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Medical Eye Care

Medical eye exams are offered to address and treat medical conditions and diseases of the eye such as glaucoma, cataracts, macular degeneration, and diabetic retinopathy. These and other conditions may potentially affect your vision or overall health if not treated properly and in a timely manner.

Allow us to help you understand more about eye care.

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Blepharitis

Blepharitis is a chronic inflammation of the eyelids. This is a common condition in both children and adults. There are three basic types of blepharitis: anterior, posterior, and mixed. Anterior blepharitis is inflammation caused by Staph bacteria or excessive and abnormal oils in the tear film. Symptoms may include itching, burning, scratchiness, foreign body sensation, swollen eyelids, dry or watery eyes, and eyelash crusting. Chronic blepharitis may lead to lid redness, scaling, and eyelash loss or misdirection. Posterior blepharitis or meibobian gland disease (MGD) is caused by clogging, inflammation, and infection of the oil secreting glands along the lid margin. These glands normally produce a healthy oil layer of the tear film which keeps the eye moist and lubricated by preventing evaporation. Posterior blepharitis results in poor function and abnormal oil layers. This leads to tired, burning, dry or watery eyes, as well as foreign body sensation, contact lens intolerance or development of chalazia (styes). Often patients have a mixture of both anterior and posterior blepharitis. Patients with rosacea are particularly susceptible to blepharitis, and it often accompanies other ocular conditions such as dry eye syndrome, chalazia, or styes, and even corneal ulcers.

Treatment of Blepharitis It is important to treat blepharitis to prevent long term complications such as eyelid and corneal scarring as well as to immediately relieve the irritating and sometimes painful acute symptoms. As blepharitis is a chronic condition, it requires a chronic and ongoing treatment. In addition to regular eye exams, keeping the eyelids clean is critical to controlling all types of blepharitis. Eyelids should washed either with special eyelid cleansers recommended by your doctor, or with a clean washcloth with no tear baby shampoo diluted with warm water (approximately 1 drop of shampoo to 20 drops water). Acute exacerbations of blepharitis may require antibiotic or corticosteroid therapy prescribed by your doctor. Certain oral antibiotics can also be helpful. If you are experiencing the symptoms of blepharitis, call us and come in for a consultation. Many people suffer for years unnecessarily, when a simple treatment regimen can have your eyes more comfortable and seeing better now and in the future. View Video

Conjunctivitis

Conjunctivitis, or “pink eye” encompasses a spectrum of bacterial and viral infections as well as allergic reactions. The conjunctiva is a thin clear layer of tissue that lines the inner surface of the eyelid and covers the white part of the eye. When it is inflamed for any reason it becomes pink or red and can be itchy, watery, or irritated. Viral Conjunctivitis Viral conjunctivitis is a common cause of pink eye. A number of different viruses, many of them related to the common cold virus can cause conjunctivitis. Symptoms may include redness, itching, watery eyes, swollen lids, and crusting or matting of the eyelashes. Generally there is no severe pain, although the eyes may become irritated. Viral conjunctivitis usually starts in one eye, but commonly spreads to both eyes. It is contagious, so hand washing is important to stop its spread. Treatment of viral conjunctivitis traditionally has been only symptomatic relief with tears and lubricant drops. Currently Atlantic Eye Institute is involved in a paid clinical study of a new medication which treats the virus itself. Study participants receive either the traditional artificial tear lubricant treatment of pink eye or an active drug. The investigational drug has already completed safety studies and is now being tested for its effectiveness against viral conjunctivitis. Study participants will be compensated for their time and feedback. If you have started having symptoms of pink eye within the last week, call us at Atlantic Eye and make an appointment to see if you may qualify for this research study. Bacterial Conjunctivitis Bacteria can also infect the conjunctiva causing similar symptoms. Common signs include redness, lid swelling, itching, thick discharge, and crusting or matting of the lids and lashes. Common causes include Staph and Strep bacteria. Treatment includes topical antibiotic therapy which usually is able to resolve the conjunctivitis as well as prevent more serious complications. Allergic Conjunctivitis Allergic conjunctivitis is an inflammation of the conjunctiva. Symptoms commonly include itching, watering, and burning of the eyes. The eyelids may also become red and swollen. It is caused by seasonal allergy such as pollen, grass, and ragweed. Year round allergens such as dust, mold, and pet dander may also cause allergic conjunctivitis. It can be treated with a number of anti-allergy drops as well as by identifying and avoiding the offensive allergen. View Video

