Eye Questions

Creative commons license, owner D Sharon Pruitt

This page has been created as a question and answer page for anyone with eye questions. Dr. Alex Baker, who will be starting his own eye care business on June 17, 2019, checked this page periodically and answered general questions about eyes that anyone may have. 

The advice and information given here are strictly for entertainment purposes only. Please understand it is impossible for any health care provider to diagnose or treat any condition via a wiki or any other online source or other media. For the most accurate information please visit your family health care provider whether optical or otherwise.

This page is intended for questions about eye exams, eye disorders, eye procedures, etc., but not for questions about billing and insurance. Questions about billing and insurance should be addressed to your optometrist/ophthalmologist or insurance company.

Other optometrists and ophthalmologists in the community are welcome to respond to questions as well.

• If you have other questions, ask the wiki!

Medical Professionals are limited by HIPAA as to what information they can make public about their patients, including who their patients are. As such it is very hard for Doctors, Dentists, and Psychiatrists to respond to negative comments on the wiki. Please keep this in mind while reading any comments.

2012-05-20 21:03:33   Dr. Baker, with today's eclipse a lot of people were talking about what you could do safely and what you couldn't. One friend used welding glasses. That worried me a bit. I got into a disagreement with another friend about whether it was worse to look at the sun during an eclipse, or just that it is always bad to look at the sun but that you would never otherwise be inclined to do that. Any thoughts about good/bad practices during an eclipse? —CovertProfessor

• I heard that welding glass No .14 has the correct filters for viewing solar eclipses, Worst come to worst you can do a pinhole in paper and view it indirectly? Daubert
• 2012-05-20 21:30:04   Not all welding filters are the same, so while some may be safe for viewing an eclipse, others may not. Don't assume that all welding filters will provide sufficient protection. The best method would be to prepare in advance by ordering relatively inexpensive eclipse glasses that are Mylar coated (so they look like what Doc Brown was sporting when he came back from 2015) and block 100% of UV and 99+% of visible light. Compare that to most standard sunglasses which only block 85% of visible light. I heard that some were available for sale at UCD this year. Sun gazing without proper eye protection during an eclipse or non-eclipse is equally dangerous. I could speculate that some people may have a false sense of security during an eclipse or simply be too intrigued to control themselves, potentially making the incidence of visual damage greater when an eclipse occurs. The major risk would be a solar retinopathy (retinal burn) or photokeratitis (corneal burn, often referred to as "snow blindness"). While photokeratitis can be extremely painful and possibly vision threatening, it is more likely that a retinopathy could result in scarring or atrophy and severe vision loss. —Dr.Baker
  • Thank you for your reply — that's very helpful. I have also heard that it could increase your chances of cataracts — is that true? —CovertProfessor
    • Yes, although in this situation cataracts would be a long-term concern as opposed to a retinal burn which could be immediate and potentially much more damaging, as cataracts can be removed but the retina will not regenerate if severely damaged. —Dr.Baker
      • Thank you again. —cp

2012-05-20 21:48:08   One of my biggest issues with spring allergies is eye irritation. I can medicate all the other symptoms, but the itchy eyes are difficult. Are there advantages or drawbacks to the different eye drops that are available over the counter? —DonShor

• Hi Don, in my opinion the most effective over-the-counter anti-allergy eye drop is ketotifen, which goes by two brand names: Zaditor and Alaway. It used to be available by prescription only and the recommended dosing is one drop twice a day in each eye. Other OTC eye drops, such as Opcon A and Naphcon A, generally seem to be less effective. Visine with tetrahydrozoline, a vasoconstrictor, may help reduce redness but may not address itching. Over-use can also result in a rebound effect, causing more redness, so save it for special occasions only, if at all. For severe ocular allergies for which OTC drops don't provide relief, prescription eye drops can often be more effective, even in once-a-day dosing, just ask your eye doctor. Conversely, for mild ocular allergies, something as simple as washing your face and using artificial tears to flush out any offending pollen may be all that is needed. —Dr.Baker

I have considered getting some form of laser surgery for my 20/140 left eye. Apparently my prescription has been increasing a slight bit every year. How long do you think it will take to stabilize and what should I look for in a Lasik Doctor? Daubert

• Hi Steven, most people with nearsightedness (myopia) tend to have their vision stabilize in their early to mid-twenties. It is a general trend, although there are certainly many people who may not follow it, so don't consider it a rule. However, it does suggest that having LASIK or another corneal refractive surgery before that time may not be ideal because any myopic progression after surgery can result in the need for glasses or contacts again. Don't count on enhancements or touch-ups to be a quick fix either, your goal would be to get it done accurately the first time. So, a good rule of thumb is that someone should at least be in their early to mid twenties and not have had any significant increase in their prescription over at least a 2 year period, ideally longer. You should find a surgeon that you feel comfortable with, someone who is willing to address all your questions and concerns, and a bonus would be to talk to someone who has had the same procedure from that doctor so you know what to expect from a patient's perspective. Refractive surgery is not ideal for everyone so the doctor will conduct a number of specific tests during a pre-operative evaluation before making a decision if you are a potential candidate or not. These criteria include overall prescription, corneal thickness and curvature, any underlying corneal dystrophies or other ocular conditions, your age, your immediate and long-term expectations, and more. If you aren't a good candidate for surgery and the doctor declines to perform the procedure, you may be out of luck but at least you know you found a trustworthy doctor! —Dr.Baker

