Dry Eye Disease and Tears

dry eye doctor, ophthalmology, diseases, eye treatment, dry eye syndromeIf your eyes sting, itch and are watery, then you might have Dry Eye Disease

Dry Eye Disease was hard to diagnose in the past because there was not an easy, accurate way to measure the osmolarity of tears (or in other words… the quality of your tears and just how dry your eyes are). Also there were not many good dry eye treatments. Today we have many Dry Eye treatments that include Restasis prescription eyedrops, punctual plugs, conjunctivochalasis treatment (known as CCH),  vitamin therapy, scleral lenses and even eyelid revision surgery. But before we can recommend a treatment, we need to find out how dry your eyes are.

What is Tear Osmolarity and what does it have to do with my dry eyes?
One of the latest in dry eye technology is the TearLab Osmolarity System. The TearLab is the first objective and quantitative test for diagnosing dry eye patients. By using the TearLab, The Eye Associates can quickly and painlessly measure a small sample of tears to determine your dryness. This helps your dry eye doctor understand the ‘level’ of Dry Eye Disease (sometimes referred to as Dry Eye Syndrome) to decide the best treatment plan.

The TearLab testing provides you with a unique tear number. The higher the number means the less quality tear film, the more inflammation, and the greater chance of damage to the ocular surface of the eye.

Does it really work for dry eye testing?
Yes. There was a 300 patient dry eye study presented at the American Academy of Ophthalmology that said that the TearLab outperformed both the old-standard Schirmer’s testing and corneal staining tests for correctly identifying mild to moderate dry eye patients. Why is that important? Because it is important to start treating this disease in the early stages before any damage has been done to the eyes.

Accredited Dry Eye Center 
We are proud to announce that The Eye Associates has been named an Accredited Dry Eye Center. Our doctors use the TearLab Osmolarity System as part of their advanced dry eye treatment plan. If you would like to make an appointment at The Eye Associates at Sun City Center, Ellenton, Sarasota, Venice, and Bradenton, just call 1-866-865-2020.

Van Gogh’s Eyesight and Paintings

There ha100 dpi 2in hi starry nights long been speculation by the eyecare community about Van Gogh’s eyesight and why he used so much yellow in his paintings. Some have suggested that he may have been over-treated with a medication called digitalis. In toxic yet non-lethal doses, digitalis is known to cause Xanthopsia, commonly referred to as ‘yellow vision.’ The extensive list of disorders treated with the medication during that period include headaches, mental illness, nausea, melancholy and inflammation of the eyes, just to name a few. We know from Van Gogh’s own letters that he suffered from mental illness and that he often complained about his eyes, so digitalis causing the yellow vision is entirely possible.

Another theory about his yellow vision is that it could have been caused by absinthe, a known side effect from excessive drinking of the potent liquor. Absinthe was very popular in France at that time, with bars actually hosting ‘the hour of absinthe’.

Maybe, just maybe, none of this is true. Perhaps Vincent Van Gogh just loved the color YELLOW.

Another visual effect in Van Gogh’s paintings is the halo swirling effect as seen in his painting, The Starry Night. It has been suggested that he may have suffered from lead poisoning, caused by the use of lead-based paints used at that time. One visual symptom of lead poisoning is the swelling of the retina, causing a halo effect around lights. Others have suggested that Van Gogh suffered from narrow angle glaucoma attacks which can also cause colored halos. Of course, cataracts cause halos around lights at night but since Van Gogh committed suicide at the early age of 37, it is unlikely that he had cataracts.

Van Gogh was also quite famous for his multitude of Self Portraits. He painted over 30 ‘selfies’, but his choice of his eye color varied from portrait to portrait. Some have hinted that he might have had 2 different colored eyes. Or perhaps he was just colorblind and didn’t really know the true color his eyes.

Whatever is the case…he certainly had an eye for beautiful paintings.


Who has a higher risk for glaucoma?



Aging is one of the risk factors for glaucoma and every birthday make you at higher risk for the disease.

Birthday seniors

Birthdays increase the risk for glaucoma

Unfortunately, the older you are over 65, the higher your risk for this disease. It affects over 3 million Americans, and it is the second leading cause of blindness in the United States. Fortunately, if it is detected early and properly treated, most vision loss is preventable.

What Is Glaucoma?

It is a disease that is often linked to a buildup of pressure in the eye. The increased buildup can cause damage to your optic nerve, thereby causing a loss of vision. The two most common types of glaucoma are Open Angle  and Narrow Angle.


