Eye Care
JEA has eleven ophthalmologists that specialize in a variety of eye disorders. We can perform general eye examinations to diagnose common problems such as farsightedness, nearsightedness, and astigmatism.
More detailed examinations, and testing may be required for conditions such as cataracts, glaucoma, and macular degeneration.
Age-Related Macular Degeneration (AMD)
AMD is a leading cause of severe vision loss in people over the age of 65. Symptoms include blurry vision, dark or empty areas in central vision, and straight lines looking wavy.
AMD affects the macula. The macula allows you to see fine details, so activities like driving, reading, and knitting may become difficult. AMD can progress quickly causing a person to lose their vision in both eyes, or it can occur so slowly that it's difficult to notice much change in your vision. Usually there is no pain associated with AMD.
A cataract is a clouding of the normally clear lens of the eye. It can be compared to a window that is frosted or yellowed.
The amount and pattern of cloudiness within the lens can vary. If the cloudiness is not near the center of the lens, you may not be aware that a cataract is present.
Common symptoms of cataract include:
- A painless blurring of vision
- Glare, or light sensitivity
- Poor night vision
- Double vision in one eye
- Needing brighter light to read
- Fading or yellowing of colors
The most common type of cataract is related to the aging of the eye. Causes of cataract include family history, medical problems such as diabetes, injury to the eye, some medications such as steroids, long-term, unprotected exposure to sunlight, and previous eye surgery.
Surgery is the only way to correct problems with cataract. You may be interested in learning about the ReZOOM lens.
Glaucoma is the leading cause of blindness in the United States, especially for older people.
There is a clear liquid that circulates in the front portion of the eye. To maintain a healthy level of pressure within the eye, a small amount of this liquid is produced constantly, while an equal amount flows out of the eye through a microscopic drainage system.
With glaucoma, the clear liquid does not flow through the drainage system properly. Over time, the eye pressure increases, damaging the optic nerve. When damage to the optic nerve occurs, blind spots develop.
There are two main categories of glaucoma
- Open-angle glaucoma: the most common form of glaucoma
- Closed-angle glaucoma: a less common but more urgent form of glaucoma
Risk factors for glaucoma include: age, family history, elevated eye pressure (IOP), African, Hispanic, or Asian ancestry, diabetes, thin cornea, and previous eye injury.
Regular eye examinations by your Ophthalmologist are the best way to detect glaucoma.
Diabetes Mellitus is the inability of the body to use and store sugar properly, resulting in high blood sugar levels. This results in changes to the veins, arteries, and capillaries in the body.
When damage occurs to the fragile blood vessels inside the retina, it is called diabetic retinopathy.
Strict control of your blood sugar will significantly reduce the long-term risk of vision loss from diabetic retinopathy. Treatment does not cure this problem, but may be effective in preventing further vision loss.
There are two types of diabetic retinopathy:
- Non-proliferative diabetic retinopathy (NPDR)-the early stage of diabetic retinopathy
- Proliferative diabetic retinopathy (PDR)- the later stage of diabetic retinopathy
What problems may affect the cornea?
The cornea copes very well with minor injuries or abrasions. If dirt scratches the highly sensitive cornea, epithelial cells slide over quickly and patch the injury before infection occurs and vision is affected.
But if the scratch penetrates the cornea more deeply, the healing process will take longer, resulting in greater pain, blurred vision, tearing, redness, and extreme sensitivity to light. These symptoms require professional treatment. Some of the more serious problems that affect the cornea are:
Microbial Infections (keratitis)
When the cornea is damaged, such as after a foreign object has penetrated the tissue, bacteria or fungi can pass into the cornea, causing a deep infection and inflammation. This condition may cause severe pain, reduce visual clarity, produce a corneal discharge, and perhaps erode the cornea.
As a general rule, the deeper the corneal infection, the more severe the symptoms and complications. It should be noted that microbial infections, although relatively infrequent, are the most serious complication of contact lens wear.
