AMBLYOPIA (LAZY EYE)
Amblyopia, which is also called “lazy eye”, is a disorder that affects the visual development in children. Amblyopia is difficult to correct just with the use of contact lenses, or eyeglasses. Ambylopia can cause vision loss if it is not treated early and properly. This vision disorder affects 2-3% of the population.
What are the symptoms of Amblyopia?
Usually children that are born with amblyopia, the symptoms start in early childhood. Some signs of amblyopia in children are squinting, closing one eye in order to see better, poor general vision, headaches, and eyestrain. Usually caretakers such as parents, caregivers, doctors, or nurses notice these symptoms and recommend the child for treatment.
What are the causes of Amblyopia?
Strabismus is usually the cause of amblyopia. Strabismus is the eyes aligning incorrectly. Amblyopia can also be caused when there is a large difference between the eyes in refractive errors (prescription much higher in one eye than the other). For example, one eye is nearsighted, while the other is farsighted. If amblyopia is not treated, the brain will learn to disregard the vision in the eye with amblyopia. The eye that is disregarded does not grow with clear image and vision loss can be permanent. This is why it is very important to get early treatment and take your child to see your eye doctor if any signs are apparent.
How is Amblyopia treated?
There are several treatments for amblyopia, depending on the cause. Often children are treated using vision therapy, which usually includes a patch on the better eye. Other treatments are atropine eye drops, correct prescription eyeglasses, or surgery.
Vision therapy consists of eye exercises, which aim to teach the eyes to work together. In cases of amblyopia, the exercises require the brain to recognize the affected eye, which restores vision in that eye. Some doctors place a patch over the more functional eye, which forces the less functional eye to work harder and become stronger. The patch is generally worn for a few hours a day. Depending on the severity of the condition, treatment can last for weeks or months. Some children refuse to wear a patch, in those cases, a prosthetic contact lens is available. These contact lenses look like the regular eye, and are designed to block vision in that eye.
Some doctors use atropine eye drops to treat amblyopia. These drops blur vision in the child’s better eye, forcing the weaker eye to work harder and get stronger. In the morning, one drop is instilled under eye doctor’s instructions. The advantage to this method of treatment is that the patch is avoided.
If your child has developed amblyopia because of uncorrected vision, sometimes all that is needed is a pair of eyeglasses. When there is strong uncorrected prescription, or when there is a large difference in prescription between the two eyes, sometimes amblyopia can result. Your eye doctor may recommend eye patch therapy in addition to corrective lenses.
Strabismus surgery is usually required if the amblyopia is due to a large eye turn. This type of surgery aligns the eyes and corrects the problem within the eye muscles. After the surgery the eyes will able to focus better. Additional vision therapy may be required after strabismus surgery.
Amblyopia must be treated as early as possible as there is no chance that it will resolve by itself. Untreated amblyopia can lead to permanent vision loss in that eye and reduced depth perception. Amblyopia needs to be treated promptly so that your child can have the best vision possible in childhood and later in life. When amblyopia is diagnosed and treated before age 9, the weaker eye can often develop significantly better vision. The most critical time to treat amblyopia is from 3 to 6 years of age. If you or anyone sees any signs of amblyopia, go to your eye doctor to find the best treatment for your child.
Many people have never heard of astigmatism, although it is an extremely common eye condition.
Astigmatism is one type of refractive error. Nearsightedness and farsightedness are other types of refractive error. Refractive errors are not eye diseases. Refractive error is a result of and imperfection of the size and shape of the eye, which results in blurry or double vision.
If left untreated, astigmatism may cause eyestrain, headaches, and blurry vision. If you have astigmatism you may not see objects in the distance or near without some form of distortion.
Symptoms of Astigmatism
Small amounts of astigmatism can go unnoticed, however, you may be suffering from eye fatigue, eyestrain, and headaches.
Astigmatism is a condition that usually can develops early in childhood. According to a study from The Ohio State University School of Optometry, 28% of school age children suffer from astigmatism. Parents should be aware that their children might not notice that their vision is blurry, not understanding that this is not normal. Nevertheless, astigmatism should be treated because vision problems can lead to learning problems and in extracurricular activities. Make sure to have your child’s eyes examined at an eye doctor’s office at least once a year.
