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In the world of medicine, a “wall fracture” generally implies the breakage of one of the bones that make up the eye socket. The eye socket (also known as the orbit) is constructed from seven different bones inside the skull. Many of these bones are thin and prone to cracking after blunt trauma to the…
This is a new combination glaucoma drop combining two separate pressure-lowering medicines – brinzolamide (Azopt) and brimonidine (Alphagan). Combination drugs are useful for decreasing the number of actual drops you must take. The downside, however, is their premium cost is not covered by your prescription drug plan.
This is an infection of the skin around the eye. The cause for cellulitis is sometimes obvious – a scratch on the skin or bug bite becomes infected. Many times, however, the initial insult is not discovered. A cellulitis infection spreads under the skin and causes skin redness, heat, and impressive eyelid swelling. When isolated…
A chemical splash to the eye can be very painful and potentially blinding. Strong acids and bases can cause corneal scarring and permanent vision loss if not treated promptly. The most common chemical injuries seen are from household cleaners splashed into the eye. Other toxins include hair dye, ear medicines, and anti-fungal nail drops mistakenly…
This is a new glaucoma drop that has recently “re-entered” the market. This medication is similar to the prostaglandin glaucoma drop latanoprost, but seems to have a slightly different mechanism of action and is not as strong acting. I utilize this drop rarely in my own practice, but it may be good for people who…
This is an anti-inflammatory eye drop (an NSAID medication) that is commonly used after cataract surgery to decrease irritation and inflammation. This medicine contains the same medication (bromfenac) as Bromday but with a slightly decreased concentration of the active ingredient. I mainly use this medicine to decrease the chance of retinal swelling after surgery.
This is a new formulation of the anti-inflammatory eye drop Nevanac. This formulation contains three times the concentration of the drug nepafenac, allowing the medication to be dosed once a day. These NSAID eye drops are useful after cataract surgery to decrease the chance of retina swelling.
Trade name for the drug fluorometholone. This is a mild steroid used to treat surface ocular inflammation.
This is the trade name for gatifloxacin 0.5%. This is the same medicine in Zymar but reformulated with a higher drug concentration. This fluoroquinolone antibiotic is used primarily with bad eye infections and as prophylactic treatment before and after cataract surgery.
This is the trade name for the antibiotic eye drop gatifloxacin. This is a powerful antibiotic used for eye infections, corneal ulcers, and after eye surgery. This drug comes in a concentration of 0.3% and is now being supplanted by the medication Zymaxid, which contains the same drug but at a higher concentration. Comparable fluoroquinolone…
This is a combination drop containing loteprednol (a steroid) and tobramycin (an antibiotic). This combination is especially useful for mild infections and blepharitis (chronic eyelid inflammation). Comparable drops include Tobradex and generic Maxitrol.
This is the term used for chicken pox (varicella zoster) in adults. While rarely a vision problem in childhood, chicken pox can reactivate in adulthood and cause an attack of shingles that can affect the eye.
These are string-like attachments that suspend the lens inside your eye. The zonules run around the periphery of the lens/cataract like trampoline springs and attach to the ciliary body muscle. Muscle contraction of the ciliary body changes the tension on the zonules, and this controls the lens shape to help with visual focus. Certain conditions…
An antiviral eye ointment containing ganciclovir. This drug is very effective for the treatment of herpetic eye disease. This is a newer medication and can sometimes take pharmacies a few days to fill. Unfortunately, there aren’t many antiviral alternatives available in the US (just Viroptic drops).
This is a preservative-free prostaglandin drop used for glaucoma. It works similar to Xalatan but comes in individual single-dose dispensers. The active ingredient is tafluprost. This medicine is best used for people with sensitive eyes or who are consistently running out of their regular prostaglandin drop.
This is a natural pigment produced by plants and absorbed by animals. This pigment is what gives corn its yellow color. This pigment, along with lutein, has been studied as part of the AREDS 2 Study and found to help slow down the progression of macular degeneration. Both these pigments are found in high concentrations…
This is a popular over-the-counter allergy eye drop. It is useful for ocular itching and swelling and is, in my opinion, one of the best allergy drops available without a prescription. The active ingredient is ketotifen, which is also found in the allergy drop Alaway. This medicine lasts about 12 hours so is usually dosed…
This is a laser procedure used to treat “after cataracts.” With cataract surgery, the natural lens is removed from the eye and replaced with a plastic lens (see implant). While very successful, some people will form a haze or cloudy membrane on the back of their implant. These “after cataracts” occur months or years after…
This is a popular glaucoma eye drop. Xalatan was the first prostaglandin drop available and is considered by many doctors the best initial treatment for glaucoma given its action and easy dosing. This drop is taken only once a day, usually at bedtime. This drug is now available as the generic drop latanoprost. Alternative drops…
This is the more serious form of macular degeneration associated with acute swelling in the retina. Macular degeneration can be thought of as a premature aging of the macula, the part of the retina responsible for good central vision. Most people have dry macular degeneration, which is a slow and progressive loss of vision. A…
A warm compress can be used to treat many eye conditions. For example, warm compresses can be used with dry eye to improve tear flow. Warmth is also useful in cases of blepharitis to increase the flow of oil from the meibomian glands. Warm compresses are usually recommended in cases of chalazion or styes as…
A simple way to describe eyes that turn outward. This term isn’t really used in medicine, but is very descriptive. We would usually describe a wall-eyed person as having an exotropia. The opposite would be cross-eyed (esotropia). Ocular alignment problems like this are called strabismus. New cases of strabismus need to be evaluated by an…
This is an NSAID eye drop designed to decrease inflammation in the eye (similar to Motrin or Advil). The active ingredient diclofenac is now available as a generic. While effective, this drop can be a little harsh on the ocular surface for some people. Other similar drops include Nevanac (nepafenac) and Bromday (bromfenac).
This is the term used to describe blood inside the eye, specifically blood in the vitreous fluid that fills the back of the eye. Symptoms of a vitreous hemorrhage include floaters and a “dark cloud” that seems to obscure vision. The most common cause for an internal ocular bleed is neovascularization, abnormal blood vessels inside…
A common cause for flashes and floaters, a vitreous detachment is when the “gel” in the back of the eye contracts inwards upon itself. Let me explain. The eye is mostly a hollow structure. In many ways, the eye is like a water balloon sitting inside your eye socket. The eye is not filled with…
This is the fluid that fills the back of the eye. The eye is mostly a hollow structure. The large back chamber is filled with vitreous humor, which is a fluid that has the consistency of Jell-O. In fact, if you were to “theoretically” open up a young person’s eye and remove the contents, the…
This is a surgery to remove the vitreous fluid from the back of the eye and replace it with saline water. This procedure is performed by a retinal specialist and is commonly performed to help repair retinal detachments. Vitrectomy is also used to remove blood from a vitreous hemorrhage and as part of membrane peel…
There has been much research on the effect of vitamins on the eye. Vitamin A in particular seems to be important to the health of the rods and cones as this vitamin is key to the conversion of light images into an electrical signal that can be interpreted by our brain. One of the treatments…
This is a test to measure your peripheral vision. There are many ways to check side vision, but when we say we’re going to get a “visual field” we are usually talking about the Humphrey Visual Field. This is a computer-controlled machine that maps out peripheral vision in an objective and precise manner. You wear…
The most important component of an eye exam is the measurement of the actual quality of the central vision. We measure this by having you read an eye chart (the Snellen chart) and tweaking the vision by having you look through the phoropter (the machine with all the lenses inside used for checking your prescription). …
Visine is a brand of over-the-counter eye drops. The original formula contained the drug tetrahydrozoline, a stimulant that makes the blood vessels on the surface of the conjunctiva constrict and shrink. This makes the eyes look whiter and thus it “gets the red out.” This effect is short-lived and many people have a rebound effect…
This is an eye drop containing trifluridine that is used to fight viral infections of the eye, such as in herpetic eye disease. While effective, the drop can be a little harsh on the ocular surface with prolonged use. Sadly, there aren’t many antiviral alternatives available in this country. Zirgan is a new antiviral ointment…
Also known as “pink eye,” this is a viral infection in the eye that makes the conjunctiva red and irritated. The conjunctiva is the thin layer of skin that covers the white of your eye. This skin layer is extremely thin, but you can see it when looking in the mirror as blood vessels course…
This is a powerful fluoroquinolone antibiotic containing moxifloxacin. This is an excellent antibiotic for treating corneal infections, especially in contact lens wearers. Alternative brands like Moxeza have come out with the same active ingredient. Similar antibiotic medications include Zymaxid (gatifloxacin) and Besivance (besifloxacin).
This is the distance measured from the eye surface (the cornea) to the back of a glasses lens. This distance is different for everyone, but on average is about 1.4 centimeters. This measurement can be important when choosing and fitting glasses frames (especially with strong glasses prescriptions). Vertex distance is also important when converting a…
This stands for Vascular Endothelial Growth Factor. VEGF is a hormone released from the retinal cells when they become hungry for oxygen. This hormone is meant to stimulate the formation of new blood vessels. The most common causes of VEGF over production are from diabetic retinopathy or a central retinal vein occlusion. When VEGF is…
This is a high quality progressive lens used in no-line bifocals. Progressive lenses are a type of no-line bifocal that gets stronger the further down the glasses you look. Many people like progressive lenses because they can “dial in” the amount of bifocal they need by tilting their head. Other people find progressives uncomfortable, however,…
This is a “hard core” IV antibiotic that is traditionally used for hospitalized patients with MRSA infections. We use vancomycin eye drops when treating bad corneal ulcers. This medicine is not available in eye drop form and must be specially created by a compounding pharmacy as a fortified antibiotic drop.
This is the trade name for valacyclovir, an antiviral pill used in cases of viral eye infection (such as herpetic eye disease or a shingles infection). It is longer lasting than the alternative acyclovir, so it doesn’t have to be taken as frequently. Valtrex may be slightly more powerful than acyclovir as well.
This is an antiviral pill, used in ophthalmology for cases of herpetic eye disease or with shingles (zoster) outbreaks. This medicine is usually referred to as the trade name Valtrex.
This is an inflammation inside the eye that involves either the structures in the front of the eye (the iris and ciliary body) or the choroid in the back of the eye. Most people with uveitis have inflammation of the iris (the colored part of the eye). This is called iritis. When the iris is…
The uvea is an anatomical term used to describe three embryologically related structures in the eye: the iris, ciliary body, and the choroid. The iris is the colored part of the eye and serves as a muscle to control the size of your pupil. The ciliary body is a ring of muscle that sits behind…
This is the technology where sound waves are bounced off internal organs in order to examine human anatomy. Ultrasound is classically used in the examination of pregnant women, but the technology has some utility in ophthalmology as well. We use ultrasound to measure the length of the eyeball prior to cataract surgery. This measurement is…
A twitch or jumping eyelid that tends to come in waves. See eyelid fasciculation for more information.
This is a surgical procedure performed for severe cases of glaucoma. With glaucoma, the eye pressure is high, which causes gradual death of the optic nerve. There are many ways to lower the eye pressure. Many doctors begin with medicated eye drops. These work to improve the outflow of aqueous fluid from the eye. Other…
Also known as dorzolamide, this is a glaucoma eye drop. This is a carbonic anhydrase inhibitor, which is effective but may be problematic if you have a sulfa allergy. Other medicines in this class of drugs include Azopt (brinzolamide) and the oral medication Diamox. This medicine is also available as the combination drug Cosopt (containing…
This is a dilating drop using during your eye exam. This drop is used in conjunction with phenylephrine to make the pupil dilate to aid in visualizing the lens and retina. Tropicamide is also a short-acting cycloplegia medicine and will make the vision blurry for a couple of hours. This drop is rarely prescribed outside…
These are glasses with three separate zones of focus. The top is set for distance, the middle for intermediate (such as computer distance) while the bottom is optimized for reading. While effective, many people don’t like having this many lines on their glasses. For these people, a progressive lens (no line bifocal) may work. Purchasing…
Also known by the trade name Viroptic, this is an anti-viral drop used primarily to fight herpetic eye disease.
This is when eyelashes grow in the wrong direction, rubbing on the surface of the eye and causing irritation. While common, trichiasis is difficult to treat as lashes are thick and the lash follicle hard to destroy. Epilation (plucking) of the eyelashes can be done in the doctors office, though some people with good sight…
More commonly known as Kenalog, this is a injection steroid used in and around the eye. Retina specialists may inject this medicine into the eye to decrease retinal swelling (macular edema) or to reduce ocular inflammation with recalcitrant uveitis. I occasionally inject this medicine into eyelid lesions, such as chalazions, in order to minimize inflammation…
These are lenses in glasses that darken when exposed to sunlight. While very effective, they can sometimes take a little while to clear again after you walk inside. Also, transitionals require UV light to change color. Since car windows block UV light (explaining why you don’t get sunburned in the car) transitional glasses don’t work…
A glaucoma eye drop medication. This is the active ingredient in the eye drops Travatan and Travatan Z. This prostaglandin medication is similar to latanoprost (Xalatan) and thus only needs to be taken once a day.
This is a glaucoma drop used to lower eye pressure. It is actually the same medicine as regular Travatan (travoprost). However, the manufacturer changed the preservative from BAK to a gentler preservative in an attempt to make the drop less harsh on the corneal surface. Like all prostaglandin glaucoma drops, it is dosed once a…
This is a popular glaucoma eye drop medicine. This is a prostaglandin drop and used once daily, usually at bedtime. Competing brands in the same drug class include Lumigan and generic Xalatan (latanoprost).
