Fuch's Endothelial Dystrophy
What is Fuchs Dystrophy?
Fuchs endothelial dystrophy (FED) is a slowly progressing disease that usually affects both eyes and is slightly more common in women than in men. Although your optometrist can often see early signs of Fuchs dystrophy in people in their 30s and 40s, the disease rarely affects vision until a person reaches their 50s and 60s. It is one of a number of corneal dystrophies (conditions that affect the cornea - the clear, front layer of the eye).
What causes it?
Fuchs dystrophy occurs when endothelial cells (the back layer of the cornea) gradually deteriorate without any apparent reason, such as trauma or inflammation. As more endothelial cells are lost over the years, the cornea becomes less efficient at pumping water out of the stroma (the middle layers of the cornea). This causes the cornea to swell and to distort vision. Eventually, the epithelium (the front layer of the cornea) also takes on water, resulting in great pain and severe visual impairment.
Epithelial swelling damages vision in two ways:
- Changing the cornea's normal curvature
- Causing a sight-impairing haze to appear in the tissue.
Epithelial swelling will also produce tiny blisters on the corneal surface. When the blisters burst, they are extremely painful.
What are the symptoms?
At first, a person with Fuchs dystrophy will awaken with blurred vision that will gradually clear during the day. This occurs because the cornea is normally thicker in the morning, and it retains fluids during sleep that evaporate in the tear film while we are awake. But as the disease worsens, this swelling will remain constant and reduce vision throughout the day.
Can it be treated?
When treating the disease, doctors will try first to reduce the swelling with ointments or soft contact lenses. They may also instruct a person to use a hair dryer, held at arm's length or directed across the face, to dry out the epithelial blisters. This can be done two or three times per day.
But when the disease makes even the simplest tasks hard to complete, a person may need to consider having a corneal transplant to restore sight. The short-term success rate of corneal transplantation is quite good for people with Fuchs dystrophy. But, some studies do suggest that the long-term survival of the donor cornea can be a problem.
If you have been diagnosed with Fuch's Dystrophy or are concerned about this or any other eye condition, contact us to book an appointment.
Glaucoma
What is glaucoma?
Glaucoma is the name for a group of eye conditions in which the optic nerve is damaged at the point where it leaves the eye. This nerve carries information from the light sensitive layer in your eye, the retina, to the brain where it is perceived as a picture. Your eye needs a certain amount of pressure to keep the eyeball in shape so that it can work properly. In some people, the damage is caused by raised eye pressure. Others may have an eye pressure within normal limits but damage occurs because there is a weakness in the optic nerve. In most cases both factors are involved but to a varying extent. Eye pressure is largely independent of blood pressure.
What controls pressure in the eye?
A layer of cells behind the iris (the coloured part of the eye) produces a watery fluid, called aqueous, which nourishes the focussing lens and the cornea. The fluid passes over the front of the lens, out through a hole in the centre of the iris (called the pupil) and over the back surface of the cornea to leave the eye through tiny drainage channels. These channels are in the angle between the front of the eye (the cornea) and the iris and return the fluid to the blood stream. Normally the fluid produced is balanced by the fluid draining out, but if it cannot escape, or too much is produced, then your eye pressure will rise. (The aqueous fluid has nothing to do with tears.)
Why can increased eye pressure be serious?
If the optic nerve comes under too much pressure then it can be damaged. How much damage there is will depend on how much pressure there is and how long it has lasted, and whether there is a poor blood supply or other weakness of the optic nerve. A really high pressure will damage the optic nerve immediately. A lower level of pressure can cause damage more slowly, and then you would gradually lose your sight if it is not treated.
Are there different types of glaucoma?
Yes. There are four main types:
- The most common is chronic glaucoma (chronic = slow) in which the aqueous fluid can get to the drainage channels (open angle) but they slowly become blocked over many years. The eye pressure rises very slowly and there is no pain to show there is a problem, but the field of vision gradually becomes impaired.
- Acute glaucoma (acute = sudden) is much less common in western countries. This happens when there is a sudden and more complete blockage to the flow of aqueous fluid to the eye. This is because a narrow 'angle' closes to prevent fluid ever getting to the drainage channels. This can be quite painful and will cause permanent damage to your sight if not treated promptly.
- There are two other main types of glaucoma. When a rise in eye pressure is caused by another eye condition this is called secondary glaucoma.
