Itchy Eyes


Eye Allergies Bothering You? Here is a little information from Dr. Nicole Shams:

Ocular allergies are a common problem in spring and fall for many people. Current studies estimate a prevalence rate of up to 40% of the population being affected during allergy season. Ocular allergies contribute to the burden of nasal allergies and are often underdiagnosed and undertreated, except when they are severe.

The target tissue in the eye is the conjunctiva, the mucous membrane, that covers most of the eye and the inside of the eyelids. Most people with ocular allergies have some degree of conjunctival redness, swelling and itching, which is sometimes accompanied by a mild watery or ropy discharge.

Your optometrist can correctly diagnose and treat allergic conjunctivitis as opposed to an eye infection, pink eye or other serious eye problems, that cause redness in conjunctiva.

Over-the-counter eye drops are usually the first go-to products for eye allergy sufferers. These products often work in cases of mild ocular allergies, but not in more severe cases. It's always best to consult your optometrist about what type of drops would be best. There are several prescription grade allergy eye drops that your optometrist can prescribe for you. Sometimes, even a mild steroid eyedrop might be the best first line treatment to get severe ocular allergies under control.

During allergy season, as well as year-round, for ocular comfort, it's always good to try these tips:

  • Don't forget your sunglasses! They can help block pollen or other allergens from getting into your eyes.
  • Wash dirty clothes and sheets and pillowcases often and keep windows closed at home or work during allergy/ pollen season.
  • Take a shower when you get home to rinse out the pollen or other allergens that have accumulated in your hair. This will also help keep your pillowcase allergen free.
  • Finally, a good ol' home remedy for ocular allergies is frequent cold compresses on your eyes.
Consulting your optometrist ensures you will be evaluated for all possible causes of red eyes and tested for more severe and serious eye diseases. Dr. Nicole Shams @ Kirkland Vision Center


Presbyopia is age-related failing near vision that usually occurs around the age of 40. Even those that have never had a vision problem before can experience poor vision when reading or looking at objects close-up. Causes of Presbyopia While nearsightedness, farsightedness and astigmatism are caused by a misshape of the eye, presbyopia is a loss of flexibility of the lens inside the eye. The lens hardens and loses elasticity making it difficult to focus on near objects. Signs and Symptoms
  • Blurred near vision
  • Clearer vision when holding objects further away
  • Headaches with near vision focusing
  • Eyestrain with near vision focusing
Treatment Options Presbyopia can be corrected with bifocals, progressive addition lenses (PALs), reading glasses, multifocal contact lenses, conductive keratoplasty (CK) surgery and, for those with far or nearsightedness and/or astigmatism, Lasik surgery can help treat multiple conditions. Presbyopia is a gradual and continuing condition and your presbyopia prescription will need to be increased as you age. Bifocal Bifocal lens provide two points of focus. The upper main portion of the lens contains a prescription for near or farsightedness and/or astigmatism and the lower portion has the stronger near vision prescription. Progressive Addition Lenses (PAL) PAL prescription eyeglasses have a gradual transition of multifocal lens powers for vision at various distances. PAL glasses do not have the visible line of the bifocal lens. Reading Glasses Both bifocals and progressive addition lenses are worn throughout the day while reading glasses are used just for close-up work for those with otherwise normal vision or those who wear contact lenses. Reading glasses can be prescription lenses or over-the-counter readers, which can be purchased at most retail stores. Multifocal Contact Lenses Multifocal contact lenses are lenses with more than one power of vision and are prescribed as either alternating vision or simultaneous vision.
  • Alternating lenses are designed similar to bifocal eyeglasses with the main portion correcting near or far vision and the lower portion correcting the presbyopia.
  • Simultaneous lenses combine both near and far correcting abilities throughout the lens. ...