This is a glaucoma laser procedure used to improve the flow of aqueous fluid out of the eye. A laser is applied to the trabecular meshwork, which acts as a filter for the fluid leaving the eye. There are two different types of laser therapy used. ALT is a “hot laser” that creates scar spots…
This is a glaucoma surgery, commonly performed to reduce pressure in the eye. Glaucoma occurs because the pressure in the eye is too high. The exact cause for this pressure elevation is unclear, though some people believe that something microscopic is clogging the drain (trabecular meshwork) inside the eye such that aqueous fluid has a…
This is the drain inside the eye where excess aqueous fluid drains and returns back to the bloodstream. This drain is located in a 360-degree ring inside the eye, right where the sclera (the white of the eye) meets the iris (the colored part of the eye). The trabecular meshwork is difficult to see directly,…
This is a prescription vitamin used to treat macular degeneration and dry eye. It contains most of the vitamins from the AREDS Study, along with the Omega-3 fatty acids and plant pigments (lutein and zeaxanthin) from the AREDS 2 Study. Tozal also contains taurine, a protein that is commonly found in energy drinks that is…
These are implants used in cataract surgery designed to counteract the eye’s natural astigmatism. Astigmatism is the condition where the eye isn’t round, but has an oval shape similar to the side of a football. This is relatively easy to correct with glasses, as the mirror image of the “football” can be ground into a…
These are contacts designed to help with astigmatism. Normally, the cornea (the clear window that makes up the front of our eye) is perfectly round like a basketball. However, in people with astigmatism, their eye is shaped more like a football … that is to say, the cornea is steep along one axis and shallower…
In relation to the eye, topography usually refers to corneal topography – this is the measurement of the surface of the cornea. The cornea, the clear window that makes up the front of our eye, works like a fixed-focus lens and actually does the majority of the light focusing in our eye. Irregularities in the…
A small hand-held electronic machine that is sometimes used to check eye pressure. While not as accurate as other methods, the Tono-Pen is useful for the bedridden and people who can’t get up to the microscope for more traditional pressure measurements. To use the Tono-Pen, the eye is numbed with anesthetic drops and the device…
This is how we measure the pressure inside the eye. The internal eye pressure is extremely important for the health of the eye. If the pressure is too high, glaucoma damage will occur. If too low, the eye deflates like a water balloon and retinal distortions and macular edema can occur. There are many ways…
This is the trade name for the antibiotic eye drop tobramycin. As tobramycin is available as a very cheap generic, I rarely see “Tobrex” in circulation anymore.
This is a combination drop containing tobramycin (an antibiotic) and dexamethasone (a steroid). Combination drops like this are especially good at treating ocular inflammation caused by blepharitis. In the eye world, we usually refer to this drop by the trade name Tobradex.
This is an inexpensive antibiotic eye drop with good bacterial coverage. It is readily available and can be found in combination drops such as Tobradex.
This is an eye drop used for treating infection and inflammation. It contains both an antibiotic (tobramycin) and a steroid (dexamethasone). This medicine is almost exactly the same as “regular Tobradex,” except it is a thicker suspension and designed to work better than the older version (at least, that is what the drug reps keep…
A popular eye drop used to limit infection and reduce inflammation of the eye. The drop is a combination drug containing two different medicines. Tobramycin is an antibiotic good for treating infections and decreasing bacterial load around the eyelids. Dexamethasone is a steroid used for decreasing inflammation. A competing eye drop with similar action is…
This is the trade name for a eye drop containing timolol. This is a beta-blocker medication that lowers eye pressure by decreasing aqueous fluid production inside the eye. I never see this medicine in circulation, as generic timolol is inexpensive and easily obtained.
This is a beta-blocker eye drop used for treating glaucoma. The GFS stands for gel forming solution. It is a thicker consistency that allows the drop to be dosed only once a day. An inexpensive generic version is also available, but is dosed twice a day. Timolol GFS is also available under the trade name…
This is a common beta-blocker eye drop used for treating glaucoma. This drop is usually dosed twice a day. Timolol is an older drop that has been around for a long time, so it is readily available as an inexpensive generic. Punctal occlusion is sometimes recommended to minimize any systemic side effects of timolol (decreased…
Thyroid dysfunction can cause a number of ocular problems. The most common is dry eye, as the hormonal changes can decrease tear production. Graves disease can stiffen the eye muscles located behind the eyeball and cause fibrous deposits that make the eye muscles swell and expand. This can actually make the eyes protrude forward in…
This a paralysis or “stroke” to the third cranial nerve. This nerve is involved with most muscles controlling eye movement. When the nerve is damaged, this causes the eye to turn down and outwards. The third nerve is also involved with controlling pupil size, so a palsy will often make the pupil dilate. Finally, the…
This is an anesthetic drop used to numb the eye during an eye exam or prior to surgery. Tetracaine works similar to the novacaine that a dentist uses, but can be applied as a simple eye drop. This drop (or a similar drop called proparacaine) is commonly used to anesthetize the cornea prior to checking…
This is an inflammatory syndrome involving the arteries of the head and neck that can cause serious vision loss. With this condition, the arteries around the head become inflamed. If enough inflammation occurs, an artery can close off and cause sudden neurologic changes. If this happens to the arteries running to the eye, this creates…
The tear film serves many functions for the eye. Tears lubricate the eye and protect the eye from foreign bodies by washing them away. Tears also help vision by creating a smooth surface for the refraction of light. Too little tears can cause dry eye, where the eyes feel irritated and “tired.” Too much and…
Your tear film is crucial for both good vision and ocular comfort. The tear film is actually composed of three different layers. The innermost layer is made of mucous that helps the tears “stick” to the eye. The middle layer is composed of an aqueous water layer. The surface layer is composed of lipid (oil)…
This is the active ingredient in Flomax, the medication used to help with urinary flow in men with prostate enlargement. Our main concern with this drug is that it can cause floppy iris syndrome during cataract surgery. Floppy iris syndrome is when the iris undulates and moves during a cataract operation and is a potential…
This is a brand name rewetting drop made by Alcon. Competing brands include Soothe, Blink, GenTeal, and Refresh.
Also known by the trade name Bleph-10, this is an antibiotic eye drop that has gone generic and can be found on the Walmart $4 list. This drug is sulfa-based and not good for those people with sulfa allergy.
Several medicines are sulfa based and can cause problems for people allergic to sulfa drugs. The main culprits are the carbonic anhydrase inhibitors used for glaucoma. Examples of these glaucoma drops include dorzolamide, Trusopt, Azopt, and Cosopt. Also, the water pill Diamox (acetazolamide) is sometimes used for treating advanced glaucoma, but is sulfa-based as well….
This is an extremely red eye that occurs when a blood vessel on the surface of the eye ruptures. The white part of the eye (the sclera) is covered by a very thin layer of skin called the conjunctiva. You can see this skin when looking in a mirror, as red blood vessels course through…
A stye is an infection of one of the oil or sweat glands running along the eyelid. Styes are tender to the touch and may form an abscess or pus layer that is visible through the skin as a “white head.” The treatment for a stye typically begins with warm compresses and gentle massage. While…
This is surgery to correct ocular misalignment (strabismus). Most strabismus surgery is performed on toddlers to correct alignment problems such as crossed-eyes. This surgery involves the weakening or strengthening of eye muscles by shortening them or changing their insertion points on the edge of the eye. While most ophthalmologists have trained in performing strabismus surgery,…
This is a descriptive term used by eye doctors to describe eyes that are in poor alignment with each other. For example, someone with strabismus may be cross-eyed, wall-eyed, or have an eye that drifts upwards. Some people have strabismus that occurs only when tired and others have a problems with double vision only with…
Steroids are useful in ophthalmology for treating ocular inflammation. This is particularly useful after cataract surgery and with internal ocular inflammation such as uveitis. Steroids can also be useful for decreasing corneal scarring, such as after a trauma or infection. Care must be used with steroids, however, as they can exacerbate infections – viruses and…
Squinting of the eyes is common, and is commonly done in an attempt to see better. If the eye has refractive error (like nearsightedness or farsightedness) the images entering the eye do not focus well on the retina and look blurry. By squinting and looking through the eyelashes, you can actually see a little clearer….
This is a brand name rewetting drops from Bausch & Lomb. Competing brands are Systane, Blink, GenTeal, and Refresh.
This is the eye chart used by American eye doctors for measuring vision. The letters on this eye chart are calibrated based on distance measurements, comparing your vision to someone with “perfect” eyes. For example, if you have a vision of 20/60 … this means that the letters you can barely see when standing 20…
This is the abbreviation for Selective Laser Trabeculoplasty – it is a glaucoma laser procedure designed to lower eye pressure in a non-destructive way. Most cases of glaucoma involve microscopic blockage of the trabecular meshwork drain inside the eye. If the internal ocular fluid doesn’t drain properly, aqueous fluid pressure builds up and causes gradual…
This is a microscope used by an eye doctor to look at the eye. The eye microscope is unique when compared to a traditional microscopes. For one thing, the microscope has been turned on its side so that people can be examined without having to lie down flat. Also, the light-source used can be narrowed…
This is a paralysis of the sixth cranial nerve. This nerve controls a single eye muscle, the abducens muscle, which is responsible for making the eye look to the side. If this muscle stops working the eye turns inward (cross-eyed) and has a hard time moving outwards. Most people complain of a side-by-side horizontal double…
This is a brand of herbal eye drop therapies. Given the shear number of FDA-approved and scientifically studied eye medicines available, I never bother with this. Someone must be using this, however, since the company is still in business and the product is still on shelves.
This is a re-outbreak of chicken pox. When people get chickenpox as a child, the viral infection can hit large parts of the body. The body’s immune system fights back and eradicates the virus. However, the virus is not completely gone, but usually sits dormant in the base of the nerves in the spine and…
This is the phenomenon where cataract formation seems to make the vision “better” by improving your glasses prescription. A cataract is when the lens inside your eye becomes cloudy. An enlarging cataract usually causes glare problems, but the cataract growth can also change the eye’s overall “glasses prescription” as well. For some people, this change…
This is a surgical procedure used to repair a retinal detachment. With this procedure, a silicone band is inserted around the eye and cinched tight, like a belt around a waistline. This decreases traction forces inside the eye which allows the retina to lay back in its normal position. Scleral buckle surgery is widely performed…
This is the white part of the eye. The sclera is the firm wall of the eye that gives the eye its shape and structure. Made of collagen fiber, the sclera is relatively tough. It is also continuous with the clear cornea in the front of the eye. The sclera is covered by a thin…
A type of photoreceptor inside the retina that senses light. Rods are very sensitive and give the eye excellent night vision. Rods can only see in “black and white” in contrast to cones, which are the photoreceptor cells that detect color.
This is a surgical procedure where a diamond knife is used to create radial cuts in the cornea. This changes the shape of the ocular surface and can help eliminate nearsightedness. See radial keratotomy for more information on this older refractive surgery
These are thick ointments used for extreme dry eye. As rewetting ointments come in tubes they are challenging to put in the eye and the ointment causes significant blurriness to the vision. As such, they are typically reserved for people with extremely dry corneas that aren’t adequately covered with traditional rewetting drops and rewetting gels….
These are a type of rewetting drop that have a thicker consistency, similar to shampoo or pancake syrup (but not sticky, obviously). This thickness keeps the drop from evaporating as quickly so that it lasts longer and gives more relief with dry eye. The downside to these gels, however, is that they make the vision…
Also known as artificial tears, these eye drops are designed to comfort and improve lubrication of the eyes. These can be bought over the counter and come with various trade names depending upon the manufacturer. Some popular brands are Soothe, Systane, Blink, and Refresh. Most of these drops contain the same ingredients, differing only by…
This is a more intense way of numbing and paralyzing the eye before difficult eye surgery. Cataract surgery is normally performed under topical anesthesia – simple numbing drops placed on the eye while the patient remains awake. However, if we anticipate that a cataract surgery may take longer than usual (a dense cataract) or may…
This is a hand-held tool the eye doctor uses to estimate refractive error such as nearsightedness, farsightedness, and astigmatism. This tool is challenging to learn and not as accurate as a true phoropter refraction. However, this is often the only method of determining a glasses prescription in a young child or non-verbal patient who can’t…
A genetic disorder of the retina that causes gradual vision loss. With retinitis pigmentosa (sometimes called RP) the photoreceptors (rods and cones of the retina) or their supporting cells gradually stop working, affecting vision. Some people develop visual loss in infancy while others have problems later in life. Often the rods (the photoreceptors responsible for…
This is an ophthalmologist (MD) who goes on to sub-specialize in the treatment of retina problems. Retina doctors perform surgeries to correct retinal problems such as retinal detachments and membrane peels. They also treat wet macular degeneration, performing injection procedures and advanced retinal laser procedures. These doctors don’t typically perform other eye services such as…
This is when the retina peels off in the back of the eye, leading to catastrophic vision loss. Because the retina works like film in a camera, it needs to be perfectly smooth and flat to take a good “picture.” The retina is plastered smooth against the inner eye like wallpaper. A retinal detachment occurs…
The retina is the light sensitive structure in the back of the eye that detects images and converts light into signals that our brain can understand. The retina works like “film in a camera.” When light enters the eye, it travels through the cornea in the front, through the dark pupil, through the lens/cataract, before…
This is a multifocal implant using during cataract surgery that can give good distance and near vision without requiring glasses. With cataract surgery, the cloudy lens is removed from the eye and replaced by a plastic “implanted” lens. A new lens is required to see clearly. The standard lens most people opt for is in…
This is an eye drop with cyclosporine used for treating dry eye. This medication improves both the quantity and quality of the tear film. Unfortunately, it can be expensive (this is getting better), stings going in, and takes a good month before improvement is seen. Also, it doesn’t work for everyone. On the other hand,…
A popular brand of artificial tear (rewetting drop). Refresh comes in different consistencies, including the thicker Refresh PM (a rewetting ointment that can be used at bedtime).
