Eye Disorders

Dry Eyes

Dry eye is a multifactorial eye disease that Dr. Budner treats with a variety of therapies in his Rockville and Fairfax office. Most people can be treated simply with eye drops such as Retaine MGDRetaine CMC or Retaine HPMC because they have the evaporative form of the disease. Other patients might need tear duct plugs. Some patients have impacted glands around the eyelids and would benefit by eyelid scrubs. Women especially are at risk. Its important they remove their makeup with an oil free product like Zoria. Some other therapies include high quality Omega 3's like Retaine Flax which soften the oils so they coat the eye better. Dr. Budner treats and prescribes all of these products with great success and our Fairfax and Rockville patients really appreciate his dedication to helping them relieve their symptoms. He enjoys treating all types of eye diseases.

Tears bathe the eye, washing out dust and debris and keeping the eye moist. They also contain enzymes that neutralize microorganisms that colonize the eye. Tears are essential for good eye health. Preservative Free drops like  Retaine MGDRetaine CMC or Retaine HPMC are the best choice to use as they mimic the eyes natural tears.

Tears are complex, containing many different essential elements, including oils produced by special glands in the eyelids called meibomian glands. These oils prevent evaporation of the tears. Many patients also suffer from a condition called Blepharitis which further aggravates the Dry Eye symptoms. Dr. Budner aggressively treats this common cause in his Fairfax and Rockville offices. Treating Blepharitis is and integral part of improving dry eye symptoms.


Eyes Are Dry Most Often When Springtime Allergens Are in the Air

May 2015 — Ever notice that your eyes are dryer in April than during other months? This happens to be the same month when springtime allergens are peaking, and a study seems to have found a definitive link between them.

Researchers at the University of Miami reviewed 3.4 million visits to Veterans Affairs eye clinics between 2006 and 2011, when about 607,000 people were diagnosed with dry eye. They also looked at the prevalence of dry eye and allergies and found that both peaked in springtime, especially in April. (Dry eye also spikes in wintertime, likely due to lower indoor humidity.)

Since dry eyes are linked to allergies, then allergy prevention such as wearing goggles outside and using air filters inside could also help prevent dry eyes.

The study results appeared on the journal Ophthalmology's website in late April. — L.S.

In dry eye syndrome, the lacrimal gland or associated glands near the eye don't produce enough tears, or dysfunction of the meibomian glands reduces oil output, leading to excessive evaporation of the tears. This is called evaporative dry eye and is now considered to be the primary cause or a contributing factor of most cases of dry eye.

Dry eye syndrome has many causes. It occurs as a part of the natural aging process (especially during menopause in women); as a side effect of many medications, such as antihistamines, antidepressants, certain blood pressure medicines, Parkinson's medications and birth control pills; or because you live in a dry, dusty or windy climate.

If your home or office has air conditioning or a dry heating system, that too can dry out your eyes. Another cause is insufficient blinking, such as when you're staring at a computer screen all day.

Dry eyes also are a symptom of systemic diseases such as lupus, rheumatoid arthritis, ocular rosacea or Sjogren's syndrome (a triad of dry eyes, dry mouth and rheumatoid arthritis or lupus).

Long-term contact lens wear is another cause; in fact, dry eyes are the most common complaint among contact lens wearers.

Recent research indicates that contact lens wear and dry eyes can be a vicious cycle. Dry eye syndrome makes contact lenses feel uncomfortable, and evaporation of moisture from contact lenses worsens dry eye symptoms. Newer contact lens materials and lens care products can help reduce contact lens dryness.

Incomplete closure of the eyelids, eyelid disease and a deficiency of the tear-producing glands are other causes.

Tears consist of three essential components:

  • The outer, oily lipid component
  • The middle, watery, lacrimal component
  • The innermost component, consisting of mucous or mucin

Each component of the tear film serves a critical purpose. For example, tear lipids prevent evaporation and increase lubrication, while mucins help anchor the tears to the ocular surface.

Each tear component is produced by a different gland:

  • The outer oily component is produced by meibomian glands in the eyelids.
  • The watery component is produced by lacrimal glands located above the outer corner of the eyes.
  • The inner mucoid component is produced by goblet cells in the conjunctiva.

