Grave’s eye disease, also commonly known as thyroid eye disease is basically a condition in which the white blood cells attack the thyroid gland. It is an autoimmune disease where the size of the thyroid increases manifold and it starts secreting hormones in an unusually large amount in response to the attack. This also has an effect on the eyes which bulge out abnormally because of inflammation in the muscles and other tissues. Grave’s eye disease also affects the functioning of the heart and brain.

CAUSES:

The attack by the white blood cells directly aims at the eye muscles and tissues that rest inside the eye socket. The eye tissues consist of proteins that the immune system mistakes for those found in the thyroid gland. Probably this is the reason why eyes are very vulnerable in this disease. Although the severity of symptoms might vary, in rare cases the patients can even lose their eyesight.

Thyroid eye disease also bothers people who have normal or thyroid hormone levels. Women are more at the risk of getting affected by this disease as compared to men. Also, people who regularly smoke are at a higher risk of developing Grave’s eye disease.

SYMPTOMS: This disease can be diagnosed by a simple eye examination if your thyroid gland problem has already been detected. Additionally, blood tests and thyroid scans are also necessary to confirm the condition.
Following are some of the symptoms associated with Grave’s eye disease:

• Redness and irritation in the eyes is one of the most common symptoms.
• Dryness appears in eyes if the tear-producing gland is badly affected.
• The eyes appear bulged out and it might seem you are staring continuously.
• Since the eye muscles suffer from inflammation, they are unable to function properly and as a result the patient might develop double vision.
• If the disease goes untreated and reaches an advanced stage, blurry vision coupled with the inability to distinguish between various colors can also occur.

TREATMENT:
In some cases, the eyes tend to return back to normal when the abnormality of the thyroid gland is fully treated. However, in other instances even the treatment of thyroid gland is rendered ineffective and there is no positive effect of its treatment on the eyes. In these conditions, the doctors prescribe steroids as well as immunosuppressive drugs to stop the occurrence of inflammation of the optic nerve and consequent blindness.

At present, intravenous corticosteroids are generally preferred by eye doctors as they are a more effective remedy. If all the measures fail, then surgery is the last resort wherein a part of the affected tissue is removed to reduce the pressure on the eyeball. An X-ray procedure can also be used to remove the damaged tissue.

Contact lenses are very liberating for those who are used to wearing spectacles, but one has to pay a price for this option. Not taking proper care of your lenses might prove detrimental for your eyes more than you can imagine. Enlisted below are some simple instructions and tips that will help you take care of your contact lenses.

• Before handling your contact lenses, make sure that your hands are clean, as you don’t want to transfer germs on to the lenses. Use a mild soap or just plain water. Then dry your hands with a lint-free cloth/ towel.
• The next step is to take the lens in the palm of your hand, and pour a few drops of the contact lens solution on to it. Now gently rub with your index finger. Take care not to handle the lenses with sharp nails, as this might damage them.
• Now rinse the debris, and place the lens in a cleaned case, filled with fresh solution. Remember not to reuse the solution, as that gets contaminated with germs.
• You do not need to fill the case till the brim, just half way through will do. The aim is to cover the lens completely in the solution, and to ensure that the solution is fresh each time.
• It is advisable to remove and insert your lenses on top of a wash basin, so that you can easily spot the lens if it slips down and falls.
• Take special care of the tip of the bottle containing the solution, ensuring that you do not touch it with your fingertips, and keep it covered at all times to avoid contamination.
• Do not splash your eyes with tap water while wearing contact lenses, as the microorganism called Acanthamoeba present in this water can cause serious eye infections.
• Try to remove the contact lenses as soon as possible, like when you get back home, as this gives your eyes the much-needed time for aeration.
• Do not sleep with your contact lenses on, since while sleeping you do not blink. It dehydrates the lenses, which hardens them.  It then becomes harmful for the delicate membrane of your eyes.
• Wash the contact lens case thoroughly with warm, soapy water every day, or at least every alternate day. 
• Follow the instructions indicated on the lens package carefully and do not exceed the time recommended by your optometrist, in case of disposable lenses.