This is the degree to which you need glasses. Examples of refractive error are nearsightedness or farsightedness. Astigmatism is another refractive error. Your refractive error is obtained with refraction, typically with a phoropter machine in the eye doctor’s office.
This is the method used to determine someone’s glasses prescription. Most refraction is performed with a phoropter. This is the optical device you look through while reading an eye chart – it contains lenses and can be used to determine your refractive error (nearsightedness and farsightedness) and correct astigmatism. Refraction requires feedback from our patients,…
This is a corneal abrasion that recurs because it doesn’t “heal right,” kind of like a skin cut that keeps reopening. The cornea is the clear structure that lies at the front of the eye, forming the ocular surface that allows light to enter the eye. The cornea is relatively tough but it is covered…
These are glasses that are focused for viewing near objects … such as when reading a book. Inexpensive, over-the-counter reading glasses work well for many people and range in diopter power from weak +1.00 glass, all the way up to +3.50 readers. The power of your “cheaters” depends upon your age and how close you…
Also called “RK,” this is an older refractive surgery style in which a diamond knife is used to make radial cuts in the cornea. These incisions change the shape of the cornea and can correct nearsightedness. This technique was invented by a Russian ophthalmologist in the ’70s and was very popular in the ’80s and…
This is the abbreviation for posterior vitreous detachment. See vitreous detachment for more information on this common cause of flashes and floaters.
The pupillary distance is the measured distance between the pupils of both your eyes. When glasses are made, they need to be created to correct for your eye separation. Some people have wide-set eyes and other have near-set eyes, so this can vary widely. This measurement is made by your optician after you pick a…
The pupil is the black circle in the middle of the eye. It is actually a hole in the middle of the iris that allows light to enter the back of the eye. The size of the pupil is controlled by the iris muscle in response to ambient lighting. In dark rooms, the pupil enlarges…
These are small silicone devices inserted into the puncta drainage holes in the eye to allow the tears to last longer and help correct dry eye. Punctal plugs are relatively easy to insert and this can be done right in the exam chair. By slowing down the tear drainage, the ocular surface is better moistened….
This is a technique used to decrease the absorption of eye drop medications. Normally when you put eye drops in, the medication drains through the puncta, down the nasolacrimal duct, and into the nose. This is why people have a runny nose when their eyes are teary. Unfortunately, the nose absorbs medicines directly into the…
This is a small drainage hole located on the inner eyelid that drains excess tears into the nose. Normally, the tear film is generated from the inner eyelids and washes down the surface of the eye like a waterfall. The fluid then forms a small “lake” along the lower eyelid. Tears from this lake drain…
A fancy way to say “droopy eyelid.” Ptosis means that the edge of the upper eyelid is actually dropping down, sometimes bad enough to cover the pupil and obstruct vision. Many people with ptosis find themselves tilting their head back or constantly raising their eyebrows in order to lift their eyelids up and see properly. …
This is a small yellow-white growth that forms on the eye, starting from the white conjunctival skin, and spreading over the clear cornea. These are harmless growths and common in people with sun exposure or who work outside. The conjunctiva is a very thin layer of skin that covers the eye. This skin can become…
This is when the pressure inside the cranial cavity (i.e., inside the skull) is too high. The brain sits inside the skull and is suspended in a bath of fluid called the CSF (cerebrospinal fluid). This fluid cushions the brain and keeps it buoyant inside this cramped space. This fluid is constantly being renewed and…
A medical term used to describe an eye that has already had cataract surgery and now contains a plastic or “pseudo” lens implant. Compare this to the term “phakic” (an eye that contains its natural lens) or “aphakic” (an eye that has no lens at all).
This is a water-borne bacteria that commonly sticks to contact lenses and can cause a corneal ulcer. Pseudomonas is the same bacteria that causes “swimmer’s ear” and it tends to proliferate in watery environments (such as contact lens solution and within contacts themselves). If this bacteria colonizes the cornea, it can cause a bad corneal…
Pseudoexfoliation syndrome is a common ocular finding, especially if you are of Scandinavian descent. With this condition, a flaky dandruff-like material forms on the surface of your lens/cataract. This material rubs off over a lifetime and can cause glaucoma if the material “clogs the drain” inside your eye. This material also forms on the support…
This stands for panretinal photocoagulation, and is a laser treatment commonly used for diabetic retinopathy. With diabetes, blood vessels become leaky and the retinal tissue in the eye can become hungry for oxygen because of poor blood delivery. The oxygen-starved retina cells respond by producing protective hormones called VEGF (vascular endothelial growth factor). VEGF causes…
This is a class of medications used for treating glaucoma. The prostaglandins work by increasing outflow of aqueous fluid from the eye. Examples include Xalatan (latanoprost), Travatan (travoprost), and Lumigan (bimatoprost). These medications are typically dosed once a day. The main complication of these drops is eye redness and irritation, which is why most people…
This is when the eye bulges out. The eye sits inside the eye socket like a scoop of ice cream sitting inside a waffle cone. When the contents of the eye socket swell, there is not a lot of room to expand except forward, so the eye tends to protrude outwards. Proptosis of the eye…
This is an anesthetic drop using during an eye exam. This drop numbs the corneal nerves and makes it easier to perform applanation tonometry (pressure checking). We also use this drop before any procedures near the eye, such as foreign body removal. Another drop we use is tetracaine, though we prefer proparacaine in the office…
These are “no line” bifocals. They look like normal glasses, but the further you look down the stronger the bifocal “progressively” becomes. This type of bifocal is useful for active people because you can literally tilt your head to appropriately focus on different objects. For example, you might look through the top part of the…
This stands for “photorefractive keratectomy” and is a laser procedure similar to LASIK used to correct refractive problems like nearsightedness. Like LASIK, an excimer laser is used to sculpt and resurface the shape of the cornea. With LASIK, however, a partial thickness flap is created and flipped up before applying the laser treatment. This flap…
This is a lens ground into a pair of glasses that is designed to bend light and help alleviate double vision. With double vision (also known as diplopia), people see two of the same object. This is usually because of an alignment problem between the eyes such as when someone is cross-eyed. To help alleviate…
In regards to the eye, “pressure” usually refers to the intraocular pressure – the pressure inside the eyeball itself. Eye pressure can be measured a number of ways, but all of the methods involve pushing on the eye to estimate the pressure within. This is akin to kicking a car tire with your foot in…
This is an eye vitamin designed to decrease the progression of macular degeneration. This brand is produced by Bausch & Lomb, but differs from their original Ocuvite product in that the pills are smaller and easier to swallow. The packaging for eye vitamins keeps changing, but as long as you take an AREDS (or AREDS…
This is the process by which you become more reliant on reading glasses as you get older. When we are born, we have a clear lens that sits inside our eye. This lens is flexible and can change shape to help us focus. The lens can “flatten” like a pancake and allow a child to…
Prednisolone acetate is the most common steroid drop we use for the eye. This comes under the trade names Pred-Forte and Econopred. Steroid drops are used to cool down inflammation and are often used after cataract surgery.
A popular steroid eye drop. Pred-Forte is the trade name for prednisolone acetate. Steroid eye drops are good at cooling down ocular inflammation caused by iritis or uveitis. This drop is commonly used after cataract surgery, as well, to speed recovery.
A synthetic lubricant used in many rewetting drops. It is safe and non-toxic, but has a terrible sounding name if you ask me … who wants to put poly, vinyl, or alcohol in their eye, after all?
This is a combination antibiotic eye drop containing polymyxin and trimethoprim. It is available as an inexpensive generic.
This is a combination antibiotic eye drop containing bacitracin and polymyxin. This drug is similar to Neosporin, except that neomycin has been removed (many people have a sensitivity to neomycin).
This is a combination antibiotic drop. The trade name for this combination is Polytrim. This drop is now generic and inexpensive. Long-term use can be irritating to the cornea, however.
An antibiotic found in combination with other medications such as in Neosporin, Polysporin, and Polytrim.
This is the abbreviation for Primary Open Angle Glaucoma. This is the type of glaucoma that most people have, where the eye pressure is chronically elevated leading to gradual optic nerve damage. See chronic open angle glaucoma (COAG) for more details on this topic.
This is a procedure used to repair a retinal detachment using a gas bubble. With a retinal detachment, the retina peels off the back of the eye like wallpaper peeling off a wall. To help reapproximate the retina into its normal position, a gas bubble can be injected into the eye. This pushes the retina…
Plaquenil (hydroxychloroquine) is an anti-inflammatory medication that is commonly used in cases of rheumatoid arthritis and lupus. It was originally (and still) used as an anti-malaria drug but has also been found to decrease inflammation in the body. While very effective, this medication can have ocular side effects. Prolonged use can lead to pigmentary changes…
This is a descriptive term for conjunctivitis. The majority of conjunctivitis cases are caused by viral infection (as opposed to allergic or bacterial infection) so the term “pink eye” is more commonly used to describe viral conjunctivitis. See the conjunctivitis entry for more information.
When we are checking your vision in our office, one of the most common tests we perform is called the “pinhole test.” After you read the eye chart wearing your glasses, we recheck your vision while you look through a plastic patch that has little holes punched through it. Many people will actually see better…
This is a white or yellow “bump” seen on the white part of the eye. The entire eye is covered by a very thin layer of skin called the conjunctiva. This conjunctiva is very delicate and thin. In fact, you can see red blood vessels coursing through this skin by looking in the mirror. The…
This is a pupil-constricting eye drop. Pilocarpine has been around for a long time and it makes the pupil constrict by stimulating the iris muscles to contract. In the eye doctor’s office, pilocarpine is often used immediately prior to SLT or ALT laser therapy. Pilocarpine is effective in lowering eye pressure, though it is no…
After light enters the eye it eventually strikes the retina, which works like the film in a camera. The photoreceptors are the cells within the retina that actually detect light photons and convert them into a signal our body can detect. These photoreceptors come in different varieties. Cones are the cells that detect color and…
This is a fancy way of saying pain or sensitivity to light. When an eye is irritated, the iris muscle inside the eye becomes sensitive. The iris is the colored part of our eye – it is a round muscle that dilates and constricts the pupil to control the amount of light entering the eye. …
This is the machine we use to check your glasses prescription. It is filled with lenses that we flip in front of your eyes, saying “one or two” the whole time as you read the eye chart. The phoropter is the best way to refine an eyeglass prescription, as we can use this machine to…
This is a dilating drop used during an eye exam to better view the retina. This drop works by stimulating the sympathetic system in order to dilate the pupil. It doesn’t cause cycloplegia so there is less problems with blurry vision when dilated. However, this drop does not dilate the pupil enough when used by…
This is a generic antihistamine drug found in many over-the-counter allergy drops such as Opcon-A and Naphcon-A. While effective, this antihistamine is not as powerful as more modern drugs like ketotifen (found in Alaway and Zaditor) and Pataday.
A term used to describe an eye that has its natural lens still in place. This is opposed to the term “pseudophakic,” which is a person who has a plastic implant in their eye (such as after cataract surgery). If a person has NO lens in their eye (neither their natural lens or cataract implant),…
This is the modern surgical technique for removing cataracts by breaking apart (emulsifying) the lens with ultrasonic vibrations. During cataract surgery, the cloudy lens is removed from the eye. To pull this off, the surgeon first breaks the lens into tiny pieces before vacuuming it out. This is accomplished with a phacoemulsification probe. This ultrasonic…
This stands for “pupillary distance,” which is the distance between the pupils of each eye. This is an important measurement used in the creation of glasses. See pupillary distance for a more detailed explanation.
Patching an eye shut is useful for several conditions. The most common one is amblyopia, where an eye becomes “lazy” from disuse in childhood. A patch is used to cover the good eye and force the “lazy” eye to work better. Patching is also used for therapeutic effect in cases of eye pain. If you…
One of the more powerful allergy drops. It is good for itching and swelling around the eyes. This is a prescription medication that has been supplanted by Pataday (which has twice the active ingredient).
A prescription strength allergy drop that is good for treating itching and swelling around the eyes. This medicine’s claim-to-fame is that it is a once-a-day drop. Similar strength allergy drops include Bepreve and Lastacaft.
A papilloma is a bump on the eyelid or skin around the eye that looks like a skin tag. These are almost always harmless proliferations of skin cells that have a stuck-on appearance and can be very unsightly. They typically form on the skin around the eyelids and even along the lid margin in the…
This is bilateral swelling of the optic nerves secondary to high intracranial pressure. The brain sits inside the skull and is suspended by membranes, floating in fluid. This fluid is the cerebral spinal fluid (CSF) and is similar to the aqueous fluid in the eyeball itself. If the pressure of this CSF is high, such…
This is the measurement of corneal thickness. The cornea is the clear window that makes up the front of the eye and allows light to enter the eye. The corneal thickness is an important measurement for a couple of reasons. An abnormally thin or thick cornea can affect pressure measurements when screening for glaucoma. With…
A doctor of optometry specializes in primary eye care with a focus on refractive correction (glasses and contacts). These doctors typically complete a 4-year undergraduate degree, before going on to 4 more years of optometry graduate school. After this, an optometrist may go directly into practice or complete further residency training if they have an…
This is the trade name for the antihistamine azelastine. This is a prescription allergy drop, used for itching and swelling of the eyes and eyelids. I’ve never prescribed this, given the ready supply of other allergy drops like Bepreve, Pataday and over-the-counter drops like Alaway/Zaditor.
