Eye Care and LASIK Surgery Q&A Forum

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Your question will be answered in a few days and posted here on KPLCTV.com. DISCLAIMER: The Eye Clinic makes every effort to address your questions based on the accuracy of the information you provide. However, these responses are not intended to be a substitute for a proper medical examination.

QUESTION #1: When I turn over during the night or turn my head too swiftly in the darkness, I see brief spurts of fireworks in my right eye. I am fearful that my retina is getting ready to detach, yet this has been going on for months. I talked to an ophthalmologist about this. He said it's Moore 's Lightning Strikes, and that I will know when the retina detaches because I'll have a HUGE floater in that eye or no vision at all. (I always have several floaters moving along.) Should I be paranoid about this occurring? I am jarred frequently while boating, etc. and live far away from a hospital. How long after a retina detaches does it become impossible to re-attach and save already poor vision?

QUESTION #2: I am 53, and have glaucoma and tiny cataracts. I also have a couple of severe ophthalmic migraines each year where I lose central vision for an hours or so, then am dizzy, weak, and disoriented for several more hours after the migraine is over. I suffer from a severe allergy to msg and its various aliases----horrible headaches that last for over 8 days, plus other mean symptoms. I now manage those with Imitrex 25 mg and try to watch every bite of food that I eat. I have used Lumigan (one drop, once daily each eye) and Cosopt (one drop, twice daily--one eye) for my pressure for a couple of years with excellent pressure results. (Took Xalatan for a long time until insurance would no longer cover it.) I have become increasingly hoarse to the point where I can speak normally for less than a minute before the gravelly voice sets in. I also feel a glob in the back of my throat and am constantly clearing. Is this a common side effect of those medications?

ANSWER #1: First, it is important to understand that in the back part of the eye is a thick fluid called vitreous and as we become older this vitreous shrinks. It also shrinks if we have a lifestyle that is conducive to jarring us, as in a riding lawnmower or boating. This vitreous shrinks away from the posterior or back part of the eye and frequently does not completely separate. In the far periphery there may be areas where the vitreous is still attached to the retina and as this vitreous moves about inside the back of the eye it tugs on the retina and we interpret this as "flashes of light". Sometimes it isn't just the tugging on an area where it is still attached, but just the vitreous rubbing on the retina can cause these flashes of light. It is important that your ophthalmologist examine the back of your eye very carefully to make sure you don't have any small holes or tears. These can be corrected quite easily with laser if they are caught early enough. If not, the retina can continue to detach to the point where it becomes so significant that you need a surgical procedure to repair it. Generally speaking, if we are able to identify a small hole or tear in the retina and repair it, this will prevent further detachments, which can involve the macula. If the detachment involves the macula, the outlook for good vision is not as good as if you catch it before the macula becomes involved. It is not necessarily how long after the retina detaches. It is, however, how much the retina has detached into the macula area. Most of the time, the retina can be reattached. However, poor vision may still result if the retina has been detached for a long period of time involving the macula. I would encourage you to continue to consult with your ophthalmologist as long as you are having these flashes of light. I hope this has been helpful.

ANSWER #2: I found that migraines can certainly can be a very disabling problem and thanks to the medications now available, many of these symptoms can be minimized. Regarding your glaucoma, Lumigan and Cosopt are two exceptional products that we have found work quite well for our glaucoma patients. Lumigan is a prostiglandin medication . The side effects are generally limited to the topical area where the drops might touch as the eyelashes may grow longer. There may be some darkness along the skin and some patients also have some darkening of the iris if they have a hazel colored iris. Cosopt is a sulfur and beta-blocker combination and some of the problems could be respiratory problems. If you have asthma, hay fever, etc., it may not be a good idea to take this drug. However, if that is not the case, these two medicines should do quite well. One of the potential side effects of Cosopt involves a bitter taste and pharyngitis, which may indeed be what your problem is. Some of this might be alleviated by obstructing the outflow of the tears and medication when you take the medication. This can be accomplished by putting the drops in the eye, and then closing the eyes and leaving them closed for a minute or so. This would plug up the drain holes in the inside corner of the eye, one on the upper lid and one on the lower lid, where the tears normally flow down and drain into the throat. If you have nice, open ducts, it may be that the medication is draining down through there and irritating your pharynx and certainly this may be making you hoarse. Another method is by applying pressure over the inside corner of each eye gently so the tears do not drain down through there. I would try these two methods and if it still remains, I would certainly discuss this with my ophthalmologist and I think he would agree this is related to the Cosopt and not the Lumigan. I hope this helps you with your problem. L. D. Stewart, M.D. The Eye Clinic

QUESTION: My husband has been walking around with a very dark red spot on the white of his right eye. It has now been one week and the red spot is still there. It is not obstructing his vision, and I was just wondering where it could have come from.

ANSWER: Without examining this red spot it would be hard to say what it is. Sometimes the white part of the eye bruises and that presents as blood red but will either begin to get larger or begin to fade. With the brief description given, it is very hard to speculate on what this might be. He may want to get his eyes examined.

I have a severe case of vertical nystagmus. Is there anything that can be done for this?

ANSWER: It depends on the cause. There are 12 types of nystagmus. The first step to take is making an appointment with one of our eye doctors who can refer you to our muscle specialist, if they think he will be able to help you. The specialist has clinic every other month and gets booked up way in advance. Call the Eye Clinic for an appointment.

QUESTION: My mom has been getting millions of floaters and cobwebs on the whole vision of one eye bringing on headaches. What should we do?

