Fouad Melamed, OD Los Angeles Eye Doctor

Don’t hesitate to see your optometrist for red eyes. There are many causes for red eyes, some very minor and some severe. If your eyes are painful and red or if you have any vision disturbances, you will need to see your eye care professional without delay.

The summertime seems to be hard on our eyes with all the blooming trees, flowers and grasses. Depending upon the allergen, irritation can start in early spring and continue on through the first really cold weather in fall. Your optometrist can provide the medication to make allergy season bearable.

Dry eyes are also a cause for red eyes. You may have tried several treatments at home without much success for dry eyes. Some patients think this is really not a problem that is serious enough to go see the optometrist for. However, the truth is, your optometrist can prescribe the correct lubricating drops that will finally provide relief.

Pink eye is a highly contagious disease that may need antibiotic treatment to be resolved. Pink eye is commonly seen in children and spreads rapidly as it is hard to keep kids from sharing the bacteria. However, adults can also have pink eye, especially if they have been exposed to a child who has the disease. Viral infections can also cause eyes to be red. Your optometrist can make a proper diagnosis and start the proper treatment

Another cause of red eyes is blepharitits. This is an infection of the skin around the eye lashes. Lashes may be crusty or you may notice little white specks at the base of the lashes. Some patients complain of greasy lashes. Your optometrist can help you get rid of this problem which can be especially troublesome if you wear contact lenses.

Eye redness can also be caused by sunburn to the face and eyes. This can be very painful. Foreign substances in the eye at the beach can also cause a whole myriad of problems. From misplaced sunscreen, especially from the spray bottles to abrasions from sand, there are lots of reasons for eyes to be red. If you have any question about the cause of the redness of the eyes or how to handle an issue, call your optometrist. It is much easier to prevent an issue from getting out of hand, than trying to resolve the problem after the fact.

Contact lens over use can cause eyes to be red. Changing contact lens solutions can also cause red eyes. Usually these are easy to treat but there can also be more serious conditions that occur with contact lens over use. If your symptoms persist for more than a day or two, see your eye care professional.

Rarely does glaucoma come on quickly, but when it does it is a true emergency. Symptoms include eye redness, pain and visual disturbances. If you have any of these symptoms call your optometrist immediately.

Seeing your optometrist for red eyes can save you time and money. Trying over the counter treatments can be expensive, especially if the treatment does not work. Let your eye care professional treat the cause of the problem and resolve the issue. Prompt treatment is key to keeping your eyes healthy.

Did you know that it is possible to beat dry eye syndrome with Restasis, a quality product designed to treat dry eyes. Dr. Fouad Melamed, a Los Angeles Eye Doctor, is now carrying Restasis for dry eyes in Los Angeles. Here is a little more information on dry eyes, and what Restasis can do for you.

Dry eye is a condition in which there are insufficient tears to lubricate and nourish the eye. Tears are necessary for maintaining the health of the front surface of the eye and for providing clear vision. People with dry eyes either do not produce enough tears. Most people who suffer from dry eyes also  have a poor quality of tears. Dry eye is a common and often chronic problem, particularly in women and older adults, but it is a treatable disease.

With each blink of the eyelids, tears are spread across the front surface of the eye, known as the cornea. Tears provide lubrication, reduce the risk of eye infection, wash away foreign matter in the eye, and keep the surface of the eyes smooth and healthy.

Restasis Prescription eye drops help to increase production of tears, thereby helping to rid people of dry eyes. Restasis can be prescribed by your Los Angeleis optometrist.,  Additional therapy can come from omega-3 fatty acid nutritional supplements. The treatment works well with prescription Restatsis. For more information on Restasis, and how Dr. Fouad Melamed can help you treat dry eye syndrome, check out his article on the subject at Melamed Eye Care. You can beat dry eye syndrome with Restasis.

EyeScience Dry Eye Formula™ is a unique oral supplement that may improve your dry eye symptoms for long lasting continuous relief. Although eye drops may provide temporary relief of your symptoms, they are inconvenient and cumbersome to use. Our formula works differently, from the inside out, addressing the underlying cause of dry-eye syndrome, not just the symptoms.

There are certainly many types of dry eye vitamins on the market, but none provide long-lasting relief quite like the EyeScience Dry Eye Formula®. Anyone who has dry eyes can attest to the discomfort that it causes, so it becomes vitally important to find reliable supplements. The EyeScience Dry Eye Formula® is just that, as it is an easy-to-use dry eyes remedy that is anything but temporary.