This is a person who fits and dispenses glasses and other corrective visual devices. Once you have a glasses prescription (from an optometrist or ophthalmologist) this is the person who actually measures your face and fits your glasses. They measure your pupillary distance, vertex distance, and determine where your bifocal should sit. They build the…
An eye test that uses light waves to measure the surface of the retina … similar to using sonar or ultrasound to measure the bottom of the ocean. See OCT for more information on this common test.
This is an inflammation of the optic nerve that causes vision loss and occasionally eye pain. The optic nerve is the large nerve that connects the eye to the brain. Inflammation of this nerve will cause vision problems such as an enlarged blind spot and decreased vision. Optic neuritis occurs more in younger people (under…
These are calcium crystals that form in the optic nerve and give the illusion of optic nerve swelling. The optic nerve is the large nerve that connects the eyeball to the brain. This nerve enters the back of the eye and this insertion can be seen inside the eye as the optic disk. Some people…
The optic nerve is the large nerve that connects the eyeball to the brain. This nerve is actually comprised of over a million individual nerve fibers that send visual signals from the retina to the brain for processing. This nerve is obviously important and several eye diseases can affect it. The most common one is…
This is the insertion point of the optic nerve into the back of the eye. The optic nerve is a large nerve that connects the eyeball to the brain. This nerve inserts on the back of the eyeball and looks like a tube or pipe piercing the back of the eye. We can see the…
This is a doctor who treats medical eye problems and performs laser and eye surgery (like me). An ophthalmologist completes a four-year undergraduate degree with a focus on “pre-med” subjects including biology, chemistry, and physics. They then complete a four-year medical school program, working in a teaching hospital to become a medical doctor (MD). After…
This is an over-the-counter allergy drop used for itching and swelling of the eyelids. This drop is the same as the competing brand Naphcon-A. Opcon-A contains both an antihistamine and a vasoconstrictor. While effective for short term relief, I prefer the more powerful second generation allergy drops like Alaway/Zaditor and Patanol.
This is the trade name for the steroid eye drop prednisolone acetate. Other names for this drop are Pred Forte and Econopred. This is a powerful topical steroid used to cool down inflammation. It is also used after cataract surgery to cool down inflammation and speed healing.
These are fatty acids obtained from deep sea fish. There is some thought that Omega-3 supplements may help with macular degeneration, but they haven’t been as beneficial as once hoped (see the AREDS 2 Study). Also, these fatty acids improve oil flow in the skin and may help with dry eye and the meibomian gland…
This is an antibiotic eye drop, also sold under the trade name Ocuflox. It is used for bacterial eye infections and often used as a prophylactic antibiotic before and after cataract surgery. This is a second generation fluoroquinolone similar to ciprofloxacin.
This is an eye vitamin, produced by Bausch and Lomb, designed to decrease progression of aging changes from macular degeneration. This vitamin formula was created after the AREDS Study showed that certain antioxidants slowed the progression of macular degeneration changes in the retina. This original formula consisted of vitamins A (beta-carotene), C, E and the…
This is a brand of pre-made lid scrubs used for the treatment of blepharitis. These pre-moistened pads are used to gently clean debris off the eyelashes, improving lid hygiene, and making the eyes less irritable. These scrubs can sometimes be hard to find in stores, but are easily found online at Amazon.com. Other companies have…
This is the trade name for the antibiotic eye drop ofloxacin. Ofloxacin is a moderately strong fluoroquinolone used for eye infections and prophylactic treatment after cataract surgery.
This is a migraine that either affects the vision (causing a migraine aura) or creates pain specifically in the eye. See migraine aura for more information on this topic.
Also known as Optical Coherence Tomography, this is a machine used to take a picture and “map” the surface contour of the retina. It works very similar to ultrasound, but instead of using sound, light waves are bounced off the internal eye structures. The scans produced by this machine look similar to that produced by…
This is an involuntary, rhythmic “to and fro” movement of the eyes. Most nystagmus are in the horizontal axis, such that the eyes are constantly moving to the left and right. There are many causes for this abnormal eye movement, though most nystagmus occur secondary to congenital motor deficits that begin in childhood. Sensory nystagmus…
These are eye drops used to anesthetize the surface of the eye. They are commonly used during an eye exam to help check the eye pressure (see applanation tonometry) and to numb the eye prior to eye surgery. See anesthetic drops for more information on this topic.
This stands for Non-Steroidal Anti-Inflammatory Drug. NSAIDs are very common. In fact, most over the counter pain relievers such as aspirin, Motrin (ibuprofen), and Tylenol are NSAIDs. In the eye, NSAID eye drops are used for pain control, but are most often used after cataract surgery to decrease the possibility of macular edema. Common NSAID…
Also known as nepafenac, this is an NSAID anti-inflammatory eye drop. It is commonly used after cataract surgery to cool the eye down and decrease the risk of post-operative macular edema.
Also called methazolamide, this is a water pill used in the treatment of glaucoma. It is a carbonic anhydrase inhibitor that works by decreasing the production of aqueous fluid inside the eye. This medicine has the same mechanism of action as Diamox (acetazolamide).
Known by the trade name Nevanac, this is an anti-inflammatory NSAID eye drop that is commonly used after cataract surgery to cool the eye down and decrease the chance of macular edema.
With neovascularization, abnormal blood vessels grow inside the eye, causing significant retinal damage. These blood vessels can also grow into the front of the eye, covering the surface of the iris, and into the trabecular meshwork drain. If this drain becomes blocked with abnormal vessels, aqueous fluid can’t exit back into the blood stream. This…
This is when abnormal blood vessels grow inside the eye. The eye is a very metabolically active organ. It continuously works and detects light, even while sleeping. In some ways the eye works like the heart … in the sense that it is “always on.” As such, the eye, especially the retina, requires a rich…
This is a combination antibiotic ointment containing neomycin, bacitracin, and polymyxin. While relatively effective as a broad spectrum antibiotic, some people have an allergy or sensitivity to neomycin. In these cases, Polysporin (which only contains bacitracin and polymyxin) can be used to good effect. I rarely prescribe this medicine given the plethora of good antibiotic…
An inexpensive combination drop containing two antibiotics to treat infection combined with a mild steroid for inflammation. This drug is available as an eye drop or an ointment. While most tolerate this medicine, some people have a sensitivity to the neomycin component. For these people, Tobradex or Zylet may be a better option. The trade…
This is a refractive error where the eyes see well at near distance, but have a hard time seeing far away. Normally, the eye works like a camera with light entering the eye being focused perfectly on the retina. The retina is analogous to the film in a camera and located at the back of…
Also known as pimaricin, this is the only commercially prepared eye drop available for fungal eye infection. While effective, it can sometimes be hard to obtain and can be expensive. The main alternative we use is amphotericin B … but this drug isn’t easy to obtain either as it has to be especially prepared by…
This is a blockage of the tear drainage pathway that connects the eye to the nose. Tears are produced in the eyelids and cover the eye like a waterfall. Because of gravity, tears eventually form a small “lake” running along the edge of the lower eyelid. This lake drains through little holes in the eyelid…
This is when the “angle” inside the eye is naturally tight, putting you at risk for having an acute glaucoma attack. The front part of the eye is filled with a fluid called the aqueous humor. This fluid is continuously produced and drained from the eye, with the balance of fluid input and output controlling…
This is an over-the-counter allergy drop, useful for itching and swelling of the eyelids. This drop actually contains two separate drugs. The first is called pheniramine – this is an antihistamine to decrease inflammation. While effective, it is not as powerful as stronger antihistamines found in newer drops. The other drug is called naphazoline. This…
This is a vasoconstrictor found in many over-the-counter eye drops such as Naphcon-A and Opcon-A. By constricting the blood vessels on the conjunctiva surface, this makes the eyes look whiter. Unfortunately, many people develop a rebound redness and their eyes actually look more red and swollen when the drop wears off. We see a similar…
This is another way of saying an eye is nearsighted. See the entry of nearsightedness for more information.
This is the trade name for the dilating drop tropicamide. This is a short-acting dilating drop used during an eye exam to dilate the pupil. This drop also has cycloplegia effects which means that it will cause a fair amount of blurriness (especially with reading). It is the shortest acting dilator available, but even so,…
This is a rare autoimmune disease that causes easy fatigue of muscles throughout the body. When muscle fatigue occurs in the eye, this creates intermittent double vision (diplopia) and droopy eyelids (ptosis), especially when tired later in the day. The mechanism of this disorder involves the body developing antibodies to its own muscle nerve receptors….
This is a hyperosmotic (lots of salt) eye drop that is used in cases of corneal edema. The cornea (the clear structure that makes up the front of our eye) is clear because it is relatively dry. With certain conditions such as Fuchs’ dystrophy or after cataract surgery, the cornea can become wet and cloudy. …
An inflammatory disorder of the nervous system characterized by multiple neurologic symptoms over time. Multiple sclerosis (MS) occurs because of inflammation of the nerves in the body and brain. A myelin sheath normally surrounds the nerves in the body, acting just like the “insulation” on electrical wires. With MS, inflammation causes this insulation to break…
This is an implant used during cataract surgery that may eliminate the need for reading glasses. With cataract surgery, the cloudy lens inside the eye is removed and replaced with a plastic implanted lens. The standard implant most people choose is focused for distance vision. These people continue to need bifocals or reading glasses after…
This is a contact lens that is designed to improve both distance and near vision. The contact has separate zones of focus to accomplish this, arranged in a concentric ring like a fresnel lens. The downside to multifocal contacts is that they may not work perfectly for everyone and they are not quite as clear…
MRI stands for magnetic resonance imaging. An MRI uses a large magnet and radio fields to view the interior body. MRI is particularly good at imaging soft tissues like the brain, but has limited use for looking at the eye itself. Some scientists estimate that a third of the brain is involved with vision in…
This is a powerful fluoroquinolone antibiotic eye drop, commonly used after cataract surgery and more serious eye infections (especially in contact lens wearers). This antibiotic is available under the trade names Vigamox and Moxeza.
This is the trade name for the antibiotic moxifloxacin. This is a powerful antibiotic eye drop commonly used after cataract surgery and for more serious eye infections (such as a corneal ulcer in a contact lens wearer).
With monovision, one eye is set for distance vision while the other is set for near. Many contact lens wearers use a “monovision contact prescription” to avoid reading glasses. Most will set their dominant eye for distance and their non-dominant eye set for reading. While some people tolerate this imbalance well, other people hate monovision. …
Many people have only one good eye. Despite this limitation, they live perfectly rich and normal lives. We recommend these fine people take extra precautionary steps to keep their good eye “healthy.” For example, if a rock randomly strikes you in the eye you don’t have a backup eye to rely on. Conversely, if you…
This is a visual distortion that can occur during or before a migraine headache. Migraines are bad headaches associated with sensitivity to light or sound (and often nausea). Like most headaches, the underlying mechanism is not entirely understood but migraines may occur because of spasm of blood vessels in the brain. With some people, the…
Also known by the trade name Neptazane, this is a water pill used in the treatment of glaucoma. It is a carbonic anhydrase inhibitor that works by decreasing the production of aqueous fluid inside the eye. This medicine has the same mechanism of action of Diamox (acetazolamide).
This is a piece of metal in the eye, and is commonly caused while grinding or working on machinery. Small pieces of metal can fly or fall into the eye, and for some reason, metal likes to stick to the clear cornea. When this happens, the metal will embed into the eye and rust into…
This is a surgery performed by a retinal specialist to remove an epiretinal membrane from the eye. An epiretinal membrane is a clear membrane that can form on the retina. While normally innocuous, this membrane may contract and can make the retinal surface “wrinkled” leading to vision loss. With a membrane peel surgery, the retina…
These are small glands that run along the edge of the upper and lower eyelid. Meibomian glands produce oil that is continuously excreted into the tear film. This oil keeps the tears slippery and also forms a protective “evaporation proof” barrier on the surface of the tear film. The meibomian gland pore openings are small,…
This is a combination of neomycin/polymyxin (antibiotics) and dexamethasone (a mild steroid). This antibiotic combination comes in both drop and ointment forms and is useful for mild infection or inflammation such as blepharitis. Some people are sensitive to the neomycin and may require more expensive alternative drugs like Tobradex or Zylet. Maxitrol is generic and…
This is a small spring-like device used during cataract surgery to help dilate the pupil. Small pupils make cataract surgery difficult, as the procedure involves vacuuming out the cataract “through” the pupil. Some people have naturally small pupils (the black hole in the middle of the iris) and don’t dilate well. Poor dilation may be…
This is a membrane that forms on the surface of the retina that causes it to wrinkle or “pucker.” Other names for this are epiretinal membrane and cellophane retinopathy. See the entry on epiretinal membrane for a more detailed explanation of this common finding.
This is a small hole that forms in the macula that creates significant vision problems. The retina is located in the back of the eye and acts like film in a camera. The macula is the most important part of the retina as it is responsible for our fine central vision. If a hole forms…
This is swelling of the macula, the area of the retina that is responsible for our fine central vision. The retina can be thought of like film in a camera. Just like film, the retina needs to be perfectly smooth and flat if we are going to “take a good picture” and see clearly. If…
Macular degeneration is premature aging of the retina. The retina is located in the back of the eye and works like “the film in a camera,” detecting light and images. The macula is the central retina responsible for fine central vision. If the macular retina wears down this can cause serious problems. For most people,…
The macula is the part of the retina that is responsible for our fine central vision. This is the vision necessary for reading a book, watching television, or seeing distant road signs. The retina works like film in a camera, and the macula is the most sensitive part of the film, containing more rod and…
An anti-VEGF injection medicine used in the treatment of wet macular degeneration. This medicine is being supplanted by other drugs in the same class such as Avastin (cheaper) and Lucentis/Eylea (possibly more effective).
