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Ocular Conditions

Dr. Bruce Coward and Associates treats a wide range of ocular conditions and disorders, such as astigmatism, glaucoma, dry eyes, and conjunctivitis in order to restore vision.

We encourage you to schedule an appointment at our office if you are experiencing any changes in your vision or have any concerns about your eyes.

Eye Floaters
Pink Eye / Conjunctivitis
Dry Eyes
Macular Degeneration

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Explaination: Eye floaters are little specks of debris floating through the vitreous fluid in the eyeball. Sometimes people may momentarily confuse them with dust or tiny insects floating across in front of the eye. However, they are within the eyeball and are not eliminated by rubbing the front of the eye. They follow the rapid movements of the eye while drifting slowly from one place to another. If floaters didn’t move, they would be invisible due to a process called neural adaptation. Under normal circumstances, eye floaters are absolutely nothing to worry about. Everyone experiences them from time to time and they cause no ill effects.

When Should I be concerned: Specks in front of the eyes are normally clearly visible when looking into a light background. However, if they start becoming visible in every background, suddenly increase in number and are accompanied by any loss of vision, it is vital that immediate medical advice is sought. This could be an early sign of retinal detachment.

If the retina has become detached or has a hole in it, you will begin to experience flashing lights before your eyes and you will also be aware of numerous floaters. These two symptoms will be accompanied by a loss of vision, so urgent medical advice is necessary. Surgery is required to seal any holes in the retina, or to re-attach the retina to the back of the eyeball.

Treatment: Most eye floaters and spots are harmless and merely annoying. Many will fade over time and become less bothersome. We have researched every possible method to cure eye floaters ranging from natural treatment to surgery. If your eye floaters persist, we recommend contacting your eye care professional.


Explanation: Conjunctivitis is swelling (inflammation) or infection of the membrane lining the eyelids (conjunctiva). The conjunctiva is exposed to bacteria and other irritants. Tears help protect the conjunctiva by washing away bacteria. Tears also contain enzymes and antibodies that kill bacteria. Viruses are the most common cause of conjunctivitis. Other causes are allergies, bacteria, certain diseases, chemical exposure, use of contact lenses (especially extended-wear lenses), fungi. “Pink eye” refers to a viral infection of the conjunctiva. These infections are especially contagious among children.
Symptoms are blurred vision, crusts that form on the eyelid overnight, eye pain, gritty/itching feeling in eyes, redness in the eyes and sensitivity to light.

Treatment: Treatment of conjunctivitis depends on the cause. Allergic conjunctivitis may respond to allergy treatment. It may disappear on its own when the allergen that caused it is removed. Cool compresses may help soothe allergic conjunctivitis.

Antibiotic medication, usually eye drops, is effective for bacterial conjunctivitis. Viral conjunctivitis will disappear on its own. Many doctors give a mild antibiotic eyedrop for pink eye to prevent bacterial conjunctivitis.

You can soothe the discomfort of viral or bacterial conjunctivitis by applying warm compresses (clean cloths soaked in warm water) to your closed eyes.

Call for an appointment with your health care provider if your symptoms last longer than 3 or 4 days.


Explanation: Dry eye means that your eyes do not produce enough tears or that you produce tears that do not have the proper chemical composition. Often, dry eye is part of the natural aging process. It can also be caused by blinking or eyelid problems, medications like antihistamines, oral contraceptives and antidepressants, a dry climate, wind and dust, general health problems like arthritis or Sjogren’s syndrome and chemical or thermal burns to your eyes.

Treatment: Dry eye cannot be cured, but your optometrist can prescribe treatment so your eyes remain healthy and your vision is unaffected. In some cases, small plugs are inserted in the corner of the eyes to slow tear drainage.


Explanation: Glaucoma is an eye disease in which the internal pressure in your eyes increases enough to damage the nerve fibers in your optic nerve and cause vision loss. The increase in pressure happens when the passages that normally allow fluid in your eyes to drain become clogged or blocked. It most often occurs in people over age 40. People with a family history of glaucoma, African Americans, and those who are very nearsighted or diabetic are at a higher risk of developing the disease.

