Got an eye itch? Are you feeling the urge to rub or scratch your eyes? Well, if so then there is a good chance that you are further damaging your eye and harming your vision. Most of us on a daily basis find ourselves rubbing our eyes throughout the day whether it be when we first wake up in the morning, or when our eyes feel irritated when exposed to pollutants in the air or even when something has gotten into our eyes. We are all guilty of this “negative” habit. Our mothers have constantly reminded us since we were little not to put our elbows on the tables or talk to strangers, but how many of our mothers have actually warned us not to rub our eyes? Sure we’ve been told not to rub our eyes if our hands are dirty but our optometrist will strongly advise us to avoid rubbing our eyes at all times in order to prevent infections, certain eye diseases, and even loss of vision. You may be wondering how simply rubbing one’s eyes could lead to such harmful effects but most, if not all, optometrists will warn their patients that constant eye rubbing is a serious threat to one’s vision. There are a number of potential problems that could eventually arise from constant eye rubbing. Many of us have at one time rubbed our eyes because they may feel dry, irritated, sore, itchy and blurry but we rarely think about the detrimental effects we may be causing our eyes. Every time we rub our eyes we fail to recognize that this action could cause a tearing of the capillaries in the eye and even worst, cause blood clots. A common belief that many regard as true is that rubbing your eyes is okay only when one has thoroughly washed their hands. However, this is a big misconception. Optometrists are constantly reminding their patients that washing one’s hands cannot fully protect one’s eye from bacteria, which could potentially get into one’s eye after eye rubbing. Furthermore, washing your hands does not simply mean you are resistant from any eye damage. On the other hand, washing your hands could mean you are less likely to get bacteria in your eye and thus less likely to get an infection. However, you must keep in mind there are other more serious effects that could ensue from long term eye rubbing.

Some of these serious risks that could result from eye rubbing include retinal detachment, development of keratoconus and cataracts, and even blindness. When we begin to notice that rubbing our eyes causes inflammation on our eyes and lids, we must take every precaution and see an eye doctor immediately in order to prevent further damage. In fact, people who rub their eyes frequently are much more prone to suffering from two very serious problems, one of which weakens the cornea (also known as keratoconus) and another that loosens the retina from the wall of the eye, known as retinal detachments. Rubbing the eyes weaken these tissues and, if frequently done, could potentially cause irreparable harm to your vision. In basic terms, what happens when we rub our eyes is that we push against the eyeball and cause pressure to build at the eye socket in which the optic nerves connect. Keep in mind that optic nerves are extremely fragile and delicate and with constant eye rubbing could detach the retina. Although we may feel immediate relief from eye rubbing, the long term effects it could have on our vision is detrimental. With that being said, is it really worth it to rub your eyes if it’s feeling itchy or dry? Rather optometrists suggest that you use a cool washcloth and lightly press on the eyes or simply squeeze your eyes shut for a few seconds. These suggestions aren’t only safer but will save your vision and health. So next time you may feel tempted to rub your eyes think twice before you do it.

Many people like to rub their eyes. They get sore, feel a little itchy, and a good rub makes them feel a lot better. Many of my patients like to rub their eyes in the morning just as a part of waking up. What almost everyone (except your eye doctor) doesn’t know is how bad it is to rub your eyes. And the harder and longer you rub them, the worse it is for your eyes.

What can rubbing the eyes do that is harmful? Well, how about retinal detachment, which can cause a serious loss of vision, requiring a surgery to maintain vision. Less serious is a vitreous detachment, which can result in annoying floaters and also lead to the more serious retinal detachment. Extreme rubbing in sensitive individual can also lead t the development of keratoconus, which is a corneal condition that can significantly impact vision.

It is okay to rub the eyelids, and the skin around the eyes – it is the eyeball itself that should not be rubbed. Rubbing increases the pressure inside the eyeball, which can lead to damage to the delicate structures inside the eye.

So if you want to rub, find something else to relieve that desire. Try a cool towel or simply squeeze your eyes close. But do not – do not – rub your eyes with your knuckles or your fingers!

onjunctivitis is one of the most common and easily treatable ocular conditions affecting both adults and children. To ensure complete clearing of the condition, it is important to differentiate between allergic conjunctivitis, vernal keratoconjunctivtis (VKC) and other diseases that may have similar symptoms.