2012-05-21 21:31:21   I have highly myopic eyes, I am 44 and my eyes are still getting more myopic every year, in stead of stabilizing. What ophthalmologists and opticians in the Netherlands always say: on average eyes stabilize only in the mid-forties, not in mid-twenties. So I never heard of stabilizing in mid-twenties? My case proves this. My father had the same. —ConstantiaOomen

• Hi Constantia, your case definitely shows that although there may be general trends, it is impossible to predict what each individual will experience. It also lends support to the idea that genetics plays an significant role in the progression of myopia. The trend that I generally see in most of my patients with myopia is that the myopic progression will slow or plateau around the mid-twenties, and the onset of presbyopia (difficulty focusing on near objects while corrected for distance) is generally in the early to mid-forties with a progression of presbyopia over about 15 years. Again, there are always a number of people who may not follow these general trends whatsoever. I was just starting to look for articles on variable progression of myopia based on geographic or racial differences to see what the general trends are in The Netherlands, but a patient just arrived so it will have to wait! —Dr.Baker

Dr. Baker Thanks, but I somehow don't think the myopic eyes of Americans will stabilize in their mid-twenties and the myopic eyes of Europeans in their mid-forties. :-) I explicitly speak about myopic eye-sight and I am definitely a highly experienced person in knowing what it is, to have ‘changing eye sight’. I wouldn't recommend eye laser surgery to anyone, accept their eye sight hasn't changed at all for -let's say – 7 years. And still, it’s a risky operation. —ConstantiaOomen

• I don't think so either! ;-) What I was able to find is that adult-onset myopia which progresses beyond the third decade shows a greater prevalence for those who live in urban areas and have higher levels of education, although it is still less common than child or school-age onset myopia. You do make a very good case for being cautious when it comes to refractive surgery. Make sure to say hi when you stop by the office! —Dr.Baker

btw: I like this page. I've been to the Helmus & Helmus Store on Second Street and the service was very good. (and I need to go there again ;-) ) —ConstantiaOomen

2013-04-10 12:15:00   Since there hasn't been any activity in a while, and I was prompted to write an article for another purpose, I thought I would include the content that I wrote here as well. Hopefully it will be useful to some. The first question is: Is it OK to sleep while wearing my contact lenses?

• It’s risky for bacterial infections. Although the latest generation of contacts provides very good oxygen transmissibility, the risk of bacterial infections is still significantly increased when sleeping with contacts. The lack of blinking while sleeping results in a stationary contact with very little tear flow beneath the lens, as well as a warm environment from a closed eyelid. Essentially, it becomes an ideal incubator for bacteria. Certainly, there are many people who have been able to sleep with contacts for years without any problem, but the risk still exists and is evident to those who have experienced an infection after sleeping with contacts. If you are able to remove the lenses at night, I would definitely recommend it.

  Also remember to wash your hands well before touching the contacts, change the contact lens solution in your case daily and clean the case between uses. Re-using solution in the case is another risk for bacterial, as well as fungal infections. —Dr.Baker

Is it bad to wear the contacts beyond the recommended disposal period?

• Again, it’s risky, but for allergic reactions. Wearing the contacts beyond the disposal date results in an increase in protein deposits on the lens surface, which aren’t removed completely by daily cleaning. As you blink, the inner eyelid surface rubs against those proteins and can develop little bumps, called papillae. The papillae can grow over months or years and eventually result in a chronic itchy, red, and uncomfortable situation. If severe enough, the best way to treat it is by discontinuing contact lenses and using an antihistamine or even steroid medication for a period of time, often weeks to months. —Dr.Baker

My contacts seem to get torn easily, what is wrong?

• Be careful when you remove the contacts from the case when you put them in. Even with short fingernails, if you swipe the lenses against the side of the case you could pinch and tear the lens. A good method is to put them in the case cup-side up (concave up) and make sure they are completely submerged in solution. In addition to preventing an air bubble that can dry out the lens, this allows you to easily dunk your finger straight in and out without swiping the side. If you do it slowly, the lens will gently grip your finger and come right out.

  Also be careful not to pinch the contacts with your fingernails when removing them from your eyes, and when cleaning them use a gentle back-and-forth motion, not a circular motion since the latter is more likely to tear the lens. —Dr.Baker

I’ve been wearing the same brand of contacts for years with no problems, so why should I switch to a newer lens?

• If you are a full-time contact lens wearer in an older lens material, you may experience low-oxygen transmissibility which can result in corneal hypoxia and neovascularization. This is a process by which blood vessels grow into the cornea (the front, clear surface of the eye) in response to low oxygen levels. The cornea is an avascular tissue, or free of blood vessels, and the addition of blood flow can result in an increased risk for inflammation in the cornea, leading to redness, pain, light sensitivity, and even corneal scarring if severe.

  In order to prevent this situation, contact lens wearers who show signs of corneal neovascularization can be switched into a contact made of a silicone hydrogel material which is more oxygen permeable. An alternative would be to continue to use the existing contacts on a reduced wearing schedule, such as no more than 8-10 hours per day as opposed to 12-14 hours per day. —Dr.Baker

I wear contacts full-time, so why do I need glasses?

• If you require corrective lenses for driving, work, or school, then you need at least one pair of glasses that works reasonably well. The reason is that if you get any irritation or an infection with contacts, you should remove them immediately to prevent the symptoms from getting worse. Too often, contact lens wearers with redness, irritation, or pain will continue to wear their contacts if they don’t have glasses and turn a small problem into a big one. When it comes to contact lens complications: “If in doubt, take them out.” —Dr.Baker