A problem with any of those sources can result in tear instability and dry eyes.

Dry eye syndrome is an eye disease more common among women, possibly due to hormonal fluctuations. A recent study also indicates that the risk of dry eyes among men increases with age.

Recent research suggests that smoking, too, can increase your risk of dry eyes.

With increased popularity of cosmetic eyelid surgery (blepharoplasty) for improved appearance, dry eye complaints now occasionally are associated with incomplete closure of eyelids following such a procedure.


The macula is the central part of the retina. Macular Degeneration It is a small-specialised central area, which is responsible for fine detailed vision such as reading. Macular degeneration usually is a slowly progressing disease where the central area becomes thin and withered, so it functions less well. This cannot be treated at present.

There is also a more severe form of macular degeneration fortunately not as common. In this condition blood vessels growing under the macula leak fluid or blood, which form distortions to the smooth, even surface of retina and damage the retina cells. Vision will become distorted and eventually reduced considerably. This condition can be treated with new therapies by specialist ophthalmologists.

If you or family members notice distortion of near vision, wavy lines, gaps and holes in a page of print, it could be sign of early macular degeneration and should be examined by an optometrist. 

NEWS FLASH:  A new diagnostic test is available that can predict your risk of developing Macular Degeneration that utilizes genetic testing ( RetnaGene). This can help us to outline a plan to reduce your risk with Nutracueticals, diet and exercise.

HOT OFF THE PRESS; A new novel eye drop ( squalamine) is being evaluated to treat patients with Macular Degeneration and the results to date are outstanding. It's not yet approved ( hopefully by 2017 ) so keep checking back.

Impressive evidence has shown that vitamin therapy based on the Ared's study will reduce the risk of Macular degeneration progressing to the devastating wet type of the disease. Low Zinc variety is now the standard found in products like Fortifeye macular Defense.


Keratoconus is a vision disorder that occurs when the normally round cornea becomes irregularly cone shaped. This abnormal shape prevents the light entering the eye from being focused correctly on the retina and causes distortion of vision and increased sensitivity to glare and light.

Keratoconus symptoms usually appear between 18 - 30 years of age and may progress for another 10-20 years. Each eye may be affected differently. As keratoconus progresses, the cornea bulges more and vision becomes further distorted. Special contact lenses such as the new SynergEyes hybrid lens or surgery may be necessary.

Keratoconus can be linked to allergy problems such as hay fever and eczema through excessive eye rubbing. If you or a member of your family has a tendency towards allergy and itchy eyes it is important to refrain from rubbing them despite a strong urge to do so.

Approximately half of keratoconus patients have no negative lifestyle effects beyond corrective lenses. The cornea stabilizes after a few years without ever causing severe vision problems. For others, the only resolution to keratoconus has been PKP, with a long healing period and unpredictable refractive error. Even after corneal transplant PKP, keratoconus can reoccur in the new donor cornea. Fortunately, there are two new methods to treat keratoconus that are much less invasive than a corneal transplant.Treating patients with kerataconus is one of our specialities.


A developing keratoconus and ectasia treatment is Corneal Collagen Crosslinking with Riboflavin (CxL), that has been proven outside of the US to strengthen a weakened corneal structure. CxL is currently in US Food and Drug Administration (FDA) clinical trials. For more information, visit CxL Clinical Trial.

This method works by increasing collagen crosslinking, which are the natural "anchors" within the cornea. These anchors are responsible for preventing the cornea from bulging out and becoming steep and irregular, consequence of advanced keratoconus.

The 30-minute corneal crosslinking treatment is performed in the doctor's office. During the treatment, custom-made riboflavin eye drops are applied to the cornea, which is then activated by ultraviolet light. This amazingly simple process has been shown in laboratory and clinical studies to increase the amount of collagen cross-linking in the cornea and strengthen the cornea. In published European studies, such treatments were proven safe and effective in patients.


The eye is one of the organs that suffers damage with diabetes. Diabetic retinopathy can weaken and cause changes in the small blood vessels that nourish your eye's retina, the delicate, light sensitive lining of the back of the eye. These blood vessels may begin to leak, swell or develop brush-like branches.

