Top 5 Most Common Eye Conditions You've Never Heard Of

All the time I am faced with diagnosing and managing very common ocular & refractive conditions that patients just haven't heard of. They often reply "I have WHAT??". But just b/c you haven't heard the correct name for it doesn't mean it's not common. The following eye conditions are my top 5 most common eye conditions you've never heard of:

1) pinguecula/pingueculitis: a pinguecula is a raised/lumpy degeneration on the surface of the white part of your eye caused by long term heat, wind & UV exposure. They are usually yellow or off-white, prompting many patients to think they have jaundice. "Pingueculitis" is when a pre-existing pinguecula becomes inflamed, usually from ACUTE heat, wind or UV exposure. Although the word "pingueculitis" may sound like I'm saying "pink eye", pingueculitis is not a form of pink eye.

2) Giant Papillary Conjunctivitis: I've repeatedly blogged about this here. Many, many people have it and IMO this condition is underdiagnosed. GPC is when inflammatory bumps or "papules" form on the backside of your eyelids, usually in people with ocular allergy who wear silicone soft contact lenses. My fix is...DAILIES AND STEROIDS.

3) Presbyopia: you'd think everyone would know what this is, but they don't. All that most people know is "when you get older, your vision goes bad". Well that's not entirely true...more like when you get 40+ you start needing reading glasses and bifocals. Everyone will have this problem eventually. LASIK does not fix this problem. It always surprises me how many 42 year olds come in telling me they're "going blind" and when I tell them they need reading glasses/bifocals they're shocked. They've never heard of this problem.

4) Latent hyperopia: poorly understood by the general populus (because its not an easy concept), latency is the very 1st thing I blogged about in 2006. Latent hyperopia is "hidden farsightedness". I tell patients that their "real" Rx is more than they will accept. It sounds a simple world we'd just Rx what we measure, but in reality it usually takes some skill & experience in order to write a good Rx for any farsighted person, especially a latent one. Most lifelong farsighted people will eventually end up with a glasses Rx that they think is "wrong" & they assume the doc was a moron & "didn't take his time" or whatever. Well It ain't all that easy, which is why I usually give the "last eye doctor" a pass on their "horrible" Rx haha! I've certainly been the "moron last eye doctor" to some farsighted patients myself. We all have.

5) Accommodative esotropia: a "crossed" eye in a young person who is moderately or severely farsighted & is not wearing glasses. This understandably freaks parents out when their child has one eye pointing towards their nose. Everyone thinks that a crossed eye is strabismus & surgery is indicated, but MOST "cross-eyed" children just need glasses. "Strabismus", "lazy eye" and "amblyopia" are all generally confused & intermingled among laypeople, and adding in "accommodative esotropia" and a patching regimen doesn't help at all. Its not all that easy to understand.


  1. This probably isn't the right place to put this, but I tried searching for entoptic phenomena and got "no results."
    When my eyes are closed (overnight, during a nap, resting, e.g.) and I quickly open them in a brightly-lit room (light coming in the windows) or look at a bright white computer screen, I can see the branchlike image in my left eye for a very brief (milisecond) time. I am 57, and have been under observation for over a year for posterior vitreous detachment. Is this weird or OK?

  2. That does not sound in any way alarming to me, PVD or not.

  3. Thank you! I was worried because everything I saw online indicated the way one would see this (Purkinje tree)was if light entered the eye at a certain, oblique angle, and when I see it, the light source doesn't seem to be at any weird angle. I guess I'm also "looking" for it, so maybe I override accommodation?

  4. It probably is the purkinje tree. And if you're 57, you are not accommodating.

  5. My eyes aren't accommodating (regarding seeing the blood vessels in my eyes) due to age? Does it then not matter what angle the light source is? Thank you again!

  6. Thanks for the clarification on accommodating esotropia. I've been cross-eyed since I was about 1 and have never fully understood why my optometrists didn't offer surgery or a patch to fix the problem. You just (four years ago) clarified that in a few sentences. You also killed the dream that some treatment would come along to make me not cross-eyed for the second half of my life. :(


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