ASTIGMATISM
Astigmatism occurs when the cornea is not uniformly shaped (football shaped rather than soccer ball shaped). Light will focus in two or more focal points causing blurry vision. Astigmatism is often present along with myopia and hyperopia. Most people have some degree of astigmatism.

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BLEPHARITIS
Blepharitis is a common infection of the eyelids.The severity may change over time. In some cases, the symptoms can disappear for long time periods, months or years, before returning.

Blepharitis can be controlled by careful cleaning of your eye lashes every day. This can be accomplished with warm water and mild shampoo (such as baby shampoo). Medication is of secondary importance in the treatment. In some cases eye drops or ointment will be prescribed to be used along with the daily cleansing. Daily warm compresses are a valuable adjunct

Seborrhea is secondary to overactive glands causing greasy, waxy scales to accumulate along the eyelid margins. Seborrhea may be a part of an overall skin disorder that affects other areas. Hormones, nutrition, general physical condition and stress are factors in seborrhea.

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CATARACT
Cataracts occur as part of the normal aging process. Studies show that virtually everyone over age 65 has some cataract formation in their eyes! Cataracts can severely reduce vision. Cataracts are a leading cause of blindness in the world. Fortunately cataracts can be easily treated. Modern surgical techniques, intraocular lens implantation and "same day surgery" make cataract surgery safe, fast and effective.

A cataract occurs when the normally clear lens of the eye becomes cloudy. As the cataract develops, the cloudiness no longer allows the lens to properly focus light on the back of the eye. This unfocused light causes the vision to look blurry or hazy.

Treatment is indicated when decreased vision affects your everyday activities or hobbies.

Cataract surgery, in which the cloudy lens is removed, is now a very successful procedure. The most widely used technique is called phacoemulsification. A very small incision is made and a tiny ultrasonic probe is used to break up the cataract and gently suction it away. A clear membrane is left in your eye where an intraocular lens is placed (IOL). This IOL is necessary to replace the focusing power of the natural lens, which was removed. With insertion of an IOL, there is little need for thick cataract glasses and contact lenses that were used years ago.

Small incision surgery has several benefits. The procedure is very quick and painless, sometimes taking less than 20 minutes. Also, recovery time is short. The results of the surgery are almost immediate. Most people notice an improvement in their vision soon after surgery. Glasses are needed to read after the surgery. Your new prescription is given several weeks after the procedure.

MULTIFOCAL IMPLANTS
This is the newest technology. These implants allow normal distant and near vision thus eliminating glasses.

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COLOR VISION
The human eye has receptors that are sensitive to three primary colors, red, green and blue. The brain is able to blend these three primary colors so that the eye is able to discriminate very slight differences. A person with normal color vision can see approximately 8,000 colors in nearly 8 million different shades and tints.

The retina is made up of 10 layers of different kinds of cells. These cells are connected to the brain by approximately 1 million tiny nerve fibers. When stimulated by light, these nerve fibers transmit electrical impulses from the eye to the brain, where the signals are interpreted to give vision. The retina is the focus of our "color receptors".

The very back layer of cells in the retina is called the photoreceptors. There are two types of these cells; rod and cones. Rod function well in dimly lit situations and can perceive only black, white and shades of gray. Rods are located in the outer parts of the retina, away from central vision. Cones are the second type of receptor and they are located primarily in the central part of the retina. This type of receptor functions to provide daytime vision and the important central detail vision, such used for reading small print. There are three types of cones; red, green and blue cones. These three types of cones combine to provide for the wide range in color vision. There are only about 1/3 as many cones as rods.

Color vision testing can be used to identify color defects in color vision. There are many types of color vision tests, from the general screening methods that test gross perception of color, to other more sensitive tests, which are more specific. The most common type of color vision loss is inherited and occurs from birth. But several diseases are also known to cause color vision losses later in life.

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CONJUCTIVITIS (Bacterial)
The conjunctiva is a clear membrane that is the tough, leathery outer coat of the eye. The white of the eye actually lies behind the conjunctiva. The conjuctiva has many small blood vessels and it serves to lubricate and protect the eye while the eye moves in its socket.

When the conjunctiva becomes inflamed, this is called CONJUNCTIVITIS. Conjunctivitis can have many causes, such as bacteria (as in "pink eye"), viruses, chemicals, allergies, and more. In many cases it is difficult to determine the primary cause for the inflammation. One of the most common is BACTERIAL CONJUNCTIVITIS.

