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Patients with systemic diseases and conditions frequently will also have ocular manifestations of those disorders. Recognizing these findings is vital to proper treatment.

Patients who come to our office with complaints of dry eyes, or inflammatory conditions like Iritis, Uveitis, Scleritis or Episcleritis frequently are also suffering form immunological conditions as well. While we can usually treat the ocular conditions effectively, the individual must seek medical treatment from his/her general practitioner for the underlying disorder.

Rheumatoid Arthritis is an autoimmune condition resulting in inflammation. The Rheumatoid factor attacks the immunoglobulin G (IgG), resulting in the release of inflammatory cytokines from white blood cells causing edema and cell death. The joints are particularly at risk for damage. In the eye, the basement membranes break down; thereby permitting the destruction of the underlying ocular tissue. At first, this occurs at the tear producing gland (lacrimal gland) causing a decrease in tear production, and then dry eye. Episcleritis, the inflammation of the outer most layer of the eye wall, is a common result as well. These conditions are frequently treated with either topical steroids, and/or NSAIDs very effectively. A more serious condition is Uveitis which is an internal inflammation. This may result in permanent damage to the eye. In severe cases Anti-rheumatoid medicines such as Plaquenil must be employed.

HLA-B27 disorders are a group of diseases that present with similar ocular findings. The conditions include Ankylosing Spondylitis, Psoriatic Arthritis, Arthritis, and Behcet’s Disease; there are other connective tissue disorders as well. The most common ocular finding with these disorders is nongranulomatous Uveitis, and Iritis. Treatment includes pupillary dilation, and topical steroids like Pred Forte. Recurrence frequently occurs, and rapid aggressive treatment is needed to prevent chronic inflammation and ocular damage.

Acne Rosacea presents with pustules, papules, and telangiectasia (small blood vessels in the skin). Ocular findings include chronic blepharitis (lid inflammations), conjunctivitis, meibomian gland break down, corneal thinning and then perforation. Treatment begins with artificial tears and warm compresses, and increases to antibiotic eye drops and steroids drops if needed. Doxycycline, an oral antibiotic has been found to be very affective in curing the blepharitis component of the disorder.

Giant Cell Arteritis is an inflammation of the giant cell arteries in the cranial cavity, and requires emergency treatment. Rapid treatment is required, or the condition can be fatal. The eye doctor may notice changes in the Optic nerve. This patient needs to be hospitalized as soon as possible.

Inflammatory Bowel Disease (IBD) such as Crohn’s, Ulcerative Colitis and Proctitis, are inflammations in the intestinal walls. Ocular manifestations may include Episcleritis and Uveitis. Unlike with the other conditions discussed, IBD may results in Posterior Uveitis which is more serious, and may result in greater ocular damage. Treatment then may require systemic immunosuppressant and injections directly in the eye. This treatment may lead to Cataracts, Glaucoma and Cystoid Macular Edema. Treatment must therefore be carefully monitored.

With immunological disorders the key to proper treatment is rapid, accurate diagnosis. If left untreated, many of these ocular findings can severely damage the eye and reduce vision.

How does this thing called vision function? How do we see? The eye, as is constantly pointed out, operates in many respects like a camera. At this moment you are looking across the room. Perhaps there is a painting on the opposite wall. Perhaps you see an easy chair with a lamp beside it. Whatever it is, for our purposes it constitutes a picture.

Suppose you want to record that picture with a camera. First, you adjust the focal length so that the image is sharp and clear without blurring or distortion on the film. If the object is at a distance, you shorten the focal length. If it is close, you lengthen it. Then you snap the picture. That is, you let light in upon the exposed plate and the picture is taken. You cannot see it, however, until the film has been developed.

How does this compare with the functioning of the eye? The eyeball of a normal eye involuntarily adjusts itself so that the image is focused on the retina (film of the camera). Once again there must be sufficient light to make your picture clear. Once again, if the object is at a distance, the focal length (the distance from the cornea to the retina) is shortened; and vice versa if the object is close. This process of adjustment to far or near sight is called accommodation. the conflicting opinions which exist in regard to its functioning.

