Andrew A. Dahl, MD, is a board-certified ophthalmologist. Dr. Dahl's educational background includes a BA with Honors and Distinction from Wesleyan University, Middletown, CT, and an MD from Cornell University, where he was selected for Alpha Omega Alpha, the national medical honor society. He had an internal medical internship at the New York Hospital/Cornell Medical Center.
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
"Oh, something is wrong with my eye!"
We have all said this at some time. How uncomfortable it can be! Fortunately, many common
eye (ocular) disorders disappear without treatment or can be managed by self-treating. Various
products -- from artificial tears and ointments to ocular decongestants -- are
available over the counter (OTC). These products can help with dryness,
itching, or excessive watering of the eye. However, a word of caution: In some
instances, what may seem like a minor eye problem may lead to a severe,
potentially blinding condition.
Many safe and effective OTC products for mild eye disorders are available for self-treatment. Two important factors to remember when considering self-treatment are: (1) if the problem appears to involve the eyeball itself, you should consult a physician immediately; and (2) if you use an OTC eye-care product for 72 hours without improvement of the condition being treated or the condition worsens, you also should see a doctor immediately. If blurring of vision or visual loss is one of your symptoms, see an ophthalmologist (MD) immediately.
To self-treat common ocular disorders with OTC eye-care
products, viewers should understand: (1) the structure of the eye; (2) the cause of the
disorder; (3) which disorders are safe to self-treat and which should be referred to a
physician; (4) the types of OTC eye-care products that are available and the
disorders in which they are useful.
What is the structure of the eye?
The eyes are complex sensory organs. About 85% of the total sensory input to our brains originates from our sense of sight,
while the other 15% comes from the other four senses of hearing, smell, touch, and taste. The eyes are designed to optimize vision under conditions of varying light. Their location, on the outside of the face, makes them susceptible to trauma, environmental chemicals and particles, and infectious agents. The eyelids and the position of the eye within the bony orbital cavity are the major protective mechanism for the eye.
The eye itself has the shape of a sphere measuring about 1 inch in diameter. It consists of a clear, transparent dome at the front (the cornea) that is surrounded by the white of the eyeball (the sclera). The iris of the eye is the circular, colored portion within the eye, and behind the cornea, and the pupil is the central opening within the iris. Behind the iris and pupil is the eye's lens. The space behind the back of the cornea and the front of the lens is called the anterior chamber and is filled with the aqueous fluid. Behind the lens is a large space that is filled by the transparent vitreous gel. The inside of the back of the eye is lined by the retina, the thin, light-sensitive tissue that changes light images to electrical signals via a chemical reaction. These electrical signals generated by the retina are sent to our brain through the optic nerve. Our brain interprets what our eyes see.
The inner sides of the eyelids, which touch the front surface of surface of the eye, are covered by a thin membrane (the palpebral conjunctiva) that produces mucus to lubricate the eye. This thin membrane folds back on itself and covers the visible sclera of the eyeball. (This continuation of the palpebral conjunctiva is called the bulbar conjunctiva.) Natural oil for the tears is produced by tiny glands located at the edges of the eyelids, providing additional lubrication for the eye. The main component of tears are formed by the lacrimal gland located under the upper lid at the outer corner of the eye. The tears are composed of a combination of the substances produced by the lacrimal gland, the oil glands, and the mucus glands. Tears flow toward the nasal side of the eye and drain into the lacrimal sac in the area between the eye and the side of the nose.
Pink eye, also called conjunctivitis, is redness or irritation of the conjunctivae, the membranes on the inner part of the eyelids and the membranes covering the whites of the eyes. These membranes react to a wide range of bacteria, viruses, allergy-provoking agents, irritants, and toxic agents.
A sty (sometimes spelled stye) is a tender, painful red bump located at the base of an eyelash or on, inside, or under the eyelid, which is the result of an acute infection of the oil glands of the eyelid. Complications of a sty can be blepharitis and chalazion.
Sjögren's syndrome is an autoimmune disease involving the abnormal production of extra antibodies that attack the glands and connective tissue. Sjögren's syndrome with gland inflammation (resulting dry eyes and mouth, etc.) that is not associated with another connective tissue disease is referred to as primary Sjögren's syndrome. Sjögren's syndrome that is also associated with a connective tissue disease, such as rheumatoid arthritis, systemic lupus erythematosus, or scleroderma, is referred to as secondary Sjögren's syndrome. Though there is no cure for Sjögren's syndrome, the symptoms may be treated by using lubricating eye ointments, drinking plenty of water, humidifying the air, and using glycerin swabs. Medications are also available to treat dry eye and dry mouth.
Retinal detachment is the separation of the retina from its attachments to the underlying eye tissue. Symptoms of retinal detachment include flashing lights and floaters. Highly nearsighted young adults and those who've had cataract surgery are at higher risk for retinal detachment.
Glaucoma is a common eye condition in which the fluid pressure inside the eye rises because of slowed fluid drainage from the eye. If untreated, glaucoma may damage the optic nerve and other parts of the eye, causing the loss of vision or even blindness.
Eye floaters are deposits or condensation that forms in the eye's vitreous humor. These deposits cast shadows on the retina, and as the eye moves, the deposits shift position, making it appear as though the shadows are moving or floating.
