Dermatochalasis

Dermatochalasis is a condition where the upper eyelid tissue begins to droop.

The most common cause of dermatochalasis is aging, and it is common among men and women ages 40 and older.  As people age, the eyelids naturally lose elasticity, causing an excessive eyelid tissue droopiness.  Stress and trauma can accelerate this process.

Dermatochalasis is typically treated surgically with a procedure called blepharoplasty.  During this procedure, the excessive, droopy tissue is removed resulting in a more natural eyelid appearance.  For some patients, this procedure can improve peripheral vision as the eyelids are no longer drooping in to view.

If you, or a loved one, are bothered by droopy eyelids, schedule an appointment now.

Dr. Bradley J. Wicklund - Optometrist

20/20 Visions, LLC

100 Carr Road

Plymouth, WI 53073

(920) 893-3937

bwicklund@20-20visions.com

www.20-20visions.com

Strabismus

Strabismus is a condition in which the eyes are not properly aligned with each other.  It typically involves a lack of coordination between the ocular muscles, preventing the gaze of each eye to match up.  This can affect binocular vision and depth perception.  Strabismus is often referred to as a "lazy eye", but other names include "crossed eye", "cock eye", or "wall-eyed".

Etiology

Strabismus can be caused when the cranial nerves 3, 4 or 6 are not working properly.  A brain lesion affecting these nerves results in lack of eye muscle control causing an abnormal eye turn.  Strabismus may be a sign of increased intracranial pressure, and cranial nerve 6 is particularly susceptible to damage from excessive intracranial pressure or trauma.

Diagnosis

Strabismus can be diagnosed by an optometrist or ophthalmologist during an eye examination with a cover test.  A person has an eye turn if their eyes cannot maintain fixation while covering one eye and then the other.  Depending on how the eyes move during the cover test, a diagnosis of exotropia (eyes deviate away from the midline), esotropia (eyes deviate toward the midline) or hypertropia (eyes deviate above or below midline) can be determined.

Onset

Strabismus can start at any time in life.  Many infants are born with their eyes misaligned.  Trauma, such as a car accident, can initiate strabismus.  There are also many pathological diseases that can also cause strabismus, including diabetes mellitus or a stroke.

Treatment

Mild varieties of strabismus can often be treated with vision therapy or an eye patch, but more advanced cases of strabismus often require surgical intervention to realign the eyes.  Glasses with prism can also help with double vision related to strabismus.  Early treatment of strabismus can reduce the chance of reduced vision in the misaligned eye (amblyopia).  Most children can recover from amblyopia if the condition is diagnosed and treated prior the age of 10.

If you think you or a family member has strabismus, schedule an eye exam with a local provider when possible.

Dr. Bradley J. Wicklund - Optometrist

20/20 Visions, LLC

100 Carr Road

Plymouth, WI 53073

(920) 893-3937

bwicklund@20-20visions.com

www.20-20visions.com

Pinguecula

A pinguecula is a common, non-cancerous growth of the clear tissue (conjunctiva) that covers the white part of the eye (sclera).

The cause of a pinguecula is technically unknown, but long-term sunlight exposure and eye irritation contribute to its' development.  Welding is a major job-related risk.

A pinguecula is a small, yellowish plaque/nodule on the conjunctiva near the cornea.  They can appear on either side of the cornea, but they tend to appear more on the nose side (nasal), and they tend to increase slowly over many years.

An eye examination is often enough to diagnose this disorder, and no treatment is usually needed.  Artificial tears and occassionally temporary use of steroid eye drops can be helpful.  Pinguecula may need to be removed if they become large enough to cause ocular discomfort.

It is unknown whether pinguecula can be prevented, but wearing good quality sunglasses when outside and avoiding eye irritants does minimize their development.

Dr. Bradley J. Wicklund - Optometrist

20/20 Visions, LLC

100 Carr Road

Plymouth, WI 53073

(920) 893-3937

bwicklund@20-20visions.com

www.20-20visions.com

Blepharitis

Blepharitis is inflammation of the eyelash follicles along the edge of the eyelid.  An overgrowth of the bacteria normally found on the skin is usually to blame.  Allergies and lice may also cause blepharitis, but these causes are less common.

People who have blepharitis often have too much oil being produced by glands along the base of the eyelashes.  This excessive oil production attracts too much bacterial growth along the lid margin.  Blepharitis may be linked to recurrent styes, eye infections, and eye dryness issues.  A person is more likely to develop blepharitis if they already have a skin condition called seborrheic dermatitis affecting the face or scalp.

Symptoms associated with blepharitis include:

• Eye or eyelid redness
• Crustiness along the lid margin
• Swollen eyelids
• Itchiness of the eyes or eyelids
• Gritty sensation when blinking

An examination of the eyelids during an eye examination is usually enough to diagnose blepharitis.

