The_Matrix

I am a licensed eye care professional in New York State, and if you have any concerns related to your eyes and/or vision, post them here on this thread and I will answer them to the best of my knowledge.

Member "S" asks:

Idoc:

Saturday night, i started feeling my Left eye was a little sore. I checked it out in the mirror, and it didnt look like anything was there and it was puffy or swollen.

The next morning, i awake to my eye swollen and a bit painful when  i applied pressure to it with a cold compress.

It went down a little bit as the day went by, but it still was tender.

I awake today, and omg, it was puffier than the hunchback of notre dame's eye. There is a bulging ball on my upper eye lid, (not on it, but on top of it). It hurts, i could barely put on makeup. it hurts when i blink.

wtf is wrong with my eye! do i need real medical attention? Is it a sty???
HELP!


It sounds like a stye. fisrt try pushing your eye lid up against your eyebrow, and then by pressing through a different area of the lid when the eye is closed. There should be pain in the first case and none in the second case, because it's in the lid. If that's the case then you are probably getting a stye which is a clogged gland on the lid. Try to turn the lid up (its going to hurt) and look for a white spot, which is the head...if you see the white spot either on the inside of the lid or on the margin, then using warm compresses twice a day for about 5 minutes, with gentle pressure, may release the contents of the stye and you will be ok. From your rather severe symptoms you are probably going to need a steroid-antibiotic ointment which is available by Rx only.

Disclaimer: I am a licensed NYS eye care professional and therefore I am qualified to dispense medical advice regarding your eyes and vision, but without having physically examined you I cannot accurately diagnose your condition, and my advice is no substitute for a thorough eye examination by a doctor

I can't see.

I think I'm going blind... again.

help.


 ???

   About 3 years ago my close up vision became blurred to the point where I couldn't read a newspaper or focus on a computer screen . I've been using magnifiers ever since , not prescription or anything , just the 1.5x you get down at the Walgreens . I wear them pretty constantly as I spend a lot of time on the computer but my eyes don't hurt ... I was wondering if it's pretty much normal for your vision to start to blur as you get older ( I'm 48 now ) and what to expect in the next few years .

Most people lose their near point vision at or around 43, give or take a few years, it's like a bell curve distribution. Some may feel it as early as 39, some may make it to mid to late 40s...depending on things such as their own sensitivity and tolerance to blur, the length of their arms (because they can hold near point print further away), and how much near work they actually do...

This condition, known as presbyopia, is due to the gradual hardening and increased rigidity of the intraocular lens..the muscles inside the eye that focus the lens for close work cannot work as efficiently. The process is steady, and progressive, there is nothing you can do to stop it, and there's nothing you did to cause it, however, you should not rely on inexpensive over the counter reading glasses because

1) They may stop you from getting regular eye examinations, which at your age should be done at least every 2 years
2) They are not the same optical quality as real prescription reading glasses
3) The frames are cheap, and not adjusted properly for your face
4) They do not balance our differences between the two eyes which most people have. Try it for yourself, focus on something close through the readers with one eye covered, then switch to the other eye. If its out of focus, even momentarily, thats the difference in the two eyes I am referring to.
5) They dont compensate for even small amounts of astigmatism, which many people have.
6) The centers of the lenses are not measured to line up exactly with the centers of your eyes, so you are essentially getting a prism effect when looking through the magnifiers.

There are other reasons but those are the main ones. Get yourself to the eye doctor and get a real pair of reading glasses.

Might be exessive masterbation. You know it can make you go blind.

Oh crap. Here i go playing eye doctor again!

Presbyopia?  What the hell does fear of Presbyterians have to do with your vision?  ;D

Um...absolutely nothing.

 :(

 ;D ;D ;D

Yeah I think I will ... these magnifiers scratch easily and I've already bought like 5 of 6 of them , I'll end up spending the money anyway so I may as well get something good .

Thanks for the advice !

