Ocular Diseases

Ocular Diseases

Ocular Diseases

Ocular Diseases

Ocular Diseases


Blepharitis can be either an infection or inflammation of the eyelid. It is a common condition. It is a dandruff-like scaling of the skin on the lid margins which results in soreness, redness, and crustiness. In its most severe stages, it can affect the lash follicle and cause the lashes to fall out. It can be the cause of dry eye and contact lens intolerance.

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A cataract is a loss of transparency of the lens inside the eye. This causes blurred vision and increased glare at night. Catracts are a normal aging process. Their main cause is long term exposure to ultra violet light from the sun. Just as a newspaper turns yellow if left out in the sun, so does the lens inside the eye. Glasses and contacts can only help so much. Ultimately, surgery is needed to remove the cataract and replace it with a clear intraocular implant. These implanted lenses last for a lifetime. In most cases the surgery is done as an out patient basis and only takes about fifteen minutes. Recovery time is usually form one day to one week.

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Conjunctivitis/Corneal Ulcer

Conjunctivitis or pink eye is a general term used to describe an eye that is red or producing discharge. It can be due to a bacterial or viral infection. Contact lens complications can mimick pink eye. Allergies can be mistaken for "pink eye" A sight threatening cornal ulcer can first present itself as conjunctivitis. The only way to determine the cause of conjunctivitis is from an eye evaluation, as different causes of conjunctivitis need to be treated differently. If you experience redness, discomfort, or discharge, an eye consultion is warranted as some forms of "pink eye" are very contagious.

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Diabetes is a condition where the tissues in the body do not receive the proper nourishment because of a person’s inability to produce insulin. Insulin is needed for the transfer of glucose in the blood into the body’s individual cells. That is why people with undiagnosed or uncontrolled diabetes have high blood sugar levels. The tissues in the blood vessel walls also need these nutrients. Without them, the blood vessel walls weaken and leak blood in unwanted areas.

An example would be having an old hose with many cracks running the length of driveway in an attempt to water flowers at the far end. As the water is turned on, much of it leaks out of the cracks onto the driveway, resulting in very little water reaching the flowers.

Over time, diabetes affects many areas of the body. Often, its in the eyes where diabetes is first detected. That's why the eyes are often referred to "THE WINDOW TO THE BODY." If diabetic changes are detected in the eye, there is a high probability that these same diabetic changes are occurring throughout the body. Often times in the early stages, patients will have fluctuating vision and have difficulty getting the correct glasses prescription. It's not until the later stages that vision loss is noticeable. Advanced diabetes can cause permanent vision loss by damaging the retina, which is the delicate inner lining that sends visual messages to the brain. Hence the importance of having periodic eye examinations with either dilation or wide field retinal scans. Diabetic retinopathy is “silent” with no outward symptoms in its early stages.

Anyone who has had diabetes for more than 10 years is a prime target for diabetic retinopathy. Detected early, it can be monitored and treated most of the time. Left untreated, it may lead to blindness and other complications. With that said, if you find that that you are thirstier, or having to urinate more frequently, or more tired than usual, you should be evaluated for diabetes.

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Dry Eye

Dry eye is a very common condition. Symptoms range from from slight discomfort to debilitating.
​​​​​​​It can due to the normal aging process, exposure to environmental conditions, problems with normal blinking, or medications such as antihistamines, oral contraceptives, or antidepressants. Dry eye can also be symptomatic of general health problems and can occur from allergy or injury to the eye. Although dry eye can be due from different causes, it can often be treated with simple, inexpensive remedies. Contact lens wear can be more difficult with dry eye. Patients should proceed with caution if considering LASIK as that procedure can intensify dry eye symptoms. In more severe cases, if left untreated, it can cause eye damage. ​​​​​​​

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Dry Eye Treatment

There are many different tests to evaluate dry eye. We measure tear quantity. We measure tear evaporation rate.
We evaluate the surface of the eye. We have infrared photography that assesses the health of the tiny tear glands in the lid.

