Month: September 2020

Optometry in Focus: Conjunctivitis (Pink Eye)

Happy Monday, y’all!

With school back in session and cooler weather on its way, I suppose it’s time for a discussion on conjunctivitis, colloquially known as pink eye.

But first, let’s start with a quick ocular anatomy review.

Anatomy

Despite how tempting it would be to just post a picture with fancy labels and the like, I think this section will work the best if you stop what you’re doing for a moment and find a way to look at your eye – a mirror would probably be the easiest.
What do you see?
If you’re like most people, you’ll notice the colored part, or the iris, first.  If you get really close to the mirror or change the lighting, you should be able to see a change in the size of the dark hole in the center of the iris. This is your pupil, which varies in size to adjust the amount of light coming into your eyes.
Above the iris and the pupil is the cornea.  This clear structure is difficult to truly see in the mirror, but if you wear contacts, this is what the contact drapes over.
In addition to the colored portions, you’re surely able to see the white part of the eye, or the sclera, which functions to maintain the shape and structure of your eye, while providing a protective barrier!
What’s missing?
If you look very carefully (or wash your hands and gently touch the white part of your eye), you’ll notice that there’s an easily moveable jelly-like material that covers a majority of your eye (minus the cornea).  And, unsurprisingly, its this structure, the conjunctiva, that is highlighted in the post today!
Ready?  Let’s get to it!

Conjunctivitis

Now that we’ve got the basic anatomy down, the question is: what is conjunctivitis?
For those of you fluent in medical-ese, you’ll know that the suffix “itis” means inflammation.  In this case, the inflammation is of the conjunctiva.
Now, conjunctivitis can come in various forms – predominantly bacterial, viral, and allergic – depending on the offending agent.  In each of these cases, a foreign object is identified by the immune cells circulating in the conjunctiva, which then activates the immune response to remove the unwanted material.  Unfortunately, this process creates inflammation – the symptoms of which are determined by the particle causing the immune response.

Viral Conjunctivitis

Viral conjunctivitis is inflammation of the conjunctiva secondary to an immune response to a viral particle. Common symptoms are:
  • Watering
  • Irritation
  • Mild light sensitivity
  • Pinkish red eye
  • Typically one eye, or one eye before the other
This often occurs in someone with a history of an upper respiratory infection, or exposure to someone with an upper respiratory infection.
Viral conjunctivitis is highly contagious (arguably the most contagious type of conjunctivitis).  For this reason, when people present with viral conjunctivitis should refrain from touching their eyes (it easily spreads between eyes as well), wash hands frequently, clean pillowcases, and use their own hand towels, etc, to prevent the spread of the infection to others in the household.
Unfortunately, especially considering the high transmission rate of viral conjunctivitis, there is no true treatment for this condition (just as there is no treatment for the common cold).  Rather, the focus is on reducing symptoms through cool compresses and artificial tears.  In cases of extreme symptoms, providing there is no corneal involvement, topical steroids may be used.

Bacterial Conjunctivitis

Bacterial conjunctivitis, as could be assumed, is inflammation of the conjunctiva caused by an immune response to bacteria.  Common symptoms are:
  • Deeper (beefy) red eye
  • Irritation
  • Significant discharge
  • Typically one eye, or one eye before the other
Bacterial conjunctivitis is also contagious, however, generally less than viral.  Additionally, this condition is generally easily managed with topical antibiotics.

Allergic Conjunctivitis

This topic is one that I already covered in my post on ocular allergies.  For a quick review, however, allergic conjunctivitis is inflammation of the conjunctiva in response to, well, a number of different particles (of non-viral or non-bacterial origin).  Common symptoms are:
  • Light red eye
  • Itching
  • Mild watering
  • Potential swelling of eye lids
  • Normally both eyes at the same time vs one then the other
Allergic conjunctivitis is NOT contagious, so there is no concern of spreading it at school or between family members. Additionally, allergic conjunctivitis can be treated with over the counter or prescription topical (or occasionally oral) medications.