Causes of Astigmatism
Astigmatism is generally caused by a cornea with an irregular shape. The cornea is the front, clear layer of the eye. With astigmatism, the cornea is not round and spherical and is instead irregular having two curves instead of one curve. Astigmatism in some cases could also be caused by the lens located inside the eye that is irregular in shape.
Eyes with astigmatism distort the light that comes into the eyes because the cornea is irregularly shaped. This causes the light rays entering the eye to create two images in the back of the eye (because of the two curves), instead of one image. This is what causes the distortion in sight.
Treatments for Astigmatism
For most people, their astigmatism is fully corrected using prescription glasses or contact lenses. If you select contact lenses to correct your vision, soft contact lenses are the most common option. If for whatever reason soft contact lenses are not an option, rigid gas permeable (RGP or GP) are also a great choice. Rigid gas permeable lenses usually give the clearest vision but the adaptation process will be significantly longer. Another option are hybrid contact lenses. These contacts have a center made from a rigid gas permeable (RGP) lens and an outer ring made of soft contact lens material. This type of lens provides both excellent clarity and comfort. LASIK could be another option to correct astigmatism. LASIK usually only corrects low levels of astigmatism and some patients with higher levels of astigmatism might not be candidates.
Blepharitis is an eye condition characterized by an inflammation of the eyelids which causes redness, itching and irritation. The common eye condition is caused by either a skin disorder or a bacterial infection. Blepharitis is generally not contagious and can affect patients of any age. While it can be very uncomfortable, it usually does not pose any danger to your vision.
There are two types of blepharitis: anterior and posterior.
Anterior blepharitis occurs on the front of your eyelids in the area where the eyelashes attach to the lid. This form is less common and is usually caused by a bacterial infection or seborrheic dermatitis, which is a skin disorder (dandruff) that causes flaking and itching of the skin on the scalp and eyebrows. While it is more rare, allergies or mites on the eyelashes can also lead to this condition.
Posterior blepharitis occurs on the inner eyelid that is closer to the actual eyeball. This more common form is often caused by rosacea, dandruff or meibomian gland problems which affect the production of oil in your eyelids.
Symptoms of Blepharitis
Blepharitis can vary greatly in severity and cause a variety of symptoms which include:
- Red, swollen eyelids
- Burning or gritty sensation
- Excessive tearing
- Dry eyes
- Crusting on eyelids
If left untreated, symptoms can become more severe such as:
- Blurred vision
- Infections and styes
- Loss of eyelashes or crooked eyelashes
- Eye inflammation or erosion, particularly the cornea
- Dilated capillaries
- Irregular eyelid margin
Treatment for Blepharitis
Treatment for blepharitis depends on the cause of the condition but a very important aspect is keeping the eyelids clean. Warm compresses are usually recommended to soak the lids and loosen any crust to be washed away. It is recommended to use a gentle cleaner (baby soap or an over the counter lid-cleansing agent) to clean the area.
For bacterial infections, antibiotic drops or ointments may be prescribed, and in serious cases steroidal treatment (usually drops) may be used.
Blepharitis is typically a recurring condition so here are some tips for dealing with flare-ups:
- Use an anti-dandruff shampoo when washing your hair
- Massage the eyelids to release the oil from the meibomian glands
- Use artificial tears to moisten eyes when they feel dry
- Consider breaking from use of contact lenses during the time of the flare-up and or switching to daily disposable lenses.
The most important way to increase your comfort with blepharitis is by keeping good eyelid hygiene. Speak to your doctor about products that he or she recommends.
CMV, or cytomegalovirus retinitis, is a vision threatening virus that causes inflammation of the retina, primarily in individuals with a compromised immune system, such as those with AIDS (Acquired Immunodeficiency Syndrome).
