Unlocking the World of Vision – A Journey with Dr. Amy Kotecha

Introduction

In this town hall, top ophthalmologist Dr. Amy Kotecha delves into prevalent eye diseases, shedding light on their causes, symptoms, risk factors, and treatments. Dr. Kotecha is an excellent ophthalmologist often recommended by NVFP for various eye conditions, and she has a wealth of information to share. Here, she describes dry eye syndromes, blepharitis, cataracts, diabetic retinopathy, macular degeneration, and glaucoma. She also shares general reminders for ocular health and preventive measures.

Dry Eye Syndrome

Dry eye syndrome is a common condition characterized by dryness of the eyes, burning, itching, redness, and blurred vision. It can result from both underproduction of tear fluid and increased evaporation. Both issues affect the ocular tear film, leading to conjunctival irritation. It is important to note that dry eye syndrome is exacerbated by increased technology use. Risk factors include poor environmental conditions, dust, hormonal issues, smoking, extensive screen time, and specific medications, including antihistamines. Treatments include lubricating drops, environmental adjustments, discontinuing triggering medications, humidifiers, and specific eye medications to maintain moisture.

Blepharitis

Blepharitis is widespread inflammation of the eyelids, manifesting in symptoms like swollen eyelids, crusty plaques, and oily deposits along the base of the eyelashes. Causes include local infections, allergic reactions, skin conditions, and sometimes gland obstruction. Initial treatments include cleaning with warm compresses and baby soap, eyelid hygiene wipes, and in more severe cases, antibiotics or anti-inflammatories. Surgical intervention is rare. Patients might not always recognize blepharitis, despite its common occurrence.

Cataracts

The most common cause of vision loss, cataracts are characterized by clouding of the lens of the eye. They are often age-related, but also influenced by steroids, trauma, and diabetes. Fortunately, cataracts are treatable via a straightforward outpatient surgery, which typically results in vision improvement within a few days, not to mention reduced reliance on glasses. It is possible to see a thin film develop again post-surgery, but this can be treated.

Diabetic Retinopathy

Diabetic retinopathy is diabetes caused by damaged blood vessels that impacts light sensitive tissue in the eyes. It is crucial that diabetics undergo annual dilated eye exams to monitor for this condition, particularly because symptoms can become quite severe and it is difficult to bring vision back if diagnosed late. Early diabetic retinopathy stages are often asymptomatic, while later stages present with blurred vision, floaters, or vision gaps. The prevalence of the condition increases the longer you’ve had diabetes and the more uncontrolled your glucose and A1C levels are. Dr. Zweig notes that the eyes can be an important indicator of overall health in cases like these. The presence of diabetic retinopathy reveals issues elsewhere in the body that must be treated.

Macular Degeneration

Macular degeneration is a condition generally affecting older people that causes central vision loss. It is the main cause of blindness in people over 60. It occurs in “dry” and “wet” forms. Wet macular degeneration is the more severe form, found in 10% of patients. It is caused by abnormal blood vessel growth, which damages photoreceptors. Treatments for macular degeneration include anti-VEGF injections and AREDS vitamins.

Glaucoma

Glaucoma is a disease of the eyes that is associated with high eye pressure, resulting in damage to the optic nerve. If left untreated, it can cause permanent vision loss and even blindness. Preventative eye exams are crucial for early diagnosis and treatment. Open-angle and closed-angle glaucoma types have different symptoms and treatment approaches. Open-angle glaucoma is far more common and leads to peripheral vision loss or tunnel vision. It can be treated through daily eye drops, beta blockers, and laser surgery. Closed-angle glaucoma is more severe and must be treated rapidly to prevent permanent vision loss.

Other Ocular Health Reminders

Dr. Kotecha reminds us that ocular health is closely intertwined with our overall health. Regular exercise, a balanced diet, not smoking, and controlling cholesterol and blood pressure are vital for ocular health. Multivitamins and omega oil supplements can be helpful for prevention, but should not be substitutes for a healthy diet. Dr. Kotecha recommends regular baseline testing for everyone beginning in childhood, but particularly after age 40.