Here is some expert advice!

"J. Jones" asks... I am experiencing up and down jumping vision in my right eye that worsens with certain head movements. My optometrist had diagnosed it as a nystagmus. Is acquired nystagmus generally reversible?
Nystagmus is an involuntary oscillation, shaking, or "jiggling" of the eyes. There are many different classifications based upon the type of the nystagmus and any associated underlying cause. The more common varieties of nystagmus result from congenital and neurological abnormalities as well as from some drugs acting on the central nervous system. Nystagmus noted only at the extreme points of horizontal gaze is a normal physiolocal phenomenon known as "end-point nystagmus." For treatment, most important is the classification of the type of nystagmus present and investigation for any underlying causes such as neurological disorders. Any abnormalities discovered are treated by the appropriate specialists. Some patients with congenital nystagmus can benefit from surgery on the eye muscles to rotate the eyes into a position where the nystagmus is less pronounced or absent. A complete ophthalmological evaluation would be advisable.

Rene from Syosset asks... I have a corneal dystrophy. What do you know about it and how will it affect my vision?
"Corneal Dystrophy" is not a single entity but rather a group of different, rare disorders affecting the clarity and transparency of the cornea. Most corneal dystrophies are inherited as dominant traits (i.e., ordinarily one half of family members are affected). Corneal dystrophies are usually classified according to the layer of the cornea primarily involved. Some examples are "Epithelial" dystrophies which affect the surface of the cornea, "Stromal" dystrophies which affect the stroma or middle layers of the cornea, and "Endothelial" dystrophies which affect the inside or back surface of the cornea. The signs and symptoms and affect on vision are very variable depending upon the specific type of dystrophy. The proper diagnosis and classification of corneal dystrophies can only be made by an ophthalmologist and this would be advisable. The treatment depends entirely on the specific type of dystrophy and its severity in the affected individual.

"Jamie" asks... Is it possible in identical twins for one to have astigmatism and the other not?
Astigmatism is one of the refractive (or focusing) errors of the eye caused by an irregularity in the shape of the cornea (and/or the lens) of the eye which distorts the light entering the eye and creates a blurred image on the retina. It is really, really unlikely in identical twins for one to have astigmatism and the other not, because the genetic material responsible for the shape of the cornea (and/or lens) should be identical in both identical twins.

Robert from Elmont asks... Can you explain what is a Cataract?
A cataract is a painless clouding of the lens of the eye, and it is a natural part of aging, affecting 80% of people over age 60. You can also be born with a cataract. Other causes of cataract include long-term sunlight exposure, diabetes (and other metabolic diseases), eye injury, and long-term use of steroid medications (and other medications). But by far, and for most people, age-related cataract is the most common cause of cataract.

Cataracts can take years to develop. Over time, they reduce how well you see. This gradually makes it harder to do everyday activities, such as driving or reading a book. Common symptoms of cataract include cloudy or blurry vision, trouble seeing at night, seeing glare or halos around lights, and a change in how you see colors.

By working with your ophthalmologist, you can find out how a cataract is affecting your vision. You can also learn about different treatment options, including surgery to replace your cloudy lens. Today's surgery is extremely advanced and is painless. It is most commonly performed without even a single stitch or needle and is done on an outpatient basis. Once the cloudy lens is removed, it will be replaced with a plastic lens called an IOL (intraocular lens) implant. An IOL does not change the appearance of your eye, but it can improve how well you see. You may still need glasses for certain tasks, but the latest "accommodating" or "multifocal" IOLs are designed to greatly reduce or eliminate your need for glasses.

For more information or for a cataract evaluation, please feel free to contact my office or your treating ophthalmologist.

Carmela in New Hyde Park asks... Sometimes I see black lines in front of my eyes... is this normal?
Most commonly, black lines or "floaters" drift across the line of vision due to the vitreous humor, which is a jelly-like substance that fills the inside of the eyeball. This substance gradually degenerates and liquefies with age. This is a normal process. There are attachments of the vitreous to the retina at various points (including the macula) and to the optic nerve. Sudden detachment of the vitreous from the macula area usually causes the perception of "flashes and floaters". The flashes can look like lightning or electric sparks, and the floaters may resemble threads or specks. If the circular attachment to the optic nerve is separated, a large ring, circle, or "C" shape may be noticed in the line of vision. The floaters often drift across the line of vision and may be more or less noticed depending upon the direction of gaze and the surrounding lighting conditions. Symptoms may last days to weeks and should always prompt an examination by an ophthalmologist to rule out more serious consequences of vitreous detachment (retinal breaks, detachments, and hemorrhages, etc.). No specific treatment is necessary, but a thorough, dilated examination of the retina and vitreous should be performed by an ophthalmologist to uncover any serious associated problems.

For more information or for an evaluation, please feel free to contact my office or your treating ophthalmologist.

Deborah in Syosset asks... My eyes are very itchy and watery this time of year... could it be winter allergies?
Allergic reactions are adverse reactions of the immune system, which can certainly occur in the winter. Ocular allergies such as allergic conjunctivitis (pink eye) generally fall into one of two broad categories: immediate hypersensitivity and delayed hypersensitivity. Examples of immediate hypersensitivity include hay fever conjunctivitis, chronic atopic conjunctivitis (eczema), vernal conjunctivitis ("vernal" meaning spring -- so this condition usually occurs in the spring) and giant papillary conjunctivitis, which is the eruption of large "papillae" (cobblestone like swelling) usually under the upper eyelids. This may result from chronic trauma from contact lenses or solutions or from other foreign bodies.

Itching, tearing, and discharge are common symptoms, and an evaluation by an ophthalmologist is recommended to identify the cause as well as to care for and treat the signs and symptoms. Often, treatment can be as simple as adjustments to contact lens usage (including solutions) and/or topical eye drops to relieve symptoms.

For more information or for an evaluation, please feel free to contact my office or your treating ophthalmologist.