While eyeglasses have made it possible for millions of people to see the world clearly, the invention of contact lenses has proved to be very useful in instances where people cannot or do not want to wear eyeglasses. For people with poor vision, contact lenses are an effective and almost invisible tool that   enables them to see clearly without letting anyone know that they are using any aid. The thin plastic lenses are fitted over the cornea of the eye to correct a number of vision problems like myopia, presbyopia, astigmatism etc.

There are a variety of contact lenses available these days. The most popular ones include:

• Soft lenses: These are the choice of most contact lens wearers. These lenses offer comfort and come in many versions, depending on how you want to wear them.
• Daily-wear lenses:  These are the least expensive, are removed nightly and are replaced on an individualized schedule. They should not be used as an extended-wear lens.
• Extended-wear lenses: These can be worn overnight but must be removed at least once in a week for thorough cleaning and disinfection. They are recommended less because there is a greater risk of corneal infection with any overnight wear of contact lenses.
• Disposable-wear lenses: These are more expensive, but convenient. They are removed nightly and replaced on a daily, weekly or monthly basis. Disposable lenses are sometimes recommended for people with allergies and for those who tend to form deposits on their lenses.
• Cosmetic contact lenses: These are colored contact lenses that change the appearance of your eye color, and in the case of circle lenses also make your iris appear bigger. Decorative lenses are available by prescription and should only be worn after an eye exam and fitting by qualified eye care professional.
• Toric soft contact lenses: These can correct astigmatism, but sometimes not as well as RGP lenses do. They usually cost more than other contact lenses.

No matter which type of lens you choose, expert fitting and daily maintenance is very crucial task. We at Killeen Eyecare Center provide you with highest quality eye exam, training and follow up as required in the complete eye care plan. We will suggest you the right contact lenses as per your eye vision and social needs.

To know more about contact lenses or our services, visit us at Killeen Eyecare Center 416, North Gray Street, Killeen, TX 76541, and Downtown Killeen. You can also call us at 254- 634- 7805.

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Choroideremia is a rare, genetic disease of the eyes, which is progressive, and ultimately leads to blindness. The disease is much more common in males than in females, and even if found in females, is usually mild. It affects the retina and choroid, causing the degeneration of the region that acts as the photoreceptor of the eye. The first symptom of the disease is usually night blindness, which might occur in early childhood. This gradually results in complete vision loss by middle age. The underlying cause of the disease is the atrophy of the light-sensitive tissue (retina) and blood vessels (choroid).

Cause:
The cause of the disease is purely genetic, with the deletion of a protein known as the Rab Escort Protein 1 (REP 1) causing the disease. Even though patients have the REP 2, which is essential for the normal functioning of any cell, this is not sufficient for normal vision. There is also an established link between increased levels of unprenylated Rab27 in lymphoblasts in patients with the disease, even though it is not known how this affects vision. Mothers serve as the carriers of the disease to their sons, since the gene for this disease is located on the x-chromosome.

Symptoms:

• Night blindness
• Poor coordination
• Loss of peripheral vision, also known as “tunnel vision”
• Loss of depth perception
• Loss of color perception
• Loss of visual acuity
• Complete vision loss in later stages
• The disease continues to progress throughout the patient’s life, even though the rate of progress and intensity of symptoms varies from patient to patient, even in the same family.

Treatment:

• Even though there is no known treatment for the disease yet, research is underway to find a cure for choroideremia.
• A gene therapy is being evaluated on animals, and is expected to result in a cure for the disease. This therapy involves introducing functional copies of the affected gene in the eye, in an attempt to halt cell death.
• The disease can be detected prenatally with the help of a genetic counselor. This is recommended in all family members of a patient with the disease. The National Eye Institute at the US National Institutes of Health provides free screening for residents of Canada and the US under the eyeGENE project.
• Presently, patients are provided with symptomatic relief, such as the use of low vision aids, vocational counseling, adaptive training, and personal counseling.

