Turning to Rust?

How many times have we been told a specific tissue is composed of 99.8% water or this structure is 98.8% water? Okay, we're carrying lots of water around, but what about that other 1.2%? Our cells are loaded with proteins, chemicals and minerals. This applies to the eye as well.

Were you aware that the tears contain iron? We're not sure what role iron plays in the tear film, but we do know that nothing in nature happens by accident. Any clinical significance? Plenty!

The healthy ocular surface is smooth, uniform and evenly contoured. Anything that disrupts that healthy surface (bumps or divots) will cause the tears to become unevenly distributed along the ocular surface. Anybody driving on a rainy day with chewed-up wiper blades knows what I'm talking about. Small puddles of stagnant tears can collect and iron molecules in the tears can become deposited on the corneal surface. Elemental iron is attracted to epithelial cells and these are the exact cells that coat the outer cornea. The result is an iron deposition line.

Iron lines can be seen with the eye doctor's slit lamp biomicroscope. They have a brown or rust color. Here are some common iron lines seen on the cornea:

• Hudson-Stahli line: where lower lid (tear film strip) rests on the corneal surface


• Fleischer line: circular ring in folks with irregular astigmatism (keratoconus)


• Stocker's line: adjacent to encroaching pterygium


• Ferry's line: adjacent to the bump caused by a glaucoma filtering bleb


• Waring line: healed RK incisions

Don't freak if your doctor tells you that you have an iron line. None of these iron lines represent eye disease, merely a clinical finding caused by local iron deposition. No treatment is necessary.

Are there other minerals associated with the eye? Sure! There's copper, calcium, silver and many more! Visit us often to learn more.

Related Topics:

• WebMD Video: Contact Lenses Help Patients with Corneal Disease
• WebMD Video: Tips for Better Vision

Technorati Tags: vision, iron lines, cornea

Tell Me Again, What Are You Treating?

Traditional medicine works this way: patient has symptoms, physician performs exam and tests, diagnosis is established, and treatment is initiated. Simple enough, right?

More and more ophthalmologists are managing patients without symptoms, with normal or near-normal exams, and recommending treatments because they might have a problem.

This is the conundrum of Glaucoma Suspects, individuals who do not have active glaucoma but exhibit so many risk factors for the disease that doctors refuse to wait. Such impatience makes a great deal of sense because the damage that occurs once glaucoma begins is irreversible.

Chronic elevated pressure from untreated glaucoma permanently destroys the delicate nerve fibers that transmit the visual signal from the eye to the brain. The eye cannot regenerate these nerve fibers or make new fibers - they are gone forever! Patients are unaware that their intraocular pressure is abnormally high and visual symptoms typically do not emerge until very late in the disease.

Rather that wait for the patient to present with advanced glaucoma, eye specialists have decided to treat individuals with changes suggestive for glaucoma -- even if the vision is 20/20 and visual field testing is normal. Some of these warning signals include:

• Family history of glaucoma
• Borderline intraocular pressures (ocular hypertension)
• Small hemorrhages near the optic nerve
• Abnormal clinical appearance to the optic nerve itself
• Unusually thin central corneas

Remember, good doctors treat patients, not numbers. Given that the damage caused by glaucoma is irreversible it makes sense to treat the condition before any damage occurs.

Related Topics:

• WebMD Video: Are You at Risk for Glaucoma?
• WebMD Video: Detecting Early Glaucoma

Technorati Tags: glaucoma, vision, intraocular pressure

New WebMD: An Overhaul, not a tweak!

All too often people try to promote some product or service as 'Totally New!' or 'Better than the Original!' Such efforts are intended to preserve current customers while seducing new prospects.

This kind of silliness happens all the time on the Internet. Alter a color scheme, swap-out a few fonts, and before you know it the old pig is wearing fresh lipstick!

If you visit this blog via a browser bookmark you likely have missed the remarkable transformation that just occurred at WebMD.

WebMD is already the Internet's busiest and most trusted health portal. This amazing upgrade will take health information access to the next level because it focuses on you, the health consumer, not diseases. Unique, reliable tools like the WebMD Symptom Checker covers over 900 different ailments. View online videos featuring world-renowned medical experts in all of our WebMD Health Guides. No aches or pains? Great! Click over to our WebMD Wellness Centers for the latest tips on exercise, nutrition and preventive medicine. It's all good!

It's fresh, authoritative, and easy to navigate. Skip the lipstick and click here to experience the next generation of dependable information for better living!

Related Topic: Healthy Changes With You in Mind

Videogames May Enhance Eyesight

Hey, it took over 30 years to identify some potential health benefits from playing videogames!

Thirty years ago (yes 1977) I was a first-year medical student and I already owned an obsolete PONG game system (manufactured by Atari!) No purported health benefits back then, simply a cool way to kill time.

Well, things have changed. Brain researchers from the University of Rochester claim that habitual videogame use may enhance the brain's visual processing capabilities by training the eyes to ignore noncontributory, distracting images.

Videogames appear sporadically in the health news. Some hand specialists worry that some gamers put themselves at risk for repetitive stress injuries - same for Blackberry addicts. Remember the false alarm about videogames and seizures? Only a rare few were susceptible and it appears that the monitors were likely more responsible, not the game content.