This is a yellow pigment created by plants that is absorbed and used by animals. Lutein is found in animal fats and is what gives egg yolks that yellow color. It is found in the retina along with another similar pigment called zeaxanthin. Lutein and zeaxanthin supplementation has been studied and found to be beneficial…
A prostaglandin eye drop used for treating glaucoma. The active ingredient is bimatoprost. Like all the prostaglandins, this medicine is dosed only once a day and usually taken in the evening. Similar medications include Xalatan (latanoprost) and Travatan (travoprost).
This is an injectable anti-VEGF medicine used primarily to treat wet macular degeneration. It works by decreasing fluid release from leaking blood vessels under the retina. Lucentis is touted as being a more selective medicine than its competitor Avastin (and Lucentis costs a premium for this reason).
This is the abbreviation for Laser Peripheral Iridotomy, a laser procedure performed on people who are at risk for having an acute glaucoma attack. To understand the purpose behind this procedure, it can be useful to think of the eye like a kitchen sink full of water. There is a “faucet” running at all times…
This is glaucoma that occurs despite the eye pressure being “normal.” Glaucoma is normally defined as high intraocular pressure that causes damage to the optic nerve over many years. The underlying mechanism behind glaucoma is poorly understood but high pressure seems to be the main instigator. Some people seem to be exquisitely sensitive to mild…
A popular steroid eye drop that is usually packaged under the trade name Lotemax. This drop is commonly used in cases of ocular inflammation and for use after eye surgery to cool the eye down. This drug is also available in lower concentrations in the drop Alrex.
This is the trade name for the steroid loteprednol. This steroid eye drop is commonly used after cataract surgery and in cases of ocular inflammation. While not quite as strong as prednisolone, Lotemax is touted as a safer medicine as it has less steroid side effects like increased eye pressure.
This is a technique for cleaning the eyelids in order to improve comfort, especially in cases of blepharitis. Debris can form on the eyelashes. This debris is typically made of dead skin cells and dried-up tear secretions. It is harmless, but bacteria living on our skin like to eat this debris because it is like…
This is an anesthetic liquid that is commonly injected into the skin prior to surgical procedures. I use it most commonly with chalazion excisions or when removing a papilloma from the eyelid. We inject lidocaine inside the eye during cataract surgery to numb the iris. On occasion, I will inject the medication behind the eye…
A glaucoma eye drop. This is a beta-blocker similar to the eye drop timolol. This drop is generic and inexpensive, but I don’t use it often as timolol is readily available.
A machine used in an eye doctor’s office that can measure the prescription in an existing pair of glasses. Some are manual and others are automated machines. Knowing your current glasses prescription gives us a starting point when performing refraction (checking your vision on the eye chart). This measurement also allows us to advise you…
The lens is the magnifying glass inside our eye that controls fine focusing. The lens is located immediately behind the iris (the colored part of the eye). Like the cornea, it is living tissue yet it is clear. When light enters the eye, it travels through the pupil, then through the lens, before striking the…
In North America, the definition of legal blindness is vision that is 20/200 or less in the best seeing eye, despite using the best correction possible (i.e., up-to-date glasses). A 20/200 vision measurement on the Snellen chart means that if a “legally blind person” stood 20 feet away from a vision chart, they could read…
This is an eye that doesn’t see well but is otherwise healthy. This occurs from disuse at a young age when the visual nervous system is still forming. See amblyopia for more information on this topic.
This is a thinning of the peripheral retina commonly found during a dilated eye exam. People with thinning retinas are at slightly higher risk for developing a retinal detachment in their lifetime. This localized area of atrophy is predisposed to forming holes or tears (especially after a vitreous detachment) that can extend into the rest…
This is a topical medicine used to make the eyelashes grow longer. This drug is the same medicine used in the glaucoma drop Lumigan (bimatoprost). Eyelash growth is a known side effect of prostaglandin glaucoma drops and Allergan is capitalizing on this with their topical product. Latisse is typically applied to the upper eyelid at…
This is a prostaglandin eye drop used for treating glaucoma. The trade name is Xalatan. For many doctors, latanoprost is the first-line drop used in glaucoma because of its powerful effect and easy once-a-day dosing.
A prescription strength allergy drop good for treating swelling and itchy eyes. It is supposed to last about 16 hours, so is usually dosed once a day. Alternative prescription allergy drops include Bepreve and Pataday.
This is a procedure where the cornea is sculpted with a laser in order to fix refractive error and decrease reliance on glasses. The cornea is the clear window that makes up the front of your eye. Surprisingly, the corneal surface does the majority of the light-focusing of the eye (not the lens inside the…
Laser stands for “Light Amplification by Stimulated Emission of Radiation” (in case you were interested). Lasers work by amplifying light (or non-visible radiation) of a single wavelength. This can create a highly controllable beam of energy which can be used to burn, cut, or ablate tissues in the body. There are many uses for lasers…
The lacrimal gland is a tear-producing gland that is located in the upper eyelid, underneath the orbital bony ridge (i.e., under the bone that makes the upper eye socket). Most people think that the lacrimal gland is the main source of tears. Actually, that’s not quite true. Most of the tears that cover our eyes…
This is a second generation antihistamine medication found in several of the better over-the-counter allergy eye drops. This medicine can be found at the store under the trade names Zaditor and Alaway. There are generic drops as well … but not much cheaper than the brand names. Allergy medications like this are good for treating…
This is the technique used to measure the steepness of the cornea (the clear window that makes up the front of the eye.) Everyone has a different corneal steepness, and this variation has a large effect on the eye’s overall focusing prescription. Normally, the cornea is perfectly round like the surface of a basketball. With…
This is an abnormal curvature of the cornea (the clear window that makes up the front of the eye). Normally, the cornea is spherical with a surface shape like a basketball. People with astigmatism have a cornea that is shaped like an American football. These shapes are easy to “fix” with glasses. Keratoconus is a…
This is a fancy and erudite way of saying dry eye. Only pompous academics use this term.
This is a steroid that is used to decrease inflammation in the eye. Unlike other steroids we use in ophthalmology, this drug is delivered as an injection. We occasionally inject Kenalog into chalazion eyelid lesions to speed their resolution. For patients with resistant ocular inflammation (uveitis), Kenalog can be injected in the skin next to…
This is an oral antibiotic that is good for skin and sinus infections. Also known as cephalexin, it is relatively inexpensive and fairly effective. This medication is on the $4 list at Walmart and free at Publix supermarket.
This is the trade name for the glaucoma eye drop timolol. Timolol is a beta-blocker similar to the beta-blocker medicine used to control blood pressure. As this medicine has been around for a long time, it is also available as an inexpensive generic. Istalol comes in a thicker consistency, so the medicine lasts longer and…
This is damage to the optic nerve behind the eye that can occur in middle age. See ION for more information on this topic.
This is inflammation of the iris, the “colored” part of the eye. The iris is a muscle that controls the size of the pupil. When inflamed, the iris muscle can “spasm” and cause intense eye pain. Most people with an iritis complain of extreme sensitivity to light (photophobia). Iris inflammation can occur from many sources…
This is an oddly shaped pupil that forms after inflammation inside the eye. The iris is the flat muscle inside our eye that controls pupil size and gives our eyes “color.” When the iris is inflamed, such as after trauma or uveitis, it tends to become “sticky” and wants to scar to nearby structures. The…
The iris is the “colored” muscle inside the eye that controls pupil size. Some people have brown irises and others have blue. The color of the eye is determined by the amount of pigment in the iris, with dark brown eyes having more pigment than lighter eyes. The iris has rings of muscle fiber that…
An ischemic optic neuropathy is a damaging event that happens in the optic nerve behind the eye when the blood supply to the nerve is temporarily blocked or interrupted. Without nutrition the nerve tissue swells and becomes damaged. Sudden and severe vision darkening occurs, often affecting either the upper or lower half of the vision….
This is a machine used prior to cataract surgery to help determine the implant to use during surgery. With cataract surgery, the cloudy cataract lens inside the eye is removed and must be replaced by a new lens implant. These implants come in different prescriptions, just like glasses or contact lenses. To help determine the…
Also called an “IOL,” this is the plastic lens placed into the eye during a cataract surgery. See implant for more information.
Also known as “IOP,” this is the pressure inside the eye. We call this intraocular pressure to differentiate it from other kinds of pressure such as BP (blood pressure) and ICP (intracranial pressure) inside the skull. Normal eye pressure is 10-21. High pressure can cause glaucoma damage to the eye. See the entry on pressure…
This is an advance in LASIK surgery where the corneal flap is created using a laser. The older method of flap creation was using a microkeratome blade. Laser flap construction may decrease the chance of human errors in flap construction and makes LASIK surgery slightly safer. See LASIK and femtosecond laser for more information about…
Several medicines are best delivered to the eye by injecting them directly into the vitreous cavity. The most common are the anti-VEGF medications like Avastin and Lucentis used for treating macular degeneration. Steroids such as Kenalog can also be injected into the eye for severe cases of uveitis and for decreasing inflammatory macular edema. Finally,…
This is a plastic lens that is placed inside the eye during cataract surgery and is sometimes called an IOL (intraocular lens). With cataract surgery, the natural lens inside the eye has become cloudy and needs to be removed. If a new lens is not put back in the eye, the vision will remain blurry…
This is a type of angiography used by a retina specialist to look for problems in the retina. With this test, indocyanine green dye is injected into a blood vessel in the arm. As the dye travels through the circulatory system, it will eventually reach the eye’s circulation. Photographs are then taken every few seconds…
This is one of the eye vitamins based on the AREDS Study used to decrease the rate of progression of macular degeneration. Just like the competing vitamin brands (Ocuvite and PreserVision) there are many variations in the formula. They appear to all follow the general AREDS formula, with several adding lutein and omega-3. If you…
This is bleeding inside the eye, occurring after trauma or spontaneously from neovascularization (abnormal blood vessels inside the eye). With a hyphema, blood leaks from internal blood vessels and pools in the front part of the eye (the anterior chamber). If there is enough blood, gravity causes the blood to sink into a visible ‘layer.’ …
A fancy way of saying farsightedness. This means that you see far away better than close-up. See the entry on farsightedness for more details.
A machine used to detect problems with peripheral vision. See visual field for more information on this common office test.
This stands for herpes simplex virus and comes in two varieties. HSV-1 is usually considered the non-sexually transmitted herpes that causes cold sores. HSV-2 is the sexually transmitted variety that causes genital lesions. We typically see HSV-1 related infections when the virus activates in the eye. See herpetic eye disease for more information on this…
HRT stands for Heidelberg Retinal Tomograph … but this is hard to pronounce so we just call it “HRT”. This is an imaging test used primarily to photograph the optic disk in people with glaucoma. The HRT uses a scanning laser to create a three-dimensional map of the optic nerve that can be used to…
This is a pupil abnormality where the eye loses its sympathetic nervous system innervation. The sympathetic system helps the body function during stressful situations … it is our “fight or flight” system. Sympathetic stimulation helps the heart beat faster and routes blood to the musculoskeletal system so we can run faster. In the eye, the…
This is a long-acting dilating drop with cycloplegia effects. We sometimes use this to treat eye pain (photophobia), especially when the cause is internal ocular inflammation from uveitis.
Herpes simplex virus (HSV) can cause cold sores around the mouth and can sometimes affect the eye. When the eye is involved we typically see a dendritic corneal ulcer on the surface of the eye. We call it “dendritic” because the infection forms a classic fern-leaf pattern on the cornea. Initial episodes cause eye irritation…
Headaches are common and their cause is difficult to ascertain. There are a couple of ocular conditions that can exacerbate headaches. If the eyes are out of alignment (a condition called strabismus) the constant eye muscle strain of looking straight ahead can cause a tension headache. Prism glasses or eye exercises may help with this….
Graves disease is an autoimmune disorder where the thyroid pumps out too much thyroid hormone. Graves’ is the most common cause for hyperthyroidism and is more common with women. Graves’ can cause ocular problems such as eyelid retraction (giving people a wide-eyed appearance) and swelling of the eye muscles located behind the eye. This swelling…
This stands for Giant Papillary Conjunctivitis and is sometimes called “contact lens overwear syndrome.” Contacts are made of plastic, but at a microscopic level they look like a sponge full of water. Just like a sponge, contacts tend to suck up irritants from the environment. Contacts also block the amount of oxygen the cornea normally…
This is the eye exam technique used to examine the drainage angle inside the eye, and is used to evaluate for glaucoma. The front part of the eye is filled with a fluid called the aqueous humor. This fluid nourishes many structures inside the eye and the balance of aqueous production and drainage is what…
This is a descriptive term for the changes that occur at the optic nerve from glaucoma damage. The optic nerve is the big nerve that connects the eyeball to the brain. It is located at the back of the eye, and its insertion can be seen inside the eye in the retina. This nerve is…
This is a person who “might” have glaucoma. The diagnosis of glaucoma is not always an obvious one. There is no “one test” that says if a person has glaucoma. Instead, we look at various risk factors to decide if you look “suspicious enough” to have glaucoma. The most obvious risk factor is high eye…
Glaucoma is best described as high pressure in the eye that causes damage to the optic nerve. The optic nerve is the large nerve that sends visual information from the eye to the brain. High pressure causes damage to this nerve over time. Glaucoma is a very slow process that usually has no real symptoms…
A glasses prescription is the little piece of paper that has your spectacle correction written on it. There are many numbers on a glasses prescription and they can be a little daunting to decode if you’ve never done this before. The first number is your basic refractive error: if you are farsighted this will be…
These are focusing lenses used to improve vision. There are many options when buying a modern set of glasses. For example, you can have them made with bifocals, trifocals, or even a no-line bifocal called a progressive lens. Glasses are also available as transitional lenses that darken when exposed to sunlight.
