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Posted on 06-30-2017
At Michiana Eye Center, our patients represent a relatively diverse sampling of the wider community of Michiana. Although typically people do not come into our offices unless they are experiencing ocular difficulty, we wanted to take a deeper look at just how varied our patient treatment is- plus, who doesn’t like “Top 10” lists?
Data was grouped based on several different factors: (1) individual patient visit (2) primary diagnosis (3) frequency of diagnosis.
If you’ve visited our office, the odds are that you’ve done so because you are experiencing some form of visual difficulty. Of the thousands of patients who visit our offices each year, 94% are diagnosed with refractive error.
Refractive error can be described as how light bends when entering the eye. It includes: myopia, presbyopia, astigmatism and hyperopia. These vision classifications represent an individual’s level of viewing objects at a distance, up close, or a variation of the two and determine the prescription for eyeglasses or contacts used to correct vision.
Age-related cataracts are also ranked high on our list of the most common conditions seen at Michiana Eye Center. In the past year, over 8,000 cataracts were diagnosed at our offices. A cataract is the clouding of the lens of the eye due to the clumping of proteins. The risk of developing cataracts increases as people age, and other factors such as smoking, or diabetes, may also expedite their presence in the ocular lens.
Dry Eye Syndrome
Dry eye occurs when the eye does not have enough quality tears to properly lubricate the eye. Unfortunately, many people experience these symptoms chronically. It is often referred to as a multifactorial disease that can be caused by aging, gender, medication, medical conditions, lid hygiene, meibomian gland dysfunction, improper blinking, or many other factors that are still being studied. The risk of developing dry eye syndrome, or ocular surface disease, seems significantly greater in women, especially after hormonal fluctuations related to menopause. Nationally, nearly 5 million Americans over the age of 50 have had dry eye symptoms. Of these, more than three million have been women. At Michiana Eye Center, of our dry eye syndrome patients, almost 75% have been women.
Although diabetes is, in general, not an ocular condition, its presence as a commonly occurring diagnosis among our patients is no coincidence. Diabetes can lead to a whole host of ocular conditions, including several of the other diagnoses listed. Cataracts, glaucoma, dry eye syndrome, and blepharitis are just some of the issues faced by those who suffer from diabetes. How does diabetes affect the eyes so significantly? Researchers are still studying the relationship between diabetes and ocular conditions, but the latest statistics suggest that those with diabetes are nearly twice as likely to develop cataracts and glaucoma, often becoming diagnosed much earlier in life than non-diabetics. Further, nearly 53% of those diagnosed with diabetes experience dry eye symptoms including burning, and foreign body sensation. Insufficient insulin levels experienced by those with diabetes disrupt the biochemical balance of the cornea and lacrimal glands, resulting in ocular dryness and discomfort. This instability creates a “domino effect” of dry eye symptoms often causing the eye to become less reactive to the bacterial invasions that lead to blepharitis.
Glaucoma is the second-leading cause of blindness, worldwide after cataracts. Open-angle glaucoma, which accounts for nearly 90% of all glaucoma cases, is caused by the slow-clogging of drainage canals into the eye, resulting in increased ocular pressure. Perhaps the most problematic about glaucoma is that there is a weighty list of risk factors that can increase your chances of development.
Macular Degeneration is also considered a leading cause of blindness, affecting millions of Americans, and 6% of our Michiana Eye Center community. About 80% of individuals with macular degeneration have dry macular degeneration. Dry AMD occurs when the macula of the eye becomes thinner with age, gradually causing a reduction in central vision. Wet macular degeneration is a much rarer version of macular degeneration in which irregular blood vessels grow under the retina causing scarring of the macula and much more rapid vision loss. Many people do not even know they have either form of AMD until they begin to experience blurry vision, making regular comprehensive eye exams extremely important, especially as the human eyes age.
About half of the corneal conditions seen at Michiana Eye Center are diagnosed as corneal erosion, while the remaining half is comprised of varying degrees of corneal ulcers. Corneal erosions occur when the outermost layer of the cornea, the epithelium becomes detached from the corneal tissue in the layers more interior to the eye. Although corneal erosion can spontaneously happen, sometimes it is associated with a history of eye injuries, eye ulcers, or corneal dystrophy. Treatment for corneal erosion varies from utilizing lubricating ointments and artificial tears, to having a corneal bandage placed over the eye to allow several days of healing.
Corneal ulcers, also called keratitis, are a form of inflammation of the corneal surface often caused by infection, injury, or a disease of the eye. Eyes can become red, painful, and cloudy for individuals with a corneal ulcer. Typically antibiotics or drops can be used to treat and alleviate symptoms.
Corneal conditions are much more likely to occur in contact lens wearers. Improperly fitting lenses that have not been seen by an eye care professional on the eye can lead to corneal injuries and erosions. Further, use of lenses for extended periods of time without cleaning can lead to bacterial build-up that could progress to corneal keratitis if left untreated. A simple Google Image search for corneal ulcers should serve as a very nice reminder to keep contact lenses clean!
