Alamo Optometry Blog

September 9, 2013

Back To School

Filed under: Uncategorized — gkblog @ 9:01 pm

(As appeared in Alamo Today,  September 2013)

Now that the summer is coming to a close, it is the time as parents where we start turning our attention to back to school for kids of all ages from elementary school to college and graduate school.  Besides stocking up on clothes and school supplies, this usually also includes visits to your child’s pediatrician, dentist, and optometrist.  School these days is difficult enough for our kids so we need to make sure they have the necessary tools and vision to start off the year on the right foot.

Vision at school requires several tasks to manage to be successful.  This includes sharp distance vision to be able to read the board and/or overhead, good near vision and binocular vision (eye teaming) to be able to read and study for long periods at a time, and depending on the class, the ability to go back and forth from the board or overhead to up close to take notes on paper or computer with ease.  In addition to these visual requirements, the eyes also need to be healthy to be able to sustain these demands.  Conditions such as dry eyes induced from allergies or medications, and the itching and tearing from seasonal allergies can hinder vision and thus needed to be diagnosed and addressed.

It is for these reasons that your child’s eyes should be checked by an eye care professional.  School and pediatrician screenings usually only test distance vision and does not address health issues of the eye and does not address near vision, depth perception, and binocular vision.  Many times a child (or adult for that matter) has “good vision” but is still having issues with near work which can include blurry vision, double vision, headaches, and overall difficulty sustaining up-close work for any period of time.  Obviously all reading issues are not caused by vision and/or binocular vision conditions, but that should be the first place you should check out to make sure all is well.

In addition to school and homework, most children are involved in school and/or recreational sports and extra-curricular activities.  Whether your child is involved in soccer, football, dance, or cheerleading, these all require good vision and ocular health to be able to succeed.  If there is vision correction required, many parents and kids are opting for daily contact lenses.  Activities are often difficult to fully participate in while wearing glasses, and contact lenses allow for good vision as well as peripheral vision, and you are not hindered by the frame.  Most patients are good candidates for contacts; however, since there is work to learn to adapt to the lenses and to be able to put them on and off, motivation on the part of the child is paramount.  If he or she is not really interested in contacts, I recommend starting the process of training and follow-ups when they are ready to tackle it.  It is also helpful if a family member already wears contacts to be able to help out as needed.  However, it is the child that needs to have the responsibility of keeping their hands clean, cleaning and storing the lenses as needed, and inserting and removing the contacts.

It is recommended for vision and ocular health changes that patients get an annual eye exam.  The testing we do at the office goes much more in depth and covers more than pediatrician and school screenings.  We hope that if you do not have any vision insurance that you take advantage of our back to school offer.  We are a family-centered practice and we look forward to seeing the entire family in the office soon.

Pinguecula and Pterygium

Filed under: Uncategorized — gkblog @ 8:59 pm

(As appeared in Alamo Today, August 2013)

Most people look at those two words and they probably ring a bell.  A patient will remember it being mentioned but can’t necessarily tell what it describes.  As I go through the definitions, most people will realize that they have these on their eyes and at times can cause a little redness or irritation.

A pinguecula (pin-GWEK-yoo-la) is a very common non-cancerous growth of the conjunctiva (the clear membrane over the front surface of the eye).  It is usually a yellowish round bump more commonly found on the side of the eye closest to the nose; and many times it can become inflamed with blood vessels running across the eye.  These do not cause any vision loss, but can cause some irritation and tend to cause patients to have a foreign body sensation.  Depending on how close it is to the cornea, it can cause increased contact lens sensation as the edge of the contact lens will rest on the pinguecula.  Regardless of how inflamed or irritated a pinguecula becomes, it will remain on the conjunctiva and will not grow onto the cornea.

A pterygium (tur-IJ-ee-um), however, can and often does extend onto the cornea.  These two conditions are very similar, but the difference is the tissue of origin and the shape.  A pterygium develops in the sclera, which is the white part of the eye underneath the conjunctiva.  These also take on a triangular shape with the wider base next to the corner of the eye and the narrower edge pointed towards the center portion of the eye.

Both of these conditions are completely benign and share similar causes.  By far the biggest culprit is UV exposure.  It is important to realize that it is a cumulative effect of UV radiation, and a very large portion of that was done by the time you turned 18.  That is why it is very important for kids to wear sunglasses and hats when they are young.  The other contributors are dusty and chemical environments.  Farmers are notorious for having very large pterygia because they have the sun, the dust, and the fumes from the chemicals that are used on the vegetation.

Treatment of these conditions is also very similar.  Besides the need for UV-blocking sunglasses, lubricating drops help with the foreign body sensation and helps to keep the area moist.  If these grow large, they become very dry because as the lids come down over the eye during blinking, it is not able to reach the entire surface and therefore it becomes dry and inflamed.  The more red and inflamed these become, they quicker they tend to grow.  In advanced cases, an anti-inflammatory is needed in conjunction with the lubricating drops to get the redness and irritation under control.  These drops will not remove or shrink the area down; it will only reduce the associated swelling and irritation.

If and when a pterygium grows far enough onto the cornea, surgical removal needs to be considered.  If it continues to grow in front of your pupil, then vision will be compromised and when it is removed it will leave a central scar on the cornea that will reduce vision.  The need for this does not happen often, due to patients taking care of it with sunglasses and artificial tears.  As I tell most of my patients, the happier you keep the pterygium; it will return the favor and not grow as quickly.

If you have any questions about which treatment would be best for your situation, we would be happy to see you.

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