Blepharitis is an inflammation of the eyelids. Patients often complain of red eyes, eye irritation, itching, foreign body sensation (feeling of something in the eye), ocular discharge, crusting and flaking of the eyelashes. Some get red pimples on the eyelid and refer to them as styes. Get more information here. Most people who develop chalazia, bumps in the eyelids, have underlying blepharitis. The absolute best treatment for chronic blepharitis sufferers is warm lid soaks as outlined in my instruction sheet. Get it here<!–adsensestart–>

• CORNEAL ULCER Eye pain, redness, light sensitivity and decreased vision can be caused by a corneal infection called an ulcer. A corneal ulcer is a collection of white blood cells in the cornea which is sometimes visible as a white dot in the cornea. You can get more information here. If you......
• Ocular Melanoma and Routine Ophthalmoscopy August 6, 2008 Noah Klein, MD Noah Klein, MD, PC   Ocular Melanoma and Routine Ophthalmoscopy   I examined a 50 year old healthy woman today who came in for stronger reading glasses.  Because she had not had a dilated eye exam (ophthalmoscopy) for years I dilated her pupils and......
• Conjunctival Hemorrhage - Blood in the Eye One of the most frequent "emergency" visits in my office is due to a conjunctival hemorrhage. This is what it looks like: /caption] Although this looks dramatic and scary it is quite harmless most of the time especially if not accompanied by any discomfort and without a history of trauma......
• EYE PAIN When a patient complains of eye pain asking the right questions often helps determine the cause of the pain. This makes the diagnosis and treatment easier. It is helpful to distinguish between eye pain caused by external factors such as a foreign body on the surface of the eye and......
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One of the most frequent “emergency” visits in my office is due to a conjunctival hemorrhage. This is what it looks like:

Conjunctival Hemorrhage

Conjunctival Hemorrhage

Conjunctival Hemorrhage

Although this looks dramatic and scary it is quite harmless most of the time especially if not accompanied by any discomfort and without a history of trauma to the eye.

Some possible associations are anti-coagulant therapy such as warfarin, Plavix or even aspirin. Vomiting and coughing can cause this too.     Why does it happen? The causal event is blood leaking out of a small blood vessel under the conjunctiva. You can think of it as a bruise.

<!–noadsense–>

If you got a bruise anywhere in your body you probably would not pay much attention to it.    However, because the red blood is outlined by the white of the eye it is very noticeable.    Often it is not the patient but a friend or relative that first notices it. Another reason it is so dramatic is that the space between the conjunctiva and the white of the eye, the sclera, is so small that a tiny drop of blood is spread over a large area and appears larger than it truly is.    It usually takes about a week for this to resolve. While resolving it can actually spread and appear as if it it getting larger. It can look yellow as it is being resorbed.<!–adsensestart–>

• EYE PAIN When a patient complains of eye pain asking the right questions often helps determine the cause of the pain. This makes the diagnosis and treatment easier. It is helpful to distinguish between eye pain caused by external factors such as a foreign body on the surface of the eye and......
• CORNEAL ULCER Eye pain, redness, light sensitivity and decreased vision can be caused by a corneal infection called an ulcer. A corneal ulcer is a collection of white blood cells in the cornea which is sometimes visible as a white dot in the cornea. You can get more information here. If you......
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• WHAT IS GLAUCOMA? WHAT IS GLAUCOMA? Glaucoma is a disease of the optic nerve often associated with increased intraocular pressure (IOP). Elevated IOP alone is not enough to make the diagnoses of glaucoma. Some patients may have glaucoma when their IOP is within normal limits. This is called Normal Tension Glaucoma (NTG). Conversely......
• Computer Vision Problems Computer glasses and eye strain computer vision syndrome   Do your eyes hurt or burn when looking at a computer screen? Do they tear, or feel tired after hours of computer use? Do you get headaches after staring at a CRT or LCD computer screen? Do you have neck or......
• Contact Lens Irritation Part 1: Contact Lens Solution Dr. Noah Klein Noah Klein MD, PC Many patients present to my office complaining of eye redness, eye irritation,  and a foreign body sensation (feeling of grit or sand in the eye) when wearing their soft contact lenses. They feel this way even when they try on a brand new pair......
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Computer glasses and eye strain

computer vision syndrome

Do your eyes hurt or burn when looking at a computer screen? Do they tear, or feel tired after hours of computer use? Do you get headaches after staring at a CRT or LCD computer screen? Do you have neck or shoulder pain? If so then you are probably suffering from computer vision syndrome (CVS).  I see many patients who suffer from this condition and have never been offered a comprehensive solution to their problem.

The best way to deal with this is to first have a comprehensive ophthalmological exam to rule out eye diseases. Once this is done then the more basic issues can be addressed.

