Dr. Reiter has more than 25 years of experience treating common and uncommon vision disorders using only the most high tech procedures and equipment. Whether you need corrective lenses, laser eye surgery, refractive lens surgery, or a combination of the three, Dr. Reiter and his friendly office staff will help you decide on the treatment plan that fits your lifestyle and your diagnosis. On this page you will find an overview of several vision disorders that Dr. Reiter treats. If you have a question or would like more information about your unique situation, please do not hesitate to call our office and schedule a consultation.
Blepharitis is a chronic inflammation of the eyelids and eyelash follicles. It can be caused by many different problems, including seborrheic dermatitis, Rosacea, bacterial infection, allergic reaction, makeup and poor eyelid hygiene. Symptoms include red eyes, blurry vision, frequent tearing, excessive eyelid crust, flakes, scales and redness of the skin around your eyelashes. In more serious cases, sores can form when the crusting skin is removed, the eyelashes may fall out, and the eyelids can deform. The inflammation can spread to the cornea. Blepharitis can cause styes, chalazions and problems with the tear film. Treatment and preventative care for blepharitis involves thorough but gentle cleaning of the eyelids, face and scalp. Warm compresses can be applied to loosen crust and dandruff shampoo can help keep the eyelids clear. This may be combined with topical and systemic antibiotics if a bacterial infection is causing or contributing to the problem. It is important to come in for an evaluation before the disease progresses.
A chalazion is a hard, painless bump in the eyelid. It may be located adjacent to the eyelid margin, near the eyelashes, or further away. It can be single or multiple. It is usually caused by a blocked meibomian glands, adjacent to the eyelashes and is strongly associated with Rosacea, blepharitis, and oily skin. When the blockage first occurs, the eyelid adjacent to the eyelash is tender. At this point, the gland can sometimes be expressed at our office and the bump prevented. This needs to be done at the microscope to avoid scratching the cornea. Hot compresses and antibiotics may be effective. If this doesn't work, an abscess may form. If it is sterile, it is called a chalazion. If it is infected, it is called a stye or hordeolum. The more advanced it is allowed to get, the more it can scar and affect the drainage of adjacent glands, making an annoying recurrence more likely. Call for a consultation early in the disease course.
Conjunctivitis is the general name given to the many conditions that cause red eyes. It can be due to many different issues. These include irritation, allergies, infection with bacteria, viruses, fungi, dry eyes, and trauma. To confuse things, the eye drops that are used to treat these conditions can also contribute to the problem. A visit to the office can ensure that you are using the correct ocular medications to address the underlying issues.
Dr. Gary S. Reiter has been successfully treating diabetic eye diseases in residents of Newport Beach and Orange County for 25 years, utilizing state-of-the-art diagnostic and treatment techniques. Diabetic retinopathy is damage to the retina (the inner eye) that, if left untreated, can eventually lead to blindness. It is often seen in association with diabetic neuropathy (nerve damage) and diabetic nephropathy (kidney damage). The early warning signs of diabetic retinopathy can be detected with regular office visits. Your visits are coordinated with your treating Internist or Endocrinologist in order to make sure that all efforts are made to keep your diabetes under control. There are two stages of diabetic retinopathy: Nonproliferative Diabetic Retinopathy (NPDR) and Proliferative Diabetic Retinopathy (PDR).
In NPDR, the small blood vessels of the retina start to leak, causing swelling and hemorrhages. If the area of the retina affected is the macula (the area of the eye responsible for high resolution vision), then your vision quality can dramatically decrease. NPDR usually progresses slowly and is treatable, when detected early. While patients can expect to recover some, or all of their visual loss when the disease is treated early, when NPDR is ignored, it can become untreatable. In this case, none of the visual loss is recovered and the disease can progress to PDR where more profound visual loss is possible.
