EXPERT
Dr. Peter J. Polack, M.D.
Ophthalmologist
Peter J. Polack M.D., F.A.C.S., is a board-certified ophthalmologist specializing in laser vision correction including LASIK and PRK, laser cataract surgery, the latest techniques in corneal transplants such as DMEK and DSAEK, and external diseases of the eye including dry eye. After attending the University of South Florida College of Medicine, he was awarded the Dyson Foundation Research Fellowship at the Cornell University Medical College. He then completed a residency in ophthalmology at the New York Eye & Ear Infirmary where he was a chief resident, followed by a fellowship in cornea, refractive surgery and external diseases at the University of South Florida. Dr. Polack has published numerous abstracts and has co-authored textbooks on ophthalmology, and has taught other doctors corneal transplantation surgery. He is a technology columnist for Ophthalmology Management magazine and is a top contributor on Quora.com with over a quarter of a million views. He also hosts an iTunes podcast and blog, Medical Practice Trends, for fellow physicians.
36 years
Experience
Dr. Peter J. Polack, M.D.
- Ocala, FL
- University of South Florida College of Medicine
- Accepting new patients
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Does not wearing glasses all the time increase eye power?
The answer to your question depends on what your prescription is and how accurate that prescription is. If the prescription is correct then it is unlikely to cause an increase READ MORE
The answer to your question depends on what your prescription is and how accurate that prescription is.
If the prescription is correct then it is unlikely to cause an increase in your eye power.
If you are near-sighted (myopia) and your prescription is too strong, it is possible for it to contribute to an increase in the eye power if your eye is still developing. This development usually stops around the age of 25.
If you are far-sighted (hyperopia) however, then it probably won't make too much difference. If the prescription is too strong, your eyes won't have to work as hard and they will get used to the glasses as a 'crutch' and you might find that you are more dependent on the glasses than you were before. But that doesn't necessarily mean that your eye power has changed.
If the prescription is correct then it is unlikely to cause an increase in your eye power.
If you are near-sighted (myopia) and your prescription is too strong, it is possible for it to contribute to an increase in the eye power if your eye is still developing. This development usually stops around the age of 25.
If you are far-sighted (hyperopia) however, then it probably won't make too much difference. If the prescription is too strong, your eyes won't have to work as hard and they will get used to the glasses as a 'crutch' and you might find that you are more dependent on the glasses than you were before. But that doesn't necessarily mean that your eye power has changed.
Is stopping restasis considered to be dangerous?
A common misconception about Restasis (and Xiidra which works similarly) is that they are interchangeable with other dry eye treatments. These are the only non-steroidal anti-inflammatory READ MORE
A common misconception about Restasis (and Xiidra which works similarly) is that they are interchangeable with other dry eye treatments. These are the only non-steroidal anti-inflammatory medications for the treatment of dry eye due to inflammation. They are not artificial tears and they are not meant to 'soothe' the eye. They are prescriptions medications.
Restasis works by blocking the white blood cells which are involved in inflammatory dry eye disease. Since these cells have about a 90-day lifespan, it can take anywhere from 3 months to 6 months for Restasis to reach a therapeutic level. Sometimes when patients tell me that they tried Restasis and "it didn't work" they were usually not on it long enough for it to count.
Likewise, if you stop Restasis, it might take a month or longer before you know for sure if the effect has worn off.
If you have been on it for years without a problem and now you have an issue with one of the eyes, Restasis is unlikely to be the culprit. But your eye doctor should review what other medications you are on. Again, it is unlikely that you are on something comparable to Restasis already so I would be hesitant to just stop it without doing some investigating as to the cause of your symptoms.
It is also possible that despite being on Restasis that your dry eye disease is nevertheless progressing. There are many contributing factors to dry eye including auto-immune diseases, diet, environment, skin type, genetics, other drug side effects, to name a few. Restasis alone might be insufficient to counteract these other causes.
To answer your question, yes it is safe to stop Restasis. But if your symptoms worsen - and this might not happen for several weeks - and you need to go back on Restasis, just be aware that you will have to start all over again as it can take several months to reach a therapeutic level again.
Restasis works by blocking the white blood cells which are involved in inflammatory dry eye disease. Since these cells have about a 90-day lifespan, it can take anywhere from 3 months to 6 months for Restasis to reach a therapeutic level. Sometimes when patients tell me that they tried Restasis and "it didn't work" they were usually not on it long enough for it to count.
Likewise, if you stop Restasis, it might take a month or longer before you know for sure if the effect has worn off.
If you have been on it for years without a problem and now you have an issue with one of the eyes, Restasis is unlikely to be the culprit. But your eye doctor should review what other medications you are on. Again, it is unlikely that you are on something comparable to Restasis already so I would be hesitant to just stop it without doing some investigating as to the cause of your symptoms.
