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The iStent Trabecular Micro-Bypass is a surgical device that is available for use in treating patients with mild-to-moderate open-angle glaucoma.

Glaucoma is characterized by an excessive accumulation of fluid inside the eye, which leads to an increase in the inner eye pressure (intraocular pressure). This can damage the optic nerve and lead to a gradual loss of vision.

How iStent Works

One cause of glaucoma is poor drainage of the fluid inside the eye, which, again, leads to increased intraocular pressure. The iStent device works by providing a permanent path for fluid to flow out of the eye. By restoring the flow of fluid, the pressure inside the eye is reduced.

While the device is used to treat glaucoma, it is implanted during cataract surgery. This is done as an outpatient surgery, which means you can go home after the procedure is finished.

The device is made of titanium and is very small (only 1 millimeter long). Once it is in place, you will not be able to see or feel it.

Safety and Benefits of iStent

After iStent surgery, most patients’ vision improves that day. Many are also able to stop using medicated eye drops to reduce the pressure inside their eye. Others may be able to reduce the number of eye drops they need to use to control their inner eye pressure.

The iStent device is implanted during a surgical procedure. The most common side effects after surgery are:

• Swelling of the cornea (corneal edema)

• Decrease in how well you can see with glasses or contacts (best corrected visual acuity)

• Thickening of the back of the eye’s lens capsule, which causes cloudy vision

• Blockage of the iStent device

• Blurred vision

• Increased pressure inside the eye
   

The iStent device is not recommended for people with certain conditions such as angle-closure glaucoma, certain eye tumors and thyroid eye disease.

Please contact our office to schedule an appointment and find out whether you are an appropriate candidate for iStent treatment.

Herpes Zoster (Shingles)

If you ever had chickenpox, you’re at higher risk of developing shingles later in life. Shingles can affect many parts of the body. If it travels to your eyes, your cornea can become inflamed and even scarred. Corneal damage might not be apparent until months after the shingles have otherwise disappeared.

Ocular Herpes

The herpes simplex virus can cause recurring flare-ups of herpes in the eye. People who suffer from ocular herpes may notice painful sores on the eyelid or the eye’s surface, or an inflamed cornea. Untreated, it can lead to blindness.

Pterygium is characterized by a pink tissue growth on the sclera (the white part of the eye), which seems to be the result of chronic exposure to ultraviolet light. In fact, because many surfers suffer from pterygium, the condition is often called surfer’s eye. Pterygium is not cancerous and may continue to grow gradually or stop growing after a certain point. If symptoms are mild, the condition does not require treatment. However, if the condition starts to interfere with vision, treatment may become necessary.

Pterygium Cause and Symptoms

A pterygium is spurred on by exposure to the sun and wind. For this reason, the condition is often referred to as surfer's eye. Pterygia often cause a foreign body sensation and can become red and swollen. When a pterygium grows large enough, it can distort the shape of the eye, causing astigmatism and visual acuity problems.

Pterygium Diagnosis and Treatment

An eye care professional will make a diagnosis based on a close observation with a slit lamp. Pterygium treatment depends on the severity of symptoms, whether the pterygium is growing, and its causes. Mild cases can be treated with steroid eye drops. Severe cases require surgical removal, usually performed in the doctor's office with local anesthetics. To prevent regrowth, an eye care provider might perform an autologous conjunctival autografting.

Corrective lenses are used to correct deviations, adjust focal points or neutralize other anomalies that impact the eyes’ ability to focus an image on the retina. To do this, the lenses must be the correct type and of the right power. Strength – which is expressed as diopeters – relies on the material of the lens, as well as the slope of the curve that is grounded into the lens. For instance, if the person is nearsighted and has trouble viewing objects far away, the lens will be concave, or thicker at the edges than in the middle, to allow for distant objects to come closer to the eyes. On the other hand, if the individual is farsighted and has a problem seeing objects up close, the lens will be convex, or thinner at the edges and thicker in the center. Convex lenses, unlike concave ones, bend toward the focal point, which makes the image appear larger than the object actually being seen.

A Marsden ball might not look very impressive, but this little ball offers big benefits for athletes and children affected by strabismus, ambylopia and other conditions. Marsden ball exercises are just one of the techniques that vision therapists use to help patients make better use of their vision.

What Is a Marsden Ball?

Marsden balls are used in used for a variety of vision therapy exercises. The hollow rubber balls are about four inches in diameter and dangle from the ceiling on a string attached to an i-hook. Depending on the exercise, the ball may feature letters, numbers, colors or a combination of letters and colors.

Why Are Marsden Balls Used?

