The Eye Practice

Laser Eye Surgery is certainly not for everyone.  In fact at least 25% of the people that inquire about Laser Eye Surgery are suitable for a variety of reasons.  It is imperative to be screen by someone that is experienced in who is suitable as treating unsuitable patients can turn out to be disastrous.  

If you’ve been disappointed to find out that you are not eligible for laser eye surgery, either due to your age, or that your prescription vision correction is too high to make laser surgery worthwhile, you don’t have to resign yourself to being stuck with glasses or contacts for the rest of your life. Actually, there is an alternative that you might find fitting for your vision needs.

REFRACTIVE LENSECTOMY

This procedure, called a refractive lensectomy, is ideal for many patients who do not fit the criteria for laser eye surgery. Basically, a lensectomy does not reshape the cornea as it would with lasers — instead, the natural lens of the eye is removed (hence the name “lensectomy”), and replaced with a permanent, human-made polymer lens. This new lens allows the eye a bit more flexibility with focusing (refractive - especially at distances), and will reduce or eliminate your dependence on glasses or contact lenses.

                         

Best Candidates

The ideal patients for a lensectomy typically fall into the following categories:

•    Age 45 and over
•    Have been disqualified from laser procedures, due to thin corneas or other reasons
•    Have signs of cataracts (early stages)
•    High prescriptions, either nearsighted or farsighted
•    Have a dependency on corrective lenses for both nearsightedness and farsightedness
•    Have no signs of other eye ailments (such as glaucoma or potential retinal detachment).

If you have the need for bifocals or multifocals, and are over age 45, then you might be a good candidate for a lensectomy procedure. You may be able to eliminate your need for corrective lenses entirely, or ditch the bifocals and just need reading glasses.

While lensectomy greatly improves your focusing capability, it does not always correct it entirely, and, if you still have the ability to focus well (in other words, your eyesight is still flexible), you will lose your natural focus powers. Therefore, this procedure is best for those who are older than 45 years, and have lost that ability through the natural aging process. 

Surgery & Recovery

The surgery is quite simple, and you would not be put under general anesthesia —you would only be given a sedative if needed, and a topical anesthetic would be used. Your natural lens is removed, and the manufactured lens is put in its place. No stitching is required (in the majority of cases), as the incision that is made seals itself through your eye’s natural pressure, and then heals itself.

There is little discomfort during the healing process, and many patients are able to see clearly in just a few hours after the operation. If you have astigmatism, it will be corrected during the procedure using limbal relaxing incisions (LRIs) —tiny incisions in the cornea —which will alleviate astigmatism symptoms.  Lately lens implants have been designed that also correct astigmatism, which has nearly made the relaxing incision procedure obsolete.

During recovery, you may experience occasional blurriness as tear film and fluid in the cornea fluctuate. Additionally, light sensitivity is often reported for several weeks after the surgery.

If you are interested in this procedure, discuss it thoroughly with Dr Jim Kokkinakis. He can detail the risks and assess you for candidacy for this procedure.  Call us on 9290 1899 or <CLICK HERE> for an appointment.

Watery Eyes can have many causes.  Some can be simple to fix, yet other causes might require surgery.

The very opposite of entropion is called ectropion (eck-TROH-pee-on). It is a condition in which some of the eyelid, or all of the eyelid, turns outward. This turning outward typically strikes the lower eyelid, and is quite irritating to the eye. The globe of your eye (your eyeball), and your inner eyelid are exposed to the air. This can dry your eyes out, and, ironically enough, when your eyes start to dry out, you will produce tears to try to compensate.

One of the signs and symptoms of ectropion is watery eyes.

There are many causes of ectropion – most are from problems with the surrounding muscle and tissue of the eyelid.

          

•Surgery: Over-correction of previous problems, such as entropion, can cause ectropion. This can also happen with cosmetic eye surgeries, or radiation therapy to treat certain cancerous growths.

• Congenital disorders: People with Down syndrome are sometimes born with ectropion.

• Weight loss surgery and other rapid weight loss: If you have had recent, rapid weight loss, ectropion can occur.

• Growths: Any kind of growths on the eyelid can cause this problem.

