Thursday, February 27, 2014

Eyelid twitching "myokymia"

We have all had an episode of a jumping or twitching eyelid. It happens at the most unexpected moment. It can last minutes to hours. What can be done? Let's review some eye lid anatomy and function to help clarifty the issue. The eyelid is composed of three layers. The outer layer is the skin, the next inner layer is the muscle and the most inner layer against the eyeball is the conjunctiva. The eye muscle is a thin sheet of tissue which has fast fibers. This means with stimulation the muscle contracts very fast, hence it can produce a fast blink. The blink can occur involunatry or when you purposely close your eye. The nerve connetion from the brain to your eyelids is by cranial nerve number 7 (CN 7) Eyelids protect the eye and spead tears over the surface. Twitching occurs when the nerve signals to the eyelid muscles are disturbed. Usually the nerve muscle complex is over excited. To much rubbing or pulling of the eye lid, stimulants(coffee, Coke, no-dose, appetite suppresants) eyelid disesase, and allergies can all contribute. Rarely,other neurological problems start as twitching lids and can progress to severe facila spasms. For severe cases, I have been treating twitching lids in my office withsmall amounts of Botox. The results a fantastic, effective, and last 3-4 months. The prcedure takes about 5-10 minutes with no recovery time. Treatment costs range from 125-165. For more information visit www.myneweyes.com

Flashes and Floaters

Very common visual problems that people experience are flashes, floaters or a combination of each. To explain these issues in better detail, I first need to review eye anatomy. The eye is a hollow structure filled with fluids. The front part of the eye has aqueous fliuid. It reside behind the cornea and in front of the colored iris tissue in a space called the anterior chamber. The majority of the eye is filled with a thick protein fluid called vitreous. It reside behind the iris in the vitreous cavity. Vitreous is like "raw egg whites." Lining the internal vitreous cavity is the retina vision tissue, which is like wallpaper. Over time, the jello vitreous fluid begins to undergo chages - mostly shrinking and denaturaization. Small clumps of proten form. thse clumps cast a shadow obn the retina. Most apparent in bright light, agaist a plain background such as a white wall or blue sky. The floater shapes are varous: strings, strands, aomebas, bugs, nats, webs etc. These are usually benign but defintely pesky. Floaters which are big, very dark grey, or block a large portion of your vision or occur with flashes ( "arcs / sparks" ) require immediate attention! Why? Well it may indicate a tear or detachment to the retinal tissue. The floaters here may be from a bleed or loose retinal tissue. A dilated exam with a good search of the retina by a qualified eye doctor is the best course of action. If there is a small tear, a outpatient laser procedure can "spot weld" the loose retina back into place. A large tear or detachment may require major surgery. For more information please visit www.myneweyes.com