Treatments consist of:

  • Personal history evaluation

  • Warm compress

  • Artificial Tears

  • Steroid eye drops

  • Restasis, Xiidra eye drops

  • Scleral Contact lenses

  • Custom Soft lenses

  • Oral medications ​​​​​​​

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Glaucoma is a painless loss of vision usually caused from eye pressures greater than 22. In the classic sense, the higher pressure causes damage to the optic nerve by restricting circulation. There are many types of glaucoma. The exact cause is not exactly known and there is no cure. However, there are treatments that are successful in slowing or even preventing progression of the disease. Glaucoma can only be diagnosed with comprehensive eye exam, and it’s essential to detect it at an early stage to prevent loss of vision, as any vision loss is permanent.

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​​​​​​​Giant papillary conjunctivitis (GPC) is a condition where there is inflammation of the membrane on the underside of the upper lid, usually caused by some type of mechanical irritant. It can make contact lens wear unbearable. It is not contagious. Wearing dirty contact lenses coated with protein deposits is a common cause. However, with the increased use of daily disposable lenses. GPC is much less prominent.

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Keratoconus (KC) is a thinning or bulging of the cornea causing blurred. distorted vision that usually can not be corrected to 20/20 with glasses or conventional soft lenses. Only speciality, custom contact lenses have the ability top provide maximum vision. There is no cure for KC, but specialty, custom contact lenses can provide a lifetime of clear vision.

Patients with large amounts of astigmatism are at higher risk. There are studies that suggest a hereditatry component. Undiagnosed keratoconus could be the reason for never achieving satisfactory vison out of glasses or soft contact lenes. KC can advance, but usually does so does slowly. A treatment called cross-linking can slow, even stop the progression. Advanced cases of Keratoconus can cause scaring, which if severe enough may require a corneal transplant to provide clear vision.

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Macular Degeneration

AGE RELATED MACULAR DEGENERATION (AMD) is the leading cause of vision loss for those 65 and older. In advanced stages, a person can only see out of the periphery, as the center vision is left with a blind spot due to degeneration of the central retina called the macula.

Vision blind spot due to AMD

The exact cause is not known. However, genetics, UV exposure, and smoking are well known risk factors. Usually the first signs are blurred distance or reading vision, and / or problems with night driving. Annual eye exams with Optos Retinal Imagining and OCT are recommended for early detection and monitoring. Optos allows us to watch and document any changes that become evident on the surface. The OCT evaluates the macula beneath the surface and enables us to detect the smallest changes, enabling us to diagnose AMD much sooner than with prior technology.

​​​​​​​We have added the Adapt Dx, dark adaptation testing. This latest technology can diagnose AMD up to three years earlier than any other current technology on the market. AMD can present itself in two varieties, the DRY form or the WET (bleeding) form. There are treatments for the WET form. Once diagnosed with AMD, specific eye vitamins (i.e Preservision / AREDS2) and a diet rich in fish and dark leafy greens is recommended. A simple genetic test and early detection have shown to be the best course for successful management.

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Retinal Detachment

Retinal detachment (RD) is one of the more serious conditions that can happen to the eye. It is painless. If not detected and treated promptly, severe permanent vision loss can occur.

The seeing of light flashes or spots in the eye are some of the warning signs of a potential RD. Some patients report seeing a curtain or veil in there eye. A vitreous detachment can also produce many of these same symptoms, but causes no visual loss. The only way to determine a retinal detachment is from an eye evaluation with dilation and retinal imaging.

It is considered an emergency and we have daily appointments available for such cases.

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Spots & Flashes

The center of the eye is filled with a clear, jelly-like fluid known as the vitreous humor. Often, small flecks of protein or other natural matter become trapped in the vitreous during the formation of the eye before birth. These particles remain in the vitreous throughout life and are occasionally seen as spots or floaters. Spots and floaters can also be caused by deterioration of the vitreous or the retina as part of the natural aging process. During childhood, the vitreous is like jello.

As we age, the vitreous begins to become more liquid and loses its gel-like consistency. Then if a sudden collapse of the gel occurs, this can cause the vitreous to separate which causes microscopic particles to "float" within the eye, casting tiny shadows on the retina. We see these floaters as specs, bugs, strings or webs depending on their shape.

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Styes are essentially a pimple of the eyelid. They are result of an infection of a clogged oil duct. They are somewhat painful to the touch. You should never try to "pop" a stye even if you see a whitehead. Inital treatment consists of applying a warm moist compress for 10-15 mins twice a day. If there is no resolution, then an eye consultaion is needed to prevent progression to a more serious stage.

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