• Muscle problems: Weakness in the muscles or facial paralysis (often seen with Bell's palsy), can relax the lid too much, causing it to droop. Aging can also cause this weakness to occur, causing ectropion.

• Scars: Scarring and trauma to the eyelids can also cause this disorder.
Because the eyelid is pulled away from the eyeball, your eye will not drain properly. This can cause the three major signs and symptoms of ectropion:

• Epiphora – the excessive overflow of tears is twofold. One, your eyes are trying to compensate for being dried out, and two, your puncta (the little tear ducts at the inner corner of your eye) are not draining properly.

• Gritty feeling in the affected eye.

• Irritation and burning in the affected eye.
Sagging or drooping eyelids are also a sign of ectropion.

If left untreated, ectropion can lead to serious problems with the eye, including corneal ulcers, and corneal abrasions. These complications can lead to permanent vision loss. Therefore, if you have any of these symptoms, it is important to see your eye care professional right away, as he or she can give you eyedrops and ointments to use to prevent damage until you can have surgical correction.

Surgical treatment varies, depending on the cause of your ectropion. Scar tissue may need to be managed, and other surgical procedures may be necessary. You will likely be given drops and ointments to use at home until the time of your surgery. In other words, don't try to treat this at home – the complications can be serious.

If you are experiencing any of the symptoms of ectropion, and have noticed that your eye lids are drooping, and have watery eyes, come and see Dr Jim Kokkinakis for advice. Though it may require referral to an oculoplastic ophthalmologist, it is well worth saving your sight!  It is imperative that you are referred to the right ophthalmologist that specialises in correcting ec tropion.

Sometimes, there’s just something about the words “blade” and “eye” that don’t want to go together. No patient enjoys the thought of having any kind of flap cut into their eye — even though the procedure is relatively safe. However, there are risks of complications when using a microkeratome blade, especially if the flap is cut too thickly. You may just not like the idea of having a blade cutting a flap open to ready your eye for the laser portion of the procedure. 

Cutting the Flap: Complications

In fact, there are several potential complications with cutting a flap for LASIK, particularly with the blade. The flap can be too thin, too thick, misshapen, incomplete, or cut off completely. All of these mishaps can result in complications with the eye, and vision problems. Additionally, the problem with cutting flaps is that they can become wrinkled if you rub your eye, or later on down the road, if you are involved in contact sports. Finally, the flaps do not always heal completely, and are weakened, and can become decentered. 

A Safer Alternative

Eye surgeons and eye care professionals are turning toward surface laser ablation as a safer alternative. There are several reasons for this:

•    Surface laser ablation uses no blades. There is no cutting into the surface of the eye, reducing the chance of complications from the flap never healing properly, and other potential complications.
•    Surface laser ablation reduces the risk of postoperative dry eye. Because the nerve endings are not cut (as there is no cutting involved), your tear secretions are not as readily affected.

•    Surface laser ablation has positive treatment outcomes without the regular LASIK complications. This is a safer alternative, and, while no surgery is 100% safe, some of the normal risks are reduced with this procedure.

 

Above are images of eyes that have been freshly lasered with no flap.  Notice the irregular finish.  This gives an inferior vision result to Lasik in the first week or so, from which time this irregularity heals and the vision will finally match the Lasik result in most cases.

Procedure

Surface laser ablation uses excimer lasers to reshape the surface of the cornea to correct vision. It is indicated for people with myopia (nearsightedness), hyperopia (farsightedness), and astigmatism, and who have thin corneas.

Many people think this is the old PRK procedure. While it is similar in principle, the advancement of technology has greatly improved the procedure itself, as well as recovery times. Improvements include:

•    Being able to drive within 24-48 hours from surgery (with PRK, it took at least one full week, and up to six months to see full results of the procedure).
•    You would have less discomfort with surface laser ablation as it’s practiced today, thanks to improved excimer lasers, better post-operative contact lens “bandages” and comfort drops.

There are several types of surface laser ablation that can be used, to customize treatment to your specific vision needs: Epi-LASIK, where the epithelial cells are removed with a tiny separator, LASEK, where the epithelial cells are loosened with an alcohol solution and then removed manually, and trans-epithelial PRK, where the epithelial cells are ablated with the same laser that will be used to reshape your corneas.