ANSWER: When someone sees floaters and cobwebs we get concerned about retinal detachment and sometimes it is just a type of migrane. The only way to know for sure is to have an eye exam.

QUESTION: I am 34 old male who is taking Xalatan once a day for ocular hypertension. I have no symptoms of glaucoma and the doctor gave me the choice of taking the drops or not. I decided to take the drops and the only side effect is they make my eyes red. My eye appointment is scheduled for the next day after I attend a wedding. I cannot reschedule either function and I do not want to have red eyes in all the wedding photos (I am in the wedding party). Can the eye doctor tell if I have stopped taking my Xalatan drops temporarily?

ANSWER: I would suggest that you call your eye doctor and just be honest. Tell him/her that you want to temporarily stop the Xalatan for the wedding and ask his/her opinion. Your doctor will appreciate your honesty and understand your situation.

QUESTION: I have to get my eyes checked randomly for cataracts due to taking 200mil. of Seroquel daily, for bi-polar disorder. Why? I have been going to a so-called chain clinic in the mall and they act as though it is not important.

ANSWER: The Physicians Desk Reference advises that a patient should have an eye exam before starting this medication and every 6 months after that to monitor for cataract formation. Many medications can cause cataracts and the medical community really doesn't know why.

QUESTION: Do you remove birthmarks close to the face in the neck area?

ANSWER: I am sorry, but we do not.

QUESTION: My eyes are always red and dry. My lips are also swollen and dry and burn all the time. They usually turn red after this occurs. What can I do to prevent this?

ANSWER: You should have your eyes checked. We have a dry eye clinic on Monday mornings with Dr. Bravin. You can call 478-3810 ext 142 and schedule with him for an evaluation.

QUESTION: My eyes stay red/blood shot, and are often tired feeling. I get plenty of rest each night. I have used several different eye drops to help. Nothing seems to help for any length of time. I wear glasses, but haven't had problems with them. I have used the same eye makeup for a couple of years. It was suggested to me that it could be sinus or allergy related. I am in the cosmetic industry and would prefer NOT to have red eyes all the time.

ANSWER: There are so many possible causes for red eye. Allergy is definitely one of them and allergy is very common this time of the year. Itching is another symptom of allergy. There are many drops, that you need a prescription to obtain, that would probably help. See an eye doctor for a diagnosis and treatment.

QUESTION: I am a 56-year-old female. Some times when I am just doing nothing, I can see my pulse in my eyes. It is like a light flashing on and off. Sometimes my right eye hurts and gets a film across it and everything is blurry in it. It goes away after about 30 minutes. What causes this?

ANSWER: Without an eye exam we cannot give you a definite diagnosis but it sounds like an ophthalmic migraine without the headache---this is called migraine with aura. You can see many different things when you have an ophthalmic migraine with aura. Some are mild and some are so severe parts of your vision can be missing. It is important to have this checked out though to be sure it isn't something else.

QUESTION: I have been diagnosed with a palsy or weak eye muscle in my right eye. This is causing me to have double vision at times. My doctor says there is a simple operation to correct this, but he wants to wait and see if it will go away by itself over the next 4-6 months. Is this standard procedure or could I go to another doctor and have the surgery now?

ANSWER: Sometimes muscles are paralyzed after someone has a stroke or if you have diabetes, your eye muscles can become paralyzed and therefore, not work together as they should. These are both temporary situations. I would give it at least 6 months before opting for surgery. You can patch one of your eyes or put frosted tape over one of the lenses in your glasses to help with the double vision. Contact an eye doctor for assistance with this. Double vision can be very frustrating.

QUESTION: My eyes stay red/blood shot, and are often tired feeling. I get plenty of rest each night. I have used several different eye drops to try and help. Nothing seems to for any length of time, they're back to the same thing. I wear glasses, but haven't had problems with them. I have used the same eye makeup for a couple of years. It was suggested to me that it could be sinus or allergy related. I am in the cosmetic industry and would prefer NOT to have red eyes all the time.

ANSWER: There are so many possible causes for red eye. Allergy is definitely one of them and allergy is very common this time of the year. Itching is another symptom of allergy. There are many drops, that you need a prescription to obtain, that would probably help. See an eye doctor for a diagnosis and treatment.

QUESTION: What can be done when a person gets double vision? Is there a simple surgery to correct the muscles in the eye if that is found to be the cause? Is there a neuro-ophthalmologist in the Lake Area ?

ANSWER: It depends on what is causing the double vision. Sometimes it is a problem with the nerves that innervate the eye and sometimes it is the muscle that controls eye movement. We have physicians at The Eye Clinic who check this and if it is found to be caused by a muscle, there is an ophthalmologist that visits from New Orleans that can do an evaluation and do eye muscle surgery, if he feels that is necessary. Please call us at 478-3810 or 1-800-826-5223 for more information.

QUESTION: First, I am actually interested in a laser peel if you have the capability. If you do, what is the average cost of the procedure? If I had to settle for a chemical peel, could you please answer the following questions: Does it have to be restricted to the face? I have age spots on my neck and on my upper chest. Also, what is the average cost for a chemical peel? Does the peel leave a reddening or blistered appearance that would restrict one from public appearance for a certain amount of time? Finally, is there any cost in the initial consulting appointment? Thank you so much for your time with my numerous questions.

ANSWER: We do laser treatments, not peels for hair removal, vessel and pigment lightening. Cost may vary. You would need to call one of our licensed aestheticians to discuss specific treatments and costs. 310-1070 is the number. Chemicals peels are restricted to the face and neck in our center. An extra charge may be applied for the chest. Chemical peel costs range from $75 to $200. There is usually no down time with our chemical peels; however, there is no guarantee how your skin will react. We do have a post-care treatment guide. Our consultation fee is $50.

