Macular Degeneration

Today we will focus on the basics regarding Age-Related Macular Degeneration (AMD). Sometimes just called macular degeneration or AMD. This is going to include important risk factors and lifestyle choices that can improve your odds against macular degeneration.

What is AMD? 

Before we can discuss this debilitating disease, I think a brief anatomy lesson is warranted. The macula is one of the most important parts of, not only the retina, but of the entire eye. Although, clinically, only about 1.5 mm across (about ⅟₁₆ of an inch; roughly the thickness of a penny), it is responsible for our entire central or “straight ahead” vision. What makes the macula unique is that it has the highest concentration of light-sensing cells, called photoreceptors. This makes it the only part of the human eye capable of seeing 20/20.

Photoreceptors are highly active cells. They require significant amounts of nutrients and a way to actively eliminate metabolic waste. One of more vital structures in this process is a layer of cells called the retinal pigmented epithelium (RPE). AMD begins by causing abnormal changes to this layer of the retina. As an area of RPE is compromised, other surrounding cells (including photoreceptors) become increasingly prone to damage. This cascade of events can lead to anything from mild cell dysfunction, to vision-threatening bleeding and scarring, or even large areas of cell death. Each stage resulting in increasing levels of permanent vision loss.

What Causes Macular Degeneration

Macular Degeneration is a multifactorial disease meaning it has lots of variables. This list is by no means comprehensive, instead it highlights a few of the major risk factors for developing macular degeneration.

Age – As the name implies, one of the greatest risk factors for developing AMD is time. As we get older, other risk factors can have an accumulative effect on the health of the retina, which can lead to the eventual manifestation of the disease. In general, AMD is most common over the age of 50.

Genetics – Family history of AMD increases your predisposition for developing the disease. In general, Caucasians are at slightly higher risk than most other races.

Smoking – Numerous studies have noted that smoking not only can lead to the development of AMD, but also significantly increases the likelihood of progression once you have the disease. 

Health Status – Heart disease, high blood pressure, high cholesterol levels, diabetes and obesity are bad for overall health. Few people know they are just a few of the systemic conditions linked to AMD.


Not all risks are modifiable. This is a short list of a few things you can do to reduce your risk of developing AMD. If you already have the disease, these same tips may improve your odds of slowing the rate of progression.

Make healthy choices

Healthy eyes start with a healthy body. Stay up to date with your general health by having regular visits with your primary care physician. Avoid smoking or being around people that smoke. Last, but not least, don’t forget your eye exam!

Eating Habits

Unhealthy eating has not only been linked to the development of AMD, but to increased odds of reaching advanced stages of the disease. Studies have shown that eating foods rich in carotenoids (antioxidants such as lutein and zeaxanthin), may help reduce the risk of AMD progression. Good sources of these antioxidants include many green, leafy vegetables such as: kale, spinach, chard and collard greens. 

Macular Degeneration Vitamins

Vitamins for macular degeneration are extremely important. Added supplementation with ARED 2 vitamins may be beneficial at certain stages of the disease. *Ask your eye doctor for more information. 

UV Protection

Just like SPF is important for the skin, wearing the proper lenses when outdoors can reduce the sun’s damaging effects on the retina. Not all sunglasses are created equal. The best protection will come from lenses rated UV400 or higher, which filter at least 99.9% of UV rays. There are also UV-filtering options for your everyday clear lenses and, to a lesser extent, contact lenses. *Ask your optometrist or optician for more information. 

While AMD can lead to severe loss of central vision, it is possible for early stages of the disease to go undetected for many years, without proper eye care. The best form of prevention is knowledge. Know your habits, know your risk factors, and know Your Eyes! Early detection is crucial.

Types of Macular Degeneration

There are 2 main forms of macular degeneration; wet macular degeneration and dry macular degeneration. The wet typically requires injections.

Your Eye Doctor can do a macular degeneration test to help answer these questions.

Thank you for reading and if you would like to get updates when we post new articles then like our Facebook page. As an Amazon Associate I can earn from qualifying purchases if you click on the above link. You can also check out our About Us.

