Ocular Disease

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Ocular surface diseases are a group of disorders that affect the cornea, the transparent surface layer on the front of your eye. These diseases include:

  • * Dry eye syndrome
  • * Meibomian gland dysfunction
  • * Blepharitis
  • * Rosacea
  • * Allergies
  • * Basement membrane dystrophies
  • * Corneal infections, ulcerations, erosions
  • * Conjunctival chalasis, tumors, cysts
  • * Pingueculae or Pterygia (scar-like growths on the conjunctiva or cornea)

Ocular surface diseases negatively affect your eyesight and can interfere with your quality of life. They may limit your ability to wear contact lenses or receive laser refractive surgeries and require proper diagnosis and treatment to protect your vision and overall eye health effectively.

In many cases, ocular surface diseases go undiagnosed and untreated, leading to more health complications. Regular eye exams are essential and allow Dr. Jaccoma to identify potential eye health complications early so he can provide effective treatment.

What are the symptoms of ocular diseases?

Many of the ocular surface diseases have similar symptoms. It’s important to schedule a comprehensive eye exam with Dr. Jaccoma to get an accurate diagnosis and receive effective treatment.

Common symptoms of ocular disease include:

  • * Irritation
  • * Redness
  • * Itching
  • * Discomfort or pain
  • * Watery eyes (especially in cold, dry, or windy conditions)
  • * Tired eyes
  • * Difficulty working on a computer, driving or watching TV

What are the risk factors for ocular surface diseases?

There are several risk factors for developing ocular surface diseases. These factors include:

  • * Age
  • * Certain medications (including some eye drops used to treat other eye conditions such as dry eyes and glaucoma – see below)
  • * Injuries
  • * Chronic disease
  • * Over-exposure to sun, wind, dry conditions
  • * Long periods of time working or playing on computers/video monitors or watching TV
  • * Poor nutrition (lack of sufficient Omega oils in the diet, or poor absorption as occurs with gallbladder disease and other intestinal ailments)
  • * Contact lenses (overwear, poor fit, some contact lens cleaners, improper contact lens hygiene, cosmetic contact lenses, etc).

Some ocular surface diseases are more prevalent in women than men due to hormonal changes during pregnancy and menopause. Makeup (some mascaras, certain makeup removers) can also play a role.

What treatments are available for ocular surface diseases?

Dr. Jaccoma offers innovative treatment solutions for a range of ocular surface diseases. He creates a customized treatment plan to improve your eye health based on your medical history and current symptoms.

Treatments for ocular surface diseases may include:

  • * Prescription eye drops: improves eye lubrication for diseases affecting tear production, such as dry eye
  • * Antibiotics: clears up bacterial infections causing inflammation and redness in the eyelids
  • * BlephEx: in-office eyelid cleaning treatment to remove harmful bacteria and irritants
  • * Prokera: therapeutic device to repair surface eye damage
  • * LipiFlow: uses heat to increase the release of tears from the eye glands
  • * Intense pulsed light (IPL): a laser therapy effective in treating rosacea that affects eyelids and tear production
  • * Radiofrequency (Ellman® devices) to smooth the conjunctival surfaces when indicated (see below) and to assist in the heating and expressing of clogged oil glands while offering an aesthetic repair of thin, wrinkled skin. RF can also be used in certain surgical indications to bloodlessly remove skin lesions and alter the position of malpositioned lids or remove unwanted eyelashes.
  • * “Bandage” or Therapeutic contact lenses
  • * Surgical removal or debridement of abnormal tissues
  • * Laser treatments

What do I do if I think my current eye drops are causing me to have ocular surface diseases?

Certain eye medications used to treat other conditions such as dry eye and glaucoma may actually worsen some ocular surface diseases. This may be because they contain products your eyes are allergic to, or because they contain preservatives that are harsh chemicals designed to inhibit germs from infecting the product. Since each squeeze of the dropper bottle dispenses a drop, that drop is replaced in the bottle by room air. Room air can contain germs, dust, mold, pollen and a host of other unhygienic things. These harsh chemicals may “clean” these contaminants at the expense of hurting your eyes. Lastly, these products contain the “active ingredients” that are nothing like a human tear and at best, replace your tear with materials that can be unfriendly. At worst they can cause tear glands to whither and surface eye cells to suffer.

Treatments for ocular surface diseases caused by eye drops may include:

  • * Preservative Free eye drops: improves eye lubrication for diseases affecting tear production, such as dry eye without the toxic preservatives. These typically come in small plastic vials that are designed for single use applications.
  • * Laser treatments for glaucoma: Dr. Jaccoma is one of the first doctors to have offered the revolutionary Selective Laser Trabeculoplasty (SLT) treatment for glaucoma in Maine and has treated thousands of eyes with this novel technology. SLT targets the debris clogging the filter over the drain inside the eye. This clogged filter is the most common cause of the buildup of excess internal eye fluid that raises pressure and damages the eye nerve. Since the drain now works better, it is common to have patients drop one (and sometimes two) glaucoma medications. The benefits can last for years and are commonly covered by most insurance plans. It takes only minutes to do, is not painful and can be repeated in appropriate cases. Not every glaucoma patient is a candidate for SLT, so Dr. Jaccoma can help you to decide if SLT may be right for you.

Dr. Jaccoma may also recommend corrective surgery to improve the eye structure or gland functioning to help increase natural tear production or repair eye damage. He discusses all of your treatment options during your eye evaluation.


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