Every initial visit to a vision therapist involves a thorough examination to identify issues that may prevent you from using your vision fully. Once your therapist identifies the source of your problem, he or she creates a treatment plan that includes both low-tech and high-tech therapies, including computer software, prisms, lenses, filters, games and exercises. The Marsden ball, one of the low-tech options, is often used if you or your child has one of these problems or conditions:

• Difficulty using both eyes together

• Hand-eye coordination problems

• Poor visual tracking skills

• Amblyopia (lazy eye)

• Strabismus (crossed eyes)

• Problems with visual spatial processing

• Traumatic brain injuries

• Autism spectrum disorders
   

Marsden ball exercises can also help an athlete improve his or her performance. Hand-eye coordination and tracking are essential skills for many types of sports. For example, poor tracking skills may make it difficult to tell where a baseball or softball will land. The exercises also improve peripheral vision, allowing an athlete to see action on the sides of the field or court without turning his or her head.

How Does the Marsden Ball Work?

Sometimes the simplest solutions are the most effective. During Marsden ball exercises, the vision therapist sets the ball in motion and asks the patient to perform a variety of tasks, such as calling out the letters they see on the ball. While performing the exercises, patients are asked to keep their heads still and move their eyes to identify letters or colors. Marsden ball exercises are sometimes performed on wobble boards or other devices that help improve balance. Depending on the exercises, patients are asked to sit, stand, walk or lie down while keeping their focus on the balls. The balls can be raised or lowered as needed.

Marsden ball exercises are just one vision therapy technique that can help improve common vision disorders, make reading easier and improve sports performance. Would you like to find out if vision therapy can help you? Call us to schedule an appointment.

Sources:

Optometry Times: Vision Therapy: A Top 10 Must-Have List

http://optometrytimes.modernmedicine.com/optometrytimes/content/tags/brock-string/vision-therapy-top-10-must-have-list?page=full

Vision Care Institute: Be the Best You Can Be

http://www.thevisioncareinstitute.co.uk/sites/default/files/private/uk/pdf/07%20PerformanceVisionSportModule3.pdf

Review of Optometry: Treating Patients on the Autism Spectrum, 4/5/11

https://www.reviewofoptometry.com/article/treating-patients-on-the-autism-spectrum

In an ideal world, everyone would have perfectly-shaped eyes. The reality, however, is that practically every eye has some form of aberration somewhere in it. These aberrations may or may not cause vision problems, but don't be too surprised if your eye doctor informs you that you are having difficulties due to some such imperfection. In addition to relatively straightforward vision problems such as nearsightedness and farsightedness, it is also possible to suffer higher order aberrations that distort images in a much more complex manner.
 

What Is an Aberration?

Any deviation from normal refraction of incoming light waves can be considered an aberration, even if that aberration is so minor that it causes no vision problems whatsoever. Any change in the shape, consistency, or functionality of any part of the eye can distort the way light is focused and turned into images by the eye. Nearsightedness and farsightedness involve a simple distortion of the eyeball's shape, while astigmatism usually involves a fairly simple distortion of the cornea. These conditions are thus easy to diagnose and correct.
 

Causes

Higher order aberrations can be caused by a number of factors. The thickened proteins that create cataracts, for instance, can interfere with proper refraction, as can a lack of tear film in people with chronically dry eyes. Corneal scarring from disease or injury, and irregularities in the lens or vitreous humor (the gelatinous substance inside the eye), can also cause higher order aberrations. These little imperfections in the eye can bend and shift the waveforms of incoming light in all sorts of ways. Eye doctors have learned to recognize these different types of distortion, assigning them such names as trefoil, quadrafoil, coma, defocus, and spherical aberration.
 

Treatment

Treatment for a higher order aberration involves either correcting the underlying cause, or compensating for the resulting vision problem. If your higher order aberration is the result of cataracts or dry eyes, for instance, your eye care professional can recommend treatments for these disorders that to dramatically improve your vision. The fitting of intraocular lens can resolve not only cataracts but other lens disorders as well.

If your eye's vitreous humor is contributing to the problem, vitrectomy or other procedures can address that issue. You may find that prescription eyewear or refractive laser surgeries such as LASIK can correct your vision adequately. Talk to your eye care professional about which treatments can help your higher order aberrations.

An eye condition affecting roughly 50 percent of individuals who need glasses, hyperopia (commonly called farsightedness) is characterized by difficulty focusing on nearby objects while being able to see objects at a distance properly. Hyperopia occurs when your eyeball is too short or when your cornea is flatter or less round than normal. This causes light entering the eye to come to focus at a spot located behind the retina, rather than being properly focused at the retina (the back of the eye where photoreceptor cells are located).
 

Hyperopia Symptoms

Farsighted individuals experience difficulty maintaining concentration or focus on close objects. If you have hyperopia, you may unknowingly exert extra effort to bring images of close objects into focus. This additional effort leads to eye strain, headaches, and sometimes fatigue after periods of going work such as reading or writing.
 

