Hamilton Vision & Eyecare

06/19/2026

Case of the week: Papilledema

Papilledema is defined as optic disc swelling produced from increased intracranial pressure. This excess pressure on the nerve can cause damage over time.

Causes: Benign or malignant tumors, hydrocephalus, idiopathic intracranial hypertension, stroke, venous sinus thrombosis, certain medications, etc.

Symptoms: transient vision loss, headache, double vision, nausea, and decreased visual acuity

Treatment: Treatment almost always starts with neuroimaging here. If we can rule out a tumor through a normal MRI, we can treat the intracranial hypertension with acetazolamide tablets.

Our patient underwent an MRI and received a clean report. The patient had been undergoing testosterone replacment therapy (TRT) recently. This has been linked to papilledema, although uncommon. He has stopped the TRT and has started acetazolamide to help bring the intracranial pressure back down to normal levels and control the nerve swelling.

Below are images of a swollen optic nerve and a normal optic nerve for comparison.

06/05/2026

We are excited about welcoming Jade and Sydney to our eye care team!😁😁

06/04/2026

Thank you Elder's Tacos & Steaks for the great lunch!!!!☺️

05/29/2026

Case of the week: Conjunctival pyogenic granuloma

A pyogenic granuloma is a benign growth of blood vessels that typically appears as a lobular or fleshy extension of tissue. It is not very common, but we do see it occasionally. Typically, they arise after trauma to the eye, surgery, or at the site of a previous stye or chalazion. Since they are heavily vascularized, bleeding is common.

Symptoms: foreign body sensation

Treatment: First line of treatment is topical beta blocker drops like timolol or corticosteroid drops. Fortunately, many completely regress after a few weeks of treatment. In some cases, simple surgical excision may be required.

05/22/2026

Case of the week: Trichiasis

Trichiasis is the inward turn of eyelashes. We see this pretty commonly in the clinic. The primary symptoms are foreign body sensation and irritation.

The easiest treatment is epilation (removal of the lash/lashes involved). Typically the lashes will regrow in a couple months and need to be removed again. Also, contact lenses can be used to protect/shield the cornea from the lash. A more permanent treatment option would be destruction of the follicle. This can be achieved by electrolysis or cryotherapy. Electrolysis uses electric current to destroy the follicle whereas cryotherapy uses extreme cold temperature to destroy the follicle.

The photo below is a current patient who is being referred for one of these procedures. We have epilated the single lash 4-5 times over the past 10 months. You can see where the lash has caused several scratches/epithelial corneal defects from constant tracking across the eye. The cornea heals quickly once the lash is removed.

05/18/2026

Hamilton Vision and Eyecare would like to wish the Hamilton Lady Aggies and the Hackleburg Lady Panthers good luck this week in the state softball tournament!!

Send a message to learn more

05/01/2026

Case of the week: Intraocular lens dislocation

An intraocular lens (IOL) dislocation is a complication where the artificial lens implanted during cataract surgery moves out of its normal position inside the eye.

IOL dislocation is relatively rare but can happen early after surgery or years later.

Early causes : surgical complications, poor capsular support, or trauma after surgery.

Late causes: progressive weakening of zonules (fibers that hold the lens in place), previous eye surgeries or previous trauma, and connective tissue disorders.

Symptoms: blurred or fluctuating vision, double vision, glare/halos, significant vision loss

Management: observation if mild; surgical options include IOL repositioning, IOL exchange, scleral fixation of the lens, or iris fixation of the lens.

Side bar: our case this week was an anterior IOL dislocation. This particular patient had severe blunt force trauma to the eye prior to having cataract surgery. The IOL has been functioning well for around 7 years. Patient presented to the office with sudden vision loss and moderate pain. The IOL had shifted forward and was in direct contact with the posterior iris. This caused vitreous prolapse, increased intraocular pressure, and mild corneal edema. The patient is currently being managed with ocular hypotensive medications until they can undergo an IOL exchange procedure.

04/24/2026

Case of the week: Acute angle-closure glaucoma (AACG)

AACG is an ocular emergency caused by a sudden rise in intraocular pressure (IOP) when the drainage angle of the eye (between the iris and cornea) becomes blocked.

What happens:
The eye normally drains fluid (aqueous humor) through a structure called the trabecular meshwork. In AACG, the iris shifts forward and closes off this drainage pathway, causing fluid buildup and a rapid increase in pressure.

Symptoms (sudden onset):

* Severe eye pain
* Blurred vision or halos around lights
* Red eye
* Headache
* Nausea and vomiting
* Fixed, mid-dilated pupil

Risk factors:

* Age > 50
* Female
* Hyperopia (farsightedness)
* Asian descent
* Shallow anterior chamber

Why it matters:
The rapid pressure increase can damage the optic nerve within hours, leading to permanent vision loss if not treated immediately.

Treatment:

* Emergency lowering of IOP with medications (topical and oral/IV)
* Laser peripheral iridotomy (definitive treatment) to create an alternate pathway for fluid flow
* Sometimes surgery if laser is not sufficient

Bottom line:
AACG is a true ocular emergency—prompt recognition and treatment are critical to prevent permanent blindness.

04/22/2026

We were pleased to be a part of the Hamilton High School ACT raffle. Tickets were awarded based on growth, achievement level, and participation during prep activities. Congratulations to Kimber Nix and the other juniors on their dedication to ACT prep!

04/17/2026

Case of the week is Stargardt Disease.

Many people haven't heard of Stargardt disease, but for those living with it, the world looks a little different.

Stargardt disease is a rare genetic eye condition that causes progressive vision loss. It specifically affects the macula, the part of the eye responsible for sharp, central vision.

Here are a few facts:
📍 **The Cause:** A buildup of fatty deposits (lipofuscin) on the retina, which eventually damages the cells we use for seeing detail.
📍 **The Symptoms:** Blurry or distorted central vision, "blind spots," and difficulty seeing in low light.
📍 **The Timing:** It usually begins in childhood or adolescence, though it can sometimes emerge later in life.
📍 **The Vision:** While it affects central vision (making it hard to read or recognize faces), peripheral (side) vision usually remains intact.

Right now, there is no cure, but researchers are working hard on gene therapies and new treatments! Below are some retinal images of an early case the we had confirmed through genetic testing. Acuity still measures good clinically at 20/25, but the visual image quality has deteriorated.