QUESTION: I am a 48 year old female. During a recent eye exam by an Opthamologist, then by a recommended Retinal Specialist, I was told that I had early Macular Degeneration. This was described as a buildup of drusden on my retina. I was told there was no cure, but that this should affect my eyesight at the present time. However, it may as I age if the drusden buildup continues. Is there any medication or assortment of vitamins I can take to slow this process down?

ANSWER: This is what we recommend: Do not smoke or be around smoke. Wear glasses or sunglasses 100% ultraviolet protection. As for the vitamins, there was a comprehensive study done called The Age Related Eye Disease Study or AREDS and they recommended the following vitamins and minerals: 500 mg of vitamin C; 400 IU (international units) of vitamin E; 15mg of beta-carotene; 80mg of zinc as zinc oxide; and 2 mg of copper as cupric oxide. These are antioxidants and have been found to hinder the development of free radicals in the body. Free radicals are thought to cause ARMD. A company called Baush and Lomb participated in the study and provided the vitamins and minerals. They sell a formulation over the counter called OCUVITE PreserVision AREDS formula, to be taken as 2 tablets twice a day. Of course, you should check with your family physician or internist before taking anything over the counter. It is advised that if you smoke, you should not take beta-carotene as it increases your chances of lung cancer. If you would like more information, call the National Eye Institute at 301-496-5248.

QUESTION: My eyelids have been extremely dry and itchy. I've tried replacing my makeup and it is still the same. It has never happened before. I've tried Vitamin E cream and vaseline and it doesn't seem to help. Also, my eyes always have a clear substance in them. It feels as though I always have something in my eyes. Any suggestions?

ANSWER: You need to see an eye doctor. It could be many things, such as dry eye syndrome, allergic conjunctivitis, blepharitis etc. Absolutely do not swipe your finger across the inside of your eyes to remove the clear substance (probably mucous). This can cause a very difficult problem. If you are doing this or have been, be sure to let the doctor know. Our clinic number is 478-3810. You can buy some artificial tears such as Refresh Tears and use them about 4 times a day until you can see an eye doctor.

QUESTION: My wife suffered a stroke about a year ago which left a blank spot in her vision on the right side. It wasn't the eyes that were affected, only the brain. Would it be possible to put some sort of prism in the right lense of her glasses which would enable her to see on the right side where the blank spot is?

ANSWER: No, prism is used to correct eye muscle imbalance (seeing double, etc.) If there are blank areas in your vision after a stroke, they sometimes get better with time but there is nothing the eye doctor can do to improve that area. Your wife's body has to heal as much as it can on its own.

QUESTION: I have kerataconis. Would the CRT lenses be helpful to me? I currently wear hard lenses and have for over 25 years.

ANSWER: The CRT lenses are not specifically for keratoconus. We have special hard contact lenses for that, lenses such as the Rose K lens.

QUESTION: I used Lumagin for about 3 weeks and stopped because I was concerned about the side effects listed on the drug brochure. Several weeks after stopping, I noticed my eyelids had gotten darker, and dark circles were developing under my eyes. This has gotten worse and worse and now, 3 months later, I look like a raccoon, especially in the morning when my eyes are baggy. Is there anything I can do to make this go away?

ANSWER : When you stopped the drops it should have cleared the dark circles. The drops did not cause the bags under your eyes, age does that. Having the problems with the dark circles probably called attention the bags under the eyes. You should call your eye doctor and discuss these concerns. Hope you are using something for the eye pressure. If you are not using anything for your eye pressure, you should be. Lumigan is a great medication but it can cause pigment changes. If you have glaucoma, you can lose some of your vision if the pressure is untreated. Please call your eye doctor soon.

QUESTION: I am 30 years old and I my question is... Will lasik help or hurt me I have these things wrong with my eyes sence birth. Retrolental fibroplasia, nystagmus, myopia, strabismus, and maculopathy in both eyes. Recently I went to the doctor because I am bothered with grare do to cataracts on both eyes. My vision is 20/700 in my right eye and 20/400 in the other eye. As a eye doctor do you thing the lasik would help me or make my vision worse.

ANSWER: Unfortunately, with all of your eye problems, you are not a candidate for Lasik surgery or any other type of refractive surgery.

QUESTION: This morning my daughter woke up with her right eye swollen. Later on in the morning, I noticed that in the corner of her left eye there was blood. I thought maybe she had caught conjunctivitis, since I had it last week, but I don't think so now with the blood in her other eye. Do you have any idea of what it could be? She is 28 months old.

ANSWER: Your daughter may have scratched herself and she needs to be checked by an eye doctor.

QUESTION: I was told by a friend that after he had lost weight, he coudn't wear his R/X sunglasses because his sight had improved so much. Is this possible?

ANSWER: Often times when we gain weight our blood sugar also increases. Sometimes we develop diabetes and it goes undiagnosed but when the blood sugar increases it converts to a sugar called sorbital and this collects in the focusing lens of our eyes. When this happens, the lens becomes thicker. If the weight is loss with subsequent reduction in blood sugar and thus the sorbital, the lens gets thinner and the vision changes. Your friend should get their eyes checked---hope the weight stays off and they do well.

QUESTION: If you have elevated pressure in your eyes, 20 & 21, would having cataract surgery reduce the pressure and the chances of having Glaucoma. I am 71 years old.