The bacteria most commonly at fault are the Staphylococcus, Streptococcus, and H. Influenza. This disease is very contagious, and can be easily transmitted by rubbing the eye and then infecting household items, such as towels or handkerchiefs. It is common that entire families become infected.

Antibiotic drops quickly clear the infection.

Conjunctivitis can be directly cured with treatment. In severe infection, oral antibiotics may be used. If left untreated, conjunctivitis can create serious complications, such as infections in the cornea.

Certain precautions can to taken to avoid the disease and stop its spread. Careful washing of the hands, the use of clean handkerchiefs, and avoiding contagious individuals are all helpful. Children frequently get conjunctivitis from other children because of close contact.

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DIABETIC RETINOPATHY
Diabetes is a disease which affects the blood vessels throughout the body, particularly vessels in the kidney and eye. When the blood vessels in the eye are affected, this is called diabetic retinopathy.

The retina lies in the back of the eye and is a multi-layered tissue which detects visual images and transmits these to the brain. The retina is rich in blood vessels. When these blood vessels are damaged due to diabetes, they may leak fluid or blood and grow scar tissue. This leakage affects the ability of the retina to detect and transmit images.

Diabetic Retinopathy is the leading cause of new blindness among adults in the United States. If untreated, there is a risk of becoming blind. The longer one has diabetes, the higher the incidence of developing diabetic retinopathy. Approximately 80% of people who have diabetes for 15 years have some damage to their retinal vessels. With today's treatment only a small percentage of people have serious vision problems.

There are two types of diabetic retinopathy. Background retinopathy is considered the early stage. Reading vision is typically not affected, but it can advance and cause severe vision problems. There are usually no symptoms with background diabetic retinopathy. An exam is the only way to diagnose changes in the vessels of your eyes.

When the retinopathy becomes advanced, new vessels grow, or proliferate, in the retina. These new vessels are not normal. They may bleed, which causes vision to become hazy and sometimes causing a total loss of vision. These new vessels can also damage the retina by forming scar tissue and by pulling the retina away from its proper location. This stage, called proliferative retinopathy, requires immediate medical attention. Treatment is necessary to prevent severe loss of vision. Regular eye exams are crucial for all persons with diabetes. Treatment consists of medicated eyedrops, medicine by injection or mouth and/or laser treatments. If needed Dr. Kansas will refer patients with diabetic retinopathy to regional and nationally known retinologists.

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DRY EYES
The eye has a tear film which coats the outer layer of the eye. This tear film is very important for the lubrication and comfort of the eye as well as for the clarity of vision. As we age, this protective tear film diminishes, and leaves the eye more exposed to the drying effects of the air, wind and dust. In many people the dryness is worse in the afternoon and evening.

Dry eye is caused by a lack of tear production. Dry eye is probably the most common problem seen in the eye doctor's office.

Dry eye symptoms include burning, stinging or a gritty sensation which may come and go depending on many factors. Itching, tearing and light sensitivity may also occur. Occasionally long strings of mucus can be removed from a dry eye.

Blinking is very important for the maintenance of the tear film. When performing such activities as reading or working on a computer, we blink less frequently. This aggravates the symptoms of dry eyes. Sometimes environmental factors can also aggravate dry eye symptoms. Dry weather, either in hot or cold temperatures, robs the eye of needed lubricants. Cigarette smoke, fumes, dust and airborne particles are common irritants. In most patients, this condition is not associated with systemic disease.

Treatment helps in most patients. We cannot cure this condition, so treatment is an ongoing project. Usually artificial tears, available over-the-counter, soothe the eyes and give temporary relief. These artificial tears work for only an hour or two, at best, and must be repeated at frequent intervals. Ointments last longer, but they blur vision and are most effective at night.

Newer techniques to treat dry eye include tiny plugs which block the tear duct. Most recently a new eye drop drug, Restasis, can dramatically help relieve dry eye symptoms.

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FLASHES AND FLOATERS
The retina lies in the back of the eye and is a multi-layered tissue which detects visual images and transmits these to the brain. In front of the retina lies the vitreous humor. The vitreous is the jelly-like material that fills the large central cavity of the eye. It is composed primarily of water, but it is also made up of proteins and other substances which are more fibrous. The water and fibrous elements together give the vitreous the consistency of gelatin.

