CataractCataract is clouding of your natural lens which impairs light from reaching the back of the eye. It is a normal aging change but can be accelerated by certain drugs and medical disorders such as diabetes. Cataract surgery removes the cloudy lens in the eye and replaces it with a clear artificial lens called an intraocular lens or IOL. Once removed, the cataract does not reoccur.

Symptoms include:

  • Blurry vision
  • Inability to see signs at a distance
  • A “film” in front of the eye
  • Difficulty appreciating colors
  • Increased glare especially at night
  • Need for more light to read

Drs. Yau and Gupta perform laser assisted cataract surgery and offer a variety of lenses to fit you and your lifestyle.

Patient Education

Browse the links below to learn more about Catarct Surgery.

What Are Cataracts? Basic Catarct Terminology Cataract Surgery May Prolong Your Life

GlaucomaGlaucoma is a leading cause of blindness in the U.S. It occurs when the the optic nerve becomes damaged and is associated with increased pressure inside the eye. The vision loss is unfortunately permanent and irreversible. The condition often develops over many years without causing pain or other noticeable symptoms!To detect glaucoma, our physicians will test your visual acuity, visual field as well as the pressure in your eye. We also use the Heidelberg Retinal Tomograph (HRT), which can digitally perceive damage that may indicate the onset of glaucoma, allowing treatment to begin before vision is lost.Once diagnosed, glaucoma can be controlled. Treatments to lower pressure in the eye include prescription eye drops and medications, laser therapy, and surgery.

Patient Education

What is Glaucoma

Corneal DisordersCornea is the transparent, front part of the eye. Disease, infection or injury can cause the cornea to swell (called "edema") or degrade (become cloudy and reduce vision). Common diseases and disorders that affect the cornea include:

  • Allergies
  • Dry eye
  • Recurrent corneal erosions
  • Conjunctivitis (“Pink Eye”)
  • Epithelial Basement Membrane dystrophy
  • Fuchs’ endothelial dystrophy
  • Keratoconus
  • Ocular Herpes & Shingles
  • Pterygium
  • Corneal Scars from trauma

Treatment for corneal disease can take many forms, depending on the underlying problem as well as the patient’s preferences. Some conditions resolve on their own and many can be treated with medication. If the cornea is severely damaged or if there is a risk of blindness, a corneal transplant may be recommended to preserve vision.

Plaquenil Retinal ToxicityHydroxychloroquine or Plaquenil, which was originally an anti-malaria drug, is now commonly used to reduce inflammation in rheumatoid arthritis and lupus. Patients on long-term treatment can accumulate the drug in their retinas, which can cause loss of vision. Traditionally, patients were followed primarily using visual field tests to detect any changes. But visual field changes may be misleading since they can result from other eye diseases such as glaucoma, cataracts and macular degeneration. Using the Multifocal Electroretinogram (mfERG) we can in most cases determine whether you actually have Plaquenil Toxicity and advise your doctor of potential problems. Dr. Lyons was one of the pioneers in detecting Plaquenil toxicity by using the Multifocal Electroretinogram (mfERG), which is a painless test, performed in our office and is the only objective test of retinal function to detect early toxicity.

Dry Eye is an extremely common eye problem which can significantly affect your quality of life! Traditionally it used to be a disease of women and old age, but thanks to our new lifestyle we are now seeing it in men and young adults as well! Dry eyes is a multifactorial disease and one approach doesn’t fit all.

There are now many advanced treatment options that can help with your symptoms and improve your quality of life. Here at Silver Spring Eye, we have the expertise and technology to prevent, diagnose and treat your dry eye symptoms so you can go on with your life with clear vision!

Symptoms of Dry Eye

The symptoms of dry are often troubling enough that they cause patients to have a combination of the common sensations of dryness, grittiness and burning, tearing, difficulty while trying to read, use computer screens, mobile devices, drive, or even watch television. Dry eyes and dry eye syndrome not only cause discomfort, but can also have a negative impact on performing daily activities. In order to be comfortable and see clearly we need to have a sufficient quantity of healthy tears on the surface of the eye at all times. Dry eye can result from not producing enough of your own tears or an excessive evaporation of the tears you do produce, or a combination of these factors.

How do tears work?

When you blink, a film of tears spreads over the eye. This keeps the eye’s surface smooth and clear. The tear film is important for good vision. The tear film is made of three layers: An oily layer, A watery layer, A mucus layer. The oily layer is the outside of the tear film. It makes the tear surface smooth and keeps tears from drying up too quickly. This layer is made in the eye’s meibomian glands.

The watery layer is the middle of the tear film. It makes up most of what we see as tears. This layer cleans the eye, washing away particles that do not belong in the eye. This layer comes from the lacrimal glands in the eyelids.

The mucus layer is the inner layer of the tear film. This helps spread the watery layer over the eye’s surface, keeping it moist. Without mucus, tears would not stick to the eye. Mucus is made in the conjunctiva. This is the clear tissue covering the white of your eye and inside your eyelids.

