Diagnosis and Treatment of Dry Eye

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Diagnosis of Dry Eye

The diagnosis of dry eye is usually a clinical diagnosis.  This means it is diagnosed often by the symptoms you report.  At the Eye Surgery Institute, Dr. Stanley Grandon, Dr. Cindy Wang and I will take a complete history of your symptoms.

If you have dry eye you may often complain of burning, irritation, a foreign body sensation and /or fluctuating vision.  The vision may blur up when you are reading, using your cell phone or on the computer for a long time.

I will perform a comprehensive eye examination including using various dyes to assess the surface of the eye.  There are various other tests that can also be used to evaluate the quality of the tears in your eyes.

Treatment of Dry EyeDry Eye diagnosis and treatment | Eye Surgery Institute| Dearborn MI | Alaina Kronenberg MD

If your dry eye signs and symptoms are mild, I may recommend over the counter artificial tears to start.  The artificial tears in a bottle (with preservative) can be used up to four times a day.

If necessary, I may recommend preservative free artificial tears that can be used more often.  Preservative free tears may also be better if you are also on other drops for glaucoma.

For more moderate signs and symptoms of dry eye, I may also add a gel or night time eye ointment.  I may also recommend a prescription dry eye medication called Restasis.  Restasis can take several months to assess if it is helping you.

Other remedies for dry eye can include punctal plugs.  This is when the opening of the tear duct (called the punctum) is partially blocked with a tiny insert.  This will allow your natural tears or artificial tears to stay on the surface of your eye longer.

Blepharitis, Dry Eye and Ocular Allergies

If you have dry eye you may also have other associated problems that are contributing to your discomfort.  I will examine your eye for inflammation of the eyelid margin which is called blepharitis.  I will also assess for ocular allergies.  These conditions need to be successfully treated to achieve ocular comfort.

Goal

When I treat you dry eyes, it is necessary to be patient.  I usually tell my patients that “the problem did not happen overnight and it will not be better by tomorrow morning.”  Also, it is important to remember that the is no cure for dry eyes.  My goals are to treat you so that your feel at least 80% better over time.  If you are suffering from burning, irritation, foreign body sensation and /or fluctuating vision give us a call for an appointment as other ocular problems can also cause similar symptoms at  313-582-8856.
Alaina Kronenberg, M.D.
Cataract Specialist
Comprehensive Ophthalmologist
Dearborn, Michigan 48126

Diabetes and the Eye

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Diabetes and the Eye

In 2012, 29.1 million Americans, or 9.3% of the population, had diabetes.  According to the American Diabetes Association, 1.4 million Americans are diagnosed with diabetes every year.  At the Eye Surgery Institute we recommend a dilated eye examination at least yearly in all diabetic patients regardless of symptoms.

Diabetes can affect the whole body, including the eye.  The eye disease is called diabetic retinopathy. Diabetic retinopathy is one of the leading causes of preventable blindness.  It is the leading cause of blindness among working adults.  Controlling your blood sugar can prevent and/or delay the onset of the effects of diabetes in the eye.

Regular dilated eye examinations are very important to screen for and detect the effects of diabetes in the eye.  Early diagnosis and possible treatment are essential for diabetic patients to maintain their vision.

Diabetic RetinopathyDiabetic retinopathy | Alaina Kronenberg MD

Diabetic retinopathy occurs when the normal blood vessels in the back of your eye start to leak.  This occurs from high blood sugars.   Diabetic retinopathy occurs in stages from mild to moderate to severe and then to proliferative.

Proliferative diabetic retinopathy is the most advanced stage. Tiny, fragile, abnormal blood vessels grow and can rupture and cause bleeding into the eye.  Sometimes, scar tissue can develop that can contract and possibly cause a retinal detachment.

Diabetic Macular Edema

The macula is the area in the back of your eye that provides your central vision.  Diabetic macular edema occurs when fluid builds up in the macula.  This can cause distorted or blurry vision.  Diabetic macular edema can occur at any stage of diabetic retinopathy.

Diagnosis

The effects of diabetes in the eye are diagnosed with a comprehensive eye examination including checking the visual acuity, dilation to evaluate the back of the eye (retina) and often an OCT image of the retina.  Depending on necessity, other tests may be recommended also.

At the Eye Surgery Institute we commonly use a fluorescein angiogram to help detect the signs of diabetic retinopathy.

Treatment

Diabetic retinopathy and macular edema can be treated with injections into the eye and /or laser treatment.  Often it needs to be treated with multiple treatments over time.  It is important to maintain good control of your sugars to decrease the effects of diabetes in the eyes.

Alaina Kronenberg, M.D.
Cataract Specialist
Comprehensive Ophthalmologist
Dearborn, Michigan 48126

How to Diagnose and Treat Glaucoma

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How to Diagnose and Treat Glaucoma

How do I diagnose and treat glaucoma?  Glaucoma has no symptoms.  Patients who come into my office for an eye examination or urgent eye problem are always tested for glaucoma.  To diagnose glaucoma, I check the patient’s intraocular pressure (IOP) and look into the back of their eye at their optic nerve during a dilated eye examination.

Diagnosis of GlaucomaTreat glaucoma | Alaina Kronenberg MD | Dearborn Michigan

Many patients with glaucoma have a normal eye pressure but have an optic nerve that looks suspicious for glaucoma.  If you have either an elevated eye pressure or a suspicious looking optic nerve, I will recommend more detailed testing including a visual field test, a picture of the optic nerve and checking the thickness of the cornea (pachymetry).

I may ask you to return to my office on another day to recheck the intraocular pressure, often at a different time of the day.  Eye pressure can vary day to day and different times of the day.

Treatment of Glaucoma

Depending on your intraocular eye pressure, appearance of the optic nerve and glaucoma testing, I may opt to treat you for glaucoma.  The initial treatment for glaucoma is often a once daily drop from the class of medications called prostaglandin analogs.  These drops are typically used at nighttime.  I will usually bring you back to the office a few weeks later to assess if the medication is working properly.

Some patients may need more than one drop to sufficiently lower their intraocular pressure.  Drops are usually added one at a time to assess their response.  Many patients may prefer to not take more than one medication, have difficulty affording or instilling the medications or the medications are not working enough.  For these patients, an in office laser procedure can be considered.

After the intraocular pressure has been sufficiently lowered, I will often recommend follow up in 3-4 months depending on the severity of the disease.  I will monitor the intraocular pressure and the testing will be repeated usually yearly.  If I feel the disease is progressing, I will add or change the treatment plan.

If your glaucoma cannot be sufficiently controlled with medical therapy or laser treatment, surgery is often considered.

Alaina Kronenberg, M.D.
Cataract Specialist
Comprehensive Ophthalmologist
Dearborn, Michigan 48126