Hey Idocsteve.Last time I went for my eye exam I was told I couldn't wear contacts anymore. I wear bifocals and have astigmatism in both eyes. I really want to wear contacts because I have these big beautiful big green eyes that are hid behind glasses.
Are there contacts for someone like me?

I've seen her pic and she does indeed have georgeous eyes! Give her contacts!  LOL funny pm to follow

I just want to know if the hicks here are full of ****. I could wear contacts and then reading glasses or something.
Where's that damn doctor. They always keep ya waiting! LOL

(http://i294.photobucket.com/albums/mm105/thorazine_9/0845c.jpg)

(http://i294.photobucket.com/albums/mm105/thorazine_9/gre.jpg)

peek a boo!

LOL your eyes are the same color as David Cassidy's. Don't worry, I won't get all sexual over you  LOL

Don't knock it unless you tried it. Just kidding. ;D

There ARE bifocal contact lenses for people with astigmatism, several of the larger contact lens companies make them. The fitting is a bit complicated and more expensive then regular contacts but sure they are available, another option is "monovision" with toric (astigmatic contacts), with one eye distance, the other eye reading, or as you said, distance contact lenses that correct your astigmatism with reading glasses over them for close work.

I have heard this same story so many times, about how "my last eye doctor told me I couldnt wear contacts for such and such a reason".

It's not true, and docs like that are really unethical to say it, simply because they don't have the know-how, the training, the time, or they just dont give a ****.

 ;) I thought so. I'm going back to contacts ASAP.  You're the best! Thanks.

 ;) never tried it

Do you think there are contacts I could comfortably wear? I'd be willing to try again if it's possible.

Yes, I do. Lots of new contacts available nowadays.

It would be really helpful to know about how much astigmatism you have. If it's at or less than 2.50 diopters, I have had the best success with the new Acuvue Oaysis astigmatism contact lenses by Johnson and Johnson, the makers of Acuvue contact lenses.

You could either do monovision, one eye distance and one eye near or both eyes distance with a pair of reading glasses over them for nearpoint work. Not sure if the complex bifocal astigmatic contacts would work for you, and you would need to find an OD who will fit them. I would be happy to try, but it might be a long trip for you...

My next question is can you recommend anyone in my area. I'll PM you on that.

Wiser I have those "monovision" contacts and I don't like them at all!  I don't get the "crisp" vision I do with my glasses so I rarely wear them. I am nearsighted and have astigmatism.  I have had these ones for about 2 years.....I still have one of the bottles one of them came it.......the one for distance I believe.  It says the BC is 8.7, DIA 14.4, PWR -3.25 -2.25x180 on it. Is there anything new on the market that can give me the vision I want?

The best solution for high astigmatism is both contacts for distance, and then throw on a pair of reading glasses for close work.

I saw a patient yesterday with a subconjunctival hemorrhage, pictured below. The truth is, they look scary but most of time they are meaningless, and do not require any treatment. If they occur repeatedly, or in both eyes then they "can" be a sign of an underlying blood disorder. They are often seen in patients who take aspirin or blood thinners and may indicate that the patient's dosage may need to be adjusted downward. Sometimes they just occur from vigorous rubbing of the eyes (which should not be done at all), or even a heavy coughing spell.


(http://farm2.static.flickr.com/1436/1287931245_a68139a2f4_m.jpg)

 

That looks awful! My right eye gets red very easily - not like that, just more of a general red. That's the eye I had operated on. I will be surprised if any contacts are tolerable at this point - it's so sensitive.

Skylla,

You are experiencing the condition known as "presbyopia", which is the natural loss of nearpoint vision due to the progressive increase in rigidity of the intraocular crystalline lens of the human eye. There is nothing you can do to prevent it, there's nothing you did to cause it, and it is not related to any of the things you mentioned in your post.

One suggestion: Get yourself to your local optometrist and get a pair of Rx reading glasses, not the over the counter magnifier/readers.

Why?