The vitreous is normally connected to the retina. During aging, the watery portion of the vitreous separates from the fibrous portions. As this occurs, the fibrous elements contract and can pull the vitreous away from the retina. This is called a Posterior Vitreous Detachment. This contraction on the retina is responsible for the characteristic "flashes" that often accompany the Posterior Vitreous Detachment. The "floaters" are frequently caused by the fibrous elements changing position during the Posterior Vitreous Detachment. Besides aging, flashes and floaters are also associated with nearsightedness and injuries to the eye.

All patients who experience a recent onset of flashes and floaters should be examined immediately by their eye doctor. Most of the time nothing unusual is found, and simple reassurance is all that is needed. The flashes eventually go away, and the floaters diminish and become less bothersome with time.

However, in about 10% of the patients with a Posterior Vitreous Detachment, a tear of the retina is found. If left untreated, these tears may lead to a full retinal detachment. A full retinal detachment is a very serious sight threatening condition requiring a major surgical procedure to repair. When symptoms appear, it is important to examine the eye within a day of their onset. Changes can occur rapidly, and time can be of the essence if a retinal detachment is present.

Retinal tears are treated by sealing the tear with a laser or freezing technique (cryotherapy).

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GLAUCOMA
Glaucoma is the leading cause of blindness in the United States. It is a disease that typically affects older people, but it can occur at any age. Loss of vision is preventable if the disease is detected early and treatment is started.

The eye has about 1 million tiny nerve fibers which run from the back of the eye to the brain. These nerve fibers allow us to see. Glaucoma is a disease which causes the destruction of these fibers. It was once thought that the loss of these fibers was due to strictly to high pressure in the eye. But now it is known that even patients with normal eye pressure can have glaucoma and loss of these nerve fibers.

In many patients, the disease is not noticed in the early stages, because there is no pain and no noticeable change in vision. Early detection by an eye doctor is the key to the prevention of vision damage from glaucoma. Routine eye examinations are recommended.

Types of Glaucoma

The reason that eye pressure is high in many glaucoma patients is that the drainage system in the eye is not working properly. The fluid in the eye, called aqueous humor, does not flow out of the eye as quickly as it should. The drainage system lies in a part of the eye called the angle, which is between the edge of the cornea and the iris of the eye.

There are several kinds of glaucoma. The most common form of glaucoma is called chronic open angle glaucoma. The drainage angle is open in these patients, but the eye fluid does not drain as quickly as it should. Closed-angle glaucoma occurs when the drainage angle closes, and almost no eye fluid can escape. During closed-angle glaucoma, eye pressure can get very high and there is pain. Angle closure glaucoma is an emergency and must be treated immediately. If the high pressure is allowed to continue for too long, blindness can result.

Some persons are more likely to have glaucoma. These include persons who are older, have nearsightedness, have a family history of glaucoma, have had past eye injury, have diabetes or have a past history of vascular shock. Also, African-Americans are 6 times more likely to have the disease.

Glaucoma is treated with eye drops that lower the eye pressure. If the pressure does not fall to a low enough level with drops, then surgery may be necessary. Glaucoma surgery opens up the drainage system in the angle so that the eye fluid can flow more freely.

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HYPEROPIA (Farsightedness)
The cornea and the lens work together to focus images from the visual world on the back of the eye (the retina). If an image is out of focus, it is typically because the overall shape of the eye is incorrect or the cornea does not have the proper curvature. Farsightedness or hyperopia occurs when the eye is too small or the cornea is too flat. When this happens, visual images are focused behind the retina.

A person with hyperopia is able to see objects at a distance, but has trouble with objects up close, like books or newspapers. Many people are not diagnosed with hyperopia without a complete eye exam. School screenings typically do not discover this condition because they test only for distance vision.

Treatment includes contact lenses or glasses which correct for near vision. Corrective lenses should be worn for near tasks, such as reading, but do not need to be used for distance vision tasks, such as driving.

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MACULAR DEGENERATION
The macula is the tiny central part of the retina which is responsible for fine detail vision and for color perception. Macular degeneration is a disease of this very important portion of the retina. It usually affects both eyes, but often begins in one eye.

In many cases, patients are not aware of macular degeneration in one eye, because the other eye compensates for the weaker one. The most common symptoms include difficulty reading, seeing up close or distorted lines. It occurs most often in people over fifty years of age. If you notice a dimness of vision in one or both eyes or if straight lines appear distorted, you should see an eye doctor immediately. There is no cure for macular degeneration, but recent research suggests that certain vitamins and nutrients may slow the progress of the disease.

