Patient Education

Vision Conditions

In this section, we provide answers to questions about a variety of common vision conditions. Whether you’re interested in learning more about near sightedness, how the eye works, or what causes the need for bifocals, your questions are addressed here.

Myopia

Nearsightedness, or myopia, as it is medically termed, is a vision condition in which near objects are seen clearly, but distant objects do not come into proper focus. Nearsightedness occurs if your eyeball is too long or the cornea has too much curvature, so the light entering your eye is not focused correctly.

Nearsightedness is a very common vision condition that affects nearly 30 percent of the U.S. population. Some evidence supports the theory that nearsightedness is hereditary. There is also growing evidence that nearsightedness may be caused by the stress of too much close vision work. It normally first occurs in school age children. Since the eye continues to grow during childhood, nearsightedness generally develops before age 20.

A sign of nearsightedness is difficulty seeing distant objects like a movie or TV screen or chalkboard. A comprehensive optometric examination will include testing for nearsightedness. Your optometrist can prescribe eyeglasses or contact lenses to optically correct nearsightedness by altering the way the light images enter your eyes. You may only need to wear them for certain activities, like watching TV or a movie or driving a car, or they may need to be worn for all activities.

Refractive surgery or laser procedures are also possible treatments for nearsightedness as is Paragon CRT. Paragon CRT is a non-invasive procedure that involves the wearing of a specially-designed rigid contact lenses to reshape the curvature of the cornea over time while you’re asleep.

Hyperopia

Farsightedness, or hyperopia, as it is medically termed, is a vision condition in which distant objects are usually seen clearly, but close ones do not come into proper focus. Farsightedness occurs if your eyeball is too short or the cornea has too little curvature, so light entering your eye is not focused correctly.

Common signs of farsightedness include difficulty in concentrating and maintaining a clear focus on near objects, eye strain, fatigue and/or headaches after close work, aching or burning eyes, irritability or nervousness after sustained concentration.

Common vision screenings, often done in schools, are generally ineffective in detecting farsightedness. A comprehensive optometric examination will include testing for farsightedness.

In mild cases of farsightedness, your eyes may be able to compensate without corrective lenses. In other cases, your optometrist can prescribe eyeglasses or contact lenses to optically correct farsightedness by altering the way the light enters your eyes.

Astigmatism

Astigmatism is a vision condition that occurs when the front surface of your eye, the cornea, is slightly irregular in shape. This irregular shape prevents light from focusing properly on the back of your eye, the retina. As a result, your vision may be blurred at all distances.

Most people have some degree of astigmatism. A comprehensive optometric examination will include testing to diagnose astigmatism and determine the degree.

Almost all levels of astigmatism can be optically corrected with properly prescribed and fitted eyeglasses and/or contact lenses.

Corneal modification is also a treatment option for some patients.

PRESBYOPIA

Presbyopia is a vision condition in which the crystalline lens of your eye loses its flexibility, which makes it difficult for you to focus on close objects. Presbyopia may seem to occur suddenly, but the actual loss of flexibility takes place over a number of years. Presbyopia usually becomes noticeable in the early to mid-forties. Presbyopia is a natural part of the aging process of the eye. It is not a disease and it cannot be prevented.

Some signs of presbyopia include the tendency to hold reading materials at arm’s length, blurred vision at normal reading distance and eye fatigue along with headaches when doing close work. A comprehensive optometric examination will include testing for presbyopia.

To help you compensate for presbyopia, your optometrist can prescribe reading glasses, bifocals, trifocals or contact lenses. Since presbyopia can complicate other common vision conditions like nearsightedness, farsightedness and astigmatism, your optometrist will determine the specific lenses to allow you to see clearly and comfortably. You may only need to wear your glasses for close work like reading, but you may find that wearing them all the time is more convenient and beneficial for your vision needs.

Since the effects of presbyopia continue to change the ability of the crystalline lens to focus properly, periodic changes in your eyewear may be necessary to maintain clear and comfortable vision.