Light enters the eye through the small hole in the iris called the pupil, and comes to a focus on the retina where, by a chemical reaction, it is changed from radiant energy into nerve impulses. Sensitive nerve receptors of the retina, which are a part of the optic nerve, carry these impulses to the visual centers in the brain where, with the assistance of memory, imagination, experience and judgment, a picture is developed. That is, the mind interprets the image.

It is, therefore, the brain that sees. The greater the degree of mental control, that is, the better your memory and imagination, the better you see.

When the camera is in the hands of a person who does not understand its functioning, the pictures are unsatisfactory, and so with the eye. If the eye fails to accommodate, as a result of some malfunctioning, it is improperly focused. If it strains to see, the individual begins to suffer from some form of eye trouble.

He goes to an ophthalmologist and, after examination, departs with a pair of glasses. The glasses fix on the individual the trouble which they are supposed to correct, while the underlying cause remains unchanged. Meanwhile, the sight will worsen when the glasses are removed. For instance, a person with 20/70 vision will find, a few weeks after being fitted with glasses, that his vision has degenerated to 20/200 when he removes them.

While many eye troubles are preventable and many more can be vastly alleviated, the only solution that is offered for this appalling condition is to fit the eyes with glasses. There are glasses for young and old, dark glasses and colored glasses, reading glasses and ornate affairs; glasses for the near-sighted and for the far-sighted; glasses for eyestrain and to relieve headache. Glasses for every purpose, indeed, except to get at the cause of the eyestrain. This is how we see.

Severe problems with eyes should always be referred to a specialist, but alternative therapies can support orthodox treatment and may be very useful in conditions that affect the eyelids and tear glands. When treating infections and inflammations of the eyes, wash your hands between treating each eye, and use fresh materials so that you do not transfer infection from eye to eye.

Conjunctivitis

Conjunctivitis symptoms are red, itchy eyes; a yellow discharge; and inflammation around the eye or eyelid. It is normally caused by infection or allergy and is not serious except in newborn babies.

Treatment

Herbal Medicine Herbal eye baths made from infusions of eyebright (euphrasia), chickweed, elderflower, or camomile flowers are a soothing, effective treatment.

Consult a qualified practitioner/therapist for:

Homeopathy A homeopath may prescribe Argentum nit. 6c for “gritty eyes” or Pulsatilla 6c for itchy eyes with a discharge.

Eyesight Problems

Hazy vision, difficulty in reading, tired eyes, headaches are all types of eyesight problems. They may be the result of vision problems, high blood pressure, and eyestrain, among other factors.

Treatment

Yoga Candle gazing is a beneficial yoga exercise for eyestrain. Sit comfortably and gaze at a candle about 3ft/1m away, without blinking, for ten seconds. Palm for 30 seconds, then resume gazing with one eye only then the other, then together, turning the head Gradually increase the time (20 then 30 seconds) over several weeks.

Consult a qualified practitioner/therapist for:

Homeopathy Specifie remedies to be taken for eyestrain include: Arnica, when the muscles, are tired; Natrum mur., when eyes ache upon looking lip down or around; Ruta grav., when the eyes burn or feel strained after close work or reading; Phosphorus, tired eyes are associated with great nervousness and apprehension.

The Bates Method This is designed to strengthen the eye muscles and rectify vision problems as a natural alternative to wearing glasses.

Cataracts

Cataracts cause cloudy, distorted vision resulting from, changes in the protein makeup of the lens. They are most common in old age, but may be caused by iritis, babies are born with cataracts.

Treatment

Diet And Nutrition Research suggests that vitamins B2 and C can help improve the condition in which sight deteriorates as the lens becomes opaque. Supplementing with vitamin E and the antioxidant mineral selenium can help rectify dietary deficiencies that can exacerbate the condition.

Homeopathy Specific remedies include Phosphorus, when there is a sensation of mist being pulled across the eyes; Calcarea, for the early stages, with circular lines visible in the lens; Silica, for the later stages, when cataract begins to interfere with sight.

