They’re more common with age, particularly between the ages of 50 and 70, due to the natural shrinkage and liquefaction of the vitreous.

Signs and Symptoms of Vitreous Floaters Floaters typically appear in many shapes and movements:

• Grey or black dots
• Squiggly lines or wispy strands
• Transparent rings or cobwebs
• Threadlike floaters that shift when you move your eyes

These often become more noticeable in bright lighting or when staring at blank backgrounds. In many cases, they become less distracting as they “settle” below your line of sight.

When to Worry: Retinal Warning Signs While floaters are usually harmless, sudden or severe symptoms may indicate a more serious issue such as a retinal tear or detachment. These include:

• Sudden appearance of new floaters
• Flashes of light (photopsias)
• A curtain-like shadow moving across your vision
• Rapid vision loss or distortion

These symptoms require immediate medical attention to prevent permanent vision damage.

Causes and Risk Factors Floaters are primarily caused by natural age-related changes, but other contributing factors include:

• Posterior vitreous detachment (PVD)
• Nearsightedness (myopia)
• Previous eye trauma or surgery
• Inflammation within the eye (uveitis)

These changes cause the gel inside the eye to clump or shrink, casting shadows perceived as floaters.

Treatment Options Most floaters require no treatment. However, if they become dense and affect vision significantly, options may include:

Vitrectomy – A surgical procedure to remove the vitreous gel and replace it with saline. It is effective but carries risks such as retinal detachment, bleeding, and cataracts.

Laser Therapy – Used in rare cases to break up floaters, though not widely adopted.

If a retinal tear is found early, non-invasive laser therapy or cryopexy (cold treatment) can be used to prevent retinal detachment. More severe cases may require:

• Pneumatic retinopexy
• Scleral buckling
• Vitrectomy for reattachment

In Summary Floaters are typically a natural part of ageing and are mostly benign. But sudden changes or accompanying flashes should never be ignored. Regular check-ups with your optometrist can ensure early detection and help preserve your long-term vision.

What Is Open-Angle Glaucoma?

Open-angle glaucoma occurs when pressure builds up inside the eye due to improper drainage of intraocular fluid. Over time, this pressure damages the optic nerve, which is essential for sending visual information from the eye to the brain.

Unlike angle-closure glaucoma, POAG develops slowly and painlessly, often without noticeable symptoms until significant vision loss has already occurred.

Signs and Symptoms

Because open-angle glaucoma affects peripheral (side) vision first, most people remain unaware of the condition in its early stages. As the disease progresses, symptoms may include:

• Loss of peripheral vision
• Tunnel vision in advanced stages
• Blind spots in the field of vision
• Frequent changes in eyeglass prescriptions

Unfortunately, central vision is only affected in the late stages, which is why many patients do not realise there’s an issue until extensive damage has occurred.

Who’s at Risk?

Everyone is at risk, but the following factors significantly increase the likelihood of developing POAG:

• Age: People over 60
• Family history of glaucoma
• African or Latino descent
• High eye pressure (intraocular pressure or IOP)
• Thin corneas
• Medical conditions such as diabetes, hypertension, and myopia
• Use of corticosteroid medications
• Previous eye injuries

Because the condition can be hereditary and progresses without pain, it’s essential to schedule eye exams at least annually—especially if you’re in a high-risk category.

Diagnosis and Monitoring

Detection of open-angle glaucoma requires a comprehensive eye examination, including:

• Tonometry to measure intraocular pressure
• Ophthalmoscopy to inspect the optic nerve
• Visual field testing to detect peripheral vision loss
• Pachymetry to measure corneal thickness

Monitoring these values over time helps eye care professionals determine disease progression and effectiveness of treatment.

Treatment Options

While there’s currently no cure for glaucoma, the damage can be significantly slowed or halted with appropriate intervention.

The main goal of treatment: Lower the intraocular pressure (IOP)

1. Medication (Eye Drops)

• Prostaglandin analogues: e.g., latanoprost, travoprost – often first-line treatment due to once-daily dosage and effectiveness
• Beta-blockers: e.g., timolol – useful in younger patients or unilateral glaucoma
• Alpha agonists, carbonic anhydrase inhibitors, and miotics are additional or adjunctive options

2. Laser Therapy

• Selective Laser Trabeculoplasty (SLT) is commonly used to enhance fluid drainage

3. Surgery

• In severe cases, surgical procedures like trabeculectomy or drainage implants may be considered

The Importance of Regular Eye Exams

Glaucoma doesn’t wait for symptoms to become obvious—it quietly progresses until the damage is permanent. That’s why routine eye check-ups, especially after age 40 or if you’re at high risk, are non-negotiable in preserving your sight.

