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Also known as demyelinating optic neuritis, optic neuritis refers to the inflammation of the optic nerve due to the loss of or damage to a protective covering called myelin, which surrounds the optic nerve. The myelin is essential to the function of the optic nerve. A more general term, optic neuropathy, refers to nerve damage or abnormalities due to blocked blood flow, disease, or toxic exposure. Optic neuritis is a type of optic neuropathy.
 

Symptoms

Several vision symptoms accompany optic neuritis including blurred vision, blind spots, pain with eye movement, and reduced color vision. These symptoms typically precede a loss of vision. If left untreated, optic neuritis can lead to permanent optic nerve damage and permanent loss of visual acuity.
 

Causes

Although the exact cause of optic neuritis is not yet understood, optic neuritis occurs when the body's immune system mistakenly attacks the myelin, which protects your optic nerve. The myelin is vital for the proper function of the optic nerve. When damaged, the nerve cannot efficiently transfer electric signals/information from the eyes to the brain, hindering vision.

Optic neuritis tends to occur in conjunction with several medical conditions, disorders, and diseases including multiple sclerosis (MS), neuromyelitis optica, systemic lupus erythematosus, sarcoidosis, Lyme disease, ocular herpes, syphilis, measles, mumps, and sinusitis. In addition, optic neuritis can also develop in reaction to certain medications.

Most common among women, young adults between the ages of 20 and 40 are at the greatest risk of developing optic neuritis.
 

Diagnosis and Treatment

Eye care professionals diagnose optic neuritis using a series of tests and evaluations including a routine eye exam, an ophthalmoscopy (to inspect the back of the eye, looking for a swollen optic nerve), pupillary light reaction test (to check for abnormal function of the pupil), and blood tests.

Patients diagnosed with optic neuritis are much more likely to develop MS. As a result, if a patient is diagnosed with optic neuritis, an MRI will often be recommended to look for further signs of nerve damage and the possible development of MS.

Optic neuritis may clear up on its own. If, however, it does not, an eye care professional will usually recommend a regimen of steroids administered both orally and intravenously to reduce inflammation and suppress the immune system.

If signs of MS are present in the patient, medications to slow the onset or development of MS will also be prescribed.

Many correctable vision problems are caused by abnormal eye anatomy. Very few people have perfectly shaped eyes that facilitate ideal vision. Rather, most people have some degree of abnormal curvature or other anatomical irregularities that cause slight visual changes. Astigmatism is one common form of visual impairment that results from irregular anatomy.
 

What Is Astigmatism?

The clear front area of the eye is called the cornea, which is important for refracting light rays to direct them onto the retinal surface. Light rays pass through the cornea onto the lens. The lens is flexible, changing shape to further focus the light rays and ensure that they hit the retina. Light must bend at a particular angle to result in clear, focused vision. Any abnormalities in eye structure may cause light to be improperly focused onto the retina, preventing visual sensory cells from processing the images.

Astigmatism occurs when either the cornea or the lens is abnormally curved. It is important to note that nearly everyone has some degree of astigmatism, as ocular structures are rarely perfectly shaped. When the cornea or lens has particularly pronounced curvature, however, light rays fail to focus onto the retina. This leads to blurry vision. Unlike farsightedness or nearsightedness, astigmatism causes blurred vision at any distance. Many people have astigmatism as well as farsightedness or nearsightedness.
 

Diagnosis of Astigmatism

A comprehensive optometry exam checks your eye anatomy and vision for signs of astigmatism. Tests of visual acuity typically reveal some inability to clearly read letters on a distance chart. The eye care provider may also use a keratometer, a tool that measures the curvature of your cornea. By shining a bright light into your cornea and measuring its reflection, the eye doctor can assess the curvature of your cornea. Your eye care provider may also place different lenses in front of your eyes to determine if you have a refractive error and to what extent.
 