Why is it called the “Silent Thief of Sight”?

Glaucoma can slowly steal your eyesight without your even realizing that anything is wrong. The damage is usually painless, it progresses slowly and most often it is without noticeable symptoms.

How do you know if you have it?

This disease is usually discovered during a routine eye examination. Since it tends to run in families, it is important for the entire family to have regular eye examinations, especially if there is a family history of glaucoma. Even though the chance for developing it increases with age, it can strike at any age. The Eye Associates tests for glaucoma at every visit, even our younger patients.

What is the difference between Open Angle and Narrow Angle Glaucoma?

Open Angle

Our eyes have a constant flow of fluid that drains through the “angle” of the eye. In Open Angle, this drainage system becomes clogged, causing a slow buildup of fluid pressure in the eye. When this happens, it reduces the blood supply to the optic nerve, causing a loss of peripheral vision, most times without notice because of the gradual nature. Often it is only after irreparable damage has occurred that a person becomes aware they even have this disease. Since open-angle glaucoma is a chronic condition, it must be monitored for life.

Watch this animation to help you better understand Open Angle Glaucoma.

Narrow Angle (or Closed Angle)

Narrow Angle results from a sudden, complete blockage of fluid drainage, causing a rapid and painful rise in pressure. It can occur at any age, and can cause blindness in a day or two if no treatment is given. Narrow Angle occurs more frequently at night, during emotional stress and even with the use of some over-the-counter medicines such as Dristan, Contac, or Benadryl.

To learn more about this eye disease, go to our YouTube channel for more information:http://bit.ly/1U8k3ci

If you would like to be evaluated by our Fellowship Trained Glaucoma Specialist, Robert Friedman, MD, or one of our board certified eye physicians, please call toll free 1-866-865-2020 or contact The Eye Associates.



True or False: Everyone Knows What Glaucoma Is

Everyone knows what glaucoma is. –  That is FALSE – A Prevent Blindness America Survey found that 50% had heard of glaucoma, but weren’t sure what it was. Another 30% of people had never even heard of glaucoma. The ones that had heard of glaucoma thought it was easily cured and did not lead to blindness.  In fact, glaucoma is the second leading cause of blindness. And it is often called the ‘silent thief of sight’ because vision loss can occur gradually, without pain and without symptoms. Fortunately, if glaucoma is detected early and properly treated, most vision loss is preventable.(15) 27894850 senior couple cropped

The two most common types of glaucoma are open angle glaucoma and angle closure glaucoma, sometimes referred to as narrow angle glaucoma.

Our eyes have a constant flow of fluid that fills the front chamber of the eye and then drains into the bloodstream. It drains through the ‘angle’ of the eye which is located between the cornea and iris. In primary open angle glaucoma, this drainage system does not function properly, causing a slow buildup of fluid pressure. When this happens, optic nerve damage may occur. As the optic nerve deteriorates, there is a loss of peripheral vision, most times without notice because of the gradual nature in which the deterioration progresses. Often it is only after irreparable vision loss has occurred that a person becomes aware they even have this disease.

Narrow angle glaucoma results from a sudden, complete blockage of fluid drainage from the angle of the eye, causing a rapid and painful rise in pressure. It generally occurs in people over 40 and may cause vision loss rapidly if no treatment is given. Patients may experience severe eye pain accompanied by nausea, redness, swelling of the eye, loss of peripheral vision as well as blurred vision and halos. These symptoms usually last until the eye pressure is lowered. It is important to reduce the pressure quickly because permanent vision loss can occur if the pressure is not reduced in a timely manner.

GET THE FACTS ON GLAUCOMA  at https://www.theeyeassociates.com/services/glaucoma-services/  so everyone knows what glaucoma is. # glaucoma

If you have glaucoma and would like to be evaluated by our Fellowship Trained Glaucoma Specialist, Robert Friedman, MD, or one of our board certified eye physicians, please call toll free 1-866-865-2020 or contact The Eye Associates.

Melanoma – A Mole Gone Bad

The quickest way to explain melanoma is the simply say that it is a mole that has gone bad. It is the most dangerous type of skin cancer. According to SkinCancer.org, everyone is at some risk for melanoma. Those with a family or personal history, lighter skin color, a weakened immune system, and excessive moles are at an even higher risk.

And melanoma is on the rise! The good news is that melanoma is almost always curable AS LONG AS IT IS TREATED EARLY. What does that mean to you? You need to get a yearly skin check as well as keep any eye on your own skin for any signs of skin cancer.

