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Boston Corneal Specialist on Herpes Eye Infections

Boston Corneal Specialist JoAnn C. Chang, M.D. commented on Herpes Simplex eye infections. “I like to educate patients with cornea infections about the seriousness of Herpes Simplex eye infections as this type of eye infection actually affects many more people each year than one might think,” stated Dr. Chang of D’Ambrosio Eye Care which serves greater Boston and central Massachusetts. “Ocular herpes or herpes of the eye is caused by the herpes simplex virus and is the most common causes of corneal blindness in the United States today. Up to 50% of people who have a single herpes simplex viral infection of the eye will experience a flare up or recurrence. The virus often leads to irreversible scarring of the cornea and possible the need for a corneal transplant.”

Ocular herpes may start as a painful sore on the eyelid or surface of the eye. If left untreated, it may multiply and begin to destroy epithelial cells and progress deeper into the cornea. If the ocular herpes penetrates the deeper layers of the cornea and causes a stromal keratitis it may cause corneal scarring-so prompt diagnosis and treatment of ocular herpes is important.

It is estimated that 400,000 people in the United States have had some type of ocular herpes, with more than 50,000 initial and recurring cases being diagnosed each year. Of these, it is believed that 25% are the more severe form of herpes stromal keratitis. The recurrence of herpes simplex eye infections is significant in that it appears to recur in about 10% of patients with one year, 23% of patients within two years and 63% of patients within 20 years of their initial infection. Sometimes a recurrence can be prompted by sunlight, stress, fevers or an unrelated eye injury. Quick diagnosis and treatment is the key to avoiding corneal scarring, vision loss and the possible need for a corneal transplant.

If you or someone you know is experiencing any signs or symptoms of corneal infection-especially if they have had any trauma to their eyes-please call D’Ambrosio Eye Care at 800-325-3937 and request an immediate appointment with Massachusetts Corneal Specialist JoAnn C. Chang, M.D.

Staffed by a team of Ophthalmologists, Optometrists, Opticians, technical and administrative staff who provide eye examinations for adults and children, cataract surgery and intraocular lens implants (IOL), refractive laser surgery such as LASIK for vision correction, diagnosis and treatment of cornea disease including cornea transplants, care for diseases of the retina including diabetes and age related macular degeneration and diagnosis and treatment of glaucoma as well as contact lenses, eyeglasses, eyewear and optical services.

DAmbrosio Eye Care is a leading eye and LASIK care practice serving the greater Boston and central Massachusetts area including Acton, Athol, Berlin, Bolton, Boylston, Boxborough, Chelmsford, Clinton, Concord, Fitchburg, Gardner, Greenfield, Groton, Harvard, Hudson, Lancaster, Leominster, Lexington, Littleton, Lowell, Lunenburg, Marlborough, Milford, Shelburne Falls, Shirley, Sterling, Stow, Sudbury, Templeton, Westminster, Westborough, Winchendon and Worcester, Massachusetts.

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Boston Corneal Specialist on LASIK Dry Eyes

“As a corneal specialist who is a LASIK surgeon I have many ways of helping patients both avoid and manage LASIK related dry eyes,” shared JoAnn Chang, M.D. a Boston Corneal Specialist at D’Ambrosio Eye Care with eye care and LASIK offices in Athol, Lancaster, Acton and Gardner, MA. “By far the most common side effect of LASIK is dry eyes. In fact, it is pretty much expected and pretty normal for all LASIK patients to have temporary dry eye symptoms after their treatment. The critical thing to know is that the dry eye symptoms should be temporary.”

“What I like to emphasize with my LASIK patients is that they need to remember that LASIK is corneal surgery. Any time we do corneal surgery we typically sever some corneal nerves and also temporarily disturb the delicate cells on the surface of the eye. This happens during cataract surgery and any other eye surgery procedures that involve the cornea,” Dr. Chang explained. She further explained, “These corneal nerves are connected to the Lacrimal Gland which is responsible for producing tears-so when the nerves are temporarily interrupted there is a decrease in the amount of tears that are produced making your eyes feel dry and gritty.”