Parting Advice

Regardless of the type of conjunctivitis, it is important to remember to wear glasses, rather than contacts, during times of ocular inflammation.
Additionally, if you are experiencing symptoms, it’s always wise to talk to your optometrist, even if you think you may know what’s going on.
If you learned something from this post, please share it with a friend or family member!  If you liked it, please subscribe, or like my page on Facebook! And as always, if you have any questions or comments, please contact me – I’d love to hear from you!

Contact Lenses: Ortho-K (Corneal Reshaping)

Happy Monday, y’all!

In today’s post, I’m taking a break from the world of neuro to answer a reader question.

JM writes: Do they still do corneal molding?  I did that for a while and loved it! I wore contact lenses at night, took them off in the morning, and could see without anything!  After a while, I didn’t even have to wear them for several nights at a time and could still see!  Freedom!!

First off, thank you so much for your question, JM!  And, believe it or not, yes we  still use corneal reshaping (or ortho-keratology) in practice! Keep reading to learn more!

Ortho-Keratology (Ortho-K)

What is Ortho-K?

As JM described in her question, Ortho-K is a process by which the cornea is molded by wearing specialty hard contact lenses over night to correct (myopic/near-sighted) refractive error.

How It Works

This process that was first introduced in the 1960s uses a gas permeable lens design that sits directly on the cornea, rather than slightly vaulting over it, to create a flattening effect.  This flattening decreases the radius of curvature of the cornea (steepness), secondary to temporary epithelial redistribution, therein decreasing its convergent power.  As myopic or near-sighted eyes have a focal point in front of the retina, this change in convergence repositions the focal point, optimally on the retina.

With that in mind, it only makes sense that different eyes will require different amounts of flattening to correct the prescription, with higher prescriptions necessitating more flattening, and lower prescriptions needing less.

This flattening is focused over a (generally) four millimeter treatment zone.

Process

Once the decision to pursue Ortho-K has been made, the process of fitting and prescribing generally goes something like this:

  1. Complete eye exam, including refraction, dilation and thorough front surface/corneal evaluation: Ensures the health of the eye and determine the current refractive needs
  2. Corneal measuring, using a keratometer: Determines the parameters of the lens for fitting
  3. Lens fitting, or actually putting lenses on the eyes: Making mild adjustments until the appropriate fit and vision are achieved
  4. Insertion/removal training: Learning how to properly use the lenses themselves
  5. Lens dispensing: Sending the lenses home
  6. First follow-up: Generally a morning appointment after the first night of wear, with the lenses still in, to verify the fit of the lenses after wear
  7. Additional follow-ups: Often spaced at one, two, four, and eight weeks to continue monitoring stability of fit

Pros

As JM mentioned, Ortho-K can be incredibly freeing, allowing patients to go without glasses or contacts during the day (and sometimes even a few nights).  This then provides an attractive, reversible alternative to LASIK.

Cons

While Ortho-K can be an awesome option for refractive error correction, it isn’t for everyone.  Some common complaints are:

  • Lens intolerance: Ortho-K requires sleeping in a hard contact lens. For those of you who have never worn them, hard lenses are called hard lenses for a reason – they’re modestly hard pieces of plastic!  While most people adapt to the lenses well, some people cannot tolerate even overnight wear of the lenses.
  • Glare/halos/distortions: This process is literally moving some of the cells on the front surface of your eye to temporarily change the power, which can cause distortions in vision – especially when driving at night, in the form of glare and halos.  It’s the worst in patients with large pupils that extend past the treatment zone, putting those distortions directly in your line of sight.
  • Temporary correction:  While JM was one of those with a successful enough Ortho-K run to be able to go several days without retreatment, this is not the case for everyone.  Some people report visual changes before the end of the day, requiring additional lenses for clear vision in the evening.
  • Risk for infection: While this risk is relatively low, it’s worth mentioning, after all, Ortho-K requires sleeping in contacts.. which is normally highly discouraged by providers.
  • Prescription parameters:  Due to the corneal flattening nature of Ortho-K, is primarily indicated for people who are near-sighted, or myopic.  Additionally, it works best on moderate to low prescriptions, with mild amounts of astigmatism.