- There is also a rare but sometimes serious condition in babies called developmental glaucoma, which is caused by a malformation in the eye. This page focuses on the chronic and acute glaucoma.
How common is glaucoma?
In the UK some form of glaucoma affects about 2 in 100 people over the age of 40.
Are some people particularly at risk of chronic glaucoma?
Yes. There are several factors which increase the risk.
- Age - Chronic glaucoma becomes much more common with increasing age. It is uncommon below the age of 40 but affects one per cent of people over this age and five per cent over 65.
- Race - If you are of African origin you are more at risk of chronic glaucoma and it may come on somewhat earlier and be more severe. So make sure that you have regular tests.
- Family - If you have a close relative who has chronic glaucoma then you should have eye tests at intervals. You should advise other members of your family to do the same. This is especially important if you are aged over 40 when tests should be done every two years.
- Short sight - People with a high degree of short sight are more prone to chronic glaucoma.
- Diabetes is believed to increase the risk of developing this condition.
Why can chronic glaucoma be a serious risk to sight?
The danger with chronic glaucoma is that your eye may seem perfectly normal. There is no pain and your eyesight will seem to be unchanged, but your vision is being damaged. Some people do seek advice because they notice that their sight is less good in one eye than the other.
The early loss in the field of vision is usually in the shape of an arc a little above and/or below the centre when looking 'straight ahead'. This blank area, if the glaucoma is untreated, spreads both outwards and inwards. The centre of the field is last affected so that eventually it becomes like looking through a long tube, so-called 'tunnel vision'. In time even this sight would be lost.
How is chronic glaucoma detected?
As glaucoma becomes much more common over the age of forty you should have eye tests at least every two years. There are 3 main tests for detecting glaucoma of which your optometrist may only need to do 1 or 2 to confirm that you don't have it.
- Viewing your optic nerve either with digital retinal photographs or using a special lens and microscope designed to give a 3D view of the back of the eye
- Measuring the pressure in the eye using a special instrument
- Visual field test - where you are shown a sequence of spots of light on a screen and asked to say which ones you can see.
All these tests are very straightforward, don't hurt and can all be carried out at Campbell Eyecare.
How is chronic glaucoma treated?
The main treatment for chronic glaucoma aims to reduce the pressure in your eye. Some treatments also aim to improve the blood supply of the optic nerve. You will need to go to hospital for treatment and have regular check-ups afterwards. Treatment to lower the pressure is usually started with eyedrops. These act by reducing the amount of fluid produced in the eye or by opening up the drainage channels so that excess liquid can drain away. If this does not help, your specialist may suggest either laser treatment or an operation called a trabeculectomy to improve the drainage of fluids from your eye. Your specialist will discuss with you which is the best method in your particular case.
Can chronic glaucoma be cured?
Although damage already done cannot be repaired, with early diagnosis and careful regular observation and treatment, damage can usually be kept to a minimum, and good vision can be enjoyed indefinitely.
What is acute glaucoma?
In acute glaucoma the pressure in the eye rises rapidly. This is because the periphery of the iris and the front of the eye (cornea) come into contact so that aqueous is not able to reach the tiny drainage channels in the angle between them. This is sometimes called closed angle glaucoma.
What are the symptoms of acute glaucoma?
The sudden increase in eye pressure can be very painful. The affected eye becomes red, the sight deteriorates and may even black out. There may also be nausea and vomiting. In the early stages you may see misty rainbow coloured rings around white lights.
Is acute glaucoma always severe?
Sometimes people have a series of mild attacks, often in the evening. Vision may seem 'misty' with coloured rings seen around white lights and there may be some discomfort in the eye. If you think that you are having mild attacks you should contact your optometrist without delay. In routine examinations the structure of the eye may make the examiner suspect a risk of acute glaucoma and advise further tests.
What is the treatment?
If you have an acute attack you will need to go into hospital immediately so that the pain and the pressure in the eye can be relieved. Drugs will be given which both reduce the production of aqueous liquid in the eye and improve its drainage.
An acute attack, if treated early, can usually be brought under control in a few hours. Your eye will become more comfortable and sight starts to return. When the pain and inflammation have gone down, your surgeon will advise making a small hole in the outer border of the iris to relieve the obstruction, allowing the fluid to drain away. This is usually done by laser treatment or by a small operation.
Usually the surgeon will also advise you to have the same treatment on the other eye, because there is a high risk that it will develop the same problem. The treatment is not painful. Depending on circumstances and the response to treatment, it may not require admission to hospital. Sometimes a short stay in hospital may be advised.
