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Dry eye syndrome is one of the most common conditions eye doctors treat on a daily basis, both here in the Hamilton and Princeton, NJ area and nationwide. It is a very common disorder, affecting approximately 30% of the population. Tears adhere to the surface of our eyes in order to protect and keep them moist. Dry eye is the result of either decreased tear production or increased tear evaporation.

There are multiple risk factors for dry eye. I find that environment plays one of the largest roles. Cold, dry winters, heaters and air conditioners, smoke, and dust are some of the factors that can aggravate dry eye. Certain medications such as antihistamines, beta blockers, and antidepressants can cause a decrease in tear production. Additionally, diseases such as rheumatoid arthritis, Sjogren’s syndrome, and lupus can have a severe impact on dry eye.

Patients with dry eye will experience symptoms such as a gritty or sandy feeling in their eyes, redness, blurry, fluctuating vision, and light sensitivity. Interestingly, patients may also experience tearing, which is a reflex secretion due to dryness.

In mild cases of dry eye where a patient has minimal symptoms, artificial tears used as needed provide relief. In more moderate to severe cases, patients will require regular use of artificial tears along with anti-inflammatory drops. RESTASIS® is a wonderful medicine for patients with moderate symptoms who need long-term treatment.

Dry eye is caused by inflammation of the glands that make tears, resulting in less production and a poor quality. RESTASIS helps to prevent this inflammatory process and improves the amount and quality of tears. Omega-3 supplements have also been shown to have an anti-inflammatory effect on the eyes, allowing for better tear production. There is even a simple and easy procedure that can be performed in the office to block the tear ducts, which prevents tears from draining out of the eyes, keeping them moister.

Although a very common disease, dry eye can be very debilitating if left untreated. Fortunately, over the years, wonderful new medicines and therapies have arisen for treating dry eye. Patients who have dry eyes should feel reassured that with the appropriate treatment, their symptoms can be dramatically improved and even completely resolved.

Do you think you may have dry eye syndrome? I urge you to contact us to find out some strategies for improving your vision, your comfort, and your quality of life.


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At some point in our lives, almost all of us experience at least some degree of floaters or flashing lights in our vision. As eye doctors, we tend to get questions about them often from our Hamilton and Princeton, NJ patients. There are various causes for these phenomena, and I will try to shed some light on this topic.

First I will start with flashes and floaters caused by problems within the eye and retina.

The inside of our eye contains a jelly called the vitreous. For most of us, there is debris within this jelly.  When light enters the eye, it hits this debris and casts a shadow on the retina, which in turn causes us to see floaters. This is a very benign condition, and although it can be annoying at times, it will not damage or harm our eyes or vision. There is also much variability from patient to patient with how noticeable these floaters are. Some patients will never notice them, while others see them constantly.

As we get a little older, the vitreous starts to contract and tugs on the retina. As it begins to tug, patients will often notice a flash of light. This flash usually lasts 1 or 2 seconds and is white in color. Eventually the vitreous will tug hard enough and separate from the retina, which is called a vitreous detachment. This leads to a different kind of floater and one that is usually larger and often looks like a circle or cobweb. This too can be very annoying but is harmless to our eyes. Over time, this floater will usually settle below our line of sight so we don’t see it as much. In certain cases, as the jelly separates from the retina, it will cause a rip or tear in the retina, which can lead to a retinal detachment. This is a more serious condition that requires prompt attention to prevent damage to the retina and vision loss. When this occurs, patients will typically notice more flashing lights, a greater number of floaters, and sometimes a veil or curtain over their vision.

In addition to flashes and floaters caused by problems to the retina, patients can experience these phenomena from other non-eye related conditions. Our eyes are an extension of the brain, so if something is disrupting the parts of the brain responsible for our vision, we can experience a number of different visual symptoms.

Transient ischemic attacks (TIAs), more commonly referred to as mini strokes, are an event in which the brain lacks proper oxygen for a timeframe of less than 24 hours. The most common cause for this is when an embolus, or blood clot, restricts the flow of blood to the brain. Depending of which part of the brain is affected, symptoms can include: weakness on one side of the body, difficulty speaking, confusion, and even visual symptoms such as loss of vision or flashing lights. There are even times when a patient can experience a mini stroke and have only these visual symptoms. Depending on where the blood clot is, these visual symptoms could affect one or both eyes. They can be described as a loss of vision, dimming of vision, or flashing lights. When patients see flashing light from a TIA or even a complete stroke, the flashes tend to last for minutes to hours, versus the retinal flashes that last for a few seconds as described earlier. This difference in duration of the flashes is important and helps to distinguish if the flashes are caused by something in the retina or brain.

In addition to mini strokes and strokes, flashes can also be a result of migraines. This type of flash is referred to as a migraine with “aura.” These flashes will often sparkle and grow in size then shrink. They will generally occur for minutes to an hour. Oftentimes, a headache will follow after the visual symptoms subside, but there are times where no headache will follow and the only symptoms are visual.

Typically, when patients come to see me complaining of flashing lights, the first concern they immediately think of is a retinal detachment. However, there are a number of different causes for flashing lights. My general advice to patients is to alert their eye care professional if they notice new flashes, floaters, or any changes to their usual floaters.

Do you have questions about floaters or flashes? Leave them for us in a comment.


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For most people, spring brings with it short sleeve shirts, outdoor activities, no more cold weather, and fun days in the sun. However, for some it means another dreaded season plagued with allergies. As an eye doctor serving Princeton, Hamilton, and other New Jersey communities, I see a lot of patients who are affected by allergies in the area.

Seasonal allergies are brought on by an immune response in certain individuals with sensitivity to certain allergens, such as pollen. As the pollens are inhaled, allergy sufferers experience rhinitis, or inflammation of their nasal passages. Symptoms include a runny nose, nasal congestion, sneezing, and itching.

If the pollens come in contact with the eyes or ocular surface, it can result in allergic conjunctivitis, otherwise know as allergic pink eye. Around 50% of allergy sufferers experience ocular symptoms. Symptoms generally include red eyes, itching, burning, and tearing. Symptoms can range from mild to very severe.

The best treatment for allergies is avoidance of the offending allergen, although this is often very difficult in regards to seasonal allergies. Some patients get relief from their eye symptoms with oral allergy medicines such as Claritin®. However, a large portion of patients require topical allergy and anti-inflammatory drops. These drops concentrate the anti-allergy effect right in the eyes. In mild cases of eye allergies, I generally prescribe drops such as Pazeo® and Lastacaft®, which helps inhibit the action of histamine and even prevents certain cells from releasing it.

I also recommend using artificial tears. They help to dilute and wash away any pollens or allergens from the ocular surface. Patients can even refrigerate the tears, which gives a soothing sensation when they use them. In more moderate cases of allergic conjunctivitis, especially when the pollen counts are high, I will add a steroid drop to help suppress the immune response. This generally produces very quick relief of symptoms.

I would urge anyone suffering from allergies to seek medical treatment. Too often, I find patients taking over the counter “get the red out” drops, because they believe these are the only therapies available. These medicines generally don’t treat the problem at its source and only mask the symptoms. I also find that I have to directly ask my patients if they experience eye allergies. Many don’t report their ocular allergy issues because they feel it’s just the norm to endure the bad months when pollens are high and their symptoms are severe. Untreated, seasonal allergies can leave a patient miserable; however, with proper medicines, patients can enjoy the spring and summer months as they should.




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Outlook Eyecare
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Monroe Township, NJ 08831
Phone: (609) 409-2777


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Outlook Eyecare
100 Canal Pointe Boulevard #100
Princeton, NJ 08540
Phone: (609) 419-1920



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