20/20 Vision

20/20 Vision is a term used to express normal visual acuity (the clarity or sharpness of vision) measured at a distance of 20 feet. If you have 20/20 vision, you can see clearly at 20 feet what should normally be seen at that distance. If you have 20/100 vision, it means that you must be as close as 20 feet to see what a person with normal vision can see at 100 feet.

20/20 does not necessarily mean perfect vision. 20/20 vision only indicates the sharpness or clarity of vision at a distance. There are other important vision skills, including peripheral awareness or side vision, eye coordination, depth perception, focusing ability and color vision that contribute to your overall visual ability.

Some people can see well at a distance, but are unable to bring nearer objects into focus. This condition can be caused by hyperopia (farsightedness) or presbyopia (loss of focusing ability). Others can see items that are close, but cannot see those far away. This condition may be caused by myopia (nearsightedness).

A comprehensive eye examination by a doctor of optometry can diagnose those causes, if any, that are affecting your ability to see well. In most cases, your optometrist can prescribe glasses, contact lenses or a vision therapy program that will help improve your vision. If the reduced vision is due to an eye disease, the use of ocular medication or other treatment may be used.

Spots and Floaters

Spots (often called Floaters) are small, semi-transparent or cloudy specks or particles within the vitreous, the clear, jelly-like fluid that fills the inside of your eyes. They appear as specks of various shapes and sizes, threadlike strands or cobwebs. Since they are within your eyes, they move as your eyes move and seem to dart away when you try to look at them directly.

Spots are often caused by small flecks of protein or other matter trapped during the formation of your eyes before birth. They can also result from deterioration of the vitreous fluid, due to aging; or from certain eye diseases or injuries.

Most spots are not harmful and rarely limit vision. But, spots can be indications of more serious problems, and you should see your optometrist for a comprehensive examination when you notice sudden changes or see increases in them.

By looking in your eyes with special instruments, your optometrist can examine the health of your eyes and determine if what you are seeing is harmless or the symptoms of a more serious problem that requires treatment.

Crossed Eyes

Crossed-eyes (strabismus) occurs when one or both of your eyes turns in, out, up or down. Poor eye muscle control usually causes crossed-eyes. This misalignment often first appears before age 21 months but may develop as late as age six. This is one reason why the American Optometric Association recommends a comprehensive optometric examination before six months and again at age three.

There is a common misconception that a child will outgrow crossed-eyes. This is not true. In fact, the condition may get worse without treatment.

Treatment for crossed-eyes may include single vision or bifocal eyeglasses, prisms, vision therapy, and in some cases, surgery. Vision therapy helps align your eyes and solves the underlying cause of crossed-eyes by teaching your two eyes to work together. Surgery alone may straighten your eyes, but unless your eye muscle control is improved, your eyes may not remain straight.

If detected and treated early, crossed-eyes can often be corrected with excellent results.

Lazy Eye

Lazy eye, or amblyopia, is the loss or lack of development of central vision in one eye that is unrelated to any eye health problem and is not correctable with lenses. It can result from a failure to use both eyes together. Lazy eye is often associated with crossed-eyes or a large difference in the degree of nearsightedness or farsightedness between the two eyes. It usually develops before age six and it does not affect side vision. Symptoms may include noticeably favoring one eye or a tendency to bump into objects on one side. Symptoms are not always obvious.

Treatment for lazy eye may include a combination of prescription lenses, prisms, vision therapy and eye patching. Vision therapy teaches the two eyes how to work together, which helps prevent lazy eye from re-occurring.

Early diagnosis increases the chance for a complete recovery. This is one reason why the American Optometric Association recommends that children have a comprehensive optometric examination by the age of six months and again at age three. Lazy eye will not go away on its own. If not diagnosed until the pre-teen, teen or adult years, treatment takes longer and is often less effective.

Eye Coordination Problems

Eye coordination is the ability of both eyes to work together as a team. Each of your eyes sees a slightly different image and your brain, by a process called fusion, blends these two images into one three-dimensional picture. Good eye coordination keeps the eyes in proper alignment. Eye coordination is a skill that must be developed. Poor eye coordination results from a lack of adequate vision development or improperly developed eye muscle control. Although rare, an injury or disease can cause poor eye coordination.

