Search for tag: "eye care"
Will eating carrots really improve your child's eyesight? Or will reading in a dim room ruin your eyesight? Dr. Cindy Gellner stops by to discuss the common eyesight myths everyone hears as a…
June 27th, 2016
Dr. Gellner: We'd all have x-ray vision if we could, am I right? Do certain activities we've been warned about actually hurt our eyes? Old wives' tales about eyes today on The Scope. I'm Dr. Cindy Gellner.
Announcer: Keep your kids healthy and happy. You are now entering The Healthy Kids Zone with Dr. Cindy Gellner on The Scope.
Dr. Gellner: They say eating carrots will improve your eyesight, not true. But this old wives' tale has a really cool back story. It may have started during World War II when British intelligence spread a rumor that their pilots had remarkable night vision because they ate lots of carrots. They didn't want the Germans to know they were secretly using radar.
Carrots and many other vegetables high in vitamin A, do help maintain healthy eyesight, but eating more than the recommended daily allowance won't improve your child's vision. In fact, it can turn your child orange like a Oompa Loompa. That's called beta-carotenemia. Not good.
Reading in dim light will damage your eyes. False. Although reading in a dimly lit room won't do your child's eyes any harm, good lighting can prevent eye fatigue and make reading easier during the pile of homework they have to do every night.
Too much TV is bad for your eyes. Well, watching television won't hurt your child's eyes no matter how close to the TV they sit. But too much TV is a bad idea for kids. Two hours of screen time or less people. Research shows that kids who consistently spend more than 10 hours a week watching TV are more likely to be overweight, aggressive, and be behind in school. So get them outside playing instead.
And we've all heard this one growing up. If you cross your eyes they'll stay that way. Sorry mom, not true. Only 4% of children in the United States have strabismus, a problem with the eyes are not aligned correctly giving the appearance that they're looking in different directions. Eye crossing however does not lead to strabismus.
And no, your child will not shoot their eye out if they play with BB guns responsibly. But when it comes to your child's eyes, if they have any problems, see a pediatric eye doctor right away.
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The occasional “knuckle rub” to an itching eye can feel relieving, especially as allergy season starts. But according to Dr. Mark Mifflin, professor of ophthalmology, chronic eye itching…
October 12th, 2018
Dr. Miller: Rubbing your eyes might feel good, but it is really bad. Is that true? We're going to talk about that next on Scope Radio.
Hi, I'm here with Dr. Mark Mifflin. He's a professor of ophthalmology at the University of Utah. Mark, is rubbing your eyes too much a problem? Can that lead to some bad outcomes?
Dr. Mifflin: Yes, actually, it wouldn't be necessarily intuitive that rubbing one's eyes could result in actual damage to the eye, but it's fairly common.
Dr. Miller: Now everybody at some time has got to be rubbing their eyes. So are we talking about a small number of people?
Dr. Mifflin: Well, we actually see a category of disease, perhaps two, that are related to chronic eye rubbing. Certainly, short term eye rubbing is probably not going to cause a problem except for maybe a very few patients who may have some kind of severe problem underlying their eye condition. But chronic eye rubbing can result in the weakening of the cornea and distortion of the cornea called keratoconus.
And it's often associated with people with very bad allergic conjunctivitis or itchy eyes and, unfortunately, some of these people are so itchy that they nothing feels better that . . . I call it the knuckle rub to the eye. Unfortunately, over time, that can actually weaken and distort the eye.
Another thing that can be associated with chronic eye rubbing is actually laxity of the eyelid. The eyelid can, over time, lose its elasticity and that's a less serious problem, but still not something that we want to happen.
Dr. Miller: So if somebody was rubbing their eyes because they have severe allergies in the spring or even year-round, how do they end up at your doorstep? Is it that their vision is blurred at some point?
Dr. Mifflin: Yes, typically, most of the patients who we feel that actually there is an association between chronic eye rubbing and disease fall into the diagnosis of the condition called keratoconus, which is a structural abnormality of the cornea causing poor vision due to an abnormal shape to the surface of the eye. The shape causes irregular astigmatism, which often cannot be corrected by glasses or even contact lenses in its severe stages.
One really important is that this disease may run in families and, typically, may start even in childhood. So certainly, parents should be advised to try to seek treatment for their young children who may have severe allergic disease and in the case of eyes, typically allergy eye drops are very effective in eliminating itch. And behavior modification just through teaching can help children not rub their eyes.
Dr. Miller: Now, how do you know if you're rubbing your eyes too hard?
Dr. Mifflin: I tell my patients that the amount of pressure needed to wash one's face with a washcloth gently or dry with a towel is the appropriate amount of pressure to put on one's eye. Anything more than that is probably unhealthy for the eye.
Dr. Miller: So if you're rubbing to the point where you're seeing stars, then it's a bad thing?
Dr. Mifflin: It is possible to induce the sensation of light or the perception of light without actually seeing light. And this can occur with the eyelid closed and these little sparks of light are called photopsia and certainly, when one rubs their eye hard enough to induce photopsia, that is not a good thing.
Dr. Miller: And if you do that repetitively, you might end up in the ophthalmologist's office.
Dr. Mifflin: I would say that there is a good chance that if you do it over a period of years, you could end up with even worse than that.
Chronic eye itching can lead to serious, irreparable damage to your eyes.
As scary as it might sound, cornea transplant surgery is actually very safe. Advances in the past 10 years have even allowed eye surgeons to shorten recovery time for some procedures from six months…
March 22nd, 2016
Dr. Miller: Treatments for a damaged cornea. We're going to talk about that next on Scope Radio.