Glaucoma

Gradual loss of vision, aching pain in and above the eyes, seeing “rings” around lights are the symptoms of glaucoma. The disease is caused by a buildup of fluid in the front chamber of the eye. Glaucoma may be asymptomatic and vision may be lost before the sufferer is aware of the disease. If there is a family history of glaucoma, ensure regular screening by an optician.

Treatment

Hydrotherapy Home hydrotherapy treatment offers immediate relid - place alternate hot and cold face towels over the eyes.

The Bates Method These exercises can also be used to treat this condition.

Homeopathy Take Belladonna 30c every 15 minutes for up to ten doses when symptoms start.

Squint

Squint is the inward or outward turning of the eye or eyes. In adults, squint is normally caused by damage to the eye muscles or the motor nerves that control the eye muscles, usually the result of diabetes, high blood pressure, brain tumor, or brain injury. In children, squint should be treated before the affected eye becomes lazy and ineffective.

Treatment

The Bates Method Minor squints can be successfully treated with the Bates Method.

Yoga Palming relaxes the eye muscles and improves squints. Rest with your arms on a table and rub your hands together. Cup hands over closed eyes, shutting out all light, and relax for 20 seconds while being aware of visual sensations. Repeat at least twice a day.

Corrective eye surgery is a heaven-sent for most people. Because of this procedure, they have improved their vision and eliminated the need for those bothersome eyeglasses and contact lenses. Today, corrective laser eye surgery is one of the newest and bays ways to have your eyesight corrected. There are generally two types of corrective laser eye surgery. There’s PRK, which stands for photorefractive keratectomy and Lasik, which means Laser-Assisted in Situ Keratomileusis.

Corrective laser eye surgery works by reshaping the cornea, allowing you to see much better. Laser eye surgery works best for people who suffer from myopia, or nearsightedness, hyperopia or farsightedness and astigmatism. The whole process takes less than ten minutes per eye so the surgery doesn’t require patients to stay in the hospital overnight. In fact, many patients walk out the door an hour after coming into the clinic! Then they can expect to resume to their normal, everyday activities in just a matter of days after the surgery. Patients report to having their eyesight dramatically improved so they no longer have to go through the hassles of wearing glasses and contact lenses.

Still, not everyone who wishes to undergo corrective surgery can. Prices of such seemingly simple surgeries can be prohibitive. Some corrective eye surgeries cost about a thousand dollars, just for one eye! In the United States, patients pay anywhere between $500 to about $2,000 per eye. The variations are due to a number of factors, including the area or the state where the corrective eye surgery is performed, as well as the equipment used and the degree of visual impediment of the patient. For example, if you suffer from severe astigmatism, then you are likely to pay much more compared to someone who suffers from mild astigmatism.

Unfortunately, most health insurance companies don’t cover corrective laser eye surgeries because this type of surgery is deemed as cosmetic. Still, keep in mind that you shouldn’t settle for anything less than the best. After all, you are dealing with a very valuable asset, your eyesight. Do not choose a doctor solely on the basis of how little he or she charges. Even if he or she charges just a little, he or she may not have the right experience, skill and equipment as other, more credible doctors. To finance your corrective eye surgery, don’t be afraid to ask around. Some clinics have partnerships with other health insurance companies that can help lower the cost of your eye surgery.

Astigmatism is a refractive error of the eye that is caused by an irregularly-shaped cornea. The irregular shape of the cornea changes the way that the rays of light are refracted, and subsequently, are focused on the eye’s retina.

It is characterized by distortions in your field of vision, such as blurring of lines. Another common presentation of Astigmatism is the development of eyestrain and headache, especially with prolonged reading.

Treatment may either be surgical or non-surgical. Non-surgical treatment involves the use of corrective lenses. Surgical treatment of astigmatism, on the other hand, is via refractive eye surgery.

CORRECTIVE LENSES

The conservative method of treating astigmatism is via the use of corrective lenses. These corrective lenses are able to counteract the irregular shape of your cornea. Corrective lenses include the use of eyeglasses and contact lenses. Another procedure, known as orthokeratology or ortho-K, makes use of contact lenses to change the shape of your cornea. Ortho-K requires you to use the contact lenses only at night. By doing this, the shape of your cornea gradually changes.