Because the images seen by each eye must be virtually the same, a person usually compensates for poor eye muscle control by subconsciously exerting extra effort to maintain proper alignment of the eyes. In more severe cases, the muscles cannot adjust the eyes so that the same image is seen and double vision occurs. Since the brain will try to avoid seeing double, it eventually learns to ignore the image sent by one eye. This can result in amblyopia, a serious vision condition commonly known as lazy eye.

Some signs and symptoms that may indicate poor eye coordination include double vision, headaches, eye and body fatigue, irritability, dizziness and difficulty in reading and concentrating. Children may also display characteristics that may indicate poor eye coordination including covering one eye, skipping lines or losing their place while reading, poor sports performance, avoiding tasks that require close work and tiring easily.

Since poor eye coordination can be difficult to detect, periodic optometric examinations, beginning at age six months and again at age three years are recommended. A comprehensive examination by a doctor of optometry can determine the extent, if any, of poor eye coordination. Poor eye coordination is often successfully treated with eyeglasses and/or vision therapy. The success rate for achieving proper eye coordination is quite high. Sometimes, eye coordination will improve when other vision conditions like nearsightedness or farsightedness are corrected. In some cases, surgery may be necessary.

Color Deficiency

Red-green color vision deficiency is by far the most common form and it results in the inability to distinguish certain shades of red and green. Those with a less common type have difficulty distinguishing blue and yellow. In very rare cases, color deficiency exists to an extent that no colors can be detected, only shades of black, white and grey.

Since many learning materials are color-coded, it is important to diagnose color vision deficiency early in life. This is why the American Optometric Association recommends a comprehensive optometric examination before a child begins school.

Color vision deficiency is usually inherited and cannot be cured, but those affected can often be taught to adapt to the inability to distinguish colors. In some cases, a special red tinted contact lens is used in one eye to aid persons with certain color deficiencies.

Eye Diseases

In this section, we provide several documents that address frequently asked about eye diseases. These papers introduce you to very general information. American Optometric Association emphasizes that it is important to have your eyes examined regularly by your doctor of optometry.

Cataract

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, but they are also occasionally found in younger people.

No one knows exactly what causes cataracts, but it is known that a chemical change occurs within your eye to cause the lens to become cloudy. This may be due to advancing age, heredity or an injury or disease. Excessive exposure to ultraviolet radiation in sunlight, cigarette smoking or the use of certain medications are also risk factors for the development of cataracts.

Although cataracts develop without pain or discomfort, there are some indications that a cataract may be forming. These 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. A temporary improvement in near vision may also indicate formation of a cataract.

Currently, there is no proven method to prevent cataracts from forming. During a comprehensive eye examination, your optometrist can diagnose a cataract and monitor its development and prescribe changes in eyeglasses or contact lenses to maintain good vision.

If your cataract develops to the point that it affects your daily activities, your optometrist can refer you to an eye surgeon who may recommend surgery. During the surgery, the eye’s natural lens is removed and usually replaced with a plastic artificial lens. After surgery, you can return to your optometrist for continuing care.

Glaucoma

Glaucoma can steal your vision gradually and without your noticing. The best defense against glaucoma is a regular eye examination. Glaucoma most often strikes people over age 50. But it is recommended that during adult life everyone be tested at least every year.

Some people with glaucoma do experience symptoms, but symptoms vary depending on the type of glaucoma.

