Here at Fusion Eye Care, we see patients with ocular lesions on a regular basis. If you think you might be developing ocular lesions, please schedule an appointment with Dr. Bassiri as soon as possible by calling (919) 977-7480.

What Are Ocular Lesions?

Ocular lesions in the eye may grow in size as time passes, however, it could take several years before the lesions grow to a noticeable size. A majority of lesions could cause surface irritation, something that may result in constant eye discomfort and redness. People with eye lesions should have them evaluated by an ophthalmologist to determine the right course of treatment based on lesion type and cause.

Pinguecula

Pinguecula are raised, yellowish lesions that build upon the “white part” of the eye known as the conjunctiva. These lesions form after an alteration of normal tissues, resulting in a deposit of fat and proteins. Why this happens is yet to be known. However, prolonged exposure to infrared radiation and ultraviolet rays from the sun is believed to encourage the growth of pinguecula.

Signs and Symptoms:

Pinguecula generally do not exhibit any symptoms; however, if irritated, you may feel as though there’s something trapped in your eye. In some cases, these lesions get infected and swell. The condition is referred to as pingueculitis and is characterized by irritation and eye redness, symptoms that may be worsened by extremely dry weather, wind, or dust.

Treatment:

The severity of pingueculitis symptoms normally determines the course of treatment to be taken. Lubricating eye drops could be prescribed for mild cases to ease dryness of the eyes. Anti-inflammatory or steroid eye drops could also be prescribed to relieve severe inflammation and swelling. In extreme cases, the removal of the lesions surgically could be prescribed if they start interfering with blinking, vision, or wearing contacts.

Pterygium

Pterygium is fleshy growths that resemble a tissue or film growing over a patient’s eye. This happens when the conjunctiva starts invading the transparent part of the eye that covers the pupil, anterior chamber, and iris known as the cornea. An overgrowth of the conjunctiva is often what gives these lesions their unsightly appearance. Just like pingueculae, pterygium is likely to be caused by an overexposure to ultraviolet rays from the sun.

Signs and Symptoms:

A majority of people with pterygium don’t experience any symptoms; however, the growth may swell or become red when infected. The lesion may also become thick or large, leaving the patient with the feeling like there’s a foreign object in his or her eye. In advanced cases, the lesion may be visible and may look like a film covering the eye. The patient could have the lesion surgically-removed for aesthetic purposes. Nevertheless, surgical removal is often unsuccessful since the lesions have a 40%-50% chance of reoccurring after the procedure.

Treatment:

If the lesion is small but becomes swollen, it could be treated with steroids or lubricating eye drops to relieve inflammation. As mentioned above, surgical removal is one way to get rid of these lesions; however, it is generally not needed. Dr. Bassiri could help determine the best course of action to take when it comes to treating the condition.

If you have any additional questions about ocular lesions, Fusion Eye Care is here to help. Please schedule an appointment with Dr. Bassiri as soon as possible by calling (919) 977-7480.

Of the many vision problems that exist, astigmatism may be the most misunderstood. Even the name, astigmatism is confusing since a person doesn’t suffer from a stigmatism, but instead has astigmatism. The condition results from a refractive error just like farsightedness or nearsightedness. It is not an eye disease nor is some type of eye health issue. Instead, it is simply an issue involving how the eye focuses light.

When a person has astigmatism, light doesn’t focus correctly on the retina. It does not narrow to properly focus on the retina which is required to see clearly. Instead, light focuses on multiple points, either behind or in front of the retina or both.

Symptoms Of Astigmatism

Individuals with astigmatism will usually experience distorted or blurred vision at all distances. They may have headaches or eye strain, especially after completing prolonged visual tasks such as reading. Another common symptom is squinting.

The Causes Of Astigmatism

Astigmatism typically results because of an irregularly shaped cornea. In a healthy eye, the cornea is symmetrically round. In an eye with astigmatism, the cornea is shaped like a football, and one meridian is much more curved than the other. The meridians are the vertical and horizontal lines across the cornea. With astigmatism, the vision problems are caused by issues with the meridians. The meridians which are the flattest and steepest are called the principal meridians. Astigmatism may also be caused when the lens of the eye is not shaped correctly. When this occurs, a patient has lenticular astigmatism.

Different Categories Of Astigmatism

Astigmatism is categorized into three different types:

• Myopic astigmatism happens when both of the eye’s principal meridians are nearsighted.
• Hyperopic astigmatism happens when one or both of the eye’s principal meridians are farsighted.
• Mixed astigmatism happens when one of the principal meridians is nearsighted and the other principal meridian is nearsighted.

Astigmatism is also categorized as regular astigmatism or irregular astigmatism. When the eye’s principal meridians are perpendicular to each other, a person has regular astigmatism. When the meridians are not perpendicular to each other, a person has irregular astigmatism. Irregular astigmatism may be caused by several things including keratoconus which is a condition that causes the cornea to gradually get thinner, an eye injury or eye surgery.

Astigmatism Is A Common Condition

Most people get astigmatism early in life. This is why it is important to schedule regular eye exams for children. If left untreated, astigmatism can cause problems with learning. According to a recent study which looked at more than 2,000 children who were between 5 and 17 years old, childhood astigmatism is a significant issue. This study found that more than 28 percent of those examined had astigmatism of 1.0 diopter or greater.

Testing For Astigmatism

During a regular eye exam, the doctor will test for astigmatism just like they do for farsightedness or nearsightedness. Be sure to tell him or her if you feel you have eyes that are dry and need treatment. There are two primary ways to test for astigmatism. In the manual test called a retinoscopy, the doctor will shine a light into the eye and using a series of lenses, will test how the light focuses in the eye.

Many eye doctors are either replacing or supplementing the retinoscopy with a test that uses automated instruments. These tests are faster and provide quicker preliminary results for astigmatism and other types of refractive errors. Following these tests, the eye doctor will also perform a manual refraction. This test further refines the tests for astigmatism.

During the manual refraction which is also known as a subjective or manifest refraction, the doctor uses a phoropter to test for the level of astigmatism. The phoropter consists of several lenses which the doctor will introduce in front of the patient’s eyes. The patient then compares how well they see with each lens.

The patient will look at an eye chart while the eye doctor demonstrates different lenses. The doctor will ask the patient different questions designed to determine the patient’s eyeglasses prescription.

When a patient is diagnosed with astigmatism, the eye doctor can correct their vision using several methods including refractive surgery, contact lenses or eyeglasses. Correcting astigmatism requires an eye doctor to use “cylinder” lens power in addition to the spherical lens power which corrects farsightedness or nearsightedness. Cylinder lens power corrects the differences between the powers of the eye’s principal meridians. For example, a eyeglasses prescription correcting myopic astigmatism would read -2.75 -1.00 x 90. Similarly, a contacts prescription correcting astigmatism would contain the same information.

Another option for those with astigmatism is gas permeable contact lenses. These are rigid lenses and may be used to optically replace the eye’s refracting surface. This means an axis and cylinder power may not be necessary, however, this will depend on the severity and the type of astigmatism that is being corrected. This is also true for hybrid contact lenses.

LASIK surgery is another possibility for correcting astigmatism. This is a quick and painless surgery that takes seconds, but which produces great results. LASIK has been used for years, but recent advancements have made this one of the safest surgeries available. Improvements in equipment and technology have also resulted in price reductions making LASIK an option for more people.

It is important to discuss all options with a patient’s eye doctor. What will work for one person may not be a good choice for another. Every individual is unique, and the choice of glasses, contacts or LASIK should be carefully considered.