Talk to Dr Jim Kokkinakis at The Eye Practice to determine which procedure is right for you.

Watery Eyes has many causes:

Ingrowing or ingrown eyelashes can cause watery eyes. The medical term for this condition is called trichiasis (trick-eye-ah-sis). When the eyelashes are misdirected, instead of growing outward as you would expect, the lash grows inward, heading for the eyeball or eyelid (conjunctiva). Not only is this condition quite uncomfortable from the constant rubbing of the lashes inward, it created epiphora (watery eyes).

Trichiasis can affect the entire lash set (your entire upper or lower lid), or, it can affect a small portion of the lashes. The former is called diffuse, and the latter is called simple trichiasis. But what causes the lashes to grow in the wrong direction?

There are several causes that can make your lashes grow in the wrong direction.

•    Infections: Though this is rare in the United States, an infection of the eye called Trachoma can cause the eyelashes to grow inward. Another infection that can do this is herpes zoster.

•    Autoimmune disorders: Stevens-Johnson Syndrome (SJS) and seasonal allergic reaction called Vernal keratoconjunctivitis (VKC), which typically occurs in Spring (hence the use of the term Vernal).

•    Eye trauma: Injuries, over-correction in surgery, chemical burns, and thermal burns are a few ways that the eyelids can be affected, causing the lashes to grow in the wrong direction.

•    Entropion: When the edges of the eyelid turn inward, either due to aging, a congenital condition, or other reasons, the lashes grow toward the eye.

•    Epiblepharon: A typically congenital condition that presents with a redundant skin fold under the eyelid, pushing the lashes toward the eye. This is common amongst Asian children.

•    Distichiasis: This can be either acquired or congenital – when the eyelashes grow out of the meibomian glands (that produce oily tears) at the inner eyelid.

 

Treatment for trichiasis depends entirely upon how you have acquired it. However, surgical treatment is a primary requirement to help encourage your lashes to grow in the right direction.

For simple trichiasis, carefully removing the offending lashes and follicles will be used.This is very simple and if done correctly can redirect the eyelashes away from the eye and hence stop the watery, irritated eyes.  This procedure is safe and non-surgical.  It is certainly the preferred approach before trying more aggressive options.

In more complicated cases, surgeries include repositioning of the lashes, repositioning of the eyelid (particularly in the case of entropion), or removal of the redundant skin fold or folds in the case of epiblepharon.  This should be done by an oculoplastic trained eye surgeon.

If you have a more serious disorder, such as Stevens-Johnson Syndrome, your referred specialist, will gear your therapeutic treatments toward managing SJS or other disorder that you have. Managing the underlying cause is important to ensuring that trichiasis isn't a repeat offender in your eye.

Trichiasis can cause problems with your eye, including scarring and vision impairment. Therefore, if you have any symptoms of watery eyes, and discomfort, and notice that some of your lashes poke your eyes or otherwise irritate them, don't try to solve it yourself (as in pulling them out with tweezers – that can be dangerous and make things worse).

Visit Dr Jim Kokkinakis at The Eye Practice, who will be able to help you with trichiasis, and prescribe therapeutic measures to treat it, and prevent future incidents.  Call now on 9290 1899 for an appointment.

Laser Eye Surgery depending on the patient and the outcome required can come in many forms.  By far the most common is LASIK.

If you’ve decided on LASIK to correct your vision, you’ve probably found out that there are many different types of laser eye surgery. Also, you’ve probably also found out there are a number of different instruments that can be used to complete the LASIK procedure.

One of the biggest debates among doctors, and, subsequently, among patients, is the use of the Femtosecond laser versus the microkeratome blade. A simple look at the differences between the two are presented below — from the perspective of patients and their doctors.

A Comparison, Side-By-Side

There are several reported differences between the use of the femtosecond laser and the microkeratome blade, by both doctors and patients. Below are several points to examine when considering LASIK surgery.

•    Discomfort levels. Some doctors have reported that patients seem to experience more feelings of pressure and discomfort during the procedure with the femtosecond laser than patients who have had the surgery with a microkeratome blade.

•    Recovery time. While recovery time with LASIK, both using a femtosecond laser or microkeratome blade, is similar. However, some patients report fuzzy vision for the first week or so with femtosecond, but not with microkeratome. However, there are some conflicting reports that femtosecond has faster visual accuracy recovery over microkeratome usage.

