Treatment of Amblyopia

The best results are always achieved if the treatment of amblyopia is started as early as possible. If necessary, children with refractive errors such as nearsightedness, farsightedness or astigmatism can wear glasses or contact lenses when they are as young as one week old. Children with cataracts or other “amblyogenic” conditions need to be treated promptly in order to minimize the development of amblyopia. One of the most important treatments of amblyopia is correcting the refractive error with consistent use of glasses and/or contact lenses. Other mainstays of amblyopia treatment are to enable as clear an image as possible, for example, by removing a cataract, and forcing the child to use the non dominant eye by patching or blurring the better seeing eye with eye drops. Eye drops are used to “penalize” the good eye and force  the use of the weaker or amblyopic eye. We may be able to use eye drops instead of patching when the amblyopia is not very bad or when a child is unable to wear the patch as recommended. For mild to moderate degrees of amblyopia, studies have shown that patching or eye drops may be just about equally effective.  Generally, we start to see improvements in vision within weeks of treatment however for optimal results it will be necessary to be patient for many months.

In some cases, treatment for amblyopia isn’t successful and it is difficult to stop treatment but is recommended when there is any real benefit. Children who have amblyopia in one eye and good vision only in their other eye can wear safety glasses and sports goggles to protect the normal eye from injury. As long as the good eye stays healthy, these kids function normally in most aspects of society.

If you or someone you know has questions or concerns about the treatment of amblyopia or needs a kids eye exam, please call The Eye Clinic of Texas, an affiliate of Houston Eye Associates, at 800-423-3937, visit The Eye Clinic of Texas, Google+  or facebook.com/ecot.lasik.

The Eye Clinic of Texas is an affiliate of Houston Eye Associates, the largest ophthalmology clinic in the nation. We are a leading eye care practice serving the greater Houston, Galveston, League City and Texas City with offices at 1100 Gulf Freeway, Suite 114, League City, Texas 77573, 7111 Medical Center Drive, Suite 110, Texas City, Texas 77590 and 2302 Avenue P, Galveston, Texas.

kid with glasses cartoon

About Headaches and Childrens’ Eye Problems

It is pretty common for parents to bring their children in for an eye exam because they are complaining of headaches. Headaches are a frequent complaint of kids but fortunately they are usually not serious. Some of the more common causes of headaches in kids include migraine, the stress and tension of school, certain foods with nitrate or MSG preservatives, physical trauma, sinus infections and of course eye problems. Parents can be concerned with the serious but truly rare occurrence of brain tumors causing headaches but this is usually accompanied by other complaints of dizziness, weakness of arms and legs and a loss of coordination.

Evaluating Kids with Headaches

As part of evaluating any child with headaches I always want to be sure that there has been a complete and thorough examination by their pediatrician who may need to order additional tests or even a referral to a neurologist. Then I will need to perform a complete eye exam including evaluation of the pupils, a refraction to determine any refractive error or  need for glasses, eye alignment and binocularity testing and sometimes possible a visual field examination. Generally I will put drops in the child’s eyes to dilate the pupils, so that the optic nerves can be properly examined and the refractive error can be most accurately measured.

Eye Problems That Can Cause Headaches

If your child has uncorrected hyperopia or farsightedness, it requires extra effort to focus clearly while reading.  This can sometimes lead to fatigue and headache.  Glasses can reduce the effort required to see clearly at near and improve the headache, if significant hyperopia exists.  Mild hyperopia is normal in children, however, and generally does not cause headaches or other symptoms.

When we read or perform other near activities, our eyes pull in toward each other, this is called convergence. The decreased ability to pull the eyes toward each other when viewing near objects (convergence), particularly while reading, may cause headaches.  This is called convergence insufficiency, and symptoms include the doubling of images or words, blurred vision, fatigue, and headaches which worsen with prolonged reading.  At home eye exercises, sometimes with the help of computer software, can help treat convergence insufficiency. Glasses are sometimes prescribed, but costly in-office eye exercises are rarely necessary.

Acute infections, allergic and inflammatory diseases of the eyes can also cause headaches.  These problems are often accompanied by redness of the eye and/ or the eyelid as well as light sensitivity or photophobia. Acute glaucoma can cause headaches, but rarely affects children.  Pseudo tumor Cerebri is a condition caused by increased intracranial pressure or too much fluid around the brain, and this causes headache and swelling of the optic nerves, but does not typically cause redness of the eyes. During the complete eye exam we perform we will be able to rule out these problems as a cause of headaches in your child. If we do not find any ocular causes of your child’s headache we may refer them back to his/her pediatrician and/or to a neurologist to look for other possible causes of the headaches.

