Understanding Age-Related Macular Degeneration (AMD)

Age-related macular degeneration is a degenerative condition of the central retina (called the macula), which results in a loss of vision. AMD is a common contributor to vision loss in adults over the age of 50. In Western countries, AMD affects nearly 30% of individuals over the age of 75. There are a number of contributing factors to AMD, including age, quality of nutrition, sunlight exposure, and genetics.

Two Types of AMD: Dry and Wet

There are two types of macular degeneration – Dry and Wet.

Dry macular degeneration is the most common type and affects about 90% of AMD patients. In this form, there is a thinning of the retinal pigment cells in the macula. These pigment cells are critical to good vision. Dry AMD often happens very slowly – so slow, that you may not even realize you have it. In fact many of my patients have AMD for many years before it even affects their vision in a significant way.

Wet macular degeneration occurs when blood vessels in your eye leak fluid into the central part of the retina. Most cases of Wet macular degeneration develop from Dry macular degeneration. Unlike Dry AMD, Wet AMD tends to appear suddenly and can get worse more rapidly.

Understanding the Symptoms of AMD

Dry AMD typically develops gradually and without pain. If this is what you have, you may find yourself in need of bright light to read, it may be difficult to adapt to low light situations, you may notice a gradual haziness in your vision, or you may have blurry central vision. A symptom of Wet AMD is seeing straight lines as wavy ones.

I see many AMD patients in our office.  A standard visual acuity test with a dilated fundus exam can help me determine if you have AMD or if you’ve had any loss in your central vision.

How is Macular Degeneration Treated?

Unfortunately there are no defined treatments for treating Dry macular degeneration except for observation  and great sun glasses.  If the dry macular degeneration turns into Wet AMD,  and if caught  early, there are some new laser surgeries using Anti-VEGF laser treatments available that seal the leaky blood vessels. This form of surgery does not restore lost vision – it simply prevents any further vision loss. Early diagnosis is critical to maximize the preservation of your vision.

I recommend that you stick to your scheduled office visits and always schedule an appointment with us (or your eye doctor) if you have any concerns– particularly if you have any sudden changes in your vision.

Are your eyes dry? Read on for some dry-eye relief.

Many options for treating your dry eyes.

If your eyes sting, burn or feel gooey, tire easily, are sensitive to light, tear, or blur at the end of the day, chances are that you have dry eye. It is officially called keratoconjunctivitis siccca (can you say that 5 times?!). It occurs when tear glands don’t produce enough fluid or there’s an imbalance in your tear’s ingredients–water, oil, and mucus. Dry eye is more common as you get older, and women are especially vulnerable due to the hormonal changes associated with menopause. Other culprits sometimes include diabetes, rheumatoid arthritis, and some medicines, including blood pressure medication, sleeping pills, antihistamines, birth control pills and antidepressants. Finally, if you’ve had LASIK or a similar procedure, you’re at risk for dry eye.

So what’s the first remedy that you should try? Non-preservative artificial tears such as Refresh Plus or Systane Ultra. They’re available over the counter and we also stock them here at Tri-City Optometry.  If these don’t help than come in to see us (or your eye doctor). Cortisone drops can also ease inflammation, and a cyclosporine emulsion can improve tear production in some people. In serious cases, a simple procedure can plug the ducts that drain moisture off the eye.

Taking Care of Contact Lenses

Over 24 million people in the US wear contact lenses – if you’re reading this, you’re probably one of them. They’re a great alternative to glasses for many of my patients.

If you haven’t worn lenses before we can easily help you decide whether they are right for you. These days, there are a broad range of options for you to select from – including gas permeable (RGPs), soft lenses (extended wear, daily wear, and torics).

I tell most patients that they should remove their lenses at bedtime. I see many lens-induced eye irritations and infections in my practice, and these problems are often attributed to improper care or wearing lenses at night. So here are some basics for all lens wearers:

• Always wash your hands with soap prior inserting or removing contacts
• Try not to take your lenses in and out during the day
• If you’re lenses are expired, don’t wear them!
• Lens cases also need to be cleaned – always rinse your case with warm water and let it air dry
• Don’t mix different brands of solutions
• Be careful about using eye drops not intended for lens wearers – the wrong drops can irritate your eyes

And here’s the most important piece of advice. If your eyes are excessively red, painful, if they feel scratchy or if you have a discharge, take those lenses off and give your eyes a rest! Put on your eyeglasses (you do have a pair, don’t you?) and go back to the lenses once your eyes are back to normal.

A Fun Makeover Party at Tri-City Optometry

Thanks too all of our new and existing patients that made our party a success! Haydee, Gulie & I had so much fun seeing everyone in the office on Saturday. Dozens of you got “a new look” using colored FreshLook contacts, the latest in Fendi glasses, and a beauty makeover – what a blast! We’ll definitely have to do this again next year.