For more details, contact us at Killeen Eyecare Center. We are located at 416, North Gray Street, Killeen, TX 76541, and Downtown Killeen or call us at 254-634-7805.

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Corneal neovascularization is a condition of the eyes, involving excessive growth of blood vessels in the cornea. This occurs as a compensatory mechanism of the body to deal with the lack of sufficient oxygen supply to the eyes. The new blood vessels originate from the limbal vascular plexus, and grow into the cornea. It most commonly occurs in contact lens wearers, which is why those who wear contact lenses, are strongly suggested to get their eyes checked annually, for early diagnosis of the disease. If it goes undetected, corneal neovascularization can result in severe vision impairment. The condition can either be superficial, as in contact lens wearers, or deep, when caused by an inflammatory condition.

Causes:

• Wearing contact lenses improperly or for a period longer than prescribed by the optometrist.
• Underlying intraocular medical condition, like glaucoma, pthisis bulbi, blepharitis, conjunctivitis, keratitis, trachoma and phlyctenulosis, uveitis, etc.
• Exposure of the eye to a caustic chemical, resulting in severe burns
• Immunological disorders
• Graft rejection
• Trauma to the eyes
• Infection in the eyes

Symptoms:

• Redness
• Irritation
• Eye pain
• Tearing
• Photophobia
• Intolerance of contact lenses after a few hours of wear
• Blurred vision even while wearing contact lenses
• Actively engorged vessels (around 12 mm long) in the ‘white of the eye’

Treatment:

• The treatment of the disease begins with identifying its cause, and working on the elimination of that cause.
• Topical corticosteroids can be administered to manage gross vascularization.
• Surgical treatment of the condition involves corneal laser photocoagulation and diathermy of the engorged vessels.
•  In case of severe chemical injuries, procedures like limbal grafting are performed. 
• The instillation of topical triamcinolone and doxycycline as a way to manage neovascularization is currently under trial, and has been proved effective in rats.
• The base curve of contact lenses should be altered in soft contact lens wearers to facilitate movement of the lenses.
• The patients might also be suggested to switch to silicone hydrogel lens materials, which are more permeable to oxygen due to their high Dk/t. These lenses are FDA approved either for 30 days extended wear or continuous wear up to 6 nights and 7 days.
• Patients should be educated on the importance of adequate corneal lubrication via proper blinking and use of lubricants, and should be advised to get annual follow-ups after the treatment is complete.

To know more about Corneal Neovascularization and its treatment, visit us at Killeen Eyecare Center located at 416, North Gray Street, Killeen, TX 76541, Downtown Killeen or call us at 254-634-7805.

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Photokeratitis is a condition of the eyes, which involves the inflammation of the outermost layers of the eyes- the cornea and conjunctiva, on exposure to natural or artificial ultraviolet rays (most commonly UVB rays). The disorder can be compared to sunburn of the skin, the only difference being that it affects the eyes. Symptoms usually appear after several hours of unprotected exposure to the UV rays.

The term photokeratitis is often used interchangeably with other terms like snow blindness, welder’s flash, arc eye, flash burns, etc. It can be prevented by using protective eye-gear like welding goggles, welding helmet, sunglasses certified to provide UV protection, and snow goggles.

All eye-gear used for protection should have side shields and large lenses, to avoid accidental exposure, and should be worn even when the sky is overcast, since UV rays penetrate clouds. Ancient Egyptians blackened the skin beneath the eyes to avoid reflection of UV rays. This method is recommended in the SAS survival guide.

Causes:

• Welding without protection (Arc eye)
• Exposure to sunlight reflected from ice or snow (Snow blindness)- Fresh snow reflects 80% of the UV radiations.
• Exposure to sunlight reflected from sea or sand- Sand reflects 15% of the UV radiations, while sea foam reflects 25%.
• Exposure to sunlight at elevated levels- The intensity of UV rays increases by 4% for every thousand feet above sea level.
• Looking directly at a solar eclipse
• Exposure to artificial sources of UV light, like carbon arcs, lighting, photographic flood lamps, halogen desk lamps, sun tanning beds etc.