  • Primary open-angle glaucoma
    By far the most common type, primary open-angle glaucoma develops gradually and painlessly. Since there are no early warning signs, it can slowly destroy your vision without your knowing it. The first indication may only occur after some considerable vision loss.
  • Acute angle-closure glaucoma
    This results from a sudden blockage of the drainage channels within your eye, causes a rapid build-up of pressure inside your eye accompanied by blurred vision, the appearance of colored rings around lights and sometimes extreme pain or redness in the eyes.
  • What is glaucoma?
    The build-up of pressure inside your eye leads to glaucoma. Aqueous fluid, which fills the space at the front of the eye just behind the cornea, is made behind the iris (the colored part of the eye) in the ciliary body. It flows through the pupil (the dark hole in the center of the iris), and drains from the ‘anterior chamber angle,’ which is the junction between the edge of the iris and the cornea. If this outflow of liquid is impaired at all, there is a build-up of pressure inside the eye that damages the optic nerve, which carries visual images to the brain. The result is a loss of peripheral vision. Thus, while glaucoma sufferers may be able to read the smallest line on the vision test, they may find it difficult to move around without bumping into things or to see moving objects to the side.
  • What causes glaucoma?
    Some causes are known, others are not. Causes differ depending on the type of glaucoma. The exact cause of open-angle glaucoma, where the drainage channels for the aqueous appear to be open and clear, is not known. Closed-angle glaucoma can occur when the pupil dilates or gets bigger and bunches the iris up around its edge, blocking the drainage channel. An injury, infection or tumor in or around the eye can also cause internal eye pressure to rise either by blocking drainage or displacing tissues and liquid within the eye. A mature cataract also can push the iris forward to block the drainage ‘angle’ between the iris and the cornea. Glaucoma can occur secondarily to a number of other conditions, such as diabetes, or as a result of some medications for other conditions.
  • Who gets glaucoma?
    Glaucoma most frequently occurs after age 40, but can occur at any age.If you’re of African heritage, you are more likely to develop open-angle glaucoma — and at an earlier age — than if you’re Caucasian. Asians are more likely to develop narrow-angle glaucoma.You have a higher risk of developing glaucoma if a close family member has it or if you have high blood pressure or high blood sugar (diabetes). There is also a greater tendency for glaucoma to develop in individuals who are nearsighted. Those at heightened risk for glaucoma should have their eyes checked at least once a year.
  • Why is glaucoma harmful to vision?
    The optic nerve, located at the back of the eye, carries visual information to the brain. As the fibers that make up the optic nerve are damaged by glaucoma, the amount and quality of information sent to the brain decreases and a loss of vision occurs.
  • Will I go blind from glaucoma?
    If diagnosed at an early stage, glaucoma can be controlled and little or no further vision loss should occur. If left untreated, side awareness (peripheral vision) and central vision will be destroyed and blindness may occur.
  • How is glaucoma detected?
    Tests for glaucoma are part of a comprehensive eye examination. A simple and painless procedure called tonometry measures the internal pressure of your eye. Ophthalmoscopy examines the back of the eye to observe the health of the optic nerve. A visual field test, a very sensitive test that checks for the development of abnormal blind spots, may also be completed.
  • How is glaucoma treated?
    Glaucoma is usually treated with prescription eye drops and medicines. In some cases, surgery may be required to improve drainage. The goal of the treatment is to prevent loss of vision by lowering the pressure in the eye.
  • Will my vision be restored after treatment?
    Unfortunately, any vision loss as a result of glaucoma is permanent and cannot be restored. This is why regular eye examinations are important.Glaucoma cannot be prevented, but early detection and treatment can control glaucoma and reduce the chances of damage to the eye and a loss of sight.

Diabetic Retinopathy

Diabetic Retinopathy. The leaking of retinal blood vessels may occur in advanced or long-term diabetes, and affect the macula or the entire retina and vitreous. Remaining vision is variable and print may be distorted or blurred.

Diabetes is a disease that interferes with the body’s ability to use and store sugar and can cause many health problems. One, called 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, or they may produce no visual symptoms at all. As the disease progresses, you may notice a cloudiness of vision, blind spots or floaters.

If left untreated, diabetic retinopathy can cause blindness, which is one reason why it is important to have your eyes examined regularly by your doctor of optometry. This is especially true if you are a diabetic or if you have a family history of diabetes.

Blurred central or side vision (left, blurred side vision) or a blind spot in central vision (right) may indicate diabetic retinopathy.