If diabetic retinopathy progresses past the NPDR stage, the circulation to your retina becomes more severely compromised. Your body tries to re-establish the missing decreased blood flow. In PDR, these attempts can damage these produce delicate new blood vessels and fibrous tissue that grows onto the back surface of the vitreous jelly (the jelly that separates the retina from the crystalline lens). These abnormal structures can break and bleed into the jelly, causing floaters and decreased vision. This damage can happen suddenly and may require months of waiting to reabsorb or may require surgical drainage to correct. With repeated bleeding, the scar tissue can contract and lift the retina away from its underlying nutrition, causing a tractional retinal detachment. The red blood cells can also plug up the drain that the eye uses to get rid of breakdown products and cause elevated pressure. This is called Ghost Cell Glaucoma. If detected, it needs to be promptly treated.
In this type of diabetic blood eye disease, tiny, delicate blood vessels like that seen in PDR grow along with fibrous (or scar) tissue along the surface of the iris and into the angle (where the colored part of your eye meets the white of the eye). The drain for the eye is located here and this tissue plugs it up, causing Neovascular Glaucoma. Treating this disease is difficult and needs to be started immediately upon diagnosis. It is closely associated with PDR and retinal vascular occlusions. It progresses rapidly and is called the 90 day glaucoma.
Flashing lights in the absence of external light sources are caused by irritation to the retina. This can be caused by direct mechanical stimulation, such as a blow to the eye. It can also be caused by stimulation from "tugging" caused by the vitreous jelly in conditions that cause retinal tear formation and retinal detachment. The retina may also be stimulated by an abrupt loss of circulation that occurs when an embolism travels to the retinal arteries from other parts of your circulation, such as the carotid arteries or the mitral or aortic valves of the heart. In this case, it can be a warning that a stroke is occurring or that you are at higher than normal risk for one to occur in the future. Flashing lights should be investigated as soon as possible.
Floaters are dark spots or clouds that appear in your vision. They become more pronounced when you look at a bright light, such as the sky. They are more common as you age. They are shadows falling on your retina, which are caused by various types of material floating in your eye. The material may occur in the vitreous jelly of the back of the eye or the aqueous humor of the front of the eye. The cause of such floaters varies from benign degenerative disease to tumors, retinal tears and retinal detachment. The new onset of floaters should be evaluated promptly. Please call our office for a consultation.
Ocular surface disease (OSD) can be caused by allergies, dry eyes, Rosacea, bacterial infections, and auto-immune inflammation. OSD compromises quality of life by decreasing vision and causing pain, tearing and redness. This family of conditions makes efficient reading difficult and may be a cause of mistakes on the job. There are medical and surgical approaches to the treatment of OSD; but early evaluation and treatment are important. Many people that suffer with OSD put off treatment. If you are experiencing any of these symptoms, come in for a consultation.
Iritis is the family of conditions that causes inflammation inside the eye. Symptoms include redness, light sensitivity and blurry vision. Patients may see clumps of inflammatory cells floating in their vision. Iritis tends to be recurrent and usually affects one eye at a time. It is extremely important to treat iritis when it first presents. If treatment is delayed, glaucoma, cataracts and swelling of the retina can complicate the course and permanently alter your vision. The quicker it is treated, the less likely it is to recur and the less severe it tends to be if it does recur.
Keratitis is a condition in which the cornea becomes inflamed. The cornea is the window to your eye and when it becomes inflamed or irritated, light cannot be properly focused on your retina. Patients who wear contact lenses are particularly likely to get this. Symptoms of keratitis include moderate to intense pain and foreign-body sensation, light sensitivity, and impaired eyesight. Just like conjunctivitis, keratitis can be caused by many different diseases. Keratitis should be treated as soon as possible to prevent permanent scarring and vision loss. Dr. Reiter's office provides state-of-the-art medical and surgical treatments, including Prokera Shield.