Normally, our eyes constantly make tears to stay moist. If our eyes are irritated, or we cry, our eyes make a lot of tears. But, sometimes the eyes don’t make enough tears or something affects one or more layers of the tear film. In those cases, we end up with dry eyes.

Tear Production

There are many potential reasons that you may not produce an adequate quantity of tears, including certain types of systemic diseases such as Sjögren’s Syndrome, Rheumatoid Arthritis and Lupus Erythematosus, various types of inflammation, long term contact lens wear, past eye infections, allergies, and even vitamin deficiencies.

Evaporation of Tears

Many factors can cause your tears to evaporate too quickly or excessively. These might include environmental factors such as exposure to forced air heating at home or at work, dry climate in general, air travel, reduced blinking from contact lens wear, prolonged computer use or reading, air pollution, or even just blowing your hair dry. It can also be due to blepharitis and meibomian gland disesase as seen in patients with Rosacea.

Treatment & Help for Dry Eye

Depending on the severity and the cause of your dry eyes, we may recommend a number of different treatment options to help your dry eye problems including artificial tears, warm compresses, Restasis® or Xiidra prescription eye drops, punctal plugs, dietary supplements and in severe cases amniotic membrane graft to provide essential growth factors to reduce inflammation and rejuvenate your corneas.

Don’t just live with dry eyes, do something about it! To schedule a dry eye consultation, call us at 301-587-1220 today!

Rheumatologic diseases such as Rheumatoid Arthritis, Lupus, Sjogren’s can also affect eyes. The same inflammation that damages the joints can also cause inflammation in the cornea, sclera, iris and retina. These patients are also more prone to developing cataracts and glaucoma, so a yearly medical exam is important especially if they are on prednisone or plaquenil.

The following are other eye conditions that are exacerbated by rheumatologic diseases: Keratitis Sicca (also called Dry Eye Syndrome) The eye, for several reasons (including the consumption of certain medications or damage to tear-producing glands), is unable to maintain a healthy film of tears. It affects those with Sjögren’s syndrome the most but can be seen in varying degrees with any rheumatologic disease. Dry eye syndrome is the most common ophthalmic manifestation of rheumatoid arthritis and women are nine times more commonly affected than men.Scleritis is inflammation of the sclera, or white part of the eye. Conditions like RA can cause the eye wall, which is the sclera, or the cornea, to become thin and that’s concerning because minor trauma could cause that part of the eyeball to split open. One may notice redness that doesn’t go away with the use of over-the-counter eye drops, sensitivity to light and perhaps reduced vision.  Uveitis is inflammation of the uvea, the vascular layer of the eye, which is sandwiched between the retina and the sclera. It causes eye pain, redness, blurred vision and sensitivity to light. If not controlled, uveitis can lead to vision loss. Retinal Vascular Occlusion: Small blood vessels that feed the retina, or light sensing layer of the eye, become blocked or backed up, akin to what happens during a heart attack or stroke.One will notice vision loss, like a curtain coming over the eye. If an artery is blocked, loss of vision may happen suddenly and come and go. If a vein is backed up, vision loss may be more gradual. It mostly affects those with lupus and scleroderma.If you have any of the above symptoms or are concerned about your eye health due to a rheumatologic condition then call our office today to schedule a consultation!

Diabetic Eye CarePatients with diabetes are at an increased risk of developing eye diseases that can cause vision loss and blindness, such as diabetic retinopathy, cataracts and glaucoma. These and other serious conditions often develop without vision loss or pain, so significant damage may be done to the eyes by the time the patient notices any symptoms. For this reason it is very important for diabetic patients to have their eyes examined once a year. Diagnosing and treating eye disease early can prevent vision loss. It is also important to maintain a steady blood-sugar level, take prescribed medications, follow a healthy diet, exercise regularly and avoid smoking.

Macular DegenerationThe macula is a part of the retina in the back of the eye that ensures that our central vision is clear and sharp. Age-related macular degeneration (AMD) occurs when the arteries that nourish the retina harden. Patients may experience anything from a blurry, gray or distorted area to a blind spot in the center of vision. AMD is the number-one cause of vision loss in the U.S. Possible risk factors include genetics, age, diet, smoking and sunlight exposure. Regular eye exams are highly recommended to detect macular degeneration early and prevent permanent vision loss.Recent developments in ophthalmology allow doctors to improve vision in many patients with AMD with the help early intervention.

Retinal Dystrophies Eletroretinograms can be a conclusive step in assisting in the diagnosis of Retinal Dystrophies. These electrophysiological tests are helpful in localizing and defining the reason for previously undiagnosed vision loss.

The ERG tests that we offer are Full Field ERG, VEP (Visual Evoked Potential), EOG (Electroculography) and mfERG (Multi-focal ERG).

Some of the Retinal Dystrophies that can be diagnosed are:

  • Retinitis pigmentosa
  • Autoimmune retinopathy
  • Cancer associated retinopathy
  • Cone dystrophies
  • Night blindness