This is when you see halos or blur when exposed to bright lights. Many people with dense cataracts complain of glare while driving at night … the headlights from oncoming traffic make it hard to see. Glare is usually associated with cataracts and one of the indicators that it may be time for cataract surgery. …
This is when you see double, but the second image is less bright and usually offset to the side of the main object you are staring at. Ghost images are usually secondary to visual opacities such as a cataract or astigmatism. Upon further questioning, most people with monocular diplopia (double vision from a single eye)…
A popular brand of over-the-counter rewetting drops. Genteal also makes a nighttime rewetting ointment called “GenTeal Gel” that is useful for extreme dry eyes. Competing brands include Refresh and Systane.
This is an older antibiotic eye drop that is also available as an ophthalmic ointment. This medicine has gone generic and is inexpensive, so I see it prescribed by many emergency rooms and urgent care clinics. While fairly effective, this medicine can be a little irritating to the eye with prolonged use. Alternative medicines like…
This is a powerful fluoroquinolone antibiotic eye drop, often used with more serious infections (such as contact lens related corneal ulcers) and after cataract surgery. The trade name for gatifloxacin is Zymaxid. Similar medicines in the same class include moxifloxacin (Vigamox & Moxeza) and besifloxacin (Besivance).
A trade name for the medication gentamicin. This is an antibiotic and is available as an ointment or eye drop. The generic equivalent is very cheap.
This is a powerful antiviral medication that is now available as an eye ointment called Zirgan. We use this medicine in our practice to treat herpetic eye disease. Retina specialists occasionally use ganciclovir to treat viral infections (usually related to HIV) in the retina.
This is another way of saying retina. The fundus describes the back portion of the retina that is visible using the eye microscope. For example, doctors use a “fundus camera” to take pictures of the retina. Fundus is a Latin term that means ‘bottom’ and is used to describe organ parts that look like the…
This is a condition where the cornea gets too wet and cloudy. The cornea (the clear window that makes up the front of the eye) is clear because it is relatively dehydrated compared to the rest of the eyeball. This may seem counterintuitive at first. After all, isn’t the eye covered by tears on the…
This is an adhesive prism that is stuck onto your glasses as a temporary method of fixing double vision. Prism glasses can be very effective for correcting alignment problems (diplopia). However, prism glasses are expensive and notoriously difficult to get made correctly. In some cases, I’ll prescribe a temporary “stick-on” prism. It is a clear…
A fresnel lens is a magnifying lens that is built into a flat piece of plastic. You may have seen fresnel magnifiers in a bookstore … they look like a clear, flexible sheet of plastic with tiny ridges along the surface. They are commonly used in overhead projectors and rear projection screen televisions. Fresnel lenses…
A prescription rewetting drop that contains several substances designed to replenish multiple layers of the tear film. It also has a higher osmotic (concentration) content than normal tears, which serves to help flatten the cornea cell layers and may be helpful for treating cloudy corneas (such as with Fuchs’ dystrophy and recurrent erosions).
This spot in the retina that is responsible for the exact center of our vision. The retina works like film in a camera and detects light. The most important part of the retina is the macula, which corresponds to our central vision. In the exact center of our macula is a small depression in the…
This is a paralysis or stroke to the fourth cranial nerve. This nerve controls a single eye muscle called the superior oblique muscle. This muscle is located behind the eyeball and it helps the eye look downward and assists with eye rotation when you tilt your head sideways. When the nerve is blocked, this muscle…
These are antibiotic eye drops especially made by a compounding pharmacy, used for bad eye infections such as a corneal ulcer. Certain strong medicines are not available in eye drop format (or don’t come in high enough concentrations). If you have a bad corneal ulcer, for example, the typical antibiotic eye drops may not be…
When a piece of dirt, plant, or metal gets into the eye, we call this a foreign body. Any foreign object in the eye will cause pain, watering, and occasionally an allergic response with swelling of the conjunctiva (the white part of the eye). Debris can scratch the cornea, causing further pain and increasing the…
A mild steroid eye drop. Also available under the trade name FML.
This is a class of powerful antibiotics that is commonly used to treat eye infection and used as prophylactic treatment after cataract surgery to decrease the chance of endophthalmitis. These antibiotics are considered “broad spectrum” and are good for treating a myriad of different bacterial infections, including the dreaded pseudomonas infection common with contact lens…
This is a diagnostic test performed by retina specialists to evaluate circulatory problems in the retina. Fluorescein is a harmless yellow dye that has the unique property that it glows under a blue/black light. This dye can be injected into the arm and introduced into the blood stream. As the dye works its way into…
This is a yellow dye used during an eye exam. This dye is an organic pigment similar to the pigments used in a highlighter … at least in the sense that it glows under a blue or “black” light. This glowing property is useful for checking eye pressure during applanation tonometry. Fluorescein is also useful…
This is an over-relaxation of the iris, usually caused by urinary medications like Flomax, that makes cataract surgery more difficult. The iris is the colored part of the eye – some people have blue irises and others have brown. The iris is a muscle as well, and this muscle makes your pupil large or small…
This is the trade name for tamsulosin, an oral medication used for urinary problems in men with enlarged prostates. This medicine helps by relaxing smooth muscle in the urinary track, but it also relaxes the smooth muscle in the iris, causing floppy iris syndrome. This creates challenges during cataract surgery.
These are little spots floating in the vision, which usually occur secondary to aging changes in the vitreous jelly that fills the eye. They are best seen when looking at plain surfaces like a blank wall or the sky and tend to move or “float” around with eye movements. While annoying, floaters are usually harmless….
This stands for Focal Laser Therapy and is the term used to describe most laser treatments used on the retina. For example, FLT laser can be used to seal leaking microaneurysms from diabetic retinopathy. Larger areas of retinal swelling and macular edema can be treated with FLT laser spots applied in a grid pattern to…
Flaxseed and other plant-based foods contain omega-3 fatty acids that may be helpful in the treatment of macular degeneration (along with the heart benefits of the Omega-3 supplements). However, flaxseed contains mainly the ALA fatty acid … not the EPA and DHA that are being studied in the AREDS2 Study. For the prevention of macular…
If you are seeing flashing lights in your vision, you are probably suffering from a vitreous detachment. This is when the vitreous jelly inside the eye contracts and peels off the retina. Many people describe seeing a flash like a “streak or arc of lightening” in their peripheral vision. While a vitreous detachment is relatively…
A type of laser that delivers energy in super-fast spurts, coming out in rapid pulses like a miniature machine gun. This technology allows a laser to make finely controlled cuts in the cornea and helps in the creation of the “flap” during LASIK surgery – this is called Intralase. The femtosecond laser is occasionally used…
This is a refractive error where close vision is blurry while distance vision is clearer. This situation occurs because the eye’s focus is too “weak.” Let me explain. Normally, the eye works like a camera with light entering the eye being focused perfectly on the retina – the retina is like the film in a…
An injectable anti-VEGF medicine used primarily for treating wet macular degeneration. Other drugs with a similar action are the injection drugs Avastin and Lucentis.
Vitamin supplementation has been found to be beneficial for people with macular degeneration. A large clinical trial called the AREDS Study was sponsored by the National Eye Institute. Its purpose was to look for supplements that might slow the progression of macular degeneration. They found that vitamins A, C, and E (along with the minerals…
This is a fancy way of saying “twitching eyelid.” Fasciculations are quite common, with people complaining that their whole eye has been twitching and jumping. Upon further discussion, we discover that it is actually their eyelid that has been twitching … they can both feel it, and often see the skin movement when looking in…
The eyelid is the mobile tissue that covers the eye, protecting the ocular surface and aiding with lubrication. The eyelids have two distinct layers. The outer layer contains the surface skin and muscles (that function to close the eyes). The inner layer contains the tarsal plate – this is a thick layer with a consistency…
Eyelashes are the small hairs that grow from the eyelid margin that serve to protect the eyes from foreign bodies. The lashes also protect the eye by providing sensory information and activating the blink reflex when touched. Certain glaucoma medications (like latanoprost) can make the eyelashes grow thicker and longer. The medication Latisse can also…
The chart used in an eye doctor’s office to measure vision. See Snellen chart.
These are the muscles that control eye movement. Eye muscles insert onto the sides of the eyeball and contract (shorten) to rotate the eye in different directions. Any problem with these extraocular muscles (such as a cranial nerve palsy) can make the eyes go out of alignment and cause double vision (diplopia). With strabismus surgery…
This is when the eyes turn outwards from each other … and is sometimes described as “wall eyed” (the opposite of cross eyed). This alignment problem can occur for many reasons. Some people have a pre-existing exophoria (a tendency for their eyes to turn outwards) since birth but have built up strong eye muscles to…
This is a tendency for the eyes to drift or turn outwards from each other. If bad enough, this can turn into a true exotropia where the eyes do turn outwards, causing diplopia (double vision).
This is a laser used in LASIK surgery. The laser “beam” produced by this laser has a very short wavelength which is outside of the visible spectrum (so it can’t be seen with the human eye). Rather than burning or cutting tissue, this laser produces such intense energy that it actually disrupts molecular bonds and…
This is when the eyes turn inwards (cross-eyed). Ocular alignment problems like this can develop from many sources such as congenital crossed-eyes (which is usually treated with strabismus surgery during childhood to straighten the eyes out). Crossed eyes can also occur from decompensation of a pre-existing esophoria (a natural tendency for the eyes to turn…
This is a tendency for the eyes to drift inwards (cross eyed). Many people are born with a tendency for the eyes to turn inwards but they build strong eye muscles in youth to offset this. With age, these muscles may weaken and the eyes may turn inwards again, causing intermittent or constant double vision….
A popular and commonly used antibiotic ointment for the eye. This ointment is commonly used for mild to moderate infections and cases of blepharitis (chronic eyelid inflammation). This ointment comes in tubes and is available as an inexpensive generic. This ointment can be rubbed into the eyelashes at night or squeezed into the eye itself…
This is a fancy medical way of saying “watery eyes.” There are several causes for epiphora, but oddly enough, watering eyes is usually caused by dry eye. When the eyes are dry, they tend to sting and cause reflexive tearing. Occasionally, epiphora occurs because of nasolacrimal duct obstruction. This is when the tear drainage pathway…
This is a clear membrane that can form on the surface of the retina and usually occurs with aging (though sometimes after ocular trauma). These membranes are common and can be detected with a dilated eye exam … they look like a shiny glistening sheen on the retinal surface. While usually innocuous, epiretinal membranes can…
This is when the eyelids turn inwards such that the eyelashes are rubbing against the surface of the eye. The eyelashes irritate the cornea and can even cause corneal abrasions and scarring. With mild cases we treat with ointments and plucking the lashes. Definitive treatment is surgical with an attempt to rotate the eyelid into…
This is an infection that occurs inside the eyeball, usually after an eye surgery or penetrating trauma. Internal ocular infection is dangerous as the eye is essentially a “big ball of water” and can quickly turn into an abscess. The vitreous gel does not have a vigorous immune response so that bacteria can replicate at…
This describes an eye that is neither nearsighted nor farsighted. An emmetropic eye is perfectly in focus for distance and does not require glasses to see far away.
A prescription-strength allergy drop containing the antihistamine epinastine. It is useful for treating puffy eyelids and ocular itching. Similar prescription-strength allergy drops include Bepreve, Pataday and Lastacaft.
This is an outward rotation of the lower eyelid, usually associated with laxity of the lower eyelid skin. This rotation causes the eyelid to pull away from the eyeball. This leads to dry eye and tearing problems. Mild cases can be treated with artificial tears and nighttime rewetting ointments. If the ectropion is bad enough,…
This is a steroid eye drop that is commonly used after cataract surgery to cool down ocular inflammation. This medicine contains prednisolone acetate. Prednisolone is also available as a generic … though there is some debate as to the quality of the generic steroid drop suspensions when compared to the brand names like Econopred and…
This is a powerful steroid eye drop occasionally used after cataract surgery. The stuff seems to be more powerful than Pred Forte, so I use it primarily with internal ocular inflammation such as iritis or uveitis.
This stands for Descemet’s Stripping Endothelial Keratoplasty. It is a “partial” corneal transplant surgery where only the inside layers of the cornea are replaced. This is a vast improvement over traditional full-thickness transplants, as the surgical and healing time are much shorter and this surgery eliminates much of the risk of more advanced transplants. This…
Macular degeneration is a progressive aging change to the retina where the retina seems to “wear out” and atrophy with time. Most people have “dry” degeneration, where the retina atrophies very slowly over many years. Gradual loss of central vision causes people to complain of difficult time reading small letters or seeing distant road signs….
This describes ocular surface irritation that occurs from an irregularity of the tear film. Dry eye causes eye irritation and redness. Many people complain of a feeling that the eyes are “tired,” especially in the evenings and when doing activities that require concentration (like reading, driving, or watching TV). Ironically, most people with dry eye…
Drusen are deposits that form under the retina. They look like yellow spots in the retina and their presence is often a precursor to more serious macular degeneration. The retina is located in the back of the eye and functions like film in a camera. The retinal photoreceptors (rods and cones) are metabolically active and…
“Doxy” is an antibiotic pill that is often used in the treatment of blepharitis. With blepharitis (chronic eyelid irritation) one of the causes of eye irritation is from poor oil flow from the meibomian glands that run along the edge of the eyelids. Doxycycline has been found to help oil flow throughout the body, and…
This is also called diplopia, and describes the situation where you see the same object twice. This should not be confused with a ghost image where a dimmer “shadow image” is seen next to the primary object. See diplopia for more information on the causes of double vision.