Contact us at Killeen Eyecare Center for eye sight check up and for procuring correct vision lenses for your eyes. We are located at 416 North Gray Street, Killeen, TX 76541, Downtown Killeen. We can also be contacted at 254-634-7805.

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Retinal hemorrhage occurs when the blood vessels in the retina get damaged or ruptured, leading to abnormal bleeding. The retina, which is composed of rods and cones is the region of the eye responsible for sensitivity to light, and vision. The retinal vein and artery, along with a dense network of capillaries, are responsible for transmitting the blood supply to the retina. When these blood vessels are damaged, due to any reason, this affects the blood supply to the retina, which in turn leads to a decrease in visual acuity.  Diabetic retinopathy is the leading cause of blindness in people aged between 20 and 65.

The dense network of cells in the retina is extremely sensitive, and can be damaged with even a slight trauma.

The causes due to which this damage might occur include:

• Diabetes
• High blood pressure
• Forceful blows in the head region
• Accidents
• Falls
• Child abuse in infants
• Improper development of blood vessels in infants born prematurely

Symptoms:

• Blurred vision
• Spotted vision
• Lines in the field of vision
• Blind spots
• Distorted vision
• Progressive vision loss

Diagnosis:

• The disease is diagnosed by an ophthalmologist, who uses an opthalmoscope to examine the internal structure of the eye.
• Another method that is commonly used to detect the abnormalities in the blood vessels is a fluorescein angiography test, in which a fluorescent dye is injected into the patient’s bloodstream, after which photographs are clicked to view the blood vessels.
• In some cases, the physician might also order for a blood test to be performed.

Treatment

• The disorder is self-limiting in most patients, with more than 85% cases healing on their own.
• The most common treatment for retinal hemorrhages is laser treatment, in which a laser beam is used to remove the affected blood vessels.
•  If the disease is caused by some underlying medical condition like diabetes or hypertension, the treatment focuses on eliminating that disorder.
• Injection of anti-VEGF drugs like Avestin has been found to be effective in the treatment of hemorrhages associated with the growth of new vessels.
• The administration of various nutritional and herbal supplements like antioxidants, omega-3-rich foods, antioxidant vitamins, zinc, lutein, pine bark extract, grape seed extract, etc. has also been found to be effective in improving the symptoms of the disease.

We at Killeen Eyecare center are renowned throughout Killeen for providing the highest quality eye care to all our patients. We help them maintain healthy eyes and treat various eye diseases using most sophisticated instruments. For more details, you can visit us at 416 North Gray Street, Killeen, TX 76541, Downtown Killeen or call at 254-634-7805.

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Vision therapy basically refers to a variety of procedures and techniques that are employed by optometrists to improve vision, and treat various eye disorders. It aims at reducing visual discomfort, increasing clarity, and helping in the alleviation of vision-related problems in learning disorders. A typical vision therapy program can last over a period of a few weeks, to several months, depending on the intensity of the disorder being cured.

It consists of exercises, which are carried out under the supervision of a trained professional, and at home reinforcement exercises, which the patient is required to perform regularly, on his own. Apart from teaching the patient various exercises that improve eye function, the experts in this field also employ certain additional visual aids, including learning glasses, balance boards, filters, prisms, patches, and electronic targets.

The therapy includes exercises like near point of convergence exercises, computerized training programs, use of concave lenses, use of convex lenses, anti-suppression exercises, and “Cawthorne Cooksey Exercises”.
Vision therapy can be of three types-

• Orthoptic vision therapy- The main focus of the exercises included in such a program is to improve binocular vision. Professionals who specialize in this technique are known as orthoptists. It has been found to be beneficial in the treatment of symptomatic convergence insufficiency.
• Behavioral/perceptual vision therapy- The aim of the exercises included in such a program is to improve visual perception and processing. Even though its efficiency stands scientifically unproven, some experts claim that it is effective in improving visual perception. This method is gaining popularity among athletes as a way of improving their field of vision beyond normal.
• Myopia related vision therapy- This category of vision therapy aims at preventing or curing myopia, or near-sightedness, which is one of the most common vision disorders among children.