Look out for the ABCDEs of melanoma.


A for Asymmetry

If you were to draw a line through the middle of the mole and the 2 sides don’t match, then you should have it checked immediately.

B is for Border

If the borders are not smooth, have it checked.

C is for Color

If the is an unusual color, you should have it checked.

D is for Diameter

If the diameter of the mole is larger than a pencil eraser, it could be melanoma…even though some melanomas can be small.

E is for Evolving

Keep a watch on your moles and if you see it changing in any way, or if it starts to bleed, make an appointment.

No one likes to go to the doctor and especially if it is for something scary like melanoma. We also hate to waste our money. What if it is ‘nothing’. It is better to have wasted an appointment for a ‘perfectly normal’ mole than to miss catching this deadly cancer early. Click here or call 1-877-816-DERM (3376) for an appointment with Dr. Gary Rosen.

NOTE: You will be seeing Dr. Rosen; not a PA or NP.

Tears for My Dry Eyes from Olive Oil

The next time you travel to the Napa Valley (California), do your Dry Eyes a favor. Visit the wonderful OLIVE OIL tasting rooms. Yes, there are now several excellent olive orchards producing what has been described as “liquid gold” of extra-virgin olive oil, right here in the good ole US of A.

Right behind the Omega 3 fish oils is extra-virgin olive oil. That is why it should be on the top of every dry eye patient’s cooking list. It is a member of the “short list” of foods that offer our body assistance in reducing inflammation our joints, but also the inflammation in our tear producing glands that leads to our dry eye symptoms.  Use it as often as you can for cooking or take it straight. I call it the “dry eye shot”. Pour out the tequila and fill your shot glass with olive oil (flavored, if you would prefer). The chocolate-infused oil is said to be great over ice cream. Wow, we can now enjoy our ice cream AND feel good because we are improving our dry eye condition at the same time.

From one ice cream lover to another,
Richard Hector

One of our favorite Omega 3 fish oils is Omega Cureby Omega3 Innovations. It is made with wild cod caught off the coast of Norway, eliminating the fishy taste while still achieving the omega 3 health benefits. The super food can also be used in juices, smoothies and even salad dressings to help you get your daily servings. Omega3 Innovations even has breakfast cookies, chocolate cookies and the tasty dark chocolate truffle surprisingly containing omega 3 fish oil.

You can find out more information on Omega Cure at https://www.omega3innovations.com/omega-cure/

If you have dry eyes and would like to be evaluated by our Fellowship Trained Dry Eye Specialist, Richard Hector MD, or one of our board certified eye physicians, please call toll free 1-866-865-2020 or contact The Eye Associates.


The World After Cataracts By Jean Steiger

I thought I was pretty well preserved for my age. A few friends made nice comments about my skin, sometimes new friends were surprised when they learned my age and I felt reasonably good about my image in the mirror.

Then I had cataract surgery in my right eye.

When the dilation and fog of surgery cleared after a few days, I gazed at my reflection and my heart sank. I had had the lens corrected for astigmatism and distance and I was seeing a whole new me. In fact, I was seeing a whole new world. When I closed the left eye (cataract and astigmatism still in place), objects were no longer fuzzy; everything had well-defined edges and colors were vibrant. My vision was clear and I could see far into the distance.

Which also meant I could see every wrinkle. When had those tiny lines on my cheeks appeared? And what about my forehead? The circles under my eyes made me look tired and – there it is – old! I would have to start wearing bangs that came down over my eyes.
Why hadn’t someone warned me about this aspect of cataract removal and vision correction? If they had, I might have gone on until the end of my life, believing I still looked 16. Okay, maybe not 16, but how about 60? I was probably a bit unrealistic. But, oh, how I loved my visual fog. Now I would have to get used to the new “mature” me.

Half-way into the first week with the new eyesight, I turned to the computer. At my last visit to the dermatologist, I had asked the doctor to recommend a face cream for wrinkles. I googled the brand he had mentioned and was immediately rewarded: a dozen sites appeared. When I hit one of them, I found the cream and almost closed the computer. Two ounces of the lotion cost $75! How long would two ounces last? The directions recommended two or three pump-fulls spread over your face every day. Maybe, if I was lucky, it would last a week!

I kept searching, desperate in my new awareness. Finally I found the cream on Amazon for half the price. I ordered two and watched for their arrival, meanwhile avoiding mirrors. When they came, I unwrapped one and carefully pumped out a few drops. Forget three pumps every day; I was going to get along on three drops. These two containers were going to have to last a long time!

