Category Archive for: ‘Clinical’

When, and why, do your eyes get itchy?

A mast cell stabiliser, such as Opticrom, or Optrex for Hayfevery Eyes, is very effective to reduce the itching and discomfort experienced by a pollen allergy – commonly called hayfever. But who knew that there were so many common causes of  an allergic reaction? – I for one thought that pollen was pollen! I was never a hay fever sufferer as a child, but recently developed an issue. Using this infograph, and also thinking about what caused my major problem, for me I reckon it is nettles! Once after strimming, I had a serious swelling of my eyes, where the conjunctiva was “spilling over my eyelids”! A couple of antihistamines and some drops later, things settled down. I still “suffer” from itchy eyes at certain times, but this year I am going to try drops for the nettle season to see how I get on! Last time I bought Opticrom locally it cost €11.22 – I recently found the package. You may need a couple or three bottles for your season, but if it reduces the problem, it may be worthwhile.

As a Scotsman, from Fife (the equivalent of a Cavan man), I bought a bottle, but having found out how much it cost, I didn’t open it, thinking that “I will use it if my eyes get worse”. I then promptly lost it, so it serves me right for being a meanie! But I did recently find it, and it is unopened, and still in date, I will try it, starting in June this year. Hopefully I can report back a success!

Scottish people, and Fife people in particular are not mean, I would imply Cavan men aren’t either –  just a joke…. Billy Connelly reckoned that two Scotsmen invented copper wire, while fighting over a penny…

As the information suggests, though mast cell stabilisers are very effective, it may take a few weeks to make a difference, so attempting to find the cause of the itch is very insightful.

If you wear contact lenses, and have itchy eyes, perhaps all year round, or getting worse, it is more likely that you have a contact lens (or solutions) issue than a pollen issue – how much contact lens solution gets in the eyes every day compared to pollen? Have a contact lens check-up where you normally go.

It is particularly  important that parents try to prevent their children from rubbing their eyes, though it is easier said than done – if they are itchy, prevent them from itching – eye rubbing is thought to be a major (perhaps THE major cause) of Keratoconus!

College-of-Optometrists-Hay-fever-infographic-240316-768x2172

 

Rosbergs Pterygium1

What is a Pterygium?

Rosberg's PterygiumA pterygium is a benign overgrowth of the conjunctiva, the tissue which lines the eyelids and the white of the eye. This overgrowth grows over the cornea (the clear window of the eye) and eventually can begin to obscure vision.

Pterygia are very common in people who live in areas of high ultraviolet radiation – sunny places, and also those who lived in very dusty places. Obviously people from Africa (but other areas too) will have a double “whammy” of both increased risk factors. People who surf also commonly get them – it is often also called “Surfer’s Eye”. People with dry eyes and those who live in windy conditions also have an increased risk.

A pterygium (named after the Greek for a Fly’s Wing – the insect’s wing) is so called because it does look a little similar to the wing of a fly, except that it is made of eye tissue and not by a fly. Fly wings also do not look as red as a pterygia, but that is where they got their name.

In years gone by, there was little to be done for a pterygium – no treatment until or unless it began to encroach into the area of the pupil, when it would affect the eyesight. This was because the pterygium would generally recur, so early treatment would mean more treatment in the long term. Not all cases will continue to grow towards the centre of the cornea – some will just stop growing of their own accord, so those who are not going to have them fixed should have regular check to make sure it is stable.

Pterygia can be uncomfortable causing

  • Burning
  • Gritty feeling
  • Itching
  • Sensation of a foreign body in the eye
  • Blurred vision

The modern way to deal with a pterygium is to do a conjunctival transplant, where the pterygium is removed, and a piece of conjunctival tissue from under the upper eyelid (which has rarely ever seen the light of day – no UV and very little dust in there) is transplanted to the area the pterygium was removed from. Because the growth does disrupt the regularity of the corneal fibres as it grows it does cause corneal scarring, so modern thoughts would be to treat it sooner rather than later, but again, not all of them do require removal.

They almost always occur in the nasal part of the conjunctiva, and can occur at any age.

I believe F1 driver Nico Rosberg has one in his left eye, but I read (somewhere) that for the time being he has decided not to have it fixed, though the eye does apparently sometimes give him issues during hot races.

Diagnostic Contact Lenses

We have a few patients who regularly call seeking free trial contact lenses. Most of these “clients” have never bought any contact lenses from us- they just request more free diagnostic lenses. All of these “clients” are also all advised that they must return for a contact lens check before we can finalise their prescription and ensure that the lenses are fitting properly, so that they do not harm their eyes.

Mostly, having issued trial contact lenses, we will not see them again for 6 months, when once again they are looking for more trials, because they have a Christmas party, or they have a “family wedding tomorrow”, and as they have no contact lenses we cannot check them in their eyes. As an aside “free trial” diagnostic lenses are not free, we pay for them, at the very least we pay for shipping.

I find this a difficult situation- I need to see the lenses in their eyes, ideally after about 4 hours of wear on the day- soft contact lenses almost always look to fit well when just inserted- but if they wear all of the diagnostics, how am I supposed to check them?