To detect diabetic retinopathy, your optometrist can look inside your eyes with an instrument called an ophthalmoscope that lights and magnifies the blood vessels in your eyes. If you have diabetic retinopathy, laser and other surgical treatments can be used to reduce its progression and decrease the risk of vision loss. Early treatment is important because once damage has occurred, the effects are usually permanent.

If you are a diabetic, you can help prevent diabetic retinopathy by taking your prescribed medication as instructed, sticking to your diet, exercising regularly, controlling high blood pressure and avoiding alcohol and smoking.

November is National Diabetes Month. Members of the American Optometric Association are joining with members of other health care organizations in an effort to prevent blindness in Americans with diabetes. If you or a member of your family has not received a dilated eye examination in the past year, you should contact your optometrist for an appointment.

Macular Degeneration

Age related macular degeneration or ARMD is the most common cause of irreversible vision loss for people over the age of 60. It is estimated that 2.5 million people in developed countries will suffer visual loss from this disorder and that there are approximately 200,000 new cases diagnosed every year.

Macular degeneration is most common in people over the age of 65 but there have been some cases affecting people as young as their 40s and 50s. Symptoms include blurry or fuzzy vision, straight lines like telephone poles and sides of buildings appear wavy and a dark or empty area may appear in the center of vision.

What is the Macula?

The macula is the small portion of the retina located at the center of this light sensitive lining at the back of the eye. Light rays from objects that we are looking at come to a focus on the retina and are converted into electrical impulses that are then sent to the brain. The macula is responsible for sharp straight-ahead vision necessary for functions such as reading, driving a car and recognizing faces.

The effect of this disease can range from mild vision loss to central blindness. That is, blindness “straight ahead” but with normal peripheral vision from the non-macular part of the retina which is undamaged by the disease.

Two types of Macular Degeneration

Ninety percent of ARMD is of the “atrophic” or “dry” variety. It is characterized by a thinning of the macular tissue and the development of small deposits on the retina called drusen. Dry ARMD develops slowly and usually causes mild visual loss. The main symptom is often a dimming of vision when reading.

The second form of ARMD is called “exudative” or “wet” because of the abnormal growth of new blood vessels under the macula where they leak and eventually create a large blind spot in the central vision. This form of the disease is of much greater threat to vision than the more common dry type.

What are the causes of ARMD?

Unfortunately, the cause of this eye condition is not fully understood but it is associated with the aging process. As we age, we become more susceptible to numerous degenerative processes like arthritis, heart conditions, cancer, cataracts and macular degeneration. These conditions may be caused by the body’s overproduction of free radicals.

During the metabolic process, oxygen atoms with an extra electron are released. These extra electrons are quite destructive and cause cellular damage, alter DNA, and are thought to be at least partially responsible for many of the degenerative diseases mentioned above. The production of these free radicals is normal during metabolism but the body produces its own “anti-oxidants” to neutralize them.

Some of the vitamins in the food we eat also have anti-oxidant properties. These are vitamins A, C, E and beta-carotene. Unfortunately, smoking, poor nutrition and other lifestyle factors result in the body producing too many free radicals. For this reason, lifestyle factors may contribute to the risk of ARMD.

There is some evidence to suggest that ARMD has a genetic basis, as the condition tends to run in families. The exact nature of this familial tendency, however, has not been clarified. It has been suggested from twin studies that there is a defect in the genes responsible for the integrity and health of the retina.

Exposure to certain types of light may also play a role. Exposure to ultraviolet light from the sun may increase the risk of ARMD and other eye conditions such as the development of cataracts

In the dry form of the disease, some form of inflammation may also be a factor although what causes the inflammation is not known.

How is it treated?

Although researchers are spending a great deal of time investigating the cause and treatment of ARMD, there is no real cure available. The goal of current treatment efforts is to attempt to stabilize the condition.

For the more severe wet form of the disease, doctors have tried laser photocoagulation. This treatment, however, is not without dangers and is only beneficial in the very early stages of the condition, which is why early detection is so important. This technique involves directing a beam of laser light at the abnormal blood vessels in order to destroy them and prevent their leaking. Provided that the blood vessels have not grown under the macula, this treatment can be helpful in arresting the progress of the disease. If the blood vessels are already under the macula, the laser may cause scarring and permanent vision loss.