Macular Degeneration

Macular degeneration is an age-related disorder where a portion of the retina (back of the eye) called the macula deteriorates and reduces central vision. Also referred to as AMD, ARMD, or age-related macular degeneration, this condition interferes with the ability to read and drive and is the leading cause of vision loss and blindness in the United States for persons 65 years and older. Peripheral vision is not affected by macular degeneration. Types of Macular Degeneration Neovascular refers to formation of blood vessels in areas where they should not form. Dry or Non-Neovascular The most common and less severe form of macular degeneration is non-neovascular and it is also the early stages of the disease. In dry AMD, tissues thin and deposits of pigment form in the macula. Yellowish spots call drusen are first noticed during examination of the eye. Drusen is evidence of the deteriorating macular tissue. Wet or Neovascular Neovascular macular degeneration is the more advanced and damaging stage of the disease. Erroneously, the body attempts to form new blood vessels to save the macula in the dry (non-neovascular) stage of the disease. However, these vessels that form beneath the retina, leak fluid and blood causing scarring and permanent damage to the retina. Partial or total central vision loss is usually experienced in this stage. Causes of Macular Degeneration Macular degeneration is an age-related deterioration disorder. Studies indicate that a gene deficiency may be a contributing factor.  Greater associated risks for developing AMD include:
  • Caucasian females
  • Inherited tendencies
  • Cigarette smoking
  • High blood pressure
  • Light eye color
  • Obesity
  • Ultraviolet (sun) light exposure
  • High fat diet
 Signs and symptoms Macular degeneration is a gradual and painless disorder. Routine eye exams are necessary to avoid complete vision loss. Early warning signs of AMD include:
  • Central vision shadows
  • Fuzzy or distorted vision
  • Sudden loss of central vision
Treatment Options Currently there are no treatment options for dry macular degeneration. However, many studies suggest that high levels of antioxidants, beta carotene, vitamins C and E and zinc can significantly reduce the risk of progressio...

Floaters, Spots, Strings and Flashes

Floaters, Spots, Strings and Flashes Floaters, spots and strings in your vision may be annoying but are quite common with age especially after age 50. Although usually associated with the aging process, the condition can start at any time including as the eye develops in the womb. You may experience the condition as dark specks or transparent strings that move with the movment of your eye and then move out of your line of vision. Most floaters are due to changes in the gel-like substance (vitreous) inside the eye, which begin to liquefy. This thinning of the gel results in it shrinking and pulling away from the interior surface of the eye causing it to clump and become stringy. The resulting microscopic fibers cluster together and create shadows on the retina, which are perceived in your vision as debris. Floater should not cause you concern unless you notice a sudden increase in the number, suffer a loss of peripheral (side) vision or experience flashes of light.  These latter signs are indicative of a retinal tear or detachment, which can cause vision loss and require immediate attention. Flashes of Light Flashes are usually due to a pulling of the retina by the vitreous and can result in retinal detachment. Flashes can be experienced as jagged lines or heat-like waves. They can last as long as 20 minutes and can cause migraine headaches as blood vessels spasm in the brain. These are known as ophthalmic migraines. Flashes may also appear together with a large number of floaters and other visual disturbances. If you experience these symptoms, you should contact us on an emergency basis. Causes of Floater, Spots and Strings Age related changes in the vitreous humor is the most common cause of floaters. Posterior Vitreous Detachment (PVD) is another common cause and occurs when the vitreous gel pulls away or detaches from the back of the eye.  Floaters are also more common in people that are nearsighted. Additional causes include:
  • Cataract surgery
  • Laser surgery
  • Diabetic retinopathy
  • Inflammation inside the eyes
  • Bleeding in the eyes
  • Tears in the retina
  • Eye trauma
Treatment Options Floaters often go away on their own or become less bothersome as the vision adjusts. However, it is important to get routine ...