Announcer: Access to our experts with in-depth information about the biggest health issues facing you today. The Specialists with Dr. Tom Miller is on The Scope.
Dr. Miller: Hi, I'm here with Dr. Mark Mifflin. He's a Professor of Ophthalmology here at the University of Utah. I'd like to talk a little bit about what patients might expect if they go in for corneal transplantation or mention of some of the newer technologies related to corneal repair. I know you're an expert in that area so you might just tell us a little bit about that.
Dr. Mifflin: Traditionally, corneal transplantation involves basically replacing the front of the eye, the windshield, if you will, which is the curved clear dome of our eye is the cornea. And so in the traditional technique that is actually cut with a special instrument and replaced with a clear cornea from a human donor cadaver eye. The cadaver tissue is processed through an eye bank and it's very safe. It's much safer than obtaining, for example, a unit of blood from a transfusion.
The tissue is carefully screened and selected and amazingly does not need to be tissue-matched, unlike a kidney or a heart or something like that because the cornea does not have blood vessels and the eye has what we call immune privilege, meaning it's designed or evolved or whatever one believes to not scar and to not create an excessive immune response to injury or surgery.
In terms of some of the newer procedures, within the last ten or so years we have made really amazing advances in just transplanting the part of the eye that is actually diseased. So for example, in a condition called keratoconus where basically the structural part of the cornea is weak and distorted, we can replace the anterior part of the cornea, leaving all of the posterior structure intact. This speeds recovery, decreases the rate of rejection and generally results in better vision.
Dr. Miller: How does one choose between the best surgery or technique?
Dr. Mifflin: Well, typically the surgeon has to kind of choose for the patient, and some of the more advanced techniques are not always possible. There are other diseases where only the very inner layer of the cornea is damaged or diseased, and certainly replacing the inner layer only allows for a very quick recovery. For example, comparing traditional cornea transplantation which might take six months for visual recovery, transplantation of the inner layer or the endothelial keratoplasty that we do now may result in good vision in as little as two weeks.
Dr. Miller: That's a huge difference. How many patients do you think would qualify for the partial thickness corneal transplant?
Dr. Mifflin: It's pretty much become the standard of care. It's not that the traditional technique is wrong, but certainly, for example, in our center here at the University of Utah we always try to do the most advanced technique if we believe that it's going to result in the best outcome for the patient. Not all surgeons are necessarily trained in the most advanced techniques, but certainly these things are literally becoming the standard of care for most patients.
Dr. Miller: Dr. Mifflin, could you talk a little about the durability of the corneal transplantation or the partial corneal transplantation?
Dr. Mifflin: Durability in terms of survival rates and longevity of the graft is actually very good. Graft rejection or failure is quite low, in the range of perhaps as low as 1% for some groups or maybe up to 30%. The most difficult transplant patients that we deal with in terms of making the graft work long-term are children. Unfortunately, children do sometimes need corneal transplantation and the success rate is lower, although sometimes there's no option and corneal transplantation is required to prevent irreversible amblyopia or loss of vision due to basically what in layman's terms is known as lazy eye.
Dr. Miller: So either transplantation technique should result in equivalent duration, longevity of the transplant?
Dr. Mifflin: Yeah, and typically transplants will last anywhere from . . . there have been documented successful transplantations lasting more than 60 years. I've only been practicing for 20 years, but most of my transplants from 20 years ago are still doing fine.
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The eyes stop growing when most people are in their twenties. By then, most people have a stable prescription for contact lenses or glasses if they need it. So if you suddenly notice your vision is…
August 18th, 2015
Dr. Miller: Your vision has been changing rapidly over time, could that be a problem with you cornea? We're going to talk about that next on Scope Radio, and I'm Dr Tom Miller.
Announcer: Access to our experts with in-depth information about the biggest health issues facing you today. The Specialists with Dr Tom Miller is on The Scope.
Dr. Miller: I'm here with Balamurali Ambati, and he's a professor of ophthalmology here at the University of Utah. And we're going to talk a bit about problems that arise with the cornea, which is the foremost part of the eye that faces the environment.
Dr. Ambati: The cornea is the front window of the eye, and it has layers to it. Even though it's very thin, it's only about 0.5mm thick, it has five different layers. And the two most common problems of the cornea are a condition called keratoconus, where the cornea changes from its normal spherical shape into more of a cone-like shape.
Dr. Miller: And it does this over time?
Dr. Ambati: And it does this over time. And usually it does this in the late teenage years, 20s and 30s. So it's a condition primarily of young adults who may know or report that the eye has been unstable and changing. Most people, the eye stops growing by age 20 or 21, and the prescription...
Dr. Miller: Like the bones almost.
Dr. Ambati: Exactly, the prescription is stable. But if someone's astigmatism is changing... Astigmatism is when the cornea is shaped more like a football than a perfect sphere. That can be an early sign of keratoconus, and patients might report needing to go from soft lenses to soft toric lenses, or to hard contact lenses. They might report increasing near-sightedness and increasing astigmatism over the course of years. And this is something that is often undiagnosed till late stages, and so if you do have an unstable refraction or fluctuating vision over time it would be wise to get a cornea scan with an ophthalmologist.
Dr. Miller: What's the difference between, as you mentioned, fluctuating eyesight and progressive worsening of vision? Can you give a definition of that? I know you mentioned that when we talked about keratoconus as a problem.
Dr. Ambati: In fluctuating vision, which can occur especially in Fuchs' Dystrophy, the vision is different between morning and afternoon. In progressive loss of vision over the course of years, people recognize that their vision was not as bad a year ago, or two years ago.