REFRACTIVE EYE SURGERY

Refractive eye surgery is used in the permanent treatment. Refractive eye surgery changes the shape of your eye permanently. There are several kinds of corrective eye surgery that can be used in the treatment of astigmatism.

Previously, a procedure known as astigmatic keratotomy, or AK, was used to cut the patient’s cornea in order to change its shape. However, with the advent of excimer lasers and novel refractive eye surgery techniques, the use of AK has diminished significantly. Newer refractive eye surgery techniques have been able to decrease the risk of complications and have produced better results, making them more favorable for both ophthalmologists and patients.

Nowadays, LASIK eye surgery is the most common refractive eye surgery used in the treatment. LASIK involves creating a corneal flap and using an excimer laser to alter the shape of your eye’s cornea. Another refractive eye surgery used in treating astigmatism is PRK, wherein only the surface of your eye is ablated. However, PRK is not as commonly used anymore. One of the newer kinds of refractive eye surgery is LASEK, wherein a thin layer of the cornea is opened so that the laser can ablate the layers underneath.

It can be adequately treated with both non-surgical and surgical techniques. Ask your ophthalmologist about the risks and benefits of these various options.

Scheduling an appointment to see your eye doctor is one of those things you normally don’t think about too often, but you should start. Just off the top of my head, I can come up with several reasons why an eye exam is important. The first being that our eyes are our windows to the world. Without them we couldn’t see all those wonderful things the world has to offer. We also suffer in our development as individuals, personally and professionally.

Everyone isn’t necessarily required to have periodic eyeglass and eye exams done but it doesn’t hurt not to. Age should not be a factor either. Just because you have 20/20 vision today, doesn’t mean you will tomorrow. All those long hours of staring at a computer screen can take its toll on your eyes. It is important that you don’t wait until it’s too late to do anything.

Here just five reasons why you should schedule an eye doctor’s appointment today:

* 20/20 eyesight - You should visit your eye doctor on a regular basis to have your eyesight checked on. Not only do you want to see clearly but it can also alleviate other health issues you may not be aware of. Many people suffer from daily headaches or fatigue because of a slight over or under correction of their eye prescription. If you work on a computer and spend two or more hours each day staring at your screen, you are at risk for CVS, also known as computer vision syndrome. This causes headaches, focusing difficulties, burning eyes, tired eyes, eyestrain, aching eyes, dry eyes, double vision, blurred vision, light sensitivity, and neck and shoulder pain and can easily be treated with eyeglasses made for computer users.

* Discover eye disease - Did you know that there are a good number of serious eye diseases which have no visible symptoms? Take glaucoma for an example. For years, doctors have referred to is as the sneak thief of sight since it comes on slowly and can cause total vision loss. Then there are cataracts and macular degeneration which develop gradually. You don’t realize something is wrong until your vision has noticeably decreased. It’s only through early detection from your eye doctor can these and other eye diseases be prevented.

* Diagnose developmental issues - Certain learning and reading difficulties stem from eye problems such as dyslexia and ADD and stem from uncorrected vision problems as children. It can also cause lazy eye or eye turn which can lead permanent loss of vision if not treated.

* Find hidden diseases - Many doctors firmly believe that our eyes are the window to our bodies. Dilated pupils, for example can tell a doctor of the presence of undiagnosed hypertension, multiple sclerosis, strokes, kidney problems, or brain tumors.

* Keep current with styles - Eyeglass fashion and frames are always changing towards new new trends and fads. You don’t want to be wearing out-dated glasses and looking old fashioned, do you? The technology used to make glass lenses is constantly improving towards thinner and stronger.

LASIK is a procedure that permanently changes the shape of the cornea, the clear covering of the front of the eye, using an excimer laser. LASIK eye surgery is basically for people who are nearsighted or farsighted and have astigmatism. The goal of LASIK surgery is to change the curvature of the cornea, which is the outermost part of the eye. It allows the person to see without glasses or contacts. After the surgery some patients may develop severe dry eye syndrome, which can be treated with artificial tears and usually takes six months to recover.