Dry Eye Syndrome

Dry eye syndrome is a chronic condition where the surface of the eye fails to maintain sufficient lubrication and moisture. Repercussions of the disorder range from slight eye irritation to an increased risk of infections and corneal inflammation. For comfort as well as optimal vision, your eyes produce a thin film of tears that consists of 3 main layers:
  • A very thin inner layer of mucin (or mucus) that helps evenly spread the watery middle layer over the eye.
  • A thick middle or aqueous layer of very diluted saltwater produced by the lacrimal glands under the upper lids and the tear glands. This layer also helps flush out any debris and dust.
  • A very thin superficial layer of lipids (fats or oils) produced by the meibomian and Zeis glands whose main purpose is to help decrease evaporation of the middle layer.
Causes of Dry Eye Syndrome When the above layers fail to adequately perform, you suffer a lack of moisture or moisture that evaporates too quickly. Defects of the middle layer are the most common cause of dry eye. Additional causes of dry eye include:
  • Aging process, especially for women over age 40
  • Hormonal fluctuations
  • Medications including antihistamines, antidepressants and birth control and those for treatment of high blood pressure and Parkinson's disease
  • Long-term contact lens wear
  • Incomplete closure of the eyelid
  • Eye lid diseases such as blepharitis
  • Eye injuries
  • Eye disorders such as drooping eyelid or bulging eyes
  • Some eye surgeries
  • Climatic factors including excessive exposure to sun, dryness, dust, wind and low humidity
  • Home and office air conditioning and heating systems
  • Insufficient blinking especially when working at a computer for extended periods
  • Cigarette smoking
  • Lupus (inflammatory disease)
  • Rheumatoid arthritis
  • Rosacea (skin disorder)
  • Sjogren's syndrome (immune system disorder)
Signs and symptoms Obviously, persistent dryness is a clear indication of the disorder. However other symptoms may not be as easily recognized including:
  • Burning sensations
  • Scratchiness
  • Foreign body sensations
  • Watery eyes due to abnormal stimulation of tears
Treatment Options Dry eye syndrome can be diagnosed during a regular eye exam. To confirm the diagnosis, we m...

Diabetic Retinopathy

Retinopathy is damage to the retina (back of the eye). This disorder is the result of damaged blood vessels in the eyes due to high blood sugar levels in those suffering from diabetes. If you have been diabetic for some time, you have a high risk of developing retinopathy and have a 25 times greater risk of vision loss. Diabetes may actually cause blood vessels to form in both the iris (colored portion of the eye) and the retina. Abnormal blood vessels can result in glaucoma.  Formed over the retina, the blood vessels can break and cause scar tissue that then pulls the retina away from the back of the eye; a condition known as retinal detachment. If left untreated, retinal detachment can cause blindness. Non-Proliferative or Background Retinopathy Diabetic retinopathy is a progressive disease where initial damage to blood vessels can cause fluid leakage or bleeding, retina swelling and the formation of deposits. This early form is known as non-proliferative or background retinopathy. Proliferative Retinopathy As the disease progresses, new blood vessels begin to develop on the retina. Breakage of the vessels can cause bleeding into the vitreous humor (gel that fills the space in the interior eye). Proliferative retinopathy is very serious and can lead to blindness. Causes of Diabetic Retinopathy
  • Long term diabetes (10 plus years)
  • Changes in blood sugar levels that cause damage to blood vessels
Signs and Symptoms If you have diabetes, you are at high risk for developing diabetic retinopathy. Unfortunately, by the time you notice symptoms, your vision may already be irreparably damaged by the disease. It is imperative that you receive regular eye exams to detect and monitor the condition. Some symptoms that indicate diabetic retinopathy is progressing include:
  • Floaters and flashers
  • Light sensitivity
  • Difficulty seeing close-up
  • Double vision
  • Clouded vision
Treatment Options If you have been diagnosed with diabetes, schedule an appointment for a comprehensive eye exam. It is important that you continue to be evaluated once every year even if you have no symptoms. Statistics show that, with treatment, 95 percent of those with diabetic retinopathy can avoid substantial vision loss. Your evaluation...

