Smoking and Eye Health

I hope everybody enjoyed their holidays. It’s the start of the new year and many of us have made resolutions that we want to keep. Quitting smoking would be high on the priority list for some of us. It has been well documented that smoking has a strong association with lung cancer and cardiovascular disease among the general population. However, according to surverys, only 9% of the population knows that smoking can be detrimental to your eye health. So what are some ocular complications from smoking?

1. Age Related Macular Degeneration (ARMD) – Smoking is the strongest epidemiolgical risk factor for developing ARMD. The understanding of the mechanism is limited but the most likely causes are oxidative damage and pathological vascular changes.

2. Dry Eyes – Smoking can damage goblet cells that are important in producing the oily layer for our tears.

3. Graves’ Ophthalmopathy – Cyanide in the cigarettes can act as an anti-thyroid agent. This directly inhibits the iodide uptake and hormone synthesis. When this happens, this may lead to proptosis (bulging of the eyeballs)

4. Glaucoma – Some studies have shown a 2.9 times increase in developing glaucoma. Smoking has also shown that it may increase your eye pressure by almost 5.0 mmHg.

5. Cataracts – There is an increase of nuclear sclerotic cataracts and subcapsular cataracts. The free radicals that are in cigarettes may trigger the development of cataracts sooner than the general population.

Your optometrist can check if there is any ocular health damage due to smoking. If you need help to quit smoking, talk to your optometrist or your family doctor.  Websites such as www.smokershelpline.ca or www.gosmokefree.gc.ca may also help.  At Avenue Eyecare, we are here to help you with all your eyecare needs.

Dr. Sherman Tung, OD FAAO

drtung@avenueeyecare.com
Vancouver Kerrisdale Optometrist

Contact Avenue Eyecare to book your appointment today.

Clogged oil glands

Within the past 6 months, I have had several  patients come into my office complaining of stinging and burning eyes.  They also had concerns regarding intermittent blurred eyesight for about 10 minutes, similar to an oil film over their vision.  In severe cases, these patients have developed recurring styes.

So what’s going on?  Most of them are suffering from something called meibomian gland dysfunction (MGD).  About 33% to 50% of patients suffer from this condition.  Meibomian glands are the oil glands on our eyelids.  They secrete the oil layer for our tears and prevent its evaporation.  When these glands are clogged up and start to be inflamed,  it’s called miebomitis.  Once the meibomian glands are clogged, the oil content usually becomes a thick buttery substance.  Deposits from bacteria, bacterial by-products, or make up at the base of the lashes can clog up the meibomian glands.

Treatments

The first line treatment includes warm compresses and lid scrubs.  The warm compresses raise the temperature of the buttery substance; therefore, thinning the meibomian gland secretions.  At Avenue Eyecare, we usually have the patient return in 1 month.  We then utilize a Mastrota Meibomian Paddle to facilitate expression of the clogged oil glands.  We usually see our patients with improved signs and symptoms.

For advanced cases, topical steroid/antiobiotic combination drugs may be used for short term use.  If the inflammation is very pronounced, oral doxycycline or Omega 3 supplements would also be recommended.

If you are suffering from burning dry eyes, sometimes artificial tears are not enough.  Come by Avenue Eyecare for an evaluation.

Dr. Sherman Tung, OD FAAO

drtung@avenueeyecare.com
Vancouver Kerrisdale Optometrist

Contact Avenue Eyecare to book your appointment today.

Night Time Driving Difficulties

The winter months are upon us and daylight savings time is in about 2 weeks.  Several patients are beginning to bring up concerns about difficulty driving at night.  In Vancouver, night driving is even more challenging with the rain, and my patients are having trouble seeing the lines between the roads.  According to National Safety Council, traffic death rates were 3X greater at night compared to day time.

There are many factors that make night driving more difficult.  A comprehensive eye exam  will help determine these causes.