“Vision lost to glaucoma cannot be restored, but early detection and consistent treatment can save what remains.”

Diabetic Retinopathy (DR) is a serious eye condition caused by high blood sugar levels damaging the tiny blood vessels in the retina, the light-sensitive tissue at the back of the eye. It affects people with Type 1 and Type 2 diabetes, often without noticeable symptoms until vision is compromised.

It’s one of the leading causes of blindness globally, especially among adults in their most productive years. Early detection through regular eye exams is essential for preventing permanent vision loss.

Stages of Diabetic Retinopathy

DR progresses through two major forms and four defined stages:

Non-Proliferative Diabetic Retinopathy (NPDR) – Early Stage

1. Mild NPDR: Microaneurysms (tiny balloon-like swellings in blood vessels) begin to form.
2. Moderate NPDR: Vessels swell and distort, impairing blood flow.
3. Severe NPDR: Widespread vessel blockage leads to areas of the retina being deprived of oxygen, triggering new vessel growth signals.

Proliferative Diabetic Retinopathy (PDR) – Advanced Stage

4. PDR: Fragile, abnormal new blood vessels form (neovascularisation), often leaking into the vitreous. This can cause floaters, blurred vision, severe haemorrhaging, or even retinal detachment and vision loss.

In some cases, patients with PDR may only see shadows or light-dark contrast in affected eyes.

Signs and Symptoms

Early stages may be asymptomatic, but as DR progresses, symptoms include:

• Blurred or distorted vision
• Floaters (dark spots or strings in vision)
• Difficulty seeing at night
• Dark or empty areas in central vision
• Fluctuating vision
• Sudden vision loss (in cases of vitreous haemorrhage)

Causes and Risk Factors

The underlying cause is chronic high blood glucose damaging retinal blood vessels. As blood vessels leak, swell, or become blocked, retinal tissues become oxygen-deprived, causing irreversible damage.

Key risk factors include:

• Duration of diabetes: Risk increases after 10–20 years of the condition.
• Poor blood sugar control (high HbA1c levels)
• High blood pressure and cholesterol
• Pregnancy (especially gestational diabetes)
• Hispanic and African heritage
• Protein in urine (marker of kidney and retinal damage)
• Smoking

Even rapid glucose correction in long-term diabetics can trigger temporary worsening of DR.

Diagnosis and Monitoring

A comprehensive dilated eye exam is the gold standard for detecting DR. Retinal photography, OCT scanning, and fluorescein angiography may also be used to assess the retina’s condition.

Regular screenings are critical—especially if you’re diabetic, pregnant, or have been diagnosed with DR before.

Treatment Options

While there is no cure, treatment can slow progression and preserve vision.

Laser Therapy (Photocoagulation)

• Used in PDR to seal leaking vessels and prevent further abnormal growth.
• Panretinal photocoagulation (PRP) targets peripheral retina to preserve central vision.

Injections

• Anti-VEGF medications like Lucentis, Eylea, and Avastin reduce vessel growth and leakage.
• Steroid injections for persistent macular swelling (DME).

Vitrectomy Surgery

• Performed when there’s significant vitreous haemorrhage or retinal detachment.
• Involves removing the gel inside the eye and replacing it to restore or maintain vision.

Systemic Management

• Controlling blood sugar, blood pressure, and cholesterol significantly reduces the risk.
• HbA1c levels should be maintained at 6–7% as per international guidelines.

Patient education and lifestyle management play a critical role in treatment success.

Have diabetes? Don’t wait for symptoms.

Schedule your retinal screening with Davida van der Merwe Optometrist today to detect diabetic retinopathy early and protect your vision for years to come.

Hypertensive Retinopathy (HR) is a condition where high blood pressure damages the small blood vessels in the retina, the light-sensitive tissue at the back of the eye. Over time, elevated blood pressure can cause these vessels to narrow, thicken, leak fluid, or even rupture—leading to swelling, haemorrhages, and potential vision loss.

