Dr. Almallah's Corner

Laser Vision Specialists serving Toms River, Brick, Barnegat & Manalapan Township, New Jersey

As men enter middle age, they can expect to experience their share of the eye condition known as “dry eye.” While this chronic lack of sufficient lubrication and tear production in the eye is more common among women, recent research shows that about four percent of men over age 50 may develop dry eye disease. Those affected by the condition report persistent dryness, itching, or burning in their eyes, along with the feeling of having grit in their eyes. Moreover, dry eye increases the risk of ocular infections, blurred/double vision, and visual disturbances that disrupt daily life. Thus, it is no wonder that dry eye is one of the most common reasons for visiting the eye doctor in the United States.

A person with dry eye should avoid anything that may cause dryness, such as an overly warm room, hair dryers, or wind. Smoking is especially bothersome.

A recent study involving people who have suffered mini-strokes called “silent cerebral infarcts” may suffer steady deterioration of their vision, which may help to explain normal tension glaucoma. The progressive loss of vision associated with glaucoma is caused by deterioration of the optic nerves, which is usually attributed to abnormally high intraocular pressure. However, some people with glaucoma have normal pressure of the fluid in their eyes (normal-tension glaucoma), which has long baffled ophthalmologists. This most recent finding of slow vision loss among 29.6 percent of people with normal-tension glaucoma and a history of a high incidence of silent cerebral infarcts (symptomless blockages of small brain arteries) may, at last, provide an explanation. If glaucoma is diagnosed and treated early, patients benefit in numerous ways, including prevention of vision loss.

P.S. In the United States, 15 to 25 percent of people suffering from open-angle glaucoma have normal-tension glaucoma.

Because the drug is so commonly prescribed for older men who may be considering cataract surgery, it bears mentioning that taking tamsulosin (Flomax) within two weeks of cataract surgery increases the risk of experiencing serious post-operative complications. Tamsulosin is commonly prescribed to treat benign prostatic hyperplasia, which affects about 75 percent of men by age 70. The drug acts on receptors that are located in the smooth muscle of the prostate and bladder neck, as well as in the dilator smooth muscle of the iris. Because of this link, research shows that men who took the drug before cataract surgery were 2.33 times more likely to require post-operative treatment for retinal detachment, lost lens or lens fragment, and endophthalmitis (inflammation of the intraocular cavity).

Cataracts affect a large percent of senior citizens age 65 and older in the United States today. It is important that patients inform their ophthalmologist whether they are currently taking alpha-blockers, such as Flomax, or did so in the past.

P.S. Research does not indicate that the use of alpha-adrenergic receptor blockers other than tamsulosin is linked to post-cataract surgery complications.

Botox® was first administered by Ophthalmologists and was approved by the FDA in the 1990’s to treat specific medical conditions such as eye lid spasms, crossed eyes and even headaches. While using Botox® for these purposes,ophthalmologists and patients noticed that the lines and wrinkles around their eyes were diminishing as a result of its use. This inevitably led to an approval by the FDA in 2002 for cosmetic uses.

Botox® targets wrinkles and facial lines known as "dynamic" lines. These lines are caused by repeated muscle movement and after time and are prevalent in and around the eyes, mouth and forehead. Therefore, by administering Botox®, we can prevent the contraction of the underlying muscles leaving a smooth and refreshed appearance.

You will notice an improvement within a few days as the Botox® relaxes the targeted muscles. This progress can continue for up to one month and the effects can last for four to five months. If you decide to discontinue Botox® treatment, you should expect your lines to gradually return to the way they looked before.

The reason Botox® is so popular is because it is affordable. Treatments can be as low as only a few hundred dollars for a selected region. As with other appearance related investments, the value is directly related to your personal expectations.

Remember, Ophthalmologists are surgeons that most commonly administer Botox® because they are qualified specialists that are intimately familiar with the eyelids, brows and other facial regions.


Laser-assisted in situ keratomileusis (LASIK) has virtually revolutionized the way we treat and even think about nearsightedness. In fact, the vision quality made possible by LASIK is actually better than that which could be attained by conventional corrective eyeglasses/contact lenses 25 years ago. The fact is that conventional lenses made the world look smaller in the eyes of nearsighted individuals. For each diopter of correction, images seen through corrective lenses shrank two percent. Thus, a nearsighted person with a -10 diopter correction would see a world that was 20 percent smaller. However, since LASIK corrects the underlying condition that leads to nearsightedness by reducing the curvature of the cornea, laser surgery leads to a more natural vision correction. LASIK may decrease your dependence on glasses and contacts or, in some cases, allow you to do without them entirely. Regular eye examinations by an ophthalmologist are important means of detecting eye disease in its early stages. Early detection, prompt treatment, and regular monitoring can enable you to continue living in much the same way as you have always lived. Don’t jeopardize this possibility.