Symptoms:

• Pain
• Swelling
• Feeling of sand particles in the eyes, which persists even after repeated washing
• Tearing
• Blurred vision
• Redness
• Itching
• Temporary vision loss
• Seeing halos around the eyes
• Headache
• Constricted pupils
• Twitching of the eyelids
• Discomfort in bright light
• While most of these symbols resolve on their own in around 36 hours, some symptoms, like constriction of the pupils can last for as long as 128 hours.

Treatment:

• Anesthetic eye drops can be administered for temporary relief of pain, but these should be avoided, as they interfere with the natural healing process, and can lead to corneal ulceration as well as vision loss.
• Cold compresses and artificial tears can be used to relieve symptoms.
• NSAID (Non Steroidal Anti-Inflammatory Drug) eye drops are useful in reducing pain and inflammation.
• Oral pain relievers can be used in case of severe pain.
• The source of exposure should be immediately removed, and the patient should preferably be isolated in a dark room, or should wear sun glasses.
• Contact lenses must be removed, and rubbing of eyes should be avoided.

To know more about Photokeratitis and its treatment, visit us at Killeen Eyecare Center located at 416, North Gray Street, Killeen, TX 76541, Downtown Killeen or call us at 254-634-7805.

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Ocular hypotony is a condition of the eyes, in which the intraocular pressure (IOP), i.e. the fluid pressure inside the eye, drops to a level of 5 mm Hg or less. It is usually an indication of an underlying eye disorder. The two most common causes of this condition are fluid leakage and eyeball deflation.

Apart from the discomfort associated with hypotony, it can also lead to various other pathophysiological complications, which become more pronounced as the IOP approaches 0 mm Hg. These include maculopathy, corneal decompensation (accumulation of fluid in the cornea), and cataract formation. 

Causes:

The underlying cause of ocular hypotony is either the decreased formation, or the increased outflow of aqueous humor, which is the gelatinous fluid contained in the space between the lens and the cornea, and is responsible for maintaining IOP. The causes for decreased IOP include:

• Conditions causing increased outflow- wound leak, cyclodialysis cleft, overfiltering belb, etc.
• Conditions causing impaired ciliary body function- hypoperfusion,  iridocyclitis, tractional ciliary body detachment etc. These conditions result in the decreased production of aqueous humor.
• Retinal detachment
• Altered osmotic state, causing greater outflow- This can be caused by the use of hyperosmotic agents e.g. glycerol, mannitol, urea, isosorbide etc.
• Inflammation, resulting in increased permeability of blood-aqueous barrier, and hence decreased aqueous humor production.
• Dehydration
• Uncontrolled diabetes
• Uremia (High level of nitrogen waste in the body)
• Rupture of the sclera with a needle, suture or trauma
• Aqueous humor suppression by certain drugs- e.g., topical beta-blockers or carbonic anhydrase inhibitors.

Symptoms:

Patients might report symptoms like blurred vision and deep pain in the eyes, or might be completely asymptomatic. Others might develop symptoms related to retinal detachment like floaters in the field of vision, “sparks of light” visible on moving the eyes, darkness in a particular region in the field of vision, etc. 

Treatment:

The primary focus in the treatment of hypotony is usually focused on the underlying disorder that causes it. However, the following lines of treatment are followed to offer temporary relief:

• Inflation of the anterior chamber with gas or viscoelastic.
• Administration of steroids to enhance aqueous humor production.
• Increased fluid intake
• Patients who have had a recent inflammatory condition, or those who have undergone surgery or trauma are administered with topical prednisolone acetate, which helps in wound-healing.
• Atropine and other cycloplegics can be administered to restore lens anatomy.
• Most of the underlying disorders that cause hypotony might need surgical correction.