In some cases, an eye exam may be the first indication of undiagnosed hypertension, making your optometrist a critical part of systemic disease detection.

Stages of Hypertensive Retinopathy

The Keith-Wagener-Barker classification outlines four stages of HR:

• Stage 1: Mild narrowing of retinal arteries. Often seen in older adults.
• Stage 2: Moderate vessel narrowing and arteriovenous nicking (veins compressed at crossings).
• Stage 3: Signs from Stage 1 & 2 plus cotton-wool spots, haemorrhages, and lipid exudates.
• Stage 4: Advanced retinal damage including optic nerve swelling (papilledema) and macular star formation. This is known as malignant hypertension and is a medical emergency.

Routine eye exams allow early detection and prevent progression to these severe stages.

Signs and Symptoms

Most people don’t experience symptoms in the early stages of HR. However, as the condition worsens, symptoms may include:

• Blurred or reduced vision
• Eye pain or headaches (in severe hypertension)
• Dark or shadowy spots in vision
• Visual disturbances such as flashing lights or distortion
• Signs during eye exam:
  • Tortuous or twisted vessels
  • Retinal bleeding
  • Cotton wool spots (indicative of poor oxygen supply)
  • Swollen optic nerve (papilledema)
  • Macular edema or retinal detachment

Causes and Risk Factors

The primary cause of Hypertensive Retinopathy is uncontrolled or long-term high blood pressure. As pressure increases, retinal vessels become fragile and damaged.

Common risk factors include:

• Chronic hypertension
• Poorly managed diabetes or cholesterol
• Smoking and excessive alcohol intake
• Obesity and inactivity
• High-salt diets
• Genetic predisposition
• Stress or anxiety-related blood pressure spikes
• Certain ethnic groups with higher hypertension rates

Malignant hypertension (BP ≥180/120 mmHg) can lead to sight-threatening emergencies, including retinal detachment and permanent nerve damage.

Diagnosis and Eye Exam Findings

Optometrists use fundus examinations, optical coherence tomography (OCT), and retinal photography to assess for signs of HR. Key diagnostic indicators include:

• Arterial narrowing
• Arteriovenous nicking
• Flame-shaped haemorrhages
• Macular star pattern from lipid leakage
• Cotton-wool spots
• Swelling of the optic disc (papilledema)

Differentiation from other retinal diseases like diabetic retinopathy is vital to accurate diagnosis and appropriate management.

Treatment Options

Hypertensive Retinopathy itself has no direct cure—treatment focuses on controlling blood pressure and preventing further eye damage.

For Stage 1 & 2:

• Regular blood pressure management
• Lifestyle changes (diet, exercise, stress reduction)
• Annual dilated eye exams

For Stage 3 & 4:

• Urgent medical treatment of systemic hypertension
• Intravitreal injections for macular edema
• Surgical intervention for retinal detachment
• Co-management with cardiologists and general practitioners

If caught early, HR is preventable and manageable. Delayed treatment in stages 3 or 4 may result in permanent vision impairment or other systemic complications like stroke or heart failure.

Macular Degeneration (MD) is a common eye disorder that affects the macula, the part of the retina responsible for sharp, central vision. As the tissue deteriorates, your ability to see fine details, such as faces, print, or road signs, is compromised—though your peripheral vision remains intact, meaning the condition does not lead to total blindness.

There are two main forms of the condition:

• Dry Macular Degeneration (slow-progressing; 85–90% of cases)
• Wet Macular Degeneration (faster and more severe)

Early detection and monitoring are essential for preserving your vision. Annual eye exams are strongly advised, especially if you are over 60 or at increased risk.

Dry vs Wet Macular Degeneration

Dry AMD

Occurs due to the gradual thinning of macular tissue and buildup of drusen (yellow deposits). It develops slowly and may cause:

• Mild central vision loss
• Difficulty reading, recognising faces, or driving
• Blurred or distorted images

Wet AMD

Caused by abnormal blood vessels growing under the retina, which can leak fluid and blood. This leads to:

• Sudden, severe central vision loss
• Dark spots, distortion, or rapid deterioration
• Scar tissue forming in the retina

Although less common, wet AMD requires urgent attention.

