Dr. Ormando is a long time member of the American Optometric Association.

Tips on Aging & Healthy Eyes

There is a lot you can do to keep your eyes and vision healthy and prevent age related eye disease and vision loss, especially if you start early. Keeping your eyes healthy and strong may require some lifestyle changes, but the good news is that these improvements will contribute to your overall health and wellness, not just your eyes.

Eye Doctor in Providence, RI

There are a number of ocular diseases such as glaucoma, macular degeneration, cataracts and diabetic retinopathy that primarily affect older adults, which can cause impaired vision and even blindness. Sometimes, they are caused by an accumulation of a lifetime of unhealthy habits; changing these poor habits may be the best form of prevention.

Small Changes in Lifestyle can lead to Healthier Eyes

Diet

Eating healthy is about much more than weight loss. Nutritious foods give your body the ability to fight disease and function optimally. On the other hand, what you put in your body can also cause disease, inflammation, and upset your body’s homeostasis. Choose a healthy, balanced diet: it’s never too late.

Sugar, processed foods and unhealthy fats can increase your risk for eye disease and many other diseases, such as cardiovascular disease, diabetes and cancer. In contrast, colorful fruits and vegetables, particularly greens, can help to fight and prevent these same diseases. In fact, studies show that people who eat a healthy diet full of greens, healthy fats (such as Omega-3s) and proteins, and a variety of foods full of vitamins and minerals (such as antioxidants like lutein, zeaxanthin, and vitamins A and C) have reduced occurrence of heart disease, stroke, diabetes, cataracts and macular degeneration.

Try to eat a diet of at least 5-9 servings a day of fruits and vegetables rich and varied in natural color to get the most nutrients. Reduce your intake of sugar, refined grains (such as white bread and pasta) and processed foods and drinks. Eat mostly whole grains and real, natural foods as much as possible and drink plenty of water.

Ultraviolet (UV) and Blue Light Exposure

More and more studies are showing that extended exposure to UV and blue light emissions correlate to increased incidences of eye diseases such as cataracts and macular degeneration. To avoid this, all you need is some proper eye protection. 100% UV blocking sunglasses should be worn each time you go outside (rain or shine) and, if you work on a computer or use an electronic device for at a couple of hours a day or more, it’s worthwhile investing in blue-light blocking computer glasses. There are also some filters and apps available to reduce blue-light exposure from digital devices and screens.

Smoking

We all know that smoking is bad for you, and eye disease is just another way it can have a negative impact on your health. Studies show that smoking increases the risk of dry eye syndrome, cataracts, glaucoma and macular degeneration as well as diabetic retinopathy.

Sedentary Lifestyle

Once again, what is healthy for your body, is healthy for your eyes. Studies correlate regular exercise with lower risk of age-related macular degeneration, glaucoma, cataracts and diabetic eye disease. Working a regular exercise routine into your schedule is important for your health and longevity. Being more active in your daily life can help too – walking up and down the steps in your house a few times, taking the stairs instead of an elevator or parking farther away from your destination are easy and free ways to incorporate physical activity into your everyday life. Additionally, individuals with diabetes who exercise regularly show less development of diabetic retinopathy. The recommended guidelines for diabetics (and most individuals) are a minimum of 150 minutes of exercise per week such as 30 minutes five times a week or three sessions of 50 minutes each.

Preventative Care (Regular Eye Exam)

Vision threatening eye diseases can often be caught and treated early, preventing further vision loss and sometimes even reversing damage. This is where annual comprehensive eye exams are key. You don’t want to wait until you have symptoms to get checked by your eye doctor because many eye diseases don’t present any signs until vision is lost and it is too late to fully recover. A yearly comprehensive eye exam can detect slight changes in your eye that could indicate a developing problem. Early detection can dramatically improve your chances for restored eye health and vision preservation.

When it comes to eye health, awareness and actions for prevention can have a huge impact on reducing your risks. Don’t wait until it is too late. Even small steps toward a healthier lifestyle can make a difference to your future eye health.

Question: What are the most common symptoms of allergies?