Symptoms of CMV Retinitis
Symptoms of CMV retinitis often appear relatively suddenly. They include general blurriness, seeing flashes or floaters, sudden loss of peripheral (side) vision, or blind spots in central vision. These symptoms all appear as the virus attacks the retina, the light-sensitive layer of nerves at the back of the eye. If left untreated, the virus can cause retinal detachment and will eventually destroy the retina and damage the optic nerve, causing permanent vision loss. Usually there is no pain felt as the retinal damage is taking place. Symptoms usually start in one eye and but can spread to the other eye as well.
Causes of CMV Retinitis
Cytomegalovirus is a herpes type virus that is actually present in most adults. However, most healthy adults never experience any symptoms or problems from the virus. Individuals with a weakened immune system however, such as those with AIDS, chemotherapy or leukemia patients, newborns or the elderly are at greater risk of the virus being activated and spreading throughout the body, including the retina.
Treatment for CMV Retinitis
Treatment includes antiviral medications such as ganciclovir, foscarnet or cidofovir, which can be administered orally, via injection through a vein or directly into the eye or through a time-release implant the releases the medication at intervals. Laser surgery to improve the damaged area of the retina, such as in a retinal detachment, may also be prescribed.
Immune strengthening is also a critical part of preventing and treating CMV retinitis. Individuals with HIV or AIDS may be put on a regimen of highly active antiretroviral therapy (HAART) to boost the immune system and fight the virus. This has been shown to be highly effective in reducing the incidence of CMV retinitis in AIDS patients and reducing the damage for those that are affected.
While these treatments can stop further damage to the retina, any vision that is lost cannot be restored. Further, even if the virus is temporarily stopped, further progression may occur in the future. This is why it is critical to see a retinal specialist on a regular basis if you have had the condition or you are at risk.
A cornea transplant, also known as keratoplasty or a corneal graft, replaces damaged tissue on the clear front surface of the eye.
When disease or injury damages the cornea, eyesight is affected. Light that enters the eye becomes scattered, resulting in blurred or distorted vision. When the cornea is extremely scarred or damaged, a corneal transplant is needed to restore functional vision.
Keratoplasty is performed routinely and is regarded as the most successful of all tissue transplants. According to the National Keratoconus Foundation, over 40,000 cornea transplants are done annually in the United States.
In recent years, an innovative type of corneal transplant has gained popularity. Known as Descemet’s Stripping Endothelial Keratoplasty (DSEK), this new procedure removes a smaller and thinner portion of the cornea. In 2009, DSEK was declared by the American Academy of Ophthalmology as superior to the conventional surgery because it may provide better vision outcomes and more eye stability. It is also associated with less risk factors. However, when the majority of the cornea is damaged, a more comprehensive removal may still be necessary to facilitate a successful transplant.
Criteria for a Corneal Transplant
A multitude of reasons indicate candidacy for a corneal transplant. Possible reasons include:
- Eye diseases, such as keratoconus
- Complications from laser surgery, such as LASIK
- Extreme inflammation on the cornea
- Scarring as a result of infections, such as eye herpes or fungal keratitis
- Thinning of the cornea and an irregular shaped cornea
- Hereditary factors
- Corneal failure due to previous surgical procedures
- Chemical burns or injuries that damaged to the cornea
Cornea Transplant Procedure
Once a patient has been recommended and approved for a corneal transplant to restore vision, the patient’s name is added to a list at an eye bank. The United States has a very advanced eye bank system, and the general wait time for a donor eye is one to two weeks. The tissue of donor corneas is checked for clarity and screened meticulously for disease before it is released for transplant.
The actual surgery is generally performed as an outpatient procedure that does not require hospitalization. General or local anesthesia may be used, depending upon the patient’s preference, age and health condition. Local anesthesia is injected into the skin surrounding the eye, which relaxes the muscles that control movement and blinking. Eye drops numb the eye itself.
Once the anesthesia has taken effect, the surgeon inspects and measures the damaged corneal area in order to decide upon the size of the transplantation. Eyelids are held open during this time. The surgeon then removes a round, button-shaped piece of the corneal tissue and replaces it with a nearly identical sized button of donor tissue. The new, healthy tissue is sutured into place. The entire procedure takes approximately one to two hours.