Treatments

Most commonly, treatment for astigmatism consists of prescription eyeglasses or contact lenses. An alternate treatment is orthokeratology, in which your eye doctor provides a series of rigid contact lenses for you to wear for relatively short periods of time. These lenses reshape your cornea, allowing you to have clear vision. Although orthokeratology does not permanently change the shape of your cornea, it may help you go without glasses or contact lenses for everyday activities. Surgery is another option for those who want a more permanent solution.

Astigmatism is very common and relatively easy to treat. If you experience any blurriness or change in vision, consult your eye doctor immediately to receive an optometric exam.

A stye, sometimes spelled as "sty," is a red, painful bump near the edge of the eyelid. It may look like a pimple or abscess, and it can form on the inside or outside of the eyelid. A stye is actually a localized infection that usually disappears by itself after a few days, although in rare cases, a stye can lead to a serious infection called cellulitis. If your stye has not resolved on its own after a couple days, contact your eye care provider for a full evaluation.
 

Causes of Styes

A stye often results from a combination of a clogged oil gland and overabundant bacteria. These bacteria live naturally on the surface of the skin without causing harm, but they can grow out of control if the conditions become just right. For instance, poor hygiene can transfer bacteria to your eyelids, and chronic inflammation can cause irritation and encourage bacteria to multiply.
 

Risk Factors for Styes

Certain behaviors can increase your risk of developing a stye:

• Inserting or removing contact lenses without first washing your hands

• Forgetting to disinfect contact lenses before putting them in

• Leaving on eye makeup overnight

• Using old or expired cosmetics, such as mascara that is more than three months old
   

Diagnosis and Treatment

Eye doctors usually diagnose styes by looking at your eyelid. He or she may use a magnifying device and light for a more thorough examination.

In most cases, a stye does not need any specific treatment; it will go away by itself. If you feel pain or discomfort, gently apply a warm washcloth to your eyelid. However, if the stye persists, then your doctor may prescribe antibiotics. A stye that is filled with pus may be drained surgically to relieve pressure and pain.

A chalazion is the medical term for a slowly developing lump on the eyelid that occurs due to an oil gland blockage. At first, the eyelid may appear to be red, tender and swollen. After several days, the chalazion will form on the eyelid, appearing as a slow growing lump. While it is initially painless and nearly impossible to detect, with steady growth, the chalazion may reach the size of pea. Chalazia are most common in adults between the ages of 30 to 50, although individuals of all ages, including children, can develop a chalazion.

Initially, chalazia can be difficult to diagnose as they are often confused with styes. A stye is also a red, swollen lump along the eyelid. However, styes are located on the edge of the eyelid or inside the eyelid’s immediate surface. They are more painful than a chalazion and typically occur closer to the eyelid’s surface. A stye is caused by an infection of the oil gland within the eyelid; a chalazion, in contrast, is caused by a blockage in the actual oil gland.
 

Causes and Risk Factors

Glands within the eyelids known as the meibomian glands naturally produce oil. Should a blockage within these glands occur, oil will build up inside the gland and eventually thicken, forming a lump known as a chalazion. In some cases, the gland may even break open, releasing the oil into the surrounding eyelid tissue, which causes inflammation. In some cases having a stye can also result in a chalazion. Risk factors for chalazion development include conditions associated with excessive oil production, such as seborrhea and acne rosacea. A viral infection, tuberculosis, and chronic blepharitis (inflammation of the eyelids and lashes) also increase the risk for developing a chalazion.
 

Diagnosis and Treatment

In some cases, a chalazion will resolve itself over the course of several weeks without the need for medical intervention. At-home remedies can speed the healing process. For example, an eye care provider may recommend the application of a warm compress to the eyelid for 10 to 15 minutes four to six times per day. Warmth from the compress can help soften the hardened oil that is blocking the gland, facilitating the healing process. Light massage on the external area of the eyelid may also help to facilitate drainage. Never attempt to squeeze or drain a chalazion by yourself. If the chalazion does not heal within one month, contact your eye doctor for additional medical care.

Seeing a spot or a flash of light in your field of vision is more than an inconvenience. It could be the first signs of a detached retina. A retina becomes detached when separated from underlying layers of support tissue. Detached retinas will lead to a permanent loss of vision if they are not quickly corrected.
 