Hyperopia Diagnosis

Farsightedness in children often goes undiagnosed during eye exams performed at school because these children can easily read the letters on an eye chart. Children are usually diagnosed with farsightedness after complaining of headaches or experiencing difficulties with tasks in school such as reading. An eye care professional diagnoses hyperopia in patients of all ages with a comprehensive eye exam.
 

Hyperopia Treatments

Depending on the severity of hyperopia, farsightedness can be treated in several ways or, in extremely mild instances, might require no treatment at all. Most cases of hyperopia are treated with corrective lenses (either glasses or contacts), which adjust the way light is bent when entering the eye, allowing it to focus at the retina.

Most farsighted individuals adjust well to wearing glasses or contact lenses. As an alternative, corrective surgeries such as LASIK or conductive keratoplasty have been developed to provide permanent treatment solutions, eliminating or reducing the need to wear corrective lenses. After a comprehensive eye exam, an eye care professional will help patients with hyperopia decide which treatment options are right for them.

Myopia, commonly called nearsightedness, is a refractive error of the eye, meaning that the shape of the eye or its cornea improperly bends light as it enters the eye. This hinders your ability to focus. Myopia is the most common refractive error of the eyes, and is caused by several factors including eye strain, overuse, and genetic predisposition.
 

Myopia Symptoms

Nearsighted eyes are longer than normal. When light enters a nearsighted eye, it focuses to a point in front of the retina, where photoreceptors are located. As a result, nearsighted individuals are able to see nearby objects clearly, but have difficulty focusing on distant objects. In addition to having difficulty seeing distant objects such as road signs, a television screen, or a chalkboard, myopia can also cause eye strain, squinting, and headaches. Nearsighted individuals might also experience a sense of fatigue during athletic activities or while driving.

Inherited myopia develops during childhood, and can progressively worsen as the eyes grow until individuals reach about the age of 20. After the eyes have developed fully, myopia can continue to progress due to eye fatigue and eye strain from activities which require the eyes to be focused on nearby objects like reading and computer work. Individuals without inherited myopia can develop nearsightedness from overuse as well.
 

Myopia Diagnosis

Myopia is usually diagnosed after the patient notices frequent headaches or difficulty seeing distant objects. After a comprehensive eye exam, an eye care professional will provide a myopia diagnosis. The severity of myopia has three classifications which depend on the strength of the prescription determined by an eye care professional: mild, moderate, and high.
 

Myopia Treatments

Several treatment options exist for individuals with myopia. These include contact lenses, glasses, and refractive surgery. Glasses and contact lenses correct the refractive error in eyes by bending light before it enters the eye, allowing it to focus on the retina. Refractive surgery, like LASIK surgery, physically reshapes the eye to correct the refractive error, eliminating or reducing the need for corrective lenses.

In addition to these treatments, which are intended to correct nearsighted vision, there are also various therapies available to hinder or slow the progression of myopia in childhood. These treatments include multifocal corrective lenses, atropine eye drops, and orthokeratology. The course of treatment which an eye care professional recommends for each patient depends on the severity of the myopia.

Every morning, we open our eyes and become immersed in a wealth of visual information. The eyes and related brain structures are a complex system that allows us to experience visual information from the surrounding world. It is easy to take clear vision for granted, but even subtle changes in the structure or functioning of the eyes can disrupt our sight. An eye care provider conducts a thorough eye exam to ensure that these components are functioning together well.
 

Basic Eye Anatomy

The eyeball is not a single, spherical structure as is commonly thought. It consists of a smaller, curved portion called the cornea that attaches to a larger, roughly spherical structure called the sclera (the white of the eye). The eyeball is filled with a jelly-like substance called the vitreous fluid.

Toward the front of the eye are three essential structures: the iris, pupil, and lens. The iris is the colored part of your eye. It can open and close to determine how much light to let in through the pupil, the black hole in the center of your eye. Finally, the lens is a flexible, convex structure that changes shape to direct light rays in different directions within the eye.

At the back of the eyeball is a layer of tissue called the retina. The retina consists of millions of photosensitive cells that react to certain types of light. Cone cells are clustered toward the center of the retina, and react to colors and details in bright light. Rod cells, which are spread toward the periphery of the retina, react to dim lighting conditions.
 

How the Eyes Facilitate Vision

When light enters the eye through the pupil, it passes through the lens, which changes shape to ensure that the light rays hit the retina. When the light rays reach the back of the eye, it stimulates the rod and cone cells to fire. Cone cells detect fine details and color in the center of your visual field. Rod cells detect edges in peripheral vision and allow us to perceive shapes in dim light.

The rods and cones in your retina convert light energy into electrical signals, which exit the eye through the optic nerve, located just below the center of the retina. The optic nerve carries visual information to the occipital cortex in the very back of your brain, where it is processed to result in a rich visual experience.