Emergency Eye Care

In this article I am going to discuss some tips to help you when needing emergency eye care from your local Eye Doctor. I will discuss tips on how to help quickly with pain and the main things to look for when in a “painful eye” situation.

Dilated Pupils and your Local Eye Doctor

I get a phone call a couple times a year with someone that is having issues with their pupils. Typically, it is one pupil is larger than the other. This phone call usually comes from someone looking for an Eye Doctor in Skiatook or an Eye Doctor in Oologah. The reason for this is some people with put on a patch to help alleviate motion sickness before getting on a boat. This medication can cause the pupils too dilate. Typically it is on the same side as the motion sickness patch. This is not a scary situation, but could be. Dilated pupils can be caused from different poisons and trauma to the head. 

Typically, I will ask the person searching for an Optometrist in Skiatook or an Optometrist in Oologah a handful of questions. Once those questions have been answered satisfactorily I typically tell them to have fun at the lake. If you have a headache with the dilated pupils don’t hesitate to call an Eye Doctor. If you don’t call an Eye Doctor, visit the emergency room quickly. Here you need a 24-hour emergency Eye Doctor near me fast.

Metal in the Eye and Your Local Optometrist

Metal in the eye is never any fun and I know from personal experience. Years ago I had an Eye Doctor in Owasso take metal out of my eye. I did have my safety glasses on, but still ended up with metal in my eye. The Eye Doctor in Owasso was able to get me fixed up pretty quick and I am able to do the same thing now for my patients. I have a good relationship with several of the businesses in Collinsville and they send me someone almost every week that needs metal removed from the eye. While metal in the eye is not something an emergency eye care center near me would act on quickly it is still something that needs to be fixed quickly.

Removing Metal from the Eye

The way I usually work is from least aggressive to most aggressive. Meaning that I start out by using a cotton tipped applicator that is wet and try and remove the metal with it after numbing the eye. This usually works best if the metal hasn’t been in the eye for more than a few hours. If the metal has been in the eye for more than a few hours then I tend to need to use my spud to remove the metal. The spud has a sharp end that allows me to get under the metal. 

Now, if the metal has been there for a few hours rust may have started to form. If rust has gotten deposited into the eye it may need to be removed. The best thing to do if you need an Eye Doctor in Skiatook to remove metal, an Optometrist in Collinsville, or an Eye Doctor in Oologah to remove the metal give us a call. We can get you fixed pretty quick. Even if we aren’t technically a 24-hour emergency eye care center. Just give the office a call (918) 371-3339.

Welding Burn and Your Eye Care Specialist

There is a lot of welders that live in and around Skiatook, Oologah, Collinsville, and Owasso. When working around welders there is always the chance of getting a flash burn. Now when I was an Eye Doctor in Nowata I heard quite a few terrifying stories from some welders. These stories were usually about what to do when you get a flash burn. A flash burn is simply over exposure to UV light to the cornea. Over exposure of UV light to the skin causes a sunburn and similar things to help a sunburn help a flash burn. I mean artificial tears will help a ton and so will time in darkness. 

Please DO NOT use a potato cut in half or milk to help with a flash burn.

The fear when we have damage to the cornea is an infection. Putting a potato cut in half is bacteria food just like milk for a possible infection. So, if the flash burn is mild put some artificial tears in your eyes. However, if it is major let your Skiatook Eye Doctor, Oologah Eye Doctor, or Collinsville Eye Doctor help you with some stronger drops than what you will get over the counter. Here is a link to a welding hood company with some other tips.

These are just a few quick and simple tips about emergency eye care from your local Eye Doctor. Again, we will gladly help anyone searching for emergency eye care near me.

Get Rid of Eye Floaters

Have you ever seen spots in your eye or tiny strings that disappear when you try to focus on them?

You could have eye floaters.

Eye floaters can be annoying for those who suffer from them, but they can also signify something more serious.

There is a new way to treat eye floaters using a natural health supplement, which has been scientifically proven to help reduce floaters.

Here is a guide to everything you need to know about eye floaters and the new treatment.

What Are Eye Floaters?

