Eye Diseases

Need an intro paragraph – see EYE CONDITIONS for an example. Below we’ve outlined detailed descriptions about common eye diseases, learn more and please contact us with any questions or concerns.

Common Eye Diseases

Bacterial conjunctivitis is commonly known as “pink eye” because it typically causes reddish swelling of the eyelid and a yellowish discharge from the eye. Sometimes the condition causes itching of the eyelids. Pink eye is caused when eyes become irritated by bacterial or viral infections, allergies, or foreign elements such as dust, chemicals, pollen, or even contact lenses. Bacterial conjunctivitis is very contagious and can be easily transmitted by rubbing the eye and then infecting household items such as towels or handkerchiefs. Therefore it is common for entire families to become infected.

Symptoms of Conjunctivitis

  • Red, watery eyes
  • Inflamed eye lids
  • Blurred vision and a sandy or scratchy feeling in the eyes
  • Pus-like or watery discharge around the eyelids
  • Matting of the eyelids


Antibiotic drops can clear up the infection, normally within a few days. Sometimes, the inflammation does not respond well to the initial treatment with eye drops. In those rare cases, a second visit to the office should be made. When there is severe infection, oral antibiotics are necessary. If left untreated, conjunctivitis can create serious complications such as infections in the cornea, eyelids and tear ducts. It is important to get treated promptly for eye infections, especially if you wear contact lenses.

The cornea is the clear surface of the eye, and a scratch in the outer layer of the cornea is called a corneal abrasion. Small abrasions usually heal quickly, sometimes within hours, while deeper or bigger scratches can take up to a week to fully heal. Because the cornea has a large number of nerve endings, any scrapes to the cornea are extremely painful.
When the surface layer of the cornea, called the epithelium, is torn or broken and the underlying tissue, the stroma, is damaged, a corneal ulcer can result. The ulcer is usually caused by microorganisms, which gain access to the stroma through the break in the epithelium.

Corneal ulcers generally heal quickly if they are treated early and aggressively. However, if they are neglected, corneal clouding and even perforation (a hole in the cornea) may develop, resulting in serious loss of vision and possibly loss of the eye. Therefore, a corneal ulcer is a serious vision-threatening condition that requires prompt medical attention.

Flashes and floaters are a condition in which a patient perceives small, floating spots and bright flashes of light in the field of vision. While they can be alarming, an eye examination by trained eye doctor usually will confirm that they are harmless and do not require any treatment.

Causes of Flashes and Floaters

Flashes and floaters are most often caused by age-related changes in the gel-like material, called vitreous, that fills the back of the eye. At birth, the vitreous is firmly attached to the retina. In very young children, the vitreous is thick, like firm gelatin. The vitreous holds clumps of gel or tiny strands of tissue debris left over from the eye’s early development. These clumps or strands are firmly embedded in the thick, young vitreous and cannot move around much.

As a person gets older, the vitreous gradually thins and becomes more watery. By the time the person is in his or her twenties or thirties, the vitreous may be watery enough to allow some of the clumps and strands to move around inside the eye. This material floating inside the eye can cast shadows on the retina, which appear in the vision as small floating spots.

Sometime after about age 55, many people experience the onset of larger, more bothersome floaters or flashes of light. By this age, the vitreous gel has usually become much more watery and it jiggles around, making flashes and floaters much more common and visible. If you experience flashes that seem to appear all of a sudden, or greatly increase in number, it may mean that there is a problem and an eye doctor should be consulted. To learn more about flashes and floaters, contact one of our doctors.

For many people, it is confusing to learn that the eye condition commonly called “dry eye” results in red eyes and/or excessive watering. The apparent contradiction makes more sense, though, when they learn that the eye makes two different types of tears. Lubricating tears, which are produced constantly by the eyes, are made up of mucous, water, oil, nutrient proteins, and antibodies designed to replenish and guard the front surface of the eyes. Reflex tears, on the other hand, are produced by the body in order to flood the eye when it becomes irritated or injured. Reflex tears are common when dust, smoke or some other substance come into contact with the eye and cause irritation or when the surface of the eye is accidentally scratched. The tears arrive in such large amounts that the eye is flushed of the irritant. These tears can arrive in such a large number that they spill out of the eye and roll down the cheeks of the face, since the eye’s own drainage system is not equipped to handle so many tears.

