Corneal and External Conditions

Serving Kingston, Scranton, Wilkes-Barre and all of Northeastern Pennsylvania (NEPA)

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The cornea is the clear, dome-shaped surface that covers the front of the eye. Refractive errors occur when the curve of the cornea is irregularly shaped (too steep or too flat) for a given eye. When the curve of the cornea is abnormally shaped, the cornea bends light imperfectly on the retina, affecting good vision. In this situation, the images that enter the eye are bent imperfectly and do not produce a clear image on the retina. About 120 million people in the United States wear eyeglasses or contact lenses to correct nearsightedness, farsightedness and astigmatism. These refractive abnormalities constitute the most common vision problems in the country. One of the technologies developed to treat refractive disorders is the excimer laser. The excimer laser uses a beam of ultraviolet light to minimize surface abnormalities and reduce or eliminate refractive disorders. Common refractive surgery procedures performed using an excimer laser include LASIK and PRK. The doctors and staff at Eye Care Specialists are experienced in these techniques and in treating the conditions listed below.

Corneal Abrasions

Sharp, severe eye pain with redness, tearing, light sensitivity, and a foreign body sensation can occur when the ocular surface is scratched. This is a common occurrence and is usually due to a corneal abrasion.

The epithelium is a thin carpet like layer of cells that cover the cornea. These cells protect the deeper layers of the cornea against infection and help to provide a smooth ocular surface to focus light onto the retina. When these cells are traumatized, the nerve endings that run in this layer are exposed, resulting in knife-like pain. This pain is similar to the pain experienced by the exposed nerve endings in a tooth cavity.

If you experience ocular trauma with pain, or if you feel that there is something in your eye that you cannot seem to get out, don’t delay. See one of our eye doctors promptly. Our eye doctors will examine the eye and likely start an antibiotic drop to help prevent infection. Neglect of this problem could lead to more serious problems such as a potentially sight threatening corneal ulcer. Unfortunately, the only true cure for the pain is complete healing of the abrasion, but luckily these usually heal in 24 to 48 hours.

Since prevention is the best medicine, try to avoid corneal abrasions by wearing protective eyewear anytime you are using machinery, striking metal on metal (i.e. hammering), or working in the yard.

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Have you ever experienced any of these symptoms: chronically red eyes, itchy eyelids, crusty eyelashes, lids sticking together in the morning, or heavy mucous build-up? If you answered yes, you may need to improve your eyelid hygiene regimen. It is a common misconception that simply washing one’s face is enough to adequately clean the eyelids and lashes.

All of us have bacteria that live on our skin without causing problems. However, occasionally (and by no fault of our own) these bacteria can overgrow and lead to problems such as blepharitis (infection of the eyelid margin), conjunctivitis (infection of the covering over the white of the eye), or Staphlococcal hypersensitivity (overactive immune response to bacterial waste products). When these conditions are present, the above symptoms are manifested.

How can you avoid these problems? The answer is lid scrubs. Lid scrubs should be done to prevent blepharitis just as tooth brushing should be done to prevent cavities. There are many variations on how to perform lid scrubs, but the idea is the same with all methods. We want to reduce the number of bacteria that live at the eyelid margin by cleaning the area where the eyelashes meet the eyelid. This can be done with over the counter medicated pads (Ocusoft), baby shampoo, or cetly alcohol based products (Cetaphil). The key is to perform the lid scrubs regularly, and make sure to remove all of the mucous and debris that may be present on the lashes. If you have any of these symptoms, come by and let us help.

Conjunctivitis

Giant papillary conjunctivitis (GPC) is an inflammation of the inner surface of the eyelids, most frequently associated with contact lens wear. It can develop in people who wear either soft or rigid gas permeable contact lenses and can occur at any time, even if an individual has successfully worn contacts for a number of years. Although not vision threatening, GPC can be inconvenient and may require one to stop wearing contacts temporarily or even permanently.

The typical symptoms of GPC include red, irritated eyes, often with itching and mucus discharge. Blurred vision and light sensitivity can also occur. GPC is not an infection, but a hypersensitivity of the membrane covering the inner lids and the whites of the eyes. The inner lining of the eyelid becomes roughened and inflamed by constant blinking over a contact lens or other foreign body such as an artificial eye. Hard, flat elevations in a cobblestone pattern develop on the undersurface of the upper eyelid. Eventually the entire eye becomes irritated.

In most cases, treatment of GPC involves discontinuing the use of contact lenses to allow the eye to rest. Eye drops are frequently prescribed to control inflammation. Many people find their symptoms are relieved when contact lens wear is discontinued. Unfortunately, the symptoms can return when lens wear is resumed.

Once GPC is under control, it may be helpful to consider changing to new contacts or disposable contacts. Changing lens care systems and cleansing solutions can also be helpful. After an episode of GPC, limit the amount of time lenses are worn, and increase the time slowly.

Once it develops, GPC may be an ongoing problem. Prolonged GPC may be more difficult to treat.

Blepharitis

Blepharitis is a chronic inflammation of the eyelids which causes irritation, itching and occasionally a red eye. The eyelids are composed of skin on the outside and mucous membranes on the inside. A cartilage-like plate, muscles, and glands are sandwiched in between. Blepharitis can begin in early childhood producing “granulated eyelids,” and may continue throughout life as a chronic condition or it may develop in later life. It may appear in one of two ways:

Seborrheic blepharitis is characterized by redness of the lids, scales and flaking around the eyelashes. It is often associated with dandruff of the scalp.

Ulcerative blepharitis is usually a more severe condition caused by bacteria and is characterized by matted hard crusts around the eyelashes which upon removal leave small ulcers that may bleed or ooze. The white part of the eye may turn red. In severe cases, the cornea (the clear front window of the eye) may become inflamed.

There may be a loss of eyelashes and distortion of the margins of the eyelids, which can cause chronic tearing.

How is Blepharitis Treated?

In view of the long-term nature of the condition, strict lid hygiene is necessary. The following regimen may be useful:

  1. Fill a small glass with warm water.

  2. Add three drops of baby shampoo.

  3. Take a cotton washrag and soak it in the solution.

  4. Gently scrub both eyelids for two minutes with eyes closed.

  5. Rinse with cool tap water.

  6. Gently dry with a clean towel.

  7. Use medications as directed.

Treatment of oily scalp with antidandruff shampoos may also be helpful.

In more severe cases, various antibiotics and even cortisone preparations may be necessary to alleviate the condition. Once the acute phase is controlled, lid hygiene, as described above, and the use of bland ointments may be sufficient to maintain control of blepharitis.

While cortisone preparations often hasten relief of symptoms, long-term use can cause side effects. Some susceptible individuals may develop glaucoma or virus infections from prolonged steroid use.

Please contact Eye Care Specialists today to schedule an appointment with one of our experienced ophthalmologists or optometrists. We serve patients in Scranton, Wilkes Barre, Kingston, and throughout Northeastern Pennsylvania.