Several new treatments are under development and scientific evaluation.

A new type of treatment called photodynamic shows promise. A drug, injected into the arm travels to the affected eye and is then exposed to a non-thermal red light. This light activates the drug to close and seal off the abnormal blood vessels. The entire treatment only takes about 30 minutes and requires no anesthetic.

Treatment using proton beams, which release power at predetermined target site and depth, has also been experimentally tested for treatment of wet-ARMD.

Are Vitamins and Nutrition Useful?

No treatment exists for the dry form but many doctors are convinced that a combination of specific vitamins and minerals helps slow the progression of the disease. This has yet to be confirmed scientifically but there are valid reasons for attempting this therapy. Anti-oxidant vitamins may help to neutralize the free radicals that are associated with this degenerative process. Zinc, one of the most common trace minerals in our body, is highly concentrated in the retina and surrounding tissues and is a requirement for chemical reactions in the retina.

Fat-soluble anti-oxidant vitamins like vitamin A and vitamin E are stored in the body and can increase to toxic levels if over used and zinc may interfere with other trace minerals like copper. Caution should therefore be exercised in the use of vitamins and minerals.

Conjunctivitis

Conjunctivitis is an inflammation of the conjunctiva, the thin, transparent layer that lines the inner eyelid and covers the white part of the eye.

The three main types of conjunctivitis are infectious, allergic and chemical. The infectious type, commonly called “pink eye” is caused by a contagious virus or bacteria. Your body’s allergies to pollen, cosmetics, animals or fabrics often bring on allergic conjunctivitis. And, irritants like air pollution, noxious fumes and chlorine in swimming pools may produce the chemical form.

Common symptoms of conjunctivitis are red watery eyes, inflamed inner eyelids, blurred vision, a scratchy feeling in the eyes and, sometimes, a pus-like or watery discharge. Conjunctivitis can sometimes develop into something that can harm vision so you should see your optometrist promptly for diagnosis and treatment.

A good way to treat allergic or chemical conjunctivitis is to avoid the cause. If that does not work, prescription or over-the-counter eye drops may relieve discomfort. Infectious conjunctivitis, caused by bacteria, can be treated with antibiotic eye drops. Other forms, caused by viruses, cannot be treated with antibiotics. They must be fought off by your body’s immune system.

To control the spread of infectious conjunctivitis, you should keep your hands away from your eyes, thoroughly wash your hands before applying eye medications and do not share towels, washcloths, cosmetics or eye drops with others.

Dry Eyes

Facts About Dry Eyes

There are as many as 33 million Americans, half of whom are over age 50, who experiencing some or all of the symptoms of the irritating conditions known as dry eye. While there are simple and generally effective forms of treatment, the great majority of those suffering from dry eye are not consulting with an eye doctor and are not undergoing any form of recommended treatment.

If left untreated, dry eye can be more than just irritating or uncomfortable. Excessive dry eye over a period of time can cause serious damage to eye tissue with possible scarring of the cornea. The cornea is the transparent protective covering of the eye. It performs 80 percent of the refractive vision function. Such damage can result in loss of vision to one degree or another.

About Tears

The human eye is lubricated by two kinds of tears produced by the tear glands in the upper and lower eyelids.

Constant tears are continuously formed to lubricate the eye and contain natural antibiotics to help fight infections.

Reflex tears are produced only in response to irritation, injury, or emotion and help rinse the surface of the eye.

A balance is necessary between the two types of tears to ensure that your eyes are comfortable and protected. When constant tear flow is reduced, there is irritation that can cause excessive reflex tearing (“watery eyes”). These excess tears lack the oil needed to keep from evaporating and do not lubricate the eye. A lack of tears, improper lubrication, or tears draining too quickly from the eye result in a condition known as DRY EYES. Dry eye is a common problem that is easily diagnosed.