Symptoms of Macular Degeneration

Patients with MD may experience:

• Blurry or fuzzy central vision
• Distorted images – straight lines may appear wavy
• Difficulty recognising faces
• Shadows or dark patches in the centre of vision
• Poor colour contrast
• Slow visual recovery after bright light exposure
• Visual acuity drops (e.g. from 20/20 to 20/80)

An Amsler grid test is often used to detect changes early. Patients may notice missing lines or blank spots.

Causes and Risk Factors

Although the exact cause remains unclear, several genetic and lifestyle factors contribute to the development of MD.

Key risk factors include:

• Age (especially 60+)
• Family history of MD
• Smoking (a major contributor to vision loss)
• High blood pressure and cardiovascular disease
• Obesity and physical inactivity
• Excessive sunlight exposure
• Poor nutrition (low in leafy greens, omega-3s, and antioxidants)
• Certain medications, including some anti-malarials and antipsychotics

Diagnosis and Monitoring

Macular Degeneration is diagnosed through:

• Dilated eye exams
• Retinal imaging (OCT and fundus photography)
• Amsler grid testing (to detect visual distortion)

Once diagnosed, it is crucial to monitor your vision regularly and report any sudden changes.

Treatment Options

While there is no cure, several treatment strategies can help slow progression and support functional vision.

For Dry AMD:

• Nutritional supplements (lutein, zeaxanthin, zinc, and omega-3s)
• Healthy diet with cold-water fish and leafy greens
• UV-blocking sunglasses
• Lifestyle changes: quit smoking, manage blood pressure

For Wet AMD:

• Anti-VEGF injections (e.g. Lucentis, Eylea, Macugen) – reduce vessel growth and leakage
• Photodynamic therapy (PDT) – seals leaky vessels using light and medication
• Low vision aids – magnifiers, reading devices, and high-contrast lighting

Your optometrist will help detect changes early and refer you to a retinal specialist if required.

Seeing distortions, dark patches, or struggling with detail?

Book a comprehensive retinal screening at Davida van der Merwe Optometrist to detect macular degeneration early and safeguard your vision.

A mature cataract occurs when the natural lens of the eye becomes completely clouded, obstructing light from passing through effectively. Unlike early cataracts—where glasses may still offer some visual improvement—mature cataracts no longer respond to stronger spectacle lenses. Instead, patients often report feeling like their glasses are always dirty, constantly trying to wipe them clean to no effect.

At this stage, a referral to an ophthalmologist is typically recommended to discuss cataract surgery, which remains the most effective way to restore vision.

How Do Mature Cataracts Affect Vision?

As the cataract progresses, it significantly impairs your ability to see clearly:

• Vision becomes cloudy, blurry, or filmy
• Glare sensitivity worsens, particularly when driving at night
• Colours appear faded or dull
• You may notice halos around lights or double vision in one eye
• Reading, recognising faces, or enjoying hobbies becomes difficult

Cataracts may affect one or both eyes, often progressing at different rates. Even activities like crocheting, playing cards, or watching TV can become challenging.

Signs and Symptoms of a Mature Cataract

If you’re experiencing any of the following, it may be time to consult with your eye care provider:

• Persistent blurry or cloudy vision
• Colours seem muted or yellowed
• Halos or glare from headlights or lamps
• Frequent changes in glasses prescriptions with no improvement
• Poor night vision
• Double vision in one eye
• Feeling like your glasses are always smudged

While these symptoms may be mistaken for other eye conditions, a full eye exam will confirm whether cataracts are the cause.

Causes and Risk Factors

Cataracts form when the proteins in the eye’s lens begin to clump, creating cloudiness and preventing light from focusing clearly on the retina. Though age is the most common factor, several others contribute:

• UV exposure
• Smoking and alcohol consumption
• Diabetes and hypertension
• Obesity
• Use of corticosteroids or statins
• Previous eye injury or surgery
• Family history of cataracts
• Hormonal changes or HRT use

Over time, the cataract thickens and hardens, eventually becoming mature and unresponsive to optical correction.

Treatment: When to Consider Surgery

If mature cataracts significantly impair daily life—making it hard to read, drive, or enjoy hobbies—it may be time to consider cataract surgery.