Can acute glaucoma be cured?
If diagnosed without delay and treated promptly and effectively there may be almost complete and permanent recovery of vision. Delay may cause loss of sight in the affected eye. Occasionally the eye pressure may remain a little raised and treatment is required as for chronic glaucoma.
Will I be able to drive?
Most people can still drive if the loss of visual field is not advanced. To assess possible damage to your peripheral vision you will need a special test to see whether your sight meets the standards of the Driver and Vehicle Licensing Authority. Ask your specialist about this. The IGA leaflet about driving may also be helpful. Campbell Eyecare has the special equipment to carry out this test in the Alness practice and are registered with DVLA.
What if my sight cannot be fully restored?
Early detection and treatment will usually prevent or retard further damage by glaucoma. Much can be done to help you use your remaining vision as fully as possible. You should ask your optician or optometrist about low vision aids and whether you are eligible to register as partially sighted or blind. Registration opens the door to expert help and sometimes to financial benefits.
Further help and information
- The International Glaucoma Association supports patients by providing information, so that they can co operate fully in their treatment and prevent sight loss. It also promotes awareness and early detection of glaucoma, and supports and carries out research. The International Glaucoma Association (IGA), Woodcote House, 15 Highpoint Business Village, Henwood, Ashford, Kent, TN24 8DH. Telephone 01233 64 81 70 Available for advice by letter or by telephone 10am - 5pm from Monday to Friday.
- The Partially Sighted Society offers information and advice, publications, aids to vision, enlargement services and local support to help you make the most of your vision. Contact: The Partially Sighted Society, The Sight Centre 9 Plato Place, 72-74 St Dionis Road, London SW6 4TU. Telephone 0207 371 0289
- Royal National Institute for the Blind, 224 Great Portland Street, London W1N 6AA
Herpes Simplex Infection
When a corneal herpes simplex infection (herpes simplex keratoconjunctivitis or keratitis) begins, it may resemble a mild bacterial infection because the eyes are slightly painful, watery, red, and sensitive to light. Corneal swelling makes vision hazy. However, the herpes infection doesn't respond to antibiotics, as a bacterial infection would, and often it continues to worsen.
Most often, the infection produces only mild changes in the cornea and goes away without treatment. Rarely, the virus deeply penetrates the cornea, destroying its surface. The infection may recur, further damaging the surface of the cornea. Several recurrences may result in ulceration, permanent scarring, and a loss of feeling when the eye is touched. The herpes simplex virus can also cause an increased growth of blood vessels, visual impairment, or total loss of vision.
An ophthalmologist may prescribe an antiviral drug as an ointment or a solution to be applied to the eye several times a day. However, they're not always effective; sometimes, other drugs must be taken by mouth. Sometimes, to help speed healing, an ophthalmologist may have to gently swab the cornea with a soft cotton-tipped applicator to remove dead and damaged cells.
Cold sores are the usually the cause of the extremely infectious Herpes simplex virus, which can also cause Corneal ulcer and genital herpes, so do not touch eyes or genitals after touching cold sores.
In first stage of infection, blisters and then ulcers form inside the mouth or on the face, accompanied by red, swollen gums, a furry tongue, mild fever, and feeling generally under par. Though these symptoms clear up within a few days, the virus may not be destroyed, so whenever immunity is at a low ebb infection tends to reappear around mouth and lips, causing blisters which weep and then become encrusted; these usually clear up within 5-7 days. As with any eye condition, be sure to contact us if your eye is ever red or painful.
Herpes Zoster Infection
What is Herpes Zoster?
Herpes zoster is the medical name for shingles. It is caused by reactivation in the adult years of the chicken pox virus that occurred during childhood (the varicalla-zoster virus). The virus can be reactivated when the body's immunity to the virus breaks down. This may happen due to normal aging, or the body's immune system may become weakened due to stress from illness, physical or emotional stress, fatigue, poor nutrition, certain medications, chemotherapy, radiation therapy, or other factors.
Once reactivated, the virus travels along nerve fibers, usually settling in fairly isolated areas of skin on one side of the body. The infected area of the body usually has severe pain, itching, redness, numbness, and the development of a rash. The rash on the skin develops into small, fluid-filled blisters called vesicles. Within a few days of their appearance on the skin, the vesicles break open and form scabs. In severe cases, the rash can leave permanent scars, long standing pain, numbness, and skin discoloration.