If you have questions about causes of kids headaches or children’s eye problems, or need assistance please call The Eye Clinic of Texas, an affiliate of Houston Eye Associates, at 800-423-3937, visit The Eye Clinic of Texas, Google+  or facebook.com/ecot.lasik.

The Eye Clinic of Texas is an affiliate of Houston Eye Associates, the largest ophthalmology clinic in the nation. We are a leading eye care practice serving the greater Houston, Galveston, League City and Texas City with offices at 1100 Gulf Freeway, Suite 114, League City, Texas 77573, 7111 Medical Center Drive, Suite 110, Texas City, Texas 77590 and 2302 Avenue P, Galveston, Texas.

About Nearsighted Progression

Anyone who has a child or teenager who is becoming more and more nearsighted each year wants to know if there are ways we can prevent the progression of myopia. Over the years there has been discussion of trying to under correct the nearsightedness, rather than prescribing the full correction, in order to slow down nearsighted prescription changes. Researchers reporting in Grafe’s Archives for Clinical and Experimental Ophthalmologystudied the effects of undercorrection of myopia on myopia progression and eye length elongation in a population of 12-year-olds. They followed more than 2,000 children for 1 year and used careful analysis to consider the effects of how much near work, how much outdoor activity and the amount of time glasses were actually used as well as the degree of nearsightedness. They tested them by measuring their cycloplegic auto refraction, axial length of the eye, visual acuity and near vision focusing lag. The results demonstrated that over a period of 1 year, prescribing an undercorrection or full correction of myopia by wearing spectacles did not show any differences in myopia progression. Whether this would be the same result for younger children, or if the correction was prescribed in contact lenses or over a longer period of time is not certain but initially suggests that it is not helpful to under correct nearsighted children with glasses to slow myopic progression.

If you or someone you know have questions about nearsightedness, types of correction for nearsightedness including glasses, contact lenses of even LASIK, please call The Eye Clinic of Texas, an affiliate of Houston Eye Associates, at 800-423-3937, visit The Eye Clinic of Texas, Google+  or facebook.com/ecot.lasik.

The Eye Clinic of Texas is an affiliate of Houston Eye Associates, the largest ophthalmology clinic in the nation. We are a leading eye care practice serving the greater Houston, Galveston, League City and Texas City with offices at 1100 Gulf Freeway, Suite 114, League City, Texas 77573, 7111 Medical Center Drive, Suite 110, Texas City, Texas 77590 and 2302 Avenue P, Galveston, Texas.

About Retinitis Pigmentosa

Retinitis pigmentosa (RP) is a progressive inherited disease of the eye, in which the light-sensitive photoreceptor cells located in the retina degenerate. This results first in the loss of night and peripheral vision, eventually progressing to the loss of central vision and total blindness. It is the leading cause of inherited blindness in the developed world.

The disease, which affects approximately 1.5 million people in the world, has no cure, but thanks to  research done at the University of California-Santa Barbara, a new stem cell therapy may soon be available that protects photoreceptor cells from the damaging effects of the gene mutation. So far, only a small number of legally blind patients with RP have begun a trial. The trial is the first attempt to use stem cells to prevent the loss of vision from RP. An experimental injection of retinal stem cells is placed in the eye with the hope that the growth factors from these cells will protect the retinal cells and prevent them from dying, thus preserving the patient’s remaining vision.

If you, a family member or someone you know would like to learn more about Retinitis Pigmentosa or many new stem therapies being developed for diseases of the retina, please call The Eye Clinic of Texas, an affiliate of Houston Eye Associates, at 800-423-3937, visit The Eye Clinic of Texas, Google+  or facebook.com/ecot.lasik.

The Eye Clinic of Texas is an affiliate of Houston Eye Associates, the largest ophthalmology clinic in the nation. We are a leading eye care practice serving the greater Houston, Galveston, League City and Texas City with offices at 1100 Gulf Freeway, Suite 114, League City, Texas 77573, 7111 Medical Center Drive, Suite 110, Texas City, Texas 77590 and 2302 Avenue P, Galveston, Texas.

