We've created this page to provide you with some useful information regarding certain topics that come up time and time again.

Use the links below to direct you to a specific topic and remember that any questions you may have can always be directed to my incredibly capable staff or myself via email or phone.

Points of discussion are:

Blepharitis is a chronic inflammation of the eyelids which causes irritation, itching, and occasionally a red eye. Blepharitis can begin in early childhood producing "granulated eyelids," continue through life as a chronic condition or it may develop in later life. There may be a loss of eyelashes and distortion to the margins of the eyelids, which can cause chronic tearing. It may appear in one of two ways.

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

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

HOW IS BLEPHARITIS TREATED?

In view of the long-term nature of the condition, strict lid hygiene is necessary. We recommend baby shampoo (less tearing) lid scrubs followed by hot compresses on a daily basis until the irritation is relieved. After comfort is achieved, maintenance lid scrubs on a less frequent basis is necessary to prevent recurrent irritation. Treatment of oily scalp with anti-dandruff shampoos (Selsun Blue™) may also be helpful.

The following regimen may be useful:

1. Fill a drinking glass with warm water.
2. Add one capful of baby shampoo.
3. Soak a clean cotton ball (or Q-tips) in the solution.
4. Gently scrub the eyelashes of all 4 eyelids.
5. Rinse with warm tap water and dry with a clean towel.
6. Place a warm compress against the eyelid for 15 minutes.
7. Use medications as directed.

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

If your eyelid irritation persists or progresses, please return for a follow-up examination. If you have any questions or concerns, please do no hesitate to contact our office!

Dry eyes can be a very uncomfortable condition which may be temporary or long term. Dry eyes can cause pain, visual blurring, burning, foreign body sensation, irritation, light sensitivity and redness The discomfort is related to the breakdown of the ocular surface and varies from mild to severe.

The cause of dry eyes may be due to environmental factors (low humidity, wind/fans, air conditioning, contact lenses,) related to medical conditions (Sjogrens' syndrome, drugs, pemphigoid, vitamin A deficiency) or from anatomic dysfunction (incomplete blink, eyelid scarring, paralysis abnormal tear film.)

The drugs which aggravate dry eyes include the following: Weight loss products (Dexatirm, Accutrim) Cough preparations (Benylin cough Syrup, Triaminic DM Liquid, Novahistine DMX Syrup) cold Preparations (Dimetapp Elixir, Alka-Seltzer Plus Cold, Contac Cold formulas, Antihpyertensives (Minipress, Catapres) Diuretics (Lasix, Bumex, Diuril) Antipsychotics (Mellaril, Thorazine) Antiparkinson Agents (Cognetin, Artane), Sedatives (Dalmane, Valium, Halcion), Caffeine and Nicotine.

TREATMENT

Dry eyes are frequently a chronic disorder that can be controlled but rarely "cured." Artificial tears are the mainstay for treating dry eyes. There are many different brands of artificial tears that may be purchased over the counter which may be helpful. They usually have the name "Tears," such as, Tears Plus, Tears Naturale, Hypotears...etc. In addition, artificial tear ointments are available (Lacrilube, Refresh PM, Duolube).

The goal in treating dry eyes is to keep your eyes comfortable all of the time. The biggest mistake is failure to use the drops enough.

You may require using drops frequently (up to every hour during the day) to keep your eyes comfortable. If hourly drops become a burden or are unsuccessful, you may use ointment. The ointment last much longer but blurs your vision. Therefore, if you alternate eyes you will have one eye for vision and the other eye protected with ointment.

If you require frequent use of artificial tears and ointment (more than four times per day) we recommend that you use preservative free preparations (Celluvisc, Refresh PM, Hypotears ointment...etc.) This will prevent the development of allergic reactions to the preservatives.

***IF YOU CONTINUE TO HAVE DISCOMFORT, REDNESS OR IRRITATION IN SPITE OF ARTIFICIAL TEARS, CONSULT YOUR DOCTOR IMMEDIATELY!!!***

PROTECTING YOUR SKIN FROM THE SUN

Excessive exposure to sunlight damages the skin and is an important factor in the development of skin cancers and accelerating aging changes. Ultraviolet rays are especially damaging. The following suggestions are beneficial in protecting your skin from the sun.

