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Teary Eyes All the Time

My Eyes water/tear all the time??
Many of our patients present with a complaint of “teary/watery” eyes. A thorough eye examination is necessary for the evaluation of underlying causes. Anatomically, tears in our eyes are produced by 3 glands:
⦁    Lacrimal Gland – produce aqueous (watery) tears
⦁    Meibomian Glands – produce oily tears
⦁    Goblet cells – produce mucous tears

Tears drain the eyes through a channel called the lacrimal punctum into the lacrimal sac and further into the nasolacrimal duct. One can experience teary/watery eyes due to 4 main causes:
⦁    Blocked punctum – If the Punctum is blocked or has stenosis (narrowing), there will be decrease in drainage of tears, which would cause the tears to overflow
⦁    Dry Eye Syndrome – Inconsistent/insufficient oil layer on the front surface of the eye can cause eyes to excessively water/tear. Lack of oil layer causes dryness of the front surface of the eye, which overstimulates lacrimal gland’s production of watery tears.
⦁    Consistent irritation with an allergen – Work/home environment can have pollutants/irritants (example – dust, mold etc) that irritate the front surface of the eye causing it to tear.
⦁    Eyelid abnormality – Ectropion (eyelid turned out), entropion (eyelid turned in) and irritation to the front surface of the eye by eyelashes can cause the eyes to tear excessively.

Infants can sometimes experience teary eye. This symptom is most commonly due to obstruction at the end of nasolacrimal duct (valve of Hesner). As the tears stay stagnant in the nasolacrimal duct, potential for infections also remains. Most cases resolve with hydrostatic/lacrimal massage but some require minor surgical interventions.

It is strongly advised to get any of the eye symptoms evaluated by your eye care physician. Symptoms can overlap and hence it is important to diagnose the underlying cause.

Allow us to serve your eye care and eye wear needs. Call us today and schedule a comprehensive eye examination.


Digital Screens and Vision

Effect on digital screens on our vision. Part 1
Latest research suggests more people are becoming shortsighted (myopia) now than they were a decade ago1. This comes as no surprise as it has been proved over and over again that excessive near work can promote myopia progression.
The direct link of digital screens and myopia progression has not been made yet, however, the progression is happening too quickly for it to be purely genetic or environmental 1. Most parents ask a consistent question about their child’s prescription increasing too quickly, and we believe there is a direct link to digital screen time (computers, laptops, tablets, smartphones, etc).
Other than myopia progression, we have also noted unstable tear film, Meibomian gland dysfunction and other eye surface conditions causing Dry Eye Syndrome at a very young age. The important thing to note is that children will not complaint of dry, irritated, red eyes or report of blur in most cases. Hence it is very important for the parents/guardians to be vigilant and get comprehensive eye examinations every year for the children.
At 20/20 Eye Care, a comprehensive eye exam <hyperlink to what it entails at our clinic> will not only be able to determine any refractive (glasses) issue, but also outline and eye health, binocular vision, 3D vision, color vision deficiencies. Call us at 905-766-3721 to schedule your eye exam today.

http://www.ubergizmo.com/2017/06/smartphones-change-shape-of-our-eyes/


Smoking and eye health

Smoking and your eye health.
Smoking contributes to a multitude of health problems, including stroke, high blood pressure, cancer and heart disease. However, many people are unaware of the toxic effects of smoking on your vision and eye health.

