Newsletter for September 2011

At OAV we frequently see patients with pterygium. A pterygium is a fleshy growth over the cornea that usually occurs on the inner corner of the eye. They are very common especially in sunny climates due to UV light exposure. Smoke, dust, wind, and dryness are also contributing factors. They are not cancerous. Sometimes, pterygium are confused with pinguecula which is a similar type of problem, but a pinguecula has not grown onto the cornea.

Avoiding environmental irritants, wearing sunglasses, and using artificial tears are the best medical treatments. There are many reasons why patients request surgical removal of pterygium. The most important reason is because the pterygium has grown close to the center of the cornea, or visual axis. It is critical to have surgery before it gets close to causing permanent scar tissue in this vital area. Other common reasons for surgery include chronic redness and irritation as well as poor appearance. Despite new surgical modalities, pterygium can recur after surgery sometimes quite quickly and aggressively because it's impossible to remove all of the abnormal tissue. Thus, we tend to be fairly conservative with surgical recommendations. New surgical techniques are aimed at preventing recurrences and improving the cosmetic result. Most of the time we either transplant conjunctival tissue from under the lid into the area where the ptergyium was or we transplant amniotic membrane tissue. Both tissues are secured in place with tissue glue rather than suturing. This is a painless, outpatient surgical procedure that takes about 30 minutes. The recovery period can be mildly uncomfortable for a few days with most patients returning to work in a few days.

Ophthalmic migraines, also known as acephalic migraines, are quite common and often painless. The term "migraine" often brings to mind a severe type of headache; however with ophthalmic migraines, patients experience visual disturbances without the painful headache. The process is thought to be related to changes in blood flow in the brain and optic nerve. Ophthalmic migraines can be produced by the body's neurological responses to certain triggers. Some common triggers include hormonal changes, chemcials in foods such as chocolate, peppermint or cheese, or irregular sleep patterns.

Ocular Migraine Symptoms

People with ocular migraines can have a variety of visual symptoms. Typically they can see a small, enlarging blind spot (scotoma) in their central vision with bright, flickering lights (scintillations) or a shimmering zig-zag line (metamorphopsia) inside the blind spot. The blind spot usually enlarges and may move across the field of vision. This entire migraine phenomenon may end in only a few minutes, but usually lasts as long as about 20-30 minutes.

Generally, ocular migraines are considered harmless. Usually they are painless, cause no permanent visual or brain damage and do not require treatment.

Still, always consult your doctor when you have unusual vision symptoms, because it's possible that you have another condition requiring treatment, such as a detached retina, which should be checked out immediately.

What Should I Do If I Have an Ocular Migraine?

The vision symptoms, accompanying painless ocular migraines are not related directly to the eyes. Instead, these visual symptoms occur as a result of the migraine “activity” in the visual cortex of the brain located in the back of the skull.

As described above, your vision and visual acuity will be affected significantly during an ophthalmic migraine attack or episode.

If sharp vision is essential for your safety, then you should stop what you are doing immediately. If you are driving, pull over until the ocular migraine passes and your vision has cleared.

Ocular Migraine Treatments

Normally, ophthalmic migraines do not require treatment.

If these symptoms recur regularly or with increasing frequency, then you may need medication to reduce the frequency and/or severity of attacks, so please consult with one of our physicians.

Our optical department is proud to announce the arrival of the Visioffice with Eyecode. This revolutionary system takes into consideration a patient’s natural head and eye movement to create customized lenses.

The Visioffice is a 3-D measuring system that determines head tilt, along with exact eye location, shape and movement. More importantly, it measures the two eyes individually, allowing for the most precise vision possible, no matter where you look through the lens. This all in one system of full range measurements gives patients the benefit they’ve never had before, ultimate lens personalization.

This technology is especially exciting for patients who wear progressive lenses. In traditional progressive lenses, peripheral vision is a challenge, as patients have to look directly at what they want to see clearly. With Visioffice the base of peripheral vision widens, giving you more reading area and less distortion.

In addition to taking the new measurements, the Visioffice also takes real time photographs. This will allow our patients to see themselves wearing the glasses to help with frame style selection.