Diabetic Retinopathy

Diabetic Retinopathy is a leading cause of blindness in adults. It is estimated that 90% of diabetics may experience some form of retinopathy over the course of their life. The risk of developing diabetic retinopathy increases with age and duration of the disease.

What is diabetic retinopathy? Diabetic retinopathy is a complication of diabetes mellitus which causes abnormalities in retinal capillaries, the tiny blood vessels that nourish the retina. These vessels weaken, leak fluid and blood, and fail to provide nutrients to the retina. Left untreated, diabetic retinopathy can cause severe vision loss or even blindness.

Background Diabetic Retinopathy Diabetic retinopathy can take two forms, early on it manifests as background retinopathy, but it can progress to a more severe form of proliferative retinopathy. During the early background stage, small capillary blood vessels can leak fluid or blood into the surrounding retina. Vessels may also hemorrhage or leak fat and protein forming deposits. If fluid collects in the central retina (the macula), this may cause blurred vision; however, if it occurs in the outer areas of the retina no symptoms may be noticed at all until significant damage accumulates.

Proliferative Diabetic Retinopathy In some cases background retinopathy may progress to proliferative diabetic retinopathy. In this stage, abnormal blood vessels grow over the retina. These new vessels tend to bleed easily, blocking light from reaching the retina and causing severe vision loss. They also may contract, pulling the retina off its underlying structures causing retinal detachments. Proliferative diabetic retinopathy affects up to 5% of diabetics, and if left untreated may lead to permanent blindness.

How is diabetic retinopathy diagnosed? A comprehensive dilated eye exam is the best protection against diabetic retinopathy. Since early in the disease you may have no visual symptoms, it is important to have at least yearly eye exams where the eye is dilated and the retina examined by a qualified eye specialist.

How is diabetic retinopathy treated? The most important treatment for diabetes is excellent blood sugar control. This will prevent many complications of diabetes including retinopathy from worsening. If diabetic retinopathy does develop, there are a number of sight saving laser and medical treatments available. At Atlantic Eye Institute we have the latest technology to detect and treat diabetic retinopathy. An on-site retinal specialist is available for diagnosis, management, and treatment of diabetic retinopathy.

Prevention is the best medicine Early detection and management of diabetic retinopathy is critical to arrest or slow the most sight damaging stages of the disease. Even when no symptoms are noticed, diabetic patients should have at least a yearly dilated eye exam. If you are experiencing vision problems or have diabetes and have not seen an eye specialist recently, call us at Atlantic Eye Institute so we can schedule a full eye exam and come up with a personalized treatment plan. View Video