On completion of LASIK surgery, the regular nerve impulses that direct the lacrimal gland to produce tears are often interrupted. It is considered an expected phase of the healing process. Dry eyes cause gritty and uncomfortable sensations. In order to avoid this condition, a surgeon carefully examines the eyes and recommends lubricating and moisturizing drops to the patients. They are also advised to keep the eye adequately bathed in tears for the eyes to heal properly and also refrain from overusing the drops.

Dry eye problems range from less serious to more serious complications. While a patient experiences itching, redness, or pain after the vision correction surgery, there are others who face minor problems that can be solved with topical treatments for the eyes. In order to resolve the serious cases of dry eye problem, a tiny plug is inserted that prevents tears from going to the nose and allows lubrication in the eye. People also rely on flax seed oil caplets and a humidifier in their home, which relieves the dry, scratchy feeling. New treatments for dry eyes include collagen or silicone punctal plugs and punctal cautery. These greatly reduce symptoms, promote healing and improve vision by enhancing the quantity and quality of the eye’s natural tear film.

Night vision binoculars allow you to see at night but how do they really work?

Night vision binoculars are the most fashionable and popular consumer durables available in the market. From children to oldies, night vision gear is bought and liked by everyone. It is very difficult to see far and if it is in the dark, it gets harder because of the simple reason that humans are not blessed with the eyes of an owl or a tiger. But the advancement of nightvision technology has solved this problem as well. Night-vision binoculars help to spot things in the night.

When infrared night vision was first launched in the market, they were very expensive and were considered as a status symbol. But with the advancement of technology and the increase in the number of binocular manufacturers, the price of these night scopes has come down substantially and now the common person can easily afford them. Presently, the cheaper night optics are used by security recruits in general days.

How do the Night-vision binoculars work?

The subsisting light is amplified by the optics used in the Night-vision binoculars. They make the light evident to our eyes and are also useful for infrared spectrum. Good and eminent night binoculars have illuminators that can amplify the existing infrared light.

But the things you see through a night vision lens will appear greenish to your eyes as your eyes don’t see the objects directly but they see their image, which is made on a phosphor screen.

The intensity of the amplified light or the performance of the night-vision binoculars depends on the conditions of the available light. There exists an inverse relation between the light situation and the power of the binoculars. You will need more powerful infrared night vision as the light situation gets weaker and weaker and vice versa.

Types of Night-vision binoculars:

The diverse “generations” of night binoculars are known as the different types of Night-vision binoculars.

•First Generation:
Generally the night-vision binoculars of first generation are used by the city dwellers. These are less expensive are easily affordable. They have the power to amplify existing light by an aspect of 1,000. These can be used when there is bright stars and a full moon covers up the sky in the night.

•Second generation:
This generation night-vision binoculars work well when there is a crescent moon. These are generally used by the law enforcement agencies. They are quite expensive as compared to the first generation binoculars but the images they provide to your eyes are brighter, sharper and even clearer as compared to the first generation night-vision gear

•Third generation and fourth generation:
Night-vision binoculars of third generation and fourth generation are used during dark and cloudy nights when the intensity of the light available is very low and weak. They are very expensive and hence are not affordable by common people. But the images they provide are much clearer and sharper as compared to all binoculars of previous generations.

How to buy the right Night-vision binoculars?

With plenty of options available in the market it is very confusing to choose the right one for yourself. There are simple binoculars for children with which they can have some fun and even some very sophisticated and classy ones, which are good for night navigation or surveillance. So, following are some tips to help you select the right one for you.

1.The first and the foremost thing you should decide prior to buying any night vision equipment is its purpose. Night-vision binoculars and scopes are used for various purposes for instance, scouting games, exploring caves, camping, surveillance and security, wildlife observation, nighttime navigation, night hunting and night boating and fishing.

2.The second thing, don’t compromise on the quality of the binocular because of the cost involved. In general, night-vision binoculars are more costly than the normal binoculars and hence be prepared for to pay for it. Always try and go for branded ones such as Weaver, Night Owl, Yukon, or N-Vision Optics as they come with more number of features than what the general manufacturers will offer.