To make you more comfortable during the time it takes for the corneal nerves to heal and regenerate we may do one of more of the following for you:

· Prescribe Artificial Tear Eye Drops
· Insert Tiny Tear Duct Plugs
· Prescribe Restasis® Eye Drops
· Prescribe Dietary Supplements with Omega-3 Oils

Each of the above acts to either retain the tears that you have, supplement the tears that are lacking or help you produce more of your own tears so that you will be most comfortable and heal properly. Each person will regenerate the fine corneal nerves at a DIFFERENT RATE and thus will need to use one or more of the above tear helpers for different amounts of time. A very important consideration is how healthy your tear film was BEFORE your surgery. A critical part of your LASIK consultation will be a careful examination of your tear film. Sometimes, in order to make you the most comfortable and make the healing and visual recovery process as quick and easy as possible for you, we may actually prescribe one or more of the above BEFORE your surgery.

If you, or someone you know, has questions about LASIK and dry eyes or would like to schedule a free LASIK Evaluation please call and schedule an appointment at D’Ambrosio Eye Care by calling 800-325-3937, visiting D’Ambrosio Eye Care or facebook.com/dambrosioeyecare.

Staffed by a team of Ophthalmologists, Optometrists, Opticians, technical and administrative staff who provide eye examinations for adults and children, cataract surgery and intraocular lens implants (IOL), laser vision correction such as LASIK, diagnosis and treatment of cornea disease including cornea transplants, care for diseases of the retina including diabetes and age related macular degeneration and diagnosis and treatment of glaucoma as well as contact lenses, eyeglasses, eyewear and optical services.

DAmbrosio Eye Care is a leading eye and LASIK care practice with offices in Athol, Lancaster, Acton, Gardner serving the greater Boston and central Massachusetts area including Acton, Athol, Berlin, Bolton, Boylston, Boxborough, Chelmsford, Clinton, Concord, Fitchburg, Gardner, Greenfield, Groton, Harvard, Hudson, Lancaster, Leominster, Lexington, Littleton, Lowell, Lunenburg, Marlborough, Milford, Shelburne Falls, Shirley, Sterling, Stow, Sudbury, Templeton, Westminster, Westborough, Winchendon and Worcester, Massachusetts.

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Corneal Pachymetry Thickness Measurement

Corneal pachymetry is the measurement of the thickness of the cornea. It can be performed by your eye doctor using a contact method such as ultrasound. After the eye is numbed with a numbing drop, a probe is touched to the surface of the cornea and measures the thickness of the cornea in microns. Noncontact methods of measuring the cornea exist also, such as optical coherence tomography (OCT).

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Corneal Ulcer in Dogs

Corneal ulcer or ulcerative keratitis is a very common canine eye diseases and it can sometimes affect cats too. In general, a corneal ulcer can be defined as a condition in which the outer layer of the cornea is damaged and lost. This condition develops due to various reasons, like trauma, eye infections or by exposure to chemicals. Corneal ulcer in dogs is a serious medical condition that may lead to loss of vision. Hence, early diagnosis and immediate treatment is absolutely necessary. As a pet owner, you must have a basic idea about this canine eye condition, its causes, symptoms and treatment.

Dogs Cornea
In order to understand the disease, you may need to know more about the cornea of dogs. A dogs cornea is made up of four layers - outer epithelium, followed by the corneal stroma, then Descemets membrane and the last endothelium. Cornea, as a whole, is a transparent membrane that is around one millimeter thick in the case of dogs and cats. This part of the eye does not have any blood vessels or pigmentation and so, it is transparent in nature. The arrangement of collagen fibers also contribute to the transparency of the cornea. However, nerves are present in the cornea and pressure and pain receptors are also there. The cornea is responsible for refracting light, thereby enabling the pet to focus on an object and to protect the inner layers of the eye.