Detached Retina Symptoms

Once the retina pulls away from surrounding supportive tissue, spots, floaters, and flashes of light start appearing. Additional symptoms crop up as detachment worsens, including blurry vision or shadows descending over the eye. These symptoms can either occur gradually or suddenly depending on the speed of detachment.

No pain is associated with these symptoms. If they occur, it is important to visit your eye doctor immediately. They can diagnose if you are suffering from a detached retina and take steps to help you regain your vision before it becomes permanently lost.
 

Detached Retina Causes

Eye or facial injuries are common causes for detached retinas. Athletes who get struck in the face or poked in the eye are usually most at risk for this method of retinal detachment.

Detached retinas can also result in cases of extreme nearsightedness. Nearsighted people have longer eyeballs and thinner retinas that are more prone to tearing or detaching. Sometimes, fluid movement or new blood vessels growing under the retina can also pull it away from surrounding tissue.

Cataract surgery, eye tumors, and diseases, such diabetes and sickle cell disease, can all lead to detached retinas. In extremely rare cases, retinal detachment can develop as a complication following LASIK surgery.
 

Detached Retina Treatments

Surgery is the only option for repairing a detached retina. It must receive immediate attention from an ophthalmologist who has received training to perform this surgery. Surgical reattachment doesn't always work. Success depends on the location, cause, and extent of the detachment.

Surgical options for a detachment include:

Scleral Buckling Surgery – a small silicone or plastic band is attached to the outside of the eye. It compresses the eye inward and lets it reattach to the interior wall of the eye.

Vitrectomy – clear fluid is removed from the posterior chamber of the eye and replaced with clear silicone oil to push the retina back onto the supporting tissue.

Pneumatic Retinopexy – a small gas bubble is injected into the vitreous body to push the retina back onto the supporting tissue.

Acanthamoeba keratitis is a relatively rare type of eye infection, but it can become quite serious. If left untreated, Acanthamoeba eventually leads to vision loss, requiring a corneal transplant to restore sight. Understanding how to prevent this infection is key.

What Is Acanthamoeba Keratitis?

Acanthamoeba is a type of microscopic, single-celled organism known as an amoeba. Acanthamoeba live in all sorts of water sources. These parasites exist in tap water, natural bodies of water, wells, hot tubs, sewage, and can survive in the moisture in soil. When an Acanthamoeba infects the translucent, outer layer of the eye (the cornea), Acanthamoeba keratitis results.

Symptoms of Acanthamoeba Keratitis

The symptoms of Acanthamoeba keratitis include eye pain, redness, sensitivity to light, blurred vision, excessive tearing, and the sensation that something is stuck in one’s eye. These symptoms reflect those of more common eye infections like pink eye, and as a result the infection can be misdiagnosed.

If you experience any of these symptoms, it is important to see an eye care professional right away, as Acanthamoeba keratitis and other eye infections can lead to permanent loss of vision if not addressed immediately.

Who Is at Risk of Contracting Acanthamoeba Keratitis?

Individuals who wear contact lenses are substantially more likely to become infected with Acanthamoeba keratitis. Improperly cleaned and disinfected contact lenses, wearing contact lenses while swimming, bathing, showering, or hot tubbing also increase the risk.

Precautions against Acanthamoeba Keratitis

One can take several precautions against becoming infected with Acanthamoeba keratitis, such as always taking proper care of contact lenses, which includes cleaning and rubbing them after each use with a brand of contact solution recommended by an eye care professional. Disinfecting a contact lens case while not in use may also prevent infection. It is also recommended that contact wearers avoid wearing contact lenses while swimming, showering, or participating in any water-related activity. If a patient chooses to wear contact lenses in the water, airtight swimming goggles should be worn, and lenses should be removed for cleaning immediately after.