Comprehensive Eye Exam

At Kirkland Vision Center, we provide technically advanced and comprehensive eye exams to evaluate not just the health of your eyes and the quality of your vision but your overall health. We also use the most technically advanced equipment available including the Humphrey Visual Field Analyzer and the Retinal Fundus Camera. Depending on your current vision needs, your examination will include the following procedures. Visual Acuity Test Eye chart assessment has been a standard vision test for many years. You will be asked to read a projected eye chart to measure your distance vision and a small card chart to measure your near vision. Cover Test Another test we use is one that determines how your eyes work together. You will be asked to focus on a small object first at a distance and then close up. You will also be asked to cover each eye alternately while staring at the object. There is more to this test than meets the eye. We will be observing how much movement or effort each eye exerts when uncovered. This simple test reveals very subtle misalignments in your binocular vision. Misalignments prevent your eyes from focusing together and can even cause amblyopia or lazy eye. This test is especially important in children’s eye exams. Slit-Lamp (Biomicroscope) Examination This magnified, three-dimensional (3-D) view of your eyes is used to determine your overall eye health. We use fluorescein dye drops to assist with observation and better enable us to detect foreign bodies in the eyes as well as infections and injuries. While you sit comfortably in an exam chair, we will exam the following structures of your eye:
  • Cornea (the clear, outer covering)
  • Drainage angle (where fluid drains from the eyes)
  • Iris (colored portion)
  • Lens (biconvex transparent body behind the iris)
  • Optic nerve (the nerve that transmits visual information from the retina to the brain)
  • Vitreous gel (the fluid in the middle of the eye)
  • Retina (the light-sensitive lining in the back of the eye)
Tonometry (Glaucoma) Test Tonometry is commonly known as the “air puff” test and is used to determine the intraocular pressure (fluid pressure) inside the eye. Elevated pressure in the eyes can result in glaucoma, a serious condition that ...


A cataract is a clouding of the eye's natural lens. The eye lens lies behind the iris (colored portion of the eye) and the pupil (the round, dark center of the eye). The eye lens is mainly composed of water and protein. During the normal aging process, the protein may start to cluster together causing a cloud to form. The cloud or cataract may continue to grow further clouding the vision. This condition is the most common cause of vision loss in people over the age of 40. Causes of Cataracts The exact cause of cataracts is unknown. They can be present at birth (congenital cataracts) but generally occur gradually with age being most noticeable around the age of 55. Cataracts can also be the result of an injury to the eye (traumatic cataracts). Studies indicate the following additional causes and risk factors for cataracts:
  • Exposure to ultraviolet (sun) light
  • Excessive exposure to radiation
  • Certain diseases including diabetes and high blood pressure
  • Long term use of medications such as steroids, diuretics and tranquilizers
  • Excess use of sodium chloride (table salt)
  • Aging
  • Obesity
  • Cigarette smoking
  • Air pollution
  • Heavy alcohol use
Signs and Symptoms Initially, you may notice only slight and occasional cloudy vision. As the cataract progresses, your symptoms will increase and you may experience the following:
  • Blurred vision that cannot be corrected with a change in prescription
  • Increased cloudy vision
  • Double vision
  • Ghost or halo vision
  • Glare from sunlight and artificial light
  • Decreased color perception
  • Increased glare during night driving
Treatment Options Once progressed to the point that your vision cannot be corrected with a change in prescription, cataract surgery is your only option. This surgery is the most frequently performed surgery in the United States and is extremely effective. In most cases, surgery is outpatient using local anesthesia to numb the area. The procedure normally takes just 10 minutes with the entire appointment usually lasting less than two hours. The clouded lens is removed and replaced with a clear, plastic intraocular lens (IOL). Advancements in these lenses have also made it possible to correct presbyopia and, thus, improve far and nearsighted vis...