•    Length of time in surgery. The actual time in surgery with femtosecond usage is longer than with microkeratome blade usage.

•    Cost. Femtosecond is more expensive than microkeratome.

 

•    Accuracy of flap shape and completeness. Some doctors report that the flap creation is cleaner and sharper with femtosecond laser usage, and a thinner flap can be created with femtosecond lasers — the thinner the flap, the better the post-surgical outcomes.

•    Risks and complications. The difference in risks and complications is often said to be negligible. However, for patients with certain eye conditions, such as epithelial basement membrane dystrophy, a microkeratome blade is not advisable, and a femtosecond laser is the better choice.

•    Evolution of technology. Side-by-side, improvements of both the femtosecond laser and the microkeratome blade come along often enough to not put one too far ahead of the other.

Ultimately, finding a doctor you trust who uses the tools you want used on your eye is the important part. The treatment outcomes for both femtosecond laser use and microkeratome blades are similar, and have negligible differences in risk. In fact, the differences between femtosecond laser and microkeratome depend on physician and patient comfort and experience. When consulting with your eye doctor, you will want to take into consideration some of the following things:

•    Do you have any conditions that would make one piece of technology the superior choice over the other?

•    What kind of tools does your eye doctor or surgeon have the most experience with?

•    What kinds of complications have they seen with their patients, with both femtosecond laser usage, and microkeratome blade usage?

Dr Jim Kokkinakis has worked as a consultant and an optometrical educator in the largest Laser Vision Correction Centre in Australia for 6 years between 1996 and 2002.  During this time up until now he has seen thousands of patients that have had the procedure.  He is therefore very experienced in choosing the right procedure and the right laser Eye Surgeon for the appropriate patient.  Call us on 9290 1899 now to make an appointment to work out if Laser Eye Surgery is right for you.

Watery Eyes we will see has many causes:

Lacrimal canaliculitis (also called canniculitis) is when the tear (lacrimal) drainage system, specifically, the canaliculus, gets inflamed, causing a blockage. This blockage causes the tears in your eye to reflux back into the eye, spilling over and causing watery eyes (epiphora). It is an infection that can be caused by bacteria, fungi, or viruses.

Canaliculitis often has more symptoms than watery eyes, although that is one sign and symptom of the infection. Other symptoms of canaliculitis include:

•    Red eyes
•    Discharge
•    Tenderness on the affected side (or both sides if both eyes are involved)

There are three major causes of canaliculitis – bacterial infections, viral infections, and fungal infections.

•    Bacterial: The most common bacteria found in cases of canaliculitis are Actinomyces israelii, although other bacteria can be responsible for the infection.

•    Viral: The most common viral infection that causes canaliculitis is a herpetic infection – namely, the herpes simplex virus.

•    Fungal: Fungal infections associated with canaliculitis are rare, but when they do occur, the culprits are typically candida or aspergillus.

 

Treatment of canaliculitis is typically successful when caught early enough. This is why it's so important to see your therapeutic optometrist as soon as you notice symptoms such as watery eyes. Of course, it doesn't mean you need to drop everything as soon as your eyes begin to water, but, if you have watery eyes that are bothering you repeatedly in a short period of time, you should get them checked out. 

If you are treated for canaliculitis, your treatment will be in two parts. The first part will include a flushing of the canaliculus to remove all the foreign material, pus, and other matter that has built up as a result of the infection. Your particular treatment will depend on what kind of infection you're experiencing.

•    Bacterial: Your eye will be irrigated with a penicillin G solution (tell your doctor if you are allergic to penicillin so alternatives can be used). Once the canaliculus is flushed, you will be given a topical solution to apply to your eyes, as well as a course of antibiotics.

•    Viral: In the case of a herpes infection, you'll be given a topical solution to apply five times a day for up to three weeks, depending on the severity of the infection.

•    Fungal: This treatment requires you to have irrigation with nystatin biweekly, as well as a nystatin ophthalmic solution applied to your eyes three times per day.

The earlier treatment begins, the better off you will be for relieving those annoying symptoms of watery eyes. At home, if your eyes are irritated and you need relief, in addition to your course of treatment, applying warm compresses help soothe the eyes and can help remove foreign material that may be contributing to your discomfort.

