of acanthamoeba keratitis is severe pain, disproportionate to the other symptoms such as watering, redness, and glare sensitivity; this is thought to be due to the microorganism specifically targeting the corneal nerves. If not treated promptly and appropriately, uncontrolled Acanthamoeba keratitis can cause permanent loss of vision in the affected eye.

 

Contact Us Today

The best thing to do if you think you may have a corneal infection is to see your eyecare practitioner immediately. Depending on the underlying cause of the keratitis, its severity, and your risk of permanent vision loss, corneal infections may be treated with topical eye drop medications, systemic medications, or a combination of both.

myopia treatment Mornington

Myopia Treatment Options To Slow The Progression

Myopia, also known as short-sightedness and nearsightedness, is one type of refractive error. It can occur alongside astigmatism, which is a type of refractive error involving multiple focal points of light through the eye, as well as in combination with presbyopia, the natural age-related deterioration of near focus. Research tells us that the prevalence of myopia is steadily increasing across the world, with projections predicting about 50% of the global population having some degree of nearsightedness by the year 2050.

 

What is Nearsightedness?

All refractive errors involve a fault in the coordination of the eyeball between its axial length (from front to back of the eye) and its refractive power (its ability to bend light to focus).

Nearsightedness occurs when the focusing power of the eye is too strong for its length. Alternatively, it can be thought of as the axial length of the eyeball is too long for its refractive power. Most cases of nearsightedness arise during school age and are due to a combination of genetic and environmental factors. However, adult onset myopia is not unknown.

myopia treatment in Mornington

Patients with nearsightedness will find that distant objects are blurry, such as when looking down the road while driving or trying to read the whiteboard while sitting at the back of the class. Conversely, near objects such as books and phones are likely to be easy to see clearly. The distance at which an object becomes blurry as it moves further away or comes clear as it moves closer will depend on a patient’s prescription – typically, the higher the prescription, the closer an object will need to be for it to be in focus. However, patients with a combination of myopia and astigmatism may find that objects are not quite clear at any distance.

We are still learning about myopia – what factors influence its development and progression, what myopia treatment strategies are most effective at preventing or slowing it down, and the health implications of having a myopic population. At this point in time we know that nearsightedness is related to an increased risk of multiple eye diseases, much more than simply being an inconvenient blur. Due to the elongated, stretched nature of a myopic eyeball, people with short-sightedness are at a higher risk of potentially sight-threatening diseases such as myopic maculopathy, retinal detachments, and glaucoma.

 

Myopia Treatment

Unfortunately, nearsightedness cannot be reversed or undone and the eye health risks that come with myopia are lifelong. However, apart from the eye health concerns that come with short-sightedness, the most obvious aspect that needs addressing is the blurry vision.

Traditionally, spectacles and contact lenses have been and will continue to be a popular solution for nearsightedness. However, as medical technologies advance, surgical procedures for the correction of refractive errors are gaining in popularity, providing a welcome independence for the inconvenience of glasses and contacts.

Myopia treatment is well served with refractive surgery as many of these methods are able to treat high levels of nearsightedness. The most suitable technique will depend on various factors such as the individual biometry of your eye, your prescription, your lifestyle, and even your age. Your surgeon will assess and discuss your suitability for treatments such as PRK (photorefractive keratectomy), LASIK (laser assisted in situ keratomileusis), ICL (intraocular contact lens), and one of the more recent innovations – SMILE® laser eye surgery.

 

SMILE® Laser Eye Surgery

SMILE® stands for small incision lenticule extraction and has been applauded in recent years due to its excellent safety profile and ability to provide great visual outcomes with reduced risk of complications.

During the SMILE® procedure, a femtosecond laser is used to create a pre-calculated, precisely shaped disc of tissue, known as a lenticule, within the corneal tissues. The cornea is the dome of transparent tissue at the front of the eye and is largely responsible for the total refractive power of the eye. The lenticule is then removed through a small keyhole incision at the surface of the cornea, resulting in an adjusted corneal curvature. The reshaping of this anatomical structure redirects the passage of light through the eye such that it ends up focusing where it should – on the retina for clear vision.

myopia treatment at MorningtonSMILE® laser eye surgery is considered a minimally invasive procedure, which carries some significant benefits. Lower risk of post-operative dry eye: As fewer corneal nerves are disrupted with the SMILE® technique, patients with pre-existing dry eye may find this a more appealing option.

Shorter recovery time: Because there is less disturbance to the corneal tissue, eyes that have undergone SMILE® are left with better biomechanical stability of the cornea, and as the delicate corneal epithelium is left intact, there is much less post-operative discomfort.

Reduced risk of trauma-related complications: One advantage of SMILE® over LASIK is that it does not require the formation of a corneal flap. In LASIK, corneal reshaping can only take place once the top layers of corneal tissue have been moved to the side in the form of a hinged flap. This flap is then repositioned but activities such as intensive physical activity, bumps to the head, or exposure to dirty environments can dislodge this flap or allow debris beneath it, causing inflammation.

Currently, SMILE® surgery can be utilised for patients with up to -10D of myopia.

 

If you suffer from nearsightedness, there are ways to slow its progression. Contact an on (03) 9070 3580 to schedule a consultation.

 

 

Note: Any surgical or invasive procedure carries risks. Before proceeding, you should seek a second opinion from an appropriately qualified health practitioner.