Dr. Peter J. Polack, M.D.

For one week after LASIK surgery: * no swimming, hot tubs, or Jacuzzis * no heavy lifting - nothing that you have to strain to pick up * no yard work - mowing, leaf blowing, weed whacking * avoid animal waste - dog poop, cat litter * aerobic exercise is ok but sport glasses are recommended - jogging, treadmill, light weights, cycling For one month after LASIK surgery: * no swimming under water * no eye rubbing * no contact sports

There are many kinds of conjunctivitis so without knowing which one you have it is not possible to answer your question. 1. Allergic conjunctivitis - usually seasonal and characterized by itchy eyes. There are OTC drops available for it. 2. Viral conjunctivitis - this is the one that most people associate with the word "conjunctivitis". It is usually fairly severe but self-limited and goes away without treatment in adults. Often it will be treated in children to prevent more serious infection. 3. Bacterial conjunctivitis - this is caused by bacteria, is more severe than viral conjunctivitis, and needs to be treated with antibiotics (drops and possibly oral). This could result in loss of vision if not properly treated. 4. There are other rarer caused of conjunctivitis which we can't cover in this forum If you are not sure what you have, it is advisable to seek medical attention for it.

The issue is not so much giving your eye time to 'rest' as it giving it time to 'heal.' The cornea will heal from an abrasion on its own within a matter of days. During this time, however, it is vulnerable to infection since the cornea doesn't have a protective blood supply like the skin for example. This is why we treat corneal abrasions with antibiotic drops to prevent infection and monitor them closely. So, if you have a small abrasion not related to contact lens use, you could probably go back to work the next day, as long as your work doesn't expose you to a lot of dust, dirt, or animal matter. It is difficult for you to know on your own if you have a simple abrasion or one that is possibly infected, requiring more intensive treatment. This is more likely in the presence of contact lens use or due to an injury from something like a plant or animal. Your eye doctor would be able to determine how quickly you could safely return to work.

What you are referring to is a change in your refraction (prescription) from -1.75 to -1.25. In other words, a slight decrease in your prescription.

This does not tell us if your vision has actually decreased or increased. We would need to know what your visual acuity is while wearing that prescription. That would be expressed as something like 20/20 or 20/40.

Based on your age, I would guess that the most likely reason your prescription has 'decreased' is because the -1.75 you were given originally was too strong. It is common for young people to be inadvertently given prescriptions that are too strong but they can still wear them. However, as we get older we cannot tolerate too strong of a prescription so it has to be decreased.

Since I didn't examine you I am just making educated guesses here but again I would say it is more likely that your vision has not really changed but that your original prescription given to you was too strong.

It is important to know that floaters are a normal phenomenon in human eyes caused by the liquefaction of the vitreous humor, the gel which fills the larger space in the back of the eye, and which begins shortly after birth.

Floaters can occur at a younger age in people who are near-sighted or myopic.

As this process of liquefaction proceeds, eventually the vitreous gel separates from the back of the eye. This is known as a posterior vitreous detachment or PVD and is experienced first as lightning-like flashes followed by a sudden burst of new floaters or a large circular one (Weiss ring). So if this is your case, you should be evaluated by an eye doctor promptly. In a small percentage of cases, a PVD can be associated with a retinal tear or hole and this can potentially progress to a retinal detachment.

As the vitreous gel becomes mostly liquid in older age, the floaters that are left mostly settle to the bottom of the eye. So patients in their 80s and 90s don't complain about them as much. On the other hand, the younger the patient, the longer it might take for the floaters to settle down since the vitreous is more jelly-like.

So what about those floaters in younger patients? If they are new floaters, you should have your eyes evaluated to make sure everything is ok. If so, the best course of action is observation. If a floater is persistent and interfering with vision, there are options for removing them from Laser Floater Treatment (not covered by insurance) to Vitrectomy (covered by insurance but more invasive). Ask your eye doctor for their recommendation.