Eye Problems from ADHD Medication

If you, your child or someone you know takes ADHD medication it is important to understand the possible side effects that might impact eyes, cause eye problems and alter vision. The most common prescription medication we see children and even adults taking for treatment of attention deficit hyperactivity disorder (ADHD) is methylphenidate which has a number of trade names such as Ritalin, Concerta, Adderall, Methylin and Daytrana. While the common side effects of loss of appetite, nervousness and difficulty sleeping are easily recognized, researchers reporting in the Journal of the American Association for Pediatric Ophthalmology and Strabismus raised some concern that this treatment may be associated with increased risk of angle closure glaucoma and a disturbance of eye refraction and optical prescriptions. They initiated a study to investigate the effects of methylphenidate treatment on refraction, intraocular pressure (IOP), and the anterior chamber in children with ADHD. This was a pilot study where children diagnosed with ADHD were examined before the start of methylphenidate treatment and again 3 and 9 months after the start of treatment. Their examinations included an eye exam with ordinary as well as cycloplegic refraction-one performed with eye drops and high resolution imaging study of the anterior chamber of the eye where the delicate structures related to glaucoma could be viewed and measured.

ADHD Medication Eye Study Conclusions

The researchers found that methylphenidate does not seem to affect refraction, or optical prescription in most children with ADHD. But, after 9 months of treatment there was a reduction in the eye anterior chamber depth, which has been described as a powerful predictor of angle closure glaucoma. As this was a pilot study more work is needed to really understand any increased risk.

What You Need to Know and Do

If you, your child or someone you know is taking methylphenidate of any type for ADHD, it would be worthwhile scheduling a routine eye examination so that we can measure the refraction, the intraocular pressure (IOP) and anterior chamber angle and depth. We do this regularly during your eye exam. BE SURE TO TELL US YOU ARE TAKING METHYLPHENIDATE. If your eye exam is normal we will most likely ask you to have a repeat exam in a year. BUT, if at any time there s a change in your vision, pain, redness, glare or light sensitivity we want you to call right away and schedule an immediate appointment for that day.

If you or someone you know is being treated for ADHD with methylphenidate medications such as Ritalin, Concerta, Adderall, Methylin and Daytrana, it is important to have a routine eye exam to avoid any risk of eye problems please call The Eye Clinic of Texas, an affiliate of Houston Eye Associates, at 800-423-3937, visit The Eye Clinic of Texas, Google+  or facebook.com/ecot.lasik.

The Eye Clinic of Texas is an affiliate of Houston Eye Associates, the largest ophthalmology clinic in the nation. We are a leading eye care practice serving the greater Houston, Galveston, League City and Texas City with offices at 1100 Gulf Freeway, Suite 114, League City, Texas 77573, 7111 Medical Center Drive, Suite 110, Texas City, Texas 77590 and 2302 Avenue P, Galveston, Texas.

About Multiple Sclerosis

Multiple sclerosis (MS) is a debilitating neurological disease that can cause patients to experience decreased vision due to optic neuritis, an inflammation of the optic nerve, as well as diplopia or double vision. We believe that MS occurs because there is an abnormal response of the body’s immune system whereby it is directed against the central nervous system (CNS), which is made up of the brain, spinal cord and optic nerves. Within the CNS, the immune system attacks myelin-the fatty substance that surrounds and insulates the nerve fibers as well as the nerve fibers themselves. When any part of the myelin sheath or nerve fiber is damaged or destroyed, nerve impulses traveling to and from the brain and spinal cord are distorted or interrupted, producing a wide variety of symptoms. 

About Optical Coherence (OCT) Eye Testing for MS

In our office, we routinely use very precise imaging technology called Optical Coherence Tomography (OCT) as part of evaluation, diagnosis and monitoring glaucoma and retina diseases because it allows us to examine the actual nerve fibers of the retina and the optic nerve.

Recent research has taught us that OCT can be used to monitor the degree of atrophy of specific retinal layers-called the “inner plexiform layer” and “ganglion cell layer”-and used as an as an indicator of neuronal tissue damage in patients with multiple sclerosis (MS). For patients with Multiple Sclerosis this is quite valuable as it gives us a non invasive in office test, that in concert with their neurologists, helps us help patients asses the stability of their disease as well as their response to new medications or treatments.

If you or someone you know has been diagnosed with MS or has questions about the eye problems that can be associated with Multiple Sclerosis, please call The Eye Clinic of Texas, an affiliate of Houston Eye Associates, at 800-423-3937, visit The Eye Clinic of Texas, Google+  or facebook.com/ecot.lasik.

