When you get an ache or a twinge or even a tickle, don’t you really just want the answer to, “Should I be worried?” I operate on the principle that 99% of the time, worrying is a waste of your time. It accomplishes nothing and causes stress that will likely manifest itself in some physical symptom that will make you worry more. However, 1% of the time, you need to worry yourself right to the Emergency Room. The trick is knowing when to take a simple deep breath and when to call 911. There are several eye conditions that require emergent or at least, urgent attention.
1. Corneal Ulcer – Yesterday, I covered the infection/inflammation of the eye known as conjunctivitis. This is a much more serious infection in which the cornea – the clear dome that covers the iris – has an open sore. A simple eye infection can worsen into an ulcer on the cornea. Trauma that results in nicks or scratches on the cornea can allow bacteria to enter. Dry eye syndromes reduce the natural defense mechanisms of the eye. Contact lenses increase your risk of acquiring a corneal ulcer, with the use of extended-wear contacts increasing your risk 10-fold. Symptoms includes severe pain, the feeling that something is in your eye, redness, blurred vision and pus or drainage from the eye. If you experience these symptoms, seek immediate medical attention. At the minimum, you will need to use medicated eye drops very frequently. You may, though, have to be hospitalized. The risk of an untreated corneal ulcer is loss of vision in that eye.
2. Retinal Detachment – Aptly named, this condition happens when the retina – the light sensitive membrane that lines the back of the eye – detaches from the underlying tissue. It is caused when the vitreous humor that fills the eyeball shrinks and literally, pulls the retina off the wall of the eye. The shrinking of the vitreous humor is a normal age-related process. (Remember what I said about the dinosaurs yesterday?) It doesn’t always result in retinal detachment but when it does, the results can be devastating. The initial symptoms can be floaters and flashes — sounds like a boat show. Floaters are the specks that pass by your line of vision. Flashes are bright lightening or sparks that can be seen best when your eyes are closed. They do not necessarily mean that retinal detachment is imminent but if they are new or increasing in frequency, it is worth a trip to the ophthalmologist. Sometimes there are no warnings signs and you will experience the signs of the detachment itself. These look like a shadow across your vision or loss of your peripheral vision. If caught early enough, your eyesight can be saved with surgery.
3. Retinal Artery Occlusion – This is essentially a stroke to the artery that supplies blood to the retina. In the same way that strokes can result in dead brain tissue, retinal artery occlusion results in loss of vision in the affected eye. Sudden loss of vision or blurred vision either in part of the visual field or in the whole visual field is the presenting symptom. It may resolve after a couple of minutes or hours (like a mini-stroke or TIA) or it may be permanent. There is no known treatment for this condition. Risk factors are essentially the same as those for stroke: high blood pressure, high cholesterol, diabetes, carotid artery disease, and heart arrhythmias and valve disorders.
4. Eye Cancer – Tumors can develop on several different parts of the eye and are often diagnosed on a well eye exam. Melanoma can present in the eye and tumors in other parts of the body can metastasize or spread to the eye. Often there is no symptom but when there are, the symptoms of eye tumors are similar to the symptoms of other eye condition. These include, changes in vision, floaters, flashes, pain, redness, etc. Retinoblastoma is the most common eye cancer in children and affected about 300 children last year. It’s primary symptom is usually a pupil that is white. Other symptoms include eyes that are misaligned or enlargement of the eye. With eye cancer, vision sparing treatment is obviously ideal, but is not always possible.
5. Beer Goggles – I can’t leave you for the weekend with #4. This is not as serious as the first four conditions, but still, not one to be taken lightly. Remember, friends don’t let friends beer goggle.
Don’t forget to take good care of your eyes. Make an appointment for a check up with an ophthalmologist. Wear good sunglasses. Eat your carrots. Manage your chronic diseases. There will never come a time in your life where you don’t need to see where you are going. I am going skiing this weekend. I am hoping not to come home with a concussion – again. Wish me luck!