Diagnosis and Treatment

The Acanthamoeba keratitis infection is often mistaken for more common eye conditions, and usually not properly diagnosed until after the failed use of antibiotics. Once diagnosed, Acanthamoeba keratitis can be fairly difficult to cure, but is treated with topical anti-microbial agents. If symptoms persist, a corneal transplant might be necessary for the patient to achieve a full recovery.

Nystagmus is a vision condition characterized by repetitive, uncontrolled eye movements. These involuntary eye movements may be side-to-side, up and down, or in a circular pattern, which hinders the eyes’ ability to focus on a steady object. Individuals with nystagmus may hold their heads in unusual positions or nod their heads in an effort to compensate for these vision obstructions. Nystagmus that develops in childhood is typically inherited; if this condition develops later in life, it may be due to an accident injury. In some cases, however, the exact cause for nystagmus is not fully known.
 

Types of Nystagmus

Forms of nystagmus include congenital nystagmus and acquired nystagmus. Congenital typically develops between two and three months of age. Eyes appear to move in a horizontal swing fashion. Congenital nystagmus is associated with conditions like undeveloped optic nerves, albinism, congenital cataracts, and the congenital absences of the iris.

Acquired nystagmus generally occurs in adulthood. While the cause is typically not know, this condition may be triggered by central nervous system issues due to alcohol or drug toxicity, stroke, multiple sclerosis, or a blow to the head.
 

Diagnosis and Treatment

A comprehensive eye exam is necessary to diagnose nystagmus. An eye care professional will first study a patient’s history to determine whether environmental factors, general health problems, or medications could be causing any of the symptoms the patient is experiencing. Next, visual acuity measurements will be taken to assess the extent to which vision has been compromised. These tests will help determine the appropriate refractive lens necessary to compensate for nearsightedness, farsightedness, or astigmatism. Finally, tests will be done to determine how the eyes work together to move in unison and focus on a single object.

While there is no “cure” for nystagmus, treatment options are available to help correct other vision problems that may be associated with this condition. Depending on the type of nystagmus, it is also possible that the condition will spontaneously correct itself. In extremely rare cases, surgery may be performed to alter the position of the muscles that move the eye. However, lifestyle changes such as using large-print books, increased lighting, and magnifying devices are generally the preferred treatment methods.

Vision that is 20/20 describes a normal level of clarity and sharpness in your vision. This is called visual acuity. This measurement offers a way to compare the quality of your vision to a professional standard. Using this tool helps your eye care provider to accurately gauge whether you need corrective lenses and to diagnose eye conditions.
 

What Do the Numbers Mean?

The term 20/20 means that you can see an object clearly when it's 20 feet away from you, just like normal. If your vision is 20/100, then viewing an object from 100 feet away is too far for you but fine for others; to see it clearly, you must come within 20 feet of that object.
 

Is 20/20 Perfect Vision?

No, 20/20 only refers to how well you see things at a distance. Your overall visual ability depends on a number of other factors as well, such as:

• Peripheral (side) vision

• Depth perception

• Eye coordination

• Ability to focus

• Ability to see colors
   

How Is Visual Acuity Measured?

Your optometry clinic has several tests that can check your visual acuity. A common test consists of a chart with letters that become smaller as you read further down the page. Each line of letters corresponds to a level of visual acuity. If the "20/20" line looks blurry to you, then you may have impaired vision.
 

How Is Impaired Vision Corrected?

If your impaired vision is not caused by a medical condition such as diabetes, then your eye care provider can help you determine the best choice for your case. Common options include:

• Eyeglasses
  This traditional technique is easy, safe, practical and affordable. It can also be stylish as well.

• Contact Lenses
  These miniature lenses rest directly on the front of your eyeball. People with an active lifestyle often favor this approach.

• Corrective Surgery
  This offers a more permanent solution. Depending on the severity and type of your visual impairment, it will improve your eyesight, but it might not be able to give you 20/20 vision.
   

If you lack 20/20 vision, corrective aids can adjust your eyesight to create clearer vision. This will help keep you safe and prevent eyestrain, which can cause headaches and fatigue. Working with your eye care provider is the best way to determine whether your vision should be corrected.