The formula created is recommended by Dr. Melamed because of vast amount of clinical research behind it. Ingredients that have been proven to increase the eyes natural tear production, such as Flaxseed Oil, Omega-3s, Lactoferrin, and several other vitamins are included in the correct amounts for adequate effectiveness.

When you purchase the EyeScience Dry Eye Formula® with the auto-delivery option, you will never again have to worry about how to find relief for your dry eyes – these dry eye supplements offer continuous relief that can’t be beat. The EyeScience Dry Eye Formula® is a particularly great remedy if you are fed up with having to use annoying eye drops that do not work or other dry eye supplements that offer little to no relief. If you are looking for a remedy for dry eyes that can offer real-continuous relief, then look no further, EyeScience Dry Eye Formula is for you.

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Corneal abrasion is a painful scratch that occurs on the clear covering over the pupil and colored portion or iris of the eye. Even though the cornea is clear, there are many nerve endings sitting right under the surface. These nerve endings an early warning detector. When there is pain in the eye something is wrong and needs to be treated. This early warning lets the patient know to see their eye care professional immediately. How to deal with corneal abrasion will involve the services of a Los Angeles Eye Doctor, or an eye doctor in your part of the U.S.

Corneal abrasions occur usually occur when a foreign object hits the cornea and scratches it. This can be almost anything from a piece of sand or small rock, a finger nail, an animal scratch, a piece of metal from an industrial accident to a tree branch

Corneal abrasions can be very difficult for the casual observer to see with the naked eye. There is also the danger in some corneal injuries that a small fragment penetrated the eye to involve deeper structures. That is a true medical emergency and demands immediate attention to preserve eye sight. If you can’t get in to see your eye care professional immediately, you will need to go to Urgent Care Eye Doctor (if one cannot be reached, seek an Emergency Room). These usually occur when small, fast moving objects hit the eye, like small pieces of metal or wood.

The most common sensation with a corneal abrasion is the feeling that there is something in the eye and you can’t get it out. You probably will not be able to see anything, but the sensation continues and is painful. You may also have a new sensitivity to bright lights. Your eye may even be red and watery. It is time to seek the help of your eye care professional.

Your eye care professional may use a local anesthetic eye drop to temporarily numb the eye. A drop of a yellow medication will then be used. Under a special light the scratch or abrasion can then be viewed by your eye care professional. A treatment plan can then be formulated.

You may be prescribed antibiotic drops or an ointment to use in your eye at home. This will help with the healing process and help prevent infection. Many times, a bandage contact lens, is used to cover the abrasion, help healing and dramatically improve comfort, but must be used under a supervision of an eye doctor.

Wearing sunglasses will help with the sensitivity to light. Simply lying down and taking a nap between eye drops may help with the discomfort. Your eye will start to feel better within a day or two. You will probably go back to see your Los Angeles Eye Doctor in a couple of days, just to make sure the cornea is healing properly.

It’s pink eye season in the Los Angeles area. This is a time of year when we see a fair bit of the disease. This is especially so in children. Pink eye is an inflammation of the conjunctiva of the eye. The conjunctiva is the transparent lining of the eyelid and eye ball. This lining becomes red as the tiny blood vessels enlarge with the inflammation. That is what gives this illness its name.  People generally think of children when they think of pink eye, but adults can also have pink eye.

The causative agent of the pink eye determines what the treatment will be. In infants pink eye can be caused by a blocked tear duct. In children and adults the causes can be bacterial,  or viral. They can also be caused by irritants that are in the eye.

Viral and bacterial pink eye is very contagious. After making an appointment to see your Los Angeles eye doctor, it is very important to try to keep the infected person isolated until the cause and treatment is determined. This is obviously much easier to accomplish with an adult than with a child. Do not share make-up, wash cloths, towels, or bed linens with the infected person until they are non-contagious.

If the cause is bacterial, antibiotic drops or ointments will probably be prescribed.  Most day cares will request that children be kept at home for at least 24 hours after medication is begun. The eyes may be watery. The eye area will need to be handled to apply the drops or ointment. Throw away any tissues immediately that have touched tears, and good hand washing is a must to prevent the spread of bacteria.