Following the surgery, a plastic shield must be worn over the eye in order to protect it against any inadvertent bumps or rubbing.
Rejection of the Corneal Graft
Although the vast majority of cornea transplants are successful, sometimes the new tissue is rejected. Warning signs of rejection include:
- Extreme sensitivity to light
- Decreased vision
These symptoms may be experienced as soon as one month after the surgery, or as delayed as five years later. Medications can be prescribed to reverse the rejection process. If the corneal graft fails completely, the transplant can be repeated and the outcome is generally positive. Yet the total rejection rates do increase with the total number of corneal transplants.
Recovery and Healing
It can take up to a year or longer to heal completely from a corneal transplant. At the beginning, vision is blurry and the transplant site is often swollen and thicker than the rest of the cornea. As vision returns, patients are able to return to normal daily tasks and most people can return to work within three to seven days after surgery. However, heavy lifting and exercise must be avoided for the first few weeks.
To help the body accept the corneal graft, steroid eye drops must be applied for several months. A pair of eyeglasses or a protective shield must also be worn for eye safety. Depending upon the health of the eye and the healing rate, stitches may be removed at any time from three months to more than a year later. Astigmatism often occurs as a result of an irregular corneal surface, and adjustments may be made to the sutures around the new cornea in an effort to reduce this problem.
Vision after a Cornea Transplant
Vision improvement after a cornea transplant is a process that can last up to one year later. Eyeglasses or contact lenses must be worn immediately after the surgery, since the curvature of the corneal transplant will not precisely match the natural corneal curve.
When healing is complete and stitches are removed, laser surgery may be indicated to correct vision. LASIK or PRK are both procedures that can help decrease dependence on eyeglasses or contacts. An irregular corneal surface may point to the need to wear rigid gas permeable (GP) contact lenses for vision correction.
DRY EYE SYNDROME
Dry eye syndrome (DES or dry eye) is a chronic lack of sufficient lubrication and moisture on the surface of the eye. Its consequences range from minor irritation to the inability to wear contact lenses and an increased risk of corneal inflammation and eye infections.
Signs and Symptoms of Dry Eye
Persistent dryness, scratchiness and a burning sensation on your eyes are common symptoms of dry eye syndrome. These symptoms alone may be enough for your eye doctor to diagnose dry eye syndrome. Sometimes, he or she may want to measure the amount of tears in your eyes. A thin strip of filter paper placed at the edge of the eye, called a Schirmer test, is one way of measuring this.
Some people with dry eyes also experience a “foreign body sensation” – the feeling that something is in the eye. And it may seem odd, but sometimes dry eye syndrome can cause watery eyes, because the excessive dryness works to overstimulate production of the watery component of your eye’s tears.
What Causes Dry Eyes?
In dry eye syndrome, the tear glands that moisturize the eye don’t produce enough tears, or the tears have a chemical composition that causes them to evaporate too quickly.
Dry eye syndrome has several causes. It occurs:
- As a part of the natural aging process, especially among women over age 40.
- As a side effect of many medications, such as antihistamines, antidepressants, certain blood pressure medicines, Parkinson’s medications and birth control pills.
- Because you live in a dry, dusty or windy climate with low humidity.
If your home or office has air conditioning or a dry heating system, that too can dry out your eyes. Another cause is insufficient blinking, such as when you’re staring at a computer screen all day.
Dry eyes are also associated with certain systemic diseases such as lupus, rheumatoid arthritis, rosacea or Sjogren’s Syndrome (a triad of dry eyes, dry mouth, and rheumatoid arthritis or lupus).
Long-term contact lens wear, incomplete closure of the eyelids, eyelid disease and a deficiency of the tear-producing glands are other causes.
Dry eye syndrome is more common in women, possibly due to hormone fluctuations. Recent research suggests that smoking, too, can increase your risk of dry eye syndrome. Dry eye has also been associated with incomplete lid closure following blepharoplasty – a popular cosmetic surgery to eliminate droopy eyelids.