To know more about Ocular Hypotony and its treatment, visit us at Killeen Eyecare Center 416, North Gray Street, Killeen, TX 76541, and Downtown Killeen or call us at 254-634-7805.

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Keratoconus is a disorder of the eye in which the cornea, which is the outer transparent layer of the eye, gets damaged, leading to a distortion in its structure. The cornea loses its normal round shape, and becomes thin and conical. The disorder is usually diagnosed in the adolescent years of the patient, and it is believed to have a one-in-a-thousand prevalence, even though these figures might be inaccurate due to the differential diagnosis of the disease. In severe cases, it might affect the patient’s ability to carry out everyday tasks like driving and reading.

Causes: Keratoconus is believed to arise from a disorder in collagen, which is the connective tissue that constitutes the cornea. Even though its exact cause is not known, the following are possible causes of the disorder:

• Some patients might have a genetic predisposition to the disease. Patients with Down’s syndrome have an increased risk of developing keratoconus.
• It can result due to untreated allergy
• Rubbing the eyes aggravates the disorder
• It is associated with other disorders like asthma and eczema
• LASIK surgery has been found to cause iatrogenic keratoconus

Symptoms:

• Blurring of vision, which remains uncorrected with the use of glasses. This is the earliest symptom of the disease.
• Rapid deterioration in eyesight as the disease progresses.
• Trouble in viewing distant as well as close objects
• The symptoms might affect only one eye, but commonly affect both eyes nearly equally.
• Itching in the eyes
• Photophobia (Finding bright light unbearable)
• Perceiving distortion and streaking around light sources
• Viewing ghostly images against a contrasting background
• Eye strain while reading or concentrating on close objects, resulting in the need to squint.

Treatment:

• The most common treatment for keratoconus is the use of contact lenses for visual correction. Soft contact lenses can correct mild astigmatism, while rigid contact lenses are needed at later stages of the disorder.
• In the most severe cases, corneal transplantation surgery might be required. The results of the surgery are mostly good, even though the recovery period might be long. Patients will still need to use contact lenses after surgery.
• The latest developments in the treatment of the disorder include intracorneal ring segments, which are high-frequency corneal implants used to correct the shape of the cornea; and corneal cross-linking, in which the cornea will be hardened, to prevent further damage.

To know more about Keratoconus and its treatment, visit us at Killeen Eyecare Center located at 416, North Gray Street, Killeen, TX 76541, Downtown Killeen or call us at 254-634-7805.

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Strabismus, commonly referred to as “crossed-eye” or “squint”, is a disorder of the eyes, predominant in young children, in which the patient does not look at the same point with both eyes. This is due to an abnormality in the muscles that control the movement of the eyes, which affects the coordination of vision from both eyes. This results in a misalignment in the eyes, and an inability of the brain to merge the vision of the left and the right eye. The disorder should be treated in childhood, because it becomes more difficult to treat with age. It can be damaging to a child’s self-esteem, and can lead to certain disorders like amblyopia (lazy eye).
Causes:

• The disease is believed to run in families.
• It can result from the eye’s attempt to compensate for other disorders in the vision, like far-sightedness and cataract.
• Congenital weakness of the nerves and muscles.
• Premature birth
• Head injury
• Other diseases like Grave’s disease, Down’s syndrome, eye tumor, brain tumor etc.
• Eye injury
• Damage to the blood vessels supplying blood to the eyes.

Symptoms:

• Visible misalignment of the eyes.
• Inability to move both eyes together in the same direction.
• Difficulty in keeping one or both eyes open in bright sunlight.
• Involuntarily tilting the head to focus on an object.
• Limited depth perception, leading to improper judgement.
• Excessive tiredness in the eyes.
• Blurred vision
• Double vision
• Sensitivity to light

If you notice crossed eyes in your newborn baby, you do not need to panic, because this might be a case of pseudostrabismus, which usually corrects itself in around 4 months. However, if the problem persists after 4 months, you need to see an ophthalmologist, who will decide the best cure for your child’s disorder.