When I returned to the Eye Associates for a check-up, I told Dr. McCabe, my cataract surgeon, about my mirror shock. She laughed and told me about one of her patients who, after cataract surgery, took a good look at the walls in her house and repainted every room. My brother, also an ophthalmologist, told me about a patient who bought a new wardrobe after cataract surgery and a third who complained about how old her husband had become. So I wasn’t alone!

With one eye changed, my glasses are no longer useful. In fact, it’s just the opposite; they cloud my vision. Of course, part of this problem is because they are so scratched. I’m one of those people who take my glasses on and off ten times a day, leaving them between couch cushions, under bed covers and in bathroom drawers. Then I spend 30 minutes searching for them while my husband is waiting for me or when I need to be out the door and on the way to an appointment. Now, with distance vision improved, I can buy inexpensive readers and leave them all over the house! Maybe this will make up for the new wrinkles!

It’s strange to drive the car without wearing glasses. I keep wondering what will happen if I get pulled over and a policeman looks at my license which specifies that I need glasses to drive. Will he or she believe my cataract story? On the other hand, this is Florida and I’m guessing I am one of thousands, if not millions in this predicament. When I made my appointment for the cataract surgery, the eye counselor told me the schedule was very full because this is “cataract season”. This is a new one. I know it is tourist season, but cataract season?

The other thing about cataract surgery is the drops; there are four of them – an antibiotic, anti-inflammatory, pain-inflammation and lubricating drops. All of these are given at different times and for different periods of time and different amounts. The office does give you a nice sheet with everything clearly listed so you can actually cross off each drop after you’ve used it. At first I resisted this approach, certain I could keep track of this myself, but as the second eye approaches, I have given up. The check-list and a pen are in place by the little bottles of drops. And tomorrow I return to the eye surgery center for cataract removal, astigmatism and distance correction in the left eye. I’m just wondering how many new wrinkles I’m going to see by the middle of the week!

NOTE: The second eye is done and my vision is wonderful! I love my crisp new eyesight and my great distance vision; I’m even making peace with the previously invisible wrinkles. Thank you, Dr. McCabe.

Blog repost from: www.stayingyounginflorida.com and the entertaining writings of Jean Steiger

Are electronics affecting your kids’ eyes?

Phones, tablets and other electronic devices

How does electronics affect kids’ eyes?

Electronic devices. Our kids were raised with them. They can’t imagine life without them. And neither can we. But how are they affecting our kids’ eyes? We know first hand the strain that we feel after a long period at the computer. But what about our kids? According to the American Optometric Association, 83 % of our kids between 10 and 17 are using electronic devices 3 hours or more a day. Most parents are surprised to hear that. While we accept that we are using smart phones and computers for hours at work, it’s hard to imagine that our kids are spending so much time on them as well.

Another study published in Journal of Pediatric Ophthalmology and Strabismus found that smartphones and tablets could be contributing to increased dry eye problems in kids’ eyes. Dry Eye symptoms such as burning, tearing, eye fatigue are common complaints that we hear everyday at The Eye Associates, and increasingly so in kids. Gaming glasses, computer glasses and digital eyeglasses are being prescribed more and more in order to offer symptom relief as well as protection against harmful bluelight emitted by electronics. The American Macular Degeneration Associations has suggested a link between bluelight and macular degeneration. Let’s start protecting our kids’ eyes early from macular degeneration.

The difference between kids and adults is the self awareness of symptoms. Adults feeling eye strain will take a break and give their eyes a rest. We find that children, especially when playing a game, will continue using the electronic device. That is why it is important for the parent to step in and institute rules about electronic use. We recommend taking a break every 20 minutes. Also remind your kids to blink. So often computer users forget to blink.

Adults are also susceptible to digital strain. Some common symptoms are tired eyes, stiff neck and headache.



Call 1-866-865-2020.

Eye exams save sight.

1) Even if You Don’t Wear Eyeglasses, You Still Need an Eye Exam.

Some sight-threatening eye diseases do not have early warning signs, and many can only be detected during a dilated eye exam. Some cataracts affect vision in such a gradual way that you do not notice the decreased vision. Half of all people with glaucoma are unaware that they even have the disease. Also, diabetics with diabetic retinopathy often do not experience symptoms when the disease is at its most treatable stage. Remember, the key to keeping good vision for a lifetime starts with early detection during an eye exam and early treatment.