Dr. Miller: The end result of that would bet at some point perhaps the contacts and lenses are no longer are effective in changing the vision, would that be the end stage?
Dr. Ambati: That can occur. The end stage of keratoconus requires what is called a cornea transplant, to replace the cornea with a donated cornea from someone who's passed away and donated their eye. Fortunately now, in the last five years, we've really changed the management of keratoconus to where we can prevent advancement from mild or moderate keratoconus to advanced keratoconus.
With things like intacs, which are rings that are placed inside the cornea that provide structural support, they're essentially an under-wire for the cornea to change it from a cone to a sphere. As well as the emerging technology of cross-linking, where we use a laser to stiffen the cornea and prevent weakening of the cornea.
Dr. Miller: So there are different options in the treatment?
Dr. Ambati: Very much so.
Dr. Miller: So is this a hereditary problem?
Dr. Ambati: It is a hereditary problem with what's called variable penetrance. So if you have a first degree relative with it you're at a higher risk for it.
Dr. Miller: Somewhat like glaucoma.
Dr. Ambati: Indeed.
Dr. Miller: And so if someone has a family history of keratoconus should they seek out an ophthalmological examination and a cornea scan?
Dr. Ambati: I think that would be advisable if they have any significant near-sightedness or astigmatism. And certainly it would be advisable if they are considering LASIK. One of the things that we do at Moran Eye Center is to carefully screen patients coming in for potential LASIK or laser vision correction to make sure they don't have keratoconus or other cornea problems.
Dr. Miller: So just to be sure, if one has keratoconus does it always require a transplant or is there, as you said, variable stages of the development of the problem?
Dr. Ambati: It is definitely a spectrum of progression, and if we can catch it in the mild or moderate stage the goal would be to employ intacs, or cross-linking, or some of these other options to prevent the need for cornea transplant.
Dr. Miller: Are there any other problems with the cornea? I notice since the cornea is the forward facing part to the environment, UV radiation, sunlight, does that affect the cornea more so than other parts of the eye such as the lens or retina?
Dr. Ambati: Certainly patients who are exposed to a lot of sunlight and UV light can develop pterygium, which is a growth on the surface of the cornea.
Dr. Miller: So that's a result of UV exposure sometimes?
Dr. Ambati: Indeed. And the UV radiation can also damage the back layer of the cornea, which is the endothelium. And those cells are actually what's called post-mitotic, they can't replace themselves. And so that can contribute to a condition called Fuchs' Dystrophy, where the cells of the back of the cornea slowly die. And that does require a partial thickness cornea transplant, but not a full cornea transplant, just replacing the back layer of the cornea. And those two conditions, Fuchs' Dystrophy and keratoconus, are probably the two most common causes of needing a cornea transplant procedure.
Dr. Miller: So in summary, would it be advisable if one has a family history of either of these problems to probably seek an ophthalmologic examination sometime in their 20s, or perhaps if they are having changing vision or astigmatism?
Dr. Ambati: Yeah, if you have fluctuating vision it is advisable to see an ophthalmologist at any time of your life. If you have a family history of keratoconus, in your brothers, sisters or parents, I think it would be advisable to see an ophthalmologist in the early or mid 20s. And if you have a family history of Fuchs' Dystrophy, that usually presents itself in the 40s or 50s, so that would be the best time to present.
Dr. Miller: Untreated what would be the end result of this if it continues untreated?
Dr. Ambati: Without therapy you would eventually lose vision, your eye would become cloudy and scarred. But generally people come well before that.
Dr. Miller: Thank you very much.
Dr. Ambati: Thank you.
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According to findings from Dr. Margaret DeAngelis of the Moran Eye Center, the health of your eyes isn’t always dependent on your overall health. She talks about new research that identifies…
June 4th, 2014
Interviewer: Could your body mass index actually affect your eyesight? We'll examine that next on The Scope.
Announcer: Medical news and research from University of Utah physicians and specialists you can use for a happier and healthier life. You're listening to The Scope.
Interviewer: We're with Dr. Margaret DeAngelis. She's at the Moran Eye Institute, also on the Utah women's eye health board. Body mass index, could that actually affect your eyesight? The answer is kind of surprising. Tell me about that.
Dr. Margaret DeAngelis: Yes, it can, and there's been a number of studies that have shown that body mass index, or your weight, can influence eye disease and eye disease progression.
Interviewer: Is this kind of a recent discovery?
Dr. Margaret DeAngelis: No.
Dr. Margaret DeAngelis: But there are recent discoveries that are still being published in how that can influence eye disease. Some of the first studies that were done were done here in the United States by the Klines, Dr. Robert and Barbara Kline, showing this influence with age related macular degeneration which is one of the leading causes of blindness, and it shows that higher body mass index, or the heavier you are, increases your risk for this eye disease. My group recently recruited a population from east Timor which is near Indonesia. This is a population that gets no blinding eye diseases.
Interviewer: Is that unusual in a population?
Dr. Margaret DeAngelis: Yes.
Dr. Margaret DeAngelis: They have a very poor diet. They eat high fat meat, goat meat, and no leafy green vegetables.
Interviewer: OK, up until this point, we were told...
Dr. Margaret DeAngelis: Yes, I know we were told to eat leafy greens, but their B.M.I. is 18.5.
Dr. Margaret DeAngelis: And remember a healthy B.M.I. is between 21 and 25, less than 25. An obese is 30 or greater.