Minor corneal infections are commonly treated with anti-bacterial or anti-fungal eye drops. If the problem is more severe, a person may receive more intensive antibiotic treatment to eliminate the infection and may need to take steroid eye drops to reduce inflammation. Frequent visits to an eye care professional may be necessary for several months to eliminate the problem.
"Pink eye" describes a variety of inflammatory and often contagious diseases of the conjunctiva. The conjunctiva is the protective membrane that lines the eyelids and covers exposed areas of the sclera, or white of the eye. These diseases can be caused by a viral or bacterial infections, environmental irritants, a contact lens product, or drug allergies.
For the most part, pink eye tends to be painless and usually does not affect vision. The infection may come and go in most cases without requiring medical care. But for some forms of pink eye, such as epidemic keratoconjunctivitis, treatment will be needed. If treatment is delayed, the infection may worsen and cause corneal inflammation and a loss of vision. Depending on the type of pink eye that a person develops, treatment often consists of antibiotics and steroids.
Herpes of the eye is a recurrent viral infection that affects an estimated 400,000 Americans with herpes. Although ocular herpes can result from the sexually transmitted herpes simplex II virus, it is usually caused by herpes simplex virus I (HSV I), the virus responsible for cold sores. In about 12 percent of those with ocular herpes, both eyes are involved.
Ocular herpes produces a relatively painful sore on the surface of the cornea. Prompt treatment with anti-viral drugs helps to stop the herpes virus from multiplying and destroying epithelial cells. In time, the infection may also spread into the stroma, causing the body's immune system to attack and destroy stromal cells. This more severe infection, called herpes simplex stromal keratitis, is harder to treat and can scar the cornea, causing vision loss. It may also produce an infection of the inside of the eye.
Like other herpetic infections, herpes of the eye remains a controllable, but incurable, problem. For those who lose vision to ocular herpes, it usually results from recurrent attacks that lead to severe stromal keratitis. Studies indicate that after a person has had an initial outbreak of ocular herpes, he or she has better than a 50 percent chance of having a recurrence of the disease. This second outbreak could come weeks or decades after the initial attack. In one large study, researchers found that recurrence rates were 10 percent after one year, 23 percent at two years, and 63 percent at 20 years. Some factors associated with recurrence include fever, stress, sunlight, and trauma. Anyone with ocular herpes should avoid using over-the-counter steroid eye drops. Steroids cause the virus to multiply and the infection to worsen.
This infection is produced by the varicella-zoster virus, the same virus that causes chicken pox. After an initial outbreak of chicken pox (often during childhood), the virus remains dormant within the nerve cells of the central nervous system. But in some people, the varicella-zoster virus will reactivate at some time during their lives. When this occurs, the virus travels down long nerve fibers and infects some part of the body, producing a blistering rash (shingles), fever, painful inflammations of the affected nerve fibers, and a general feeling of malaise.
Varicella-zoster virus may travel to the head and neck, perhaps involving an eye, part of the nose, mouth, cheek, and forehead. In about 40 percent of those with shingles in this area, the virus infects the cornea. These zoster-related corneal lesions will usually clear up on their own. But without early anti-viral treatment, a person runs the risk of the virus infecting cells deep within the tissue, causing inflammation and scarring of the cornea. The disease may also cause decreased corneal sensitivity. For many, this decreased sensitivity will be permanent.
Although shingles can occur in anyone exposed to the varicella-zoster virus, several studies have established two general risk factors for the disease: (1) advanced age and (2) a weakened immune system. Studies show that people over age 80 have a five times greater chance of having shingles than adults between the ages of 20 and 40. Unlike herpes simplex I, the varicella-zoster virus does not usually flare up more than once in adults with normally functioning immune systems.
Be aware that corneal complications may arise months after the shingles are gone. For this reason, it is important that patients schedule followup eye examinations.
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