Welcome! This is the free PDF version of this book. Feel free to share and e-mail it to your friends. If you find this book useful, please support this project by buying the printed version at Amazon.com. Here is the link: http://www.rooteyedictionary.com/printversion Timothy Root, M.D. Root Eye Dictionary A "Layman's Explanation" of the eye and common eye problems Written and Illustrated by Timothy Root, M.D. www.RootEyeDictionary.com 1 Contents: Introduction The Dictionary, A-Z Extra Stuff - Abbreviations - Other Books by Dr. Root 2 Intro 3 INTRODUCTION Greetings and welcome to the Root Eye Dictionary. Inside these pages you will find an alphabetical listing of common eye diseases and visual problems I treat on a day-to-day basis. Ophthalmology is a field riddled with confusing concepts and nomenclature, so I figured a layman's dictionary might help you "decode" the medical jargon. Hopefully, this explanatory approach helps remove some of the mystery behind eye disease. With this book, you should be able to: 1. Look up any eye "diagnosis" you or your family has been given 2. Know why you are getting eye "tests" 3. Look up the ingredients of your eye drops. As you read any particular topic, you will see that some words are underlined. An underlined word means that I've written another entry for that particular topic. You can flip to that section if you'd like further explanation, though I've attempted to make each entry understandable on its own merit. I'm hoping this approach allows you to learn more about the eye without getting bogged down with minutia ... but if you are interested in a topic, you can dive in as deep as you like! Even though this book is full of information, I discourage you from trying to diagnose your own eye problems ... or opening your own eye clinic in your garage. Many eye diseases present with similar symptoms and can only be diagnosed by examination under a microscope. When in doubt, it is best to consult with an actual eye doctor. You should look upon this book as supplemental education and NOT as medical advice. With that said, I hope you find this information useful. Timothy Root, M.D. 4 Root's Disclaimers Here are a couple of things to keep in mind as you read this book: Accuracy: With many of the topics here, I faced a dilemma between factual accuracy and maintaining "understandability." When in doubt, I've decided to err on the side of understandability. You may occasionally find information that is not 100% technically accurate. This is a book designed to improve comprehension through intuitive examples and metaphor. If you need more exact definitions, I can point you toward medical textbooks and journal articles that I've written for this purpose. Cartoons: A "dictionary" can be a rather boring textbook to read. To keep this book interesting, I've added many cartoons and comic strips. These silly jokes are not meant to downplay eye disease or disrespect patients. Rather, this lighthearted approach is meant to keep this book palatable and easy to read. No offense is intended, and I hope you approach these cartoons with the same good-natured outlook that I had when I illustrated them. Opinion: If you see another doctor, you may find information in this book that conflicts with what you've been told about the eye. When in doubt, listen to the doctor who has actually examined your eyes. This book reflects my own personal beliefs, medical experiences, and is specific to the greater Daytona Beach area. 5 6 A 7 accommodation. Accommodation is the process by which the eye focuses to see near objects. A normal eye, that is to say, an eye that is neither nearsighted nor farsighted, is naturally focused to see distant objects clearly. To see close-up objects, such as when reading, the flexible lens inside the eye changes shape and becomes "rounder." This process is called accommodation and is quite versatile when young. After the age of 40, however, our lens becomes stiff and accommodation becomes more challenging. We lose our ability to accommodate and we become more dependent on glasses and bifocals with time. This loss of accommodation is called presbyopia. With accommodation, the lens becomes rounder. acetazolamide. An oral water pill that is used to treat glaucoma. This pill is a diuretic and will dehydrate the body, but it will also dehydrate the eye and decrease eye pressure. This medication is also known as Diamox and is normally used in cases of extremely high eye pressure where we've exhausted our topical eye drop options, or used immediately after other eye surgery to avoid pressure spikes. Don't confuse this with acetomenophine (Tylenol). If you switch these, you might be up all night peeing instead of curing your headache. This pill is also used for people going to high altitudes to avoid