ANSWER: Many times having cataract surgery does reduce the internal pressure of the eye. However, having a pressure of 20 or 21 doesn't necessarily mean that you have glaucoma. We really do not know what causes glaucoma but the thought process now is leaning toward poor circulation as one of the possible reasons for damage. There are many different types of glaucoma, but the most common one is open angle glaucoma--the one that has no symptoms until it is too late. A good eye doctor can diagnose glaucoma in the early stages.

QUESTION: My right eye cries a lot and about twice a week I wake up in the night with pain. It's a stabbing pain in back of my eye. The other eye is fine.

ANSWER: Have you ever been scratched in that eye with anything organic such as a fingernail, dog or cats claws or nails, tree branch? It sounds as if your eye is very dry and you may have what is called recurrent erosion. Some people remember distinctly being scratched and others have no memory of it. We will be unable to tell for sure without an eye check up. In the meantime, artificial tears in that eye 4 to 6 times a day will help. Use the tears even if you get up in the middle of the night.

QUESTION: What vitamins are good for eye care. I have Bausch and Lomb "Ocuvite" with Lutein pills that claim to be nutrition for eyes. I have also seen Lutein by itself in pill form for eyes. I am a 62-year-old female with high blood pressure. Would vitamins be too late at this point?

ANSWER: Ocuvite with Lutein is an excellent choice. We recommend that brand. It is never too late.

QUESTION: Every once in a while, about twice a month I have trouble seeing. There is no pain, but if I'm looking at someone's face I can see only part of it. I can close my eyes for 10 - 15 minutes and it is cleared up and I see perfectly. What is going on?

ANSWER: You absolutely need to be checked. I would go to an internist first and he can direct you to any other doctors he feels you need to see. With symptoms like that, it could be your brain or circulation.

QUESTION: My eye sight is fine for distances, and since I turned 40, I have to wear reading glasses for close-up. No problem except when I look through the zoom lens of my camera, everything is blurry, even if I wear the reading glasses. I have to rely on the camera's automatic focus to take pictures. Why won't my eyes focus through the lens?

ANSWER: You probably need a little distance correction that you don't notice unless you look into the viewfinder of your camera. Everyone 40 and over should have an eye exam anyway. You can wear a CTL only when you are taking pictures or you may choose to wear bifocal CTL's as I do. I enjoy photography as well. If you are not interested in CTL's, glasses are an option. In any case, have it checked out just to be sure.

QUESTION: The cornea of my right eye has scar tissue resulting in an irregular astigmatism. Is there any way this can be corrected?

ANSWER: You will have to be checked by an Ophthalmologist to find out exactly how much the scar tissue is causing the astigmatism. There are a couple of things that can be done. One is a chemical chelation and the other is laser. Please call us if you would like more information. (337) 478-3810 or 1-800-826-5223.

QUESTION: I have just found out that I need bifocals. My prescriptions -.25 and add 1.00. I have opted for contacts instead. Is this going to make by eye site worse in the long run wearing bifocal contacts. How long will it take for me to get use to the contacts?

ANSWER: I personally wear the Accuvue bifocal CTL's and love them. Contacts will not make your vision worse. It may take a few weeks to adjust to the lenses. Your add power will increase about every 5 to 10 years due to aging changes. I hope you enjoy the CTL's.

QUESTION: My son's friend has found that Timoptic XE or timolol maleate eye drops for glaucoma were causing him stomach and intestinal distress. It is a beta blocker and I imagine one could get too much of it. All he did was stop taking these drops and his problems went away. I use these eye drops every morning as well as Xalatan at night. I have many health problems similar to my son's friend. That includes swollen big toes, anxiety or nervousness, depression, diarrhea, difficulty sleeping, hoarseness, muscle pain in left leg above knee, constipation, unusual tiredness or weakness. Thus far, the medical profession has said this is IBS but I am wondering if the Timoptic is part if not all of my problem. I hope you can shed some light on this.

ANSWER: Unfortunately, Timoptic is a beta blocker and they have the potential to cause all of the problems you have listed. Please call your doctor and let him know that you are having these difficulties. There are many new glaucoma drops on the market now that have very few side effects but are very effective in treating glaucoma. Please don't continue to suffer with these symptoms. Let us know if we can be of further assistance.

QUESTION: Is dilation of the eye necessary for an eye exam?

ANSWER: If you are under 40 years of age, have a slight glasses prescription or none at all and no family history of eye disease and no symptoms such as flashes of light or floaters then you can get away with none dilated eye exams. And it is recommended that the patients that fit the criteria listed above be dilated at least every three years. There is some newer equipment that can see more of the retina in an undilated patient but this equipment cannot see all of the retina. A good eye doctor looking at a well-dilated eye can see more of the retina.

QUESTION: Does dry eye lead to macular degeneration? Also I have floaters from vitreous detachment, will the floaters go away eventually? Also I have a little bit of cataracts, will the floaters & cataracts make it very difficult to see?

ANSWER: No, dry eyes do not lead to macular degeneration. Vitreous floaters caused by a vitreous detachment do not go away but they can settle out of your field of vision so you do not notice them. Macula degeneration and cataracts can reduce your vision but because we cannot diagnose over the phone, it is best that you see your eye doctor and discuss these questions with her/him.

QUESTION: I was diagnosed with glaucoma of the right eye about two years ago, with a pressure of 28 in the eye. It is now 23. My problem is that my eye stays red and looks irritated all the time and the skin right below my eyelid stays red and itches. I am presently using Lumigan drops once daily at bedtime and Alphagan drops twice daily, at bedtime and first thing in the morning. Are they the cause of the redness and if so are there other drops I could be using? Also, do you have an office in Jennings?

