Other Diseases and Treatments
Blepharitis is a condition in which the eyelids are swollen, red, and inflamed. It occurs when small glands at the margin of the eyelid do not work properly. Under normal circumstances, these glands secrete oil onto the surface of the eye to lubricate the eyelids and prevent the evaporation of tears. In patients with blepharitis, they become plugged. This allows their secretions to stagnate and break down into fatty acids, which irritate the surface of the eye. These irritated eyes secrete more mucous and proteins that build up on the margins of the eyelids and create a crust that is most noticeable in the morning. If untreated, the condition may create painful swelling of the lid margin, discomfort of the ocular surface, and poor vision.
At Woolfson Eye Institute, our strategy for managing blepharitis is to interrupt the “vicious cycle” in as many ways as we can, using some or all of the methods of treatments outlined above.
The dosage of oral and topical drugs, with potential complications, can be reduced once a positive response is obtained to the treatments. Long-term treatment plans will be determined by response to medications and the appearance of the eyes on follow up examinations.
It is important to remember that blepharitis is a chronic disease. Most patients with blepharitis have had it for months or years before they even seek care. It is important to realize that several weeks or even months of treatment may be required before any improvement occurs. Medications should not be stopped just because they “don’t seem to be doing any good.”
Fuchs’ Dystrophy is a slowly progressing disease that usually affects both eyes. It is slightly more common in women than in men. Expertly trained Woolfson Eye Institute surgeons can often see early signs of Fuchs’ dystrophy in people in their 30s and 40s, but the disease rarely impacts vision in a noticeable way until people reach their 50s and 60s.
This condition occurs when endothelial cells gradually deteriorate without any apparent reason and the endothelium becomes less efficient at pumping water out of the stroma causing the cornea to swell and distort vision. Eventually the epithelium also takes on water, resulting in pain and severe visual impairment. This swelling damages vision by changing the cornea’s normal curvature and causing a sight-impairing haze in the tissue. Epithelial swelling may also produce tiny blisters on the corneal surface that are extremely painful when they burst.
A person with Fuchs’ dystrophy will typically awaken with blurred vision that will gradually clear during the day, because the cornea is normally thicker in the morning from retaining fluids during sleep that evaporate through the tear film during the day. As the disease worsens, this swelling will remain constant and reduce vision all day long.
At Woolfson Eye Institute, your surgeon will try first to reduce the swelling with drops, ointments, or soft contact lenses. They also may instruct you to use a hair dryer directed across your face to dry out the epithelial blisters two or three times a day. When the disease interferes with daily activities, you may need a corneal transplant to restore sight. The success rate of corneal transplantation is quite good for people with Fuchs’ dystrophy.
A pinguecula is a common type of lesion that occurs from damage to the conjunctiva and is often referred to as a “fatty degeneration” of the tissue. It is seen as a yellowish to white deposit on the conjunctiva that is seen when collagen fibers degenerate and are replaced by thicker more durable fibers. In layman’s terms, a pinguecula is a “callous” on the eye.
The primary causes of pinguecula are exposure to the sun’s ultraviolet (UV) rays and insufficient moisture or dry eyes. Often, it may appear after only a brief exposure, and it can take several weeks to heal even with proper treatment.
During your comprehensive consultation at Woolfson Eye Institute, your treatment options will be reviewed. Typically, the first course of treatment is to provide moisture with artificial tears that are preservative-free along with nutritional support. In many cases, the condition can be reversed if diagnosed early – before it is too advanced.
A pterygium is a non-cancerous, pinkish, triangular-shaped tissue (conjunctiva) growth that lays over the white part of the eye (sclera) on the cornea. Pterygia are more common in sunny climates and among people between the ages of 20 and 40; however, the exact cause is unknown. Studies suggest that where sunlight is strong, wearing protective eyeglasses, sunglasses, and/or hats with brims may help reduce the incidence of pterygium.
A pterygium is usually not too noticeable unless it becomes red and swollen from dust, air or other pollutants. Surgical options to remove a pterygium can be considered during your comprehensive evaluation with a Woolfson surgeon if it has a suspicious appearance. This is important to review because it can affect your vision and cause significant discomfort.
There are instances, because a pterygium is visible, where patients choose to have it removed for cosmetic reasons. You should feel free to discuss this with your surgeon during your evaluation.