3.Range of Night vision is another important thing to look in a night-vision binocular. The range of a binocular depends on its resolution, gain and magnification. Look for binoculars with powerful lenses as they help in good magnification. Night vision binoculars are a good and a costly investment and hence, look for all the possible options available and then choose one for yourself; compromising on the quality is certainly not advisable.

Lazy eye is a disorder of the coordination between the eye and the brain, usually beginning in childhood. This disorder causes the body to prefer one eye over the other. It is known medically as amblyopia.

Lazy eye is characterized by poor or blurry vision in an eye that otherwise seems normal.

Someone with lazy eye experiences no transmission or poor transmission of the visual image from the eye to the brain for a period of time during early childhood. Lazy eye usually only affects one eye but it is possible to be amblyopic in both eyes if both are similarly deprived of a good, clear visual image.

Studies estimate that about one to five percent of the population suffers from lazy eye. It is believed that three percent of children under six have some form of amblyopia. Many people who are afflicted by lazy eye, especially those with a mild case, aren’t even aware they have it until they are tested at later ages. This is true because vision in their stronger eye is normal.

A severe case of lazy eye, however, can be associated with other visual disorders, particularly poor depth perception.

Lazy eye cannot be corrected by glasses or contact lenses, and is not due to any eye disease. The brain, for some reason, does not fully acknowledge the images seen by the amblyopic eye.

Many people think someone who has a crossed or “turned” eye has lazy eye. However, “crossed eyes” is actually a different eye condition known as strabismus.

Because of this misunderstanding, many people describe someone who has “crossed eyes” as having a lazy eye.

The most important means of determining if someone has lazy eye or amblyopia is a series of special visual acuity tests. The “20/20 letter charts” currently used by schools, pediatricians and many doctors are generally not sufficient for diagnosing lazy eye.

Since lazy eye usually occurs in one eye only, many parents don’t realize their child may have it. A large number of kids with lazy eye go unnoticed until they have their eyes examined when they get older. Therefore, comprehensive vision evaluations by a trained and qualified vision professional are a smart idea, even for infants and pre-schoolers.

Treatment options for lazy eye include glasses, drops, and certain vision therapies, possibly including the use of a patch.

Recent medical research has shown that lazy eye can be successfully treated up to the age of 17. As the patient grows older however, successful treatment of lazy eye requires more intense effort, including vision therapy. Improvements are possible at any age with proper treatment, but early detection of lazy eye still offers the best chance of a positive outcome.

Presbyopia is an eye disorder that normally sets in between the ages of 40-50. A lot many theories have been suggested to delineate its proper cause. However, the most convincing theory is that the eye lens loses its elasticity over time, and this in turn results in the loss of accommodation power of the lens. Consequently, the lens is unable to focus on nearby objects, and hence the patient’s near vision is rather blurry. Presbyopia affects everyone at a certain age and it is not routinely curable.

The loss of accommodation power can be compensated for through LASIK surgery by producing what’s called “monovision”. Normally, people possess binocular vision. That is, both eyes work together equally while viewing an object. On the other hand, in case of monovision, one eye is corrected for near vision and the other is corrected for distant vision. LASIK surgeons make use of this technique to counter presbyopia.

LASIK can be a viable option for producing monovision. However, there is a caveat. Monovision is not appropriate for everyone. Furthermore, monovision may also interfere with depth perception. That is, the patient may not be able to perceive the accurate distance of any object, since accurate 3D perception requires input from both eyes. Therefore, it is recommended that the patient first uses contact lenses to produce monovision, in order to ensure that he or she can adapt to the change. Apart from surgery, a patient may use prescription glasses (bifocal or progressive) to compensate for the loss of power of accommodation.

Intraocular lens implant is another viable alternative to counter presbyopia. In essence, the natural lens is replaced with a new lens to achieve accurate refraction. Another interesting aspect is that presbyopia may not have a major affect on people with myopia. In general, a myopic does not have trouble reading without glasses. Thus a myopic often possesses perfect reading vision, without any visual aid, even in the old age and even after presbyopia sets in.