One of the most common applications of vision therapy is in increasing the educational performance of children with learning disabilities, by improving their ocular coordination and visual processing. Vision therapy is usually recommended by school teachers when they notice that the child is exhibiting trouble in reading or writing.

If your child has been referred for vision therapy, be sure to get a proper diagnosis of the eye disorder that your child is suffering from. 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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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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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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Cranial nerve palsy is a neurological condition in which the functioning of one or more of the cranial nerves is affected. Palsy basically refers to the paralysis of a muscle or a group of muscles. In cranial nerve palsy, these muscles are the facial muscles, over which the patient loses control. This results in erratic movements, lack of control over facial expressions and involuntary jerks. A patient with cranial nerve palsy might find it difficult to perform simple facial movements like smiling and rolling the eyes.

This disorder is usually easily identifiable, since it is accompanied with a distinct change in the facial expressions and general appearance. Other symptoms include:

• Double vision (Diplopia) - This is caused due to the fact that while the unaffected eye remains straight, the affected eye tilts outward, resulting in double vision.
• Drooping eyelid in affected eye
• Permanently dilated pupil
• Sudden severe headache
• Drowsiness
• Decreased responsiveness

If one experiences any of these symptoms, it is advisable to immediately consult a neurologist. The neurologist will then carry out an examination of the cranial nerves, to identify which of these nerves is damaged, and to ascertain the extent of damage. The patient must provide detailed information regarding his history to the neurologist, since at times, facts that one might consider insignificant, might be imperative in pinpointing the cause of the disorder.

The various causes that can result in cranial nerve palsy are:

• Facial or head trauma
• Inadvertent damage to cranial nerve during surgery
• Degenerative conditions (e.g. multiple sclerosis)
• Certain health complications (e.g. diabetes, high blood pressure, meningitis etc.)

Before treatment of cerebral palsy can be begun, it is important to identify the cause of the condition in the particular patient. The aim of treatment for the disorder is to reverse the damage caused to the cranial nerve and restore its function. While this is not possible in a few cases, most patients regain some level of control with the help of a physical therapist. Regular sessions with a therapist help to develop coping skills in a patient, making it easier to live with a condition. Along with this, it is also essential for patients with the disease to consult their neurologist regularly, so that any further damage to the cranial nerves can be diagnosed and dealt with in time.

For more information about Cranial Nerve Palsy or to know about any other eye disease, 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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If your kid is suffering from frequent headaches or is having problem while trying to read, do not take it lightly as these are the signs of poor eye sight. The situation may get worsened, if not treated on time. As a parent you would never want your child suffer from any eye problem or disease. For this purpose, it becomes essential to get your kid’s eye checked at regular intervals of time.

A comprehensive eye examination is not just limited to checking eyesight or checking for requirements of eye glasses or contact lenses. During an eye exam, an optometrist also checks the eyes for common eye problems and diseases. He will check how your eyes work together and provide you with complete information about the overall health of your eyes. Eye exams can also show signs of chronic diseases like diabetes and high blood pressure.

Eye examinations are important part of health maintenance for every age group, if there are any ailments, eye should be treated as soon as possible to avoid complications at the later age. For kids, regular eye exams should be considered as an important feature as they tend to stress it a lot while studying, watching televisions and playing for long hours on computers. They do not relax when they are indulged in activity of their choice and can develop any eye related issue. Such issues can latter on develop into serious problems which can hamper child’s academic or professional career latter in life.

So if you see any signs of any eye related ailments in your child, you should get him/her examined by a renowned eye specialist. We at Killeen Eyecare Center are a team of highly qualified and experienced optometrists who offer a complete eye check up for all age groups. Our aim is to provide our patients with the best quality eye care utilizing modern optometric instrumentation and therapeutic treatments.

For more details, contact us at Killeen Eyecare Center 416, North Gray Street, Killeen, TX 76541, Downtown Killeen. You can also call us at 254- 634- 7805.

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