What Causes a Swollen Eyelid?

Looking in the mirror first thing in the morning can be a shocking experience when you have a swollen eyelid. Whether you have a small bump or your eyelid is completely swollen, you're probably wondering what caused the swelling. These conditions are often to blame for swollen eyelids:

Allergies

Allergies might be the reason for the swelling in your eyelids. Allergic reactions occur when your immune system gets a little confused and begins to attack pollen, ragweed, animal dander, dust, and other harmless substances. Your body tries to get rid of these substances by releasing chemicals called histamines. Unfortunately, the release of histamines triggers inflammation and swelling, which is the reason that your nose runs or your eyelids look puffy. If you have a runny nose, nasal congestion, and itchy, watery eyes in addition to eyelid swelling, allergies could be the reason for the change in your appearance.

Stye

A painful red bump at the base of your eyelid could be caused by a stye. Styles happen when you have an infection in an oil gland at the base of your eyelid or in the follicle (sac) that holds your eyelash. In some cases, the inflammation from the infection can cause swelling in your entire eyelid. Other stye symptoms can include watery eyes, light sensitivity, crusty eyelids, or a feeling that something is stuck in your eye.

Chalazion

A chalazion can also cause a red bump or swollen eyelid. The bump appears when an oil gland in your eyelid becomes clogged. A chalazion isn't usually painful but may feel sore if it becomes infected.

Blepharitis

Blepharitis is a common cause of eyelid swelling. If you have blepharitis, you may notice that your eyes are watery and sting or burn. Other symptoms may include:

• Sensitivity to light

• Dry eyes

• Itching

• The feeling that something is stuck in your eye

• Crusty or flaky eyelids
   

The condition occurs when the oil glands in your eyelid become inflamed. You may be more likely to develop blepharitis if you have allergies, oily skin, rosacea, or dandruff, according to the National Eye Institute.

Conjunctivitis

Commonly called "pink eye," conjunctivitis causes inflammation in the conjunctiva, the layer of tissue that lines the insides of your eyelids and covers the whites of your eyes. Conjunctivitis can be caused by a virus or bacteria. If you wear contact lenses, your swollen eyelid may be due to giant papillary conjunctivitis. This condition causes bumps under your eyelids due to allergies to contact lenses, solutions, or protein deposits. Contact lens wearers who also have allergies or asthma are more likely to develop giant papillary conjunctivitis, according to the American Academy of Ophthalmology.

Graves' Eye Disease

Eyelid swelling might be related to Graves' eye disease. The eye disease affects about 50 percent of people who have Grave's disease, an autoimmune condition caused by an overactive thyroid gland, according to the American Thyroid Association. Other symptoms of Graves' eye disease may include bulging eyes, dry or watery eyes, double vision, light sensitivity, or a feeling that something is stuck in your eye.

Cellulitis

This bacterial infection can affect the eyelids or the tissues around the eyes. Cellulitis is a serious infection that can cause vision loss, meningitis, or a brain abscess if not treated promptly. If you have cellulitis, you may experience swelling, eye pain, bulging eyes, difficulty moving your eyes, or vision changes.

What to Do If You Have a Swollen Eyelid

Luckily, most swollen eyelids soon get better with a little home treatment. Depending on the cause of the swelling, one of these suggestions may be helpful.

• Use Compresses. Use a warm compress to open clogged oil glands, or try a cold compress to decrease inflammation, swelling, and relieve allergy symptoms. Place a washcloth under warm or cool water, wring out excess water, and put the cloth on your eyelid for 10 to 15 minutes. Compresses can be used throughout the day to improve your symptoms.

• Take Out Your Contact Lenses. It's always a good idea to wear your glasses if your eyes are red, painful, or swollen. Keeping your contacts out for a few days may help inflammation subside and relieve swelling.

• See Your Optometrist. Call your eye doctor if eyelid swelling is accompanied by eye pain, trouble moving your eye, fever, discharge, vision changes, or if your eye doesn't improve after a few days of home treatment.
   