Viral causes of pink eye will not require antibiotic treatment. If the causative agent is herpes simplex an antiviral medication may be prescribed. That is why it is so important for a proper diagnosis to be made by a Los Angeles area eye doctor. Antibiotics are not effective for viral infections. Your eye care professional may want to send a sample for a definitive diagnosis.

For either viral or bacterial pink eye, refraining from rubbing the eye area will help prevent infecting the other eye. If the eye area is touched, thorough had washing is a must. Eye make up must be discarded to prevent re-infection of the eye. If contacts are worn, be sure to seek advice from your eye care professional on the proper course of action. You may need to refrain from wearing your contacts until the pink eye has resolved. Your eye care professional can guide you in how to clean non-disposable lenses.

Other causes of conjunctivitis include allergic reaction. While this form of pink eye is not contagious, the symptoms can be very distressing. The first treatment is to remove the allergen, although that is not always possible. Your Los Angeles eye care professional will probably prescribe eye drops or even a combination of several different drops to provide symptomatic relief.

In addition to any prescribed medication, a cool cloth on the eyelids may offer symptomatic relief. Some patients prefer a warm wash cloth. If the eyes are crusty in the morning, a warm cloth may help to remove the dried mater on the eye lashes and corners of the eye lids. Just be sure to place the cloth immediately in the wash when done, and wash hands thoroughly.

Fouad Melamed, O.D., is a Los Angeles Eye Doctor. He frequently writes about issues related to eye health, pink eye, contacts, fitting eye frames, etc. You can contact him at melamedeyecare@gmail.com, or  just visit www.melamedeyecare.com to make an appointment in the greater Los Angeles, Beverly Hills area.

Glaucoma is not just one disease that affects the eye, but rather, a group of diseases. The one common factor is the damage to the optic nerve. It is this damage that leads to impaired vision or even blindness. Glaucoma is one of the leading causes of blindness.

In the early stages of glaucoma there are almost no warning signs. Glaucomatous damage first steals the far peripheral vision, thus explaining why most patients with the early disease have no symptoms. For roughly half the patients diagnosed with glaucoma the disease is discovered on a routine eye examination. Early diagnosis and treatment is essential to saving vision. An example of the view of the glaucoma patient is depicted on the right.

In the early days of glaucoma research, it was thought that the rising intraocular pressure caused the optic nerve damage. As treatments and research have progressed over the years it is understood that this is only part of the problem. Increased intraocular pressure a known risk factor, but there are other issues involved too.

Glaucoma that affects adults’ falls into two broad categories: open angle glaucoma and closed angle glaucoma. Open angle glaucoma is the most common form and also the easiest to treat. Angle closure glaucoma is a more devastating disease, because of its fast progression, but thankfully it only affects 5% of glaucoma cases in the U.S.

In glaucoma, the pressure of the inside of the eye is too high for that specific patient and causes damage to the optic never. So there is nothing for the patient to notice externally. This is a completely different mechanism than tears. Tears are actually produced outside of the eyeball. The process is gradual and most patients have no symptoms in the early stages when treatment is the most successful at vision retention.

The good news is because it is a gradual process; regular eye exams will detect the disease early. This form of glaucoma usually responds very well to medication. Optic nerve damage can be usually stopped as the intraocular pressure decreases. Patients will need to be diligent about using their glaucoma drops and having regular eye exams to ensure that the pressure in the eye remains normal.

Closed angle glaucoma is much less common than open angle glaucoma.  The iris of the eye is not as open as it should be and as it closes or bunches up at the edges the drainage system of the eye gets clogged. When this happens the intraocular pressure increases rapidly. Surgery will be done to increase the opening of the iris. This will allow the fluid to drain again. Although yearly exams are still needed to monitor the pressure, reoccurrence of increased pressure is rare.

Normal tension glaucoma is a bit of a mystery. This type of glaucoma causes nerve damage even though the pressure in the eye is normal. While the cause is poorly understood, treatment involves the use of eye drops to keep the pressures as low as possible. People that have a family history of normal tension glaucoma need to be diligent about yearly eye exams.

Risk factors for glaucoma include being over age 40.  African Americans are at the highest risk than the general population to develop glaucoma. Older Hispanic populations are also at an increased risk for developing glaucoma. Interestingly, patients with sleep apnea are also at higher risk. Researchers are recently coming out with results of nutritional supplements that can possible reduce the risks of glaucoma. Finals results have not yet been published.