Dry Eye Syndrome

Dry Eye Syndrome is a common eye problem which can be caused by lack of tear production, rapid evaporation, or inflammation in and around the eye. Tears normally keep the eye moistened and lubricated; however, if tears are insufficient stinging, burning, dryness and redness will result. While discomfort is the primary result of dry eye syndrome, more serious complications such as infection and corneal scarring may result if left untreated. What is the tear film? The tear film which covers the surface of the eye is made up of three layers. The oil based outer layer reduces evaporation. The watery middle layer cleanses the eye and washes away foreign particles and irritants. The innermost layer consists of mucous and coats the surface of the eye evenly and allows tears to adhere to the surface of the eye. It is extremely important for these three layers to remain in the proper balance, otherwise dryness may occur. For this reason, a common symptom of dry eye syndrome is actually tearing. Although there is excess watery tear production, these unbalanced, unhealthy tears do not properly moisturize the eye. Tears are constantly produced by a main lacrimal gland underneath the upper eyelid as well as many accessory glands located over the surface of the eye and inner eyelids. Tears are drained out of the eye by two tear ducts located in the inner corner of the upper and lower eyelids. These ducts drain tears into the nose and throat, which makes it possible for us to “taste” some eye drops. What Causes Dry Eyes? Normally, tear production decreases with age, leaving the delicate eye tissues exposed to the irritating effects of the environment. Dry eyes are more common in contact lens wearers and women; particularly during pregnancy or after menopause. Dry eyes often occur in patients with arthritis and particularly in those with a genetic condition called Sjogren’s syndrome. Medications and vitamin deficiency may also cause reduced tear secretion. In addition, environmental factors such as sun, wind, and pollution may cause dry eye outside, while air conditioning, heating, ceiling fans, and smoke contribute to dry eye indoors. Finally, abnormalities in the eyelid and tear system may cause dry eye syndrome. How are Dry Eyes diagnosed? Dry eyes are most often diagnosed during a complete eye exam. Special dyes and stains are used to highlight damage done by dryness and are visible under microscopic examination in our eye clinic. Schirmer’s testing allows us to measure the production of tears and can also be performed quickly and painlessly during a complete eye exam. How are Dry Eyes treated? Artificial tears, ointments, and gel lubricants are the most common first line treatment for dry eye syndromes. Eye drops are used to lubricate the eyes and replace missing moisture. Patients should also take steps to eliminate some of the causes for dry eye such as turning off ceiling fans and redirecting air vents to avoid air blowing directly into the eyes. For patients with mild dry eye syndrome, these conservative measures may provide relief from the symptoms of dry eye. Many patients with dry eye will require more intensive therapy to relieve symptoms. The medicated drop Restasis® can be used to increase the quantity and quality of tears. Restasis® has given many patients a safe and effective long term solution to the pain and discomfort of dry eye. Click here (www.restasis.com) for more information on Restasis®. Another option to increase the amount of tears in the eye is to block the tear ducts which drain tears from the eye. Temporary or permanent punctal plugs may be inserted to keep tears in the eye longer and reduce dry eye symptoms. Insertion of plugs is a quick and painless procedure which takes only minutes and can provide months or years of relief from dry eye symptoms. Plugs are always present, so your dry eye is treated even when you are not putting in eye drops. Ask your doctor if punctal plugs may be able to help your dry eye. Other treatments for dry eye include a healthy diet high in omega 3 and fish oils. You may take fish oil and flax seed supplements to improve the quality of your tears. Adding moisture to the air with humidifiers or even moisture chamber goggles may be necessary in cases of severe dry eye. At Atlantic Eye Institute our Dry Eye Clinic headed by Dr. Steven Lancaster is up to date on the latest dry eye treatment modalities. If you are suffering from dry eye syndrome, whether it is mild or severe, we have the latest treatments to improve your quality of life. Call today for your evaluation.View Video

Flashes and Floaters

Sometimes people see small spots or specks moving in their field of vision or experience flashes of light. In many cases these problems are benign; however, in some cases they can symptoms of a more serious eye problem such as a retinal detachment.

What are Floaters? The main body of the eye is filled with a clear gel called vitreous. Floaters are small clumps and condensations in this vitreous gel. They may be seen as dots, lines, cobwebs or spiders, and are most often noticed reading, or looking at a blank wall or clear sky. Although they appear to be in front of the eye, these clumps are actually floating in the vitreous and casting shadows on the retina (The retina is the thin membrane in the back of the eye that absorbs light and converts it to electrical impulses that form images sent to the brain).