If any part of this complex arrangement functions improperly, vision is impaired. Thus, it is essential to receive regular optometry exams to have your eye structures and visual abilities checked.

Does Outside Play Improve Children's Eyesight?

Do you see many children playing outside when you drive home from work? Although kids once spent long periods of time outdoors in previous generations, today's youth are less likely to enjoy spontaneous games of hide and seek or kickball. In fact, parents of eight to 12 year olds reported that their kids spend three times as much time using computers and watching TV as they do playing outside, according to The Nature of Americans National Report. Unfortunately, lack of outdoor time can make it hard to see clearly.

What Happens When Kids Spend Less Time Outdoors?

Lack of exposure to sunlight has been linked to an increased incidence of myopia in children. Myopia, commonly called nearsightedness, makes it difficult to see distant objects clearly without prescription eyeglasses or contact lenses. The refractive error occurs when the eye becomes too long from the front to the back. As a result, light rays don't focus directly on the retina, but in front of it.

Although wearing glasses has always been a part of childhood for some children, myopia rates have been increasing lately. Genetics certainly plays a role in myopia. Children of myopic parents are more likely to develop myopia themselves, but inheritance isn't necessarily the sole cause of nearsightedness. Close work, like reading or working on computers for hours at a time, may increase the chance that a child will develop the refractive error.

In most cases, myopia is merely an inconvenience, but it can cause other eye problems in adulthood if it's severe. Retinal tears, cataracts, retinal and vitreous detachments, glaucoma and macular degeneration may be more likely to occur if you need corrective lenses greater than 5 diopters.

Myopia Rates Are on the Rise

In the past, myopia rates remained fairly steady, but that's changed in the last several decades. Myopia cases increased by 66 percent from 1971-72 and 1999-2004, according to a National Eye Institute Research Study. Researchers believe that the increase is due to fewer hours spent outdoors and increased reliance on digital devices, like smartphones, laptops and tablets.

Spending Time Outdoors Offers a Simple Solution

Increasing outdoor exposure can have a very beneficial effect on kids' eyes. Chinese children who spent an additional 40 minutes outdoors every day experienced a lower level of myopia when compared to their classmates who remained indoors. Another study determined that children who have myopic parents but spend 14 hours outside weekly have the same risk of developing nearsightedness as peers whose parents aren't myopic.

Although it may not be possible to prevent every case of myopia, you can reduce your child's chances of becoming nearsighted by:

• Encouraging More Outdoor Time. Spending an hour or two outdoors every day is a simple way to protect your child's vision.

• Limiting Digital Devices. Reducing the time your child spends playing games or surfing the Internet not only offers protection against myopia, but also prevents painful back and neck pain that can occur when your son or daughter bends his or her neck to view digital devices.

• Requiring Frequent Breaks. Whether your child is an avid reader or gamer, ask him or her to take breaks every half hour for at least 20 minutes. Breaks are the perfect time to spend a little time outdoors.

• Provide Foods That Nourish the Eyes. Foods that offer vitamins A, C, E or other nutrients necessary for good vision can help your child reduce his or her risk of developing several eye disease and conditions, including cataracts, glaucoma and age-related macular degeneration. Vision-friendly foods include carrots, peppers, whole grains, dairy products, salmon, citrus fruits, blueberries, spinach and other dark, leafy vegetables.
   

Increased outdoor time, reduced reliance on digital devices and regular visits to the optometrist can help you protect your child's vision. If it's time for a vision exam, or your son or daughter has been complaining of blurred vision, headaches or eyestrain, call us to schedule an appointment.

Sources:

Yale Environment 360: U.S. Study Shows Widening Disconnect with Nature, and Potential Solutions, 4/27/17

https://e360.yale.edu/digest/u-s-study-shows-widening-disconnect-with-nature-and-potential-solutions

CNN: Outdoor Playtime Might Help Kids Eyesight, 10/3/17

https://www.cnn.com/2017/10/03/health/eyesight-play-outdoors-partner/index.html

Investigative Ophthalmology & Visual Science: Early Childhood Refractive Error and Parental History of Myopia as Predictors of Myopia, 1/10

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2869059/

20/20: Controlling Myopia in Children, 8/14

https://www.2020mag.com/article/controlling-myopia-in-children

JAMA Network: Additional Time Spent Outdoors by Children Results in Decreased Rate of Developing Nearsightedness, 9/15/15

https://media.jamanetwork.com/news-item/additional-time-spent-outdoors-by-children-results-in-decreased-rate-of-developing-nearsightedness/

National Eye Institute: Myopia Increases in the U.S. Population, 2/17/10

https://nei.nih.gov/news/briefs/myopi