Artificial Tears

Tears can be replaced by using eye drops called artificial tears. They replace the moisture that is missing and lubricate the eyes. They temporarily soothe dry eye symptoms; however, they also wash away the natural, infection-fighting tear film. For many people, artificial tears are inadequate or impractical.

One or more factors may contribute to dry eyes

  • Aging – As we age, tear production decreases. Men and women of any age can be affected; however, after menopause and during pregnancy, women are especially susceptible.
  • Contact Lenses – Wearing contact lenses often increases tear evaporation. Dry eye has shown to be the leading cause of contact lens discomfort.
  • Medications – A variety of common medications reduce tear secretions. These include: decongestants, antihistamines, diuretics, beta-blockers, sleeping pills, antidepressants, pain relievers, and alcohol.
  • Environment – Occasional or continual exposure to various environments can reduce eye lubrication. These include: sunny, dry, windy conditions; areas with heaters, dehumidifiers, fans, or air conditioners.
  • Work settings; high altitudes, smoke or air pollution, sand, dust, or airborne pollen.
  • Treatment…
  • Artificial tears have provided a quick, short-term solution to dry eye. today, tear-duct closure, which allows you to retain your own natural tears, may be the best solution.

Treatment

  • Temporary closure of the tear duct is accomplished by inserting a tiny plug to prevent tear drainage. Your own tears will bathe your eye for a longer time and, in about one week; this plug will dissolve and wash away with your tears. You and your doctor can then evaluate the benefit of tear duct closure for you.
  • Long-term closure of the tear drainage ducts involves the use of a non-dissolvable, yet removable, plug to seal the tear duct. This non-surgical procedure is painless and takes only a few minutes in your doctor’s office.
  • With the insertion of permanent plugs, relief from the discomfort of dry eyes may be immediate, while for some patients relief may be more gradual.

Ocular Hypertension

Ocular hypertension is an increase in the pressure in your eyes that is above the range considered normal with no detectable changes in vision or damage to the structure of your eyes. The term is used to distinguish people with elevated pressure from those with glaucoma, a serious eye disease that causes damage to the optic nerve and vision loss.

Ocular hypertension can occur in people of all ages, but it occurs more frequently in African Americans, those over age 40 and those with family histories of ocular hypertension and/or glaucoma. It is also more common in those who are very nearsighted or who have diabetes.

Ocular hypertension has no noticeable signs or symptoms. Your doctor of optometry can check the pressure in your eyes with an instrument called a tonometer and can examine the inner structures of your eyes to assess your overall eye health.

Not all people with ocular hypertension will develop glaucoma. However, there is an increased risk of glaucoma among those with ocular hypertension, so regular comprehensive optometric examinations are essential to your overall eye health.

There is no cure for ocular hypertension, however, careful monitoring and treatment, when indicated, can decrease the risk of damage to your eyes.

Anterior Uveitis

Anterior Uveitis is an inflammation of the middle layer of the eye, which includes the iris (colored part of the eye) and adjacent tissue, known as the ciliary body. If untreated, it can cause permanent damage and loss of vision from the development of glaucoma, cataract or retinal edema. It usually responds well to treatment; however, there may be a tendency for the condition to recur. Treatment usually includes prescription eye drops, which dilate the pupils, in combination with anti-inflammatory drugs. Treatment usually takes several days, or up to several weeks, in some cases.

Anterior uveitis can occur as a result of trauma to the eye, such as a blow or foreign body penetrating the eye. It can also be a complication of other eye disease, or it may be associated with general health problems such as rheumatoid arthritis, rubella and mumps. In most cases, there is no obvious underlying cause.

Signs/symptoms may include a red, sore and inflamed eye, blurring of vision, sensitivity to light and a small pupil. Since the symptoms of anterior uveitis are similar to those of other eye diseases, your optometrist will carefully examine the inside of your eye, under bright light and high magnification, to determine the presence and severity of the condition. Your optometrist may also perform or arrange for other diagnostic tests to help pinpoint the cause.