Corneal Ulcer in Canines
The condition denotes the cell loss in the corneal epithelium (that may be accompanied by a loss of the underlying corneal collagen) due to various reasons that will be discussed later. Injury to the corneal epithelium is common in dogs and cats. In most cases, the lost cells are naturally replaced by new ones and the ulcer is healed fully. But in some cases, either the new cells are not formed or the newly formed cells are weak to cause further injury or infection. Such corneal ulcers may allow microorganisms to enter the eye and the eye gets infected. Otherwise the ulcer may spread to the deeper layers of the eye and may lead to eye ruptures.

Corneal ulcer in dogs can be of two types - superficial and deep. While the superficial ulcers involve a loss of the outer layer of the cornea (partial or full), deep ulcers cause a loss of more than one half the thickness of the cornea, as it extends through the stroma. Superficial ulcers take only a few days to heal, whereas the deep ones need much more time for healing. The latter category may leave a corneal scar or may re-ulcerate or may refuse to heal. The healing process involves either by a shifting of the surrounding epithelial cells to fill the space by rapid cell division or by an introduction of blood vessels to that area from the conjunctiva. In the latter case, white blood cells and fibroblasts produce scar tissue to cover the area. The first type of healing can be seen in superficial ulcers and the second type occurs in deep ulcers.

Causes and Symptoms
Dogs eyes are prone to corneal ulcers, as they indulge in many activities that may cause scratches and injuries to the cornea. A scratched cornea in dogs may occur by their own paw rubbing, by a blade of grass, by fighting with other animals and by ingrown or misplaced eyelashes. Ulcers may also develop from eye infections caused by viruses or bacteria, exposure to chemicals (like that in harsh shampoos) and heat or smoke. Dry eye or keratoconjunctivitis sicca (reduction in tear production) is another reason for corneal ulcers in dogs. Inadequate blink responses may also give rise to this condition. However, it is mostly seen in dog breeds with protuberant eyes and also in older dogs. As the condition is painful, the symptoms of corneal ulcer in dogs include increased pawing or rubbing at the eye, squinting, redness, tearing, cloudy cornea, red or green mucus discharge form the eye, redness of the eyelids and the area surrounding the cornea, lethargy and changes in normal dog behavior.

Treatment for Canine Corneal Ulcer
If you notice any of the above said symptoms, take your pet dog to a veterinarian immediately. The doctor will conduct a diagnosis through direct observation, after using fluorescein stain. They may also resort to tests like, Schirmers test for detecting dry eyes or tests to analyze facial nerve function, to detect facial nerve paralysis. If the cause is eye infection by bacteria or virus, samples are collected for conducting cytology, culture and antibiotic sensitivity, in order to find out the particular infectious agent.

The most common treatment for corneal ulcer in dogs includes pain medication and topical application of antibiotics to prevent the infection. This treatment may be sufficient to heal superficial corneal ulcers, but deep ones may require suturing, conjunctival grafts or conjunctival flaps. In some cases, soft contact lenses are used, whereas some others may undergo corneal transplant. The affected dogs may be fitted with an e-collar around their necks, to prevent them form rubbing the eyes with paws. For severe corneal infections, oral antibiotics are also administered and oral anti-inflammatory drugs are given if there is inflammation inside the eye. However, topical application of corticosteroids and anesthetics is avoided, as these drugs can make the situation worse.

However, the most important point is that you have to treat the condition of your pet dog at the earliest, to avoid complications, like loss of sight. With good dog care this common dog illness can be easily overcome.

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Boston Corneal Specialist on Eye Health Contacts Swimming

Boston Corneal Specialist JoAnn C. Chang, M.D. of D’Ambrosio Eye Care commented on eye health, contact lenses and swimming. “Understanding how swimming can affect your eyes, eye health and vision is worth learning a little about as summer typically means lots of water activities for all of us,” said Dr. Chang. ”In general, unless you are wearing goggles, it is best not to swim with your eyes open under water and whenever possible, to avoid splashes of water into your eyes. This is because the various types of pool chemicals that are used for keeping the water clean and free of contamination may actually be irritating at a minimum and in some instances damaging to the surface of the eye,” she further explained. Maintaining the proper pH levels in swimming pools takes considerable monitoring and effort and as the pH varies so does the possibility of eye irritation. Your natural tears have a pH of 7.0, if the pH of the pool water is below or above that level that level, it will certainly cause your eyes to burn or sting. The proper pH level for swimming pools is in the range of 7.2 to 7.8. If the pH is maintained within this range, burning eyes shouldnt be a problem for swimmers.