If your eyes are chronically watering, don't wait to find out what the problem is – seek the advice of our therapeutically qualified optometrist Dr Jim Kokkinakis as soon as possible.

Laser Eye Surgery to try and reduce the dependence on glasses has been around in Australia since 1991.

These days some people who are tired of having to wear glasses and contact lenses all the time often find themselves looking into LASIK eye surgery to correct their vision problems.

If you’re one of the many looking for an alternative to traditional vision correction, you might be wondering about LASIK and other laser eye surgeries.

Which one is best?

There are many different types of laser eye surgeries, and determining which one is “best” could be misleading. The better question might be, “which one is best for you?”

•    PRK Surgery: This is the “pre-LASIK” surgery that was developed in the 1980s. It stands for “photorefractive keratectomy,” and uses a cool ultraviolet light beam to ablate corneal tissue to reshape the cornea. Recovery takes a lot longer than with LASIK, but it is often a better alternative for patients with thin corneas.

•    LASIK: “Laser-assisted in situ keratomileusis” is a popular choice for many people due to its fast recovery time (as short as a day in many cases), and reshapes the cornea with cool ultraviolet light — after creating a flap in the cornea, which can be done with a special tool called a microkeratome, or a laser. This surgery is not recommended for people with very thin corneas.

•    Wavefront LASIK: This is also known as “custom LASIK,” and follows regular LASIK procedures. It is not for people with thin corneas, but will often work for those have high degrees of nearsightedness, farsightedness, or astigmatism.

 

•    LASEK: Standing for “laser epithelial keratomileusis,” and is different from PRK and LASIK procedurally. A thin, epithelial layer is removed prior to reshaping the cornea with a laser, and then replaced onto the surface of the eye. This surgery is for those with thin or steep corneas so much so that LASIK is inappropriate for them.

•    Epi-LASIK: While similar to both LASIK and LASEK, Epi-LASIK uses different tools in order to preserve epithelial cells. This type of surgery works best for patients who have lower degrees of myopia. The recovery time is longer than with LASIK, with final results of vision improvement sometimes taking as long as six months.

•    Bladeless LASIK: The procedure is similar to LASIK, but uses 100% lasers (femtosecond) in order to cut the corneal flap and to reshape the cornea. While complications with regular LASIK are rare, bladeless LASIK reduces the risks even further.

Currently, LASIK is not appropriate for people with presbyopia (both near and farsightedness), although PresbyLASIK is currently being developed for approval in the United States, it is approved in other countries. If you’re in the US and have presbyopia, you may want to talk to your eye care professional about getting in on a trial study. In Australia PresbyLASIK is available but success is far from guaranteed.  It compromises distance and near vision to try and get an overall independence.  Some people will love it, some people will hate it - careful assessment and boxing in of expectations are required.

Some laser surgeries for the eye are not for everybody. People with diabetes, autoimmune disorders such as AIDS, lupus, rheumatoid arthritis, or similar disorders, or eye conditions such as glaucoma, retinal disease, cataracts, or corneal scarring, possibly would not do well with the surgery.

Discuss your personal options with Dr Jim Kokkinakis at The Eye Practice.  He has worked part-time in the largest laser centre in the country from 1996 to 2002.  During this time he was responsible for the Laser Eye Surgery education program and lectured nationally and internationally on Laser Eye Surgery - its advantages, its disadvantages, its complications and it solutions - make an appointment now for a Laser Eye Surgery Assessment on 9290 1899 or book an appointment online by <CLICKING HERE>.

Watery Eyes is another one of those common symptoms that annoys patients and practitioners.  Like dry eyes it is often ignored even though most watery eye causes have a solution if analysed and treated properly.

So why are you crying when you're not sad? The easy answer is that you have epiphora – watery eyes. The more challenging part is figuring out what causes those watery eyes!

Basically, there are two main causes of epiphora – either from a blocked tear duct, or an overproduction of tears due to irritants. Once the main cause is identified, a sub-cause has to be identified, such as canaliculitis, ectropion, conjunctivitis (allergic, bacterial, or viral), dacryocystitis, or even ingrown eyelashes, and other causes.