Macular degeneration is a group of diseases that damages the part of the retina responsible for central vision, causing a central blind spot to develop. It frequently affects both eyes. This is a disease that can prevent you from driving and reading efficiently. Most patients afflicted with macular degeneration retain peripheral vision, although variants of the disease exist that minimize peripheral vision as well. There are strong genetic tendencies in macular degeneration. Smoking at any time in your life amplifies the expression of these genes and should be avoided. Other risk factors that affect the development of macular degeneration include: female gender, obesity, Caucasian race, light colored eyes, prolonged sun exposure, a high fat diet and/or one that is low in nutrients and antioxidants, hypertension, and cardiovascular disease. Blue light activates the molecule that is involved in causing the damage, making blue-blocking sunglasses helpful.
Macular degeneration is separated into two classes:
Dry macular degeneration involves inflammatory degeneration of the retina over time. Structures called drusen appear. These contain what is thought to be metabolic waste material that is normally removed by the body. In wet macular degeneration, breaks occur next to these drusen that let abnormal blood vessels leak through and into the retina, causing folds and wavy vision. Effective treatment for the wet variety of macular degeneration exists, while treatment for the dry form is still in FDA trials. Treatment is most effective if the leaking blood vessels seen in the disease are detected early. By effective, it is meant that the treatment can actually improve and maintain the improvement in the vision that you present with when diagnosed with wet macular degeneration. This treatment involves monthly intravitreal injections of either Avastin, Lucentis or the VEGF eye-trap molecule EYELEA Eylea. Research is underway to find ways to safely increase the time interval between injections.
Early diagnosis of the disease is extremely important. Micronutrient supplementation with the vitamin formula AREDS 1 has shown to help halt disease progression from the intermediate dry type to the wet type. Over 6 years, in 5,000 patients studied by the AREDS 1 trial, patients with intermediate macular degeneration showed 25% less chance of progressing to wet macular degeneration. However, the supplementation did not, by itself, improve vision and had significant side effects. An AREDS 2 formula is being investigated that features decreased doses of AREDS 1 micronutrients. The AREDS 2 formula also includes Omega 3 fatty acids, Lutein, Xeazanthine, and Bilberry. This formula is being developed to decrease the quantities of micronutrients that have possible negative side effects and make already compromised vision better. It should be emphasized that AREDS 1 nutritional supplements have not been found to be effective in preventing or stopping the progression of mild macular degeneration to intermediate macular degeneration. This means that high dose supplements should be avoided in these situations. It is safer to rely on a good balanced diet, high in green, leafy vegetables. Micronutrient supplementation should be limited to Calcium and Vitamin D along with Omega 3 fatty acids, Lutein and Xeazanthine. Bilberry may also be used. There have been no significant side effects found with using these substances. In light of recent controversy over the association of daily multivitamins intake with shorter life spans, it is advisable to avoid them in favor of a good balanced diet.
If you have macular degeneration, it is important to correctly stage the disease in order to determine your risk of progression and choose your safest therapy. Therapy has risk.
Both dry and wet macular degeneration should be followed with weekly attempts to find evidence of leakage from abnormal blood vessels into the retina. This leakage makes straight lines appear wavy. It is detected by a simple test called an Amsler Grid. Please go to the forms section of this web site to print and take the test. If you notice any abnormalities, please contact my office or an eye professional immediately. The Amsler Grid should be performed at least once weekly to ensure that you do not have early leakage, which is the stage at which treatment is most effective.
Rosacea is an inflammatory disease that often presents with a rash on the face, usually around the nose. It is primarily a disease of adults and has a predilection for those with a fair complexion. The signs and symptoms may come and go. Flare ups can be brought on by exposure to the sun, alcoholic beverages, and balsamic vinegar salad dressing among others things. Rosacea can cause or be associated with blepharitis and changes in the structure of the nose. Left untreated, it can become progressively worse, sometimes causing scarring of the eyelids and cornea. The treatment is relatively simple when the disease is in its early stages. Please call today for an evaluation.