1. Refractive Error: Sometimes a small refractive change in either hyperopia, myopia or astigmatism will make all the difference in the world.  At Avenue Eyecare, we love to trial frame the prescription to see if makes any difference in your distance vision before you purchase your glasses.  It’s like trying on your glasses before you buy them.  It takes away all the guess work on how your glasses will turn out.

2. Media opacity like cataracts:  When driving at night, the pupils are usually enlarged due to your physiological response to darkness.  This allows more light to enter the eye. This is a great thing for normal people.  However, when it comes to people with cataracts, the increased amount of light gets diffracted causing haloes or glare.  If the cataracts are significant enough, a cataract consult would be warranted.

3. Corneal problems: Dry eye disease is a common condition that affects the cornea.  This dryness is exacerbated when the heater is on and may lead to reflex tearing which causes blurred vision.  Other corneal problems may include keratoconus.  Keratoconus is a corneal thinning disease and causes the diffraction of light in random directions.  This causes haloes and glare during night time driving.

4. Retinal problems:  Retinal diseases may be the cause of difficulties with vision in dim lighting.  This may include retinitis pigmentosa (night blindness disease) or macular degeneration (accumulation of waste products in the eye).  Low vision devices may be needed to help you drive.

5. Low quality lenses and coatings:  Lower quality lenses have more distortions and aberrations which cause blurred vision.  Poor quality anti-reflective coatings also tend to peel off and distort vision.  At Avenue Eyecare, if driving is your main priority, we usually recommend Essilor Varilux 360 Lenses with a Crizal Sapphire coating or  Nikon See Max Lenses with a SeeCoat Blue.  Once you try one of the high definition lenses, you’ll appreciate the clarity and brightness of your vision.

Dr. Sherman Tung, OD FAAO

drtung@avenueeyecare.com
Vancouver Kerrisdale Optometrist

Contact Avenue Eyecare to book your appointment today.

Laser Eye Surgery 101

Throughout my career, one of the most popular discussions that have been raised by my patients and even my friends is regarding laser eye surgery.  There are some common questions and concerns regarding this procedure and I will address them here.

Is Laser correction surgery safe?

It is a safe procedure if you are a good candidate.  There are many factors that are considered including your prescription, overall change in prescription in the past few years, age, cornea thickness and ocular health.  If you meet all the criteria, you will be an excellent candidate and the procedure is safe.

What are the different types of laser correction?

There are several different types but I will discuss the most popular two.

1. LASIK (Laser-Assisted in Situ Keratomileusis) – This operation involves creating a thin flap on the eye, lasering the middle part of your cornea, and replacing the thin flap on the eye.  The advantage of this type of surgery is the quick recovery time and it is ideal for patients with low prescriptions.  This would not be a good option for active candidates that play a lot of contact sports because the flap may dislodge with great blunt force.
2. PRK (Photorefractive Keratectomy) – This operation does not involve any incisions.  It is essentially no-touch laser surgery.  The disadvantage of this
   type of surgery is a longer period of recovery time, which may take up to 3 months.  The advantages of this surgery are that higher prescription patients can still be ideal candidates and there will never be a flap to be worried about.

How much does it cost?

You may read on advertisements that the cost for each eye can start as low as $490.  But be aware, you should expect to pay an all-inclusive package around $3000-$4000 for the overall procedure.  There are many hidden costs including your prescription, pre-operative exam, surgery itself, medications and all the post-operative exam costs that are not mentioned in their advertisements.

What are the common complications?

The most common complication is experiencing “dry eyes” after the surgery and this may be temporary or permanent.  Other complications may include haloes during night driving, infection, light sensitivity, or ghost images. This is why it is very important to ensure you are a good candidate before you do the surgery to reduce the risk of these complications.

Each individual is different and it is best to have a consultation with your optometrist to see whether you are a good candidate or not. 

Dr. Sherman Tung OD, FAAO  drtung@avenueeyecare.com