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Diabetes

Diabetes is a major health issue in North America. There are approximately 3.4 million people in Canada with diabetes and this number is expected to increase to 5 million by 2025. The most damaging eye condition caused by Diabetes is Diabetic Retinopathy. The incidence of this disease increases the longer someone has diabetes. Diabetic retinopathy causes the blood vessels of the retina (inner layer of the back of the eye) to leak, swell or develop abnormally which causes damage to the retina. This can result in vision loss that can range from mild to severe.

Laser surgery can be used by an ophthalmologist to minimize the damage caused by Diabetic Retinopathy. However, laser surgery must be done in a timely fashion to be effective and it does not always return vision back to normal levels. Another surgical option for patients suffering from persistent Diabetic Retinopathy involves the surgeon injecting the eyeball with a steroid to stabilize the damaging effects of the Retinopathy. There are now new medications that can be injected in the eyeball that can prevent the growth of the abnormal blood vessels seen in Diabetic Retinopathy.Very often people with diabetes do not know that they have diabetic retinopathy until significant damage is done to the retina. Prevention of Diabetic Retinopathy is best accomplished by maintaining normal blood glucose levels, blood pressure and blood lipid levels. A regular eye exam (minimum once a year) with Dr. Guthrie is essential to detect retinal changes as early as possible.

Macular Degeneration

Macular Degeneration is the progressive damage of the macula. The macula is an extremely sensitive portion of the retina (inner layer of the eyeball) that is responsible for our central vision. Some of the risk factors of macular degeneration include: family history, smoking, high blood pressure, poor nutrition, and patients over 65 years of age. There are two types of Macular Degeneration: dry MD and wet MD.

Dry MD is less severe of the two types. In this type, the blood vessels and support cells under the macula break down resulting in macular damage. Symptoms of dry MD may include: fuzziness of central vision, the need for increased lighting to read, distortion of objects, or the development of a central vision blind spot. These symptoms tend to appear gradually.Wet MD is more severe than dry MD. In this type, there is an abnormal growth of blood vessels underneath the macula. These blood vessels are extremely porous causing blood and fluid to leak under the macula. As this blood and fluid collects, scar tissue develops which causes significant damage to the macula. Symptoms of wet MD are the same as that of dry MD however they tend to occur more rapidly and more severely.

Glaucoma

Glaucoma is an eye disease that affects nearly one percent of the people in Canada. Initially, glaucoma causes peripheral vision loss. If left untreated, it can lead to a complete loss of vision. Glaucoma is a very serious disease but with routine eye exams and early detection, the visual damage can be minimized.

Unfortunately, there are very few symptoms associated with glaucoma. Some patients may notice mild vision loss if any at all. Early signs of glaucoma can be detected by testing the pressure in the eye, measuring peripheral vision, and assessing the optic nerve.How is Glaucoma treated? The goal of Glaucoma treatment is to lower the eye pressure even in cases of low-tension glaucoma. This is accomplished with several types of pressure-lowering eye drops. Occasionally laser treatment or surgery has to be considered if the drops prove to be ineffective. Dr. Guthrie advises for all adults to have an eye exam every one to two years to properly screen for Glaucoma and other eye diseases.

Vitreous Detachment (Floaters)

The vitreous is a semi-solid to liquid material that occupies up to 75 per cent of the eyeball volume. Over time, the fibers of the vitreous become more mobile and clump together forming a floater. The floater casts a shadow on the retina, which may appear to the individual as a dust particle or a tiny insect floating in your vision.

The vitreous sac can pull away from the retina resulting in the sudden onset of flashing lights with one or more floaters. This may occur spontaneously, after eye surgery, physical trauma to the head or eye, or due to an inflammatory process. Generally, no treatment is required. Even though the appearance of flashes and floaters from a vitreous detachment can be more of a nuisance than anything, you should have your eyes examined by Dr. Guthrie promptly. You will need to have your pupils dilated to ensure the health of the retina. A cautious approach can go a long way towards preserving vision.

Blepharitis

Blepharitis is a common condition which causes inflammation of the eyelids. It is a chronic external eye disorder resulting in red, burning, and irritated eyes.

The cause of Blepharitis is due to the inflammation of the tear glands that are located behind the eyelashes. These tear glands are responsible for producing the oily component of tears. With Blepharitis, the oils from these glands do not flow freely and the gland openings become plugged. Left untreated, these glands can become infected. Loss of eyelashes can occur as well as recurrent painful eyelid swelling or styes. Dandruff-like scales may be found at the base of the eyelashes. Many patients complain of burning eyes, worse in the morning upon awaking in addition to their eyelids being matted shut.

Since blepharitis is a chronic condition, there is no cure. There are several ways to treat it and patients can manage it quite well. Cleaning away the crusty material around the lashes with warm compresses helps to keep the lashes clean. To help keep the effects of Blepharitis in check, the above therapies may have to be done on an ongoing basis. Early diagnosis and strict compliance with the treatment suggested by Dr. Guthrie is crucial in the management of Blepharitis.

Keratoconus

The cornea is the clear, dome-shaped covering of the eyeball. In order to see clearly with or without glasses or contact lenses, the cornea must be clear as well as maintain this dome shape. For some patients, the cornea becomes thin and distorted and eventually bulges forward like a cone. This is called Keratoconus.

How is Keratoconus treated? There is no cure for Keratoconus. In the early stages we prescribe new eyeglasses. As the disease progresses, soft and then hard contact lenses are considered. Hard contact lenses work best since they maintain their shape and can help to mask the corneal irregularity that results from Keratoconus. Keratoconus can also be treated with a new surgical procedure called corneal cross-linking. This procedure uses Riboflavin (Vitamin B12) and ultraviolet light to strengthen the corneal framework which can stabilize and sometimes improve the corneal irregularity.

Any patient who has any sign of Keratoconus should not have refractive laser eye surgery.Keratoconus does not result in blindness. Improving a keratoconic’s vision requires patience and persistence on the part of the patient and optometrist since no single treatment option works on every patient.