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The Mysterious “Pink Eye”: AKA Conjunctivitis

“Pink eye” or conjunctivitis is a common eye condition that ranges from mild to severe, acute to chronic and has a wide variety of causes. It can affect all age groups and is often misdiagnosed and mistreated. Fortunately, most conjunctivitis gets better on its own. Treatment can be helpful to reduce symptoms and sometimes prevent more serious consequences.

To confuse things, there are other diseases, such as anterior uveitis, episcleritis  and corneal disease, that can make the eye look red but are completely different. It is very important to consider  these conditions in any “pink eye”.

The conjunctiva is the transparent tissue covering the “whites”of the eye and the underside of the eyelids. When this tissue becomes inflamed for any reason, the little blood vessels in the conjunctiva enlarge and the eye looks more pink or red. Often patients correctly or incorrectly equate pink eye with an eye infection.

Important: With any red eye, if you experience significant pain, blurred vision or significant eyelid swelling, call your eye care practitioner right away.

Baterial-Conjunctivitis

There are  four main causes of conjunctivitis: infection, allergy, toxic/irritant and dry eyes.

Infectious conjunctivitis:

Viral is the most common type of infectious conjunctivitis. Many different viruses can affect the eye. Often cold or flu like symptoms are associated with the conjunctivitis and both eyes are usually effected, one more than the other. One particular viral infection, epidemic keratoconjunctivitis, is quite prolonged and very contagious. The eyes are red, weepy, scratchy and  a bit sensitive to light.

Antibiotic drops such as polysporin, allergy drops or “red eye” drops like Visine are ineffective. Supportive measures such as cold compresses, lubricating drops, avoidance of eye rubbing and rest are most helpful.  Good hygiene measures such as frequent hand washing, not sharing towels or pillows, and keeping the hands away from the eyes are most helpful to reduce the spread to others. Eye cosmetics should be discarded and new makeup avoided until the condition clears. Contact lenses should not be worn. Viral conjunctivitis can last up to 3 weeks.

More serious eye infections caused by the herpes simplex virus or the herpes zoster virus can involve the cornea and can lead to permanent scarring and loss of vision. Accurate diagnosis and aggressive treatment is important.

Chlamydial conjunctivitis is sexually transmitted disease and acts a bit like a viral conjunctivitis that doesn’t get better on its own. Accurate diagnosis and appropriate treatment is important.

Bacterial conjunctivitis is less common and can involve one or both eyes. Usually there is more thick and sticky discharge. Often this will clear on its own but antibiotic drops can clear it up faster. Warm compresses and lubricating drops can help with comfort. Again, contact lenses should not be worn and eye makeup discarded. If abnormal pain or blurred vision is present, or it involves a young child who is quite ill, examination by your optometrist is vital to rule out a more serious, vision threatening corneal ulcer, orbital disease or other problem.

Allergic conjunctivitis

Allergic conjunctivitis is a common cause of “pink eye”. Often this is seasonal with symptoms of itchy, stingy, weepy eyes. Both eyes are effected equally. Pollens, animal dander and molds are common triggers of allergic conjunctivitis. Avoidance of the cause, if possible, air filters, good house cleaning and frequent laundering of bed sheets can be helpful. Cold compresses, eye lubricating drops and avoiding eye rubbing are simple solutions. For more persistent allergies, your optometrist may prescribe allergy drops and/or anti-inflammatory drops which can be very effective.

Toxic/Irritant conjunctivitis

Toxic/Irritant conjunctivitis can occur for a variety of reasons. The conjunctiva can be inflamed because of exposure to chemicals such as chlorine in pools, volatile fumes from paints and thinners, soaps and facial cosmetics, nail polish and compounds released from chopping onions. A misdirected eyelash, poor quality eyeliner and masquera, dust exposure, UV exposure, poor eyelid closure and excessive eye rubbing can inflame the conjunctiva. Contact lens wear, contact lens solutions and eye drops sometimes irritate and inflame the eye.

Dry eye related conjunctivitis

Dry eye related conjunctivitis is quite common, especially as we age. It tends to be chronic with symptoms that wax and wane. I discussed the problem of dry eyes  more fully in a previous blog post, “These Cry’n Eyes”.

“Pink eye” is not as simple as it appears. Having a correct diagnosis of the underlying cause is important to properly treat the condition. Check with your optometrist for the most appropriate care.

photo of staff

Congratulations Julie!

Congratulations to Julie for recently earning her Canadian Optometric Assistant certification. She joins Lisa, Cheryl and Jody who are Certified Canadian Optometric Assistants. Pictured from left to right are Jody, Cheryl, Lisa, Tracy, Julie, Morgan and Kaytiee.