The early stages of diabetic retinopathy may cause blurred vision. As the disease progresses, you may notice a cloudiness of vision, blind spots or floaters. If left untreated, diabetic retinopathy can cause blindness and is one reason why your Primary Eyecare Optometrist recommends regular eye examinations, particularly if you are a diabetic or if your family has a history of diabetes. New treatments are available to treat Diabetic retinopathy. Soon a new eye drop may be available to greatly improve the vision outcomes.

HOT OFF THE PRESS; A new novel eye drop ( squalamine) is being evaluated to treat patients with Diabetic Macula edema and the results to date are outstanding. Its not yet approved ( hopefully by 2017 ) so keep checking back


A stye develops when a gland at the edge of the eyelid becomes bacterial infected. Resembling a pimple, a sty can grow on the inside or outside of the eyelid. Styes are not harmful to vision and they can occur at any age.

A stye initially brings pain, redness, tenderness and swelling in the area before a small pimple appears. Sometimes just the immediate area is swollen, other times the entire eyelid swells. Most styes heal within a few days. Applying a hot compresses for 10 - 15 minutes three or four times a day over the course of several days will help relieve the pain and bring the stye to a head. The stye ruptures, drains and heals. Never burst a stye; allow it to rupture on its own. Styes formed inside the eyelid are more serious and may need to be treated by us.


Glaucoma is one of the leading causes of blindness. Approximately 25 of people over the age of 40 have glaucoma and the risk increases with age.

Glaucoma is an eye disorder in which the internal pressure in your eyes increases enough to damage the nerve fibres in your optic nerve and cause vision loss. The increase of pressure happens when the passages that normally allow fluid in your eyes to drain become clogged and blocked.

The most common type of glaucoma develops gradually and painlessly without symptoms in the early stages. Severe loss of peripheral vision may occur before the sufferer realises there is a problem. A rarer type of glaucoma occurs more rapidly and its symptoms may include blurred vision, loss of side vision, seeing coloured rings around lights and pain or redness in the eyes.

Glaucoma most often occurs in people over the age of 40. People with a family history of glaucoma and those very near sighted or diabetic are at higher risk of developing the disease. Early detection is important. Glaucoma cannot be prevented, but if diagnosed and treated early, it can be controlled. Vision lost to glaucoma cannot be restored.

A comprehensive vision assessment and eye health examination will include a tonometry test to measure the pressure in your eyes; an examination of the inside of your eyes and a computerised visual fields test to check for changes in central and side vision to help diagnose Glaucoma.

Early detection is important for effective treatment. Glaucoma is usually only detected in the course of an eye examination. Regular eye examinations are important for the detection and management of glaucoma.


A cataract is a clouding of all or part of the normally clear lens within your eye, which results in blurred or distorted vision. Cataracts are most often found in persons over age 55.

Although cataracts develop without pain or discomfort, indications of cataract development may include blurred or hazy vision, the appearance of spots in front of the eyes, increased sensitivity to glare or the feeling of having a film over the eyes.

During an eye examination your optometrist will diagnose any cataract development. Currently there is no proven method to prevent cataracts forming, however, your Visique Optometrist can monitor its development and prescribe spectacles or contact lenses to maintain good vision.

If the cataract develops to the point that it affects your daily life your Visique Optometrist can refer you to an eye surgeon who may recommend surgery to remove the natural lens and replace this with a new plastic lens.


Pink eye (conjunctivitis) is an inflammation or infection of the transparent membrane (conjunctiva) that lines your eyelid and covers the white part of your eyeball. When small blood vessels in the conjunctiva become inflamed, they're more visible. This is what causes the whites of your eyes to appear reddish or pink.

Pink eye is commonly caused by a bacterial or viral infection, an allergic reaction, or — in babies — an incompletely opened tear duct.

Though pink eye can be irritating, it rarely affects your vision. Treatments can help ease the discomfort of pink eye. Because pink eye can be contagious, early diagnosis and treatment can help limit its spread.

Serving Patients from Fairfax, Rockville, Potomac, Silver Spring, Olney, Reston, Centreville, Oakton, Kensington, Aspen Hill