Eye Diseases

Aqueous Deficient Dry Eye

Aqueous Deficient Dry Eye occurs when the lacrimal glands fail to produce enough of the water (aqueous) component of the tear film. Without adequate tear volume, the eyes become dry, irritated, and more prone to inflammation or infection.

Dry Eye Treatment Options

Treatment for Dry Eye Syndrome depends on the type and severity of the condition. At 512 Eye, we tailor treatment plans to each patient’s needs, starting with the most conservative methods and progressing to more advanced options if necessary. Common treatments include:

• Over-the-counter artificial tears
• Prescription eye drops such as:
  • Restasis® (cyclosporine 0.05%)
  • Xiidra® (lifitegrast)
  • Cequa® (cyclosporine 0.09% with improved absorption)
  • Tyrvaya® (varenicline nasal spray, stimulates natural tear production via nasal nerves)
  • Miebo™ (targets evaporative dry eye by stabilizing the lipid layer)
• Punctal plugs to reduce tear drainage
• Treatment of meibomian gland dysfunction (clogged oil glands)
• Nutritional supplements and lifestyle modifications

Our goal is to improve long-term eye comfort and tear film stability using the safest and most effective options available.

Glaucoma

Glaucoma is a serious eye condition that can lead to irreversible vision loss if left undetected and untreated. Often referred to as the “silent thief of sight,” glaucoma typically progresses without noticeable symptoms until significant damage has occurred. It is most commonly caused by increased intraocular pressure, which can damage the optic nerve over time.

The most common type—primary open-angle glaucoma—develops gradually and painlessly, making routine eye exams essential for early detection. At 512 Eye, Dr. Langer performs advanced glaucoma screenings using state-of-the-art diagnostic technology to identify the earliest signs of disease. During your comprehensive eye exam, she will measure your intraocular pressure and carefully assess your optic nerve for any glaucomatous changes.

Glaucomatous damage typically begins with a loss of peripheral vision and may eventually progress to tunnel vision or even blindness if not managed appropriately. Fortunately, most forms of glaucoma are highly treatable when caught early. Treatment options often begin with prescription eye drops to lower intraocular pressure and may include oral medications, laser procedures, or surgical referral in more advanced cases.

At 512 Eye, we are committed to protecting your vision through proactive, personalized care. Regular eye exams are your best defense against vision loss from glaucoma.

Advanced Glaucoma Testing at 512 Eye

Many patients are familiar with the traditional “air puff” test used to measure eye pressure. At 512 Eye, we use the Icare tonometer, a modern, no-puff alternative that is both comfortable and highly accurate. This makes glaucoma screenings more pleasant while maintaining precise intraocular pressure readings.

In addition to tonometry, Dr. Langer utilizes cutting-edge diagnostic tools to detect glaucoma as early as possible. Two of the most essential technologies we use are:

• Optical Coherence Tomography (OCT): This advanced imaging tool captures detailed, cross-sectional images of the retina and optic nerve, allowing us to detect subtle structural changes before vision loss occurs.

• Visual Field Testing: This test measures your peripheral (side) vision and is key in identifying early blind spots or patterns of vision loss associated with glaucoma.

By combining these advanced technologies, 512 Eye provides a comprehensive and accurate evaluation of your eye health—giving you the best chance at early diagnosis and effective management of glaucoma.

Age Related Macular Degeneration

Macular degeneration is a hereditary eye disease that leads to the gradual loss of central vision. It is one of the leading causes of blindness in adults over the age of 70. The macula, located in the central part of the retina, is responsible for sharp, detailed central vision and color perception. When this area becomes damaged, everyday tasks such as reading, recognizing faces, and driving can become difficult or impossible.

One of the earliest signs of macular degeneration is the presence of yellow deposits called drusen in the macula. These deposits can interfere with normal retinal function and may indicate the early stages of the disease, where the macula begins to degenerate, leading to a gradual loss of central vision. Macular degeneration may progress slowly over many years or advance more quickly.

There are two main types of macular degeneration:

• Dry macular degeneration: The most common form, involving gradual damage to the macula without bleeding.

• Wet macular degeneration: A less common but more serious form, where abnormal blood vessels grow and leak under the retina. This type often requires prompt surgical or pharmaceutical intervention to preserve vision.

During a comprehensive eye exam, Dr. Langer carefully evaluates the macula using a biomicroscope to check for drusen, bleeding, or other signs of damage. If any signs of macular degeneration are present, you will be monitored regularly.

While there is no cure for macular degeneration, certain vitamin supplements—especially those based on the AREDS2 formula—have been shown to slow the disease’s progression in patients already diagnosed. Dr. Langer will help determine whether these supplements are appropriate for you.

You can also lower your risk of developing macular degeneration by avoiding smoking, eating a diet rich in green leafy vegetables, and engaging in regular aerobic exercise.

Corneal dystrophies

Corneal dystrophies are a group of inherited eye conditions that affect the cornea—the clear, protective outer layer covering the front of the eye. These disorders cause abnormal material to accumulate within the cornea’s layers, which can interfere with vision and eye comfort. The cornea is made up of five distinct layers, and the symptoms of corneal dystrophies vary depending on which layer is affected.

Patients may experience symptoms such as:

• Blurred or reduced vision
• Glare, particularly at night
• Ocular discomfort or pain upon waking
• A sensation of having something in the eye (foreign body sensation)
• Increased light sensitivity
• Or, in some cases, no symptoms at all

Corneal dystrophies are typically progressive and often appear later in life, though some can begin earlier. Two common forms are Epithelial Basement Membrane Dystrophy (EBMD) and Fuchs’ Endothelial Corneal Dystrophy.

Treatment options depend on the type and severity of the condition. Mild cases may be managed with lubricating eye drops or hypertonic saline solutions, while more advanced cases may require surgical intervention, such as a corneal transplant.

If you have a family history of corneal dystrophy, or you’re experiencing eye discomfort or unexplained vision changes, we recommend scheduling a comprehensive eye exam with Dr. Langer at 512 Eye.

Pterygiums and Pingueculas

Pingueculas and pterygiums are common, benign growths on the surface of the eye caused primarily by sun exposure. These conditions are especially common in sunny climates like Austin, where UV exposure is frequent year-round. A pinguecula is a small, yellowish, raised bump that appears on the conjunctiva—the clear membrane covering the white part of the eye (sclera). It typically forms near the edge where the white of the eye meets the colored part (iris). A pterygium occurs when a pinguecula enlarges and begins to grow onto the cornea, the clear surface over the colored part of the eye. Pterygiums can cause redness, dryness, irritation, and in some cases, changes in vision or glasses prescription.

Both conditions tend to develop slowly over time and may affect one or both eyes. Although they are not usually harmful, larger or more aggressive growths can interfere with vision and may require surgical removal.

Wearing UV-protective sunglasses and using lubricating eye drops can help prevent irritation and reduce the risk of progression. If you notice any new growths or changes in your eye’s appearance, schedule an evaluation with Dr. Langer at 512 Eye