Dr. Keg's Podcast
Eye Health Awareness
Eye Q
Ask the Doctor
Q. My husband is 76 years old and was just diagnosed with Glaucoma. He doesn’t have high eye pressure though. How can that be?
Your husband’s diagnosis is based on a number of factors, most importantly, the health of his optic nerves. Glaucoma, by definition of The American Optometric Association and The Academy of Ophthalmology is a chronic optic nerve disease characterized by loss of healthy nerve tissue resulting in characteristic side vision losses.
Note that “eye pressure” is not even included in the definition. Eye pressure is considered a risk factor and is a treatable one in the presence of optic nerve damage. Not everyone with high eye pressure will develop glaucoma and not everyone with glaucoma will have high eye pressure.
Q. I poked myself with a hairbrush 4 months ago and was treated for a corneal abrasion. It healed well and yet, suddenly, over the past few days, the eye that was injured feels like the abrasion is back. It really hurts. Why has the pain returned?
- It sounds like you have a recurrent corneal abrasion which eye doctors call a recurrent erosion. This can occur in the aftermath of a corneal injury, like an abrasion. The original injury may have healed symptomatically, but structurally the layers of the cornea did not plant down firmly. This makes them vulnerable to suddenly “falling off” at a later date and is essentially another abrasion. Corneal abrasions hurt, as you will attest! You should see your eye doctor as there are eyedrops, and treatments to manage the pain, help the layers stick better and minimize the chance of recurrence.
Q. Do all people with diabetes lose their vision? I was just diagnosed with Type 2 diabetes and am worried about going blind.
Fortunately no. Most patients with Type 2 diabetes can retain their vision, yet annual, or more frequent eye health and vision examinations need to be part of your treatment plan. The risks of vision threatening changes increase the longer you have diabetes, the higher and longer you have an elevated HBA1c (a marker of the average blood sugar over the past three months), and if you also have other cardiovascular conditions.
Because we don’t know how long many of our Type 2 adult diabetic patients have had insulin insufficiency, an eye health exam including a dilated or widefield imaging with OCT is recommended at the time of diagnosis. Technology, examination methods and specialized drugs to treat diabetic leakage from retinal blood vessels have helped many patients retain their vision for many years.
Our advice: exercise, lower your A1c, practice more strict control of blood sugar, manage all treatable cardiovascular conditions and stay regular with your internal medicine, eye doctor, dental and podiatric visits.
Q. I have astigmatism. Will I pass that on to my children?
Great question and the likelihood is yes. Yet here is why I say that. Astigmatism which is really an oval shaped optical prescription (football) rather than a sphere (basketball) is really common. About 90% of people have some level of measurable astigmatism, so the odds are forever in your favor…and that of your kids.
So, if it is common to have some astigmatism, what is the big deal? It depends on the magnitude or amount of astigmatism. Some people have so little astigmatism they do not even need to wear glasses. Many need the astigmatism corrected with glasses and/or contact lenses. We can correct it with Lasik (laser vision) also. Higher amounts are a bit more likely to be inherited so your risk of passing it on to your kids and it being significant may be more due to your genetics? There is a condition where patients have high levels of astigmatism due to a thinning of the cornea. This is called Keratoconus. That is a bit of a different beast altogether but there are optical, contact lens and stabilizing treatments for that condition if it is the cause of high astigmatism.
