What Do Cataracts Look Like?
I have found that the media has perpetuated a misconception about the appearance of cataracts, and so I wanted to share with you the scoop.
The first question is, what is a cataract?
The natural lens inside the eye is supposed to be clear, but with time it becomes clouded, and that is a cataract. As you can see in the picture below, the natural lens is located behind the pupil/iris which is the colored part of your eye (pictured in blue).
Given that the lens is located behind the iris, a cataract is virtually imperceptible. 95% of the time when I identify a cataract, I need to use my slit lamp, which is a specialized microscope.
Now, let me show you how cataracts are commonly portrayed in the media:
This is a picture from Smallville. Notice how the eyes look white? The reality is if an eye looked white like this, there would in fact be a problem with the cornea. As you can see in the diagram above, the cornea is the front surface of the eye which vaults over the location of the iris and lens. Despite what the media tells you, this is NOT what a cataract looks like. As I said before, a cataract is almost always imperceptable without a slit lamp aka a specialized microscope.
So, how would you know if you have a cataract?
The main symptoms are difficulty with glare at night, particularly from oncoming headlights. There can also be the appearance of halos around street lamps. Cataracts also cause progressive blurry vision which cannot be improved with glasses. The only treatment is to have them surgically removed; a very common, simple, and safe procedure. Cataracts are like looking through a dirty windshield; until the cataracts are removed (aka the windshield is cleaned), there is only so much that can be done to correct the vision with glasses.
Envision
Silver Strand Optometry offers innovative technology by Envision which allows us to perform two types of therapy: Radio Frequency (RF) and Intense Pulsed Light (IPL). IPL and RF have been used for 25-35 years respectively, and (like cell phones) has evolved significantly during that time to provide unprecedented therapy to the delicate tissues around your eyes.
One of the many diagnoses RF and IPL can treat is dry eye. Dr. Castillo sees so many patients with dry eye that she felt like she would be doing a disservice to you to not invest in this technology. The goal with RF and IPL is to get you creating your own good quality tear film and off of using dry eye drops and/or hot compress/lid scrubs all together. RF and IPL is more effective than even some of the prescription drops on the market for dry eye. For example. Restasis only has an efficacy of 15%, so low that it is not even approved for use in many countries. Whereas RF and IPL have an efficacy of 85%! Here are more details about each individual therapy:
RF is exclusive to Envision technology and can be used to treat:
Meibomian Gland Dysfunction (MGD) is a type of dry eye. You know you have MGD if I have recommended that you use hot compress and lid cleansers at home, and possibly also recommended you come to the office for gland expressions. MGD causes the glands that secrete your tear film to die off. The treatments available until this point help to slow down this process. RF can actually help regrow the lost glands. After just four treatments it negates the need to use hot compresses, lid cleansers, and to come in to the office for gland expressions.
Wrinkles around the eyes. RF stimulates the growth of collagen and tightens the skin!
RF can also be used to treat droopy eyelids. Here is a before and after:
Chalazions are bumps that can develop after a person has a stye. Until now the only treatment options for Chalazions have been surgical excision if hot compresses were ineffective. RF is a non-surgical alternative to breaking up the Chalazion. Here is a before and after:
IPL has been around for a few years and is not Envision specific. It can be used to treat:
Inflammatory Dry Eye. You know if your dry eye has an inflammatory component if you are using Pure&Clean, Restasis, Tyrvaya, or Xiidra. IPL can be more effective than any of the treatments listed above.
Demodex are parasites which can live in the base of your eyelash follicles. You will know if you have an infestation of Demodex if I have told you that you have parasites living at the base of your eyelashes. Until now the only treatments have been hot compress and lid cleansers to control the population of the parasites, as well as a medication that was FDA approved at the end of July. RF is now another treatment option.
Rosacea and spots on the skin can also be treated with IPL. Here is a before and after:
If you are interested in either of these treatments, please feel free to call our office at 805-486-3585 to schedule a free consultation. Dr. Castillo would be happy to review if you're a candidate and how Envision can benefit you.
