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.

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!

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.

• <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.

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.

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.

The sun is always here…

please wear sunglasses

The invisible part of sunlight – the ultraviolet rays (UV) – are damaging to the eyes. It is easy for us to see what these invisible sun rays do to a carpet (fade the color) or to your skin (sun damage). The sun causes similar damage to the eyes, resulting in cataracts, macular degeneration, and in rare cases partially reversing the effects of Lasik. Whether you have had Lasik or not, it is very important to wear sunglasses when you are out in the sun, especially if you will be exposed to the sun for a prolonged period of time. Higher altitudes and reflecting surfaces such as snow, sand, or water increases the amount of UV light that can reach your eyes. Also, you must still be careful on cloudy days – these harmful UV rays are only partially blocked by clouds.

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

The military has now performed over a quarter of a million laser vision correction procedures. The Department of Defense carefully monitors the results of all of their laser vision treatments. Some interesting results of the many clinical trials conducted by the Department of Defense include:

•In an evaluation of 785 Navy aviators, 89% of Navy pilots rated their ability to land on an aircraft carrier as moderately to significantly better after laser vision correction. None said it was worse after laser vision treatment. This includes difficult and dangerous nighttime aircraft carrier landings.

•Over 90 percent of marksmen had improvement in marksmanship skills after laser vision correction, a significant result given the visual precision of marksmen.

Troops who are treated with Lasik no longer need to worry about dirty, sweat-covered glasses, dirty and irritating contact lenses, or losing their glasses or contact lenses during life-threatening combat. This applies to troops on the ground, in submarines, or aviators who fly very fast and expensive fighter jets. As one Army sergeant explains, “After Lasik, our vision is always ready for combat. No worries about dirty glasses or watery contact lenses.”