During the procedure, the cloudy lens is removed and replaced with a clear, artificial intraocular lens (IOL). This restores the eye’s ability to focus light and improves vision dramatically.

Key points about cataract surgery:

• It is safe and routine, with over 3 million procedures performed annually in the U.S. alone
• Surgeries on each eye are done several weeks apart to prevent complications
• Most patients achieve 20/20 to 20/40 vision post-surgery

Your optometrist will assist you before and after the procedure. At Davida van der Merwe Optometrist, temporary reading glasses are offered during your healing period, followed by a complete eye exam and personalised prescription once your eyes have stabilised.

Note: Avoid using off-the-shelf readers long-term. They may be unbalanced, leading to unnecessary eye strain or fatigue.

Feel like your glasses are never clean? Vision increasingly foggy or frustrating?

Book an assessment with Davida van der Merwe Optometrist for expert advice on managing mature cataracts and referrals for safe, life-changing cataract surgery.

A cataract is the gradual clouding of the eye’s natural lens, leading to reduced vision over time. In the early stages, cataracts often go unnoticed—but subtle symptoms like blurred vision, increased glare, and frequent prescription changes may begin to appear.

Contrary to popular belief, not all cataracts require immediate surgery. In fact, many people with early cataracts experience excellent improvement with updated spectacles, anti-glare coatings, or lifestyle adjustments.

How Cataracts Affect Vision

The lens in your eye must remain clear to focus light sharply onto the retina. When protein fibres within the lens begin to clump and cloud, light is scattered, and vision becomes foggy or distorted. This is particularly noticeable when:

• Driving at night
• Reading small print
• Recognising faces or colours
• Working in bright lighting conditions

One telltale sign of early cataracts? You feel like your glasses are constantly dirty, even after cleaning them.

Signs and Symptoms of Early Cataracts

As cataracts form and progress, you may notice:

• Cloudy, blurry, or hazy vision
• Colours appear faded or yellowed
• Increased sensitivity to glare, especially at night
• Halos around lights
• Poor night vision
• Double vision or ghosting in one eye
• Frequent changes in your glasses prescription
• Contact lenses or spectacles no longer feel effective

These symptoms can also mimic other eye conditions, which is why routine eye exams are essential.

What Causes Cataracts?

The lens is made primarily of water and proteins, which must remain transparent. Over time, protein clumping and oxidation lead to the clouding of the lens.

Common risk factors include:

• Ageing (most common cause)
• Long-term UV exposure (sunlight or tanning beds)
• Diabetes and hypertension
• Smoking and excessive alcohol consumption
• Long-term use of steroids or statins
• Obesity and poor nutrition
• Family history of cataracts
• Eye injuries or prior surgeries

Managing Early Cataracts

Cataracts do not need to be removed immediately. In many cases, non-surgical solutions provide noticeable improvement in vision:

Early-Stage Management Options:

• Updated prescription lenses
• Anti-reflective coatings and UV-blocking sunglasses
• Improved indoor lighting
• Bifocals, magnifiers, or reading aids

Routine check-ups allow your optometrist to monitor progression and recommend when—or if—referral to an ophthalmologist is appropriate.

When Should Surgery Be Considered?

Cataract surgery becomes an option when:

• Vision significantly affects daily activities (e.g. driving, reading, recognising faces)
• Night driving becomes dangerous
• There’s frequent lens prescription changes with minimal improvement
• Vision loss impacts work or independence

Surgery is not urgent and can be postponed until you’re ready. Your optometrist will guide you, helping you make a well-informed decision without pressure.

Noticing blurry or foggy vision that glasses can’t fix?

Schedule an eye exam with Davida van der Merwe Optometrist to assess for early cataracts, explore non-surgical solutions, and make informed choices about your eye health.

Keratoconus is a progressive eye condition where the cornea (the clear, dome-shaped front surface of the eye) gradually becomes thinner and bulges outward into a cone-like shape. This irregularity distorts how light enters the eye, causing blurred or distorted vision that cannot be corrected by glasses alone.

Often confused with standard astigmatism in its early stages, keratoconus requires professional diagnosis and management. The condition can affect one or both eyes (often asymmetrically) and typically develops during the teenage years or early adulthood.