Additional Indications

In relatively recent years, Ortho-K has been investigated as a method of controlling myopia progression in children and teens, secondary to its creation of peripheral myopic blur.  This myopic blur serves to inhibit axial elongation (or prevents the eye from getting longer), therefore decreasing myopic progression.  While results vary by case, studies have proven that Ortho-K may reduce progression by, on average, 45%.  As such, Ortho-K is an attractive option for young, near-sighted individuals, as it provides unobtrusive day-time refractive error correction while concurrently reducing myopic progression.

Personal Experience

My first personal experience with Ortho-K was during the summer of my first year of optometry school, when I was lured by the financial gains and visual promises of a corneal reshaping study. The process went much like how I described above, with the exception of some additional study related measurements and paperwork.  All seemed to be going well until somewhere around a week or so into the study – I had even been able to go without wearing any lenses for the first time in like 13 years.  It felt so freeing!

Until I went out of the sun.

Everything was blurry. Everything had halos.  I got dizzy and nauseous just looking around.

But I was determined to succeed and convinced it would pass, if only I wore the lenses more.

(Mind you, this was over July 4th, and I was on vacation.)

I tried.  And tried.  And tried.  No matter how many hours I wore the lenses (which became increasingly difficult as the irritation of wearing the lenses increased), nothing got better.  I was miserable.

Finally, I texted my contact in the study and informed her that I could take it no longer.  Whether she liked it or not, I was done.  I threw on my brother’s glasses (which happened to be just the prescription that I needed during the transition), and never looked back.

A few weeks later when I returned to school to turn in my lenses, I discussed my results with the study coordinator.  Our best guess theory was that a combination of my relatively large pupil size and moderately high prescription (I was at the upper bounds of the study limits) created the distortions that plagued me during the study, and while we were curious of the effects of a larger treatment zone on my visual outcome, I was too over it to continue.

Takeaways

Considering my personal experience, it would probably be reasonable to wonder if I believe in prescribing Ortho-K lenses at all.

Admittedly, it did take me a while to come to terms with the benefits of the lenses, but now, I am happy to prescribe corneal reshaping therapy.  It definitely has its place in current optometric practice, and over time, I have come to accept that my experience was more of an exception, rather than the rule.

With this in mind though, I am more cautious with Ortho-K prescribing, typically preferring it for younger patients with fewer visual demands and a lower prescription.


If you learned something from this post, please share it with a friend or family member!  If you liked it, please subscribe, or like my page on Facebook! And as always, if you have any questions or comments, please contact me – I’d love to hear from you!

(Neuro)Optometry in Focus: Cranial Nerve Basics IV-VI

Hello, and welcome to part 2 of my Cranial Nerve Series!

In the previous post, I introduced cranial nerves and discussed the basics of CN I-III.  Ready for IV-VI? Let’s get started!

CN IV: Trochlear

Cranial nerve IV, or the trochlear nerve, is solely responsible for controlling movement of the superior oblique muscle, which functions to help rotate the eye in an inwards motion (intorsion).  As such, CN IV is a general somatic efferent nerve.  
 
Like the oculomotor nerve, the trochlear nucleus originates in the midbrain.  However, instead of immediately going forward towards the eyes, the trochlear nerve crosses to the opposite side, and then passes dorsally (posteriorly or to the back) out of the midbrain, and then proceeds to wrap towards the eyes.  This pathway will prove very important in my CN IV palsies post!

CN V: Trigeminal

While CN IV was short, sweet, and to the point, the trigeminal nerve is anything but!  Trigeminal by definition means threefold, which speaks to the three primary divisions of the trigeminal nerve… which doesn’t sound bad, until you look at all the many subdivisions of these three.  Think you’re ready?  Hold onto your hats, and let’s give it a go!