-OTC readers do not have quality optical lenses
-the frames are poor quality and are rarely adjusted properly
-the lenses do not correct imbalances between the two eyes that most people have, however small they may be.
-the lenses to not correct astigmatism, which is an out of roundness of the eyes, which causes blur. Many people have this.
-the lenses are not measured so that the optical centers line up with the centers of your eyes, known as "pupillary distance". This in effect results in you reading through "induced prism".


(http://www.newportmesaoptometry.com/disorders/Presbyopia_eye.jpg)

GW, your eyes get "hyperemic" which is a diffuse redness, not a blood spot. There are some great ophthalmic medications available. One that I have had excellent success with is "systane". It's a soothing, tear stablizing, dry eye product and it has worked for patients who have had no luck with other products.

It's available OTC, recommended dosage is 3-5x per day.

Here's a link (click) (http://images.google.com/imgres?imgurl=http://www.systane.ca/ca_en/media/Systane_product.jpg&imgrefurl=http://www.systane.ca/ca_en/consumer/Systane_Difference.asp&h=231&w=133&sz=10&hl=en&start=4&tbnid=3RCLkcgPw2Nc7M:&tbnh=108&tbnw=62&prev=/images%3Fq%3Dsystane%26gbv%3D2%26hl%3Den%26sa%3DG) with more information.

(http://www.systane.ca/ca_en/media/Systane_product.jpg)

Last time I went to the eye doctor....I got a pair of bi-focals, I don't think I spelled that right but you know what I mean.  They were expensive.

I am one who looses glasses.....all the time.....they just disappear....so I buy the cheap glasses...I call them "disposable" glasses.  And that is what they are, but I suspected they are not good for my eyes.

But you are right, I do need to go to the eye doctor again, my husband has been telling me to do just that for years now.  I lost my prescription glasses about 6 years ago and I never went back.  My bad.

To clarify..

"disposable" glasses are not "bad for your eyes". You aren't going to damage your eyes or make your vision worse by using them. What might happen is:

-you will fatigue more rapidly when reading
-the vision will not be as clear
-you might lose your place
-comprehension might not be as good
-you could get headaches

Those are some examples.

I forgot to mention (actually I DID mention it but I lost the post because when I went looking for an image I reloaded the browser by mistake and had to retype it)...

EVERYONE experiences presbyopia at some point, usually between 39-45, most commonly 42-43. Some people don't notice it because they are nearsighted (blurred distance vision) and they simply take off their glasses to read..or they tolerate the blur, or they have long arms and push the print further out which buys them more time. But sooner or later, they have to deal with it too.

What are floaters? I get them

Also, this was 10 yrs ago, I puked up one night and there a million fast moving floaters for about 30 seconds?

Floaters are most often due to the degeneration or age related break down of the vitreous, which is the jelly-like substance that fills up most of the eye. After a period of coughing, or exercise, or puking as in your case, the contents of the vitrous can be "shaken up" like a snowglobe and be more obvious.

I grabbed most of this as a cut and paste from another site, it covers it quite well:

Simple floaters most commonly occur due to degeneration within the vitreous jelly. The hyaluronic acid component, which normally separates the invisible vitreal fibres, collapses. Then the fibres stick together and become apparent to the patient; this is particularly noticeable against a bright background or a blue sky, or when very tired. These are harmless.

Pathological floaters are those in which there are floaters with accompanying features. These may include soreness, redness, and loss of part of the visual field, or a reduction in vision. Any of these symptoms deserve prompt assessment by an expert to ensure that the person is not developing inflammatory eye diseases like iritis or choroiditis; there are many causes for these conditions, but treatment is needed to minimise damage to the eyes.

Sudden onset of floaters may be due to haemorrhages into the vitreous cavity associated with hypertension (high blood pressure), diabetes or retinal breaks. Again, thorough examination is required with the pupil dilated.

For most people, simple floaters are permanent and harmless. After a while, people tend not to notice them so much as the brain lets you ignore them. To limit new ones will depend upon the original cause of the floaters. There are things that can be done by the specialist, such as vitrectomy, and sometimes the judicious use of special laser equipment.