mountain sickness. Side effects are minor but can include tingling sensations in the fingers/toes and carbonated soft drinks may taste odd. 8 Acular. This is an eye drop in the NSAID class of medicines. It is an anti-inflammatory drop with a mechanism similar to Advil or Motrin. It is occasionally used to help with ocular discomfort but mainly used after eye surgery. This class of medicines is good at decreasing the chance of macular edema (retinal swelling) after cataract surgery. It can sting a little going in, however. acute glaucoma. Acute glaucoma is when the pressure inside the eye goes up suddenly. This usually occurs because of a sudden closure of the drainage "angle" inside the eye. With no drainage, the aqueous humor fluid builds up and causes a spike in eye pressure that can lead to rapid vision loss. Symptoms include extreme eye pain along with nausea and halos seen around lights. Treatment is geared toward lowering the pressure and "breaking the attack," often with a laser, eye drops, and diuretic pills like Diamox. Acute glaucoma is less common in the USA as most people with glaucoma have chronic "open-angle" glaucoma. If an eye appears to be at risk for having an attack, then we will sometimes perform a prophylactic laser procedure called a laser peripheral iridotomy (LPI) to decrease the likelihood of this problem. acyclovir. An antiviral pill used for viral infections such as shingles (chicken pox) and herpetic eye disease. This medication is cheap and effective, but requires a lot of pills to get the correct dosing. A similar medicine we use is called Valtrex (valacyclovir). Some people with these recurring infections will take a maintenance dose of acyclovir to decrease the chance of a new outbreak. Adie's pupil. This is a neurologic disorder in which one eye becomes dilated. Most patients have no symptoms or visual complaints, but a friend points out that one of their pupils is now much larger than the other. Also, the pupil does not seem to constrict normally with light. An Adie's pupil usually occurs from damage to one of the nerve clusters behind the eye (inside the eye socket) that controls pupil constriction. This damage can occur from an otherwise harmless viral infection such as a common cold. The problem is usually temporary and goes away after a few months. The opposite condition is called Horner's syndrome. Horner's causes pupil constriction and is potentially dangerous. 9 after-cataract. This is a cloudy membrane that forms on the back surface of an implant lens inside the eye after cataract surgery. This opacity can form months or years after a successful cataract operation and can cause blur and glare symptoms (similar to the original cataract). These "after cataracts" are not a complication from cataract surgery, but rather a continued proliferation of tissue inside the eye (similar to scar tissue). After-cataracts are easy to treat with a laser. A YAG capsulotomy can be performed to create a hole through the opaque membrane. This is a simple, painless procedure, and once performed the "after cataract" does not typically reoccur. Alaway. An effective over-the-counter allergy drop. Alaway contains the medicine ketotifen and is usually used twice a day. Allergy drops are good for itching and swelling, and can make the eye feel less sensitive. Alaway and Zaditor (which contains the same active ingredient) are two of my favorite over-the-counter allergy drops. allergic conjunctivitis. The eyes are particularly sensitive to environmental allergens. Symptoms are usually bilateral, with both eyes being itchy and puffy. Eyelid swelling can be so bad that you look like you've been in a fight ... we call these "allergic shiners." Treatment for allergic conjunctivitis involves cool compresses, antihistamine allergy drops, and occasionally mild steroid drops. allergy drops. Allergy drops are commonly used to treat ocular itching and swelling. There are several types of allergy drops on the market. The first generation antihistamine drops like Opcon-A are effective but tend to give short-lived relief. Second generation antihistamines like Alaway/Zaditor are more effective and what I recommend for most of my patients. Prescription strength allergy drops are also available such as Bepreve, Pataday, and Lastacaft. 10 Alphagan. A glaucoma drop used to lower eye pressure. This drop went generic so many people have switched to generic brimonidine or moved up to Alphagan P. Alphagan P. This is a glaucoma eye drop designed to lower eye pressure. It is actually a "new" formulation of brimonidine that has a lower concentration of active drug and a less harsh preservative in it. Despite the decreased concentration, the drop appears to have the same efficacy as the old Alphagan but with less irritating side effects.