Dr. Margaret DeAngelis: These people have a B.M.I. of 18.5 which the World Heath Organization puts as the thinnest population in the world so this is not in Africa, this is in Timor. Now we're trying to figure out why they get no blinding eye diseases of the retina, the back of the eye, which is like the camera in the film, the film in the camera excuse me. And even though they have some protective alleles or variance in genes that could maybe predict that they're not getting eye diseases, that doesn't explain the full story. We think that it is these environmental factors as well, and we think that it may have to also do with their very low body mass index so we're exploring that element further.
Interviewer: So traditionally diet matters, but their diet should give them eye disease. Do they smoke?
Dr. Margaret DeAngelis: Yes.
Interviewer: And they smoke as well.
Dr. Margaret DeAngelis: They smoke cigarettes.
Interviewer: And that is known to help...
Dr. Margaret DeAngelis: We've shown that as a risk factor for many eye diseases.
Interviewer: And I would imagine... What's their access to healthcare like?
Dr. Margaret DeAngelis: Very poor.
Interviewer: Yeah, but yet... So wow, this must be kind of exciting to have this population.
Dr. Margaret DeAngelis: Yeah, and we don't... So we think it's a combination of genetics and a low body mass index.
Dr. Margaret DeAngelis: In this particular population.
Interviewer: Is that something that could be scaled do you think? This information you're going to gain, is it going to help combat eye disease through the rest of the population?
Dr. Margaret DeAngelis: Well, that's the idea. That's why we study populations throughout the world because we hope that it would have global applicability to other ethnicities.
Interviewer: And when can you talk about... I feel like I've gotten halfway through a great book and now you can't tell me the end.
Dr. Margaret DeAngelis: Well, we're also at the same time trying to discern the ethnicity of the Timor race because nobody's quite sure what their ethnicity is because they've been at times settled by the Portuguese, the Indonesians, and a mixture of other populations that have come in and tried to colonize them through the last century.
Interviewer: So even that's a little confusing.
Dr. Margaret DeAngelis: So that's confusing so we're trying to figure out their genetic make up at the same time.
Interviewer: Gotcha. When will we be able to hear the rest of your story?
Dr. Margaret DeAngelis: We're hoping to publish this in the next two months.
Interviewer: Gotcha. And the results, I know you probably can't give me a sneak preview but what are the implications going to be do you believe?
Dr. Margaret DeAngelis: The implications are going to be that all these diseases are a combination of genetic and environmental factors and how the two interact together to manifest disease or protect us from disease so if we can do things to prevent the disease in the environment like not smoke, eat healthy. If we eat healthier, hopefully that will lower our B.M.I. because certainly the way you control your weight is also, we have a predisposition to that, so anything we can do to modify our environment to help us would also help us reduce our risk of getting these blinding diseases and especially if we're women.
Interviewer: Yeah, I'm really trying to wrap my head around this. It seems to me as a non-scientist that wow, the B.M.I. looks like it could be the major factor in this particular study.
Dr. Margaret DeAngelis: Yes, for this. That's what was surprising because we've compared this, we have several other populations part of this study. We have a group from central Greece. We have a group from Boston. We have a group from northern Italy, and a group from South Korea. All with different B.M.I.s closer to what we find here in Utah.
Interviewer: And are you watching the graph go up as B.M.I. goes up?
Dr. Margaret DeAngelis: Yes, our heaviest population is from Boston, where I moved from before I came here to Utah.
Interviewer: Well, you look fabulous by the way.
Dr. Margaret DeAngelis: You're kind.
Interviewer: What take away would you like for our listener to have after hearing this discussion?
Dr. Margaret DeAngelis: To try to eat healthy, to exercise.
Interviewer: And watch that B.M.I.
Dr. Margaret DeAngelis: And watch that B.M.I. definitely.
Announcer: We're you're daily dose of science, conversation, medicine. This is The Scope, University of Utah Health Sciences radio.
Newborns can’t always control their developing eyes and sometimes go cross-eyed. But if your child is older than two months and you notice her or his eyes looking in different directions,…
January 18th, 2021
Your child's eyes, when do you think they need glasses? When do you think something's wrong? Is this something you can pick up or something your pediatrician needs to pick up? Eye problems, we are going to discuss them today on The Scope.When Should Your Child Start Having Vision Exams
So when do you start worrying about kids: their eyes, glasses, things like that? The good news is that for most kids, they don't start needing to wear glasses until they are about elementary school age. And you notice they are squinting when trying to do their school work or they have to get moved up to the front of the classroom because they can't really see that well, or complaining of really bad headaches after reading. That's another sign that your child might need glasses.
We actually start vision exams at three and your child should have a vision exam by your pediatrician every year at a well visit starting at age three.
They have different eye charts. You can do letters or you can do ones that just have pictures and the kids can tell us what pictures they are until they are able to learn their letters.
But what about littler kids? What do we start looking for in littler kids when we start shining those lights in their eyes during exams? Well, we are looking for different things in terms of making sure that their eye balls are focusing properly.
So one thing that a lot of people start asking about is, "My newborn baby looks cross-eyed." Well, your newborn baby can't focus their eyes very well and they don't have good control over their eye muscles until they get about two months old. After that, you should be able to notice your child is able to move their eyes in the same directions.
What if your child can't? What if one eyeball is looking down or up or to the left or to the right and the other eyeball's looking forward? That's different.Strabismus in Young Children
Strabismus is the fancy name for that. That is where your child's eyes point in different directions. One is pointed straight ahead, the other is pointed in a different direction. Sometimes you get what's called "walleyed" where one or more of the eyes turn outwards towards your child's ears. And then you got cross-eyes, which means they are looking towards your nose.
But both of them are forms of strabismus. Strabismus happens when the six muscles that work together to move your child's eyes don't work together. It can be caused by a problem with the muscles, with the nerves, or problem in your child's brain, but most people with strabismus are born with it and it does tend to run in families.