Treatment for Dry Eye
Dry eye syndrome is an ongoing condition that treatments may be unable to cure. But the symptoms of dry eye – including dryness, scratchiness and burning – can usually be successfully managed.
Your eyecare practitioner may recommend artificial tears, which are lubricating eye drops that may alleviate the dry, scratchy feeling and foreign body sensation of dry eye. Prescription eye drops for dry eye go one step further: they help increase your tear production. In some cases, your doctor may also prescribe a steroid for more immediate short-term relief.
Another option for dry eye treatment involves a tiny insert filled with a lubricating ingredient. The insert is placed just inside the lower eyelid, where it continuously releases lubrication throughout the day.
If you wear contact lenses, be aware that many artificial tears cannot be used during contact lens wear. You may need to remove your lenses before using the drops. Wait 15 minutes or longer (check the label) before reinserting them. For mild dry eye, contact lens rewetting drops may be sufficient to make your eyes feel better, but the effect is usually only temporary. Switching to another lens brand could also help.
Check the label, but better yet, check with your doctor before buying any over-the-counter eye drops. Your eye doctor will know which formulas are effective and long-lasting and which are not, as well as which eye drops will work with your contact lenses.
To reduce the effects of sun, wind and dust on dry eyes, wear sunglasses when outdoors. Wraparound styles offer the best protection.
Indoors, an air cleaner can filter out dust and other particles from the air, while a humidifier adds moisture to air that’s too dry because of air conditioning or heating.
For more significant cases of dry eye, your eye doctor may recommend punctal plugs. These tiny devices are inserted in ducts in your lids to slow the drainage of tears away from your eyes, thereby keeping your eyes more moist.
If your dry eye is caused by meibomian gland dysfunction (MGD), your doctor may recommend warm compresses and suggest an in-office procedure to clear the blocked glands and restore normal function.
Doctors sometimes also recommend special nutritional supplements containing certain essential fatty acids to decrease dry eye symptoms. Drinking more water may also offer some relief.
If medications are the cause of dry eyes, discontinuing the drug generally resolves the problem. But in this case, the benefits of the drug must be weighed against the side effect of dry eyes. Sometimes switching to a different type of medication alleviates the dry eye symptoms while keeping the needed treatment. In any case, never switch or discontinue your medications without consulting with your doctor first.
Treating any underlying eyelid disease, such as blepharitis, helps as well. This may call for antibiotic or steroid drops, plus frequent eyelid scrubs with an antibacterial shampoo.
If you are considering LASIK, be aware that dry eyes may disqualify you for the surgery, at least until your dry eye condition is successfully treated. Dry eyes increase your risk for poor healing after LASIK, so most surgeons will want to treat the dry eyes first, to ensure a good LASIK outcome. This goes for other types of vision correction surgery, as well.
Along with congestion, runny nose, coughing, sneezing, headaches and difficulty breathing, individuals with allergies often suffer from eye allergies or allergic conjunctivitis resulting in red, watery, itchy and sometimes swollen eyes. Just as irritants cause an allergic response in your nasal and respiratory system, your eyes also react with an oversensitive immune response, triggered by an environmental substance that most people’s immune systems ignore. Most individuals with allergies also suffer from eye allergies which affect millions of North Americans, particularly with seasonal allergic conjunctivitis (SAC) which is common during the spring, summer and fall.
What Causes An Eye Allergy?
Eye allergies, or any allergies for that matter, occur when the immune system is hypersensitized to a stimulus in the environment that comes into contact with the eye. The allergen stimulates the antibodies in the cells of your eyes to respond by releasing histamine and other chemicals that cause the eyes and surrounding tissue to become inflamed, red, watery, burning and itchy.
Eye allergens can include:
- Airborne substances found in nature such as pollen from flowers, grass or trees.
- Indoor allergens such as pet dander, dust or mold.
- Irritants such as cosmetics, chemicals, cigarette smoke, or perfume.
Tips for Coping With Eye Allergies
Allergies can go from mildly uncomfortable to debilitating. Knowing how to alleviate symptoms and reduce exposure can greatly improve your comfort and quality of life, particularly during allergy season which can last from April until October.