Conjunctivitis occurs when the conjunctiva, the thin transparent tissue covering the eye and eyelid, becomes inflamed, irritated, or swollen. There are three main types of conjunctivitis:
As with other conditions of the eye such as blepharitis and keratitis, conjunctivitis also has a great to deal with proper eye hygiene. Keeping your eyes free from the creepy, crawly things that harm the eyes can keep your eyes safe and happy. Just because our eyes can’t see the bacteria lurking, doesn’t mean that it isn’t there…
Strabismus is a condition in which both eyes do not track objects to the same place at the same time. Poor eye muscle control, as well as farsightedness (hyperopia) can contribute to strabismus. Typically, strabismus develops in infants and young children, and if treated early, can be corrected with excellent results. Eyeglasses, prisms, vision therapy, and in some cases, eye muscle surgery are used in the treatment of strabismus. Nationwide, there are nearly 3 million individuals who have varying degrees of strabismus.
Rounding out our Top 10 list are those eye conditions which exist typically as a result of a sudden impact, accident, or trauma to the eye. About 1% of our patient visits from last year were due to an eye injury. Unfortunately, since eye injuries are usually the result of an accident, prevention of these conditions fall into a broad range. However, protecting your eyes with appropriate eyewear while playing sports or performing certain jobs will certainly improve your chances of avoiding an unexpected visit to our offices!
…What was most surprising?
When we compiled our list, the most surprising ranking to us was just how often we saw patients who were diagnosed with diabetes, but not necessarily diabetic retinopathy. Only 16% of diabetic patients at our offices are diagnosed with a form of diabetic retinopathy, which is often considered the most common ocular condition associated with people who have diabetes. This common misconception is concerning, in that so many diabetic individuals may only focus on symptoms associated with diabetic retinopathy, and not the heightened risks associated with developing glaucoma, macular degeneration, or ocular surface disease. The relationship that exists between diabetes, and so many of the other conditions in the ranking was a reality check that diabetes is a systemic, head-to-toe disease that effects many facets of an individual’s way of life.
Keep an eye out for our next post, where we will take a look at how our Top 10 ranking compares to national averages for ocular conditions. How do you think Michiana Eye Center will do?
 “Strabismus (Crossed Eyes),” The American Optometric Association: 2017. https://www.aoa.org/patients-and-public/eye-and-vision-problems/glossary-of-eye-and-vision-conditions/strabismus?sso=y
 “Strabismus (Crossed Eyes)”
 “Conjunctivitis,” The American Optometric Association: 2017. https://www.aoa.org/patients-and-public/eye-and-vision-problems/glossary-of-eye-and-vision-conditions/conjunctivitis?sso=y
 “Corneal Erosion,” The American Academy of Ophthalmology: 2014. https://www.aao.org/eye-health/diseases/what-is-corneal-erosion
 “Corneal Erosion”
 “What is Keratitis?” The American Academy of Ophthalmology: 2012. https://www.aao.org/eye-health/diseases/what-is-keratitis
 “What is Macular Degeneration?” The American Academy of Ophthalmology: 2017. https://www.aao.org/eye-health/diseases/amd-macular-degeneration
 “What is Macular Degeneration?”
 “What is Macular Degeneration?”
 “Primary Open-Angle Glaucoma” The American Academy of Ophthalmology: 2016. http://eyewiki.aao.org/Primary_Open-Angle_Glaucoma
 “Types of Glaucoma,” The Glaucoma Research Foundation: 2016. http://www.glaucoma.org/glaucoma/types-of-glaucoma.php
 “Primary Open-Angle Glaucoma”
 “Diabetes and Cataracts,” The American Academy of Ophthalmology: 2013. https://www.aao.org/eye-health/tips-prevention/diabetes-cataracts
 “Diabetes and Your Eyesight,” The Glaucoma Research Foundation: 2016. http://www.glaucoma.org/glaucoma/diabetes-and-your-eyesight.php
 Horn, Milton. “Diabetes and Dry Eye: The Forgotten Connection,” Review of Optometry: 2010. https://www.reviewofoptometry.com/ce/diabetes-and-dry-eye-the
 Horn, Milton
 “Diabetes and Your Eyesight”
 Horn, Milton
 Horn, Milton
 Horn, Milton
 “Dry Eye,” The American Optometric Association: 2017. https://www.aoa.org/patients-and-public/eye-and-vision-problems/glossary-of-eye-and-vision-conditions/dry-eye?sso=y
 “Dry Eye”
 “Facts about Dry Eye,” The National Eye Institute: 2013. https://nei.nih.gov/health/dryeye/dryeye
 “Facts about Cataracts,” The National Eye Institute: 2015. https://nei.nih.gov/health/cataract/cataract_facts
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