Hyaluronic adid tablest at the health food store: worth taking or BS?

There is some evidence that "ocular vitamins" may have some beneficial effect in preventing macular degeneration and other degenerative conditions of the eye.

They can't hurt...I would take those sooner than Hyaluronic acid tablets.

Thinflap Lasik. Worth the risks or not? Yay or nay?

I am not a surgeon and I am not familar with that particular procedure.

Sorry Rod.

Most LASIK surgeons offer free conults...get a few, ask your questions.

Is it possible to get addicted to Visine?

Its not an addiction, it's called a "rebound" effect. Long term use of antihistamine vasoconstrictors will ultimately cause the exact problem they are designed to treat.

Short term use only! Then get to the root of the problem which is usually a dry eye or an allergy...

Ever hear of a supplement called Bio Tears? Is it worth the price to treat dry eyes?

If a treatment is successful, it's worth every dime.

hmm so what's going to happen to me.. im 39 and have 20/400 vision in the left eye 20/200 in the right.. what the hell kind of glasses will i be wearing in the future to read?

I kicked the Visine addiction.

With that sort of uncorrected visual acuity:

If you're nearsighted then you might not need reading glasses at all.

If you're farsighted, then you'll need fairly strong reading glasses and you'll do well to consider a thinning material which is known in the industry as "high index" lenses.

Im very near sighted. I can hold a book 2 inches away from my face and read it (if i close my right eye that is lol)  I have been thinking of lasik.. but scared about it.. I used to get pink eye when i was a kid, over and over.. soon as one eye would heal the other would explode and i have scar tissue from it.. if you shine a bright light in my eye you can see it around the black ring (whats that part called again? ) so i am a little nervous that any sort of cutting on my eye would backfire.. but it sure would be nice to not wear glasses anymore..

I'm nearsighted like that too! It's a pain in the butt.

LASIK is approved for just about any prescription nowadays. Sure there are risks but statistically speaking the odds are very much in your favor of a desirable outcome. The key is to use an experienced surgeon who has the latest technology.

Pink eye, also known as conjunctivitis is an inflammation of the white part of the eye, due to infection (bacterial or viral), or due to allergies. It doesn't cause an eye to explode nor does it typically result in scarring.

Whatever you got a scar from, it was something unusual, especially if you can see the scar when you transilluminate the Iris. Sometimes scar tissue can be removed or reduced during LASIK.

I didn't mean explode literally.. just meant that the infections would go from eye to eye.. lol  the scar tissue came about after my last horrid bout with pink eye around 14 years old.  During that time you could see the white scar even without shining a light in my eye.  We thought it was puss at the time..  ugh.. pink eye was horrible. I used to get teased about it so much. I had it so often they started calling me Dead Eye at school... 

You most likely had a corneal ulcer, which is the most serious form of eye infection.

I've only seen a few of those in 20 years of doing eye exams. There are surgical techniques to reduce the scarring and like I said it could possibly done in conjunction with refractive surgery to reduce your dependency on eyeglasses.

You were called "Dead Eye", huh? I was called "Fish Lips" because my upper lip was thick and turned up a bit.

We would have been quite a pair.

 :azn1:

damn... why the hell didn't anyone take this seriously back then?! A corneal ulcer??!?!?!  wtf?!?!  Those assholes just gave me the standard drops and sent me on my way.. it sounds like i probably needed a lot more care then that. Maybe they were on autopilot because i had suffered from it so often..  but dang.. corneal ulcer????

oh jaysus.. i gotta get out of this thread.. I started googling images of corneal ulcers and now i'm freaked the hell out! damn... I've totally got the heebie jeebies now!  I need to chillax...

The standard treatment for a corneal ulcer is high dose of antibiotics every 1-2 hours for the first few days, and followed by a steroid after the infection is sterilized to reduce the inflammatory response and resultant scarring.