To reduce exposure to allergens:
- Stay indoors and keep windows closed when pollen counts are high, especially in the mid-morning and early evening.
- Wear sunglasses outside to protect your eyes, not only from UV rays, but also from airborne allergens.
- Avoid rubbing your eyes, this can intensify symptoms and increase irritation. When the eyes get itchy, it is difficult not to rub and scratch them. However, rubbing the eyes can aggravate the allergic cascade response, making them more swollen, red, and uncomfortable.
- Check and regularly clean your air conditioning filters.
- Keep pets outdoors if you have pet allergies and wash your hands after petting an animal.
- Use dust-mite-proof covers on bedding and pillows and wash linens frequently.
- Clean surfaces with a damp cloth rather than dusting or dry sweeping.
- Remove any mold in your home.
- Reducing contact lens wear during allergy season or switch to daily disposable contact lenses.
Treatment for the uncomfortable symptoms of allergic conjunctivitis include over-the-counter and prescription drops and medications. It is best to know the source of the allergy reaction to avoid symptoms. Often people wait until the allergy response is more severe to take allergy medication, but most allergy medications work best when taken just prior to being exposed to the allergen. Consult your eye doctor about your symptoms and which treatment is best for you.
Non-prescription medications include:
- Artificial tears (to reduce dryness)
- Decongestant eyedrops
- Oral antihistamines
Prescription medications include eyedrops such as antihistamines, mast-cell stabilizers, or stronger decongestants as well as non-steroidal anti-inflammatory drugs (NSAIDs) or corticosteroids.
Immunotherapy which are allergy injections given by an allergist are sometimes also helpful to assist your body in building up immunity to the allergens that elicit the allergic response.
If no allergy medicine is on hand, even cool compresses and artificial tears can help alleviate symptoms.
Finding the right treatment for your allergies can make all the difference in your quality of life, particularly during the time of year when most of us like to enjoy the outdoors.
EYE FLOATERS & SPOTS
Eye floaters are spots, squiggles or flecks that appear to drift into your visual field. Usually they are harmless, a benign, albeit annoying sign of aging. If however, your floaters are accompanied by a sudden loss of vision, pain or flashes, they could be a sign of an underlying serious eye condition and should be checked out by an eye doctor as soon as possible.
What are Eye Floaters and Spots?
Floaters, like their name, are specks or spots that float in and out of your visual field. Usually they move away when you try to focus on them. They can appear as dark dots, threads, squiggles, webs, or even rings.
But what causes them to appear? Floaters are shadows from clumps of fibers within the vitreous, the jelly-like substance in your eye, that are cast on the retina at the back of the eye. Usually, floaters don’t go away, but you tend to get used to them and eventually notice them less. Patients usually see them more when they are looking at a plain background, like the blue sky or a white wall.
In most cases, there is no treatment for floaters, people just get used to them, however if there are more serious symptoms that accompany them, there could be an underlying problem such as inflammation, diabetes or a retinal tear that needs to be addressed and treated. If the floaters are so serious that they are blocking your vision, a surgical procedure to remove the clumps may be performed.
What Causes Floaters?
Age: Although floaters may be present at any age, they are often more apparent as a result of aging. With time, the fibers in the vitreous begin to shrink and clump up as they pull away from the back of the eye. These clumps block some of the light passing through your eye, causing the shadows which appear as floaters. You are also more likely to develop floaters if you are nearsighted.
Eye Surgery or Injury: Individuals who have previously had an injury, trauma or eye surgery are more susceptible to floaters. This includes cataract surgery and laser surgery as well as other types of eye surgery.
Eye Disease: Certain eye diseases such as diabetic retinopathy, eye tumors or severe inflammation can lead to floaters.
Retinal Tears or Detachment: Retinal tears or detachments can be a cause of floaters. A torn retina can lead to a retinal detachment which is a very serious condition where the retina separates from the back of the eye and if untreated can lead to permanent vision loss.