If you plan on spending any lengthy period of time in the water you should protect your eyes by wearing goggles. Swimming with contact lenses is very risky. The eye health risk of swimming with contacts depends on the body of water you are in. When swimming on lakes and in rivers there is a considerable risk of the microorganism, Acanthamoeba, adhering to your contacts. Acanthamoeba keratitis is a severe and potentially blinding infection and inflammation of the cornea. This same risk is present when wearing contacts in hot tubs or spas. While the risk of sight-threatening infection is lesser in properly chlorinated swimming pools and the ocean, other problems may be encountered. In a swimming pool eye irritation is possible when chlorine sticks on the surface of your lenses. In the ocean, your contact lenses can be dislodged when you encounter large waves. You need to carefully consider whether to wear contact lenses while swimming. Keeping your head out of the water and wearing goggles will help to greatly reduce risk.
If you worry about not being able to see clearly without glasses or contacts and want to see clearly while in the pool or ocean, you may wish to consider LASIK as a vision correction method so as not to be dependent on eyeglasses or contacts for swimming.
If you or someone you know has questions about swimming, swimming pools, eye health, vision and contact lenses please feel free to schedule an eye examination at D’Ambrosio Eye Care by calling us at 800-325-3937, visiting D’Ambrosio Eye Care or facebook.com/dambrosioeyecare.
 Staffed by a team of Ophthalmologists, Optometrists, Opticians, technical and administrative staff who provide eye examinations for adults and children, cataract surgery and intraocular lens implants (IOL), laser vision correction such as LASIK, diagnosis and treatment of cornea disease including cornea transplants, care for diseases of the retina including diabetes and age related macular degeneration and diagnosis and treatment of glaucoma as well as contact lenses, eyeglasses, eyewear and optical services.

DAmbrosio Eye Care is a leading eye and LASIK care practice serving the greater Boston and central Massachusetts area including Acton, Athol, Berlin, Bolton, Boylston, Boxborough, Chelmsford, Clinton, Concord, Fitchburg, Gardner, Greenfield, Groton, Harvard, Hudson, Lancaster, Leominster, Lexington, Littleton, Lowell, Lunenburg, Marlborough, Milford, Shelburne Falls, Shirley, Sterling, Stow, Sudbury, Templeton, Westminster, Westborough, Winchendon and Worcester, Massachusetts.

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Help for Boston Corneal Infections

“For a lot of our Boston patients, spring is the time we like to get outdoors and participate in activities where corneal infections can become somewhat of a risk”, commented Boston Corneal Specialist JoAnn Chang, M.D. “I would like to remind patients that normally the cornea is very resistant to infection. However, if the outermost layer of the cornea-called the epithelium-is damaged from even mild accidents like getting a poke in the eye from a branch or a finger, a foreign body such as metal or even from a dirty or damaged contact lens, it is possible for bacteria, viruses or fungi to penetrate the cornea and cause an infection. Situations like these can cause painful inflammation and corneal infections called Keratitis,” remarked Dr. Chang.

Anyone concerned about a corneal infection should become familiar with the signs and symptoms of a Keratitis which may include redness, pain, light sensitivity, watering and even the formation of a white spot indicating the focus of the infection. In some instances this can cause a painful inflammation with a discharge, which if not treated quickly and appropriately, can lead to corneal erosion, corneal ulceration and corneal scarring which can impair vision and may require a corneal transplant. Quick diagnosis and treatment are the best way to avoid the potential for damage and vision loss from a corneal infection.

If you or someone you know is experiencing any of these signs or symptoms-especially if they have had any trauma to their eyes, please call D’Ambrosio Eye Care at 800-325-3937 and request an immediate appointment.

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