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The most common complaints reported to eye doctors involving burning, itching, puffy eyelids and watery eyes can be attributed to ocular allergies. It has been estimated that 60% of the population has some degree of discomforting symptoms related to ocular allergies.

To provide some biological detail, the tear layer of the eye contains specialized cells called mast cells. Mast cells are large container cells that store large amounts of histamine cells. Under optimum conditions the cell walls of mast cells break releasing histamine in response to eye injuries and eye infections. In ocular allergies, especially if there is excessive eye rubbing, mast cells break open unnecessarily releasing large amounts of histamine. As a result, excess histamine causes the eyes to itch, thus the common historic treatment was to introduce anti-histamine drugs to reduce the itch symptoms.  

Eye rubbing increases the itch response 15 fold, so all patients are urged to limit rubbing of the eyes as much as possible. Cool compresses may also helpful in reducing symptoms. The causative source of ocular allergies varies greatly including, seasonal pollens, animal dander, mold, etc. Reducing exposure to known allergy sources is prudent, but since we don't live in a bubble, it is difficult.

For patients troubled by ocular allergies, over-the-counter eye drops are often recommended to improve comfort. For patients with more troublesome symptoms, prescription medication is needed to help eliminate symptoms. Some of the prescribed drugs are called mast-cell inhibitors. These new classes of drugs are safe and generally used once or twice daily depending on a patient's symptoms during troublesome allergy times.


The cornea is the central clear window of the eye. A corneal ulcer is an area of tissue disruption of this sensitive tissue often extending deep into the corneal structure. In most cases, corneal ulcers result from bacterial infection.  Pain, light sensitivity, decreased vision and tearing are common symptoms of these lesions.

All types of corneal ulcers are serious, sight threatening lesions that require aggressive treatment and careful monitoring. Treatment usually includes special antibiotics, and often, anti-inflammatory medications. Scarring to the cornea may result despite treatment. Frequent examination is necessary until the ulcer is completely healed.



Problematic dry eyes are one of the most common problems reported to eye doctors.  Dry eyes result from either a decrease in the amount of tear production, or the quality or composition of the tears produced.

There are many common causes of dry eye syndrome including: advancing age, allergies, poor diet, heating/cooling environmental circumstances, normal hormonal changes, health status such as diabetes, arthritis, lupus, thyroid dysfunction, chemotherapy, radiation, acne rosacea, contact lens use, computer use and patients that have a history of LASIK surgery.  In addition certain medications can contribute to dry eye symptoms such as antidepressants, antihistamines, decongestants, acne treatments, diuretics and some blood pressure medications.

Common symptoms of dry eyes may include blurred or variable vision, sensitivity to light, dryness, burning, stinging, gritty or foreign body sensations.  Occasionally, the dry eye patient may experience a paradoxical excess or "reflex" tearing caused by the underlying eye surface irritation.

Treatment of this condition may include artificial tears, gels and/or lubricating ointments at bedtime, daily eyelid hygiene scrubs, a prescribed medication regime, Omega-3 essential fatty acid nutritional supplements (fish and flaxseed oil), and punctal (tear drainage) occlusion of the eyelid to retain moisture.

As you can see, the causes and possible treatment options are complex.  An individual treatment plan will be formulated for you based on severity and known causes.  Please follow my recommendations and outlined treatment plan carefully.



Keratoconus is a condition of the normally clear outer window of the eye, the cornea.  The word keratoconus is formed from two Greek words, kerato, meaning cornea, and konus, meaning cone.  The cornea is generally shaped like a dome or sphere.  It is primarily responsible for surface protection of the eye and performs a greater degree of light focusing than any other part of the eye.

Keratoconus gradually causes the central area of the cornea to weaken, thin, or bulge.  It eventually distorts from its more spherical shape to a cone shape.  This distortion may cause significant changes in vision which may begin in the late teen years and may not stop until age 40.  While keratoconus can be an inherited bilateral (two eye) condition, many patients have no clear inheritance pattern.  It has been estimated to occur in 1 out of every 2,000 persons.

The earliest changes of keratoconus may require frequent changes of glasses.  As the corneal distortion worsens, contact lenses may be required to obtain adequate vision.  In this case, contact lenses mask the warp or cone-like changes of the underlying cornea.  Generally, most keratoconus patients can be safely managed with contact lenses yielding good vision and comfort.  In more advanced cases of keratoconus, vision in an eye can be suddenly, yet usually temporarily, lost through an event called "hydrops."  During this process, the stretching cone-area of the cornea cracks, swells and in some cases may causes scars.

When contact lenses can no longer correct vision adequately, or when highly specialized contact lenses can no longer be made to remain comfortably on the eye surface, surgical replacement of the distorted corneal area may be considered.  Surgical treatment is found to be necessary in only about 10% of the cases.  This surgery is performed using donor cornea tissue to return the eye surface to a more normal shape.  Cornea transplants are highly successful (over 95%).  Although a transplant may not eliminate the need for glasses or contacts it will likely restore the visual function that keratoconus slowly distorts.

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Albertville Eye Care, 2011