• Canaliculitis: Tears drain from the puncta (at the inner corner of your eye) into the canaliculus. If the canaliculus becomes inflamed or blocked, the tears will “back up” into the eye, and spill over.  The picture below shows a blocked infected canaliculus. This needs treatment with antibiotics.

• Dacryocystitis: Congenital dacryocystitis is a rare but serious condition in newborns and must be treated promptly. Dacryocystitis in adults is when the tear sac itself is inflamed, which blocks the ducts and prevents tear (lacrimal) drainage. This can cause overflow of tears ans watery eyes.

• Conjunctivitis: Allergies, bacteria, and viruses are all causes of conjunctivitis – the lining of the eyelids becomes irritated and swells – this membrane is called the conjunctiva, hence the name conjunctivitis. Watery eyes are commonly seen with this condition.

• Ingrown eyelashes: Known as trichiasis (trick-eye-ah-sis) among medical professionals, this is exactly like it sounds – the eyelash grows inward towards the the eye, and can cause infections and scarring if you do not treat it promptly.

• Ectropion: This condition should be treated right away to prevent infections and scarring to the eye. Ectropion is the name of the condition where the eyelid, typically the lower eyelid, folds inward towards the eye. It is not only the cause of watery eyes, it is also quite uncomfortable. Treatment is a simple surgery, and the outlook for patients with ectropion is good, especially if it is treated prior to corneal damage.

• Entropion is the opposite of ectropion, where the bottom lid droops down and away from the eye.  This in turn takes the puncta (drain of the eye) away from the tears of the eye, which then cannot drain away.  They overflow and watery eyes or epiphora is the consequence.  Surgery by an oculoplastic surgeon is the way to fix this problem.

• Foreign objects or eye injury: Dirt, sand, grit, pebbles, pollen, dander, and dust can get into the eye, making the tears produce in an attempt to wash out the foreign object. If the eye is injured, you will also produce tears to try to keep the eye safe.

• Dry Eyes can be a cause of watery eyes!  This sounds ridiculous but can happen when the eyes get excessively dry.  Irritation finally sets in, which them stimulates the tear gland to over produce tears.  the problem with these tears that are produced in reflex to a dry eye is that they are usually quite salty.  Patients with this condition typically complain of their eyes burning and stinging.

• Other causes: Other causes of watery eyes can include simple allergies, sleep deprivation, eyestrain, and emotional stress.

You can see that the causes of watery eyes are quite diverse, and many causes require immediate treatment to avoid damage to the eye. While the above list is not an exhaustive one, it is a list of the most common causes. Many of these causes can be treated with good results, particularly if they are treated early, before the condition has a chance to do any damage to the eye (which could result in permanent vision loss).

Tears are a necessary part of protecting the eye, but a constant overproduction can be not only annoying, but dangerous (especially if you're trying to drive) in some cases. If you're having trouble with watery eyes, consult us at The Eye Practice for a proper diagnosis and then a treatment plan.
 

Eye Injuries are serious business – and should always be considered an emergency. 

At The Eye Practice, Dr. Jim Kokkinakis has both the therapeutic training and experience to treat such injuries and to remove foreign particles that have entered the eye.

The main problem with eye injuries is that the damage that has been done may not be obvious at first. You get something in your eye at work (this is especially common among tradies) – say, either a chemical or bit of metal, and you run to an eyewash station. The eyewash station floods your eyes with water, and, hopefully, removes all the material that got into your eye. Some people will just stop there, thinking they're fine.

That's when the problems can really start.

When you ignore the potential severity of an eye injury, you are putting yourself at risk for going blind. Globally, over one million people have gone blind from eye injuries, and 90% of those injuries could have been prevented with protective eye wear, worn properly.

• Any eye injury, whether it is in your house while cleaning your floors, or just having a walkabout in your garden, is a medical emergency. Certainly, you can wash out the eyes thoroughly before you come in, in order to try to remove any large foreign bodies, but DO come in to see us. We have equipment to magnify the eye area, examine for any deeper damage or bits of debris that need to be removed, and can offer treatments that can save your eyes from further damage.

The fact is, you may not realize the injury is worse than it seems – but left untreated, and you could lose an eye.