Treatment:

• Wearing glasses/ contact lenses to correct vision problems
• An eye patch can be used to cover the stronger eye in patients with amblyopia (lazy eye). This forces the unused eye to focus on objects, making its muscles stronger, and hence aid in the correct alignment of the eyes. This patch might need to be worn for a few months.
• Surgery is usually the most effective form of treatment of the disorder. It aims at improving the alignment of the eyes and making vision better. Multiple surgeries might be needed, and your child might still need to wear glasses even after surgery.
• Eye exercises can improve the condition to some extent.

To know more about Strabismus and its treatment, visit us at Killeen Eyecare Center 416, North Gray Street, Killeen, TX 76541, and Downtown Killeen or call us at 254-634-7805.

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Corneal erosion is an eye condition in which the epithelial layer of the cornea is damaged, usually due to a foreign body invasion in the eye, resulting in discomfort in the eye. The condition results from the erosion of the epithelial layer, which is a protective layer of the cornea.

Causes:

• The most common cause of corneal erosions is the presence of a foreign body in the eye. This can happen as the result of an injury caused by jabbing a finger, fist etc. into the eye, colliding with a tree branch, impact of projectile metal during construction, or any other foreign body invasion.
• Another common cause of the disorder is hard contact lenses that are not taken out of the eye in time.
• Relatively less common causes are excessive drying of the cornea, and other eye disorders like lattice corneal dystrophy.

Symptoms:

• Pain
• Photophobia (Intolerance of bright light)
• Sensation of a foreign body being present in the eye
• Swelling in the eyelid
• Inflammation of the conjunctiva
• Enlargement of pupils
• Excessive secretion of tears
• Build up of yellowish crust around the eyes
• Edema (Fluid accumulation)
• Feeling of heaviness in the eyes
• Squinting

Diagnosis:

Eye doctor can easily detect corneal erosions by using an ophthalmoscope. A slit lamp microscope provides larger magnification, aiding in the diagnosis. When the corneal erosion is diagnosed, a fluorescein stain is instilled into the affected eye, and viewed under cobalt-blue light. The area of the corneal erosion gets highlighted, and glows in the light. This is useful to determine the progress of treatment. Diagnosis also involves a careful search for any foreign body that might be present in the eye.

Treatment:

• The first-line of treatment for large corneal erosion is a topical antibiotic to prevent infection in the eye.
• Topical cyclopegic drugs can also be administered to reduce pain and discomfort.
• Eye pads can be used to prevent repeated blinking of the eye, which is believed to speed the recovery process, even though the efficiency of this treatment has not been supported by controlled studies.
• ‘Bandage contact lenses’, which are a new form of porous contact lenses made of substances like silicone hydrogels, are an effective treatment option for contact lens wearers, as they provide sufficient oxygen to the cornea, and have a tight fit, which prevents moving, and hence abrasion.

To know more about Corneal Erosion, visit us at Killeen Eyecare Center 416, North Gray Street, Killeen, TX 76541, and Downtown Killeen or call us at 254-634-7805.

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Retinopathy refers to an abnormality in the retina, often due to traumatic damage or abnormal development of blood vessels. In Central Serous Retinopathy, the condition involves the accumulation of a transparent fluid (thin and watery serum, hence the word ‘serous’), in the region under the central macula. This eye disease is believed to result from the leakage of fluid from the retina, and is 10 times more likely to affect men (aged 20-50) than women. It is a temporary condition, and is self-limiting. It can be associated with varying degrees of visual disturbances. Most patients have recurrences after the disease is resolved.