Allergic conjunctivitis, VKC and diseases, such as uveitis and chalazia, require different treatment modalities for effective clearing. Proper treatment begins with a diagnosis made during a comprehensive eye examination. In both allergic conjunctivitis and VKC, most treatments aim to reduce symptoms, but in the case of VKC, antibiotics might be necessary to treat corneal ulcers, and cycloplegia might also be required to treat an iritis caused by the corneal ulcers. VKC can be identified during an eye examination by several hallmarks, including the presence of large conjunctival papillae on the back of the superior tarsus and areas of superficial punctate keratitis. Severe cases may also present with well-demarcated corneal shield ulcers. Chalazia and uveitis, on the other hand, are characterized by a build up of immune cells and are often effectively cleared with topical steroids.

The most common symptoms of allergic conjunctivitis are itching and redness. Eyelids may also be swollen and red, and in most cases patients will report a history of allergies. Allergic conjunctivitis typically produces a watery discharge and does not involve the cornea. If a patient presents with a thick, rope-like discharge with severe itching and corneal involvement, VKC is most likely the culprit.

Patients experiencing allergic conjunctivitis may find some relief with the following treatments:

• cold compresses;
• artificial tears and other eye drops, which lubricate the ocular surface and flush away the allergens; and
• topical decongestants that cause vasoconstriction, which may also prevent the release of chemical mediators, reducing hyperemia and other symptoms.

Any eye condition that causes persistent irritation can result in more-serious complications if not treated quickly and effectively. Because allergic conjunctivitis is common, but other conditions may mimic its symptoms, a thorough eye examination is essential for a proper diagnosis.

Vision disorders are the fourth most common disability in the United States and comprise the most widespread handicapping condition in childhood. Early detection of vision problems, such as amblyopia, strabismus, and significant refractive error, ensures effective treatment and arrest the further development of many of these conditions. Yet

• <15 % of preschool children undergo a comprehensive eye examination and

• <22% receive any type of vision screening.

The American Academy of Pediatrics, the American Association of Certified Orthoptists, the American Academy of Ophthalmology and the American Association for Pediatric Ophthalmology and Strabismus have issued a joint policy statement recommending that every child undergo a comprehensive vision examination before entering school, preferably between the ages of 3 and 3/12 years.

The National Eye Institute, part of the National Institutes of Health, created the Vision in Preschoolers (VIP), a multicenter clinical study designed to determine the efficacy and accuracy of preschool vision testing for amblyopia, strabismus, significant refractive error, and/or reduced visual acuity. During the first 2 study phases, approximately 4000 children received comprehensive eye examinations to test for these conditions.

The results of phases 1 and 2 indicated that >99% of children enrolled in the study were able to be successfully tested. Moreover, when the tests were used by highly skilled personnel, such as ophthalmologists trained to work with young children, approximately 66% of children within ≥1 targeted disorders were identified, as well as 90% of those children with the most serious conditions. Phase 3 is still ongoing.

Baby boomers who want to rid themselves of their contact lenses should consider laser in-situ kertomileusis (LASIK) surgery as a viable option. Although LASIK traditionally has been considered less effective in individuals >40 years of age, a study shows new techniques offer better outcomes for middle aged and older patients.

In this retrospective consecutive cases series, Ghanem et al from Harvard Medical School, Massachusetts, studied outcomes in 710 eyes of 424 patients aged 40-69 years who underwent LASIK between 1999 and 2005.

The study group had refractive spherical errors ranging from -10.5 diopters (D) to +6 D and cylinder of up to 2.50 D.  Patients were divided by age into 3 groups: 40-49 years, 50-59 years and 60-69 years.  All LASIK procedures were performed by the same surgeon.  Outcomes were analyzed for nearsightedness with or without astigmatism (511 eyes) and farsightedness with or without astigmatism (199 eyes).  Outcomes were based on postoperative follow-up visits of at least 6 months.