We have to fix this – we cannot issue contact lenses on an ongoing basis to people who do not have a valid contact lens prescription!

The only solution to this is that no trial contact lenses will be issued without a check appointment being booked, and if the client fails to show for that appointment, no further lenses will be issued. We do try very hard to be accommodating, but there was a chap due to come in for a contact lens check in Kingscourt on Saturday, who has been “trialling” contact lenses on and off since 2012, and once again he did not show for his check appointment. He recently stated that he “might get his eyes tested this year”. His spectacle prescription is now out of date, and we have never finalised his contact lens prescription- he won’t be getting any more contact lenses, at all, ever, from us!

I would personally like to apologise for this, but we are legally and professionally responsible for all contact lenses issued – they are classed as medical devices, and it seems that there are numerous patients in Kingscourt, who have been “trialling” contact lenses, sometimes on and off, for over four years.

No more. They will be issued with one pair to apply 4 hours before their appointment, if they do not show……

A very painful eye

Killinkere MudVenture

A very painful eyeFolks, there was a “MudRun” in Killinkere this weekend, it seemed to be a huge success (and my son won, he reckons the under 18 category!?) But correct us if we are wrong there – I am not sure – he did win, but perhaps a different class?

Please be aware than many of the bacteria found in soil are not known to mankind – we know mostly about bugs that we so far know cause infections – these are the ones which we can grow on Agar plates in Petri dishes, in a laboratory- it has been estimated that there are billions more about which we know nothing – we do not know how to cultivate them! Probably this is a good thing?

Mud runs must be great fun if you are sporty – my son had a great time! We are not suggesting that mud runs are not a great source of fun and exercise, but I made sure that Niall took a spare pair of contact lenses, to be replaced immediately after the event – something he had not thought about. There are various reports also about people becoming sick, with gastrointestinal infections following mud runs, after accidentally swallowing contaminated water- that is up to your GP and nothing to do with us!

We are not in any way suggesting to not partake is such an event, but please be aware that if you wear contact lenses, you should remove them after the run, and probably bin them. Tap water is not safe for contact lenses, so muddy water, with unknown microbial contaminants, plus the abrasive risk of soil and/or grit getting underneath the lens, cannot be safe. One of the most significant contact lens risks is an amoeba, called Acanthamoeba, which can cause a very serious (sight threatening) eye infection and is endemic to water and soil in many countries, including Ireland. We recommend that no-one should shower/ bathe/ hot tub or swim in contact lenses. Mud runs were not on our (my) RADAR until very recently. Official guidance, I do not know, but it will probably be that you should not mud run in contact lenses? (It will probably be that you should MudRun wearing “closely fitting and well sealed swimming goggles!”)

Anyone who is going to take part in next years MudVenture can call to McLeish Optometrists – but give us notice first- to get some free daily disposable contact lenses for the run, to be thrown away afterwards!!! Though if you already wear daily disposables, take a spare pair, Niall!

There are not too many conditions, but you MUST be an existing wearer of contact lenses, and we WILL need a copy of the up to date contact lens prescription before supplying you! If it is not in date, we cannot supply.

If you are a client of ours, then happy days, no problems, assuming you have an up to date prescription!! All contact lens prescriptions vary  – please give us enough advance notice to get them in for you! There are monthly lens wearers, and others, who may not be suitable for any type of daily disposable, but we will do  our best, to sort out something… Even if it is not perfect, it should hopefully get you through the run.

Someone once told me than when you get to 40, each year lasts six months, but at my age I think they were exaggerating! Honestly the mud run was here before I knew it, but we will be more prepared next year!

Although this page references the Daily Mail, there are hundreds online with the same story, I am just too old to get it to you on time. Maybe next year??

I understand that the poor unfortunate lady in the article doesn’t even wear contacts!?


Brittany Williams of Dallas, Texas competed in a mud run two weeks ago, and woke up the day after to see the whole room was white, learning soon after that she was blind from flesh-eating bacteria.

Source: Brittany Williams left BLIND after catching flesh-eating bacteria on mud run | Daily Mail Online

Statin may help AMD in future?

Cholesterol drugs hold promise for advanced AMD?

Statin may help AMD in future?A new study has found that there may be a potential benefit in the treatment of the most common dry form of Age Related Macular Degeneration (AMD), using a commonly prescribed Statin drug (used to lower cholesterol). This drug, known by the brand name Lipitor is already commonly prescribed to treat raised cholesterol, but has been found (in a small trial) to reduce the build up of debris underneath the retina which is associated with the dry type of AMD.

The study found that the drug could reduce, or eliminate these deposits, called drusen, particularly “soft” drusen, and lead to a moderate increase in Visual Acuity in affected subjects. The study was trialling a higher dose of the drug than commonly prescribed to treat the cholesterol issue alone, but seemed to be effective –  further investigations, with a larger study will be required to ensure that the treatment is safe and effective.

Until now, the only effective help for Dry AMD has been anti-oxidant Vitamins, minerals and other supplements, which do seem to slow the progression of the disease, but perhaps in future there may be other possibilities?

As this problem affects millions of people worldwide, this is potentially exciting news!

Source: Optometry Today | Cholesterol drugs hold promise for advanced AMD

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