Retinitis Pigmentosa

Retinitis pigmentosa (RP) is a group of inherited diseases that damage the light-sensitive rods and cones located in the retina, the back part of our eyes. Rods, which provide side (peripheral) and night vision are affected more than the cones which provide color and clear central vision.

Signs of RP usually appear during childhood or adolescence. The first sign is often night blindness followed by a slow loss of side vision. Over the years, the disease will cause further loss of side vision. As the disease develops, people with RP may often bump into chairs and other objects as side vision worsens and they only see in one direction – straight ahead. They see as if they are in a tunnel (thus the term tunnel vision).

Fortunately, most cases of retinitis pigmentosa take a long time to develop and vision loss is gradual. It may take many years for loss of vision to be severe.

Currently, there is no cure for RP, but there is research that indicates that vitamin A and lutein may slow the rate at which the disease progresses. Your doctor of optometry can give you more specific information on nutritional supplements that may help you.

Also, there are many new low vision aids, including telescopic and magnifying lenses, night vision scopes as well as other adaptive devices, that are available that help people maximize the vision that they have remaining. An optometrist, experienced in low vision rehabilitation, can provide these devices as well as advice about other training and assistance to help people remain independent and productive.

Since it is an inherited disease, research into genetics may one day provide a prevention or cure for those who have RP.

Blepharitis

Blepharitis is a chronic or long term inflammation of the eyelids and eyelashes. It affects people of all ages. Among the most common causes of blepharitis are poor eyelid hygiene; excessive oil produced by the glands in the eyelid; a bacterial infection (often staphylococcal); or an allergic reaction.

Seborrheic blepharitis is often associated with dandruff of the scalp or skin conditions like acne. It can appear as greasy flakes or scales around the base of the eyelashes and a mild redness of the eyelid. It may also result in a roughness of the normally smooth tissue that lines the inside of the eyelid.

Ulcerative blepharitis is less common, but more serious. It is characterized by matted, hard crusts around the eyelashes, which when removed, leave small sores that ooze or bleed. There may also be a loss of eyelashes, distortion of the front edges of the eyelids and chronic tearing. In severe cases, the cornea, the transparent front covering of the eyeball, may also become inflamed.

In many cases, good eyelid hygiene and a regular cleaning routine may control blepharitis. This includes frequent scalp and face washing; warm soaks of the eyelids; and eyelid scrubs. In cases where bacterial infection is a cause, eyelid hygiene may be combined with various antibiotics and other medications. Eyelid hygiene is especially important upon awakening because debris can build up during sleep.

If you experience symptoms of blepharitis, your doctor of optometry can determine the cause and recommend the right combination of treatments specifically for you.

Keratoconus

Keratoconus is a vision disorder that occurs when the normally round cornea (the front part of the eye) becomes thin and irregular (cone) shaped. This abnormal shape prevents the light entering the eye from being focused correctly on the retina and causes distortion of vision.

In its earliest stages, keratoconus causes slight blurring and distortion of vision and increased sensitivity to glare and light. These symptoms usually appear in the late teens or late twenties. Keratoconus may progress for 10-20 years and then slow in its progression. Each eye may be affected differently. As keratoconus progresses, the cornea bulges more and vision may become more distorted. In a small number of cases, the cornea will swell and cause a sudden and significant decrease in vision. The swelling occurs when the strain of the cornea’s protruding cone-like shape causes a tiny crack to develop. The swelling may last for weeks or months as the crack heals and is gradually replaced by scar tissue. If this sudden swelling does occur, your doctor can prescribe eyedrops for temporary relief, but there are no medicines that can prevent the disorder from progressing.

Eyeglasses or soft contact lenses may be used to correct the mild nearsightedness and astigmatism that is caused by the early stages for keratoconus. As the disorder progresses and cornea continues to thin and change shape, rigid gas permeable contact lenses can be prescribed to correct vision adequately. In most cases, this is adequate. The contact lenses must be carefully fitted, and frequent checkups and lens changes may be needed to achieve and maintain good vision.

In a few cases, a corneal transplant is necessary. However, even after a corneal transplant, eyeglasses or contact lenses are often still needed to correct vision.