The Myth of Visine/ClearEyes
Visine and ClearEyes are common eye drops that many people use to treat a variety of problems ranging from ocular redness and allergies to Dry Eye. As it turns out,Visine and ClearEyes are NOT good for the eyes. Visine and ClearEyes are both vasoconstrictors. Meaning, they make eyes look less red because they constrict the ocular blood vessels. However, after long term use of Visine/ClearEyes the eyes will essentially get “addicted” to the drops and cause the ocular blood vessels to become constantly engorged.
There are other over-the-counter eye drops that I recommend instead of Visine/ClearEyes. The drops I recommend vary based on what the patient is trying to treat with the drops.
For those who are using Visine/ClearEyes to relieve redness, I recommend using Lumify drops instead.
For those who are using Visine/ClearEyes to treat ocular allergies/itching I recommend using Pataday, Alaway, or Zaditor instead.
For those who are using Visine/ClearEyes to treat Dry Eye, please bear in mind there is a large variety of treatments for Dry Eye. The most accessible over-the-counter treatment option is artificial tears, and these are the brands of artificial tears that I recommend: Optase, Refresh, Systane, Blink, Retaine, GenTeal, and Thera Tears. With regards to Dry Eye, artificial tears are really treating the symptoms instead of the cause of the dryness. If you do have Dry Eye and would like to explore further treatment options please do not hesitate to make an appointment at our office 805-486-3585.
How to Elongate Your Eyelashes
People who want to elongate their eyelashes tend to go with eyelash extensions. Eyelash extensions come in a few forms, and usually individuals go with either do-it-yourself extensions or visit an eyelash technician for customized extensions. Neither one of these are terribly good for eyeballs for a couple of reasons.
First, over time many people develop an allergic reaction to the adhesive/glue used to attach the extensions, which can be very uncomfortable and lead to temporary loss of eyelashes (usually as the person tears out the lashes due to intense itching).
The second reason why eyelash extensions are not good for the eyes is they tend to matt the base of the eyelashes. There are tear glands at the base of eyelashes which secrete a tear film that covers the front surface of the eyes and allows the eyelids to glide over the eye instead of cause chaffing. If the base of the eyelashes are matted from the eyelash extensions, then this can prevent the tear glands from secreting a proper tear film, which can lead to Dry Eye. In addition to being uncomfortable, Dry Eye can cause blurry vision and difficulty with glare.
This being said, I do not recommend that my patients elongate their eyelashes with extensions.
An alternative that I do recommend is an eye solution called Latisse. This solution comes with an applicator and is applied at night before bed to the base of the upper eyelashes, much like eyeliner. Latisse will cause the eyelashes to grow longer and thicker. It is prescription only, but I would be happy to prescribe it for anyone who is interested. Please either ask me about it during your next eye exam or schedule an appointment to discuss further. The office number is 805-486-3585.
Eye Drops to Improve Vision
I am sure that many of you have seen the advertisements regarding new Vuity eye drops on the market that can improve vision. So, I wanted to take a moment to explain what’s the story with these eye drops.
I think a more accurate, simple description of the Vuity drops is they could replace reading glasses.
Patients who are a good candidate for these drops are those who need reading glasses. The best candidate is someone who has “perfect” distance vision and only needs help with reading. Patients who need distance as well as reading glasses could also be candidates, but they would still need to wear distance glasses as well as use the drops. Another case when these drops could be helpful would be for patients who want to wear contact lenses for distance and then put in the eye drops to see at near.
The way the drops work is they constrict your pupils, working in the same way as a pinhole camera. In other words, the constricted pupil allows only parallel light to enter the eye, reducing scattered light from causing blur. The constricted pupil also increases the focal length of the eye, allowing for a greater range of clear vision. If you want to learn more about how a pinhole camera works, this is a pretty good video: https://youtu.be/jhBC39xZVnw
The way you would use the drops is you would put them in your eyes in the morning, and after they constrict your pupils, you should be able to see at near. The drops wear off after about 6-8 hours, in which case they need to be reapplied. However, I do discourage re-application too late in the day because otherwise your eyes would be constricted at night, and then it would be very hard to see without enough light. 2:00 pm is about the latest I’d recommend re-applying the drops. As with a new glasses prescription, it can take time to get used to seeing with the Vuity drops.
If you are interested in learning more about the Vuity drops please do not hesitate to call our office at 805-486-3585 to schedule an appointment.