How It Affects Vision

As the cornea thins and begins to bulge:

• Vision becomes increasingly distorted
• Light entering the eye is scattered, resulting in ghosting, halos, and multiple images (monocular polyopia)
• Night vision deteriorates, with glare from headlights and streetlamps becoming overwhelming
• Spectacle prescriptions change frequently, often with minimal improvement in clarity

Patients may report a sensation like looking through wavy or distorted glass, with worsening of symptoms in low-light environments.

Signs and Symptoms of Keratoconus

Symptoms may develop slowly and vary in severity. Common signs include:

• Blurred or distorted vision at all distances
• Frequent changes in eyeglass prescriptions
• Sensitivity to light (photophobia)
• Halos or ghosting around lights
• Eye strain and irritation
• Difficulty driving at night
• Increased eye rubbing

In the early stages, symptoms may resemble normal refractive errors. However, as the condition progresses, regular lenses no longer offer visual clarity.

Causes and Risk Factors

The exact cause of keratoconus remains unknown, but contributing factors include:

• Genetic predisposition (family history)
• Chronic eye rubbing, often linked to allergies
• Underlying atopic conditions like eczema, asthma, and hay fever
• Oxidative stress and a reduced ability of the cornea to repair itself
• Deficiencies in collagen and anchoring fibrils that maintain corneal structure
• Hormonal fluctuations, especially during puberty

Keratoconus is not caused by infection and is not contagious, but it can significantly impact quality of life if untreated.

Diagnosis

Keratoconus is typically diagnosed through:

• Corneal topography (maps the shape of the cornea)
• Slit-lamp examination
• Pachymetry (measuring corneal thickness)
• Keratometry (measuring curvature of the cornea)

Early diagnosis is crucial to managing the condition effectively and preventing irreversible visual impairment.

Treatment Options for Keratoconus

Treatment depends on the severity and stage of the condition. Options include:

Non-Surgical Management

1. Spectacles or custom soft contact lenses – useful in early stages
2. Rigid Gas Permeable (RGP) lenses – provide a smooth surface for light to enter
3. Piggybacking lenses – soft lenses beneath rigid lenses for improved comfort
4. Hybrid contact lenses – rigid centre with soft outer ring for comfort and clarity
5. Scleral and semi-scleral lenses – ideal for advanced cases, offering better fit and comfort
6. Collagen Cross-Linking (CXL) – a clinical procedure that strengthens corneal tissue to halt progression

Surgical Options

7. Intacs – tiny ring segments implanted into the cornea to flatten its shape
8. Corneal transplant (keratoplasty) – for severe cases where lenses no longer provide usable vision

Blurry vision, frequent prescription changes, or ghosting around lights?

Book a comprehensive corneal assessment with Davida van der Merwe Optometrist to detect keratoconus early and protect your vision with expert care.

Dry Eye Disease, also known as Keratoconjunctivitis Sicca, is a common and often chronic condition that occurs when your eyes don’t produce enough quality tears to stay lubricated. This can cause irritation, blurred vision, and a persistent gritty or burning sensation.

Tears are composed of three layers: a lipid (oil) layer, an aqueous (water) layer, and a mucin (mucus) layer. When any one of these becomes deficient—due to environmental factors, medications, systemic health issues, or aging—dry eye symptoms can develop or worsen.

What Causes Dry Eye?

DED can result from a wide range of issues, including:

• Prolonged screen use (reduced blinking)
• Air conditioning or windy environments
• Hormonal changes, especially in menopausal women
• Certain medications such as antihistamines or antidepressants
• Autoimmune diseases like Sjögren’s syndrome, lupus, or rheumatoid arthritis
• Contact lens wear or post-LASIK surgery
• Vitamin imbalances or poor nutrition
• Skin conditions and eyelid inflammation

Signs and Symptoms of Dry Eye

While the symptoms can vary in intensity, the most common include:

• Burning or stinging sensation
• Grittiness, as if sand is in your eyes
• Redness and occasional eye pain
• Watery eyes (reflex tearing)
• Stringy discharge
• Blurred vision, especially after reading or screen use
• Eye fatigue and heavy eyelids
• Contact lens discomfort
• Difficulty with prolonged focus tasks

Sometimes, the eye produces excess tears as a response to dryness, but these tears are often watery and lack the protective quality of a full tear film.

Who Is at Risk?