Cranial nerve V is a mixed nerve, containing both sensory and motor components. For the sensory side, the trigeminal nerve conducts sensory signals via generals somatic afferent fibers from a number of smaller nerves that we’ll discuss further in a moment.  On the motor side, the trigeminal innervates the muscles of mastication (chewing), as well as a few others that I’ll briefly cover.  Due to the embryologic origins of these muscles, the signal is transmitted via special visceral efferent fibers.

Interestingly, rather than having a single nucleus like CN III and IV, the trigeminal nerve actually has four nuclei: three sensory (primary, spinal and mesencephalic) and one motor.  These, essentially, end up passing through a majority of the brainstem, converging into the trigeminal ganglion near the petrous portion of the temporal bone.

From there, as previously mentioned, the trigeminal splits into three branches: the ophthalmic (V1), the maxillary (V2), and the mandibular (V3).

    Ophthalmic

  • Sensory nerve
  • Further divides into:
    • Lacrimal nerve (lacrimal gland/upper eyelid)
    • Frontal nerve
      • Supraorbital nerve (sensory from skin of lower forehead)
      • Supratrochlear nerve (sensory from nose/upper eyelid)
    • Nasociliary nerve
      • Anterior ethmoid nerve (sensory from nasal cavity)
      • Posterior ethmoid nerve (sensory from sinuses)
      • Long/short ciliary nerves (sensory for eye)
      • Infratrochlear nerve (sensory for conjunctiva and central upper eyelid)
    Maxillary
  • Sensory nerve
  • Further divides into:
    • Infraorbital nerve
      • External nasal nerve(sensory for skin on side of nose)
      • Internal nasal nerve(sensory to nasal septum)
      • Superior labial nerve (sensory for upper lip)
      • Inferior palpebral nerve (sensory for lower eyelid)
      • Anterior superior alveolar nerve (sensory for teeth)
      • Middle superior alveolar nerve (sensory for teeth)
    • Meningeal nerve
    • Pterygopalantine nerve
      • Lateral superior posterior nasal (sensory for nose)
      • Medial superior posterior nasal (sensory for nose)
        • Nasopalatine
      • Major palatine (sensory for palate)
      • Minor palatine (sensory for palate)
    • Zygomatic nerve
      • Anterior zygomaticofacial nerve (sensory from far side of face)
      • Posterior zygomaticotemporal nerve (sensory from far side of face)

    Mandibular

  • Sensory and motor nerve
  • Sensory:
    • Buccal nerve
    • Inferior alveolar nerve
      • Inferior dental plexus (sensory for teeth and gums)
      • Mental nerve (sensory for teeth and gums)
    • Lingual nerve (sensory for tongue and floor of mouth)
  • Motor: (muscles of mastication)
    • Mylohyoid
    • Anterior belly of digastric
    • Tensor palantini
    • Masticatory muscles
    • Tensory tympani

Phew! We made it!

 

CN VI: Abducens

Last, but not least (for eye people anyway), in today’s cranial nerve discussion is cranial nerve VI.  The abducens nerve is responsible for innervating the lateral rectus, or the muscle that allows you to turn your eye out.  As such, it is made of general somatic efferent fibers.

The abducens nucleus is located in the pons, or the middle portion of the brainstem.  Like CN IV, it has an interesting path through the skull that predisposes it to lesions… but we’ll talk about that more in CN VI palsies!


Annnd that’ll be all for today!  Tune in next time for CN VII-IX!


If you learned something from this post, please share it with a friend or family member!  If you liked it, please subscribe, or like my page on Facebook! And as always, if you have any questions or comments, please contact me – I’d love to hear from you!

(Neuro)Optometry in Focus: Cranial Nerve Basics I-III

Howdy, y’all!