Eye floaters can be described simply as spots that appear in your vision. However, there are different kinds of spots that take on different shapes.

They tend to appear as dark specks, sometimes gray or black. However, they also appear as tiny strings. Sometimes they are even described as looking a bit like cobwebs.

Source: Wikipedia

You may not notice them all of the time. For example, those who suffer from eye floaters often find them more visible when looking at a white or bright surface like a wall.

Floaters are not fixed and seem to drift around as your gaze moves—hence the term ‘floaters.’ If you try to focus on them, they move away quickly. At other times, they appear to be hovering in your vision.

Eye Floater Symptoms

There are various symptoms you may experience if you are seeing floaters.

Floaters are essentially tiny shapes that appear in your vision. They do not have a fixed shape and may appear as specks or strings that are often gray and transparent.

These floaters move around and appear to be floating, especially when you try to look at them directly. They will move when you shift your gaze and disappear out of your line of vision.

You may find that they become more visible when you look up at the sky or a plain background. But, on the other hand, you may not notice them as you go about your day.

Primary Cause of Eye Floaters

The primary cause of eye floaters is simply the natural aging process. As people age, they experience changes in the vitreous, which can increase floaters.

The vitreous in your eyes is made primarily of water and has a soft texture. But, as well as water, it is made of collagen and hyaluronan. It fills the space between the retina and the lens and helps keep the eye’s round shape.

But the vitreous can change over time. As the years go by, it can liquify and contract. This can force it to move away from the inside of the eyeball.

Source: Health Jade

When this happens, collagen fibers form into strings and clumps inside the vitreous. These then block the light coming into the eye and, as a result, form shadows on the retina. You then see these shadows moving around on the eye, which are the floaters.

Other Eye Floaters Causes

As seen, aging is the main cause of eye floaters. However, other factors could present this issue. In some extreme circumstances, you could get eye floaters for the following reasons also:

1.    Torn Retina

When the vitreous contracts and pulls on the retina, this can lead to retinal tears, which are very serious. If you do not get the tears treated, fluid can leak behind the tear, and the retina can separate from the back of the eye.

Retinal detachment is very serious. If retinal detachment is not treated, it can lead to permanent loss of vision.

2.    Inflammation

Inflammation can be another cause of eye floaters. This inflammation can occur on the back of the eye on the choroid, which is part of the uvea. This type of inflammation is called posterior uveitis. It has various causes, including infection and inflammatory diseases. This affects both the choroid and the retina and can also cause the appearance of floaters.

3.    Bleeding

Blood entering the vitreous can cause the appearance of eye floaters. This has several potential causes, including diabetes, high blood pressure, and injury. In this case, blood cells cause the eye floaters that appear in the vision.

4.    Medications

When injected into the vitreous, certain eye medications can form air bubbles that look like shadows and take on the appearance of floaters. These floaters are usually temporary because the eye later absorbs the bubbles.

5.    Surgery

Some surgeries can also cause eye floaters. For example, during cataract surgery, where silicone oil bubbles are added, these can take on the appearance of floaters. However, you must note that these might have already been there in this instance. If you have had cataract surgery to clear your vision, floaters might have already been there, and you just could not see them.

Who Gets Eye Floaters?

As mentioned, eye floaters are primarily a problem related to aging. As such, age is one of the biggest risk factors, and people over 50 tend to get more eye floaters than younger people.

Apart from aging, diabetes is one of the main health conditions that can increase the likelihood of eye floaters. Diabetic retinopathy is a condition where damage is caused to the retina’s blood vessels, which can cause floaters.

Eye injuries could also increase the chance of experiencing eye floaters. In addition, certain types of eye surgery can increase the chances of getting them. For example, floaters can be more likely to appear when complications arise during cataract surgery.

Also, people with nearsightedness are more at risk of getting floaters. This is due to the elongated form of the eye, which increases the possibility of the vitreous detaching from the retina.

Are Floaters Serious?

In most cases of age-related eye floaters, they are not too serious. However, that does not mean you should not get floaters checked out if you are experiencing them. If they start to bother you, it is always getting your eyes examined.

