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Dr. Kayla Bechthold Blog: Cataracts, AMD, Glaucoma and Dry Eye Management

Updated: Jul 20, 2019


Cataract is the natural clouding of the lens inside of the eye. The lens is located behind the colored part, or iris, of the eye. By age 75, 100% of the population has cataracts. Not everyone needs them removed, however. There are several different types of cataracts, and some need to be removed sooner than others. Currently there is no treatment for cataract besides removal.

Symptoms of cataracts include: blurry vision, halos or starbursts around headlights, trouble seeing road signs or distance objects.

Changing your glasses prescription can help for awhile, but when your vision with best glasses or contact lens prescription is still only 20/40, then cataract surgery is the only thing that will improve the vision.

We co-manage your cataract surgery with a surgeon, so most pre-op and post-op visits can be done at our offices in Chisholm or Cook.

Age Related Macular Degeneration (AMD)

Macular degeneration is an eye disease where the central retina, or macula, is affected. The macula is responsible for all of the clear central vision we use every day. Macular degeneration is a build-up of waste products in the lower layers of the retinal tissue, causing thinning and death of the tissue above. This causes tiny spots of missing vision that, over time, get larger and larger, causing loss of the central vision.

Symptoms of AMD include: blurry vision with reading, needing more light to read, waviness in straight lines, and, in some cases, loss of central vision.

Prevention is the best treatment, and studies have shown that eating 2 servings of fruits and vegetables per day and 2 servings of fish per week significantly decrease your risk of macular degeneration. If you smoke--stop. Smoking greatly increases risk and severity of AMD. Preservision multivitamins with lutein were shown to stop vision loss in 30% of people with intermediate or advanced AMD. Macular degeneration can tend to run in families, but is not completely hereditary.

Sometimes macular degeneration can trigger blood vessels to grow behind the macula-- this is called wet macular degeneration. The new blood vessels are weak and may break and bleed, causing severe vision loss. Treatment for wet macular degeneration includes injections to stop blood vessel growth and sometimes laser treatment. Referral to a retinal specialist for these services is necessary, and quick diagnosis by your eye doctor is needed for the best outcome. People who have AMD or strong risk of AMD should be seen for eye exams each year, or more often as determined by your optometrist.


The eye needs a certain amount of fluid inside of it to work properly. Too much or too little fluid inside the eye can cause damage. Glaucoma is an eye disease that occurs when there is too much fluid inside the eye. The excess fluid increases the eye pressure and damages the nerve tissue of the retina, leading to loss of peripheral vision. There are several types of glaucoma. Sometimes glaucoma starts because the eye makes too much fluid, sometimes it is because the fluid cannot drain properly.

Usually glaucoma has no symptoms. There is no pain, and by the time a person notices the loss of peripheral vision the disease is very severe.

Glaucoma tends to run in families, but is not necessarily hereditary. Regular eye exams and good cardiovascular health are the best way to prevent vision loss from glaucoma.

An eye exam with one of our doctors includes a check of the eye pressure inside the eye, as well as an examination of the optic nerves. If needed, a detailed check of the peripheral vision is done (a visual field test) as well as a measurement of the nerve tissue in the eye (an OCT). There are several factors that go into the diagnosis and treatment of glaucoma, but seeing your eye doctor for a complete exam is a good starting point.

If you receive a glaucoma diagnosis, our doctors will prescribe eye drops. Eye drops are usually the first line of therapy. The drops lower the eye pressure, thus halting the changes from glaucoma. Sometimes more than one drop is needed, or surgical or laser procedures are necessary to keep the eye pressure down. Regular follow up is needed to make sure things are under control.

Dry Eye

Do your eyes get tired, feel gritty, burn, or water? These are all symptoms of dry eye syndrome. In northern Minnesota dry eye syndrome is very common. Dry eye happens when either the eye doesn’t make enough tears or the tears are of a poor quality. The tear film can be affected by age, medications, work environments, smoking, pregnancy, refractive surgery (LASIK) and many systemic diseases. Contact lenses can make symptoms worse.

When the eyes become dry one of the first symptoms can be watery eyes! The eye will “reflex tear” when it is dry. These tears are not as beneficial as the normal tear film and can make the situation worse. Dry eyes can cause blurred vision and even scarring of the cornea.

If you have any of the above symptoms an eye exam with one of our doctors is a great place to start. Your optometrist can evaluate the tear film quality and garner the best treatment plan for your individual needs. Drinking plenty of water, staying away from fans and quitting smoking are good ways to help too.

Treatment options vary, from artificial tears to prescription medication to improve the symptoms. Sometimes it helps to prevent the tears from draining using punctal plugs. In severe cases surgical procedures may be necessary. In many cases dry eye syndrome also has a portion of ocular rosacea or eyelid oil gland issues at the same time. There are other treatments geared just for the eyelids including oral antibiotics, fish oil, hot packs and eyelid cleaners, as well as in-office eyelid gland expressions.

Usually dry eye syndrome is treated, not cured. It is a chronic condition that requires some maintenance for both the patient and doctor to keep it under control. The good news is, though, it can be controlled.

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