Giant Papillary Conjunctivitis

Giant Papillary Conjunctivitis or GPC, is typically associated with contact lens wear. Symptoms include, contact lens discomfort and fluctuating vision. There is often mucus discharge from one or both eyes. A particularly annoying symptom of GPC is dislocation and excess movement of the contact lens.

GPC may occur months or even years after you begin contact lens wear. Among the things that may cause GPC are improper cleaning of contact lenses, infrequent contact lens replacement, and wearing contact lenses for too many hours.

There are tiny papilla on the inside of the upper eyelid normally. Allergies can cause the papilla to swell and secrete histamine which causes itchy eyes. In GPC, the papilla greatly enlarge due to interaction with foreign bodies such as debris on the contact lens or the contact lens itself. The large papilla secrete sticky proteins which adhere to the contact lens causing more debris and forcing the lens to move out of place.

Resolution of GPC includes decrease or cessation of contact lens wear, and often treatment with topical cortico-steroids and mast-cell inhibitors eyedrops. Contact lens wear can usually be resumed with modifications in the lens type and care regime.


Springtime Allergies

AllergiesEye allergies, or allergic conjunctivitis, develop when the body’s immune system reacts to an allergen that gets into the eyes. This is worse on windy days because the environmental irritants are blowing all over the place. There are mast cells under the upper eyelid. The allergens cause the mast cells to release histamine and other substances or chemicals that cause blood vessels in the eyes to swell and itch.

Although allergic conjunctivitis can’t harm your vision, it can be extremely uncomfortable, annoying and disruptive. You may become intolerant to wearing your contact lenses due to the swelling and discharge. The best way to treat your eyes for allergies is to avoid the allergens that trigger your symptoms. The most common outdoor allergens include grass, trees and weed pollens. Indoor allergens include pet hair/dander, dust mites and mold.

Complete avoidance is impossible, so treatment may be indicated. Many sufferers choose to treat their symptoms with over-the-counter allergy medication. Unfortunately, antihistamine tablets and nasal sprays commonly used for allergies are not designed to relieve eye symptoms; in fact, 73% of patients who take oral or nasal allergy medication still suffer from itchy, red eyes. Clinical research has shown that these antihistamines can cause drying of the eyes, resulting in a reduction of tear flow of up to 50%. This means there is the potential for symptoms to be more severe and longer in duration because pollens aren’t rinsed as quickly from the eyes and may accumulate.

Over-the-counter eye drops may provide some relief, but many consist of a short-acting vasoconstrictor with an antihistamine, which result in a short duration of action (usually 2 hours) and a masking of the redness rather than a treatment of the cause. There are combination drops which treat the mast cells and inhibit the histamine. To work properly, correct usage is required.

Additionally, self-diagnosis and treatment can make other conditions such as an eye infection or  dry eyes worse as some of the symptoms are the same.

Contact lens wearers may suffer added discomfort because allergens can get on the lenses, and can also cause the eye to produce excessive amounts of discharge that adhere to the contact lenses too. Clinical studies have shown that contact lens wearers suffering from allergic conjunctivitis who used prescription eye drops before inserting their lenses had significantly greater comfort. Call to make an appointment at the first hint of allergies. Treating the condition sooner results in faster and less complicated relief.

For temporary relief before you can get an eye examination, use a cold compress ( a clean washcloth with ice cubes) over the eyes for ten minutes. An artificial tear or sterile saline solution can remove allergens from the eyes. Chilling the solution adds even greater comfort.


Allergic Conjunctivitis

Allergies are widespread, affecting 30% or more of the U.S. population. Allergic conjunctivitis and rhinitis (runny nose) can exact a significant toll on individuals. The most common Allergiessymptom of eye allergies is itching, which can range from mildly uncomfortable to severely bothersome. Itching and other symptoms which include watery eyes, redness, pain, soreness, stinging and swelling, may reduce a persons ability to perform daily routines or activities at school or work.

There are two common forms of ocular allergy,  seasonal and perennial. Of the two, seasonal allergies are the more common. Seasonal allergies are triggered by seasonal items such as tree, grass and weed pollens that abound in spring and fall. People sensitive to these allergens tend to have symptoms most frequently during those seasons. When the allergies are no longer present, a seasonal allergy sufferer doesn’t have symptoms.
Perennial allergies, by contrast, are triggered by environmental allergens commonly found in the home – such as dust mites, mold spores or animal dander – and do not follow a seasonal distributions. As a result, if you have perennial allergies, you suffer all year long.

Avoidance of the allergen or cause of the allergy is the most successful, but unfortunately isn’t always possible. Minimizing contact can still reduce symptoms however. Many people have found relieve with air filters that remove airborne allergens from the home or office. Dust mites or animal dander control measures can help. Keeping the house and car windows closed will minimize allergens. Simply wearing sunglasses as a mechanical barrier and washing hair in the evening can help reduce allergen exposure.

If your symptoms are minimal or intermittent, applying a cold compress (10-15 minutes) may relieve symptoms, especially itching. Artificial tears can bolster ocular defenses by flushing out antigens and can relieve mild ocular allergy symptoms. Benefits of these measures include simplicity, minimal expense and no side effects.