These researchers warn that any "improvement" is marginal, hard to appreciate in someone already seeing 20/20. Besides, 30 hours or more of playtime is needed to generate any measurable changes. They hypothesize that the real payoff may come in youngsters with lazy eye (amblyopia) by reawakening portions of the brain involuntarily inactivated so as to prevent a young child from having double vision. Imagine the bribes, "Timmy, you can play XBox all day so long as you keep your good eye patched!"

Hmmm. Maybe they are on to something!


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• Violent Video Games May Rev Teen Brain
• Video Game Technology and Targeting Cancer Tumors

Technorati Tags: xbox, wii, playstation, eyesight

Monovision: Some People Just Want Everything...So Why Not?

Yep, we're back talking about refractive surgery.

The number of USA refractive surgery cases being performed is staggering. The pendulum has definitely swung back. Nowadays so many people are seeking refractive surgery that a decade-long effort to restrict the number of ophthalmologists-in-training has been abandoned. Most training programs are increasing the number of new ophthalmology residents and the number of young doctors seeking such training has also blossomed.

Enough health policy; back to our discussion topic - refractive surgery. If you had to decide, would you choose clear distance vision or sharp reading vision? When refractive surgery was in its infancy patients weren't given such a choice (they were the lucky ones!) The early procedures like RK and PRK accurately corrected distance refractive errors like nearsightedness and farsightedness.

Since most patients were young adults their robust powers of accommodation automatically gave them whatever near focusing power they needed. When these happy campers turned 40 they drove to the drug store (without wearing glasses!) to buy some cheap readers. Presbyopia had caught up with them.

Today, adults over 40 considering refractive surgery want more options. Is is possible to correct for distance in one eye, for near in the fellow eye? Can you really have it all?

One solution is called Monovision: near vision correction in one eye, distance correction in the opposite eye. Monovision was introduced long ago by contact lens practitioners, prescribing two different contact lenses with two different corrections. Applied to refractive surgery, the patient is treated so that one eye sees clearly at distance, the other eye reads without correction. No glasses whatsoever. When it works it is absolutely magical. Patients are ecstatic!

When it works.

Not everyone tolerates monovision. For some it confuses the brain, induces problems with depth perception, makes others dizzy.

If you are contemplating monovision refractive surgery ask the ophthalmologist to perform this simple experiment before you consent to undergo surgery. Have yourself fitted with a trial pair of contact lenses that will optically simulate the results of monovision refractive surgery. While wearing these contact lenses attempt a variety of visual tasks: drive a car, read the newspaper, operate a computer, descend stairs, go shopping, etc. It won't take long for you to decide if monovision agrees with you.

Unsure about monovision? Take the time to fully discuss with your eye surgeon all of the proposed benefits and potential complications. No single procedure is right for every patient. The more questions you ask the more options become available to you.

Related Topics:

• WebMD Video: Age-Related Vision Loss
• WebMD Video: Tips for Better Vision

LASIK versus LASEK

Every year millions of Americans undergo laser refractive surgery. The two most commonly performed procedures are LASIK and LASEK. These are acronyms for some outrageously complicated medical terms. Just to satisfy your curiosity, the 'K' stands for keratomileusis!

LASIK requires a surgical incision to create a flap of clear cornea underneath which the laser energy is applied. That flap never really heals -- it can always be dislodged or lost...yikes!

LASEK only lifts the superficial corneal epithelium and heals permanently within days.

Technical differences, but are the outcomes similar?

Surgeons from the University of Illinois at Chicago reviewed 122 pairs of patients. They were matched by age, refractive error and many other criteria. These folks all had less than 8 diopters of myopia.

After all of the patients recovered from their surgery it was determined that both techniques were safe and effective. Six months later the postoperative uncorrected visual acuity was similar in both groups as was the rare incidence of complications.

Given that these operations are felt to be equivalent, the authors of the study acknowledge that LASEK offers the additional advantage of no flap-related complications as occurs with LASIK.

Thinking about laser refractive surgery? Ask your eye surgeon with which procedure she feels more comfortable and more experienced. Because this is elective surgery you do not want to be someone else's guinea pig, right?

SOURCE: American Journal of Ophthalmology, Dec 2006

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• WebMD Video: LASEK for Eyes
• Action Video Games May Boost Vision

Technorati Tags: LASEK, LASIK, eye surgery

Delaying Tactic Boosts Eyedrop Power

A recent visitor to our WebMD Eye Disorders Message Board asked about tasting her daily eyedrops. YECCHH!

Many of you experience the same situation. Now, think about this. If you can taste the medicine then those eyedrops drops must be in your mouth and no longer on the surface of your eye, right? It just takes three blinks for all of the medicine to be washed away... wasted!

Attention prospective pharmacologists. Eyedrops in the mouth have no beneficial effect on the eye. They are gone and unavailable to do the job for which they were prescribed: kill bacteria, lower intraocular pressure, quiet inflammation, etc.

Some eyedrops are prescribed for once-a-day use. That means 24 hours of effective drug activity hinge on that one eyedrop. If you can taste it then the eye has not absorbed it!

Here's how to maximize the effect of your eyedrops. As soon as the eyedrop is instilled (dropped!) close the eye and gently press the tip of your index finger against the inner corner of the eye. This will block normal tear drainage and keep the medicine available longer. Try to do this for two full minutes. Even if you taste the drug afterwards you will know that you gave the eye sufficient time to absorb an adequate dose of medication.

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• Dry Eye Syndrome
• Pinkeye

Technorati Tags: eyedrops, how-to