In addition, there are certain situations when you should always contact your optometrist or eye specialist immediately.

For example, if you experience a sudden appearance of new eye floaters or if you suddenly notice you have more than usual, always get your eyes checked.

If, in addition to your eye floaters, you experience any of the following, always get your eyes checked urgently:

  • Light flashes in the eye
  • Blurred vision
  • A gray area blocking some of your vision
  • Peripheral vision loss

These symptoms may be painless but could result from a retinal tear. As previously mentioned, this can be incredibly serious and requires immediate attention.

VitreousHealth: A New Solution for Eye Floaters

Source: MacuHealth

If you have ever heard someone tell you, ‘I cured my eye floaters,’ you may be interested in searching for a solution.

If your eye floaters are not related to a retinal tear or something more serious, and they are bothering you, there is a chance you can do something about them and reduce their severity.

In this case, you may be interested in VitreousHealth from MacuHealth.

MacuHealth has a long history of formulating successful treatments, and it developed VitreousHealth to help reduce the severity of eye floaters.

Launched in April 2022, VitreousHealth has been developed specifically to help people suffering from floaters. It is also the first formula to be scientifically proven to reduce the severity of eye floaters.

What Is It?

VitreousHealth is a non-invasive treatment for eye floaters in the form of a dietary supplement. It is the first to be scientifically proven to treat eye floaters.

Made with a patented blend of antioxidants, VitreousHealth nourishes the eye and protects against oxidative stress, which helps to reduce the appearance of floaters. In addition, all the ingredients are natural and free of lactose.

It is manufactured in the USA in a GMP facility and tested by third parties for safety and quality.

How VitreousHealth Helps

VitreousHealth reduces floater severity and improves contrast sensitivity and the visual experience. It does this by decreasing vitreous opacity while also decreasing discomfort.

The vitreous needs antioxidants to function properly. These protect from disease and oxidative stress. When the vitreous loses its nutrients, which can happen as we age, it can lead to floaters.

VitreousHealth helps sufferers to manage the condition by providing a natural option to reduce symptoms.

It is based on the Floater Intervention Study (FLIES), in which 67% of patients saw an improvement in their symptoms within six months, experiencing enhancement in visual comfort and contrast sensitivity.

Should You Try VitreousHealth?

If you are experiencing eye floaters, the first thing to do is get your eyes checked by an eye specialist.

As long as there are no serious underlying causes, like a detached retina, you may want to try VitreousHealth and see if it can help you get relief from your annoying eye floaters.Try VitreousHealth today.

SoonerCare Vision Information

As an eye doctor in network with SoonerCare Insurance in Broken Arrow, I have to be familiar with all the rules or guidelines that apply. I will discuss some of those rules in this article. Now, please understand that SoonerCare could change those rules tomorrow, but here is information about SoonerCare in the current environment for Tulsa.

SoonerCare Guidelines

SoonerCare’s purpose and goal is to make sure no one goes without their needed vision correction due to their financial situation. Eye examinations with SoonerCare are covered for individuals under the age of 20. SoonerCare also covers basic glasses, again, for those under 20 years old. If you are over the age of 20, then SoonerCare will only cover the examination for medical reasons such as allergies, dry eyes, diabetes, or other eye conditions. 

Does SoonerCare Pregnancy Cover Eye Exams?

If you are pregnant SoonerCare will cover the eye exam if you have an eye medical condition. Those conditions could be dry eyes, cataracts, watery eyes, glaucoma, headaches, or any other eye related medical condition. SoonerCare will not cover glasses over the age of 20 regardless of if you are pregnant or not.

What Does SoonerCare Cover for Kids?

SoonerCare covers a yearly examination and any requested follow-ups by your Eye Doctor or Optometrist. SoonerCare will also cover a pair of glasses. This includes both the lenses and the frames. The lenses are to be polycarbonate material. The frames are expected to last the patient 1 year, but if broken SoonerCare will cover an additional frame within that year. One Vision has a large selection of SoonerCare-eligible glasses. Our SoonerCare eyeglasses come in a wide variety of colors and styles.