So when your child's eyes don't tend to work together to look at an object, the brain pays attention to the image from only one eye and ignores the image from the other eye. So what you need to do is to watch: does this happen more when your child is tired or sick? That's usually when we pick this up. When you can see they're getting tired and one of the eyes is just kind of wandering away, it's time to mention that to your doctor.Methods for Testing and Treating Strabismus
A good thing is we don't normally see your children when they are tired and tiredness is usually when it happens. Take a picture. That's great because you'll often notice to the red eye reflex, you know when you take a picture and you've got to use that red-eye reduction thing on Photoshop because their child looks like they've got bright red eyes? Okay, those bright red eyes--that's actually good. That's looking at the back of the eye. It's called the retina, and you're looking at all the blood vessels in the back.
So that's what we are looking for and if we find it, what do we need to do? Well we usually refer to an eye doctor because they will be able to help with actually managing this. They usually start with patching, or sometimes using eye drops, depending on the age of the child to force your child's brain to pay attention to the weak eye. And then the weak eye works harder and develops more normally.
The eye doctors can tell you about some different eye exercises and what that does is that also helps with helping the eyeballs focus at the right spot. Unfortunately, a lot of the forms of strabismus do not improve with eye exercises, but it's always something that they try.
What's the other kind of thing that we hear most with the eye balls not focusing right? Lazy eye. We hear this a lot too. Lazy eye, the fancy name is amblyopia, and that's also where the eyes just don't go in the right spot.
It works the same way in the fact that the brain is getting images from the good eye and not the bad eye and this is more due to the eye ball shape and also the eyeball muscles. So there's more things going on to try to cause amblyopia.
Again, just like the strabismus, the treatment for lazy eye starts with patching, to make the weaker eye do a little harder work. And then if the eye patches don't help, then you move to glasses.
Helping Your Child Love Their Glasses
So you've tried the patching and the eye doctor says it's time for glasses. So how do you help your child adjust to wearing glasses? Well, that can be hard.
You know, it's hard to transition to glasses, but if you help your child understand why they need to wear glasses, they'll be more likely to wear them. Make sure that your school-age kid understands wearing their glasses will help them read. If they get headaches from their vision problems, it will decrease their headaches, and actually a lot of people wear glasses, so it's not like they are alone. Point out people who do wear their glasses, because then you'll be able to say, "See, look at that person wearing their glasses, look how good they can see."
Another thing, have your child involved in picking out what kind of frames they like. Have them pick their favorite color, what matches with their wardrobe, some of them have characters on them that they like. Make it something so it's more of a fashion statement than a medical device.
Again, you should also remember to keep safety in mind. Kids will break their glasses, I will guarantee you that one, so make sure that their lenses, instead of being made with glass, are made with something called polycarbonate. It's a safe material. It's lighter than other lenses and if your child plays sports, you can also get sports goggles made with the same material that will help protect them against eye injury.
And make sure that your child is getting regular appointments with the eye doctor to make sure their prescriptions are up to date. Again, we check their eyes at every well visit, so we do every year and if we notice that their vision is off with their glasses on, then we can even say it's time, even though you saw the eye doctor six months ago, something has changed with your child's eyes and you should go ahead and get your eye doctor to check the prescription again and make sure it's the right one or that they don't need a different prescription.
So the bottom line is if you think you notice something wrong with how a child is looking at things, go ahead, have your pediatrician take a look at them. We can check out the eyes. We can do a vision exam, see how they are looking, if they are old enough to do a vision exam. The main thing is that for children, their eyes are still developing, so the sooner you get an eye problem identified and corrected, the better it will be for their overall vision health.
How to tell if your child’s eyes are developing in a healthy way.
Women’s eyes are different from men’s, which can lead to diseases and conditions that are more common in women. Dr. Kirtly Jones talks with Dr. M.E. Hartnett from the Moran Eye Center…
May 15th, 2014
Dr. Kirtly Parker Jones: How are women's eyes different from men's eyes? We know that women's eyes are much more beautiful, but there may be some other differences. And what do women need to know about their family's eyes? Today on The Scope, we're going to be talking to Dr. M. E. Hartnett from the Moran Eye Center. This is The Scope from the University of Utah, and this is about eyes.
Announcer: Medical news and research from University of Utah physicians and specialists you can use for a happier and healthier life. You're listening to The Scope.
Dr. Kirtly Parker Jones: So with us today is Dr. M. E. Hartnett from the Moran Eye Center who is a specialist, an ophthalmologist, with a very particular interest in women's eyes. Welcome this morning.
Dr. M. E. Hartnett: Thank you very much. It's nice to be here.
Dr. Kirtly Parker Jones: I would say, having taken care of women all of my professional career, that I do pay attention to women's eyes. But, in fact, women's eyes may not be the same as men's eyes in terms of the diseases. Can you talk a little bit about men's eyes and women's eyes and the differences?
Dr. M.E. Hartnett: Sure. Women tend to have certain eye conditions more often more commonly than men do. Some of these examples include dry eye, that is much more common in women. And many of the age-related eye diseases that occur in both sexes, but this is thought to be partly because women live longer than men.
Dr. Kirtly Parker Jones: What about eyes and pregnancy? I've certainly had women say, "Oh, you know, my contacts just don't work since I got pregnant."
Dr. M. E. Hartnett: Right. Those are very important issues. So it's thought, especially in the third trimester, that there may be some swelling that occurs in some of the layers of the cornea and that this may change the visual acuity. It also may change the feel of the contact lenses. There can be dry eye more commonly in pregnancy as well. One of the things to remember is if a woman is pregnant, it's probably not a good time to get refractive surgery because it may change after pregnancy, the refraction.