How does Herpes Zoster affect the eyes?
The eyes are sometimes affected by herpes zoster. This is due to the fact that the eyes are connected to nerves that may be infected with the herpes zoster virus.
The usual shingles rash can spread from an involved area of the forehead or cheek to the upper or lower eyelids. Shingles may cause redness of the conjunctiva (the mucous membrane covering the white of the eye). It can also cause small scratches or scarring of the cornea. The scratches on the cornea may increase the risk of bacterial infection in the eye. Shingles may also cause inflammation inside the eye, known as iritis or uveitis. It can also affect the optic nerve or the retina.
Herpes zoster infections of the eye can lead to redness, swelling, pain, sensitivity to light, and blurred vision. Severe or repeated episodes of herpes zoster infection are associated with other eye conditions, including glaucoma, scarring inside the eye, and cataract formation.
Are Herpes Zoster infections contagious?
Shingles caused by herpes zoster is not contagious and should not be confused with herpes simplex virus (HSV) infections. At the time the herpes zoster or varicella zoster virus first infects the body causing chickenpox, the infection is contagious. The outbreak of shingles later in life is not a new infection, but rather a reactivation of the dormant virus. For this reason, shingles is not contagious.
How are Herpes Zoster eye infections treated?
Treatment of the symptoms of shingles through compresses and pain relievers is usually recommended by your optometrist. Lubricating eyedrops or antibiotic eye drops may aso be prescribed.
The use of antiviral medications may be recommended by an ophthalmologist. The medication most commonly prescribed is acyclovir. Occasionally, steroids may be prescribed to reduce inflammation.
By its very nature, herpes zoster infections are prone to return from time to time, especially when the immune system is weakened. Early diagnosis and treatment is important to minimize the symptoms and reduce the risk of complications that may compromise vision so contact us if you are concerned.
Iritis
What is iritis?
Iritis is the inflammation of the iris, the coloured portion of the eye. It can cause extreme pain, light sensitivity and sight loss, and is often the result of a disease in another part of the body. Most cases of iritis recur in small attacks. Once treated the attack will usually respond to various medications. However, the condition may become sight threatening when left untreated. Medication for iritis varies, treatment that works for one will not always work with another.
What is the iris?
The iris is a circular muscle near the front of the eye. Besides giving colour to the eye, the iris controls the amount of light that enters the eye through the pupil. The iris is located behind the cornea (the clear protective layer of the eye) and just in front of the focusing lens. To see clearly, the proper amount of light must enter the eye. Just as the shutter controls the amount of light that enters a camera, the iris regulates the amount of light that enters the eye. The iris contains two muscles that control the size of the pupil opening. When too much light is present, the muscles cause the pupil to become smaller to reduce excessive light and glare. In dim light or at night, the muscles make the pupil larger to increase the amount of light entering the eye.
Is it serious?
Since iritis is an inflammation inside the eye, the condition is potentially sight threatening. Proper diagnosis and prompt treatment of iritis are essential. To minimise any loss of vision, you should have a complete eye examination as soon as symptoms occur. If diagnosed in the early stages, iritis can usually be controlled with the use of eye drops before vision loss occurs. If you are experiencing the symptoms of iritis or have other vision problems, you should have a full eye examination.
What causes iritis?
In many cases, iritis is related to a disease or infection in another part of the body. Diseases such as arthritis, tuberculosis, or syphilis can contribute to the development of iritis. Infection of some parts of the body (tonsils, sinus, kidney, gallbladder and teeth) can also cause inflammation of the iris. In other cases, iritis may follow injury to the eye or accompany an ulcer or foreign body on the cornea. Often, the exact cause of the disorder remains unknown.
What are the symptoms of iritis?
The symptoms of iritis usually appear suddenly and develop rapidly over a few hours or days. Iritis commonly causes pain, tearing, light sensitivity and blurred vision. A red eye often occurs as a result of iritis. Some patients may experience floaters, small specks or dots moving in the field of vision. In addition, the pupil may become smaller in the eye affected by iritis.
How is iritis diagnosed?
A careful eye exam is extremely important when the symptoms of iritis occur, as inflammation inside the eye can affect sight and could lead to blindness. A slit lamp, which illuminates and magnifies the structures of the eye, is used to detect any signs of inflammation. A diagnosis is often made on the basis of an eye examination. Since iritis can be associated with another disease, an evaluation of your overall health is sometimes necessary for proper diagnosis and treatment. In some cases, blood tests, skin tests, and x-rays may be conducted and other specialists may be consulted to determine the cause of the inflammation.