Dr. Thirion a pediatric eye doctor doing a pediatric eye exam.

What All Does SoonerCare Cover for Adults?

When it comes to adults, SoonerCare will cover an eye examination for a medical reason. In other words, SoonerCare will cover the examination if you have eye allergies, dry eyes, diabetes, macular degeneration, cataracts, or any other eye disease. Currently, it doesn’t help with glasses for anyone over 20 years old.

Does Medicaid Cover Vision Therapy?

Sadly Medicaid does not cover vision therapy. Years ago SoonerCare did cover vision therapy, but those guidelines got changed and it no longer covers vision therapy. However, I am hopeful that one day they will change that guideline back and start allowing vision therapy treatments. 

Does SoonerCare Cover Contact Lenses?

So, SoonerCare views contact lenses as a convenience and therefore it does not cover them. Thankfully, contact lenses are not nearly as expensive as they were in years passed, so even though SoonerCare does not cover contact lenses you or your child may be able to afford contact lenses.

Tulsa Eye Doctors in Network with SoonerCare

Now, most of the Eye Doctors in Tulsa and Owasso accept SoonerCare. After all, with over 70% of Tulsa kids enrolled in the program, it makes sense that SoonerCare would be the first vision insurance most Eye Doctors would apply to get in network with, and therefore be able to take more patients.

Dr Thirion performing a children's eye exam on a patient in network with soonercare. Best Eye Doctor Broken Arrow.

Will SoonerCare Cover Replacement Glasses?

Next, Soonercare will cover replacement glasses under certain circumstances. Here are the guidelines from the Oklahoma Health Care Authority:

“Eye glasses, lenses and frames, are covered for children. Prior Authorization is required for additional eye glasses for children beyond 2 pairs in a 12 month period. It should be unusual for a child’s vision to change so frequently that greater than two pairs of eye glasses are needed within a 12 month timeframe. However, if this should occur, the documentation should clearly demonstrate changes in the member’s vision necessitating the new prescription. PA will provide if the services are reasonable and medically necessary.”

Here is a list of indications for additional eye glasses:

  1. Change in Vision:
  • Documentation should indicate a change in correction of 0.5 diopters or greater in either sphere or cylinder power in either eye since last examination; OR
  • A shift in axis of greater than 10 degrees in either eye since last examination; OR
  • A change in the member’s head size warranting a new pair of eyeglasses; OR
  • The member has an allergic reaction to the eyeglasses materials; OR
  • A comprehensive or intermediate vision examination shows that a change in eyeglasses is medically necessary.

2. Irreparable Lenses/or Frames

  • Documentation should indicate the nature of the incident resulting in irreparable damage, including how and when the lenses and/or frames were damaged; AND
  • A statement indicating why the lenses and/or frames cannot be repaired. 

3. Lost or Stolen Eye Glasses

  • Documentation should include a signed statement from the parent/caregiver attesting to the loss of the eye glasses and that reasonable attempts were made to locate the lost or stolen eye glasses and failed.

Next, here are some links to help you get started with Soonercare. If you find yourself with more questions, feel free to call us at 918-286-2020.

Apply for Soonercare

Soonercare Benefits Information

Soonercare Eligibility Guidelines

Summary of Eye Doctor in Network with SoonerCare

Therefore, One Vision is proud to be a practice in network with SoonerCare. Our Eye Doctors became Eye Doctors to help people. As an Optometrist office in network with SoonerCare, we can do just that. We are an Optometrist that accept SoonerCare. Also, if you want to learn more about SoonerCare, you can visit their website here. Thanks for reading, and we hope to see you (and get you seeing) soon!

-Doctor James Thirion

Astigmatism Facts and Fiction

It is estimated that one in every three people have an astigmatism and almost three out of four glasses prescriptions have the correction for it in the prescription. Most Eye Doctors field questions about astigmatism daily if not hourly. I am going to go over several aspects and help shed some light on the facts and fiction of having an astigmatism. After all a condition this common in society should not be something that strikes fear into most patients when they hear they have one.

What is an Astigmatism?