Even if you are not in a high risk group, yearly eye examinations are essential. Early detection and early treatment is the cornerstone to preserving eye sight where this insidious disease is concerned. The tests are a painless part of a thorough yearly eye examination.

Hordeolum is the medical term for a stye (sometimes spelled sty- both are correct). Hordeolum treatment can be very simple or invasive depending upon the extent of the stye. Anyone who has had a stye will tell you for such a little bump, the pain can be intense.

Hordeolum (or hordeola if there is more than one) is caused by the Staphylococcus aureus bacteria in fully 90 per cent of cases. Unfortunately, MRSA or methicillin-resistant Staphylococcus aureus can also be the causative agent in some cases of styes. Hordeolum can be more than just a minor irritation so if there are any questions as to the severity of the stye call your eye care professional immediately.

Hordeolum generally occur in one of two places. Those that are along the eyelash line are called external hordeolum. Those that occur under the eyelid are referred to as internal hordeolum. Both are a result of an impacted oil gland which then gives the bacteria a place to grow.

The hordeolum will begin as a reddened and swollen area on the eye lid or below the eye. As the pressure builds from the bacteria and the growing accumulation of white cells a bump will appear. As it matures it will develop a whitish yellow spot called the point. This is where the stye will rupture allowing the purulent material or pus to escape.

If the point is on the inside of the eye lid, every time the eye is blinked it can cause a scratching sensation. As the stye grows, just the mass itself will cause discomfort. Plus as the hordeolum grows it looks painful and infected, which it is. The eye may also become sensitive to light and water frequently.

During an examination the optometrist or eye doctor can evaluate the status of the hordeolum and prescribe the necessary course of treatment. Most of the time, topical antibiotic drops will not enter the eyelid where the hordeolum presides. Therefore, at times, oral antibiotics are given to treat the infection with topical drops to prevent any secondary infection of the eyeball itself.  Be sure to finish all antibiotics as prescribed.

Occasionally, surgical intervention will need to take place. This will be done under a local anesthetic unless the patient is a young child who will need sedation for the procedure. The area will be anesthetized and a very small stab wound will be made to allow the purulent material to be released.

If the stye is along the lashes care will be taken to not interrupt eye lash growth. Internal hordeolum stab wounds will be made inside the lid if possible for the best cosmetic affect. Usually, external stab wounds can be made in naturally occurring skin folds to provide for excellent cosmesis.

The cause of hordeolum is not well understood but there are a few precautions that can help reduce risks. Never share eye makeup with anyone. Any eye care products that are suspected of contamination should be discarded. Eye make-up and eye care solutions have a shelf life once opened. Do not keep these products indefinitely. Always wash hands thoroughly before working with the eyes. A diet full omega-3s, such as fish oil or flax oil will also help. Patients with recurrent styes can be put on prescription omega-3 dosage to prevent future outbreaks.

Diabetics are more prone to stye formation, as are people that have chronic inflammation of the eye lids. Stress also seems to be a causative factor in some patients. High blood lipids also seem to predispose some people to stye development.

Contact lenses should generally not be worn while there is a hordeolum present, unless ok’ed by your eye doctor. If the patient wears contacts and a stye develops, remove the contact lens, and call your eye care professional immediately for instructions. Never pinch or squeeze a stye to speed the rupture process. This can damage the delicate tissue around the eye.

Complications from a hordeolum are rare but they do occur. A chalazion is the most common complication. This is a cyst that forms in the oil gland where the stye occurred. Hordeolums seem very small and simple, but should be checked out by an optometrist for treatment, whether it is warm compresses, oral antiobiotics and/or topical antiobiotics drops. They can help you with symptomatic relief and complication prevention. You can find out more at http://melamedeyecare.com

Fouad Melamed, O.D.

Kerataconous is the thinning and the subsequent development of a dome shaped cornea. The cornea is the clear lens that covers the pupil and iris of the eye. For reasons that are not fully understood this gently curved surface can become dome shaped.

The purpose of the cornea is to focus light on the retina that is located in the back of the eyeball. As the cornea becomes dome shaped, the area of focus on the retina changes. Vision then becomes blurred and images are no longer distinct.

Kerataconous is usually diagnosed during puberty until the late teenaged years. The dome will usually increase in size for about 10 years and then stop growing. Nothing can be done to stop the progression of kerataconous. Kerataconous will decrease visual acuity dramatically as the cornea becomes more misshaped.