Without treatment, people with glaucoma will slowly lose their peripheral (side) vision. As glaucoma remains untreated, people may miss objects to the side and out of the corner of their eye. They seem to be looking through a tunnel. Over time, straight-ahead (central) vision may decrease until no vision remains.

A comprehensive dilated eye exam can reveal more risk factors, such as high eye pressure, thinness of the cornea, and abnormal optic nerve anatomy. In some people with certain combinations of these high-risk factors, medicines in the form of eyedrops reduce the risk of developing glaucoma by about half.

Treatment: Immediate treatment for early-stage, open-angle glaucoma can delay progression of the disease. That’s why early diagnosis is very important.

Glaucoma treatments include medicines, laser trabeculoplasty, conventional surgery, or a combination of any of these. While these treatments may save remaining vision, they do not improve sight already lost from glaucoma. Medicines, in the form of eyedrops or pills, are the most common early treatment for glaucoma. Taken regularly, these eyedrops lower eye pressure. Some medicines cause the eye to make less fluid. Others lower pressure by helping fluid drain from the eye.

You can protect yourself against vision loss by working in partnership with your eye care professional.


Explanation: Astigmatism is a type of refractive error of the eye. Refractive errors cause blurred vision and are the most common reason why a person goes to see an eye professional.

Other types of refractive errors are farsightedness and nearsightedness.

People are able to see because the front part of the eye is able to bend (refract) light and point it to the back surface of the eye, called the retina.

Changes in the length of the eye, or the shape of either the lens or the cornea make it more difficult for the eyes to focus light. If the light rays are not clearly focused on the retina, the images you see may be blurry.

With astigmatism, the cornea (the clear tissue covering the front of the eye) is abnormally curved, causing vision to be out of focus.
The cause of astigmatism is unknown. It is usually present from birth, and often occurs together with nearsightedness or farsightedness.
Astigmatism is very common. It sometimes occurs after certain types of eye surgery, such as cataract surgery.
Astigmatism makes it difficult to see fine details, either close up or from a distance.

Treatmeat: Mild astigmatism may not need to be corrected. Glasses or contact lenses will correct astigmatism. Laser surgery can help change the shape of the cornea surface to correct astigmatism, along with nearsightedness or farsightedness.


Explanation: Macular degeneration is an eye disorder that slowly destroys sharp, central vision. This makes it difficult to see fine details and read. The disease is most common in people over age 60, which is why it is often called age-related macular degeneration (AMD). The retina is at the back of the eye. It changes light and images that enter the eye into nerve signals that are sent to the brain. A part of the retina called the macula makes vision sharper and more detailed.
AMD is caused by damage to the blood vessels that supply the macula. This change also harms the macula.
There are two types of AMD:
1. Dry AMD occurs when the blood vessels under the macula become thin and brittle. Small yellow deposits, called drusen, form. Almost all people with macular degeneration start with the dry form.

2. Wet AMD occurs in only about 10% of people with macular degeneration. New abnormal and very fragile blood vessels grow under the macula. This is called choroidal neovascularization. These vessels leak blood and fluid. This form causes most of the vision loss associated with the condition.

The condition is rare before age 55. It is most often seen in adults 75 years or older.
You may not have any symptoms at first. As the disease gets worse, you may have problems with your central vision.

The most common symptom in dry AMD is blurred vision. Often objects in the central vision look distorted and dim, and colors look faded. You may have trouble reading print or seeing other details, but you can generally see well enough to walk and perform most routine activities.

As the disease becomes worse, you may need more light to read or perform everyday tasks. A blurred spot in the center of vision gradually gets larger and darker.
In the later stages, you may not be able to recognize faces until they are close.
The most common early symptom of wet AMD is that straight lines appear distorted and wavy.
There may be a small dark spot in the center of vision that gets larger over time.
Central vision loss can occur very quickly. If this occurs, you will need urgent evaluation by an ophthalmologist with experience in retinal disease.

Treatment: If you experience any of these, contact your doctor of optometry immediately for a comprehensive examination.