An astigmatism is when the front part of the eye, also called the cornea, is not shaped perfectly round like a basketball. Instead the cornea is more like a football in shape where one sided is steeper than the other. Being shaped this way causes light to come into focus in two spots in the back of the eye instead of only one. This is not a big deal. It is perfectly “normal”, but not the ideal situation for clear vision. That is all that it is. Simply the front part of the eye being shaped “improperly. This is why there is no reason to stress if your Eye Doctor tells you that you have one.

Symptoms of an Astigmatism

Some of the symptoms of astigmatism can be as follows. You might notice lights, such as street lights, which should have a circle of glare around them instead have an area of glare that is longer than others. You also might notice images are slightly out of focus or have a slight shadow or ghost image to them. An uncorrected astigmatism can also frequently cause low grade dull type daily headaches. If you would like to read more about other ways the eyes can cause a headache check out my other post about headaches.

What Can Cause an Astigmatism?

There is a genetic component to astigmatism, so you have your ancestors to partially blame for it. Injury to the eye can sometimes cause it as well. As a medical community we aren’t 100% certain of the causes, but we do know those things can play a role in someone having one. However, it is a myth that reading in low light environments can cause one. Reading in low light can give you a headache or exhaust your vision, but it can’t cause an astigmatism. 

Different Types of Astigmatism

While there are technically multiple types of astigmatism that is mainly for the academics to argue and debate. For the most people it is not something to really talk about, but I am going to anyways. The different types of astigmatism are classified as compound hyperopic astigmatism, compound myopic astigmatism, and mixed astigmatism. All these mean is that both points of focus of light are behind the retina, in front of the retina, or one in front and one behind.

How to Fix An Astigmatism

Glasses, contacts, or refractive surgery like LASIK can easily correct it and rid the things you might notice from it. When it comes to the glasses it is an extremely easy fix. Depending on how high the astigmatism is will determine if certain eyeglass frame styles are an option for you. Most contact lens companies will make a topic or astigmatism version of contact lenses.

Having this added to your glasses or contact lenses is a simple fix. The glasses won’t cost more because of it, but sometimes the contact lenses do cost more. Having one is not the worst thing because again almost a third of the population has one. So, know that you are in good company if you have one because if you are in a room of more than 5 people someone else probably has one.

If you still have questions or want to know if you have one come by our offices for an eye examination. If you ever have a topic you would like me to talk about please send us an email and I will gladly talk about any topic. I am adding more topics every month, so make sure to check beak monthly to see what other topics I have covered. You can also give us a call! I know there are tons of articles you could have read, and I appreciate you taking the time to read my article. I hope you have a great day and thanks for reading.

Does Smoking Marijuana Lower My Eye Pressure?

This is a really popular question I get as an eye doctor. Although marijuana can lower eye pressure, it isn’t really recommended due to the side effects, short duration of action, and lack of evidence.

Worldwide Blindness

After cataracts, glaucoma is a leading cause of blindness worldwide, affecting more than 60 million people. Glaucoma is a disease where the optic nerve is damaged. The optic nerve carries visual signals from the eye to the brain. Damage to this part of the eye causes vision loss and eventually blindness. Usually, the damage to the optic nerve is caused by high eye pressure. Treatment for this is either eye drops or surgeries to lower the eye pressure and prevent further damage and vision loss. 

Does Marijuana Lower Eye Pressure

So, is marijuana a good option for lowering eye pressure? Not really. Smoking marijuana will lower eye pressure, but it only lasts for 3-4 hours. So, in order to lower the eye pressure throughout the whole day it would have to be smoked 6-8 times a day. Other medicines reduce eye pressure equally well and need only be taken once or twice a day. Marijuana prevents patients from driving and functioning at full mental capacity so smoking all day would really not be an option for most people. Marijuana cigarettes also contain compounds that damage the lungs and chronic use can cause brain damage. Consider this: Alcohol also lowers eye pressure for an hour or so after a drink. But no doctor would recommend that you drink alcohol every hour to treat glaucoma. Many other effective treatments are available that don’t have the side-effects of alcohol.