A glaucoma eye drop used to lower eye pressure. The trade name is Trusopt but this medication has gone generic. This is a carbonic anhydrase inhibitor and works by decreasing the production of aqueous fluid inside the eye. It is usually taken twice a day. This medication is also found in the combination drop Cosopt…
This is when a person sees double … that is to say, they see the same object twice. This can be a horizontal side-by-side doubling, a vertical up-down effect, or a combination of the two. Whenever a person has “double vision” the biggest question we ask is whether this is a monocular (one-eyed) diplopia or…
A diopter is a unit of measurement that describes the power in a pair of glasses or contacts. For example, weak reading glasses have a diopter power of +1.00 while stronger readers have a power of +3.00 diopters. Farsighted people require positive (+) diopter glasses to improve their vision, while nearsightedness requires negative (-) diopter…
The pupil is the black “hole” in the middle of the iris (the colored part of the eye). The pupil looks black because the inside of the eye is dark. Eye doctors dilate the pupil with eye drops to help them view the retina. There are many causes for a dilated pupil outside of the…
This is an NSAID eye drop. Like all NSAIDs, diclofenac has a mechanism similar to Motrin or Advil and is good for inflammation. This class of medications is often used after cataract surgery to decrease the chance of retinal swelling (macular edema). This drop is also known under the trade name Voltaren. Diclofenac has gone…
This is the trade name for the oral medication acetazolamide. This is a water pill that is sometimes used in cases of poorly controlled glaucoma and to treat acute eye pressure spikes (such as after a complicated cataract surgery). Diamox can also decrease the pressure around the brain in cases of pseudotumor cerebri. See the…
The term diabetes is used to describe large amounts of sugar floating in your bloodstream. This sugar weakens the blood vessels throughout your body and makes them “leaky.” This can cause health problems with major organs, including the eyes. For example, diabetics can develop kidney problems and difficulty with healing. In the eye, diabetic vessel…
This is a steroid eye drop that is good at treating ocular inflammation. This medicine is normally found in combination eye drops like Tobradex (dexamethasone and tobramycin) and generic Maxitrol (dexamethasone, neomycin, and polymyxin).
This is excess skin that forms over the upper (and sometimes lower) eyelids. This skin can droop down to cover the upper eyelashes and even obstruct vision. If bad enough, a blepharoplasty surgery can be performed to surgically remove this skin.
This is the method for checking glasses prescription in children. Children have strong muscles inside their eye that make it hard to measure their vision during a refraction. They can “strain” while reading the eye chart, throwing off our measurements. By using cycloplegia dilation drops, we temporarily paralyze these eye muscles and can capture a…
This is when the eyes are dilated using eye drops. Certain dilating drops make the pupil larger, but they also paralyze the muscles inside the eye that control lens focusing. This paralysis is called cycloplegia. This effect is helpful when checking the vision in children (we call this cycloplegic refraction) as kids tend to “strain”…
This is a moderate strength dilating drop used in the office to enlarge the pupils. This dilating drop lasts longer than tropicamide and is usually reserved for dilating children as they have strong eye muscles and are harder to dilate. This drop also has cycloplegia effects and is helpful when performing cycloplegic refraction in children. …
This is a premium implant used in cataract surgery that allows people to focus at both distance and near. Standard implants are fixed focus lenses, like a magnifying glass, and are only calibrated for one distance (i.e., you will need reading glasses after surgery). The Crystalens has a unique hinge design that allows it to…
This is when the eyes turn inwards toward the nose. In medical circles, we call this esotropia. This alignment problem can be congenital or arise in adulthood from a cranial nerve palsy or a stroke. In childhood, crossed eyes are usually corrected with strabismus surgery. The goal is to straighten the eyes for primary vision…
An older allergy drop. I never prescribe cromolyn given the plethora of newer allergy drops available.
The head and face are innervated by twelve separate “cranial” nerves. Each of these nerves has a different function. For example, the first cranial nerve (CN1) controls smell, while the eighth nerve (CN8) controls hearing. The main nerve we are concerned with is the second nerve (CN2) which is the optic nerve and transmits visual…
This is a combination glaucoma drop. It contains dorzolamide (Trusopt) and timolol. It is usually used twice a day. A preservative-free version is now available, though it is more expensive.
This is when an infection (bacterial, fungal, or viral) invades the cornea, the normally clear window that makes up the front of your eye. The cornea is unique because it is one of the few tissues in the eye that is clear, allowing us to see bacterial infections with no opaque skin blocking our view. …
A corneal transplant is when part of the cornea is replaced surgically. This may be necessary because of corneal opacities from past infections, traumatic scars, or decompensation of the cornea from prior intraocular surgeries. Several congenital abnormalities, such as keratoconus, may also need a corneal transplant to rehabilitate vision. Traditionally, a full thickness corneal transplant…
This is the measurement of the surface characteristics of the cornea. See topography for more information on this topic.
The cornea is the clear window that makes up the front of the eye. It has a normal thickness of 540 microns and this can be measured in the office with a handheld device called a pachymeter (see pachymetry). Corneal thickness is important for a couple of reasons. When we check eye pressure using applanation…
A corneal abrasion occurs when the surface layer of the cornea (the clear tissue that covers our eye) gets scratched. This usually occurs when a foreign body, like a piece of sand, gets into the eye. The surface layer of the eye is extremely thin and scratches easily. Fortunately, this tissue also heals quickly and…
The cornea is the clear window in the front of our eye that lets light inside. If you were to touch the “colored part of your eye” with your finger, you’d be touching the cornea. The cornea is an extremely important part of vision – it acts as a fixed lens and actually provides the…
This is when the eyes turn inwards. For example, the eyes need to converge when looking at close objects such as when reading a book. People with a convergence insufficiency have a hard time with this and may have double vision when reading. Treatment may involve prism reading glasses and occasionally eye exercises to strengthen…
Contacts are plastic lenses that are placed directly onto the eye to improve vision. There are two main varieties: soft contact lenses, and hard rigid gas permeable (RGP) lenses. Most people use soft contacts as they are more comfortable and inexpensive, though hard RGP contacts are easier to manipulate with the fingers and get into…
This is an irritation or infection of conjunctiva and is sometimes called “pink eye.” There are many causes for conjunctivitis, but these usually fall into three categories: allergic, bacterial, and viral infection. With allergic conjunctivitis, the eye is typically irritated and “itchy.” The eyelids can become puffy, and fluid can collect under the conjunctival skin…
This is the thin layer of skin that covers the white part (the sclera) of the eyeball. The conjunctiva is very thin and has blood vessels coursing through it that you can see when looking in the mirror. The conjunctival skin also loops over and forms the inside of the eyelids themselves. This “looping” is…
Cones are the photoreceptor in our retina that let us see in color. Cone cells are located deep in our retina and come in three different varieties, each sensitive to a different color spectra: red, green, and blue. Cones are very important for daylight vision and also for detecting fine visual needed to read small…
This is a combination glaucoma drop. It contains brimonidine (i.e., Alphagan) and the beta-blocker timolol. This drop is usually used twice a day. Combination drops like this decrease the number of drops you have to take and tends to improve eye comfort by minimizing exposure to preservatives like BAK. This convenience may cost more, however, as…
This is when a person has a difficult time with color vision. Cones are the light receptors in our eyes that detect color and there are three types: red, green, and blue detectors. If any of these color-sensors are abnormal, color-detection will become flawed and a person may be considered “color blind.” Many of the…
This is an antibiotic eye drop that is also available in pill form – it is commonly called “cipro.” This antibiotic is in the fluoroquinolone class of drugs and therefore has good general bacterial coverage … including covering most strains of pseudomonas (a particularly virulent bacteria found with many contact lens). Newer medicines in this…
This is the trade name for the antibiotic eye drop ciprofloxacin (commonly called “Cipro”). Ciprofloxacin is a fluoroquinolone antibiotic that has good general bacterial coverage and is good for infections of the cornea. It may not be as powerful as the newer (and more expensive) medicines in the same class, however, such as moxifloxacin (Vigamox)…
This is a ring of muscle that sits behind the iris (the colored part of the eye). The ciliary body has two main functions – to focus the vision and to produce aqueous fluid. To help the eye focus, the ciliary muscle can contract like a sphincter. The ciliary body is attached to the lens…
This is the most common type of glaucoma. Glaucoma is usually described as high pressure inside the eye that causes damage to the optic nerve over time. The mechanism of this damage is not entirely clear … but something about high pressure causes atrophy of the optic nerve over many years. The optic nerve is…
The choroid is a layer of blood vessels that lie underneath the retina and supply some of the blood supply to the retina. The choroid circulation also helps remove the waste products from the photoreceptors (rods and cones) and processes them back into the circulatory system. Conditions like macular degeneration create a blockage between the…
This is swelling of the conjunctiva skin, usually from allergy. The surface of the eye is covered by a very thin layer of skin called the conjunctiva. This skin layer is clear, but has blood vessels running through it that you can see when looking at the white of the eye in the mirror. Irritation…
This is a large lump that forms in the eyelid. They occur when one of the oil-producing meibomian glands that run along the eyelid margin become blocked. Oil backs up into the eyelid, and causes a large bump … this can be tender at first but usually becomes painless with time. Sometimes warm compresses and…
An oral antibiotic (trade name Keflex) that is often used for skin and sinus infections. This pill is available as an inexpensive generic. Some people find it a little harsh on the stomach.
This is a blockage of the main vein that drains blood out of the eye. Without this drainage, blood can’t get out of the eye and it backs up into the retina. The retina can become swollen with blood, causing serious problems. Depending upon the severity of the swelling, vision can be severely affected, though…
This is the main vein that drains blood out of the eye and away from the retina. This vein runs with the central retinal artery and leaves the eye through the optic nerve.
This is a blockage of the all-important central retinal artery that supplies blood to the inner eye. This blockage usually occurs from embolic sources, such as a cholesterol plaque from the carotid artery or a blood clot from an irregular beating heart. Unfortunately, the retina has no backup blood supply, so when the central retinal…
This is the main artery that supplies blood to the eye, specifically the retina. The artery travels inside the optic nerve. Once the artery enters the back of the eye at the optic disk, it branches widely within the superficial layers of the retina. These coursing blood vessels can be examined during a dilated eye…
Cataract surgery is a procedure that involves removing the cloudy cataract from your eye and replacing it with a clear lens implant. This procedure takes only 15 minutes and with modern techniques can be done with no needles or stitches. A small microincision is created through the cornea to gain access to the cataract lens. …
This is a fancy way to say cataract surgery. We say “extraction” because the cataract lens is removed from the eye during surgery. See cataract surgery for more details on the actual procedure.
A cataract is when the normally clear lens inside the eye becomes cloudy. This cloudiness is a normal aging process and occurs in everyone with time, though congenital and premature cataracts can occur in youth as well. A cloudy cataract can cause visual difficulties. One of the earliest symptoms is glare or halos, especially with…
This is a class of drugs that are often used for treating glaucoma. These drugs work by decreasing the production of aqueous fluid inside the eye. Examples of this drug class include Trusopt (dorzolamide), Azopt (brinzolamide) and the combination drop Cosopt. This medication is also available as a diuretic pill Diamox which we sometimes use…
A B-scan is a type of ultrasound of the eye, similar to a fetal ultrasound. This is usually required to evaluate the interior eye when our view is otherwise obscured. For example, if a person has a dense white cataract, it is impossible to detect a retinal detachment or tumor inside of the eye without…
This stands for Branch Retina Vein Occlusion. This occurs when one of the veins leaving the eye becomes blocked. With this blockage, blood can’t drain out of the retina, so it backs up into the retinal tissue instead. This causes swelling, then hemorrhage, with resulting vision loss. The amount of visual change is quite variable…
This is an NSAID anti-inflammatory eye drop. It is usually known by the trade names Bromday. This drop is commonly used after cataract surgery to decrease the risk of macular edema.
This is an NSAID anti-inflammatory eye drop. It is commonly used after cataract surgery to sooth the eye and decrease the chance of macular edema. Bromday contains bromfenac and its claim to fame is its once-a-day dosing.
This is an eye drop used to treat glaucoma. The trade name for this medicine is Alphagan. A newer version is out now called Alphagan P. This eye drop is dosed twice a day.
This stands for Branch Retina Artery Occlusion. This is a blockage of a retinal artery in the back of the eye. The retina is very sensitive tissue. Without a constant supply of blood and oxygen from the retinal arteries, it quickly starves and dies. The cause of an arterial artery blockage can sometimes be seen…
A popular brand of rewetting drop that is available over the counter. Competing brands include Systane, Refresh and GenTeal.
The blind spot is an area in your vision where you can’t see. Every eye has a small blind spot. This is due to where the optic nerve enters the back of the eye. At this insertion site, there are no retinal photoreceptors, so we don’t detect light hitting this area of the retina. Fortunately,…
This is an antibiotic eye drop containing sulfacetamide at a concentration of 10%. This class of medication is often used for skin infections and to treat acne and rosacea. I rarely prescribe this eye drop because of the potential for sulfa allergy and the slew of alternative antibiotic options available today.
A surgical procedure to remove excess skin (dermatochalasis) from above the eye. The excess skin is removed in the operating room and sewn up with a running baseball stitch. This running stitch is typically removed after a week.
Blepharitis is a catchall term that means “eyelid inflammation.” There are many causes of blepharitis, such as rosacea and sensitivity to environmental irritants. For most people, blepharitis is a self-limited condition that causes episodic eyelid irritation. Most people complain of red, watery eyes with a sandy or gritty sensation. The eyelids may look red and…
This is the medication Lumigan, a prostaglandin eye drop used to treat glaucoma. It works by decreasing production of aqueous fluid inside the eye. This drug is also found in Latisse, a cosmetic drug used to make the eyelashes grow longer.