How is iritis treated?
Treatment of iritis is often directed at finding and removing the cause of the inflammation. In addition, eye drops and ointments are used to relieve pain, quiet the inflammation, dilate the pupil, and reduce any scarring which may occur. Both steroids and antibiotics may be used. The application of hot packs may also provide relief from the symptoms of iritis. In severe cases, oral medications and injections may be necessary to treat the condition. A case of iritis usually lasts 6 to 8 weeks. During this time, you must be observed carefully to monitor potential side effects from medications and any complications which may occur. Cataracts, glaucoma, corneal changes, and secondary inflammation of the retina may occur as a result of iritis and the medications used to treat the disorder.
Keratoconus
Keratoconus is a vision disorder that occurs when the normally spherical cornea (the front part of the eye) becomes thin and irregularly (cone) shaped. This abnormal shape prevents the light entering the eye from being focused correctly on the retina and causes distortion of vision.
In its earliest stages, keratoconus causes slight blurring and distortion of vision and increased sensitivity to glare and light. These symptoms usually appear in the late teens or late twenties. Keratoconus may progress for 10-20 years and then slow in its progression. Each eye may be affected differently. As keratoconus progresses, the cornea bulges more and vision may become more distorted. In a small number of cases, the cornea will swell and cause a sudden and significant decrease in vision. The swelling occurs when the strain of the cornea's protruding cone-like shape causes a tiny crack to develop. The swelling may last for weeks or months as the crack heals and is gradually replaced by scar tissue. If this sudden swelling does occur, your optometrist can prescribe eye drops for temporary relief, but there are no medicines that can prevent the disorder from progressing.
Glasses or soft contact lenses may be used to correct the mild short-sightedness and astigmatism that is caused by the early stages for keratoconus. As the disorder progresses and cornea continues to thin and change shape, rigid gas permeable contact lenses can be prescribed to correct vision adequately. In most cases, this is adequate. The contact lenses must be carefully fitted by a specialist, and frequent check-ups and lens changes may be needed to achieve and maintain good vision.
In a few cases, a corneal transplant is necessary. However, even after a corneal transplant, glasses or contact lenses are often still needed to correct vision.
Long-sightedness (Farsightedness or Hyperopia)
What is Long-sightedness?
If you can see objects at a distance clearly but have trouble focusing well on objects close up, you may be long-sighted.
Your optometrist may refer to long-sightedness as farsightedness, or by its medical names, hypermetropia or hyperopia. Hypermetropia causes the eyes to exert extra effort to see close up. After viewing nearby objects for an extended period, you may experience blurred vision, headaches and eyestrain. Children who are long-sighted may find reading difficult.
Hypermetropia is not a disease, nor does it mean that you have "bad eyes." It simply means that you have a variation in the shape of your eyeball. The degree of variation will determine whether you will need corrective lenses.
What causes long-sightedness?
Hypermetropia most commonly occurs because the eyeball is too short; that is, shorter from front to back than is normal. In some cases, the cornea having too little curvature may cause hypermetropia. Exactly why eyeball shape varies is not known, but the tendency for long-sightedness is inherited. Other factors may be involved too, but to a lesser degree than heredity.
How does long-sightedness affect sight?
Our ability to "see" starts when light enters the eye through the cornea. The shape of the cornea, lens and eyeball help bend (refract) light rays in such a manner that light is focused into a point precisely on the retina.
If, as in long-sightedness, the eyeball is too short, the "point of light" focuses on a location behind the retina, instead of on the correct area of the retina, known as the fovea. Consequently, at the point on the retina where a fine point of light should be focused, there is instead a disk-shaped area of light. Since light is not focused when it hits the retina, vision is blurred.
Convex lenses are prescribed to bend light rays more sharply and bring them to focus on the retina.
Who is affected by long-sightedness?
Many people have a degree of long-sightedness, yet it is only a problem if it significantly affects our ability to see well or causes headaches or eyestrain.
How is it diagnosed?
Hypermetropia is seldom diagnosed in school eye-screening tests, which typically test only the ability to see objects at a distance. A comprehensive eye health examination that checks both near and far vision is necessary to diagnose long-sightedness. Contact us to book an appointment.
How is it treated?
Convex lenses as glasses or contact lenses are usually prescribed. They bend light more sharply and bring the light rays into focus on the retina. If you do not have other vision problems such as astigmatism, you may only need glasses for reading or other tasks done at a close range.