A subconjunctival hemorrhage is bleeding under the eye's conjunctiva. There is usually no obvious cause for a subconjunctival hemorrhage, but it may be caused by sneezing, vomiting, infections on the outside of the eye, coughing, and clotting disorders. Symptoms and signs include blood in the white of the eye and a sense of fullness under the lid. No treatment is needed.
Dry eyes are caused by an imbalance in the tear-flow system of the eye, but also can be caused by the drying out of the tear film. This can be due to dry air created by air conditioning, heat, or other environmental conditions.
A cataract is an eye disease that causes the eye's lens to become cloudy and opaque with decreased vision. Causes of cataracts include diabetes, hypothyroidism, certain genetic illnesses, hyperparathyroidism, atopic dermatitis, and certain medications. Symptoms and signs include a decrease in vision and a whitish color to the affected eye. Treatment depends upon the patient's specific visual needs and may involve cataract surgery.
Blepharitis is inflammation of the eyelids. Acne rosacea, Staphylococcal bacteria, allergies, sensitivities to makeup or contact lens solutions, head lice, or other conditions may cause blepharitis. Symptoms and signs include itchy eyelids, burning sensation in the eyes, crusting of the eyelids, light sensitivity, red, swollen eyelids, loss of eyelashes, and dandruff of the lashes and eyebrows. Proper eyelid hygiene and a regular cleaning routine controls blepharitis.
Eye strain is a symptom caused by looking at something for a long time. Symptoms and signs include redness, light sensitivity, headaches, and blurred vision. Symptoms may be treated by closing the eyes and taking a break from the visual task.
Uveitis is inflammation of the eye. Symptoms include blurred vision, eye pain, eye redness, and floating spots before the eyes. Treatment may involve prescription eyedrops, antibiotics, and wearing dark glasses.
The most common cause of a black eye is due to an injury to the face or head. Most black eye injuries are minor and heal on their own, however, some may lead to significant injury. In addition to trauma to the face, cosmetic surgery can cause a black eye(s) as a side effect. People should be aware of the situations in which medical care should be sought immediately for a black eye.
Astigmatism is a common eye condition that's easily corrected by eyeglasses, contact lenses, or surgery. Symptoms of astigmatism are headaches, fatigue, eyestrain and blurred vision.
Blindness is the state of being sightless. Causes of blindness include macular degeneration, stroke, cataract, glaucoma, infection and trauma. Symptoms and signs may include eye pain, eye discharge, or the cornea or pupil turning white. Treatment of blindness depends upon the cause of the blindness.
Age-related macular degeneration (AMD) is a disease that gradually destroys the central vision. In people over 60, AMD is a leading cause of vision loss. Wet AMD occurs when abnormal blood vessels behind the retina start to grow under the macula, leaking blood and fluid and causing rapid vision loss. In dry AMD, light-sensitive cells slowly break down in the macula, resulting in gradual vision loss. Pain is not associated with either form of AMD.
Diabetes and eye problems are generally caused by high blood sugar levels over an extended period of time. Types of eye problems in a person with diabetes include glaucoma, cataracts, and retinopathy. Examples of symptoms include blurred vision, headaches, eye aches, pain, halos around lights, loss of vision, watering eyes. Treatment for eye problems in people with diabetes depend on the type of eye problem. Prevention of eye problems include reducing blood pressure, cholesterol levels, quitting smoking, and maintaining proper blood glucose levels.
Double vision (diplopia) is a symptom that my indicate Graves' disease, myasthenia gravis, stroke, multiple sclerosis, Guillain-Barre syndrome, diabetes, cataracts, aneurysm, brain tumor, or migraine. Symptoms and signs include eye pain, droopy eyelids, nausea, headache, and a cross-eyed appearance. Treatment of double vision depends upon the underlying cause.
eye. Read about symptoms, signs, diagnosis, treatment, and prognosis.
Coats' disease is a rare eye condition that typically progresses to vision loss or blindness in one eye. Gradual vision loss is usually the first symptom, followed by a cloudy white or yellow pupil due to the presence of a cataract. Treatment focuses on limiting the blood vessel progression and may involve cryotherapy or laser photocoagulation.
Nonprescription eyeglasses are available over the counter (OTC) and are typically used by people who can no longer read fine print. OTC trifocals are helpful for those who require multiple distances or focal lengths for near and intermediate tasks. OTC sunglasses should offer 100% protection from the sun's UVA and UVB rays. OTC magnifying glasses are useful for viewing tiny objects or fine print.
The macula is in the center of the retina, the light-sensitive layer of
tissue at the back of the eye. The macula is responsible for central vision
(straight-ahead vision). Degeneration of the macula occurs most often after the
age of 60 years and is termed age-related macular generation (AMD).
AMD is a painless condition.
There are two types of AMD: dry AMD and wet AMD.
Smoking, high blood pressure,
obesity, a
diet high in unsaturated fats and
simple carbohydrates and lack of exercise all increase the risk of AMD.
Early
symptoms of dry AMD include slightly
blurred vision, the need for more light for
reading, and difficulty recognizing faces until very close to the person. A
symptom of more advanced dry AMD is the presence of a blurred spot in the center
of vision. An early symptom of wet AMD is the wavy appearance of straight lines.
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