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Horner's Syndrome

Horner’s syndrome is a pattern of eye and facial changes caused by reduced “sympathetic” nerve signals to one side of the face. It isn’t a disease by itself—it’s a clue that something along that nerve pathway has been affected, so clinicians focus on finding the underlying cause. Q: What is Horner’s syndrome? A: A condition where the nerves that help control the eyelid, pupil size, and sweating don’t work normally on one side of the face. Q: What are the usual signs? A: A droopy upper eyelid (ptosis), a smaller pupil on that side (miosis), and sometimes less sweating on that side of the face (anhidrosis). Some people also notice the affected eye looks “less open.” Q: Does it hurt or affect vision? A: Horner’s syndrome itself doesn’t usually damage the eye or directly cause vision loss, but the pupil difference can be more noticeable in dim light and may be associated with other symptoms depending on the cause. Q: What causes it? A: Anything that disrupts the nerve pathway from the brai...
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Cancer: Questions and Answers

  Cancer: Questions and Answers Q: What are the earliest warning signs of cancer? A: Cancer can cause many different symptoms depending on where it begins. Some general warning signs include unexplained weight loss, persistent fatigue, unexplained fever or night sweats, a new lump, persistent pain, changes in bowel or bladder habits, unusual bleeding, a persistent cough, changes in a mole, or a symptom that is new and does not go away. These symptoms are often caused by conditions other than cancer, but persistent or unexplained changes should be evaluated by a healthcare professional. Q: Does having one of these symptoms mean that I have cancer? A: No. Most individual symptoms have many possible causes, and many are not related to cancer. The concern increases when a symptom is new, unexplained, persistent, worsening, or accompanied by other concerning symptoms . A medical evaluation is the best way to determine the cause. Q: How long should I wait before seeing a doctor about a...
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Thyroid Eye Disease (TED): Why Do Eyes Bulge?

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  Thyroid Eye Disease (TED): Why Do Eyes Bulge? If you or someone you love has thyroid problems, you may have noticed a change in the eyes — they seem to push forward or look more open than usual. This is called Thyroid Eye Disease, or TED , and the bulging is called exophthalmos or proptosis . It can be alarming to see, but understanding why it happens makes it much less mysterious. What's Happening Behind the Eye? Think of your eye socket (the orbit) like a fixed-size bony cup. Inside that cup, there are: Extraocular muscles - the tiny muscles that move your eye Orbital fat - a cushion of fatty tissue that supports the eye The eyeball itself (globe) In TED, your immune system mistakenly attacks the tissues behind the eye. This is an autoimmune inflammation. It doesn't affect the eye itself, but it inflames the muscles and fat around and behind the eye (doctors call this retrobulbar tissue). When those tissues become inflamed, two things happen: The eye muscles swell and ...
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# Glaucoma Early Signs: When to Get Screened in Brookline, MA

 # Glaucoma Early Signs: When to Get Screened in Brookline, MA Glaucoma is often called the silent thief of sight - early signs are subtle. At Paddy Kalish, OD - Coolidge Corner, 1296 Beacon St, Brookline, MA 02446 - Dr. Paddy Kalish, OD provides early glaucoma testing as part of comprehensive eye exams for adolescents and adults. **Early signs to watch:** - No signs at first - that is why screening matters - Later: peripheral vision narrowing, eye pain, headaches, halos around lights, fluctuating vision **Who is at higher risk in Brookline?** - Age over 40, family history, high eye pressure, high myopia, history of eye injury or iritis. **How we screen at paddykalish.com:** - Eye pressure measurement, optic nerve evaluation, visual field discussion, and Optical Coherence Tomography (OCT) to measure nerve fiber layer thickness. Dr. Kalish completed residency at Hadassah University Hospital in Jerusalem and has 30+ years detecting early glaucoma and iritis. He customizes treatment p...
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# Contact Lenses After 60: Comfort, Safety, and Options in Brookline, MA

 # Contact Lenses After 60: Comfort, Safety, and Options in Brookline, MA Can you still wear contacts after 60? Yes - but the fitting changes. At Paddy Kalish, OD, 1296 Beacon St, Brookline, we fit adolescents and adults, including patients in their 60s, 70s, and beyond in Coolidge Corner and surrounding Boston neighborhoods. **What changes after 60:** - Tear film becomes less stable = need more breathable lenses - Presbyopia = may need multifocal contacts or monovision strategy - Dry eye and medications affect comfort **Dr. Paddy Kalish's Approach:** As an OD with 30+ years of contact lens fitting, he evaluates visual acuity, corneal health, tear film, and lifestyle. He provides guidance on proper contact lens care, cleaning, and wear schedule to maintain optimal eye health. We carry a variety of contacts and eyeglass frames in-office, and customize treatment for dry eyes that can interfere with lens wear. **Tips from Brookline patients:** - Daily disposable lenses reduce infectio...
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# OCT Eye Scan vs Regular Eye Exam: What Brookline Patients Need to Know

 # OCT Eye Scan vs Regular Eye Exam: What Brookline Patients Need to Know A regular eye exam checks your prescription. An OCT (Optical Coherence Tomography) scan shows what is happening *under* the surface of your retina and optic nerve. At Paddy Kalish, OD in Coolidge Corner, 1296 Beacon St, Brookline, Dr. Paddy Kalish uses in-office OCT to identify early refractive issues, glaucoma risk, and retinal changes long before symptoms. **Regular Eye Exam includes:** - Visual acuity, eyeglasses and contact lens prescription, eye pressure check, front-of-eye health. **OCT adds:** - Cross-sectional imaging of retina layers (like an MRI for the eye) - Early detection of glaucoma, macular changes, and optic nerve swelling - Baseline for tracking changes year over year **Who should consider OCT in Brookline?** - Adults over 40, family history of glaucoma, high myopia, diabetes, persistent headaches or eye pain. With 30+ years experience, residencies at Healthcare America Medical Group (Florid...
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# Dry Eye in Boston Winters: Why It Happens and How We Treat It in Brookline

 # Dry Eye in Boston Winters: Why It Happens and How We Treat It in Brookline If you live in Coolidge Corner or Brookline, you know winter dry eye is real. Indoor heating, wind on Beacon Street, and low humidity irritate the tear film. At Paddy Kalish, OD - 1296 Beacon St Main Level, Brookline, MA 02446 - we see dry eye daily in adolescents and adults. Dr. Paddy Kalish, OD, with 30+ years in Brookline, takes an integrative, one-on-one approach. **Why Boston makes it worse:** - Forced-air heat reduces indoor humidity to 20-30% - Cold wind increases tear evaporation - Screen time at work reduces blink rate **What we do differently:** 1. **Comprehensive evaluation:** Visual acuity, tear film assessment, and Optical Coherence Tomography (OCT) when needed to rule out surface damage. 2. **Personalized plan:** Not just artificial tears. We tailor lid hygiene, warm compress protocol, contact lens modifications, and prescription options for inflammation. 3. **Prevention:** Guidance on humid...
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