ANSWER: The eye can sometimes be red for about one month with the Lumigan. The redness and itching signify an allergic reaction to one of them. We do have an office in Jennings and I would suggest that you be seen there at your next convenience. The number is 337-824-0040.

QUESTION:  Last week, LC American Press had article about how an injected drug had surprising affects of improving eyesight lost to wet macular degeneration. I would sure like to know more about this and even though it may be experimental at this stage, where can I try it if recommended by you? Mine is the dry version of MD. I know about the Oculite Preservision Bausch and Lomb vitamin supplement and am trying it now.

ANSWER: Choroidal Nevus is a benign pigmented or non-pigmented lesion (freckle) in the choroid or blood vessel layer of the retina. They do not usually require treatment, but should be followed closely by a medical eye doctor. This link to the "learn more" section of our website will give you an overview of macular degeneration. If you need more information, please call me at 494-4960 and I can mail you a brochure about macular degeneration. Thank you.

QUESTION: Hi, recently my son received a severe black eye. Now that the swelling is gone down, he has a blood red spot over about a quarter of his eye, this I am told will go away, but, he is complaining about his peripheral vision. He did have x-rays done and there is no fracture around the eye. Should we be concerned about his vision, or just wait until the red goes away?

ANSWER: Due to the fact that your son experienced trauma to his eye, it is very important that he receive a complete eye examination to rule out anything as severe as retinal detachment. More than likely, your son has broken blood vessels, or a bruise on the conjunctiva (white part) of the eye, which until the blood spots break up, can interfere with vision, however, to be on the safe side, you should probably get him in to see the eye doctor. Kimberly R. Donalson Refractive Surgery Coordinator The Eye Clinic

QUESTION: Why are more people prone than other to getting styes on the eye? I have had several recently all in the same eye. I would like to know what I can do to prevent them.

ANSWER: Are you getting styes or chalazia? A stye, sty or external hordeolum is an acute pustular infection of the oil glands of Zeis, located in an eyelash follicale at the eyelid margin. A chalazion (plural is chalazia) is an inflamed lump in a meibomian gland (in the eyelid). Inflammation ususally subsides, but may need surgical removal. One is an infection and the other is inflammation. A stye is located at the lid margin in the lash follicle and a chalazion is located in the meibomian gland (located within the eyelid tissue) under the lid. The chalazian looks like a big lump under the lid -- almost as if someone put a pea-size marble under the lid. To remove these, the lid has to be flipped. However, we try to use antibiotic/steroid combination drops along with warm compresses first. If the chalazion does not resolve then surgery to remove it is indicated. To finally answer your question as to why you may be getting these so frequently, there is a condition called meibomian gland dysfunction (MGD) that is an abnormality in the composition of the secretion from the meibomian glands. One cause is blepharitis or inflammation of the eyelids. The only way to get an accurate diagnosis and treatment/prevention recommendations is to see your eye doctor.

QUESTION: My wife was told during the last eye examine that she had cataracts and they should be taken care of. She told the doctor that she had always heard that they had to be ripe before they could be removed. The doctor said that is not the case now, that there is a procedure they use to make them ripe and the cataract can be removed anytime. Is this true? Dr. Sorrels with the eye clinic told us this. I also have a beginning of cataracts. Your answer would be appreciated.

ANSWER: Cataract surgery is almost always an elective procedure. Which means you decide when your vision is poor and is affecting your quality of life. Most of the time, the cataracts cloud the vision so gradually that life changes are made very slowly. An example would be driving at night very infrequently, or not at all, because of the glare from oncoming headlights. Colors are distorted by cataracts -- white looks yellow; bright colors look dull. Details such as leaves on a tree, squirrels in the yard or street signs are blurry or not distinct. Lights get a starburst appearance usually noticed at night. When you and your eye surgeon decide that the cataracts are ready to be removed, cataract surgery can be scheduled. You should choose a surgeon who is board certified in ophthalmology. Years ago we waited for cataracts to become much more advanced than we do now. We did this because the possible complications of the surgery were much greater at that time. Cataract surgery today is much safer. The incision is only 5 - 6 mm. There are no stitches, or only one in some cases. Most patients still require glasses after cataract surgery even if it is only to read small print. Since cataract surgery in our modern world is so much easier and safer, why give up your independence by not having it? Why give up driving a night or drive and be unsafe behind the wheel of a car? We recommend testing your vision under different circumstances and then decide for yourself. Please let us know if you need any additional information.

QUESTION: I have a 10-year old son who was diagnosed with a lazy in his right eye. The doctor said there was nothing we could do for it. When closing his left eye he has very little vision in the right eye. Is there anything that should be done? Thank you.

ANSWER: Amblyopia or "lazy eye" refers to reduced visual acuity due to an abnormal visual experience early in life. If a child has blurry vision or double vision in an eye for an extended period -- years-- , the brain will "shutoff" vision in that eye in order to stop the distortion. It is generally felt by physicians that this is not correctable once the child is past 5 years old; some doctors say nine years old. It is very important that he wear safety glasses when participating in sports or any activity that could result in eye damage.

QUESTION: I have been having sharp, jagged type streaks shoot across my right eye for about a second recently. It's a little painful while happening. Had it happen years ago but not as severe............they have increased in severity and in number of occurrences. A few weeks back it happened real often and seemed to leave my eye feeling tired, if that makes any sense. I did have an eye exam where my eyes were dilated 2 or 3 years back. I mentioned this sensation to the doctor at the time and he could see nothing wrong. Is this a normal part of aging? I am almost 53.