2) Eye Exams Detect Other Health Problems Too

Most people don’t know that many general health problems are often first detected during a routine comprehensive eye exam. The reason is that the eye is the only place where blood vessels can be viewed in their natural state without a surgical procedure. Changes in the blood vessels of the eye or fluctuations in vision sometimes lead to the first diagnosis of common diseases such as diabetes, high blood pressure, arthrosclerosis (hardening of the arteries) and high cholesterol. Graves’ disease is often first noticed as protruding eyes and double vision. Neurologic diseases such as MS may be first suspected when an eye doctor finds changes in the eye and the optic nerve. Even cancer and brain tumors, although rare, are sometimes detected during an eye exam. Our board certified physicians are always looking out for your overall health and well-being; not just your vision.

3) Good Vision Increases Safety

Poor vision can have an adverse effect on many life issues, such as depression, increased car accidents, and drug-related errors, but none of these are more concerning to life than a fall. Falls are among the leading cause of death of people age 65+, and people with low vision are at even greater risk. Reduced contrast sensitivity, decreased depth perception, and a reduction in the field of vision can inhibit balance and one’s ability to detect environmental hazards. Increased safety is one of the most compelling reasons to have an annual eye exam.

4) Vision Affects a Child’s Success in Life

Did you know that 80% of all learning is through the visual system, and decreased vision can significantly affect educational success, athletic ability and even social interaction? Countless children are receiving poor grades simply because they cannot see the blackboard; causing them to lose a desire to learn, and even stunting their social skills. While most parents recognize the value of routine dental care, they often underestimate the importance of testing a child’s vision.

5) Changing Eyecare Technology

We are living in a time when sight-saving technology is changing at an astonishing rate. Conditions once considered untreatable are now able to be corrected with cutting-edge technology. Just a few years ago, someone with wet macular degeneration would have lost most, if not all of their vision, but now we can help them with sight-saving medications. A cataract surgery patient who has worn glasses their entire life now has a choice of a high tech lens implant so they never have to wear glasses again. These are just a couple of examples of what we are able to offer patients today. So even if you’ve been told in the past that your condition was untreatable, technology may have changed all that. Only with a comprehensive eye exam can you know for sure.

You Only Have 2 Eyes! Sight does more than let you see what is in front of you. It allows you to safely live your life to the fullest with the ones you love. Schedule your yearly eye exam today!

Call 1-866-865-2020 for an appointment today!

Comfort For Your Dry Eyes

7 Things You Might Not Know About Dry Eyes

1. Do you need another reason to quit smoking? Add Dry Eye Disease to the list. Recent studies have shown even second hand smoke is very harsh to the surface of the eye. There are so many toxic chemicals in cigarette smoke that can break down your protective tear film and the surface corneal tissue. If you are around a lot of cigarette smoke, you probably have noticed the need to increase the use of artificial tears. Also, smoking is known to be a strong contributor to the development of macular degeneration. Outside of family history, smoking is most common denominator in macular degeneration patients.

2. I know I’m spoiling your fun but alcohol is also not dry-eye-friendly. It causes dehydrate which is never good for Dry Eyes. And forget that drink on the plane because studies have shown that the atmosphere on a commercial aircraft is drier than any desert. Drink plenty of water on your trip instead.

3. Make-up and dry eyes: Make-up, such as waterproof eye make-up, mascara, shadow, etc., has a much higher discomfort rate and sometimes causes a toxic reaction to the sensitive skin of dry eye sufferers. Always keep your make-up fresh by disposing old bottles after 2-3 months. And thoroughly clean off your make-up every night before going to bed.

4. Contact lenses are not just an aggravating factor for dry eye sufferers, but they can even cause dry eye damage to the cornea. Daily disposable lenses are the safest contact lens for dry eye patients. And never, never wear your contacts if your eyes are red and uncomfortable.

5. We used to recommend that you avoid too much caffeine because it is a mild diuretic. But some recent studies have shown a reduced risk of dry eye in coffee drinkers, and that caffeine might actually stimulate tear production.

6. Did you know that children can also suffer from dry eyes, secondary to congenital endocrine, autoimmune and inflammatory disorders. If your child has persistent complaints of painful, irritated eyes, don’t ignore it… Bring it to the attention of your pediatrician or better yet, make a visit to an eyecare professional for an evaluation.

7. Those simple carbs that are bad for the waistline are also bad for your eyes. They compete with the complex carbs needed by ocular tissue and aggravate your dry eye symptoms.

Do you need any more evidence that Dry Eye Disease is a very complex problem that needs something more than an artificial tear once or twice a day?

By Richard Hector, MD