Proper treatment of blepharitis includes careful, daily cleaning of the eyelid margins to remove the extra oils that cause the bacterial overgrowth.  Your eye care provider might recommend using baby shampoo or special cleansers.  Antibiotic ointment may also be helpful.  Continued attention to lid cleanliness may be required to prevent repeated problems, and with time the eyelids will become less red and more comfortable.

Dr. Bradley J. Wicklund - Optometrist

20/20 Visions, LLC

100 Carr Road

Plymouth, WI 53073

(920) 893-3937

bwicklund@20-20visions.com

www.20-20visions.com

Corneal Ulcer

A corneal ulcer (aka ulcerative keratitis) is an inflammatory or infectious condition of the cornea involving disruption if the outer and middle layer.   Corneal ulcers are common condition in humans, particularly with people living in tropical climates.  Children with vitamin A deficiency are also at high risk of corneal ulcers and may suffer permanent visual damage.

Corneal ulcers are often caused by trauma, chemical injury, contact lens wear, and infection.  Advanced eye dryness (keratoconjunctivitis sicca) is also another possible cause.  Many micro-organisms cause infective corneal ulcers; among them are bacteria, fungi, viruses, protozoa, and chlamydia.  

Corneal ulcers are extremely painful due to nerve exposure, and can cause tearing, squinting, and blurry vision.  Eye redness and light sensitivity is also common.

A corneal ulcer is typically diagnosed by an eye care provider, and proper treatment depends on the cause.  Bacterial  ulcers require potent antibiotic therapy while fungal ulcer require intensive anti-fungal treatment.  Viral ulcers, often caused by a herpes virus, respond well to antiviral medication.  Superficial ulcers will often heal in less than a week, but deep ulcers may require more invasive treatment including surgery.  Proper nutrition including vitamin C and protein is usually advised.

If you have signs and/or symptoms of a corneal ulcer, contact your eye care provider immediately. 

Dr. Bradley J. Wicklund - Optometrist

20/20 Visions, LLC

100 Carr Road

Plymouth, WI 53073

(920) 893-3937

www.20-20visions.com

bwicklund@20-20visions.com

Subconjunctival Hemorrhage

A subconjunctival hemorrhage is a bright red patch appearing on the white of the eye.  This condition occurs when a small blood vessel breaks open and bleeds just under the surface tissue (conjunctiva) of the eye.  A sudden increase in blood pressure is often the cause of a subconjunctival hemorrhage.  Events such as violent sneezing or coughing, vomiting, or heavy lifting can often be blamed.  People with hypertension or who take blood thinners are more prone to getting subconjunctival hemorrhages.

Subconjunctival hemorrhages do not cause pain, and there is no discharge from the eye.  Vision is unaffected.  It is often a good idea to have your eye care provider take a look at any eye redness to verify the true cause.  I would suggest checking your blood pressure if you are prone to subconjunctival hemorrhages.

No treatment is often required for a subconjunctival hemorrhage unless an underlying cause is uncovered, such as hypertension or other cardiovascular issues.  Alternating warm and cool compresses can often speed resolution of the eye redness, but a subconjunctival hemorrhage will usually go away on its’ own in about a week

Dr. Bradley J. Wicklund - Optometrist

20/20 Visions

Plymouth, WI 53073

(920) 893-3937

www.20-20visions.com

bwicklund@20-20visions.com

Giant Papillary Conjunctivitis

Giant Papillary Conjunctivitis – by Dr. Brad Wicklund

While it sounds like quite a mouthful, giant papillary conjunctivitis (GPC) is a common eye condition.  GPC is actually a chronic allergy to contact lens wear.  Patients with GPC have typically worn contact lenses for years, and it eventually makes their contact lenses feel uncomfortable.  Slight discharge from the affected eye is also common.  Sleeping in contact lenses can significantly increase the risk of GPC.

A person with asthma, hay fever or environmental allergies are at a greater risk of developing GPC.  This condition is believed to be caused by an allergic reaction to protein deposits building up on the contact lenses.  The GPC name comes from the large 2mm bumps under the upper eyelid called “giant papillae”.

The key to treatment is decreased contact lens wear time, frequent replacement of contact lenses, and diligent cleaning of the lenses each day.  Daily disposable lenses are best for people with GPC because the contact lenses are disposed of before the protein buildup occurs.  Treatment may also include medicated eye drops prescribed by your eye doctor.  Refractive surgery, such as LASIK, is a good alternative to contact lens wear, and it can help get GPC to go away.

If you have having trouble with your contact lenses, please contact our office so we can help.  We are always accepting new patients, and most insurance plans are accepted.  We can be reached at (920) 893-3937.

Visit our website at www.20-20visions.com for more information.