Published: 24 November 2021

A common question asked during the eye exam is, “When is the puff coming?” Patients are referring to air-puff or non-contact tonometry. Tonometry is the procedure used to measure eye pressure, and this is important for diagnosing and monitoring glaucoma. In non-contact tonometry, a puff of air is used to measure the pressure inside the eye. The benefit of this test is there is no actual contact with the eye, but the air puff is sometimes very startling for patients. Most people hate that test and it isn’t the most accurate way to measure your eye pressure. Some doctors don’t even use the air-puff test. Instead, they place a yellow drop that consists of a numbing medicine and then shine a blue light on the eye. This is done in front of the slit lamp and a small tip gently touches the eye to measure the eye pressure. This procedure is called Goldmann tonometry and is considered the gold standard for measuring eye pressure. Another method for checking eye pressure is the Tonopen. This is a portable, hand-held instrument that is useful when patients can’t sit in front of the slit lamp to have their eye pressure checked. The Tonopen also requires a numbing drop to be placed in the eye, and the tip gently touches the eye. A common question related to tonometry is “what normal eye pressure?” Normal eye pressure ranges from 10-21 mm Hg. Eye pressure doesn't have any relationship to blood pressure. Many times, people are surprised that their eye pressure is high, but they have normal blood pressure. In general, there is no diet or exercise that will significantly affect eye pressure. It is therefore important to have your eye pressure checked regularly because there are usually no symptoms of high eye pressure until it has affected your vision. Article contributed by Dr. Jane Pan

Published: 12 October 2021

The tears that coat the surface of your eyes have both a liquid and a mucous layer to them. It is normal to have a small amount of mucus in your tear film. But that mucus can significantly increase when the eye gets irritated. Some of the most common causes of irritation that can make the eye overproduce mucus are: Conjunctivitis, which could be caused by an allergy, bacteria, or virus Blepharitis, which is an inflammation of the eyelids Dry Eye Syndrome When any of these conditions occur, the eye will begin to make more mucus. Sometimes the mucous production really is excessive and there is a temptation to keep pulling it out with either your fingers or a cotton swab. DON'T DO THIS--it will just lead to recurring irritation and problems. Any mucus that gets deposited OUTSIDE the eye on the outer eyelid or on the lashes is fair game for removal. In fact, anything on the exterior of the eyelid or stuck to the eyelashes should be cleaned off. Just don’t reach INSIDE the eyelids. Every time you go inside the eye to remove mucus, your finger or a cotton swab further irritates the eye and causes it to make even more mucus and you end up with the viscious cycle that we call mucus fishing syndrome. If you have an acute problem that is causing excessive mucus, you need to try and get the underlying problems treated and under control. That means treating the allergy, blepharitis, infectious conjunctivitis, or dry eye syndrome. In addition, you need to STOP putting your fingers in your eye and pulling the mucus out. Sit on your hands if you have to--but you have to stop or it is never going to get better. If you have gone through treatment for the original problem but still find yourself pulling mucus out of your eye, you may need your doctor to try a steroid drop in order to decrease the production and try to help you get out of the habit of putting your fingers in your eyes. Article contributed by Dr. Brian Wnorowski, M.D.