To determine the best avenue of treatment, your optometrist will ask a number of questions about your lifestyle, occupation, daily activities and general health status. For instance, you may be asked whether you frequently need good near vision. Providing candid, considered answers to the questions and working with your optometrist will help assure that your corrective lenses contribute to clear sight and general comfort.
How will hypermetropia affect your lifestyle?
If glasses or contact lenses are prescribed, it may take a few days to adjust to them. After that, long-sightedness probably will not significantly affect your lifestyle.
Campbell Eyecare recommends a comprehensive eye examination regularly to ensure that minor changes in vision are diagnosed and treated so that your vision will remain as clear and comfortable as possible Contact us to book an appointment.
Short-Sightedness or Myopia
What is Shortsightedness?
If you can see objects close up clearly but have trouble focusing well on objects further away, you may be short-sighted.
Your optometrist may refer to short-sightedness by its medical name myopia. Myopia means that the focussing system within the eye cannot clearly focus distant objects.
Myopia is not a disease, nor does it mean that you have "bad eyes." It simply means that you have a variation in the shape of your eyeball. The degree of variation will determine whether you will need corrective lenses.
What causes shortsightedness?
Myopia most commonly occurs because the eyeball is too long; that is, longer from front to back than is normal. In some cases, the cornea having too steep a curvature may cause myopia. Exactly why eyeball shape varies is not known, but the tendency for shortsightedness is inherited. Other factors may be involved too, but to a lesser degree than heredity.
How does shortsightedness affect sight?
Our ability to "see" starts when light enters the eye through the cornea. The shape of the cornea, lens and eyeball help bend (refract) light rays in such a manner that light is focused into a point precisely on the retina.
If, as in short-sightedness, the eyeball is too long, the "point of light" focuses on a location in front of the retina, instead of on the correct area of the retina, known as the fovea. Consequently, at the point on the retina where a fine point of light should be focused, there is instead a disk-shaped area of light. Since light is not focused when it hits the retina, vision is blurred.
Concave lenses are prescribed to bend light rays and bring them to focus on the retina.
Who is affected by shortsightedness?
Many people have a degree of shortsightedness, yet it is only a problem if it significantly affects our ability to see well or causes headaches or eyestrain.
How is it diagnosed?
Myopia may be diagnosed in school eye-screening tests or parents may notice their child sits closer to the television or the teacher moves them closer to the board in class. Contact us to book an appointment.
How is it treated?
Concave lenses as glasses or contact lenses are usually prescribed. They bend light and bring the light rays into focus on the retina.
To determine the best avenue of treatment, your optometrist will ask a number of questions about your lifestyle, occupation, daily activities and general health status. For instance, you may be asked whether you frequently need good distance vision. Providing candid, considered answers to the questions and working with your optometrist will help assure that your corrective lenses contribute to clear sight and general comfort.
How will myopia affect your lifestyle?
If glasses or contact lenses are prescribed, it may take a few days to adjust to them. After that, shortsightedness probably will not significantly affect your lifestyle.
Campbell Eyecare recommends a comprehensive eye examination regularly to ensure that minor changes in vision are diagnosed and treated so that your vision will remain as clear and comfortable as possible Contact us to book an appointment.
Vernal Keratoconjunctivitis
Vernal keratoconjunctivitis is a recurring inflammation of the conjunctiva, usually in both eyes, that may damage the surface of the cornea. Because the condition is typically caused by allergies, it tends to recur in the spring and summer. Vernal keratoconjunctivitis is most common in children; it usually begins before puberty and resolves before age 20.
Symptoms include intense itching; red, watery eyes; sensitivity to sunlight; and a thick, sticky discharge. In one form of the condition, the conjunctiva under the upper lids is most affected, becoming swollen and pale pink to greyish, while the rest of the conjunctiva becomes milky white. In another form, the conjunctiva covering the eyeball is thick and greyish. Sometimes a small area of the cornea is damaged, causing pain and extreme sensitivity to light. All symptoms usually disappear in cold weather and become milder over the years.
Antiallergy eye drops such as cromolyn, lodoxamide, ketorolac, and levocabastine are the safest treatments. Oral antihistamines may also help. Steroids may be given by a doctor and are more potent so must be used under close supervision of the hospital to avoid increased pressure in the eyes, cataracts, and opportunistic infections which may result from their use.