 

Some people avoid coming in after an eye injury because they're embarrassed over how it happened. They think they've removed the chemicals or debris on their own, and just want to move on – but the problem is, fragments and chemicals that your eye can't feel could be working their way into the tissue, causing permanent damage. Once that damage is done, there is little anyone can to to help you. Swallow your pride after an eye injury, and get in to see us – we take same day appointments for just such a possibility.

Probably the most serious eye injury is an alkaline chemical burn.  Alkaline chemicals include:

• Lime
• Ammonia cleaning products
• Drain Cleaners
• Oven Cleaners

Alkaline chemical can penetrate the eye if not washed out immediately.  Potentially these could blind you.  If you get any of these products in your eyes, it is imperative to keep flushing out the affected eye with running water and get your self immediately to an eye hospital.

With the amount of eye injuries we have seen at The Eye Practice, and the many stories we've heard about how those injuries happened, we've seen and heard just about everything. Remember, we are professionals who deal with many different situations on any given day, and we want to help you protect your sight. So no worries – just come in and get treated before it's too late!

So don't wait – come in to The Eye Practice the moment an injury happens. It could literally save your sight. Call us immediately on 9290 1899.

Dry Eyes can soe serious consequences and need to be aggressively managed - sometimes by a number of different specialists.  One of these conditions, which we see a lot of at The Eye Practice is Sjogren's Syndrome.

Sjogren's Syndrome is a serious auto-immune disorder where the immune system attacks the mucus membranes. Considering you have mucus membranes throughout your whole body, this can become quite serious.  In particular Sjogren's syndrome attacks the salivary glands of the mouth and the tear glands of the eyes.  Dry mouth and dry eyes are the most common symptoms.

Many eye doctors wind up working in conjunction with Rheumatologists in order to make sure our patients with Sjogren's are getting the best treatments possible for their symptoms and complications. Sometimes, patients don't even know they have Sjogren's, until they see their eye doctor – and we ask about any other potential systemic problems. Once the assessment has been made, we can refer you to a Rheumatologist for a proper evaluation.

       

The major characteristic of Sjogren's Syndrome, and the reason we see patients with this disorder, is dry eye. In severe cases, or during a flare-up (when the eye is under attack from the immune system), corneal inflammation can occur, along with other issues, such as blepharitis.

Relief for dry eye from Sjogren's Syndrome is possible. There are several measures that can help, that can be done in our office, and when you get home from your treatments.

•    LipiFlow® Treatments – These treatments are done in office with a patented medical device that uses heat and vibrations to soften and loosen blockages from the meibomian glands to increase the lipid layer output into the tear film. We hope to have this device at The Eye Practice in the near future.

•    Moisture goggles – like the Blephasteam goggles we've talked about in the past, these goggles use warm steam to add water to the tear film, and encourage proper meibomian gland function.

•    Antibiotic gels – With dry eye caused by Sjogren's Syndrome, eye infections become common, and conjunctivitis is often seen as a complication. Antibiotic gels and drops are used to control infections, and provide relief to the eyes. These need to be preservative free as preservatives of any type can cause severe irritation in Sjogren's syndrome.

•    Cyclosporine – These drops encourage aqueous tear production – it is an immunomodulator that decreases swelling in the eye.

•    Warm compresses – Once you've been treated for dry eye, you can use warm compresses to help alleviate any additional eye discomfort. Use at bedtime and upon awakening for five minutes in order to get continued relief.

•    Over-the-counter (OTC) eye drops – Drops recommended by your eye doctor can help keep your eyes comfortable when you have Sjogren's – prevention of discomfort is much better than trying to treat the discomfort once it returns! These also must not have preservatives.

•    Eye hygiene – Avoid getting eye creams and lotions too close to your eyelids, as they can irritate the eye. Remove eye makeup completely every night, and never sleep with eye makeup on – this will help reduce risk of infections. Additionally, make sure that you wash your eyelids with proper eyelid cleansers.

•    Special lenses – People with Sjogren's Syndrome related dry eye have a tendency to be photosensitive – meaning bright lights are a hazard. Lenses with an FL-41 filter can help diminish the intensity of sunlight.

If you have Sjogren's Syndrome, or want help with chronic dry eye, give us a call on 9290 1899 or click here to book an appointment.