I would need more information to answer your question. Is there a preliminary diagnosis? If I see some sort of lesion on the eye or eyelids, most pathologists would be familiar with those. If, however, it is something more unusual, I would want someone with ophthalmic pathology training. This is additional training on top of a regular pathology residency. I would ask if the pathology department or lab has someone that can take a look at the specimen. In some cases the tissue is sent to the nearest academic center which has an ophthalmology department with an ophthalmic pathologist on staff.

Everything has a tradeoff. Glasses are the gentlest on the eyes but you have to deal with inconvenience. Soft contact lenses are the most convenient in terms of lifestyle, although they are not recommended for people in dusty or dirty environments. They also increase the risk of infections such as corneal ulcers so proper hygiene is a must. Hard contacts - called rigid gas-permeable contact lenses - are not as comfortable as soft contacts but they give the clearest vision of either soft contacts or glasses. These are usually reserved for people with high corrections who are not ideal candidates for soft contacts.

He really needs to be examined as there are a variety of conditions that can cause red eyes, which is just a response to something bothering the eyes. This can range from allergies (most likely) to dry eyes (uncommon in children) to some sort of auto-immune condition (again less common but possible). I would see an eye doctor, preferably someone who specializes in cornea and external diseases.

You don't specify what kind of laser eye surgery you are referring to so I would assume you are talking about LASIK to correct your vision problem. Laser eye surgery is surgery so there are entire books written on the subject including possible complications, so there is not enough space here for a complete discussion. But it is a very safe procedure. You could probably find what you are asking for online such as Quora.com but consider the source: there are unhappy patients who will tell you it is evil and corporate laser centers that will tell you nothing ever goes wrong. Your best bet is to get information from a reputable surgeon and laser center with a long track record and that is willing to connect you with other patients so you can get an honest answer.

I would see a pediatric ophthalmologist for a discussion about this. Recently, there have been studies looking at performing laser vision correction in children who have high corrections and this may become a viable option. But right now this is being done at academic centers so you want to make sure you are dealing with a reputable surgeon and institution.

It sounds like you have symptoms of dry eye syndrome. This is more common with aging especially in women due to hormonal changes. It can also be related to diet, autoimmune conditions, allergies, genetics, environmental conditions, mechanical issues (eyes don't close all the way), etc.so you can see without a proper evaluation it is just guesswork as to what is causing your problems.

Eye(lid) twitching is known as myokymia and is very common. It is often related to fatigue or stress. The more you pay attention to it the more noticeable it becomes. Often increasing your intake of Magnesium (glycinate) can help. It can last for a few weeks and then goes away. If it persists, see your doctor. Rarely it can be something nerve-related.

Ophthalmologists do perform cataract surgery. I'm surprised she has not been seen sooner by an ophthalmologist. But if she is having problems with her vision and has never had eye surgery, then it is important for her to have an evaluation. It could also be a number of other things. Before a discussion about cataract surgery, other causes of decreased vision need to be ruled out.

You don't say how old your daughter is, but I am guessing not very. Nevertheless, colored contact lenses are not a good idea.

Simply using regular prescription contact lenses, particularly if they are soft contacts which is what most people wear, increases your risk of serious infections such as corneal ulcers. If they are worn overnight, the risk goes up even higher. Extended wear contacts? The risk goes up even more.

But patients who need to see are willing to accept some of these risks so that they can function.

Someone who just wants their eye color to be different is taking a significant chance of harm to their eyes for a cosmetic reason. This risk can be much higher for people who get these colored contacts from novelty stores or places that don't take the time to ensure a proper fit.

Bottom line: colored contact lenses are not advisable, especially for younger people. If an adult still insists on getting these, they should at least see an eye doctor such as an optometrist to ensure that they are getting a health product and that it is properly fitted and maintained and subject to proper followup exams.

As long as his vision is normal this should not be a problem. In fact, this may even be a good habit to have growing up. I grew up the child of an eye doctor and started wearing sunglasses at a young age, too - not 5, but a bit older.

Sun exposure to the eye is associated with macular degeneration - in people who have a hereditary tendency - cataracts, growths on the eye (pterygium and pingueculum) as well as cancers of the superficial layers of the eye and the eyelids.

The only thing I would have checked is that he does not do that because his eyes are sensitive to light, because that can indicate a possible problem.