When to See a Doctor
There are some cases where seeing spots is accompanied by other symptoms that could be a sign that there is a more serious underlying problem. The most common of these is seeing flashes of light. This often happens when the vitreous is pulling on the retina which would be a warning sign of a retinal detachment. Retinal detachment must be treated immediately or you can risk a permanent loss of vision. Flashes of light sometimes also appear as symptoms of migraine headaches.
If you experience a sudden onset or increase in floaters, flashes of light, pain, loss of side vision or other vision disturbances, see a doctor immediately. Further, if you have recently had eye surgery or a trauma and you are experiencing floaters during your recovery, it is advised to tell your doctor.
Generally, floaters are merely a harmless annoyance but keep an eye on your symptoms. As with any sudden or serious change in your health, it is worth having them checked out if they are really bothering you. In some cases, they may be an early warning sign of a serious problem that requires swift treatment to preserve your vision.
Farsightedness or hyperopia is a refractive error in which distant objects are clear, while close objects appear blurry. A refractive error occurs when the eye is not able to refract (or bend) the light that comes in into a single point of focus, therefore not allowing images to be seen clearly. Nearsightedness, farsightedness and astigmatism are the most common types of refractive error.
What Causes Hyperopia?
Hyperopia is usually caused when the shape of the eye is shortened or the cornea (which is the clear front surface of the eye) is flatter than normal. This prevents light that enters the eye from focusing properly on the retina, and rather focuses behind it. This condition causes close objects to appear blurry, while typically objects at a distance remain clear.
Farsightedness, which is less common than nearsightedness, is often an inherited condition. It is common in children who experience some amount of hyperopia during development which they will eventually grow out of as the eye continues to grow and lengthen. Sometimes these children don’t even have symptoms as their eyes are able to accommodate to make up for the error.
Symptoms of Hyperopia
Symptoms of hyperopia vary. As mentioned, sometimes people with hyperopia don’t experience any symptoms while others will experience severe vision difficulties. In addition to blurred near vision, often squinting, eye strain and headaches will occur when focusing on near objects.
Treatment for Farsightedness
Farsightedness is easily treated with prescription eyeglasses or contact lenses. These lenses, will correct for the refractive error by changing the way the light bends upon entering the eyes. Refractive eye surgeries such as LASIK or PRK that reshape the cornea may also be options for vision correction. Treatment for farsightedness depends on a number of factors including your age, lifestyle, eye health and overall health.
Farsightedness vs. Presbyopia
Farsightedness is not the same as presbyopia, an age-related condition that also affects one’s ability to see near objects clearly. Presbyopia is caused when the natural lens of the eye begins to age and stiffens, causing difficulty focusing.
Farsightedness or hyperopia is a common refractive error that is easily treated. If you are experiencing difficulty seeing close objects it’s worth having an eye exam to determine the cause, ensure your eyes are healthy and to find a solution to improve your vision and quality of life.
Keratoconus is a progressive eye disease in which the cornea thins and bulges into a cone-like shape, losing its roundness. The eventual cone shape deflects light which enters the eye towards the light-sensitive retina. The result is distorted vision.
Keratoconus can occur in one or both eyes. Keratoconus is relatively rare. If it does occur the onset usually begins in the teens or early twenties.
Symptoms of Keratoconus
Keratoconus may be difficult to detect and it typically develops slowly with few cases proceeding rapidly. As the cornea gradually becomes irregular in shape, progressively nearsightedness and irregular astigmatism increase. This creates problems such as distorted and blurry vision. Glare and light sensitivity as well. Keratoconic patients often need prescription changes every time they visit their eye doctor.
Causes of Keratoconus
The weakening of the corneal tissue which leads to keratoconus appears to be from an imbalance of enzymes in the cornea. The enzyme imbalance makes the cornea susceptible to oxidative damage from free radicals, causing weakness and corneal bulge.
Risk factors for this type of oxidative damage and weakening of the cornea include genetic predisposition, which explaining why keratoconus often affects multiple members of the same family. Keratoconus is also connected to ultraviolet (sun) overexposure, excessive eye rubbing, a history of poorly fit contact lenses along with chronic eye irritation.