Dr. Pukl: The most common symptoms are itchy, watery eyes, swollen eye lids, coughing, sneezing, wheezing, congestion, and runny nose. In addition, some people experience rashes on the skin in different areas of their body.

Question: How do allergies directly affect the eyes?

Dr. Pukl: Most common is itching of the eyes. Other eye symptoms are heavy swollen eye lids, the white part of the eye gets red and irritated, and can look almost clear.

Question: What is allergic conjunctivitis?

Dr. Pukl: This is when the mast cells release histamines, and triggers an allergic response in the eyes, which is the redness, swelling, itchiness in the eyes.

Question: Is allergic conjunctivitis the same as pink eye?

Dr. Pukl: No. They are very different. With allergic conjunctivitis, the mast cell is releasing the histamine in response to the allergen in the air that the patient is sensitive to, and this is not contagious. Even though Pink Eye has a lot of the same symptoms, the eye is typically less itchy and more irritated, sore and with a sandy feeling. Additionally, Pink Eye has more watering and discharge from the eye, and is an infection caused by a virus or bacteria and can be contagious.

Question: If I have an allergy to something and the symptoms are in my eyes, I can also experience symptoms in other parts of my body. What does this have to do with my optometrist? Wouldn’t I just need to go to an allergy specialist?

Dr. Pukl: A large percentage of allergy sufferers also have allergic conjunctivitis, and while most people may be able to find cure in a basic antihistamine from their allergist, others have really severe allergies where they need something stronger, such as a steroid. Once someone begins steroid treatment, they should be managed by an optometrist or ophthalmologist, because steroids can cause glaucoma and cataracts when they are used long-term.

Question: Typically, a patient comes to you saying, “I have something in my eye, what is it?” and you see that they have allergies, or do patients with allergies usually come to you from a referral from an allergist or physician?

Dr. Pukl: Most of the time we see patients for their routine eye exam or they wake up and their eyes are really red and swollen and itchy, and they come in to see us on their own. They think they may have Pink Eye. The real difference between coming to see us, as opposed to their physician or allergist, is that we have a slit lamp. This is a special microscope with a very high-intensity light that focuses a thin sheet of light into the eye. It is used in conjunction with a biomicroscope. This allows us to get a much closer look at the tissues of the eye. We see all parts of the eye under high magnification and really explore the tissues of the eye and are able to identify some of the very subtle nuances between causes of conjunctivitis and allergic conjunctivitis, and also be able to grade it in terms of severity at a much more accurate level.

Question: How do you determine if I’m having an allergic reaction?

Dr. Pukl: It’s case by case, but allergic conjunctivitis is one of the most common things we see. Typically, when we are told the symptoms and we have a full case history and a complete eye exam, we can tell right away what it is. Allergies are usually more chronic in nature, however sometimes they come on acutely. We look at the patient’s history to help us make the determination. We might see that the patient touched something or came into contact with something, or that when they woke up in the morning both of their eyes were swollen shut. It’s pretty obvious from those signs and symptoms that it’s allergic vs infection. With Pink Eye it’s more likely that the patient has had a cold or virus for a couple of weeks, or his sister or mother had Pink Eye and now his eyes are red and irritated also.

Question: Does it ever happen that the patient comes for a regular eye exam and they are not aware of any allergies they have, and you tell them that you see they are allergic to something?

Dr. Pukl: Yes. I will see they have allergic conjunctivitis and tell them, and they will say “Oh yeah, I did get a new cat recently” or “you are right, they have been bothering me lately” and things like that.

Question: What is the difference between seasonal and perennial allergies?

Dr. Pukl: Seasonal allergies are seen in the spring and summer and usually an immune response to the pollen from trees, weeds, plants and flowers. The perennial allergies are present year-round or flare up only when you come into contact with certain things that are around all the time. The most common perennial allergies are to dust mites, animal dander, and different molds and fungi.

Question: Can allergies do any permanent damage to my eyes?

Dr. Pukl: Yes. In certain instances, where the conjunctivitis is severe, it may involve the cornea, which can get scarred. In addition, allergic dermatitis, which is when the skin around the eye lids is irritated and someone is rubbing it constantly, has been frequently associated with keratoconus, a conical thinning of the cornea which can cause vision loss.