ANSWER: Jagged streaks usually indicate ocular migraines. We call the streaks "seeing an aura." You can have headaches with it, but not always. Only 1 in 7 migraine sufferers have an aura. However, it is always a good idea to have your eyes dilated if you are seeing any type of flashing light. This could also be caused by the vitreous jelly within your eye "tugging" on the retina.

QUESTION: Are cataracts or macular degeneration inherited? If a family has a history of these conditions, at what age and how often should younger family members see the eye doctor?

ANSWER: Cataracts and Macular degeneration can be inherited. T Basic screening guidelines from the American Academy of Ophthalmology are listed below. However, you should have your eyes examined anytime you experience changes in your vision . Before age 5 Toddlers should be screened for common childhood eye problems, such as strabismus (crossed eyes) and amblyopia (lazy eye), as well as refractive errors such as nearsightedness and farsightedness. Children should be screened younger than age 5 if there is a family history of childhood vision problems, or if they appear to have wandering or crossed eyes. Puberty to age 39 Most young people have healthy eyes. However, you should see an Eye M.D. if you experience any eye problems such as visual changes, pain, flashes of light, seeing spots or ghost-like images, if lines and edges appear distorted or wavy, a dark spot appears in your central vision, excessive tearing, dry eyes with itching or burning, or if you sustain an injury to the eye. One of the most common causes of vision loss in children and young adults is accidental eye injury. Common causes of vision-threatening eye injury include: sports-related accidents, work-related accidents, wood or metal shop debris, debris from yard work, chemical splashes from household cleaners and battery acid burns from jump-started vehicles. Make sure to protect yourself from accidental eye injury by using the appropriate eye protection. Your Eye M.D. or eye care professional can recommend the right protection for your activities. Ages 40 to 65 Schedule an exam every two to four years. Over age 65 Older adults should be examined at least every one to two years for cataracts, glaucoma, macular degeneration and other eye conditions. Some people may be at higher risk for eye-related diseases and will need to see an Eye M.D. more often than recommended above. People at risk may include: African Americans over age 40, people with diabetes, those with a family history of eye problems and those with a history of eye injury or other problems.

QUESTION: I had RK surgery on both eyes 16 years ago. One of the side effects was 'ghosting'---when it is dark, I see double of every light object ---lights, reflectors, etc. Is there any way to correct this problem?

ANSWER: Depending on your individual situation, there may be options that provide relief. Contact lenses may help. You would need to see an eye doctor to be evaluated. We recommend that you see an eye doctor that has performed both RK and LASIK. Please let us know if you need any additional information.

QUESTION: I am 71 years old and my last eye appointment was in August, 2001. In the past few months whenever I walk into a dark room, I see flashes of light whenever I blink my eyes. Should I be concerned and get another appointment soon or wait for my annual checkup in August, 2002?

ANSWER: You should be seen as soon as possible, preferably within a week. Please let us know if there is anything we can do to help.

QUESTION: I'm 36 years old and for the past five to six months when I'm sleeping I get awakened due to my right eye. I have bad eye pain like someone has stuck me in the eye. It burns so bad that I have to get up and I use to wash it out with an eye drop but lately a wet wash rag helps. This never happens in the daytime and its not every night-- it occurs maybe once or twice a month. This month it has happened twice in two weeks. I have not noticed any change in my eyesight. It just hurts. Could you please let me know if this is something to worry about or if you know what it could be. Thanks so much.

ANSWER: Try using tears (Refresh Tears) four times a day and at bedtime. These are available at most pharmacies and pharmacy sections in other stores. Do not rub inside your eye with a finger or washcloth. If the tears do not provide relief and the problem continues, see an eye doctor for further treatment.

QUESTION: I am 20 years old and wear glasses. I have been experiencing a strange blinding in one eye for a few years. Sometimes it will happen a few times a month and sometimes it won't happen for a few months. It starts off in the outer corner of my eye and moves inward to eventually the whole eye. During this blindness I see a colorful wheel spinning - (which may sound strange). It usually takes about 30 minutes to 1 hour and then I have my vision back. Then, I get a bad headache. What causes this? Is this something that I should see an ophthalmologist about?

ANSWER: This is called a migraine with aura and is very common. It can be triggered by some foods, smells, etc. Everyone should have their eyes checked by an ophthalmologist on a regular basis, however, migraines are not caused by eye problems. We have a headache brochure we can send you if you would like to give us your address. You can email the address to karmand@lcmh.com or call 494-4960. Thank you.

QUESTION: I am 55, amblyopic and presbyopic. I had a full exam at the Eye Clinic in Jan 2000 (when I had health insurance) and asked my doctor about a chronic problem: a blinding in my eyes when I am reading and look up at a tv screen or a window or light bulb. It lasts 3-5 seconds and fades away and then I can start reading again. I had a friend who suffered from macular degeneration, and am mostly concerned about that possibility. Is there anything else you can suggest as a cause or remedy? Thank you.

ANSWER: It would be difficult to suggest a cause or remedy without a complete exam. There could be many causes, and the remedy would depend upon the specific cause.

QUESTION: I recently had Trabeculoplasty surgery on both eyes. I am using Xylatan and Cosopt drops for my eyes. Are there safer drops. Xylatan is darkening the cornea of my eyes.

ANSWER: There are many different drops available. The color change is not harmful, but if it makes you uncomfortable, ask your ophthalmologist about the different drops available.

QUESTION: I had been diagnosed with pinguecula a couple years ago. The doctor prescribed medicine which did not cure it. Is there a cure? The condition seems to be getting worse.