There are ways to ingest THC, the active ingredient of marijuana, that avoid the harmful effects of marijuana smoke, but there are still systemic side effects such as drowsiness and loss of judgement. There is some evidence that a synthetic cannabinoidlike compound known as HU-211 has nerve-protecting properties, although it does not reduce eye pressure. HU-211 is chemically similar to THC, but it is not found in the marijuana plant and does not bind to the cellular receptor in brain cells that THC activates.

Don’t Forget About Blood

Marijuana does lower eye pressure and blood pressure as well. Lower blood pressure can cause the blood supply to the optic nerve to be reduced which in turn might harm the optic nerve. This is the opposite effect that you want! For this reason and many others, marijuana is not recommended without a long-term clinical trial. 

What is a Subconjunctival Hemorrhage

Frequently I have patient’s come into the office because their eye is blood red. Most of the time, these patients don’t even notice it themselves. Usually they will say “My husband/wife/etc. looked at me and freaked out!” These subconjunctival hemorrhages look really bad, but they actually come without symptoms, other than redness, and are typically not a sign of anything going on medically. 

So, what exactly is a subconjunctival hemorrhage? It is basically a bruise on the white part of the eye. The eye’s conjunctiva has lots of tiny blood vessels that can break and bleed. When you have a bruise on other parts of the body, your skin covers it which gives it the blue/purple/green coloring. On the eye, since there is no skin, you are seeing the actual blood pooling. They look very scary but are usually harmless and heal on their own. 

What kind of symptoms can you expect?

There are usually no other symptoms other than the eye looks blood red. In fact, like I said earlier, someone else may notice it before you do or you may not notice until you look in the mirror. Occasionally it can cause some very mild irritation. 

What Causes Subconjunctival Hemorrhages?

These can be caused by coughing, sneezing, straining, or other similar actions because it will raise blood pressure in the veins which causes the capillaries to break and bleed. 

Trauma can also cause a subconjunctival hemorrhage. Surprisingly enough, rubbing your eyes too hard may also cause the blood vessel to break!

Other more uncommon causes include:

  • Diabetes
  • Hypertension
  • Blood thinning medications like aspirin or Coumadin

Very rarely, subconjunctival hemorrhages can be a sign of a blood clotting disorder or other blood problem that affects the body. 

Subconjunctival Hemorrhages Treatment

A subconjunctival hemorrhage should resolve on its own.  Small ones may only take a few days but larger ones can take a few weeks. It may look worse before it looks better as gravity pulls the blood down.

If the eye is irritated, artificial tears can be used. 

Diabetes and Dry Eyes

We are able to detect lots of systemic diseases just by looking into the eyes. By looking at the blood vessels in the back of the eye, the retina, we can detect signs of diabetes and heart disease. We are also able to detect signs of diabetes in the eyelids by problems with the meibomian glands. 

What is Meibomian Gland Dysfunction?

Meibomian glands line our upper and lower eyelids and contain an oil-like substance called meibum. Each time you blink, meibum comes out of the gland to coat your tears and keep them on your eye longer. A healthy tear film relies on these glands to prevent tears from evaporating too quickly. 

Meibomian gland dysfunction, or MGD, is where these glands become clogged which makes it harder for the oil to come out. The meibum becomes thicker and is poorer in quality. This results in irritation and dry eyes due to evaporation. If the MGD is left untreated, the glands will atrophy and cease functioning permanently which causes severe dry eye. Risk factors for MGD include natural aging, hormone changes, certain medications, and medical conditions, diabetes included. 

How Does Blood Sugar Affect Meibomian Glands?

There was a study performed in 2020 that was published in The Journal of Endocrine Society that looked at the link between uncontrolled blood sugar and the ability of meibomian glands to function properly. They found that elevated A1C levels can cause the meibomian glands to atrophy. We know that diabetes damages small blood vessels in the retina, but that also includes the blood vessels that supply the meibomian glands with oxygen and nutrients that they need to survive and function. Researchers also suggest that insulin resistance may affect the meibomian and sebaceous glands. Also, high blood sugar can impact the quality of the meibum. 