Histamine is central to the allergic reaction and symptoms. Antihistamines are intended to block the effects of histamine. Oral antihistamines can relief systemic symptoms, but may have side effects of sleepiness, dry mouth, and dry eyes. Topical antihistamines target the eye allergy and have less side effects.

Some allergy eye drops combine the antihistamine with mast cell inhibitors. The mast cell inhibitors inhibit the release of histamine and prevent the allergic reaction from starting. I recommend starting this drop at the first sign of symptoms.

For severe eye allergies, a steroid eye drop may be necessary to interrupt the allergic cycle. Steroid eye drops are very effective but have many potential side effects and must be used only as prescribed.

Don’t suffer from allergies. Discuss your symptoms and concerns with Dr. Griffith or Dr. Staton.



Meibomian Gland Dysfunction

A common complaint I hear is  “my eyes burn and water.” Meibomian Gland Dysfunction is a common, chronic condition and is usually the cause of the discomfort. MGD occurs when the opening to the meibomian gland is plugged. The openings to the glands are at the edge of the eyelid margins, near the base of the eyelashes. The blockage can be caused by make-up, lotions, and sunscreens that plug the opening. Other factors are usually involved too. For example, skin conditions such as acne rosacea are a common cause of MGD.  Age, sex, hormonal disturbances, allergies and certain medications negatively affect the glands too.
The treatment depends on the severity of the condition. Hot compresses and eyelid hygiene is always recommended. Dietary modifications, inclusion of omega-3 fatty acids and hydration are beneficial. For more advanced cases, topical and/or oral medications may be required to control MGD.
If left untreated, the glands will thicken and scar causing chronic dry eye signs and symptoms and more discomfort.


Swollen Eyelids

A swollen eyelid occurs when there is inflammation or excess fluid (edema) in the connective tissues surrounding the eye. Swollen eyes can be painful or non-painful, and involve one eye or two and top or bottom eyelids.

Symptoms of Swollen Eyelids

Swelling of the eyelids is a symptom of an underlying cause, such as allergy or infection. Swollen eyes usually are accompanied by one or more of the following:

  • Eye irritation, such as an itchy or scratchy sensation
  • Excess tear production, resulting in watering eyes
  • Obstructed vision (depending on the extent of the swelling)
  • Redness of the eyelid
  • Redness and inflammation of the white of the eye (conjunctiva)
  • Discharge from the eye
  • Pain, particularly when swollen eyelids are caused by infection

Treatment of Swollen Eyelids

The first step in treating swollen eyelids is to identify the cause. The doctors at Eyelid Swollen Westside Optometry may write a prescription, recommend an over the counter remedy or suggest hot or cold compresses depending on the diagnosis.

Tips for Preventing Swollen Eyelids

Control your allergies
Choose and use cosmetics, lotions and skin products carefully
Pay attention to eye drops you use, do not share them, check the expiration date and verify the intended use.
If you wear contact lenses, you can minimize your risk of eye infection or irritation by practicing proper hygiene, replacing contacts and contact cases as prescribed and not over-wearing your lenses.

To read more about the causes of swollen eyelids click here


If you’re itchy and you know it…

Are your eyes itchy, red or watery? Seasonal allergies are caused by the allergens in the air. When they come in contact with the tissues of your eyes, your eyes may over-react. With allergies, your body releases histamine that causes your eyes to itch and water.

Itchy EyesPreventing the allergens from getting into your eyes is the first line of defense. Keep your home free of pet dander and dust. Stay inside with the windows closed when there is a lot of pollen in the air. Use high quality furnace and vent filters that trap common allergens and replace the filters frequently.

Wear wraparound sunglasses to help shield your eyes from allergens, and drive with your windows closed during allergy season.

If despite your best efforts to avoid allergens your eyes are still itchy and watery, it may be time to try eye drops. Some products have ingredients that act as mast cell stabilizers, which alleviate redness and swelling if used properly. It can take 10 – 14 days for the active ingredients to have a noticeable effect on the mast cells so it is important to use the drop as prescribed. Antihistamines are known for their immediate relief and are often combined with the mast cell inhibitor for a single solution.

Over-the-counter (OTC) and prescription eye drops each have their advantages; for example, OTC products often are less expensive, while prescription ones usually are stronger and more effective.

Non-steroidal anti-inflammatory eye drops can be prescribed to decrease swelling, inflammation and other symptoms associated with seasonal allergic conjunctivitis. Steroid eye drops provide quick relief but must be used cautiously as the possible side effects are severe.

If you wear contact lenses, you may find yourself less comfortable during the allergy season. Excess discharge and the allergens can get on the contact lenses, increasing irritation. Diligent control of the eye allergy and daily use contact lenses may be an option to continued contact lens wear.

For more details about eye allergies click here.


Eye Infections

“Pink Eye” is a common term referring to conjunctivitis. The conjunctiva is the outer white part of the eye and the inside lining of the eyelids. The conjunctiva is normally clear, but if it is inflamed it becomes pink or red. Conjunctivitis can be caused by allergies, bacteria, viruses or other irritants. The treatment depends on the cause.