The Eye Clinic of Texas is an affiliate of Houston Eye Associates, the largest ophthalmology clinic in the nation. We are a leading eye care practice serving the greater Houston, Galveston, League City and Texas City with offices at 1100 Gulf Freeway, Suite 114, League City, Texas 77573, 7111 Medical Center Drive, Suite 110, Texas City, Texas 77590 and 2302 Avenue P, Galveston, Texas.

Lazy Eye Amblyopia: What is it?

Amblyopia or “lazy eye” is a very common vision problem that we see in children. In fact it is responsible for more vision loss in kids than all other reasons combined. Amblyopia is a decrease in the child’s vision that occurs even without any structural problem being present. The decrease in vision results when one or both eyes send a blurry image to the brain. The brain then “learns” to only see blurry with that eye, even when glasses are used. Only children can get amblyopia. If it is not treated, it can cause permanent loss of vision. There are a number of types of amblyopia including strabismic amblyopia which is caused by an eye alignment or eye turning problem, deprivation amblyopia which is caused by cataracts or other condition that “deprives” the eye of a visual image and refractive amblyopia which is due to an uncorrected refractive error such as farsightedness or astigmatism.

Depending on the cause of the amblyopia and whether there is an underlying uncorrected refractive error sometime glasses can help but will not correct the vision to 20/20.  With amblyopia, the brain is “used to” seeing a blurry image and it cannot interpret the clear image that the glasses produce. With time, however, the brain may “re-learn” how to see and the vision may increase. Remember, glasses alone do not increase the vision all the way to 20/20, as the brain is used to seeing blurry with that eye.  Because of this most of the time the normal eye is treated with patching or eye drops to force the amblyopic eye to be used and make it “stronger.” to make the amblyopic (weak) eye stronger.

If you or someone you know wishes to learn about “lazy eye” or amblyopia or has questions or concerns about amblyopia or needs a kids eye exam, please call The Eye Clinic of Texas, an affiliate of Houston Eye Associates, at 800-423-3937, visit The Eye Clinic of Texas, Google+  or facebook.com/ecot.lasik.

The Eye Clinic of Texas is an affiliate of Houston Eye Associates, the largest ophthalmology clinic in the nation. We are a leading eye care practice serving the greater Houston, Galveston, League City and Texas City with offices at 1100 Gulf Freeway, Suite 114, League City, Texas 77573, 7111 Medical Center Drive, Suite 110, Texas City, Texas 77590 and 2302 Avenue P, Galveston, Texas.

Eye health and vision problems from contacts lenses can be prevented by avoiding known risky behaviors. According to the Centers for Disease Control and Prevention almost all of the 41 million estimated contact lens wearers in the United States may be engaging in at least one behavior known to increase their risk of eye infections. Nearly one-third of contact lens wearers who participated in a national survey reported going to the eye doctor for red or painful eyes related to wearing contact lenses. More than 99 percent of survey respondents reported at least one risky behavior. The majority of wearers reported:

• Keeping their contact lens cases for longer than recommended (82.3 %)
• “Topping off” solution in the case by adding new solution to the existing solution instead of emptying the case out fully before adding new solution (55.1%)
• Wearing their lenses while sleeping (50.2 %)

Each of these behaviors has been reported in previous studies to raise the risk of eye infections by five times or more!
An online survey was administered to a sample of contact lens wearers to determine how often contact lens wearers engaged in behaviors that could put them at risk for an eye infection. CDC collaborated with the Contact Lens Assessment in Youth (CLAY) group, a multi-university group of researchers, to conduct the survey. A separate survey was used to estimate the number of contact lens wearers – about 41 million adults. Taken together, the survey results indicate that millions of Americans could be at risk for serious eye infections because of poor contact lens hygiene behaviors.

We know that contact lenses can be worn safely if wearers are mindful of using good hygiene. To prevent eye infections, contact lens wearers should:
• Wash hands with soap and water and dry them well before touching contact lenses
• Take contacts out before sleeping, showering or swimming
• Rub and rinse contacts in disinfecting solution each time they remove them
• Rub and rinse the case with contact lens solution, dry with a clean tissue and store it upside down with the caps off after each use
• Replace contact lens cases at least once every three months
• Avoid “topping off” solution in lens case (adding fresh solution to old solution)
• Carry a backup pair of glasses in case contact lenses have to be taken out

If you or someone you know have questions about contact lens care, hygiene, safety and how to avoid eye infections from contact lens wear, or wish to have a contact lens consultation or fitting, please call The Eye Clinic of Texas, an affiliate of Houston Eye Associates, at 800-423-3937, visit The Eye Clinic of Texas, Google+ or facebook.com/ecot.lasik.