Question: What treatments are there for allergy sufferers?

Dr. Pukl: It all depends on the severity of the allergies. First and foremost we want to educate the patient and identify the allergen and see if they can avoid it. However, for seasonal allergies, you can’t just stay indoors for half the year. This is when treatment options are presented. For the mild cases, you can flush the eyes with artificial tears, or use cold compresses or ice packs to provide relief of the symptoms. If it’s more advanced, my favorite drops are combination drops, which are a mast cell stabilizer – an antihistamine. This drop is great because it works in two ways: #1 it provides immediate relief from the symptoms of itching, redness and irritation, and #2 when it’s used properly it actually helps to prevent these symptoms in the future because it stabilizes the mast cells and it no longer releases histamines.

In more sever allergy cases we will go straight to a steroid, which provides immediate relief of the inflammation, but we are careful because these drops can be dangerous when used long-term, meaning more than six weeks. We manage these patients a little bit closer. I have two patients, who are pediatric patients, where chronic use of steroids is associated with more severe adverse reactions, so I have co-managed them with the ophthalmologist. This way, together, we minimize the number of steroids while keeping the patient comfortable.

Question: What demographics are more prone to allergies?

Dr. Pukl: The elderly and people ages 20 years and younger constitute about 20% of allergy sufferers. From 19 years to 40 years old is the bulk of the allergy sufferers.

Question: Does insurance cover office visits and treatment for allergies?

Dr. Pukl: Yes. Almost all medical insurance will cover the office visits and treatment of allergies.

Question: Is there anything else you would like to tell us?

Dr. Pukl: We have a big staff and we are open six days a week, day, night and weekends, and we are really here to accommodate anyone who may have any signs or symptoms of allergies. Please call us and make an appointment.

Conjunctivitis, also called pink eye, is one of the most frequently seen eye diseases, especially in kids. It can be caused by viruses, bacteria or even allergies to pollen, chlorine in swimming pools, and ingredients in cosmetics, or other irritants, which touch the eyes. Some forms of conjunctivitis might be quite transmittable and quickly spread in school and at the office.

Conjunctivitis is seen when the conjunctiva, or thin transparent layer of tissue covering the white part of the eye, becomes inflamed. You can identify conjunctivitis if you notice eye redness, discharge, itching or swollen eyelids and a crusty discharge surrounding the eyes early in the day. Pink eye infections can be divided into three main types: viral, allergic and bacterial conjunctivitis.

The viral type is usually a result of a similar virus to that which produces the recognizable red, watery eyes, sore throat and runny nose of the common cold. The red, itchy, watery eyes caused by viral pink eye are likely to last from a week to two and then will clear up on their own. You may however, be able to reduce some of the discomfort by using soothing drops or compresses. Viral pink eye is transmittable until it is completely cleared up, so in the meantime maintain excellent hygiene, remove eye discharge and try to avoid using communal pillowcases or towels. If your son or daughter has viral conjunctivitis, he or she will have to be kept home from school for three days to a week until symptoms disappear.

A bacterial infection such as Staphylococcus or Streptococcus is usually treated with antibiotic eye drops or cream. One should notice an improvement within just a few days of antibiotic drops, but be sure to adhere to the full prescription dosage to prevent pink eye from recurring.

Allergic pink eye is not contagious. It is usually a result of a known allergy such as hay fever or pet allergies that sets off an allergic reaction in their eyes. First of all, to treat allergic pink eye, you should eliminate the irritant. Use cool compresses and artificial tears to relieve discomfort in mild cases. When the infection is more severe, your eye doctor might prescribe a medication such as an anti-inflammatory or antihistamine. In cases of chronic allergic pink eye, topical steroid eye drops could be used.

Pink eye should always be diagnosed by a qualified eye doctor in order to identify the type and best course of treatment. Never treat yourself! Keep in mind the sooner you begin treatment, the lower chance you have of giving pink eye to loved ones or prolonging your discomfort.