Initially the condition may be helped by glasses or soft contact lenses. However, as the dome shape a progress, the best vision acuity is obtained when the patient is fit with rigid gas permeable (RPG) lenses. Both eyes may be affected but not always to the same degree. Severe cases of kerataconous may require surgery.

If you are diagnosed with kerataconous, it is important to go to an eye care professional that has experience with treating this condition. This is a progressive condition that will require a change from soft contacts or glasses to rigid gas permeable lenses over time. Your eye care professional will need to be ever vigilant to your changing cornea shape to make the appropriate changes.

Generally patients with kerataconous will not see optimally with glasses or soft contact lenses because of the irregular corneal shape. In most cases, RGP lenses, or rigid gas permeable contact lenses, will give the best vision. It takes a skilled practitioner to get the right fit of the RGP lens over the cone shaped cornea. You will need to expect to make a couple of trips back to your eye care professional to have the initial fit checked and the prescription fine tuned. Regular eye exams will need to become part of your routine for the rest of your life. But that really isn’t any different from anyone who doesn’t have kerataconous.

The symptoms of kerataconous can be easily dismissed at first, which is why yearly eye exams are so important. Headaches that are caused by eye strain, blurry or distorted vision, and increased sensitivity to bright lights are a few of the common symptoms. Patients can also have real issues with glare from lights.

Some patients find out they have kerataconous when they are being examined for LASIK surgery because their glasses or soft contact lens have become ineffective. Unfortunately, at this time LASIK surgery is not advised for patients that have kerataconous.

The cause of kerataconous is not known. Patients that frequently, vigorously rub their eyes are more prone to develop the condition. It has also been occasionally known to run in families, although generally someone will develop kerataconous without any family history.

Catching kerataconous early and then following up with the treatment plan is absolutely essential. If left untreated, kerataconous can cause scar tissue to form at the point of the cone. This scar tissue will have a devastating effect on visual acuity. The only reliable treatment at that point is surgical corneal transplantation.

Kerataconous is a manageable eye condition. If left untreated vision can become very poor. If treated early by an eye care professional that is experienced with kerataconous, visual acuity can be optimized. Early treatment is key is maintaining excellent vision. Your eye care professional will also keep you abreast of any new treatment options that may become available.

Fouad Melamed, O.D.

Eyelid twitching (myokymia) is a spontaneous contraction of the upper or lower eyelids. Patients usually come in at first annoyed as well as slightly concerned of its presentation. A normal examination will include a full medical and social history of the patient. Then proper external examination of the eyes including several diagnostic testing for irritants, infections, allergies, and dry eye signs will be looked it.

The underlying cause eyelid myokymia is not very well understood. The event is most likely nerve fibers within the eyelid muscle caught in a spasm.  Possible precipitating factors include stress, anxiety, fatigue, and excessive caffeine or alcohol intake. Dry eye syndrome (linked to several risk factors) and contact lens side effects are also a possible cause. Fortunately some of these factors can be dealt with and treated with your eye doctor, and possibly calming the eyelid twitching.

Lid myokymia most often is benign and self-limiting. It is important to have a it looked at by a competent eye doctor. If you are in the Los Angeles area, Dr. Fouad Melamed is a licensed optometrist and accepts your medical health insurance with your regular office copay to have a full look at your eyelid twitching.

“Doctor, I think I have Pink Eye!” The term “pink eye” is actually a general term used by patients for a variety of inflammations of the conjunctiva. What we optometrists and eye doctors look for is a more specific diagnoses and cause of what is causing your eyes to become red/pink, watery, painful, or itchy.

Pink Eye or Conjunctivitis can be allergic, bacterial, or viral.In many cases, it is just an irritated eye from a very common condition called Dry Eye Syndrome. A corrected diagnoses is important because that’s what is needed in order to get a correct treatment.

Patients usually (and unsuccessfully) attempt to treat themselves with over the counter medication or unfortunately finding and using “any eye drop” in the drawers at home. This usually does not solve the problem and in many cases can make things worse.

To watch a short video on this topic visit, Pink Eye on our website.

The important take home point is that if you see a case of “pink eye/conjunctivitis” coming, call your eye doctor. If you are a contact lens wearer, it is very important to remove your contacts, and wear your glasses until you can be seen. Los Angeles residents can visit Melamed Eye Care, where most PPO health plans are accepted as well.