Hyperopia (Farsightedness)

Hyperopia, more commonly known as farsightedness is a refractive disorder where light rays do not bent (refract) properly. This results in a visual image being  focused behind rather than directly on the retina (the layer in the back of the inner eye). If you are farsighted, you have good distance vision but difficulty seeing objects up close. Farsightedness effects about 25% of people in the United States. It is often present at birth, but many children outgrow the condition. Farsightedness can be a risk factor in developing glaucoma and amblyopia (lazy eye). Corrective lenses are often necessary especially as one ages. Farsightedness is often confused with presbyopia, a condition where flexibility of the lens inside the eye decreases and makes seeing close up difficult. Causes of Hyperopia Farsightedness occurs when light rays entering the eye focus behind the retina, rather than directly on it. This can be due to:
  • Corneas or eye lenses that are not evenly and smoothly curved
  • Weak focusing power
  • Genetic factors
  • Aging intensifies the condition because the lenses of the eyes are no longer flexible enough to compensate for the poor vision.
Signs and Symptoms The stress and strain of tying to focus the eye can result in the following signs and symptoms:
  • Blurred vision of close objects
  • Squinting that improves focus
  • Headaches
  • Eye fatigue
  • Aching eyes
  • In children, strabismus (crossed eyes)
Treatment Options A routine eye exam can determine if you are farsighted, presbyopic, have glaucoma or other conditions that are causing poor close-up vision. Corrective lenses including bifocals, trifocals, reading glasses and contact lenses correct farsightedness by changing the way light rays bend into the eyes. Refractive surgery Surgical correction for farsightedness involves reshaping the curvature of cornea. Your examination will determine which of the following procedures is best for your condition.

LASIK (Laser Assisted in Situ Keratomileusis)

LASIK is non-heat productive laser surgery where the ophthalmologist cuts and removes layers from the center of the cornea to steepen its domed shape.

LASEK (Laser Assisted Subepithelial Keratectomy)

In this procedure, the surgeon creates a flap involving on...


Glaucoma is actually a category of eye disorders involving an increase of intraocular (internal) eye pressure. Pressure builds because the eye is producing too much fluid or the fluid is not adequately draining. This pressure damages the eye's optic nerve (structure that transmits visual information from the eye to the brain). Glaucoma is the second leading cause of blindness in the United States.  Cases of the disease are expected to increase due to an aging population. Often called the silent thief of sight, most glaucoma sufferers are unaware that they have the condition. Glaucoma can be painless and develop over time. Loss of peripheral vision can be the only noticeable symptom. Unfortunately, permanent damage usually occurs before symptoms are noticed. Types of Glaucoma The two major categories of glaucoma are chronic and acute. Chronic glaucoma is referred to as primary open-angle glaucoma and acute is referred to as angle-closure glaucoma. Angle (referenced in both conditions) pertains to the structure inside the eye that is responsible for fluid drainage. Primary Open-Angle Glaucoma (POAG) With POAG, normal or low tension or pressure is present and pain and damage to the optic nerves is not experienced until the end phase of the condition. A gradual loss of peripheral vision is usually the only symptom noticed with POAG.  If internal eye pressure is allowed to remain high, the optic nerve is so destroyed that only limited tunnel vision remains. Acute Angle-Closure Glaucoma Angle-closure or narrow angle glaucoma produces a sudden onset of symptoms including eye pain, headaches, nausea, vomiting, ghost or halos vision, dilated pupils, red eyes and even vision loss. Symptoms may last for hours, subside and then reappear. Each attack causes significant damage to the optical nerve and some loss of vision While chronic and acute glaucoma are the most common, the disorder can be due to other conditions including: Congenital glaucoma This is a congenital defect in the eye’s drainage system that is present at birth and usually diagnosed by age one. Because children cannot communicate any associated problems, you should take note of clouding in the eye or enlargement or protrusions of the eyes. Early eye exams will help...