Dry Eye Causes

Dry eye can be caused by a variety of factors, including:

  • Age: As we get older, the glands in the eyelid produce less oil that keeps tears from evaporating from the eye. Decreased oil production allows tears to evaporate too quickly, leaving the eye too dry.
  • Diseases including diabetes, Sjogren’s and Parkinson’s.
  • Hormonal changes in women, especially after menopause.
  • Prescription medications: Some high blood pressure medications, antihistamines, diuretics, antidepressants, anti-anxiety pills, sleeping pills and pain medications. Over-the-counter medications, including some cold and allergy products, motion sickness remedies, and sleep aids, can also cause dry eye.
  • Hot dry or windy conditions: High altitude, air conditioning, and smoke can also cause dry eye.
  • Reading
  • Using a computer
  • Watching TV
  • Contact lenses
  • Eye surgery: Some types of eye surgery, including LASIK, can aggravate dry eye.
  • Inflammation: Recent research suggests that dry eye may be caused by inflammation due to an imbalance of “good” fats and “bad” fats.

Dry Eye Treatment Options

Dry eyes are most commonly treated with the use of artificial teardrops that help make up for the lack of natural lubricating tears and often provide immediate relief from irritation and red eyes. Artificial tears can generally be used as often as needed, from a few times per day to every few minutes. They come in liquid form and longer lasting gel forms, and in a long-lasting ointment, which is most often recommended for nighttime use. Many different brands of artificial tears are available over the counter. When artificial tears are not enough there are other options to consider such as:

  1. There are now FDA approved medications that have been proven to actually stimulate tear production, rather than just tear replacements.
  2. Punctal Plugs are another option to prevent more drainage of the natural tears than necessary.

At 20/20 EyeCare, we can manage your dry eye with our knowledge and expertise in this high climate. Ask us when making the appointment if we can bill your medical insurance for your dry eye evaluation.

Over fifty percent of people 60 years and older suffer from cataracts. Almost everyone develops cataracts as they grow older. Cataract formations occur at different rates and can affect one or both eyes. A cataract is a progressive clouding of the eye’s natural lens. It interferes with light passing through the eye to the retina. Aging and other factors cause proteins in the eye’s lens to clump together forming these cloudy areas. Early changes may not disturb vision, but over time cataracts typically result in blurred or fuzzy vision and sensitivity to light. People with progressed cataracts often say they feel as if they’re looking through a waterfall or a piece of wax paper. Causes include natural aging, eye trauma, heredity, diabetes, smoking, glaucoma and the use of some medications.

Symptoms of Cataracts

  • Decreasing vision with age
  • Blurred or double vision
  • Seeing halos around bright lights
  • Difficulty seeing at night
  • Vision that worsens in sunlight
  • Difficulty distinguishing colors
  • Poor depth perception
  • Difficulty reading


There is no medical treatment to reverse or prevent the development of cataracts. Once they form, the only one way to regain clear vision is through cataract surgery. Delayed onset can be attempted with UV protective sunglasses and a high-nutrient rich diet.

It is estimated that over two million Americans have glaucoma and half of them do not know it. Ninety percent of glaucoma patients have open-angle glaucoma. It can’t be cured, but it can be managed. Vision loss may be minimized with early treatment. The eye receives its nourishment from a clear fluid that circulates inside the eye. This fluid must be constantly returned to the blood stream through the eye’s drainage canal. With glaucoma, problems develop in the drainage canal and the fluid cannot drain fast enough, so pressure inside the eye begins to build. This excess pressure pushes against the delicate optic nerve that connects the eye to the brain, and can cause irreversible vision loss.

Symptoms of open-angle glaucoma

  • Mild aching in the eyes
  • Gradual loss of peripheral vision (the top, sides and bottom areas of vision)
  • Seeing halos around lights
  • Reduced visual acuity (especially at night, that is not correctable with glasses)


Doctors typically use medicines, laser surgery or filtration surgery. The goal of treatment is to lower the pressure in the eye and the best type of treatment will be determined by your doctor.

Types of Glaucoma

Open-angle glaucoma, the most common form of the disease, affects approximately three million Americans. The form of glaucoma occurs when fluid drains too slowly from the angle between the iris and the cornea. The built up fluid elevates pressure within the eye, which, if left untreated, can damage the optic nerve damage and lead to blindness. The same fluid buildup can also occur if the eye produces excess fluid. Open-angle glaucoma generally starts in one eye, but it often advances into the other eye. Glaucoma treatment usually begins with the use of oral and/ or topical medication. If the person does not respond to the medication, corrective eye surgery may be an option. Open-angle glaucoma can be primary (occurring for no known reason) or secondary (occurring due to previous illness or injury).