What Causes Floaters? The most common cause of new floaters is a separation of the vitreous from the retina called a posterior vitreous detachment (PVD). This commonly occurs after age 55, and is a normal part of aging. As we mature, the vitreous gel liquefies, shrinks, and pulls away from the retina. Floaters are most commonly formed by reorganization of the vitreous, but can also represent retinal fragments or blood. Rarely, as the vitreous detaches it pulls on the retina and may tear it, this can lead to a retinal detachment, a serious complication from a normally benign process. If you experience a sudden onset of new floaters or flashes, you should have a dilated eye exam to ensure that a retinal tear or detachment has not occurred. Prompt treatment may be essential to preserve your vision.

What Causes Flashes? Flashing lights or lightening strikes in the vision may be caused by traction or tugging of the vitreous gel on the retina. They may occur in conjunction with a posterior vitreous detachment (PVD), and when they do they indicate that there is tension on the retina that could lead to a tear. If you begin experiencing these flashes you should have a dilated eye exam to ensure that you do not have a retinal tear or detachment. Flashes may also be caused by migraines. These type flashes may appear as jagged lines or geometric shapes. They may start peripherally and move to your central vision, and they usually last less than an hour. In classic migraines they are followed by a migraine headache, although a specific subclass called “ocular migraines” is not followed by a headache. If you have these symptoms you should have a full eye exam to ensure that a more serious condition does not exist.

Will Flashes and Floaters ever go away? Floaters may fade or get smaller, or they may be stable over time. Even if floaters do not disappear completely, we become very used to and tolerant of floaters. It is rare that stable floaters require treatment. Flashes usually occur only during the period before and shortly after a posterior vitreous detachment. Prolonged or worsening flashes are cause for concern and should be evaluated.

Retinal Tears and Retinal Detachments Retinal tears and detachments are serious eye conditions which the only early symptoms may be flashes and floaters. If untreated, retinal detachments lead to permanent blindness. Other than new floaters and flashes of light, symptoms may include a curtain or veil coming across one eye’s field of vision, or simply blurred vision in one eye. If caught early retinal tears can be treated with laser to strengthen surrounding retina tissue and prevent a retinal detachment. Retinal detachments usually require emergent surgical treatment. If you have any of the symptoms of retinal tears and detachments you should have a full eye exam immediately.

Glaucoma

Glaucoma is a leading cause of vision loss and blindness which affects approximately 1 in 50 adults. Although glaucoma can occur at any age, the risk of developing the disease increases dramatically after the age of 35. It is more likely to develop in persons with a family history of the disease, severe near sightedness, diabetics, and in African-Americans. Because the early symptoms of glaucoma are slight and the progression occurs over many years, the disease often goes unnoticed until permanent vision loss occurs. However, with early diagnosis and treatment, vision loss from glaucoma can be prevented. What is Glaucoma? Glaucoma is a collection of diseases where eye pressure damages the optic nerve. Damage to the optic nerve causes blind spots in the field of vision, and may eventually lead to complete blindness. When light enters the eye, it is focused and absorbed by the retina. The retina then converts it to electrical impulses which are transmitted to the brain through the optic nerve. If the optic nerve suffers damage from glaucoma it will transmit these impulses, resulting in decreased vision or blindness. What causes Glaucoma? Glaucoma is usually caused by an increase in the fluid pressure inside the eye. The front part of the eye contains a clear, nourishing fluid called aqueous which constantly circulates through the eye. Normally this fluid leaves the eye through a drainage system called the trabecular meshwork to return to the blood stream. Pressure increases if the aqueous fluid is overproduced or if the drainage system becomes blocked or clogged. The reason for this blockage differentiates the different types of glaucoma. By far the most common type of glaucoma is Chronic Open Angle Glaucoma. In this type of glaucoma the drainage system is gradually blocked with age, causing eye pressure to slowly build. This type of glaucoma is usually asymptomatic until late in the disease unless it is discovered during an eye examination. Acute Angle Closure Glaucoma occurs when the drainage system is suddenly and completely blocked. This causes a rapid, painful increase in eye pressure. Common symptoms include pain, redness, headache, blurred vision, and halos around lights. This is an emergency and requires immediate treatment from an eye specialist. Other less common types of glaucoma include Congenital Glaucoma caused by developmental anomalies at birth, or secondary glaucoma due to infection, inflammation, drugs, or scar tissue. What are the symptoms of Open Angle Glaucoma? The early symptoms of Chronic Open Angle Glaucoma, the most common type, are usually unnoticeable. In most cases the build up of pressure is gradual without any discomfort or pain. Peripheral vision is usually lost first, and most people do not detect a change in their vision due to the fact that our visual fields overlap in both eyes. Therefore, vision loss in one eye is compensated by the other eye. Eventually, when both eyes are affected and field loss overlaps, patients start to notice vision loss. Since the loss is irreversible, it is much better to have regular eye exams to detect glaucoma before advanced disease occurs.  View Video

