By Dr. Domenic Turco

In one of our previous blogs, we discussed primary open angle glaucoma and gave a general overview of the disease, the pathology behind the disease, and some of the various treatments available. One of the available treatment options for glaucoma is an in-office laser procedure called Selective Laser Trabeculoplasty (SLT) which is offered by all of the surgeons at Heimer, Fiore, Turco Eye Care and Surgery. SLT is a non-destructive laser procedure that is targeted at the trabecular meshwork—the area of the eye that is responsible for the majority of the drainage of fluid that is produced inside the eye. Resistance of fluid drainage at this area is thought to cause a pressure increase inside the eye leading to optic nerve damage and glaucoma.

SLT is presumed to work by increasing outflow through the trabecular meshwork and thereby lowering the pressure inside the eye. The procedure takes less than 5 minutes and is relatively painless, only requiring an anesthetic eye drop prior to the procedure. In some cases, your physician may have you use a steroid or anti-inflammatory eye drops for up to one week following the procedure. If successful, the procedure may help to lower your eye pressure without the need for additional eye drops or, in patients who have never been on therapy, it may eliminate the need for eye drops for a period of time.

SLT does not provide permanent intraocular pressure lowering but has the potential to last for several years, and since the laser is not destructive it can be repeated multiple times. Unfortunately, just like not everyone responds to certain eye drops for pressure lowering, not everyone responds to SLT. However, about 70-80% of patients achieve the goal of lowering eye pressure by 15-20% from baseline.

Recent studies, including the LiGHT trial, have confirmed that SLT is a very safe and effective means of achieving eye pressure lowering. In fact, the LiGHT trial found that SLT done as a first-line treatment can actually slow progression of visual field loss as compared to eye drops alone. If you have any questions about SLT or glaucoma, please feel free to contact Heimer, Fiore, Turco Eye Care and Surgery at 814-234-1002.

By Dr. Jill Finke

Eyelids are wonderful creations to protect our eyes. They help to keep out intruders. They smooth moisture over the surface of the eyes like windshield wipers. And they provide coverage for our eye surface during some of our favorite hours–sleep!

When your eyelids are working well, it is likely you don’t give them a second thought. However, it is quite normal that at some point in your life you may notice a bump on your eyelid. Knowing some common causes may help you determine your next step if you notice a new bump.

One frequent cause of a bump on the eyelid is a stye, or hordeolum. This type of bump is an infection within an oil gland of the eyelid. The oil glands of your eyelids allow for moisture to be smoothed over the surface of your eyes when you blink. However, if bacteria finds its way into these moist, warm oil glands, an infection may result. Not only will you notice a bump on your eyelid, but the eyelid may feel sore and appear swollen and red. The first course of action in the presence of this type of bump is to start using warm, wet compresses on the affected eyelid for about 5-10 minutes four times per day. If the discomfort, redness, or swelling seem to be progressing, an evaluation with your eye care provider is recommended. Your eye doctor may recommend an antibiotic to help the infection clear up.

This stye can also lead to a different kind of eyelid bump, a non-infectious chalazion. In some cases, your body will detect the infection in the oil gland and encapsulate the infection in a cyst with firm walls. This cyst formation is your body’s way of fighting the spread of infection. However, most people do not enjoy being stuck with a hard bump in their eyelid. Frequently, continuing the warm compresses as above will gradually lead to the bump decreasing in size and disappearing. When the bump does not resolve with continued compresses, it is possible that the bump can be removed in the office of your eye care provider.

A third type of bump that is common to eyelids are skin growths and cysts. Skin growths are usually not red, swollen or painful. Usually these bumps develop slowly over a span of months. In many cases, the skin growths are benign. However, the area around your eyes is a common place for the development of skin cancers. If you notice a new bump developing on your eyelid or around your eye area that is an unusual color or seems to be changing in color or shape, make an appointment with your eye doctor.

Following this introduction to eyelid bumps, if you develop any new eyelid changes, you will be armed with some ideas on what a good next step is for your eyelid health. And if you have any additional questions or concerns, do not hesitate to reach out to your eye care provider for more helpful information.

By Dr. Marla Moon

One in 20 Americans have vision too poor to read a newspaper with ease, watch television, read a product label while shopping, even with eyeglasses.  Low vision is a term that is used to describe a significant vision loss that cannot be corrected fully with eyeglasses, contact lenses, eye medication and/or eye surgery.

Some people are born with low vision, but it can also be caused by health conditions that affect the eyes or an injury to the brain or eyes.  A few of those conditions are as follows: albinism, macular degeneration, diabetic retinopathy, glaucoma, and other conditions such as a traumatic brain injury or stroke.

Help is available for most patients that possess low vision.  If there is enough remaining vision to see a newspaper headline (about an inch high) held at any distance, there is a good probability that vision may be improved by special magnifiers, lenses, technology, or vision enhancement devices.  The amount of benefit gained will depend on the amount of vision remaining, and one’s motivation along with appropriate goals and objectives.  Special devices and training techniques are utilized to enable more efficient use of the remaining vision.  Examples of activities include:

• Reading – using handheld magnifiers, high powered lens systems or electronic magnification devices can help with reading newspapers, the Bible, novels, bills, mail, recipes, or items on your phone.
• Activities performed at arm’s length such as sewing, reading music, or playing cards may require a specialized telescope or loupe magnifier.
• Viewing recreational activities such as sport events, movies, concerts and television may be able to be helped with telescopic or bioptic devices.

Through low vision rehab services, vision is improved but not restored.  With proper training, low vision rehabilitation devices enable a person to perform many visual tasks and activities with greater ease.

Low vision rehabilitation is not a substitute for any ongoing medical treatment, nor will it reverse the process of vision loss or restore sight.  However, in many cases, it can help improve and enhance as much of a person’s remaining vision as possible and assist in their independence and safety.  Please contact our office if you or a family member or friend might be in need of such services.