Dr. Kirtly Parker Jones: Refractive surgery. Tell me what that is in English.
Dr. M. E. Hartnett: So that could be something like LASIK or PRK, photorefractive surgery or keratectomy.
Dr. Kirtly Parker Jones: Well, most women are pretty careful about not having . . .
Dr. M. E. Hartnett: Right.
Dr. Kirtly Parker Jones: . . . unnecessary surgical procedures when they're pregnant, but that's a good thing to know. How about at menopause? Clearly, that's where my patients complain of both dry eyes and dry mouth. But tell me about some things that might happen in menopause or aging and what you think might be related to hormones and what might be related to just getting older.
Dr. M. E. Hartnett: So certainly dry eye is a big concern for women, and there's recent research that suggests it has to do also with not having as much androgens, believe or not, and some of the lines of evidence are suggesting looking for treatments related to that. But besides dry eye, age-related macular degeneration is seen in women, and this may be because women live longer than men. And in some situations, cataract may be more commonly seen in women.
Dr. Kirtly Parker Jones: What can women do about dry eyes? Should they just get some drops or should they throw away the drops that they've had for two years or . . .
Dr. M. E. Hartnett: Yes.
Dr. Kirtly Parker Jones: . . . how long should you keep drops? What kind of drops? Are there prescriptions for dry eyes?
Dr. M. E. Hartnett: Yes. Okay. So all these things. There are artificial tear supplements. These are just natural tears that you can buy over the counter in the drugstore. But also bathing your eyes, using lid hygiene. You know, we bathe every day, but we don't often bathe our eyelids. And so warm compresses can help to promote the blood supply to the lids and the meibomian glands, which produce an oily substance that helps to reduce the evaporation of the tears.
Dr. Kirtly Parker Jones: What about soap? We're not supposed to put soap on our eyes, are we?
Dr. M. E. Hartnett: Well, no. No, that's true, but you can use baby shampoo, and there also are individual packets that you can use to clean your eyelashes of any debris and then be sure to rinse it free.
Dr. Kirtly Parker Jones: Yeah.
Dr. M. E. Hartnett: The other thing . . . sometimes if that's not enough, there are prescriptions that can be used for dry eye. And there also are punctal plugs that can keep the tears around longer, but that you would need to see an ophthalmologist for.
Dr. Kirtly Parker Jones: Well, are there any behaviors that make dry eyes worse?
Dr. M. E. Hartnett: Yes. Whenever anybody focuses on something to read for a long period of time or on a computer screen, there can be evaporation of the tear film, and that makes a dry eye worse. So I often recommend that people use a tear supplement right before planning on, you know, to be at a computer screen or working for a long period of time and then to supplement as needed. There's some evidence that alcohol in extensive amounts can also increase the symptoms of dry eye.
Dr. Kirtly Parker Jones: Well, what should women know about their family's eyes? We know women are really in charge of their family's health. So what kinds of things would happen in their kids or in their husband, or they're often caretakers for their parents or parents-in-law. So give me some things that women should know about their family's eye health.
Dr. M. E. Hartnett: Women are often the caregivers, as you say, and so if we can educate women about not only their own eye health but everyone's eye health, we can promote better prevention of eye diseases in some cases. So for children, let's start there, I think probably one of the most important things is to promote protective eyewear in sports or any type of activity where there can be knives like carving pumpkins, or fists or balls coming at the child. So protective eyewear in all sports is very important.
Dr. Kirtly Parker Jones: How early should kids start wearing sunglasses? Babies should wear sunglasses? Five-year-olds should wear sunglasses?
Dr. M. E. Hartnett: I usually think that when a child is old enough to walk around and be outside, that might be a reasonable time. When they're babies, many times they have their eyes closed or they have some kind of shield over their head, and a hat is a very good way to reduce the amount of light going to the eyes. But sunglasses are particularly important in conditions like if you're on a ski slope. Or if you're in a boat, the water, the reflected light can also be damaging to the eyes.
Dr. Kirtly Parker Jones: So how often should you get an eye checkup? When someone's healthy, let's just take women and mom, how often do you think they should get their eyes checked?
Dr. M. E. Hartnett: Certainly with any symptoms of distortion or changes in visual acuity, we generally recommend about every couple of years and to be checked also for glaucoma.
Dr. Kirtly Parker Jones: Okay, now let's get to what I really want to talk about, and that is eye makeup. So tell us a little bit about the dos and don'ts of eye makeup really in critical importance for your eye.
Dr. M. E. Hartnett: Okay, I'll do my best on this. So, you know, I think for eye makeup, it's the same kind of thing that I would say for eye drops. Don't touch. You know, be careful. Think of cleanliness when you use your eye makeup. Don't use eye makeup that's a year old. You know, after a period of time, get new makeup. Clean your eyelashes at the end of the day. You can use a warm wet washcloth and just kind of clean off any of the debris or the makeup. And then in the morning, that's also helpful as a prevention or as a way of treating the symptoms of dry eye as well.
Dr. Kirtly Parker Jones: So these are the artificial lashes or these are the drops that make your eyelashes grow longer?
Dr. M. E. Hartnett: So these are the artificial lashes. The drops that make the eyelash grow were developed based on a glaucoma medication. It may lower intraocular pressure. If you use it only on your eyelashes, one of the concerns is that it can also cause staining or discoloration of the lids and also of the conjunctiva as well, so . . .
Dr. Kirtly Parker Jones: The white part.