Think about the extent and type of your computer use by reviewing the following issues:

• If your computer vision use is mostly work related do you feel better on weekends than during the work week? If you feel better on days that you do not work then CVS may be an issue.
• Do you primarily use a laptop or desktop computer? Where is the computer display relative to your eyes?  Is it directly in front of you or do you look down as when using a laptop? Your doctor should know where the display is in order to customize your computer glasses. Measure the distance between your eyes and the computer screen before coming in for customized computer eyeglasses.
• Is your display an old fashioned CRT or an LCD screen? LCD screens are easier on the eyes and usually have an anti-reflective surface. Old-fashioned CRT screens can cause a noticeable “flicker” of images on the screen, a major source of computer eye strain. Even if this flicker is imperceptible, it can still contribute to eye strain and fatigue during computer work. Complications due to flicker are even more likely if the refresh rate of the monitor is less than 75 hertz (Hz). If you must use a CRT at work, adjust the display settings to the highest possible refresh rate.

·        How is the lighting in your computer workspace? Glare is a factor for computer eye strain. It is important to understand that glare can come from various sources, such as reflections off of walls, and not just your computer screen. Several tools can be employed to reduce glare, such as placing an anti-glare screen or a computer hood on your monitor.

• Do you wear bifocals or reading glasses? These are usually not appropriate for computer use. Dedicated specially prescribed computer glasses are necessary if you wear bifocals or progressive lenses, because these lenses are generally not optimal for the distance to your computer screen. Putting the head back to see the screen through bottom of bifocals or progressives is what causes neck and shoulder pain.
• Are your eyes dry? Even if they aren’t dry under normal conditions people tend to blink less frequently when they stare at a computer monitor, so additional lubrication with artificial tear drops is very helpful. The tears coating the eye evaporate more rapidly during long non-blinking phases, which can be especially problematic for contact lens users. Blinking is very important when working at a computer; it rewets your eyes to avoid dryness and irritation.
• A component of computer eye strain is focusing fatigue. To reduce your risk of tiring your eyes by constantly focusing on your screen, look away from your computer every 20 minutes and gaze at a distant object outside or down the hallway. Looking far away relaxes the focusing muscles inside the eye to reduce fatigue. This is especially true for patients under forty (40) years of age.

Please go to this link to see how I solved Dr. Simon Rosenberg’s computer related problems http://www.youtube.com/watch?v=goWoYXEEKo8

• CORNEAL ULCER Eye pain, redness, light sensitivity and decreased vision can be caused by a corneal infection called an ulcer. A corneal ulcer is a collection of white blood cells in the cornea which is sometimes visible as a white dot in the cornea. You can get more information here. If you......
• Senator Barak Obama Has A Head Tilt August 18, 2008 Noah Klein, MD Noah Klein, MD, PC   Senator Barak Obama Has a Right Head Tilt    Watching the Saddleback Church Forum with Pastor Rick Warren interviewing Senator Barack Obama on Saturday August 16, I was struck by the marked and obvious tilting of the Senator’s head......
• BLEPHARITIS Blepharitis is an inflammation of the eyelids. Patients often complain of red eyes, eye irritation, itching, foreign body sensation (feeling of something in the eye), ocular discharge, crusting and flaking of the eyelashes. Some get red pimples on the eyelid and refer to them as styes. Get more information here. Most......
• Contact Lens Irritation Part 2: Dry Eye Dry eye is a very common cause of contact lens problems and contact lens intolerance. It causes wearers to feel as if there is something in their eyes, a foreign body sensation in their eyes, as if there is grit or dirt in the eye, and eye pain when......
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• Ocular Melanoma and Routine Ophthalmoscopy August 6, 2008 Noah Klein, MD Noah Klein, MD, PC   Ocular Melanoma and Routine Ophthalmoscopy   I examined a 50 year old healthy woman today who came in for stronger reading glasses.  Because she had not had a dilated eye exam (ophthalmoscopy) for years I dilated her pupils and......
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August 6, 2008

Noah Klein, MD

Noah Klein, MD, PC

Ocular Melanoma and Routine Ophthalmoscopy

I examined a 50 year old healthy woman today who came in for stronger reading glasses.  Because she had not had a dilated eye exam (ophthalmoscopy) for years I dilated her pupils and found a melanoma in her left eye. I referred her immediately to an ocular tumor specialist.  With prompt modern treatment she stands an excellent chance of retaining her eyesight and surviving this cancer.

If I had not performed this “routine ophthalmoscopy” today she would not have been referred promptly to an ocular tumor specialist.  Instead the cancer in her eye would grow and perhaps lead to blindness in one eye, removal of the eye, or even death from metastatic disease.

I have seen many diseases of the back of the eye such as retinal detachments, macular degeneration and cancerous tumors. Many were detected with routine ophthalmoscopy.

Insurance companies refuse to pay ophthalmologists to perform “routine ophthalmoscopy.”  I suggest that when you see your ophthalmologist (Eye MD) you ask for this test and agree to pay for it out-of pocket. It could save your sight and maybe even your life.

There are 1400 new cases of ocular melanoma in the United States every year.

I hope you found this post helpful.