Normal-tension glaucoma, also called low-tension glaucoma or normotensive glaucoma, accounts for about 25 to 30 percent of all glaucoma cases in the United States. Unlike other forms of glaucoma, this disease is not associated with elevated intraocular pressure. Patients with this type of glaucoma have normal pressure inside their eye, but have some optic nerve damage.

Macular degeneration is a disease of the macula, an area of the retina at the back of the eye that is responsible for fine detail vision. Vision loss usually occurs gradually and typically affects both eyes at different rates. Even with a loss of central vision, color vision and peripheral vision may remain clear. The root cause is unknown but may include sun exposure, smoking, heredity, diabetes, high blood pressure and other medical conditions.

Symptoms of macular degeneration

  • Difficulty reading without extra light and magnification
  • Seeing objects as distorted or blurred, or abnormal in shape, size or color
  • The perception that objects “jump” when you try to look right at them
  • Difficulty seeing to read or drive
  • Inability to see details
  • Blind spot in center of vision


Most cases are not treatable, but low vision aids may help make it easier to live with the decreased vision of macular degeneration. Dr. Zwelling did her residency training in Low Vision. Please call 20/20 Eyecare for more information on vision rehabilitation.

Types of Macular Degeneration

About 9 out of 10 people with age-related macular degeneration suffer from dry macular degeneration, an early and less severe stage of this disease. Though the cause of dry macular degeneration is not clear, it is believed that a part of the retina becomes diseased, which leads to the destruction of the light-sensing cells in the macula. Aging and thinning of macular tissues can also lead to dry macular degeneration.

Approximately 10 percent of people are affected with an advanced type of age-related macular degeneration known as wet macular degeneration. More advanced and damaging than dry macular degeneration, wet macular degeneration leads to the formation of new blood vessels within the eye that leak fluid and blood under the macula. This fluid leakage damages the macula and leads to vision loss in a short amount of time.

Treating Macular Degeneration

The dry form of macular degeneration, which affects the vast majority of patients who are diagnosed with the eye disease, is still largely untreatable, although incorporating antioxidant and nutritional supplements into your diet has been shown to slow its spread.

When the condition is detected early, wet macular degeneration is most commonly treated with laser eye surgery or photodynamic therapy. While these treatments can effectively stop further formation of blood vessels, they have not been proven effective at reversing damage that has already occurred.

Diabetes is a disease that affects blood vessels throughout the body, particularly vessels in the kidneys and eyes. When the blood vessels in the eyes are affected, this is called diabetic retinopathy. The retina is in the back of the eye. It detects visual images and transmits them to the brain. Major blood vessels lie on the front portion of the retina. When these blood vessels are damaged due to diabetes, they may leak fluid or blood and grow scar tissue. This leakage affects the ability of the retina to detect and transmit images and can cause loss of vision. Causes are having diabetes for several years.

Symptoms of Diabetic Retinopathy

  • Floaters Difficulty reading or doing close work
  • Double vision
  • If left untreated, severe vision loss can occur


For advanced cases, laser surgery can make the retina stop manufacturing new blood vessels, and those that are already present tend to decrease or disappear. If diabetic retinopathy has caused cataracts, they can be corrected with cataract surgery.

The cornea is the clear front window of the eye. It transmits light to the interior of the eye allowing us to see clearly. Corneal disease is a serious condition that can cause clouding, distortion and eventually blindness. The three major types of corneal disease are keratoconus, Fuchs’ endothelial dystrophy and bullous keratopathy. Causes include infection, aging, heredity, contact lenses, eye trauma and eye diseases as well as other medical conditions.

Symptoms of Corneal Disease

  • Vision becomes increasingly blurred and contact lens wear, becomes difficult.
  • The contact lens may not stay on the eye due to the irregular shape of the cornea.
  • Glare with lights at night or in bright sunlight.
  • Pain in the eyes.


Corneal disease should be treated immediately. Although corneal transplant is almost always the necessary treatment to restore vision when the cornea becomes clouded, there are other measures that can be taken to prolong vision in the early stages of disease.