Dr. M. E. Hartnett: Yes.
Dr. Kirtly Parker Jones: So it might make the white part turn color?
Dr. M. E. Hartnett: Darker.
Dr. Kirtly Parker Jones: Do you know how often does it happen? One in ten or one in a hundred? Have you seen very many ladies who have their sclera, the white part, get colored?
Dr. M. E. Hartnett: No, I don't. But I also . . . you know, my practice is mainly in retina, so I probably don't see that many people who use Latisse, but those are the concerns.
Dr. Kirtly Parker Jones: They all came to me, and they looked fabulous. But we should make people aware that . . .
Dr. M. E. Hartnett: That it can happen . . .
Dr. Kirtly Parker Jones: First of all, it's prescription only.
Dr. M. E. Hartnett: Right. And I don't think it's common. It's more what we read . . .
Dr. Kirtly Parker Jones: It's expensive.
Dr. M. E. Hartnett: Is it?
Dr. Kirtly Parker Jones: Yeah.
Dr. M. E. Hartnett: So it's more what we read in the literature, but it is something that can happen, that you can get pigmentation.
Dr. Kirtly Parker Jones: And eyelash extenders can, when they stick the little extra eyelashes on for a party or for a wedding or something, but people do it all the time, it make actually . . .
Dr. M. E. Hartnett: Yeah, if it's kept on for a long time, it may be associated with that.
Dr. Kirtly Parker Jones: Okay. Well, anything else women should know either about their eyes or their family's eyes?
Dr. M. E. Hartnett: You know, a lot of the things that are healthy for your eyes are healthy for your heart. So things like having a diet rich in green and yellow and orange vegetables and maybe eating fish three times a week, those things can be healthy. Avoid smoking. Smoking is bad for your eyes. It increases the risk of cataract and of age-related macular degeneration. And then to protect your eyes from light, that may be useful, but also whenever you're involved in a sport or any activity where you could have a ball or something come to your eye.
Dr. Kirtly Parker Jones: Well, I actually saw on a handout from the Moran Eye Center that fish oil as supplements may actually help dry eyes. Is that true? Do you think there's much evidence of that?
Dr. M. E. Hartnett: I'm not aware of experimental evidence that has absolutely shown that or flax oil, and I've recently asked my [inaudible 00:11:49] colleagues about that. As far as a clinical trial that was done where they had placebos and it was randomized, I don't think there's been that kind of evidence. But there's been anecdotal evidence that it may be useful. And since there's not a lot of harm to it, it may be helpful.
Dr. Kirtly Parker Jones: So protect your eyes from trauma. Protect your eyes from too much bright light. A good diet for your heart is a good diet for your eyes. And don't use old makeup. Does that sum it up?
Dr. M. E. Hartnett: I think that sounds good.
Dr. Kirtly Parker Jones: From The Scope here at the University of Utah Health Care, thank you.
Dr. M. E. Hartnett: Thank you.
Announcer: We're your daily dose of science, conversation, medicine. This is The Scope, University of Utah Health Sciences Radio.
Many have thought that men were the ones who generally get macular degeneration, but quite the contrary. Studies have shown that women are more likely to have loss of eyesight due to aging. Dr.…
April 17th, 2014
Interviewer: Are women more likely to get macular degeneration than men? We'll examine that next on The Scope.
Announcer: Medical news and research from University of Utah physicians and specialists you can use for a happier and healthier life. You're listening to The Scope.
Interviewer: Dr. Margaret DeAngelis is at the Moran Eye Institute. She also is on the Utah Women's Eye Health Board. Let's talk about women and macular degeneration. Maybe I'm wrong on this. I kind of thought generally it was men that got it, but that's not the case.
Dr. Margaret DeAngelis: No. Women, it's actually been shown, in two studies done ten years apart from each other in what's called a meta analysis where you combine all the studies that are out there, that women are at higher risk of getting age-related macular degeneration than men. Now, why is that you might ask.
Interviewer: Why is that?
Dr. Margaret DeAngelis: Why is that? Well, we're not sure. So some people, some groups have looked at that it may be due to hormone replacement therapy or estrogen that increases one's risk so certain groups are studying that. Some groups have found an association while other groups have not so there's a lack of consistency from study to study. So we still don't have the answer for why women are at risk. Some people have argued that maybe women are more inclined to join studies, to sign up for studies, but that hasn't been the answer either. Or maybe women smoke more cigarettes or these other things, but after you've controlled for all these external factors, there hasn't been the answer there so we're still looking for the reason for why women are at a slightly higher risk. And we do know that genetics plays a strong role but that is equally so in men and women so what that means is if you have a first degree relative, either a parent or a sibling, a brother or sister, with age-related macular degeneration, you're at six to twelve times higher risk than somebody from the general population of getting age-related macular degeneration yourself. So it's highly recommended if you have a family member with age-related macular degeneration you should get your eyes checked age 50 and over at least once a year.
Interviewer: Six to twelve times more. Put that in perspective for me in relation to other things like smoking which has also been shown to cause macular degeneration or a relationship. How much does that increase my risk?
Dr. Margaret DeAngelis: It depends. Different groups including our group have shown that that's based on the number of pack year so if you smoked a pack of cigarettes a day for one year, the more cigarettes you've smoked or pack years your risk increases exponentially, and smoking by everybody has been shown to increase risk.
Interviewer: Got you.
Dr. Margaret DeAngelis: Please understand that that increases your risk, you're susceptibility. It doesn't mean that you will get the disease because you have a first degree relative or you smoked cigarettes. It means your susceptibility has increased. That's a difference between susceptibility and causality.