It is also possible that despite being on Restasis that your dry eye disease is nevertheless progressing. There are many contributing factors to dry eye including auto-immune diseases, diet, environment, skin type, genetics, other drug side effects, to name a few. Restasis alone might be insufficient to counteract these other causes.
To answer your question, yes it is safe to stop Restasis. But if your symptoms worsen - and this might not happen for several weeks - and you need to go back on Restasis, just be aware that you will have to start all over again as it can take several months to reach a therapeutic level again.
Is there an age restriction for a refractive surgery?
Refractive surgery, LASIK or PRK, is approved for 18 years and older. Most surgeons like to wait until at least age 21 AND evidence of a stable refraction (prescription) to ensure READ MORE
Refractive surgery, LASIK or PRK, is approved for 18 years and older. Most surgeons like to wait until at least age 21 AND evidence of a stable refraction (prescription) to ensure that the eyes have stopped growing.
In most cases, this applies to patients with myopia (near-sightedness). If she has hyperopia (far-sightedness), this can continue to increase for a longer time and so she might not be a candidate even after she is fully grown because the refraction is not stable.
Exceptions are made in children for when one eye is much weaker than the other and is at risk for losing vision (amblyopia). This is typically done at an academic center after careful consultation and review by pediatric ophthalmologists if all other options have been exhausted.
In most cases, this applies to patients with myopia (near-sightedness). If she has hyperopia (far-sightedness), this can continue to increase for a longer time and so she might not be a candidate even after she is fully grown because the refraction is not stable.
Exceptions are made in children for when one eye is much weaker than the other and is at risk for losing vision (amblyopia). This is typically done at an academic center after careful consultation and review by pediatric ophthalmologists if all other options have been exhausted.
Can i be affected with two types of cataract in the same eye?
A cataract is the aging of the natural crystalline lens of the eye. Once it is removed it does not grow back (unless you are a salamander). The confusion comes from the fact that READ MORE
A cataract is the aging of the natural crystalline lens of the eye. Once it is removed it does not grow back (unless you are a salamander).
The confusion comes from the fact that most people will develop scarring of the posterior capsule - the sac that holds the intraocular lens implant placed inside the eye. The symptoms are very similarIn the old days this was called an 'after cataract'. Some eye doctors may still use similar terminology but it is not a cataract, simply scar tissue.
It is easily removed with a YAG laser, completely painless, safer than the original cataract surgery and there are no restrictions after the procedure.
The confusion comes from the fact that most people will develop scarring of the posterior capsule - the sac that holds the intraocular lens implant placed inside the eye. The symptoms are very similarIn the old days this was called an 'after cataract'. Some eye doctors may still use similar terminology but it is not a cataract, simply scar tissue.
It is easily removed with a YAG laser, completely painless, safer than the original cataract surgery and there are no restrictions after the procedure.
What is the safe age for wearing sunglasses?
Honestly, younger children are probably especially sensitive to the harmful effects of UV radiation so I commend you for even thinking about it. No, there is no issue regarding READ MORE
Honestly, younger children are probably especially sensitive to the harmful effects of UV radiation so I commend you for even thinking about it. No, there is no issue regarding age for when they can be used. The real challenge will probably be getting her to keep them on. But if she doesn't mind wearing them, it will certainly be beneficial. Most sunglasses - except for the cheapest ones - are UV-blocking. If you want to be sure, buy them in an optical store where they have a UV-filtering device and they can tell you for sure.
My eyes feel very dry after LASIK. What could be the cause for this?
You are still quite early in the postoperative period and I would expect your symptoms to eventually improve. The LASIK procedure involves creating a flap of corneal tissue, either READ MORE
You are still quite early in the postoperative period and I would expect your symptoms to eventually improve. The LASIK procedure involves creating a flap of corneal tissue, either with a laser or a blade, which results in the 'disconnection' of the nerves which supply the surface of the cornea and are involved in the lubrication process. It is typical for these symptoms to show up around the 2 week mark but can take several weeks to months to recover.
Studies have shown that these nerves regenerate over a period of several months to sometimes as long as a year. This can be more sigfnicant if a patient had a dry eye problem to begin with so most LASIK surgeons will be diligent about identifying those patients with dry eye and treat them aggressively prior to the procedure in order to ensure an optimal outcome. Fortunately it is only a minority of patients who have a persistent, serious dry eye problem after LASIK.
Many cases of dry eye are actually due to an instability of the tear film due to a deficiency of oil due to meibomian gland dysfunction. This is often overlooked by eye doctors who don't specifically look for it. So in addition to using artificial tears - and I would recommend using preservative-free artificial tears for the first several weeks after surgery - you also want to promote adequate oil production from the eyelids.