So, as long as everything - including his vision - checks out as normal and he is just doing it to be fashionable and he is not using them inappropriately (in the classroom for instance) but mostly when outside, then this should not affect the eyes negatively.

Periodic checkups will insure that this is the case. There are studies that suggest that exposure to blue wavelengths of light during childhood - such as what is in natural sunlight - are associated with a decreased incidence of myopia (near-sightedness). So, if there is a family tendency to be myopic, then at least some time outdoors exposing the eyes to natural light would be in order.

Astigmatism, or an out-of-roundness of the eye, does not make the eye look different than the other eye. It can, however, make the 'vision' different from the other eye, usually as blurriness. Most astigmatism can be corrected, but it depends on the severity, the cause, and the age of the patient. Without this information, it is not possible to say what can be done. You should probably see a cornea-refractive specialist who can determine the cause and possible treatment. But if your eye 'looks' different to you in the mirror or to other people, this is probably due to something else, not astigmatism.

The most likely cause of contact lens intolerance - what you are describing - is dry eyes. This is by far the most common diagnosis we make when patients are referred to us for contact lens-related problems. Dry eye has many potential causes so a thorough examination and medical history are essential as it can get progressively worse.

Another cause of contact lens intolerance is allergies to either something external or to the lens or lens solutions or cleaners. This will usually have tell-tale signs on examination so the doctor that prescribed the contact lenses should be able to tell you. If they are not sure you can request to be referred to a cornea specialist.

In the early stages, it is often a challenge to tell them apart.

Some clues that this is probably allergic conjunctivitis: history of other allergy signs (itchy nose, sneezing, asthma-like symptoms, constant rubbing of eyes, pets in the house, seasonal occurrence

Clues that this is more likely infectious conjunctivitis: acute (sudden) onset, usually starts in one eye, mucus discharge (pus-like), fairly swollen lids (which may swell shut), extremely bloodshot (might even have splotches due to broken blood vessels, pain, light-sensitivity, cases of pink-eye going around the school or community.

If it is allergic, using topical allergy eyedrops and/or antihistamine like Benadryl, cold compresses, it will usually be better the next day.

If it is infectious conjunctivitis, it will get worse before it gets better, no matter what you treat it with. Note that, although primary care doctors will usually prescribe them, antibiotic drops will not cure most cases of conjunctivitis since they are due to viruses (which are not affected by antibiotics) and not bacteria.

In infants or children under 2, it is not inappropriate to use antibiotics as protection against bacteria which can coexist in infections since children this age don't have the same immunity.

In either case you can use a decongestant/antihistamine drop such as Naphcon-A up to 4 times a day. Again, if it is allergic it will get better pretty quickly. If it is an infection, it will get worse before it gets better and can last up to a week. In severe cases, the eye doctor might prescribe steroid drops but this should be used with extreme caution as it can cause glaucoma and other possible complications.

Children should be kept from school if they have an infection or if the parents aren't sure.

If you discover a way to treat cataracts without surgery you would win the Nobel Prize in Medicine, be on the cover of Time magazine, and save the government billions of dollars.

Alas, this is not the case. It is a normal part of aging and cataract surgery has been around since the time of the Egyptians, who would 'couch' or push the cataract into the back of the eye and to the side with a sharp reed (since there was no way to remove it surgically in those days).

Nowadays, it is one of the most common procedures performed in the world and is extremely safe with a very low complication rate. It has also been shown improve the quality of life in elderly people as well as decrease the rates of accidental falls and fractures, as well as depression.

In good hands and at a reputable place, he has an excellent prognosis. If his diabetes is controlled, it usually does not have a bearing in most cases.

Dry eyes are very common after LASIK and patients with significant dry eye may be advised to have PRK instead of LASIK for that reason. In most cases, the eyes return to their baseline from before surgery but that can take several weeks to months depending on the patient: younger men more quickly, older women more slowly, everyone else in between.

If you are only 10 days out, I would not be overly concerned. You should be using frequent preservative-free artificial tears. And you should be asking your surgeon for recommendations specific to your situation. He or she knows your eyes a lot better than I do!