Causes:

• Leakage of choroidal fluid due to the detachment of macular tissues from supporting layers.
• High levels of stress
• High levels of cortisol
• Diseases like Cushing’s syndrome and MPGN Type II kidney disease
• Administration of corticosteroids
• Microorganisms like Helicobacter Pylori

All these are potential causes, even though research has not yet been able to prove the exact causes of the disease. For instance, the fact that people with more stressful lives are more prone to the disease might be simply due to the fact that these people are more likely to notice even a slight abnormality in their eyesight and opt for a diagnosis.

Symptoms:

• Blurring of vision
• Farsightedness
• Seeing abnormal colors in objects
• Finding objects to be smaller than they actually are
• Dark spots in vision
• Distorted vision, e.g. viewing straight objects to be crooked
• Decreased night vision
• Migraine-like headaches
• Difficulty in reading, driving, and other activities requiring visual acuity
• Some patients report normal 20/20 vision, while for others it can be as bad as 20/200. The average visual acuity of patients with the disease is 20/30.

Treatment

The condition usually disappears on its own in around 6 months. However, the following treatment options are opted for to expedite recovery, or in case the symptoms persist for longer:

• Discontinuation of corticosteroid treatment
• Administration of low-dose aspirin
• Counselling for patients with psychosocial stress
• Laser photocoagulation to burn off the affected area- This can have potential hazards, and must be carried out with careful consideration, by a well-trained professional.
• Transpupillary thermotherapy- This is a safer alternative, also known as ‘cold laser’, and is effective in case of a leak in the central macula.
• Nutritional supplements like zeaxanthin and lutein
• Photodynamic therapy

For more details, contact us at Killeen Eyecare Center. We are located at 416, North Gray Street, Killeen, TX 76541, and Downtown Killeen or call us at 254-634-7805.

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Retinopathy of prematurity refers to a condition of the eyes that primarily affects infants. The condition is associated with a wide gamut of problems, ranging from nearsightedness to visual loss. The infants who are at the greatest risk of developing the condition are those who are born prematurely (before 30 weeks gestation), and those with a low birth weight (less than 3.3 lb).

Causes:

The underlying cause of the disease is the improper development of the vessels that supply blood to  the retina, which is the tissue responsible for supplying visual signals to the brain. Ideally, the blood vessels around the retina are supposed to develop completely before birth. However, when a baby is born prematurely, the blood vessels develop strangely after birth, leading to various abnormalities, including bleeding, scar tissue and retinal detachment.
Even though the cause of retinopathy of prematurity is poorly understood, research establishes that both a deficiency, as well as an overdose of oxygen can aggravate the situation. That is the reason that doctors carefully monitor affected infants with a pulse oximeter and blood tests, to ensure that they get just the right amount of oxygen.

Symptoms:

• Most of the symptoms of the disorder are not visible to the naked eye, and can only be detected by a well-trained pediatric ophthalmologist, with the help of special instruments. If left untreated, retinopathy of prematurity can result in the following symptoms:
• Leukocria- This results in a white tinge in the pupils
• Nystagmus- This a condition that is accompanied with abnormal eye movements
• Strabismus- Commonly referred to as “crossed eyes”, this condition can result in case of untreated retinopathy of prematurity
• Myopia- Retinopathy of prematurity can result in severe nearsightedness, known as myopia

Treatment:

The treatment of the disease is decided based on the severity of the condition. While mild cases of ROP usually resolve on their own, medical intervention is required in severe cases, where the sight of the baby is at risk. The basic goal of the treatment is to reduce retinal detachment, which if left unchecked, can result in visual impairment. The most common treatment option for ROP is laser photocoagulation. This process employs a laser directed to a specific spot in the eye, to destroy abnormal vessels and seal leaks. It is advisable to treat the disease in its initial stages, to decrease the risk of permanent eye damage.

For more details, contact us at Killeen Eyecare Center. We are located at 416, North Gray Street, Killeen, TX 76541, and Downtown Killeen or call us at 254-634-7805.

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