Tri-City Optometry Makeover Party – Come by!

Join our makeover party!

Get a makeover at Tri-City Optometry in Newark, CA! For all of our current patients, we’re hosting a party on Saturday Dec. 20th from 12 – 4pm. You’ll have a chance to get a makeover by Amy Robins from BeautiControl, enhance the appearance of your eyes with Freshlook Color Contacts, and try on the latest eyewear styles from Fendi and other high-end designers. We’ll have plenty of refreshments, raffles, and much more…so I hope to see you there!

Also, remember to use your Flex Spend Account (FSA) dollars before the end of the year on eyewear or contacts at Tri-City Optometry. Most plans give you until the end of the year, so hurry on in if we haven’t seen you in 2008!

Whoa – why’s there blood in my eye?!

Don't worry!

In the past few weeks, I’ve heard from a lot of patients who have blood that appears on the “white part” of their eye (otherwise known as the sclera). If you wake one morning and notice a painless, bright red splotch on your sclera, in most cases there’s no need to be concerned. You probably have what is known as a subconjunctival hemorrhage, which is simply a rupturing of the blood vessels under your conjunctiva. The conjunctiva is a very thin membrane that covers your sclera.

So, what caused this? You probably don’t even remember. Because the blood vessels in your eye are so fragile it doesn’t take much for them to burst or rupture. The hemmorhage could be caused by sneezing, coughing, rubbing your eye, or weightlifting. Obviously, it could also be caused by blunt force trauma to your eye but you’d remember that!

If you think you have a hemmorhage just give it some time and it will go away. Usually there is no need to come in to see us or your eye doctor unless you feel pain or if it affects your vision. I tell most of my patients to use some non-preservative tears and cold compresses since it will help vasoconstrict the blood vessels. In addition, I tell my patients to sleep with their head elevated about 30 degrees in order to speed up their recovery.

Within a week, you’ll notice that the red will turn a yellowish color (this is totally normal). And within two weeks it should simply disappear.

Hey, what’s that bump on my eyelid?

If you wake up one morning with a little bump on your eyelid, there’s a good chance that it’s a “stye“. Styes are bacterial infections that block the oil producing glands around your eyelashes. These little bumps are harmless and will likely go away in a few days. In some severe cases, large styes require surgical draining and the use of antibiotics. But the best treatment is one that you can do entirely on your own, at home.

Here are a few quick tips on treating styes:

1. Apply a warm compress 2-3 times a day (e.g., a towel soaked in warm water)

2. Don’t rub! 

3. If the stye is painful and doesn’t go away in a few days, come in for a checkup. 

That’s it – quick and easy.

How often should you get an eye exam?

My patients and friends frequently ask, “how often should I get my eyes checked?” As a guideline I suggest that you see your Optometrist or Opthamologist once per year, but no less than once every two years.

Think of your eyes as an important part of your overall health care routine – just like your annual checkup with your general physician. Even if your eyes feel fine, it’s important to get them checked because a lot of vision problems d
on’t present obvious problems and may not even affect your vision in the short-term.

There are many variables that affect how often you should see your eye doc – for example, if you are diabetic or have other risk factors you may need more frequent exams in order to catch problems early. Otherwise, most folks will be fine seeing the eye doc once a year. Plus if you’re covered by a vision plan you’ll be eligible for an annual exam. So take advantage of it!

Here’s a handy little guide from the American Optometric Association. I expect each of you to clip it out and stick it on your refrigerator door .

FREQUENCY OF EXAMINATION

Patient Age	Examination Interval
	Asymptomatic/Risk Free	At Risk
Birth to 2 yrs	By 6 months of age	By 6 months of age
2 to 5 yrs	At 3 yrs of age	At 3 yrs of age
6 to 18 yrs	Before 1st grade then every 2 yrs	Annually
18 to 40 yrs	Every two to three yrs	Every one to two yrs
41 to 60 yrs	Every two yrs	Every one to two yrs
61+	Annually	Annually or as needed

Source: American Optometric Association

So, why a blog about your eyes?

Most patients who come into my office are genuinely interested in maintaining the health of their vision and taking care of their eyes. But I know that most patients only think about their vision when they are in for their annual eye exam, when they face a problem such as conjunctivitis or dry eye, or when they lose their contacts or glasses. Let’s face it, unlike taking care of your teeth (which your brush and floss each day) or your general health (when you eat and exercise), most of us take our vision for granted. So through this blog I plan to provide a little advice on the importance of good vision health. It’s not meant for just my patients, but for anyone who wants to make sure you give a little love to your eyes. So welcome!