Eye Diseases

Dr. Langer is able to diagnose and manage most eye diseases. Dr. Langer has great working relationships with area ophthalmologists to co-manage patients with more complicated conditions. Below are several common eye diseases we treat and/or co-manage at 512 Eye.

Dry Eye Syndrome

Eye Drops - Allergies

The tear film consists of three distinct layers, an oil layer (lipid), a water layer (aqueous), and a mucin layer (mucous). This film helps keep our eyes moist and deter eye infections. When one or more of these layers does not work correctly, this leads to Dry Eye Syndrome. With Dry Eye, eyes often burn, water, or feel like there is something in them (such as an eyelash).

Evaporative Dry Eye

The most common cause of Dry Eye is called evaporative Dry Eye. In this condition, clogged glands at the lash margins cause poor production of the oil component of the tear film. With less of the oil layer available, the water layer evaporates very easily, leading to dryness.Aqueous Deficient Dry Eye

Aqueous Deficient Dry Eye

In this form of Dry Eye, the gland responsible for producing the water layer of the tear film (aqueous) does not produce enough aqueous.
Treatment for Dry Eye Syndrome may vary depending on which type of Dry Eye Syndrome is present. Treatments include over the counter artificial tears, prescription eye drops such as Restasis and Xiidra, punctal plug insertion (a minor surgical procedure that decreases tear drainage), treatment of clogged eyelid glands, and several other options. At 512 Eye, we try the most conservative treatment approaches first, to more aggressive treatment options if necessary.


Glaucoma is an eye disease characterized by defects in the optic nerve. The optic nerve is located in the retina (back of eye), and is responsible for transmitting information from the eye to the brain. Glaucoma is a complicated disease that presents in several different forms. It is most common in patients over 40 with a family history of glaucoma, but can also effect children and infants on rare occasions. There is an increased prevalence of glaucoma amongst diabetics.

Most forms of glaucoma don’t present with any symptoms. That is why we screen every single patient for glaucoma. It takes many years of having glaucoma (in most cases, not all) before symptoms occur. Many forms of glaucoma present with increased intraocular pressure. There are fluids inside the eyeball that the body is constantly producing and subsequently draining. If the body produces too much of this fluid, or does not drain the fluid properly, this increased intraocular pressure slowly damages the optic nerve. These changes to the optic nerve are often visible during an eye exam. Over time, damage to the optic nerve causes reduced peripheral vision, eventually leading to tunnel vision and potential blindness. The good news is that most forms of glaucoma are very treatable if they are diagnosed early. During your comprehensive eye exam, Dr. Langer will measure your intraocular pressure and evaluate your optic nerve for any signs of glaucoma. If you appear suspicious for glaucoma, we will refer you for further testing.

You are likely familiar with the dreaded “air puff” test. This test measures eye pressure to screen patients for glaucoma. The Icare tonometer allows Dr. Langer to check your eye pressure without the air puff. It is much more comfortable and very accurate. At 512 Eye, we incorporate the latest technology into our practice.


Age Related Macular Degeneration

Macular degeneration is a hereditary eye disease that causes loss of central vision. Unfortunately, there are no cures for macular degeneration, and it is a major cause of blindness for patients over the age of 70. The macula is an area in the retina responsible for sharp central vision and color vision. In macular degeneration, yellow deposits called drusen form in the macula, casing deterioration of central vision. Macular degeneration may progress rapidly, or very slowly. If the drusen are accompanied by bleeding in the macular region, this is known as wet macular degeneration. Most cases of macular degeneration are not accompanied by bleeding, and are referred to as dry macular degeneration. When wet macular degeneration is present, surgical intervention will likely be necessary to preserve vision.
During an eye exam, Dr. Langer will view the macula with a biomicroscope to look for any signs of drusen or retinal bleeding. If any signs of macular degeneration are present, you will be monitored closely. Certain vitamin formulations have been shown to slow down the progression of macular degeneration for those already diagnosed, and Dr. Langer is well versed in these treatment options. Unfortunately, there is no cure for macular degeneration. Studies have shown you can reduce your risk of developing macular degeneration by not smoking, eating green leafy vegetables, and engaging in regular aerobic activity.

Corneal dystrophies

Corneal dystrophies are genetic diseases which effect the cornea, the clear protective layer that covers the front surface of the eye. There are many types of corneal dystrophies, and they have different symptoms depending on what layer of the cornea is affected. The cornea consists of five layers. With corneal dystrophies, irregular material deposits in various layers of the cornea. Patients with corneal dystrophies may experience ocular pain, decreased vision, a foreign body sensation, glare at night, eye pain upon awakening or may have no symptoms at all. Treatment options vary depending on the type of corneal dystrophy present. Treatments range from therapy with over the counter eye drops in mild cases, to needing a corneal transplant in rare severe cases.
Two common forms of corneal dystrophy are Epithelial Basement Membrane Dystrophy and Fuchs Endothelial Corneal Dystrophy. Corneal dystrophies are often progressive and present later in life. If you have a family history of corneal dystrophy, or are experiencing eye discomfort and/or reduced vision, call us for an appointment.

Pterygiums and Pingueculas

Pterygiums and Pingueculas

Pterygiums and Pingueculas are benign growths caused by sun damage. They are very common in Austin due to our beautiful sunny weather. Pingueculas are small yellow elevated bumps that appear on the conjunctiva. The conjunctiva is the clear layer that covers the white part of the eye. Pterygiums occur when pingueculas grow larger, covering both the white (sclera) and colored portion of your eye (iris). Pterygiums may cause the affected eye to appear red, feel dry, or cause a change in glasses prescription. Pingueculas and pterygiums form where the colored portion of the eye (iris) meets the white portion of the eye (sclera). Pingueculas and pterygiums grow over time. They don’t usually pose any significant issues, but if they grow very large they can cause eye irritation or decreased vision. Pingueculas and pterygiums can be surgically removed in these instances.