Meet Morgan, our newest optometric assistant!

Morgan is the most recent member of our optometric team. She is a recent graduate from the Georgian College Opticianry program and will be writing her national examinations later this year.

It is obvious that Morgan enjoys her work and she brings with her a high level of enthusiasm and expertise. You will likely meet her during specialized testing or helping you in the frame gallery.

Ultrawide field image

Introducing Ultrawide Field Imaging!

New technology has brought about several remarkable transformations in the way we provide eye care since we began our practice in 1979. Equipment has been introduced over time which has allowed us to diagnose eye conditions with greater accuracy and at much earlier stages than ever before.  Utilizing these new technologies allows you to receive more complex and comprehensive care with the aim of maintaining good eye health and vision. In keeping with our mission to provide the best care possible for our community, you will be introduced to an exciting new diagnostic instrument during your next visit to our office.

Ultrawide field imaging is a new technology designed to better assess the health of the entire retina in patients of all ages. Macular disorders, age-related macular degeneration, diabetic retinopathy, retinal holes or tears, peripheral retinal degeneration, retinal detachments, retinal tumours, vascular disorders, glaucoma, and hypertensive retinopathy are some of the conditions that can affect the eye, often without pain or visual symptoms. Children are not exempt from having retinal disease and require a thorough examination too.

Previously, the examination of the retina was best performed by direct examination with ophthalmoscopes and retinal photographs, often through dilated pupils. These techniques allowed a detailed view of a small part of the retina at a time, akin to examining a dark room with a flashlight. These techniques will not be abandoned and are still required for assessment in many situations.

Optos Daytona

The company Optos, has developed an instrument, Daytona Optomap, that uses scanning lasers of 2 different wavelengths to rapidly generate a detailed view of 80+% of the entire retina, far more area than any previous instrument. The procedure is painless and easy for the patient and may lessen the frequency of pupil dilating drops. The doctors are able to immediately view the various images generated during the examination.

Eyemaginations has produced a short video describing ultrawidefield imaging and the Optomap instrument that you can view here.

As doctors and optometric personnel charged with the responsibility of providing you the best in eye care, we are excited to offer you this new service and to answer any questions you may have about it.

Sunglasses and tints – so many choices!

The warm March sun on the snow covered ground, although welcome, can seem a little too bright! With the changing season I find myself reaching for my prescription sunglasses on many occasions and for a variety of activities.

We choose tinted lenses for at least five reasons: comfort, vision enhancement, fashion, concealment and protection. It can be uncomfortable driving into the rising sun on our way to work in the morning. The golf ball can get completely lost against the sky. Sunglasses can equal “cool” or “hot”.  Some tired eyes do better with shades. And the sun’s ultraviolet radiation (UV) and short wavelength blue light (SWBL) can damage eye structures with prolonged exposure.

So how do I choose which tinted lenses are best for me? And what if I wear prescription glasses?

Generally sunglasses tend to be bigger than prescription glasses, providing more coverage of the eye area. This allows a wide field of vision and lets in less peripheral light that can cause glare. Most good sunglasses provide UV protection but not all offer SWBL protection. Other important considerations are impact resistance, scratch resistance, back surface anti-reflection coating to reduce glare and lens optical designs to reduce distortion from the curvature of the lens.

And then there is the myriad of colours! Consider yellow, amber, rose or brown lenses if you want to improve contrast. They work well in activities such as golf, cycling, skiing, running, hunting and driving in “flat” light conditions but do distort colours. Green also helps to improve contrast in tennis, baseball and golf while reducing some blue light. Gray is the best tint for reducing overall light while allowing colours to remain true. And a dark tint is great on a very bright day but not so good when the light levels drop. It is very helpful to see and test the tints of which our office has many samples.

Should sunglasses be polarized? Polarization selectively reduces light reflecting of flat smooth surfaces such as water, asphalt, vehicles surfaces, etc. Polarized lenses can be great for boating, fishing, cycling and driving.

Photochromic lenses lighten and darken in response to light level, particularly UV levels. Convenience is their main benefit. Photochromic lenses darken quickly when exposed to bright light, they are a little slower to clear and they only darken a little behind a windshield or glass. They have good UV protection like other sunglasses. Available colours are gray, brown and green.

Prescription sunglasses are great for those who require corrective lenses. Clip-on sunglasses or fit-over sunglasses can be a less expensive option.

So how best to decide? Of the five reasons highlighted in the second paragraph, which reasons are most important to you? Be prepared to discuss this when you speak to our knowledgeable staff and they will help you find your perfect shades.

