The 5 most common eye problems I see and what to do about them

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Every different service oriented trade has their day to day clients. These are the valued clientele that occupy most of their time with the most common problems. Medicine is the same. Even though I commonly share accounts with my friends about strange and compelling cases, nearly all of my time is spent examining lots of people with only a few common issues. I thought I’d relate a portion of those ailments and what we can do to begin addressing them around the home and possibly ward off a doctor appointment.


#5 - Styes: You could notice a funny sensation in your eyelid, perchance even pain. You feel it and the eyelid is puffy. It appears red in the mirror with a lump that has readily become gigantic. You most likely have one of two problems: a stye (hordeolum) or a chalazion. A stye is an infected eyelash follicle. It shows up as a bulging, aching sore at the eye lash margin. It comes on quickly and regularly spontaneously opens up. Styes are really not as common as their relative, the chalazion. A chalazion develops when  oil glands along your eye lid border get blocked up and  oil has nowhere to go. It ultimately ends up getting backed up into the skin of the eye lid and forming a red, non-painful nodule. This bump will be deeper inside the eye lid off from the lash hair follicles. It really isn't an infection and is not going to recover on anti-biotics. Both of these are treated first with warm compresses and eye lid scrubs with baby shampoo or mild soap a couple of times daily. They must be treated for a few weeks before they will disappear for good. In the instance that they will not drain and resolve on their own, you may have to have them cut open in an ophthalmologist's office. Most adults presenting with chalazions have blepharitis, which is a mild inflammation of the lids. It is frequently associated with rosacea. It causes to crusting of the eyelid edges and overgrowth of bacteria along the lashes. Hot compresses and lid scrubbing are the key treatment.


#4 - Dry eyes: I’ve written with regards to this before on my blog, utahoc.com/bog. To review, dry eyes are quite common, contribute to eye irritation, watering, “tired eyes”, and blurry vision. See my past post for the best solutions, many of which you can perform alone after you are diagnosed.


#3 - Floaters: These are potentially the most frequent grievance I hear about, but not usually the reason folks present to the office. They can be brought up as an “Oh yeah, I've developed these annoying spots floating around in my vision.” Floaters are most often utterly unhazardous and simply irritating, but there will be a couple instances when you cannot ignore them and must see your doctor immediately. Suddenly developing a great deal of new floaters, specifically if they are associated with flashes of light or a hazy loss of a part of your sight, could mean a retinal tear or detachment. The gel that occupies the greater part of the eye is called vitreous humor. It is firm like jello when we are babies and incrementally liquifies and clumps together as we age. It is made up of 98% water and a host of thin collagen fibers and other elements that hold the water together. The collagen strands are affixed to the retina along blood vessels, at the optic nerve, around the macula (center of the retina) and just behind the lens. When the vitreous humor liquefies it detaches from these bonds and can on occasion make a tear in the retina along the way. Through these tears, the liquified vitreous can get below the retina and strip it off like wet paper (retinal detachment). This can cause fixed vision damage if not immediately addressed. Retinal tears can often be treated with a laser or by freezing the eye (cryotherapy). Once a detachment happens, an emergency surgery to fix the complication is often necessary. Bottom line: if new flashes of light and floaters are developing, get to an eye doctor without delay for a dilated eye exam. For individuals with long-standing, but unacceptable floaters, you’ll just need to become accustomed to them. Surgery would be required to remove them, which is very hazardous and could lead to a retinal detachment by itself. (On occasion, floaters are caused by an infection or inflammation within the eye, but this would generally be accompanied by other difficulties such as reduced eyesight or eye irritation).


#2 - Eyelid twitching: This happens in basically one and all sooner or later in their lives and is medically known as myokymia. Commonly one lid begins shaking and might not stop for days or weeks. It is typically just intense enough to be irritating, but doesn’t affect visual sensation or interrupt sleep. The typical triggers are fatigue, stress and caffeine, but it can also manifest spontaneously for no evident reason at all. If this starts, get a little introspective and consider if you have brought it on yourself. I remember enduring eyelid myokymia in medical school for a month, only to have it resolve during vacation. In rare cases, the twitch may continue and include a much wider area, such as the lids on both sides, or the upper half of one area of the face. If spasm lasts more than a few weeks, impact on vision or eyelid opening, or includes the muscles of the cheek or corner of the mouth, you really should have it checked out out by a ophthalmologist. Eye specialists often treat this lingering spasm with Botox injections or other treatments.


#1 - Pink eye: Pinkeye is what we call any contagion or chemical irritation of the mucous membrane of the eye, the clear thin surface of the eye itself. The most common place causal agent for contagious pinkeye is adenovirus, the equivalent virus that brings about a cold. This typically triggers both eyes to become bloodshot within a day or two of each other or at the same time. They might be itchy and watery and yield a little mucous secretion. They can be sensitive to light and commonly inflamed if the cornea is involved. Being a virus, you can’t use an antibiotic  or  a drop to make it go away. You have to wait it out and treat the symptoms. Chilled  tears are good to calm the irritation, and diligent hand washing is absolutely essential to counter distributing the ailment. Bacteria can also cause conjunctivitis, but this in most instances leads to a busload of generation of mucus or pus. The eyes will likely to be even more reddish and the cornea can be infected, on occasion serious enough to cause fixed injury. Bacterial conjunctivitis will respond to medicine, so seeing your ophthalmologist is suggested. If you are unsure which form you have, an doctor can advise you here at the same time, just don’t be angry when that person tells you your condition is viral and endorses an over the counter medication.

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Salt Lake City Oculoplastic Surgeon