The study indicated postoperative safety, efficacy and predictability were comparable among all age groups.  At the final follow-up, 80-100% of eyes in all groups had 20/30 or better uncorrected visual acuity and 81-90% were within ±1 D. In all 3 groups, 91-100% of patients achieved 20/40 or better visual acuity following LASIK.

Many LASIK patients in the study opted for monovision, a strategy that offers distinct advantages in addressing presbyopia, a condition often present in an older population.  In monovision, one eye is corrected for distance vision, while the other eye is corrected for near vision, often eliminating the need for reading glasses.  Researchers indicated that monovision can effectively compensate for the loss of accommodation that often occurs in older patients.  The study concluded that despite challenges unique in the 40- to 69-year age group, LASIK correction for nearsightedness and farsightedness has reasonable safety, efficacy and predictability.

Ghanem RC, de la Cruz J, Tobaigy FM, et al. LASIK in the presbyopic age group: safety, efficacy, and predictability in 40- to 69-year-old patients. Ophthalmology 2007; 114:1303-1310.

Thanks to continued advances in refractive surgery tools and techniques, glasses and contact lenses are fast becoming obsolete for many patients with astigmatism. Patients with undetected astigmatism often experience headaches, fatigue, eyestrain and
blurred vision at all distances. Because astigmatism may not be recognized as the cause of these symptoms, this condition may go undiagnosed and continue to affect sufferers. Astigmatism can also
be present in children, affecting their ability to see well in school and while playing sports.

Characterized by an irregular curvature of the cornea, astigmatism can be detected by regular eye examinations and successfully treated using procedures such as laser in-situ keratomileusis (LASIK), photorefractive keratectomy (PRK), laser epithelial keratomileusis (LASEK), laser thermokeratoplasy (LTK) and astigmatic keratotomy (AK; Table 1). An ophthalmologist can determine which type of procedure will work best for each patient.

Worldwide, >17 million people have undergone laser refractive surgery, and refractive surgery is one of the most commonly performed operations in the United States. The newest laser-assisted procedures are approved by the U.S. Food and Drug Administration to treat up to 6 diopters (D) of astigmatism correction, which includes roughly 98% of all astigmatism patients. Advances in laser technology continue to improve treatment outcomes.

Guttman reported on a recent study by Barraquer, a private practitioner in Colombia, of 364 astigmatic myopic patients treated with a new generation “flying spot” excimer laser. Barraquer reported postoperative best-corrected visual acuity of 20/20 or better in 99% of treated eyes at 3 months. Astigmatic correction was achieved to within ±0.50 D in 92% of eyes.

Regular eye examinations can detect the presence of astigmatism and treat it in its early stages. Because children may also have astigmatism, it is important that eye examinations be scheduled at regular intervals to detect any astigmatism early on.

Guttman C. Laser yields safe, predictable correction for astigmatism. Ophthalmology Times, Advanstar Communications, January 1, 2008;36.

Doctors say there is too much staring and not enough blinking among Americans, and it is resulting in an annoying condition called “computer vision syndrome.” This syndrome is not one defined disorder, but a collection of symptoms that are affecting people young and old who work, study, and play in front of a screen. Industry officials believe it’s more widespread than repetitive motion injuries, such as carpal-tunnel syndrome.

42 percent of respondents in a recent nationwide survey say they use a computer or hand-held device for three or more hours a day.  Most people fail to blink or take enough breaks, their lights are too bright and their computer screens are positioned incorrectly, with the result that about three-quarters of the computer users report eye problems.

The solutions are simple, but not always easy to implement: 1) Take a “vision break” for a few seconds every ten minutes: close your eyes or stare at some distant object out the window or across the room to relax your focusing muscles. 2) Remember to blink enough. We should blink every five seconds in order to keep our eyes properly healthy and moist. When we are concentrating on a screen, we on average blink only once every ten seconds, which can cause the eyes to become dry and fatigued, also blurring the vision. 3) Be aware of the angle of your computer screen and your distance to the screen. Sitting closer to the screen causes more eye fatigue.

Andrew Caster MD – Caster Eye Center:  Excellence in Laser Vision Correction of Nearsightedness · Farsightedness · Astigmatism