These Cry’n Eyes

The eye’s tear film is a vital but often neglected component of clear vision and comfortable eyes. It is one of the most frequently encountered conditions we see in our practice. An individual with dry eye disease (DED) may complain of dryness, burning, itching, stinging, watering, “stickiness”, “grittiness”, fluctuating vision, “smeary” vision, and contact lens intolerance. Symptoms can be severe or nonexistent. Curious, isn’t it, that watery eyes can be a symptom of DED! Some people are bothered with symptoms just occasionally and others continually.

Dry eye disease (DED) has recently been defined as a “multifactorial disease of the tears and ocular surface that results in symptoms of discomfort, visual disturbance and tear film instability with potential damage to the ocular surface…”1 In other words, there are several possible causes of DED with a variety of symptoms and consequences to the eye.

Along with a detailed history, there are several different tests we do to help differentiate the cause and severity of a patient’s DED. Risk factors for DED include:

  • Age – DED increases with age
  • Gender– Females have an increased risk, especially post-menopausal
  • Environment – Exposure to harsh environments, outdoor work, computer work, exposure to dust, dry air, airplanes, cosmetics
  • Smoking – Is a risk for many conditions including dry eye
  • Previous eye surgery or disease – chronic allergies, refractive surgery, abusive contact lens wear
  • Medications – Certain medications such as anti-histamines, anti-depressants, diuretics, and others.
  • Systemic disease – A higher risk in diseases such as rheumatoid arthritis, diabetes, rosacea, thyroid disease, etc..

 

Targeted treatment of DED, following a proper diagnosis, may be prescribed as periodic or continual and often over a long term. It may involve environmental or lifestyle modifications, lid care, targeted tear lubricants, topical medication, punctual occlusion (blocking the tear drainage ducts), oral medication/supplements, chronic disease management, and sometimes in severe cases, more advanced procedures.

Treatment carries a high degree of success when diligent self-management is in place. Comfortable eyes and consistent clear vision is the welcomed reward of a collaborative effort between the doctor and patient.

“Will being overweight affect my vision?”

“Will being overweight affect my vision?” This is a question I almost never hear. Maybe because most of us don’t think there is a relationship between body weight and our eyes. Obesity has become a major health concern globally in recent years with well-established evidence linking overweight to illnesses and early death.

If we review the scientific literature, it quickly becomes apparent that being overweight has a strong link to several eye conditions. Diabetes and  high blood pressure can cause significant changes to the eyes. Diabetic and hypertensive retinopathy can lead to profound vision loss if left untreated. First line management of each of these conditions is achieving and maintaining a healthy body weight.

Age-related macular degeneration is the leading cause of vision loss in Canada. There is no single cause of macular degeneration, but several excellent studies have shown obesity to be a significant risk factor for progression and severity of the disease.

A recent meta-analysis of six important studies reveals an association between obesity and cataract development, particularly posterior subcapsular cataracts which tend to occur at a younger age and develop more quickly.

Pseudotumour cerebri, retinal vascular occlusive disease, floppy eyelid syndrome, entropion, sleep apnea related eye disease and stroke related vision loss each have an association with obesity.

Overweight is just one of the “lifestyle” factors which influence health. Regular exercise, smoking cessation, healthy diet, adequate sleep and stress reduction also contribute to eye health.

The individual and societal factors that influence healthy weight management are numerous and have been discussed extensively in many circles. Weight management is a billion dollar industry with magical products, quick weight- loss programs, fads, celebrities, countless books and organizations. Medical management often includes counselling and in extreme cases, bariatric surgery. In most instances though, achieving and maintaining a healthy weight is a lifelong task assumed by the individual.

A local physician has just published a valuable resource for those willing to confront their disease.“Overweight is a Disease, A Canadian Doctor’s Prescription for Self-management”, by Dr. Lori Teeple, is a new book designed to be a key resource for those who struggle with overweight who wish to understand their disease and gain the skills necessary to self-manage for life.

Boxes of Food!

Here’s what you helped us collect for the Forest Food Bank this year. You response and generous contributions were amazing.! Thank you from all of us.

Congratulations Food Drive Winners!

Congratulations to all who made this year’s food drive such a success. Thanks to everyone who contributed to the Forest Food Bank’s shelves during the last 4 weeks. Each week we drew a name from all the contributors and gave away a prize.  Remember, you can continue to donate directly to the Food Bank. Here are the winners:

Week 1
Dina Koolen
Week 2
Chris Porter (daughter Eden standing in)
Week 3
Gwen Scott-Moffatt
Winner week 5
Jacob & Bessie Lagerwerf

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