If you are experiencing dry eye symptoms it is important to schedule a comprehensive eye exam with your eye doctor to determine the underlying cause. This is important to catch early before the glands become irreversibly damaged. 

A Deep Dive into Steph Curry’s Eye Disease

Keratoconus is a disease that affects the cornea, the clear, dome-shaped coating over the front of the eye. The cornea helps to focus light into the eye. With keratoconus, the cornea thins and beings to bulge out like a cone. Since the cornea has a different shape, the light rays that enter the eye become out of focus making vision blurry and distorted. 

What Causes Keratoconus?

There is no known cause for keratoconus. In some cases, it appears to be genetic. About 10% of people with keratoconus report a parent with it too. Keratoconus does have some associations which include:

  • ocular allergies
  • excessive eye rubbing
  • connective tissue disorders such as Marfan syndrome and Ehlers-Danlos syndrome

What are Symptoms of Keratoconus?

Keratoconus typically starts in young people, late teens to early 20s. Vision will slowly get worse over the next 10 to 20 years. Most of the time, both eyes are affected. Symptoms may be different in each eye and change over time. 

Symptoms of early keratoconus include:

  • blurred vision
  • distorted vision, lines appear wavy
  • light sensitivity
  • redness or swelling

Symptoms of late-stage keratoconus include:

  • -more blurred and distorted vision
  • -increased astigmatism
  • -contact lens intolerance

It usually takes years for keratoconus to progress from early to late stage but for some people it can deteriorate much faster. The cornea can start to suddenly swell which leads to scarring which has a big impact on vision. 

Keratoconus Treatment

Treatment for keratoconus depends on symptoms. If symptoms are mild, vision can usually be corrected with glasses or soft contacts. As the disease progresses, special hard contacts may be required to help keep vision clear. 

Here are a few other ways to treat keratoconus:

  • Intacs: This is a small, curved device that is inserted into the cornea. These devices help to flatten the curvature of the cornea to improve vision
  • Collage cross-linking: This is where UV light and riboflavin (vitamin B2) drops are used to help strengthen the cornea. This will not reverse any thinning or protruding that has already happened but will help prevent it from bulging any further. 
  • Corneal transplant: This is the last option. If symptoms are very severe or there is a lot of scarring, corneal transplantation may be suggested. The diseased cornea is replaced with a healthy donor cornea. 

  If you are concerned that you may have keratoconus, bring it up with your eye doctor. Getting annual exams with also help catch keratoconus at early stages where other treatment options are still available to us. 

Review of the New Treatment for Macular Degeneration Called Syfovre

There has been some news regarding macular degeneration that came out a few weeks ago and I wanted to talk a bit about that today. The FDA has approved Syfovre (pegcetacoplan) for the treatment of geographic atrophy due to dry age-related macular degeneration. 

What is Geographic Atrophy?

Geographic atrophy is a chronic progressive degeneration of the macula that occurs as part of late-stage age-related macular degeneration. There is atrophy of the outer retinal tissue, retinal pigment epithelium, and choriocapillaris. It causes missing spots in the center of the vision called central scotomas and permanent loss of visual acuity. Typically, it occurs in both eyes. Geographic atrophy occurs in about 20% of cases of macular degeneration. 

Before now, there has been no treatment available to halt or reverse the progression of geographic atrophy, so this is big news!

What is Syfovre?

Syfovre contains pegcetacoplan, which has been investigated as a targeted C3 inhibition therapy. It regulates excessive activation of the complement cascade, which could lead to the onset and progression of diseases. 

It is administered via intravitreal injection once every 25-60 days to reduce the progression of geographic atrophy. 

There were two studies, the DERBY and OAKS studies, that tested its efficacy and safety. The results showed a clinically meaningful reduction in geographic atrophy growth when compared to sham injections from months 18-24. There was a 36% reduction in DERBY and 29% reduction in OAKS. 

As far as adverse reactions, the most common was ocular discomfort, neovascular AMD, floaters, and conjunctival hemorrhage. 

Syfovre is expected to be made available this month! This is a really amazing and historic first for treating these patients who previously had no options.