Some things to try:
- preservative-free artificial tears
- moist heat on the lids (but avoid pressure on or rubbing of the eyelids for the first month)
- take fish oil, flaxseed oil, or black currant seed oil (the latter can be found in a supplement called HydroEye)
- cut wheat out of the diet =3D Paleo Diet. Wheat has been linked to inflammation and autoimmune disorders including dry eye due to decreased tear production
- limit omega-6 oils - these are found in fried foods and most processed foods and listed as hydrogenated oils and fats and are also linked to inflammation
- make sure you don't have a ceiling fan or AC duct blowing on you at night. Even a fan in the corner of your room can be blowing enough to dry your eyes out
- if fans or AC are not an issue, consider using a lubricating gel or ointment at night to keep the eyes from drying out while you sleep
- if you are still struggling, you might benefit from Restasis, a prescription eye drop that decreases inflammation and can increase tear production. Be aware that this medicine can take a few months to reach a therapeutic level.
Bottom line: dry eye is common early after LASIK and usually improves with time. But you should discuss your symptoms and concerns with your surgeon. Untreated dry eye is associated with regression which can lead to undercorrection of your refractive error. So your doctor will want to know so they can address it properly.
Studies have shown that these nerves regenerate over a period of several months to sometimes as long as a year. This can be more sigfnicant if a patient had a dry eye problem to begin with so most LASIK surgeons will be diligent about identifying those patients with dry eye and treat them aggressively prior to the procedure in order to ensure an optimal outcome. Fortunately it is only a minority of patients who have a persistent, serious dry eye problem after LASIK.
Many cases of dry eye are actually due to an instability of the tear film due to a deficiency of oil due to meibomian gland dysfunction. This is often overlooked by eye doctors who don't specifically look for it. So in addition to using artificial tears - and I would recommend using preservative-free artificial tears for the first several weeks after surgery - you also want to promote adequate oil production from the eyelids.
Some things to try:
- preservative-free artificial tears
- moist heat on the lids (but avoid pressure on or rubbing of the eyelids for the first month)
- take fish oil, flaxseed oil, or black currant seed oil (the latter can be found in a supplement called HydroEye)
- cut wheat out of the diet =3D Paleo Diet. Wheat has been linked to inflammation and autoimmune disorders including dry eye due to decreased tear production
- limit omega-6 oils - these are found in fried foods and most processed foods and listed as hydrogenated oils and fats and are also linked to inflammation
- make sure you don't have a ceiling fan or AC duct blowing on you at night. Even a fan in the corner of your room can be blowing enough to dry your eyes out
- if fans or AC are not an issue, consider using a lubricating gel or ointment at night to keep the eyes from drying out while you sleep
- if you are still struggling, you might benefit from Restasis, a prescription eye drop that decreases inflammation and can increase tear production. Be aware that this medicine can take a few months to reach a therapeutic level.
Bottom line: dry eye is common early after LASIK and usually improves with time. But you should discuss your symptoms and concerns with your surgeon. Untreated dry eye is associated with regression which can lead to undercorrection of your refractive error. So your doctor will want to know so they can address it properly.
Why are my eyes blood red when I wake up?
Redness of the eyes is a 'non-specific' sign indicating that something is bothering or irritating the eyes. And if they are red primarily in the morning, it means that something READ MORE
Redness of the eyes is a 'non-specific' sign indicating that something is bothering or irritating the eyes. And if they are red primarily in the morning, it means that something is bothering them either during the night or late in the day and they are not having a chance to recover.
Some things that can irritate the eyes at night include allergens such as dust/dust mites/animal dander/perfumes or dyes from detergents used on bedding/etc, the eyes cracking open while you are asleep and they are drying out, a ceiling fan or AC blowing on the eyes.
Could it be that the eyes are irritated during the evening? Staying up late watching TV or using the computer? Drinking alcohol late? These would be some other possibilities to consider.
Try to eliminate possible allergic irritants. Put some lubricating gel or ointment in the eyes at bedtime and also consider wearing a sleep mask to keep the eyes from drying out.
If these options don't do the trick, then you should definitely see an eye doctor to rule out other causes.
Some things that can irritate the eyes at night include allergens such as dust/dust mites/animal dander/perfumes or dyes from detergents used on bedding/etc, the eyes cracking open while you are asleep and they are drying out, a ceiling fan or AC blowing on the eyes.
Could it be that the eyes are irritated during the evening? Staying up late watching TV or using the computer? Drinking alcohol late? These would be some other possibilities to consider.
Try to eliminate possible allergic irritants. Put some lubricating gel or ointment in the eyes at bedtime and also consider wearing a sleep mask to keep the eyes from drying out.
If these options don't do the trick, then you should definitely see an eye doctor to rule out other causes.