⦁    Cornea/Tear film: Increased risk of Dry Eye Syndrome
⦁    Symptoms: Burning, itching, redness, tearing, foreign body sensation and intermittent blurry vision.
⦁    Extraocular muscles (EOM – six muscles that control the eye): increased risk for Graves’ Disease.
⦁    Symptoms: Stare due to eyelid retraction, redness, irritation, light sensitivity, double vision, EOM restriction, increased eye pressure
⦁    Conjunctiva: Increased risk of conjunctivitis (pink eye)
⦁    Symptoms: Pink eye, burning, stinging, itching, swollen eyelids, light sensitivity
⦁    Lens: Cataracts. Risk >3x vs non smokers.
⦁    Symptoms: blurred vision, difficulties with night driving (glare and halos)
⦁    Optic Nerve: Increased risk and progression of Glaucoma, Toxic Optic neuropathy, ischemic optic neuropathy, increased risk of progression and relapse or optic neuritis.
⦁    Symptoms: visual field defect, pain, blur (or loss) vision, color deficiency.
⦁    Retina: Increased risk and progression of diabetic retinopathy and age related macular degeneration. Risk of macular degeneration in smokers is 2-3x more than non smokers.
⦁    Symptoms: Loss of vision, distortion in vision.
⦁    Refractive changes: Research shows relationship between child’s myopia and history of maternal (mother) smoking during child’s life and pregnancy and history of paternal (father) smoking.
⦁    women smoking during pregnancy are more likely to give birth prematurely, putting the newborn at potentially blinding disease called Retinopathy of prematurity.
The toxic effects of smoking are caused by decreased flow to blood to the vessels of the eye, increased formation of clots within these blood vessels and cell damage from free radicals. However studies have shown a dose dependent relationship between tobacco use and its health side effects, therefore, these diseases (risk of) will likely decrease after smoking cessation. Some ocular conditions related to tobacco smoking have no cure, and therefore it is crucial to realize the importance of smoking cessation.

Age-Related Eye Disease Study 2 Research Group. Lutein + zeaxanthin and omega-3 fatty acids for age-related macular degeneration: the Age-Related Eye Disease Study 2 (AREDS2) randomized clinical trial. JAMA. 2013 May 15;309(19):2005-15.
Asensio-Sánchez VM, Gómez-Ramírez V, Morales-Gómez I, Rodríguez-Vaca I. Clinically significant diabetic macular edema: systemic risk factors. Arch Soc Esp Oftalmol. 2008 Mar;83(3):173-6.
Caban-Martinez AJ, Davila EP, Lam BL, Dubovy SR, McCollister KE, Fleming LE, Zheng DD, Lee DJ. Age-related macular degeneration and smoking cessation advice by eye care providers: a pilot study. Prev Chronic Dis. 2011 Nov;8(6):A147.
Krishnaiah S, Vilas K, Shamanna BR, Rao GN, Thomas R, Balasubramanian D. Smoking and its association with cataract: results of the Andhra Pradesh eye disease study from India. Invest Ophthalmol Vis Sci. 2005 Jan;46(1):58-65.
Iyer JV, Low WC, Dirani M, Saw SM. Parental smoking and childhood refractive error: the STARS study. Eye (Lond). 2012 Oct;26(10):1324-8
Lawrenson JG, Evans JR. Advice about diet and smoking for people with or at risk of age-related macular degeneration: a crosssectional survey of eye care professionals in the UK. BMC Public Health 2013;13:564.
Lin P, Loh AR, Margolis TP, Acharya NR. Cigarette smoking as a risk factor for uveitis. Ophthalmology 2010;117:585- 90.
Macsai MS. The role of omega-3 dietary supplementation in blepharitis and meibomian gland dysfunction (an AOS thesis). Trans Am Ophthalmol Soc. 2008;106:336-56.
Physician behavior and practice patterns related to smoking cessation summary report. Washington (DC): American Association of Medical Colleges; May 2007. http://www.aamc.org/workforce/smoking-cessation-summary.pdf.
Timothy CO, Nneli RO. The effects of cigarette smoking onintraocular pressure and arterial blood pressure ofnormotensive young Nigerian male adults. Niger J PhysiolSci 2007; 22:31–35
US Department of Health and Human Services. Agency for  Healthcare Research and Quality. Clinical Care Guideline. Treating
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Vingerling JR, Hofman A, Grobbee DE, de Jong PT. Age-related macular degeneration and smoking. The Rotterdam Study. Arch Ophthalmol. 1996 Oct;114(10):1193-6.
https://www.aao.org/eye-health/tips-prevention/smokers
http://www.aaopt.org/sites/default/files/userfiles/2014_Handouts/PH-06.pdf
https://en.wikipedia.org/wiki/Graves%27_disease