Worried about a swollen eyelid? Give our office a call.

Sources:

American Academy of Ophthalmology: Giant Papillary Conjunctivitis, 5/18/2021

WebMD: Swollen Eyelid, 4/16/2020

All About Vision: Swollen Eyelid Causes & How to Treat a Swollen Eyelid, 7/2021

American Academy of Ophthalmology: What Are Styes and Chalazia?, 11/18/2021

National Eye Institute: Blepharitis, 8/13/2020

American Thyroid Association: Graves’ Eye Diseas

How to Deal With Foreign Objects in Your Eye

Whether it's a speck of dust or a bug, getting something in your eye is a very uncomfortable sensation. Like most people, rubbing your eyes may be your initial reaction to the problem. Unfortunately, that may only make the situation worse and may damage your sensitive eye tissues. So what should you do when there's something stuck in your eye?

Wash Your Hands

When your eye is watering and you can barely see, washing your hands is probably the last thing on your mind. Unfortunately, if you don't wash your hands before touching your eyes, you may be more likely to develop an infection or increased eye irritation from dirt, dust, or debris.

Take a Good Look at Your Eye

It's not easy to get a piece of sawdust or sand out of your eye when you're not sure if the speck is stuck to the side of your eye or is trapped by your upper eyelid. If opening your eye is difficult, you may need to ask a friend to gently lift your upper and lower eyelids to find the foreign object. Moving your eyes up and down or from side to side may make it easier to find the foreign body.

Remove the Object or Substance Safely

Some foreign bodies can be removed simply by gently pulling your upper eyelid over the lower one. If that doesn't work, flushing your eye with eye drops can be helpful. Flood your eye with the drops, then blink a few times to help the object exit your eye.

A cotton swab or a cotton ball may make it easier to remove something from your eye. Pour a few eye drops or a small amount of saline solution over the swab or cotton ball, then gently place the cotton against the object. When you remove the cotton, check if the object is now stuck to it.

Don't use a swab or cotton ball if the object is stuck to your cornea, the clear, rounded layer of tissue over your iris and pupil. Touching this area could damage or scratch the cornea, causing a painful scratch. See your optometrist if you can't easily remove the foreign body.

Do-it-yourself removal isn't a good idea if a piece of glass or metal is stuck in your eye or an object has penetrated your eye. If you try to remove the object yourself, you could cause permanent damage to your eye. Call your optometrist immediately or go to the emergency room if this happens.

How to Handle Chemicals In Your Eye

Chemicals in toilet cleaner, bleach, battery acid, dishwasher soap, paint, and other products can irritate your eye or cause burns and damage. Flushing your eye with water is a must if this happens. Hold your eye under the faucet or shower for at least 15 to 20 minutes if this happens. Go to the emergency room or call 911 immediately if your eye has been exposed to a caustic chemical.

When a Contact Lens Is Stuck in Your Eye

Is your contact lens trapped under your upper eyelid? One of these techniques may help dislodge it:

• Use artificial tears or eye drops to unstick the lens and move it downward

• Pull your eyelid up gently while looking down

• Place your finger on the outside of your upper eyelid and gently push the lens down (stop if the lens doesn't budge)
   

Let your optometrist know if you can't safely remove a stuck object or have any of these signs or symptoms after removing a foreign body from your eye:

• Vision change

• Pain

• Bleeding

• Change in the size of your pupil

• Trouble moving your eye

• Your eye sticks out more than usual

• Difficulty opening or closing your eye

• A feeling that something is still stuck in your eye
   

Whether there's something stuck in your eye or it's time for your next vision exam, we can help you protect your vision. Give us a call and let us know how we can help you.

Sources:

All About Vision: How to Safely Remove Something from Your Eye, 11/21

WebMD: What Should You Do When You Get Something in Your Eye?, 6/21/20

Medline Plus: Eye - Foreign Object In

NCBI: Small objects in the eye: Overview, 5/25/20

American Academy of Ophthalmology: How Do I Get a Contact Lens Out from the Top of My Eye?, 9/18/1