The Eye Clinic of Texas is an affiliate of Houston Eye Associates, the largest ophthalmology clinic in the nation. We are a leading eye care practice serving the greater Houston, Galveston, League City and Texas City with offices at 1100 Gulf Freeway, Suite 114, League City, Texas 77573, 7111 Medical Center Drive, Suite 110, Texas City, Texas 77590 and 2302 Avenue P, Galveston, Texas.

Dry Eye Slows Reading Speed

Anyone who experiences the symptoms of dry eye is familiar with dryness, discomfort, burning, light sensitivity and even watering that can mark the presence of dry eye disease. But, did you know that dry eye problems and disease can impact visual function? Researchers reporting in Cornea compared visual function using reading tests including the Radner Reading Test, the International Reading Speed Texts [IReST], and the Wilkins Reading Test and studied cognitive function, fatigue, dry eye symptoms, reading acuity, reading rate and blink rate. The results showed significantly lower reading rates in all reading tests in patients with dry eye and a significantly increased fatigue level when reading in dry eye patients.

If you suffer from symptoms of dry eye such as dryness, burning, light sensitivity or watering and have noticed an uncomfortable slowing of your reading ability and even greater eye fatigue or tired eyes when reading, please call The Eye Clinic of Texas, an affiliate of Houston Eye Associates, at 800-423-3937, visit The Eye Clinic of Texas, Google+  or facebook.com/ecot.lasik.

The Eye Clinic of Texas is an affiliate of Houston Eye Associates, the largest ophthalmology clinic in the nation. We are a leading eye care practice serving the greater Houston, Galveston, League City and Texas City with offices at 1100 Gulf Freeway, Suite 114, League City, Texas 77573, 7111 Medical Center Drive, Suite 110, Texas City, Texas 77590 and 2302 Avenue P, Galveston, Texas.

About Angle Closure Glaucoma

Angle Closure Glaucoma is a type of glaucoma caused by a blockage or complete closure of the drainage structure of the eye called the trabecular meshwork. The trabecular meshwork is actually a fine filter, and if it is blocked or obstructed by any alteration in the size or shape of the surrounding structures, or by change in the size or shape of the tissue itself, it will cause the intraocular pressure (IOP) to elevate. In instances where the meshwork becomes blocked abruptly, it will cause a sudden rise in the intraocular pressure (IOP), resulting in Acute Angle Closure Glaucoma. Acute Angle Closure Glaucoma is characterized by this sudden rise in pressure which will cause pain, redness, light sensitivity, colored haloes around lights, nausea or vomiting, and blurred vision, and if left untreated permanent loss of vision.

Medications Can Cause Angle Closure Glaucoma

In patients who may already be at risk for Angle Closure Glaucoma because they have certain tissue and anatomical features inside their eyes, certain medications can significantly increase their risk. Two medications that are worth mentioning are the antidepressants Wellbutrin (Buproprion) and Topamax® (Topiramate). While both of these are often used to treat mild to moderate depression, they are also used to help patients stop smoking! Researchers reporting a study in Archives of Ophthalmology found that the risk of angle-closure glaucoma in patients younger than 50 years was twice as high in patients taking Wellbutrin and more than 5 times higher in patients taking Topamax®.

If you or someone you know is being treated for depression or has been prescribed Wellbutrin or Topamax® to help stop smoking, please make sure you tell your eye doctor and ask about your risk of Angle Closure Glaucoma, as well as become familiar with the symptoms above. If you have not had an eye exam with glaucoma testing and are taking these medications, please call The Eye Clinic of Texas, an affiliate of Houston Eye Associates, at 800-423-3937, visit The Eye Clinic of Texas, Google+  or facebook.com/ecot.lasik.

The Eye Clinic of Texas is an affiliate of Houston Eye Associates, the largest ophthalmology clinic in the nation. We are a leading eye care practice serving the greater Houston, Galveston, League City and Texas City with offices at 1100 Gulf Freeway, Suite 114, League City, Texas 77573, 7111 Medical Center Drive, Suite 110, Texas City, Texas 77590 and 2302 Avenue P, Galveston, Texas.