This is a secondary lens built into the bottom of glasses to help with reading. Though there is some historical debate, most people credit Benjamin Franklin as the inventor of the modern bifocal. There are many styles of modern bifocals. Progressive lenses are bifocals, without a visible line, that progress to a stronger view the…
This is the trade name for the drug betaxolol, a beta-blocker eye drop used for treating glaucoma. Unlike other beta-blockers (like timolol), this is a “selective” blocker with less systemic side effects. That being said, it is not often used because the side effects of timolol are usually negligible and timolol is available as an…
A trade name for the glaucoma eye drop timolol. Timolol is a common beta-blocker glaucoma eye drop that has been around for a long time and is available in generic form.
This is a selective beta-blocker eye drop used for treating glaucoma. This medication is similar to timolol, except it may have less systemic side effects such as bronchospasm (asthma). I don’t prescribe this drop often, as betaxolol can be expensive and few of my patients complain of timolol side effects.
This is a beta blocker eye drop used in the treatment of glaucoma. The generic name is levobunolol. I rarely prescribe this medication given the universal availability of timolol (which has the same efficacy and mechanism of action). Both of these drops are generic and inexpensive.
This is the red-orange pigment found in carrots. It is converted to Vitamin A inside the body. Vitamin A is important in the retina for converting light into an electrical signal at the photoreceptors. High doses of Vitamin A have been used for the treatment of retinitis pigmentosa. This vitamin is also found in the…
This is an antibiotic (besifloxacin) used with eye infections and after cataract surgery. This drug is in the fluoroquinolone class of drugs and is good for treating contact lens-related infections as well. The claim to fame with this particular medicine is that it was developed only for the eye and not used for systemic infections…
This is a prescription strength allergy drop. It is good for ocular itching and swelling around the eyes. It is usually dosed twice a day. This is one of my favorite drops and I have had good success with it. Similar prescription allergy drops include Pataday and Lastacaft.
This is a preservative used in many eye drops to keep the bottles from being colonized from bacteria in the environment. See BAK for more information.
This stands for benzalkonium chloride. BAK is a preservative found in many eye drops and rewetting drops. This preservative is necessary to keep bacteria from colonizing the bottle after being opened. Unfortunately, the preservative itself is a little harsh on the cornea. This is one of the reasons why we don’t recommend using drops more…
This is an infection in the eye involving the conjunctiva skin (the white of the eye). When it comes to conjunctivitis (also known as ‘pink eye’) it is often hard to determine the exact cause of an eye infection … be it allergic, viral, or bacterial. Symptoms and presentation can give us clues, however. Bacterial…
An antibiotic used primarily for eye and skin infections. It is available as an ointment, and is found in other “combination” medications like neosporin and polysporin. Interesting tidbit about this drug: it was discovered at Columbia University (my alma mater) in 1943, and derived from a strain of Bacillus bacteria found in a 7-year-old girl…
A non-irritating shampoo sometimes used for treating blepharitis. Read the entry on lid scrubs for more details on how baby shampoo is used with the eyes.
A glaucoma eye drop used to lower eye pressure by slowing the production of aqueous fluid inside the eye. This is a carbonic anhydrase inhibitor. Other glaucoma drops in this class include Trusopt and dorzolamide.
An antibiotic pill commonly used for pneumonia and upper respiratory infections. It is available as a dose pack called a “Z-pack.” This medicine has been formulated into an eye drop called AzaSite for topical use for eye infection and for the treatment of blepharitis (chronic eyelid inflammation).
This is an antibiotic drop containing azithromycin. You may know azithromycin in its pill form, where it is marketed as the “Z-pack” and is good for treating lung infections and pneumonia. AzaSite has been packaged as an eye drop and is sometimes used in treating blepharitis (chronic eyelid inflammation). The drop may have some anti-inflammatory…
This is an injection medicine used to treat wet macular degeneration and sometimes used for other causes of macular edema such as diabetic retinopathy. Avastin was originally developed for systemic use to treat colon cancer. However, its anti-VEGF properties are good at targeting abnormal retinal blood vessels and so it is commonly used in the…
This is a machine used in the eye doctor’s office to help determine your glasses prescription. While not as accurate as actual refraction (the process by which you read the eye chart through the phoropter machine), the autorefractor provides a useful starting point that can be further refined in the exam room.
An antibiotic pill that is good for skin, sinus, and inner-ear infections. It can cause mild diarrhea. Another oral medication I use is Keflex.
A powerful dilating drop. This drop is so powerful, in fact, that your eye may be dilated for a week after its use. This is also a cycloplegia drop typically given in cases of ocular inflammation (iritis) to help with pain control by temporarily paralyzing the iris muscle inside the eye. The drop is often…
This is when the eye is oval in shape. Normally the surface of the cornea is perfectly round like a basketball. Some people’s cornea is shaped more like a football … that is to say, the cornea is steep along one axis and shallow along the other. This is called astigmatism and is completely normal….
This is a fancy word for eye strain or discomfort. There are many causes for eye strain, including incorrect glasses, motility problems (the eyes out of alignment), or even from surface irritation such as dry eye.
This is a harmless condition where calcium soap deposits form inside the vitreous fluid that fills the back of the eye. During an eye exam, these little specks glow brightly under the microscope – in fact, the inside of the eye looks like a blizzard or snow globe. Despite the impressive microscopic appearance, these deposits…
This is a type of ultrasound used on the eye and is primarily used to measure the length of the eyeball. This measurement is needed prior to cataract surgery so that we can calculate the correct implant power for the replacement lens. A-scan ultrasound can be very precise but only focuses on one parameter –…
These are rewetting drops that can be bought over the counter and used for dry eye. Artificial tears are produced by many manufacturers and are essentially all the same. The only real difference between them is what preservative is used to keep the drops sterile. This preservative is crucial for keeping the drops fresh and…
This stands for Age-Related Macular Degeneration and is just another way of saying macular degeneration. See the entry on macular degeneration for more details.
This is the latest study searching for additional supplements that slow down macular degeneration progression. In the original AREDS Study, researchers found that Vitamin A (beta-carotene), C, E and the metals zinc and copper were helpful in slowing the progression of vision loss. However, there are many more supplements out there that have been theorized…
This stands for the Age-Related Eye Disease Study. This large study was conducted to study the effects of vitamin supplements in slowing the progression of macular degeneration. The study showed that certain antioxidants were more helpful, such as Vitamin A, Vitamin C, and Vitamin E and the metals zinc and copper (cupric acid). While these…
This is a white haze or ring on the cornea that occurs with age. The cornea is the clear window that makes up the front of the eye. This living tissue has no blood vessels running through it because it needs to be perfectly clear. To get its nutrition, the cornea depends upon the tear…
The aqueous “humor” is the fluid that fills the front part of the eye (the anterior chamber). This clear fluid maintains the shape of the eye and affects the eye pressure. Glaucoma can occur if the pressure gets too high, and most glaucoma treatments are geared toward regulating the production and drainage of the aqueous…
This is a method for checking the pressure inside the eye. The eyeball is a closed ball of fluid so that there is no good way to measure the internal pressure of the eyeball directly. However, we can estimate the eye pressure by pushing on the surface of the eye and feeling “how hard” it…
This is when the natural lens has been removed from the eye (such as after cataract surgery) but has not been replaced with a new lens implant. In the early days of eye surgery, cataracts were removed but not replaced with anything. The vision was better but “aphakic people” required thick coke-bottle glasses to see…
This is a class of medicines that are designed to combat neovascularization inside the eye and decrease blood vessel leakage. They are usually used for treating problems like macular edema, caused by wet macular degeneration, though occasionally they are used for treating swelling from other sources such as diabetic retinopathy or central retinal vein occlusion….
This usually refers to a drop or pill that is designed to kill or decrease the proliferation of bacteria. The eye is well protected from infection by the conjunctiva and the corneal epithelium. In addition, the tear film contains antimicrobials and the tear flow itself tends to wash away pathogens. The eye also harbors a…
This is the fluid-filled space in the front part of the eye, located immediately behind the cornea but in front of the iris. This “chamber” is filled with clear aqueous fluid and easy to examine by the doctor using the slit lamp microscope in the office. In cases of trauma or iritis, the anterior chamber…
This is when the pupils are of unequal size. Many people have slightly different sized pupils and this is considered normal. Large differences between the eye is not normal, however. See dilated pupil for more information.
In regards to the eye, the “angle” usually refers to the drainage angle inside the eye where excess ocular fluid (aqueous) is reabsorbed back into the blood stream. This angle is located at the intersection of the iris and the white sclera of the eye … in other words, in a 360-degree ring where the…
There are several drops we use to anesthetize the surface of the eye. The most common one is called proparacaine, though we occasionally use tetracaine. These drops are very similar to the “novacaine” that a dentist uses … but fortunately we don’t have to use a needle to apply it! Numbing drops make it easier…
A checkered pattern used at home for detecting retinal distortions, such as from macular degeneration or an epiretinal membrane. To use, a patient is instructed to look at the central dot while covering an eye. If the surrounding lines are missing or look distorted, then the surface of the retina (which acts like “film in…
An antifungal medicine that can be compounded (see fortified antibiotics) and used to treat fungal eye infections. There are not many antifungal eye medications out there – the only other eye drop easily available is Natamycin.
This is a commonly used oral medication that is used to help with abnormal rhythms of the heart (arrhythmias). While effective, amiodarone can occasionally cause changes in the eye. One of these changes is “corneal verticillata,” which are pigment deposits in the clear cornea that can be seen with the slit lamp microscope. These corneal…
Also known as “lazy eye.” Amblyopia occurs at a young age from disuse when an eye doesn’t see well. A child’s visual nervous system is still developing until age seven. If during this developmental period, one eye has poorer vision, the “brain wiring” for that eye does not form as strongly as the better eye….
This stands for Argon Laser Trabeculoplasty and is a laser procedure designed to lower the eye pressure in people with glaucoma. This procedure involves using a “hot” laser to burn spots into the trabecular meshwork (the drainage filter of the eye). By doing this, scar tissue forms that opens up the meshwork and creates better…
A mild steroid eye drop. Useful in cases of ocular inflammation and irritation. This drop has the same ingredient (loteprednol) as Lotemax but with a third of the steroid concentration. By reducing the steroid concentration, this decreases the chance of untoward reactions such as premature cataract formation and glaucoma pressure spikes.
This is a glaucoma eye drop designed to lower eye pressure. It is actually a “new” formulation of brimonidine that has a lower concentration of active drug and a less harsh preservative in it. Despite the decreased concentration, the drop appears to have the same efficacy as the old Alphagan but with less irritating side…
A glaucoma drop used to lower eye pressure. This drop went generic so many people have switched to generic brimonidine or moved up to Alphagan P.
Allergy drops are commonly used to treat ocular itching and swelling. There are several types of allergy drops on the market. The first generation antihistamine drops like Opcon-A are effective but tend to give short-lived relief. Second generation antihistamines like Alaway/Zaditor are more effective and what I recommend for most of my patients. Prescription strength…
The eyes are particularly sensitive to environmental allergens. Symptoms are usually bilateral, with both eyes being itchy and puffy. Eyelid swelling can be so bad that you look like you’ve been in a fight … we call these “allergic shiners.” Treatment for allergic conjunctivitis involves cool compresses, antihistamine allergy drops, and occasionally mild steroid drops.
An effective over-the-counter allergy drop. Alaway contains the medicine ketotifen and is usually used twice a day. Allergy drops are good for itching and swelling, and can make the eye feel less sensitive. Alaway and Zaditor (which contains the same active ingredient) are two of my favorite over-the-counter allergy drops.
This is a cloudy membrane that forms on the back surface of an implant lens inside the eye after cataract surgery. This opacity can form months or years after a successful cataract operation and can cause blur and glare symptoms (similar to the original cataract). These “after cataracts” are not a complication from cataract surgery,…
This is a neurologic disorder in which one eye becomes dilated. Most patients have no symptoms or visual complaints, but a friend points out that one of their pupils is now much larger than the other. Also, the pupil does not seem to constrict normally with light. An Adie’s pupil usually occurs from damage to…
An antiviral pill used for viral infections such as shingles (chicken pox) and herpetic eye disease. This medication is cheap and effective, but requires a lot of pills to get the correct dosing. A similar medicine we use is called Valtrex (valacyclovir). Some people with these recurring infections will take a maintenance dose of acyclovir…
Acute glaucoma is when the pressure inside the eye goes up suddenly. This usually occurs because of a sudden closure of the drainage “angle” inside the eye. With no drainage, the aqueous humor fluid builds up and causes a spike in eye pressure that can lead to rapid vision loss. Symptoms include extreme eye pain…
This is an eye drop in the NSAID class of medicines. It is an anti-inflammatory drop with a mechanism similar to Advil or Motrin. It is occasionally used to help with ocular discomfort but mainly used after eye surgery. This class of medicines is good at decreasing the chance of macular edema (retinal swelling) after cataract…
An oral water pill that is used to treat glaucoma. This pill is a diuretic and will dehydrate the body, but it will also dehydrate the eye and decrease eye pressure. This medication is also known as Diamox and is normally used in cases of extremely high eye pressure where we’ve exhausted our topical eye…
Accommodation is the process by which the eye focuses to see near objects. A normal eye, that is to say, an eye that is neither nearsighted or farsighted, is naturally focused to see distant objects clearly. To see close-up objects, such as when reading, the flexible lens inside the eye changes shape and becomes “rounder.” This process is called accommodation and is quite versatile when young. After the age of 40, however, our lens becomes stiff and accommodation becomes more challenging. We loose our ability to accommodate and we become more dependant on glasses and bifocals with time. This loss of accommodation is called …
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