1. Clothing: Protective clothing, such as long sleeved shirts and wide brimmed hats, should be worn to protect the skin.
2. Activity: Sun bathing should be avoided. Sports and recreation involving sun exposure should be done early in the morning or late in the evening to decrease sun exposure.
3. Ultraviolet Screening Sunglasses: Regular sunglasses decrease the intensity of sunlight. However, the damaging ultraviolet rays cannot be seen and may still penetrate regular sunglasses. UV light may be an important factor in the development of skin cancer of the eyelids, growths on the eyeball, and possibly cataract. There are special lenses that filter out the ultraviolet rays to protect your eyes and eyelids. There are many different brand names for these lenses (UV-400, Revo, Bolle, etc. and you should ask if the sunglasses you are considering filter out the ultraviolet light. These UV protective lenses are available in any shade, tint or may even remain as clear glass. Ask your optician.
4. Sunscreens: Sunscreens and suntan lotions are extremely important. They are rated on a sun protection factor. This is noted on the container as SPF. A sun protection factor of 15 (SPF-15) would mean that use of this agent would expose your skin to the same amount of UV light rays after 15 hours that you would have otherwise received after 1 hour without it. In Arizona, we recommend using a sun protection factor of at least 15. There are sunscreens with SPF over 30. Clinique and Estee Lauder are two products with high sun protective factor ratings. A #15 sunscreen lip balm is available that can be easily applied to the lips as well as the lower eyelids to offer protection in these vulnerable areas. Remember that sunscreens should be reapplied frequently to maintain their protective effect.
5. Tanning Booths: The AMA Council on Scientific Affairs has reported the widespread use of fluorescent sunlamps, and tanning booths are potentially dangerous and constitutes a health hazard. The ultraviolet light used (UV-A) penetrates deep into skin and may cause premature aging by modifying fibers that maintain the skins normal resiliency. In addition, both short and long term exposure to high intensity UV-A radiation may cause disturbances in the immune system, skin cancer, cataracts, or possible retinal damage. The best protection according to the report is to avoid cosmetic tanning altogether including tanning with natural sunlight.

If you have any suspicious skin lumps or sores
that do not heal, the area should be evaluated by
a physician interested in skin cancer.

CORTICOSTEROID INFORMATION

Corticosteroids are powerful medicines used to treat a variety of inflammatory disorders to prevent or reduce damage to your body. In ophthalmology, steroids are used to preserve vision by supressing inflammation that destroys or interferes with the normal structure and function of the eye and its surrounding tissues.

Steroids are normally produced by your body daily, but are used in much greater doses for medical purposes. The effects of steroids at high doses are powerful and beneficial. However, common side effects include the following: weight gain, fluid retention, elevated blood pressure/sugar, weakening of bones, stomach ulcers, nervousness and supression of your immune system.

Therefore, you will require careful monitoring while you are being treated with steroids, particularly if you have a chronic infection (ie. TB), hypertension, peptic ulcer or gastritis, diabetes, cardiovascular disease, osteoporosis or psychologic disturbances.

Important DO'S and DON'TS while on therapeutic corticosteroids:

DO's:

• Follow directions carefully.
• Take steroids with meals or snacks.
• Always take steroids in the morning if only one dose.
• For multiple doses, take them at evenly spaced intervals.
• Eat meat, bananas, raisins or juices rich in potassium.
• Antacids, mild or non-spicy foods, or a high calcium diet are helpful
• Minimal salt intake, or use a potassium chloride salt.
• Exercise regularly.

DON'Ts

• Do not stop taking steroids suddenly, they must be tapered.
• Do not get vaccinated, especially against smallpox.
• Avoid contact with patients with colds, flu or infections.
• Avoid sweets, starches and salty foods

When you become ill or need an operation, your body normally increases its steroid output 5-15 times the normal amount. While on oral steroids, your body may not be able to produce the amount you need in such emergencies. Therefore, it is important to see your physician on a regular basis to regulate your steroid dose for the appropriate circumstances.

NOTIFY YOUR DOCTOR FOR THE FOLLOWING:

Before taking new medications, before modifying the current dose of steroids, visual change, eye pain, weight gain, swelling, muscle weakness, black tarry stools, vomiting of blood, infection, burning, pulling of the face, menstrual irregularities, prolonged sore throat, fever, cold, fatigue, depression, change in appetite, nausea, dizzyness, nervousness or change in sleep patterns.