ANSWER: Pinguecula are caused by ultraviolet rays, wind and dry air. People who work outside, or are outside a lot, get them. There is no cure, but there are things you can do to slow or stop its progression: 1) Wear glasses with UV 400 protection. This has nothing to do with tint. Sunlight is not the problem, it is the UV rays. 2) Keep eyes lubricated by using artificail tears four times a day and more often when outside. Especially on windy days. A pingueculum can progress into a pterygium which can grow across the eye obscurring vision. These can be removed, but it is a painful operation and they grow back 75% of the time. If you work or play outside in the wind and sunshine, wear sunglasses or glasses with UV 400 protection and use artificial tears.

QUESTION: Hello, I have had surgery done for detached lens caused by Marfans. My son has the same eye problem. He received a blow on the forehead and was sent to New Orleans where they did some type of surgery on his eyes. They put a band around the right eye and he is blind in it. He has very little vision in the left eye. He holds his papers to the eye lid to see. He states he can see only out of the top section in the eye. It's a very small area he says. Dr. Yokubaitis is the doctor that saw me and helped me go to Houston for the surgeries. Since he recently came home I was trying to find help for him. Is there any programs that can help out financially to get his eyes checked by the correct doctors?

ANSWER: We can see him and set up a payment plan. Then we would pursue other avenues if additional surgery were needed. It sounds like he had retinal detachment surgery, possibly following lens extraction. Hard to tell if glasses would help without an eye exam first. He could be a candidate for a low vision device. Our accounts receivable department would need to speak to him before any visit with a doctor.

QUESTION: I wrote you, previously, about my eye disease. After checking with my eye doctor, I learned that I have "dry" macular degenerative disease of the right eye. What can you tell me about that condition? Is there anything that can be done for it and will it lead to blindness? I would greatly appreciate your response.

ANSWER: Dry macular degeneration is very common. The severity can vary a great deal. It does affect vision but someone with this condition will never go blind from its effects. If affects the central part of our vision which is the part that we use to read and watch television. If she wants to give us her mailing address, we can mail her a brochure on macular degeneration. She can also visit our website for more information on this condition. Recommended vitamins for eye health are vitamin E, C and Zinc.

QUESTION: This question is about general eye care. I am 27 weeks pregnant and a gestational diabetic, I haven't had an eye exam in about 3 years, by the end of the day my eyes are extremely tired and I cant see as clearly or crisp as in the morning, do I need a new prescription? Will my pre-pregnancy vision return? Thank You

ANSWER: During pregnancy, your eyes change due to increased hormone levels. This is compounded when gestational diabetes is involved. Blood sugar is converted to sorbital and this collects in the natural lens of the eye, essentially changing your prescription. The tricky part is that it is not permanent and it changes throughout the day. Possible options: 1) Get new glasses with the understanding that you may need to use your old ones at certain times of the day. And you will probably need to change them again after the baby is born. Wait at least three months after delivery to do this -- longer if you are breastfeeding. 2) Do nothing---keep your old glasses until three months after the baby is born before deciding if you need a new prescription.

QUESTION: Can you explain the term "detached retina?"

ANSWER: A retinal detachment is a very serious problem that almost always causes blindness unless treated. The appearance of flashing lights, floating objects, or a gray curtain moving across the field of vision are all indications of a retinal detachment. If any of these occur, see an ophthalmologist right away. As one gets older, the vitreous, the clear gel-like substance that fills the inside of the eye, tends to shrink slightly and take on a more watery consistency. Sometimes as the vitreous shrinks it exerts enough force on the retina to make it tear. Retinal tears increase the chance of developing a retinal detachment. Fluid vitreous, passing through the tear, lifts the retina off the back of the eye like wallpaper peeling off a wall. Laser surgery or cryotherapy (freezing) are often used to seal retinal tears and prevent detachment. If the retina is detached, it must be reattached before sealing the retinal tear. There are three ways to repair retinal detachments. Pneumatic retinopexy involves injecting a special gas bubble into the eye that pushes on the retina to seal the tear. The scleral buckle procedure requires the fluid to be drained from under the retina before a flexible piece of silicone is sewn on the outer eye wall to give support to the tear while it heals. Vitrectomy surgery removes the vitreous gel from the eye, replacing it with a gas bubble, which is slowly replaced by the body's fluids.

QUESTION: I have heard they are doing laser surgery for farsightedness. Is that being done here? What are the costs?

ANSWER: Hello, my name is Kimberly Donalson and I am the refractive surgery coordinator here at The Eye Clinic. As you may know, The Eye Clinic was the first to perform Laser Vision Correction. We have addressed the correction of presbyopia by utilizing monovision correction with the use of the VISX Star 2 Excimer Laser. With this treatment, patients have both eyes treated with the laser, however, one eye is left slightly undercorrected for reading vision. When using both eyes together, there is not much of a noticeable difference. The patient will train themselves to depend on the slightly undercorrected eye for reading purposes. This allows the patient to enjoy both far and near vision, without the use of glasses or contact lenses. Please feel free to call us for more information at 1-877-95-FOCUS (1-877-953-6287) or to schedule an appointment.

QUESTION: I am contemplating laser vision correction. My question is: can "floaters" be corrected with the laser? If so, can it be done in conjunction with the lasik vision correction?