The most severe form of macular degeneration results with bleeding in the retina (wet form of macular degeneration). This occurs in a small percentage of patients already afflicted with dry macular degeneration. For reasons yet undetermined, abnormal blood vessels grow beneath or near the macula and a certain point begin to bleed. The bleeding seriously disturbs the vision and if not treated immediately by laser, injection of medicine or both, permanent loss of vision ensues. With today's treatment visual damage can be arrested and in some patients even improved.

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MYOPIA (Nearsightedness)
The cornea and lens of the eye work together to properly focus visual images on the retina. If an image is out of focus, it is because the overall shape of the eye is incorrect or because the cornea does not have the proper curvature. When the eye is too big or the cornea is too steep, visual images are focused in front of the retina. This condition is called nearsightedness or myopia.

Myopia normally starts to appear between the ages of eight and twelve years old, and almost always before the age of twenty. Once myopia starts, as the body grows, the myopia often increases. It typically stabilizes in adulthood. Changes in glasses or contact lens prescriptions are necessary during growth periods.

Someone with myopia has an inability to see objects at the distance, such as street signs, chalk boards and television. Many times, myopia is diagnosed during school screenings.

The treatment for nearsightedness includes lenses which allow visual images to be focused on the retina. These lenses can be in the form of contact lenses or glasses. Once the eye has stabilized and myopia is no longer progressing, laser vision correction is an option for many.

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OCULAR MIGRAINES
The classic migraine is a severe headache, which in some instances may be accompanied by nausea. Ocular migraines are visual disturbances in which visual images look gray or have a wavy appearance. The visual distortion, when it occurs, normally starts in central vision and then moves off to one side.

The ocular migraine can occur either in conjunction with the common migraine or without the corresponding headache. Generally, when it accompanies the common migraine, the visual disturbances happen before the onset of headache symptoms. In younger people with common migraine, it is typical for the ocular migraines to also occur. As people age, it becomes more common to experience ocular migraines without headache symptoms.

In general there is no serious complications caused by ocular migraine. Treatment, in most instances, is not necessary unless the ocular migraine is linked to severe headaches.

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RETINAL DETACHMENT
The retina lies in the back of the eye. It is a multi-layer tissue which is responsible for detecting visual images and transmitting these to the brain. The retina is similar to the film inside a camera. A retinal detachment occurs when it pulls away from the back of the eye.

Symptoms include flashing lights, an apparent covering or curtain over part of the visual field or many floaters. Importantly, these symptoms can also be present without a retinal detachment. An immediate exam is necessary if you experience these symptoms.

Sometimes the retina does not fully detach, but only tears. In these cases, treatment is done with a laser or freezing technique (cryotherapy) that seals the tear. If the retina is fully detached, surgery is performed to place the retina back into position.

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RETINITIS PIGMENTOSA
The retina lies in the back of the eye and is a multi-layered tissue which detects visual images and transmits them to the brain. Retinitis pigmentosa (RP) refers to a group of related diseases which tend to run in families and cause slow but progressive loss of vision. Night vision difficulty is noticed first.

Retinitis pigmentosa causes night blindness and loss of side vision. In normal persons, the visual system adjusts to darkness after a very short period. People with night blindness adjust to darkness very slowly, or not at all. Due to the loss of side vision (peripheral vision) in patients with retinitis pigmentosa, mobility becomes more difficult.

Most forms of retinitis pigmentosa are inherited. Different patterns of heredity are associated with different degrees of progression. An attempt to know more about how severely the disease has affected other family members may help predict how a specific person might ultimately be afflicted, though variability exists within each family.

In general, there is no specific treatment. Recent research suggests that some patients may benefit from vitamin therapy. Periodic examinations by an opthalmologidst is advised

It is important to keep in mind that patients with retinitis pigmentosa may develop other treatable disease, such as glaucoma or cataracts.

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TRANSIENT ISCHEMIC ATTACK (TIA)
Short, temporary loss of vision in one eye is usually caused by a cholesterol embolism to the retinal artery or one of its branches. The emboles originates from a atheromatous plaque in the carofiol artery on the same side.

Carotid artery usually is stenosed and needs to be surgically repaired (endarterectomy). This symptom requires immediate attention.

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Kansas Eye Surgery Associates, P.C.
Dr. Peter Kansas
24 Century Hill Drive - Suite #001, Latham, NY 12110
(518) 690-2015
info@drkansas.com