You’re more likely to develop DED if you:

• Are over the age of 50
• Are female, especially postmenopausal
• Spend long hours on computers or smartphones
• Live in dry or windy climates
• Have chronic allergies
• Use medications that affect tear production
• Wear contact lenses regularly
• Have had cosmetic or refractive eye surgery

Treatment Options for Dry Eye

Dry Eye Disease is manageable, especially when diagnosed early. Your optometrist can help tailor a treatment plan to suit your needs.

Lifestyle and Home Adjustments:

• Blink more frequently, especially during screen use
• Take regular breaks while reading or working
• Remove eye makeup thoroughly
• Use high-quality sunglasses outdoors
• Maintain proper eyelid hygiene

Medical Treatments:

• Artificial tears or ointments – daily use maintains moisture
• Steroid eye drops – short-term relief of inflammation
• Punctal plugs – tiny devices placed in tear ducts to prevent tear drainage
• Omega-3 supplements – promote tear quality and reduce inflammation
• Warm compresses and lid massage – unblock Meibomian glands
• Topical immunosuppressants or anti-inflammatories (prescribed)
• Surgical intervention (in rare, extreme cases)

Struggling with tired, burning, or gritty eyes—especially after a long day on screens?

Book a dry eye assessment at Davida van der Merwe Optometrist for expert diagnosis, tailored treatment, and real relief.

Giant Papillary Conjunctivitis (GPC) is a non-contagious, chronic inflammatory reaction that affects the delicate tissue lining the underside of the eyelids. It is most commonly triggered by extended contact lens wear or allergic responses to lens materials, cleaning solutions, or even environmental allergens like dust, makeup, or fabric softeners.

Despite its name, GPC is not an infection, but rather a mechanical and allergic irritation, where small inflammatory bumps (papillae) form under the upper eyelid. If left untreated, these papillae can grow large enough to disrupt vision and make contact lenses intolerable.

What Causes GPC?

GPC is typically the result of constant micro-trauma to the conjunctiva from the blinking motion over contact lenses or other ocular devices (e.g. sutures, prosthetics, or corneal scars).

Additional risk factors and triggers include:

• Wearing reusable or poorly cleaned contact lenses
• Sleeping with contact lenses
• Using expired lens solutions or harsh preservatives
• Allergies (pollen, dust, animal dander, etc.)
• Makeup or skincare products
• Conditions like eczema, asthma, or hay fever

Even pillows, detergents, or cosmetic ingredients can irritate the eyelids and contribute to GPC.

Signs and Symptoms of GPC

Symptoms often develop gradually, and early signs may go unnoticed until discomfort becomes more pronounced. Look out for:

• Itching, burning, or gritty eyes
• Redness and lid inflammation
• Stringy or watery mucus discharge
• Blurry vision
• Contact lenses feeling loose, sticky, or constantly out of place
• Increased lens intolerance and discomfort while blinking

Often, the only way to detect early-stage GPC is through a professional eye exam—especially for regular contact lens wearers.

Diagnosis and Risk Groups

GPC is most commonly diagnosed during a routine slit-lamp exam by your optometrist. If you wear contact lenses—especially for extended periods—or have chronic allergies, you are considered high risk.

You’re more susceptible if you:

• Wear soft reusable lenses
• Sleep in lenses
• Suffer from allergies or asthma
• Have poor lens hygiene
• Use lens solutions with preservatives

Treatment and Management of GPC

Effective treatment focuses on eliminating the cause, soothing symptoms, and preventing recurrence.

Initial Management

• Stop contact lens use for several weeks
• Switch to glasses temporarily
• Identify and eliminate allergen or irritant triggers
• Consider switching to daily disposable lenses

Medications and Therapies

• Cold compresses to reduce itching and swelling
• Antihistamine or mast cell stabiliser eye drops
• Lubricating drops to reduce irritation
• Topical corticosteroids (for severe cases, under supervision)
• Oral antihistamines
• Immunotherapy (in very persistent allergic cases)

Long-term, the goal is to reduce recurrence through good lens hygiene, frequent lens changes, and avoiding high-risk products or environments.

Wearing contacts and noticing discomfort or blurry vision?

Book a professional eye exam at Davida van der Merwe Optometrist to detect early signs of GPC and get expert advice on lens care and allergy management.