Besides redness, other symptoms include tearing, itching, sensitivity to light, mucus and/or a gritty feeling.

It can be difficult to tell one type of conjunctivitis from another and often requires a thorough examination with the biomicrosope to make the diagnosis. There are some serious conditions that mimic conjunctivitis; if you or your child is suffering from a red eye,  call the office.

How to Avoid Pink Eye

Wash your hands frequently and avoid touching or rubbing your eyes. Avoid sharing items that touch your eyes such as washcloths, contact lenses and make-up.

If your child has an eye infection, alert the school. Because viral conjunctivitis is very contagious, it’s a good idea to keep children with pink eye home until the condition resolves. The same is true for adults who work with others.

If you wear contact lenses and develop pink eye, remove your lenses and call the office immediately. Sometimes, more serious contact lens-related infections can mimic conjunctivitis, and appropriate treatment is required.

For more details on the different types of conjunctivitis click here.



Itchy, Watery Eyes

girl with allergies

I hope this is the peak of the allergy season and the air clears soon. There are a lot of people suffering from itchy watery eyes. Besides locking yourself indoors or wearing goggles to avoid the cause of seasonal allergies there are a few things you can do.

  • Wear sunglasses outdoors to minimize exposure to wind
  • Start using an allergy drop with mast cell inhibitors to reduce the allergic response. At your next visit to Westside Optometry we can write a prescription and make recommendations.
  • Rinse your eyes with cool, sterile saline. This soothes and rinses out allergens.
  • If you wear contact lenses, consider switching to glasses temporarily. Pollen and irritants stick to the lens creating more time for the eye to react to them. The glasses will create a barrier between the eye and wind too.
  • Do not rub your eyes! This will only create more of a reaction and cause swelling. Instead put ice cubes in a washcloth and gently rest on closed eyes to soothe them.

Allergies are so common in Petaluma, I wrote about them in April, Eye Allergies. If you suffer all year long, I have more information about indoor allergies such as dust and animal dander, too.  Your Eyes and Allergies



Eye Allergies

Driving through the Sonoma wine country last weekend, I thought how lucky I am to live in such a beautiful place. The fields were green, the lambs were frolicking and the mustard was in full bloom. Gorgeous! But if you suffer from allergies, Sonoma County can be wicked to your eyes and sinuses. Petaluma tends to be particularly windy, stirring up the pollen even more.

Eye allergies are also called “allergic conjunctivitis.” It is a reaction to indoor and outdoor allergens (such as pollen, mold, dust mites or pet dander) that get into your eyes and cause inflammation of the conjunctiva, the white tissue that lines the inside of the eyelid and eyeball. Eye allergies are not contagious.

Other substances called “irritants” (such as dirt, smoke, chlorine, etc.) and even viruses and bacteria, can compound the effect of eye allergies, or even cause irritating symptoms similar to eye allergies for people who are not even allergic. The eyes are an easy target for allergens and irritants because like the skin , they are exposed and sensitive. Dry eyes tend to be more susceptible to ocular allergies because there are less tears to rinse allergens and irritants away.

Certain medications and cosmetics can also cause eye allergy symptoms. By way of response to these allergens and irritants, the body releases chemicals called histamines, which in turn causes inflammation. This reaction makes the eye tissues red and swollen.

The signs of eye allergies are red, itchy, burning, tearing, swollen eyes, along with a gritty sensation. These symptoms may be accompanied by a runny or itchy nose, sneezing, coughing, or a sinus headache. Many sufferers also find that their vision is temporarily blurred.

I find it best to treat eye allergies before the onset of symptoms, but treatment can improve comfort and the appearance of the eye anytime. Do not suffer, there are treatments to control eye allergies.


Eye Allergies

Spring is in the Air
And so is the pollen

75% of allergy symptoms involve the eye. These symptoms include itching, watering and redness. In moderate to severe cases, contact lenses can not be tolerated.

Oral allergy medications can help, but not as quickly or effectively as an allergy eye drop. There are several allergy drops available, some prescription and some over-the-counter. Some of the drops contain antihistamines, decongestants and/or mast cell stabilizers. Antihistamines provide immediate relieve of itching, the mast cell stabilizers provide long-lasting relief. Decongestants constrict the blood vessels to minimize redness, but offer no reduction in the allergic reaction. None of these drops can be used while wearing contact lenses. I will be happy to assist you in selecting the best pharmaceutical solution to your ocular allergies.

Below are some suggestions to minimize the symptoms of ocular allergies and related discomfort.

Recommendations to Reduce Allergic Reactions
 Avoid exposure to allergens
 Rinse eyes with sterile saline solution.
 Cold compresses – place a couple of ice cubes in a clean washcloth
 Maintain contact lens integrity by replacing and cleaning the lenses as prescribed
 Reduce irritation with proper eyelid and eyelash hygiene
 Control ocular dryness with artificial tear drops, proper hydration and supplements
 Begin allergy drops at the first signs of a reaction
 Wear wraparound sunglasses to shield the eyes