Dr. Noah Klein

• WHAT IS GLAUCOMA? WHAT IS GLAUCOMA? Glaucoma is a disease of the optic nerve often associated with increased intraocular pressure (IOP). Elevated IOP alone is not enough to make the diagnoses of glaucoma. Some patients may have glaucoma when their IOP is within normal limits. This is called Normal Tension Glaucoma (NTG). Conversely......
• Contact Lens Irritation Part 1: Contact Lens Solution Dr. Noah Klein Noah Klein MD, PC Many patients present to my office complaining of eye redness, eye irritation,  and a foreign body sensation (feeling of grit or sand in the eye) when wearing their soft contact lenses. They feel this way even when they try on a brand new pair......
• BLEPHARITIS Blepharitis is an inflammation of the eyelids. Patients often complain of red eyes, eye irritation, itching, foreign body sensation (feeling of something in the eye), ocular discharge, crusting and flaking of the eyelashes. Some get red pimples on the eyelid and refer to them as styes. Get more information here. Most......
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August 18, 2008

Noah Klein, MD

Noah Klein, MD, PC

Senator Barak Obama Has a Right Head Tilt 

Watching the Saddleback Church Forum with Pastor Rick Warren interviewing Senator Barack Obama on Saturday August 16, I was struck by the marked and obvious tilting of the Senator’s head Forum. The tilt is to the right side. This phenomenon has not been widely written about from a medical perspective.

A head tilt can be a sign that a patient has double vision also known as diplopia.  Diplopia can be benign if it is caused by a congenital (from birth) eye muscle weakness or it can be associated with autoimmune medical disorders such as thyroid disease or Myasthenia gravis.  Serious medical conditions such as a brain tumor or stroke can also cause it.

The value of looking and observing the entire patient not just their eyes is an invaluable tool for me as an ophthalmologist and doctor.

How does diplopia occur?

Both eyes must work together to create a single image in the brain called binocular vision. In order to avoid double vision both eyes must be focused on the same object and the eyes must perceive the object on the same vertical and horizontal plane. If this alignment is not perfect then the images sent to the brain are` dissimilar and the brain registers two different pictures simultaneously causing double vision.  Double vision is when the brain sees two copies of the same object at the same time. The two objects can be next to each other horizontally causing horizontal diplopia, one on top of the other causing vertical diplopia, or at an oblique angle.

Each eye has six muscles, called extraocular muscles, that control its movements, and those muscles are innervated by four different cranial nerves, the third, fourth, sixth and seventh nerves. Four of the muscles control simple movements such as up, down, right and left, and the other two the inferior and superior oblique muscles are responsible for tilting and rotating the eye. 

A muscle or a cranial nerve disorder can cause an extraocular muscle to be weak or not function at all. As a result the two eyes send dissimilar images to the brain causing the patient to complain of double vision.

A head tilt is frequently seen in patients who are trying to overcome diplopia by turning their head in such a way as to avoid using a certain extraocular muscle. 

Why SENATOR OBAMA’S HEAD tilt is  important

Senator Obama should have a medical evaluation, perhaps even an MRI to determine the cause of his head tilt.  Hopefully the cause is not serious, but early detection is always best.

Dr. Noah Klein

Noah Klein, MD, PC

• Conjunctival Hemorrhage - Blood in the Eye One of the most frequent "emergency" visits in my office is due to a conjunctival hemorrhage. This is what it looks like: /caption] Although this looks dramatic and scary it is quite harmless most of the time especially if not accompanied by any discomfort and without a history of trauma......
• CORNEAL ULCER Eye pain, redness, light sensitivity and decreased vision can be caused by a corneal infection called an ulcer. A corneal ulcer is a collection of white blood cells in the cornea which is sometimes visible as a white dot in the cornea. You can get more information here. If you......
• VIRAL CONJUNCTIVITIS - PINK EYE Dr. Noah Klein Noah Klein, MD, PC August 4, 2009 Red eyes with itching, tearing, clear discharge and a foreign body sensation (feeling of something in the eye) can be caused by a virus. This is called viral conjunctivitis or “pink eye” and can be quite uncomfortable.It may be difficult......
• EYE PAIN When a patient complains of eye pain asking the right questions often helps determine the cause of the pain. This makes the diagnosis and treatment easier. It is helpful to distinguish between eye pain caused by external factors such as a foreign body on the surface of the eye and......
• Contact Lens Irritation Part 2: Dry Eye Dry eye is a very common cause of contact lens problems and contact lens intolerance. It causes wearers to feel as if there is something in their eyes, a foreign body sensation in their eyes, as if there is grit or dirt in the eye, and eye pain when......
• Contact Lens Irritation Part 1: Contact Lens Solution Dr. Noah Klein Noah Klein MD, PC Many patients present to my office complaining of eye redness, eye irritation,  and a foreign body sensation (feeling of grit or sand in the eye) when wearing their soft contact lenses. They feel this way even when they try on a brand new pair......
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