Macular Degeneration

Macular Degeneration is the leading cause of impaired reading vision in people over the age of 55 in the United States. Macular degeneration is a result of a combination of aging and genetic predisposition, with a number of other factors such as diet and UV light exposure playing a role in progression. Macular Degeneration has two major forms, “dry” macular degeneration and an often more severe “wet” macular degeneration. What is the Macula? The macula is a very small area in the central retina responsible for central vision, fine detail vision, and color vision. The retina is a thin layer of light sensitive tissue which makes up the inner lining of the eye. When light enters the eye, it is focused by the cornea and the lens onto the retina and specifically the macula. Clear vision depends on each of these structures functioning properly, and ultimately our fine focus central vision we use for reading and seeing distant objects is dependant on a healthy macula.

What is Dry Macular Degeneration? Dry Macular Degeneration usually occurs in people over age 55, and consists of deposits in retinal tissue and breakdown of those tissues. The deposits, or drusen, accumulate in the macula and can distort or blur vision. They also promote breakdown, or degeneration and atrophy of the retinal tissue. The most common symptom of dry macular degeneration is blurry or distorted and wavy central vision; however, in many mild cases there are no symptoms at all. Therefore, it is important to have routine eye exams periodically over the age of 55 to monitor for macular degeneration as well as other age related eye conditions. Progression of Dry Macular Degeneration is generally slow, with most people maintaining relatively good vision. In some cases, rapid progression to a more severe Wet Macular Degeneration is possible.

What is Wet Macular Degeneration? In about 10% of cases of Macular Degeneration, new abnormal blood vessels form and may leak or bleed leading to a more rapid loss of vision. Symptoms of this type of Macular Degeneration are significant blurred vision, strait lines appearing wavy or distorted, difficulty reading or driving, or distortion of central vision. It is important to see an eye care specialist immediately if you have these symptoms, as timely treatment is critical to saving vision.

How is Macular Degeneration Treated? New and exciting advances in medical treatment have made it possible to prevent some of the most severe vision loss in wet macular degeneration. The injectable drugs Avastin and Lucentis can arrest and in some cases reverse the vision loss fromWet Macular Degeneration. Laser treatments may also augment these treatments in some cases. It is critical to be evaluated and treated promptly for Wet Macular Degeneration as the damage done by leaking vessels may become permanent over time if untreated. Atlantic Eye Institute has the latest diagnostic and treatment technology on site, and has medical retina specialists available to our patients at all times.

Does Dry Macular Degeneration have any treatment? There is currently no cure for Macular Degeneration. It is still important to monitor macular degeneration and it may be possible to slow its progression with lifestyle and nutritional supplements. Aside from regular dilated eye exams , home monitoring is accomplished by periodically checking an Amsler Grid for wavy lines and central distortions. Your doctor at Atlantic Eye Institute will be happy to provide you with this grid for home use. Vitamin supplementation has also been shown to reduce the chances of progression from Dry to Wet Macular Degeneration. Another important tool is UV protective eyewear to reduce the damaging effects of UV light on the retina. Finally, at Atlantic Eye Institute we strive to maximize your vision even if you do have vision loss from Macular Degeneration. A variety of vision aids, as well as treatment for other eye conditions will help to give you the best possible vision for your life.

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