Since it’s been a while since I wrote any neuro-related posts, I figure it’s as good of time as any to begin a discussion on cranial nerves.  Let’s get started!

 

What are cranial nerves?

Cranial nerves are simply the 12 pairs of nerves that originate in the brain, and then travel to various parts of the body.  Typically, these 12 nerves are referred to by roman numerals.

Before we dive further into each of the 12 cranial nerves, it’s nice to have some understanding of, well, nerves.  So here it goes:

Nerves can be classified in several different ways, but the most common are:

  • Size
  • Conduction speed
  • Function
  • Origin
For right now, I primarily want to focus on function.

One major functional distinction is sensory versus motor.

  • Sensory nerves carry information regarding your senses to the brain.
  • Since they are going to the brain, they are considered afferent. 
  • Motor nerves carry information from the brain to the body to create movement.
  • Since they are coming from the brain, they are considered efferent.

Nerves may also be classified as special or general.

  • Special nerves are those related to special senses – sight, smell, hearing, taste, and balance.
  • General nerves are for everything else.
Finally, nerves can be responsible for either somatic (general body) or visceral (internal organ) functions.
 
Okay, I think that covers the basics. Now onto cranial nerves!
 

CN I: Olfactory

The Olfactory nerve is responsible for smell.  There’s some debate as to its classification – special somatic afferent or special visceral afferent.  Regardless, it’s a sensory nerve for a special sense!
Interestingly, this nerve doesn’t have a technical nucleus, but rather originates in the nasal cavity, with its branches passing through the cribriform plate of the ethmoid bone.  This creates a perfect location for picking up smells!
The fibers then travel to the olfactory bulb to become the olfactory tract, and then pass to other parts of the brain to play roles in memory!

CN II: Optic

The optic nerve is most optometrists’ favorite.  After all, it’s the one we work with all the time!
 
Due to its role in sight, the optic nerve is again a special nerve that carries sensory information to the brain – special somatic afferent!  Like CN I, CN II does not have a nucleus.
 
You can read more about the pathway of the optic nerve in my post: How Do You See?
 

CN III: Oculomotor Nerve

With the oculomotor nerve, we’re starting to get into more interesting territory!
 
CN III is a motor nerve that actually has two branches – one for somatic muscle and one for visceral muscle! For this reason, the oculomotor nerve is both general somatic efferent AND general visceral efferent.
 
Unlike CN I and II, CN III has a true nucleus – the oculomotor nucleus.  This structure is located in the midbrain (uppermost) part of the brainstem. Fibers then pass forward (towards the face) through the cavernous sinus and into the superior orbital fissure where it divides into two branches: superior and inferior.
The superior branch of the oculomotor nerve is responsible for somatic innervation of levator and superior rectus.  As an optometrist, these two muscles are extremely important, as the levator is responsible for movement of the upper eyelid, while the superior rectus helps to lift the eye up!
The inferior branch of the oculomotor nerve provides somatic innervation to the medial and inferior rectus muscles, as well as the inferior oblique.  Once again, these muscles are important in optometry, as the medial rectus turns the eye in, the inferior pulls the eye down, and the inferior oblique helps to rotate the eye!
The inferior branch of the oculomotor nerve additionally carries visceral (parasympathetic) innervation to ciliary muscle and pupillary constrictor.  These are once again important to optometrists, as the ciliary muscles drives accommodation (or the ability to focus), while the pupillary constrictor muscle is responsible for contracting the pupil!
Well, that’s enough typing for now.  Check back soon for Part II of this series!
If you learned something from this post, please share it with a friend or family member!  If you liked it, please subscribe, or like my page on Facebook! And as always, if you have any questions or comments, please contact me – I’d love to hear from you!

Optometry in Focus: Eye Turns (Strabismus)

For those of you with children, have you ever seen your child’s eye turn in or out and wonder how concerned you should be?

In working with pediatrics, this is one of the more common questions that I am asked, and so, for tonight’s post, I’ll try to shed some light on eye turns.  Check it out!