ANSWER: LASIK laser vision correction does not eliminate floaters, however, having floaters should not prevent you from having the procedure. The best way to find out would be to schedule a free consultation at our Laser Center. Floaters are actually tiny clumps of gel or cells inside the vitreous, the clear jelly-like fluid that fills the inside of your eye. While these objects look like they are in front of your eye, they are actually floating inside. What you see are the shadows they cast on the retina, the nerve layer at the back of the eye that senses light and allows you to see. Floaters can have different shapes: little dots, circles, lines, clouds or cobwebs. Floaters usually occur after middle age. The vitreous gel which fills the eye may start to thicken, or shrink, forming clumps or strands inside the eye. The vitreous gel pulls away from the back wall of the eye, causing a posterior vitreous detachment, the most common cause of floaters. Medical treatment is not usually required for floaters, unless they involve damage to the retina as mentioned above. The appearance of floaters can get in the way of clear vision, which may be quite annoying, especially if you are trying to read. You can try moving your eyes, looking up and then down to move the floaters out of the way. While some floaters may remain in your vision, many of them will fade over time and become less bothersome. Even if you have had some floaters for years, you should have an eye examination immediately if you notice new ones.

QUESTION: Do you have to be a certain age to have laser surgery? I'm 71 and I don't know if I'm eligible.

ANSWER: Most adults are candidates for LASIK. There is no upper age restriction, but candidates must be at least 18 years of age or older, with a relatively stable prescription. A comprehensive evaluation is performed on all patients prior to LASIK to ensure that the eye is healthy and does not have any pre-existing conditions, such as catarats. The best way to find out if you are a candidate is to schedule a free screening to learn more. After the screening, the LASIK exam with one of our Board certified physicians can be scheduled.

QUESTION: A friend of mine has told me he has a condition called RP and that he will eventually lose his eyesight entirely. What is RP and what does it do to a person's vision?

ANSWER: Retinitis pigmentosa (RP) describes a group of related diseases that tend to run in families and cause a slow but progressive loss of vision. RP affects the rods and cones of the retina, the light-sensitive nerve layer at the back of the eye, and results in a decline in vision in both eyes. RP usually affects both eyes equally with severity ranging from no visual problems in some families to blindness at birth in others. RP gets its name from the fact that one of the symptoms is a clumping of the retinal pigment that can be seen during an eye exam. The earliest symptom of retinitis pigmentosa, usually noticed in childhood, is night blindness or difficulty with night vision. People with normal vision adjust to the dark quickly, but people with night blindness adjust very slowly or not at all. A loss of side vision, or tunnel vision, is also common as RP progresses. Unfortunately, the combination of night blindness and the loss of peripheral vision can be severe and lead to legal blindness in many people. While there is a pattern of inheritance for RP, 40% of RP patients have no known previous family history. Learning more about RP in your family can help you and your ophthalmologist predict how RP will affect you. Considerable research is being done to find the hereditary cause of RP. As hereditary defects are discovered it may be possible to develop treatments to prevent progression of the disease. While developments are on the horizon, particularly in the area of genetic research, there is currently no cure for retinitis pigmentosa. Nutritional supplements may have an effect on RP. It has been reported that Vitamin A can slow the progression of RP. Large doses of Vitamin A are harmful to the body and supplements of Vitamin E alone may make RP worse. Vitamin E is not harmful if taken with Vitamin A or in the presence of a normal diet. Your ophthalmologist can advise you about the risks and benefits of Vitamin A and how much you can safely take. Despite visual impairment, people with RP can maintain active and rewarding lives through the wide variety of rehabilitative services that are available today. Until there is a cure, periodic examinations by your ophthalmologist will keep you informed of legitimate scientific discoveries as they develop.

QUESTION: What are your costs regarding Lasik?

ANSWER: The cost for the LASIK procedure is $1995 per eye. Most insurance plans do not cover this procedure, but some do. We do offer financing options. Anyone interested in learning more about the procedure and payment options can call 1-877-95-FOCUS for more information or to schedule a free screening in our office.

QUESTION: My father has been diagnosed with macular degeneration (I hope I'm spelling that correctly). He is 73 and his vision is still okay, but he's been told that it will begin to affect his eyesight over the next few years. He's very concerned that he won't be able to drive. What is this affliction and how long might it be before his driving ability is affected?

ANSWER: Age related macular degeneration (AMD) is one of the most common causes of poor vision after age 60. Although the specific cause is unknown, AMD seems to be part of aging. While age is the most significant risk factor for developing AMD, heredity, blue eyes, high blood pressure, cardiovascular disease, and smoking have also been identified as risk factors. AMD accounts for 90 percent of new legal blindness in the US. Nine out of 10 people who have AMD have the dry form, which results in thinning of the macula, the area of the retina responsible for central vision. Dry AMD takes many years to develop. Currently there is no treatment. The wet form of AMD occurs much less frequently (one out of 10 people) but is more serious. Laser surgery is the only proven effective treatment, to date, for wet AMD. The procedure usually does not improve vision but prevents further loss of vision. The visual symptoms of AMD involve loss of central vision. While peripheral vision is unaffected, one loses the sharp, straight-ahead vision necessary for driving, reading, recognizing faces, and generally looking at detail. Imagine being able to see a clock on the wall but unable to make out the time or unable to read because you could not see parts of words on the page. Promising AMD research is being done on many fronts. In the meantime, high-intensity reading lamps, magnifiers and other low-vision aids help people with AMD make the most of remaining vision. A patient's ability to drive is impaired once their central vision is affected by this disease. This can vary from person to person. Your father should have his eyes examined regularly by a qualified physician who can tell him when he is unable to safely operate a vehicle. Visit The Eye Clinic' website at http://www.theeyeclinic.net/