Interviewer: Is the direct relative susceptibility? Are we talking susceptibility if I have a first...?
Dr. Margaret DeAngelis: We're talking it increases your susceptibility, correct.
Interviewer: How significant is six to twelve times more susceptible? Put that in a perspective for me. Is it like, "Oh wow, that's a lot. That's frightening. Like you should go see the eye doctor right now."
Dr. Margaret DeAngelis: Six to twelve is a lot. If you're 50 years old and older, the American Academy of Ophthamology recommends that.
Announcer: We're your daily dose of science, conversation, medicine. This is The Scope, the University of Utah Health Sciences radio.
Sometimes when you pay the doctor a visit, he’ll hold a little flashlight up to your eye and joke that he's looking into your soul. But what are doctors really trying to find when they…
October 31st, 2018
Interviewer: What is a physician trying to find when they look into your eyes? That's next on The Scope.
Interviewer: A lot of times on TV you'll see, or if you've ever even gone to the doctor yourself, they got the little flashlight and they start looking in your eyes and I've always wondered, what are they looking for? We're with Dr. Troy Madsen, emergency medicine at the University of Utah Hospital. In your particular situation, in the emergency room, if you get out the light and are looking into somebody's eyes, what are you trying to figure out?
Dr. Madsen:It's going to vary depending on who I'm looking at. But it's just part of a standard physical exam that when I see a patient I will document something that says on the chart, PERRL. What that stands for is the pupils are equal and reactive to light. And the pupil is the black part of your eye so I'm looking at that. I'm looking at are they the same size, and when I shine a light into it does it close? Does it react to that light and constrict like you'd expect?
And the relevance of that kind of varies from person to person. I mean, in the average person, it's not really a big issue. I can just kind of look at you and look at your eyes and say, "Oh, yeah, they look fine." But in different situations I'm looking for different things.
So if someone comes in after a head injury and they've been in a trauma, I really want to get a good look at those eyes to make sure the pupils are equal, because if they're not, that can be the sign of potentially something very serious in the brain that is affecting the brain's ability to send that message to the eye to have that pupil squeeze down and constrict. That can be a sign of some kind of bleeding in the brain, which is the more serious thing I'm really looking for there. So that's kind of the number one thing I'm looking when I do that.
The other thing I'm looking for often times, and this is a tough thing to do sometimes in the E.R., but sometimes I'll try and get a look at the back of the eye at what's called the fundus of the eye, called a fundoscopic exam, where I'm looking at optic nerve, so where the nerve inserts into the back of the eye. And if a person has a lot of pressure in their brain from bleeding in the brain or something like that, I can actually see swelling on that nerve. So that for me says this person potentially has something that's raising the pressure in their brain, like bleeding, a tumor, something like that. So that's kind of the other big thing I'm looking for when I do that.
Interviewer: All right. So two reasons you would look into somebody's eyes, none of them related to the eyes. Are there things you're looking in somebody's eyes for if they have an eye issue?
Dr. Madsen: Oh, certainly. Yep. And that's one of these things where if someone . . . and usually there I need to have something that's going to push me toward that, someone saying I'm having a lot of pain in my eye or I feel like just something is scratching my eye. And there, I'm going to do an even more detailed exam. I'll kind of flip their eyelid out, kind of like kids do to gross people out. So I'm doing that to look for some kind of piece of dirt or a splinter or something like that in the eyelid itself that's scratching the eye.
Interviewer: And that actually happens?
Dr. Madsen: It does.
Interviewer: That's gross.
Dr. Madsen: Oh, it does, yeah. And then I'm looking at the cornea, so the front part of the eye and sometimes you'll look at that, you'll see little pieces of metal that are stuck on there, say, from a welder or someone who is working with metal. I can see that. Sometimes I'll see a rust ring there. You can actually see rust on the eye itself from a piece of metal that may have been there and then came off.
And then I'll do a very detailed exam, something called a slit lamp exam. It's basically a microscope where I'm sitting down kind of with this microscope that focuses right on the person's eye. I'm looking in the front part of the eye for any, what we call just any cells, any inflammation there that would suggest a lot of irritation in the eye itself. And then I actually put a little thing on the eye that's kind of like a dye that will light up to look for any scratches.
Dr. Madsen: Which is what's called a corneal abrasion.
Dr. Madsen: So lots of different things you're looking for there on the eye.
Interviewer: So any of these tricks that people can try at home? For example, taking the flashlight and if a person's pupils aren't dilating properly, knowing that you might potentially have an issue?
Dr. Madsen: Yeah, and that's something you can do. If you've had a head injury and you feel comfortable looking at that, you can even look at your own eyes in a mirror and just say, "Do my pupils look like they're the same size?" If you have a family member who's had a head injury, you can shine a light in their eye, just watch, does that pupil squeeze down? And at the same time that one squeezes down does the other one do the same thing? And if it's not, those are concerning things.
Interviewer: Is time of the essence for any sort of eye injuries, generally?
Dr. Madsen: It is, yeah. So time is really of the essence for eye injuries if you actually have something that cuts the eye open. So if we have what's called an open globe injury, so the globe being the eye, the big eyeball, if something actually gets in there and cuts that where there's fluid coming out, time is absolutely of the essence. You need to get to the emergency department. We call our ophthalmologist and they'll oftentimes get you to the operating room to repair that emergently.
Interviewer: All right. Any final thoughts on the eyes?
Dr. Madsen: Final thoughts on the eyes. Obviously, a lot of these things are things we are going to need to do in the E.R. but, like you said, you can kind of take a look at the eyes at home. And certainly if anything comes up, make sure you come in so we can evaluate you further.
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