Strabismus

The Basics

Eye turns, or strabismus, can be described in several ways.  The first is by consistency, with the deviation being either constant or intermittent.  The second is by time of onset – whether congenital/early onset or acquired.  Eye turns can also be described by the direction of the eye turn. In this, the eye can turn in (esotropia), out (esotropia), up (hypertropia), or down (hypotropia).  Finally, a single eye can turn, or the eyes can alternate.

Who?

At the end of the day, essentially anyone can have an eye turn. However, early onset eye turns may have a genetic component. Additionally, eye turns may be associated with ocular pathology or problems with the development of the brain (ie hydrocephalus).  Inward eye turns that are worse when focusing at near may be associated with a moderate to high far-sighted prescription.
Acquired eye turns are more likely to present after an acquired brain injury, as a result of damage to the nerve pathway.

Signs/Symptoms

The biggest sign or symptom of strabismus is simply an eye turn. However, additional signs include closing or covering an eye and blinking excessively.  These both may be indications that your child is seeing double.  The first is used to remove the second image formed by the deviating eye, while the second is used to help focus.
In new onset or acquired strabismus, double vision, or diplopia, is common, as the brain has not adapted to automatically suppress the additional image.  This may be perceived as blur. 

Why?

The complete explanation behind early onset eye turns is not fully known, but the basis is this:
All eye movements are controlled by six muscles on each eye.  These 6 muscles in turn are controlled by three cranial nerves (in each eye).  Damage to the nerve or the muscle can cause  deviation from normal eye position and movements.

When to be Concerned

In the first few months of life, it is very common for your child’s eyes (as well as the rest of their body) to not be perfectly synced.  They’re just trying to get the hang of coordinating and focusing, so this should come as no real surprise.
However, if an eye turn continues after the first 3-4 months, or is constant or always the same eye, it’s worth getting checked out to rule out pathology.  Additionally, a constant, or near constant, eye turn is a risk factor for ambloypia – decreased vision that is not attributable to glasses prescription alone!
Additionally, if you ever notice a new onset eye turn, or your child begins to complain of double or closes an eye for specific tasks, an exam is warranted.

Treatment Options

The treatment options for eye turns vary significantly depending on the size, direction, and frequency of deviation.  Large angle deviations often end up requiring surgery to decrease the demand on the muscles.  Smaller angle outward eye turns, or exotropias,  may be managed by vision therapy, additional minus lens power, or prisms.  Inward eye turns, or esotropias, especially those associated with focusing the eyes (accommodation) may be managed by plus lenses, prisms, or in more rare cases vision therapy.
Eye turns up or down (though the eye that is higher, or hyper, is more typically referenced), are less frequent than eye turns in or out.  When they’re small, prisms, or a combination of prisms and vision therapy, may be used for treatment.  Larger deviations, as before, are more likely to be surgically managed.
And there you have it!
If you learned something from this post, please share it with a friend or family member!  If you liked it, please subscribe, or like my page on Facebook! And as always, if you have any questions or comments, please contact me – I’d love to hear from you!

Optometry in Focus: Ocular Allergies

Happy Friday y’all!

First things first: how many of you haveseasonal allergies?

If you’re anything like me, (especially when residing in Texas) allergy season has come to include every month of the year.  Interestingly, while most people are aware of the effects of allergies on their sinuses, I find that many people are unaware of how allergies affect their eyes.

Insert today’s post!  Let’s get started!

Ocular Allergies

Causes

Pretty much all allergic reactions in the body have the same basic cause: the body identifies something (an antigen) as a foreign entity, and decides to attack it.  Allergies specifically are associated with a Type 1 Hypersensitivity reaction, mediated by the specific antibody Ig-E.  In this, the Ig-E antibody that is specific for the antigen that you’re allergic to (ie pollen, dander, etc) binds to an immune cell called the mast cell, which contains products that are meant to destroy or remove the antigen.
The most prominent product in mast cells is histamine.  This chemical causes all the typical allergy symptoms – a runny nose, watery eyes, and itching!

