Could you have a cone in your cornea?

Keratoconus bay eye care

Have you or someone you know had problems with blurry vision, even with the help of glasses? You may have undiagnosed keratoconus, a condition more common in New Zealand than anywhere else in the world. Keratoconus occurs most often in people of Maori or Pacific Island descent, those with a family history of the condition, and those who are prone to eye-rubbing, often due to allergies.

Using corneal topography to detect keratoconus.

Keratoconus means ‘cone-shaped cornea’ and occurs when the front layer of the eye becomes thin and bulges into an irregular shape. This may only be detectable with specialist optometry equipment that can map the shape of the eye. Even with glasses vision may appear blurred, ghosted or double, and is often worse in one eye that the other.

Generally the best vision for someone with keratoconus can be achieved with the use of specialty contact lenses. The newest type of contact lens for keratoconus, a scleral lens, offers more comfort, stability and quality of vision than traditional smaller rigid lenses or soft lenses.

Normally keratoconus starts in the teens, and tends to get worsen with age. Eventually this may lead to scarring and poor vision, meaning a corneal transplant may be required. These days a special strengthening procedure called corneal-crosslinking can be performed to prevent further keratoconus progression.

A scleral lens for providing clear vision for someone with keratoconus.

A scleral lens for providing clear vision for someone with keratoconus.

If think you or someone in your family may have keratoconus see Bay Eye Care as our optometrists specialise in managing the condition and have access to all the best tools and treatments for optimal results. Remember that early diagnosis is key to ensure the best quality vision is maintained into the future, so have any children and younger relatives screened for the condition if they are in the high-risk groups mentioned above.

Watery eyes? Ironically you may have dry eye disease!

As we head into winter it is not unusual to notice some extra ocular moisture when outside on a crisp morning. However if your peepers are welling up throughout the day, even when not watching ‘The Notebook’, then you may have an eye problem to blame.

The puncta: Our eye’s drainage channel. This can block up downstream and cause watery eyes.

Tears drain out of the eye through two holes, called puncta, at the inside corner of our eyes. These channels can block up due to a build-up of debris, infection, or age-related narrowing. Just like plugging a bath and filling it up, eventually your tears will spill out onto your cheeks. If the drainage holes flop away from the eye when your lids become loose with age this can also lead to bothersome watering. Our optometrist Mr Alex Petty can perform a treatment called lacrimal lavage to flush out any blockage, or recommend alternative treatments to help any faulty ocular plumbing.

Hayfever sufferers will be well aware how watery their eyes can become when their allergies flare up. Many people are not aware they have ocular allergies, and can help their symptoms with appropriate anti-histamine eye drops. These are best prescribed by your optometrist, as some allergy drops available in pharmacys do not reduce the action of the histamine molecule which cause the symptoms of allergy, or can lead to rebound redness of the eyes when the drops wear off.

Watery Eyes June 2019 Bay Eye Care.jpg

However the most common cause of a watery eye is in fact dry eye disease, which can affect ~20% of kiwis. When the corneal nerves get irritated from dryness, the lacrimal gland can overcompensate and flood the eyes with unstable tears, blurring vision. In some people this can occur without the classic dry eye symptoms of red, gritty and sore eyes. Dry eye disease has a range of causes and requires a thorough examination to determine the best management. At Bay Eye Care we offer a comprehensive dry eye work-up, using cutting edge diagnostic tools to evaluate your eye condition.

If symptoms are bothering you visit our therapeutic optometrist Mr Alex Petty, and take control of those troublesome tears in your eyes!

Have your child’s vision assessed to detect hidden eye problems

With Easter holiday’s coming up now is the perfect time to make sure your little one does not have an eye condition that may be affecting their learning, or possibly causing permanent vision loss. These conditions can be present without any symptoms or complaints from your child, so all too often will go undetected for years.

Correction of children’s focusing problems with glasses can improve concentration at school and prevent permanent vision loss caused by amblyopia.

Correction of children’s focusing problems with glasses can improve concentration at school and prevent permanent vision loss caused by amblyopia.

Common eye conditions that can affect children includes hyperopia and astigmatism, which are different errors of the eye’s focus. Hyperopia, also know as long or far-sightedness, means that excessive effort is needed to focus on reading and near-work, sometimes leading to fatigue, headaches, inattention at school and behavioural problems.

If just one eye has a focusing error this can affect how well that eye develops its connections with the brain. If undetected this can lead to permanent vision loss later as an adult, even with correction with glasses or contact lenses. This is known as amblyopia. Therapy to improve amblyopia is possible if it detected early enough, generally before the age of 7-8 years.

Even if our eyes are seeing well there can also be issues with co-ordination and accuracy of eye alignment and focus. This to can lead to discomfort and fatigue when using the eyes for reading or school work, double vision, and even amblyopia in some cases.

Early detection of these hidden eye conditions gives the best chance of improving sight. If your child has not seen an optometrist before they started school arrange a thorough vision assessment with our therapeutic optometrist Mr Alex Petty at Bay Eye Care this Autumn before it’s too late!

Be on the look out for buzzing insects, blobs of ink and shooting stars in your vision!

These symptoms, known as ‘flashes’ and ‘floaters’ can be a sign of an ocular emergency. ‘Floaters’ are drifting shapes in the vision, which people describe as buzzing insects, drifting spots, or blobs of ink or jelly. ‘Flashes’ are light effects that appear briefly, and can look like a shooting star or arcs of light, generally in the peripheral vision. For most people these symptoms come on quickly, generally just in one eye, and are more obvious when looking at a blank background like the sky or a wall, or when the light is dim.

A representation of the symptoms of floaters and floaters.

The cause of these symptoms is because the vitreous humour, the collagen gel that fills the eyeball, becomes more liquefied as we age, and eventually collapses. This process is called a posterior vitreous detachment. Clumps of vitreous debris can form that cast a shadow on the retina – creating ‘floaters’. When this gel gently tugs on the retina (the light sensitive nerves of the eye) a signal is created which the brain sees as ‘flashes’. These symptoms eventually decrease with time, generally because gravity drops the debris out of your line of sight, or more commonly the brain learns to ignore them! This can take many months, and sometimes they may never disappear completely.

Diagram of the eye showing the vitreous humour, the jelly that fills the eye. Sadly if the vitreous pulls on the retina causing a tear or detachment it can be anything but humorous.

Unfortunately approximately 1 in 10 people that experience these symptoms suddenly will have more serious issues in the eye including holes, tears or detachments of the retina. These conditions are more common in people with short-sightedness, or myopia (one of the reasons we try to limit the level of myopia in our kids as they grown older - more info here) and require urgent surgical repair to avoid the risk of permanent vision loss. Results following surgery are better with early detection.

Our optometrist Alex has been unfortunate enough to have three retinal detachments already in his life, but fortunately these were picked up very early and emergency surgery was able to save his sight. The only symptoms Alex noticed were subtle arcs of light in his peripheral vision the day before. The next day he started losing peripheral vision in one eye so rushed himself to the hospital knowing that due to his high myopia that it was highly likely he had a retinal detachment!

So if you notice new ‘floaters’ or ‘flashes’ see Alex at Bay Eye Care promptly for a thorough retinal examination. This will done with the help of eye-drops that dilate your pupil to allow Alex the best view of the peripheral retinal areas. If retinal damage is found then Alex can swiftly arrange a referral to his eye surgeon colleagues for treatment.