Frequently Asked Questions

My eyes tear a lot. What does that mean?

There can be several reasons for this to happen. Believe it, or not, one of the most common reasons is dry eyes. The eye produces two kinds of tears. The basal tear is composed of three parts: Water, Mucin and Oils. The eye constantly produces a small amount of this mixture to keep the corneal surface moist. As we age the production of the basal tear slows. If any of the components of the basal tear are decreased or missing, the tear film becomes inadequate and the surface of the eye becomes dry and irritated.

The reflex tear, or the “boo-hoo” tear, is an abundant wash of tear from the lacrimal gland if the eye perceives any irritation or as a reaction to strong emotions.

So if the eye is dry or irritated the “boo-hoo” tears let down and you get a watery eye.

To treat dry eyes we first recommend using lubricating eye drops. Any drop in a bottle can be used up to four times a day, if drops are needed more frequently than that, non-preserved drops can be used up to once an hour. Sometimes something thicker than a liquid is needed and a tear gel or ointment can be helpful. (Never use any drops that say “get the red out” on the bottle to treat dry eyes. They contain a medication that will make eyes even dryer.) Studies have shown that adding Flax Seed oil and Fish oil to your diet can also help decrease the occurrence of dry eyes. If you are using artificial tears and supplements without relief there are medications and procedures that can be considered. We recommend seeing an Ophthalmologist to discuss those options.

Another reason for excess tearing could be inadequate drainage of the tears from the surface of the eye. On the upper and lower inside corner of the lids are small holes called puncta. The job of the puncta is to take excess tears and drain them away from the eye and into the lacrimal system. The lacrimal system is composed of small tubes that empty into a sac. That sac empties the tears through a duct behind the nose and throat. If any of the tubes, sacs or holes are obstructed then there may be an overflow of tears.

The only way to correct a problem with the lacrimal system is with surgery. If the puncta are small or if there is a minor obstruction in the lacrimal tubes an office procedure can be performed to correct the tearing. If the problem is located further along the system in the areas behind the nose a more extensive surgery needs to be performed by an Oculo-Plastic surgeon.

My eyelids frequently get red and sore. Sometimes I even get bumps along my lid margin. What can I do?

Blepharitis or sometimes called “Granulated Eyelids” is the most common cause of your symptoms. Blepharitis occurs when the oil glands that line the eye lids become plugged with oils and bacteria and get inflamed. If the oils back up into the tissue of the lid, the body will send white blood cells to clean up the oils and that becomes like a boil, or stye. A lot of people have mild forms of this condition but are asymptomatic. When it starts to bother the patient it needs to be treated with at least conservative measures. The most conservative being lid hygiene. We recommend a hot compress and lid massage daily using a mild cleanser on the lids to remove any crusting, old oil and bacteria. Sometimes medications are needed to calm down the inflammation and fight any overgrowth of bacteria. If the styes do not resolve on their own there is a surgical procedure that not can be performed to remove them. For our information sheet on Blepharitis and instructions on how to do lid hygiene follow this link.

I have seasonal allergies and sometimes my eyes get very red, itchy and water. My allergy pills don't seem to help. What can I do?

Allergy pills do not always reach the tissues that cause allergy symptoms in the eye. Allergy eye drops are needed to treat the conjunctiva (clear covering over the white of the eye) which is what is affected by allergens. Sometimes using an artificial tear to rinse the allergens out of the eye are enough to relieve symptoms. There are also several over the counter eye drops specific for allergies that work very well. If the over the counter drops do not help, there are prescription allergy drops. Sometimes even that is not enough and mild steroid eye drops can be used to relieve your symptoms. (Any use of steroids in the eye should be closely followed by an Ophthalmologist because there may be side effects.)

My mother has been diagnosed with Macular Degeneration. Is there any treatment available and do I need to be concerned about my eye health?

Age Related Macular degeneration (or ARMD) is a deterioration of the macula. The macula is the part of the retina responsible for our straight ahead, fine detailed vision. When the macula does not function properly, your central vision will be blurry, missing or distorted. ARMD only affects the central vision and leaves peripheral vision intact.

There are two types of Age Related Macular Degeneration: Dry (or atrophic) and Wet (or exudative). Dry ARMD is the most common form seen and is treated with eye specific vitamins based on the AREDS study. Patients with Dry ARMD notice a slow decrease in vision over time. Patients with Wet ARMD notice a sudden decrease and or distortion of central vision. Wet ARMD can be devastating to vision but if caught early enough can sometimes be treated with lasers and with injections in the eye.

Macular degeneration does tend to run in families. There is no current data that suggests treatment prior to having ARMD will lessen chances of one day developing it. However there are several things you can do to increase your eye health in hopes of staving off future eye disease. Eat a well balanced diet high in fruits and vegetables and/or take a vitamin supplement, avoid “fast foods” high in fat, do not smoke and wear sunglasses that protect you 100% from UV light.

Questions for the Doctor

If both eyes are diseased, will they be treated simultaneously?

Will the eyes need to rest after surgery? Will protective lenses be required following the procedure?

Will eyeglasses be needed eyeglasses?

How many times has the surgeon performed this specific procedure?

Should the physician be contacted if pain develops after the surgery?

When can normal activities be resumed? What about driving?

The surgeon, operating room staff, and an anesthesiologist are present for ophthalmologic surgery. For many eye surgeries, only a local anesthetic is used, and the patient is awake but relaxed. The patient's eye area is scrubbed prior to surgery, and sterile drapes are placed over the shoulders and head. Heart rate and blood pressure are monitored throughout the procedure. The patient is required to lie still and for some surgery, especially refractive surgery, he or she is asked to focus on the light of the operating microscope. A speculum is placed in the eye to hold it open throughout surgery.

Common ophthalmologic surgery tools include scalpels, blades, forceps, speculums, and scissors. Many ophthalmologic surgeries now use lasers, which decrease the operating time as well as recovery time.

Surgeries requiring suturing can take as long as two to three hours. These intricate surgeries sometimes require the skill of a corneal or vitreo-retinal specialist, and require the patient to be put under general anesthesia.