Symptoms

The most common symptoms of ocular allergies (as could probably be guessed from above) are:
  • Watery eyes
  • Itchy eyes
  • Swelling
  • Mild discharge
  • Blurred vision
Some additional signs of ocular allergies are:
  • Redness (generally in both eyes)
  • Papillae (little red bumps on the inside of your eyelids)

Treatment

Ocular allergies are treated much in the same way that systemic seasonal allergies are treated.
The first course of action is to remove the offending agent – aka, stay away from  what you’re allergic to!
However, when you’re allergic to the air in the entire state, that’s hard to do.
The second step is to take systemic allergy medications.  More often than not, these can be over the counter.  However, if your allergies are severe, you may need stronger, prescription medications.  If possible, try to stay away from decongestants though, as they can cause dryness and increase ocular irritation.
In the case of ocular allergies, it is often necessary to specifically treat the eyes.  I most commonly advocate for the use of over the counter eye drops before proceeding to prescription mediations.  My favorite drop is Pataday (olopatidine 0.2%), as it is relatively cost effective and only needs to be used once a day!  Other great the counter option are Zaditor and Alaway (both are ketotifen 0.035%), which are used twice a day.  Make sure to wait 5 minutes after using your drops to put in contact lenses or using any other drops.
As ocular allergies may be exacerbated by longer contact lens replacement schedules, I tend to prefer to fit patients with symptomatic ocular allergies in daily lenses.  This reduces the potential for buildup on lenses, and therefore decreases the likelihood of an allergic response.
Symptoms may also be mitigated by strategic hygienic considerations, such as showering in the evening and frequently washing pillowcases to reduce the number of potential allergens around the eyes while sleeping.
Finally, cool compresses are often helpful in reducing the itch that accompanies ocular allergies!
If you learned something from this post, please share it with a friend or family member!  If you liked it, please subscribe, or like my page on Facebook! And as always, if you have any questions or comments, please contact me – I’d love to hear from you!

Optometry in Focus: Ocular Emergencies

Happy Monday, y’all!

One of my favorite COVID-era eye questions (thanks to 4 months of emergency care, triage, and telehealth calls to round out residency) is, “what constitutes an ocular emergency?”
(Which is closely related to, “do I really need to see a doctor for this?”)
With that in mind, today’s post is going to cover some common signs and symptoms that really do require a trip to your OD!

Flashes and Floaters

Flashes and floaters are most commonly associated with a posterior vitreous detachment (not an emergency).  However, they may also be an indication of a retinal tear or retinal detachment.  If you have a sudden increase in flashes and floaters, call your eye doctor up, so that they can take a look!

Loss of Vision

A sudden change in vision can also be a sign of significant ocular problems.  From sudden blurry vision (that lasts more than a few seconds and doesn’t get better with artificial tears, cleaning glasses, or changing contacts), to a complete loss of vision, these changes should not be taken lightly.  Don’t wait for a few days to see if your vision gets better, call your doctor up immediately!

Painful Red Eye

Unfortunately, not all red eyes are created equally – which is probably why they’ll end up in a series sooner or later.  When does a red eye need to be seen?  When it’s painful or associated with changes in vision. (Okay, and a few other times, but we’ll talk about those later…)

Foreign Body

Knowingly getting something in your eye (especially if you suspect/know that it may have penetrated your eye) also gives cause to call up your eye doctor.  They’re able to perform rinses, remove foreign bodies, and prescribe mediations (often antibiotics) to decrease the changes of an infection forming.
If you have other signs or symptoms not listed here, don’t be afraid of checking in with your provider! If you’re afraid there might be a problem, it’s always better to be safe than sorry!
If you learned something from this post, please share it with a friend or family member!  If you liked it, please subscribe, or like my page on Facebook! And as always, if you have any questions or comments, please contact me – I’d love to hear from you!