For mild forms, eyeglasses or soft contact lenses help. As the severity of the disease progresses and the cornea thins and increasingly distorted shape, glasses or soft contacts will no longer provide adequate vision correction.
Treatments for moderate to advanced keratoconus include:
Gas permeable contact lenses. If eyeglasses or soft contact lenses cannot control keratoconus, then gas permeable (GP) contact lenses are usually the effective. Rigid materials enable the GP lenses to dome over the cornea, replacing the irregular shape with a smooth, uniform refracting surface thus improving vision.
There is a comfort cost though because GP contact lenses can be less comfortable to wear compared to soft lenses. Fitting of the contact lenses on keratoconic corneas are also challenging and more time-consuming. Expect frequent office visits for fine-tuning and fitting of the prescription, especially as the keratoconus continues to progress.
Piggybacking lenses. Some practitioners advocate “piggybacking” two different types of contact lenses on the same eye to better fit the gas permeable contact lens over the cone-shaped cornea. Some patients may find this a bit uncomfortable. The GP lens is fitted on top of the soft contact lens which sits on the eye. The approach is thought to increase patient comfort as the soft lens acts as a cushion under the rigid second lens, the GP lens.
Hybrid contact lenses. Hybrid contact lenses are a relatively new design combining highly oxygen-permeable rigid center with a soft peripheral lens “skirt.” Manufacturers claim their hybrid contacts provide crisp optics of GP lenses alongside wear- comfort rivaling soft contact lenses. Hybrid lenses are available in a wide variety of parameters to provide optimal fit which conforms best to the irregular shape of a keratoconic eye.
Scleral and semi-scleral lenses. These are gas permeable contact lenses which have a large diameter allowing the edge of the lenses to rest on the white part of the eye -the sclera. These lenses will also dome over the irregularly shaped cornea, allowing for a most comfortable fit. They will move less during eye blinks. Scleral lenses cover a larger portion of the sclera, whereas semi-scleral lenses cover a smaller white (eye) area.
Intacs. These are tiny plastic inserts which are surgically inserted just underneath the eye surface in the periphery of the cornea helping to reshape the cornea. The result, clearer vision. Intacs may be advised when keratoconus patients no longer can obtain functional vision with contact lenses or eyeglasses.
Studies show that Intacs can improve the spectacle-corrected visual acuity (BSCVA) of a keratoconic eye by an average of two additional lines on a standard eye chart. The implants have the additional advantage of being removable and changeable. The surgical procedure takes 10 minutes. Intacs might delay but will not prevent the required corneal transplant, if keratoconus progresses.
Corneal crosslinking. This procedure, “CXL” for short, strengthens corneal tissue slowing or preventing the bulging of the eye surface. In turn this procedure can reduce the need to undergo a corneal transplant.
There are two types of corneal crosslinking: epithelium-off and epithelium-on. Epithelium-off crosslinking is where the outer portion of the cornea (epithelium) is removed to allow entry of riboflavin, a B vitamin, to the cornea. Once administered, the riboflavin is activated with UV light. With the epithelium-on method (transepithelial crosslinking), the corneal surface is left intact.
Neither procedure is FDA-approved. However, multiple clinical trials are currently underway. Although cross-linking may already be common in some countries — few doctors in the United States will perform the procedure until it is FDA-approved. For that reason, it’s also not covered by insurance. The procedure costs $2,500 per eye, not including the contacts or eye drops.
Corneal transplant. Some people with keratoconus cannot tolerate a rigid contact lens, or they are beyond the point of contact lenses or known therapies providing acceptable vision. The last resort remedy may be a corneal transplant, also called a penetrating keratoplasty (PK or PKP). Note that after successfully completing a cornea transplant, most keratoconic patients will still need glasses or contact lenses for clear vision.
Nearsightedness, technically known as myopia, is a condition which causes difficulty focusing on objects at a distance, while near vision remains normal. Myopia is one of the most common vision problems worldwide and it is on the rise.
Myopia Signs and Symptoms
People with myopia are usually able to see well up close, but have difficulty seeing objects at a distance. Due to the fact that they may be straining or squinting to see into the distance, they may develop headaches, eye fatigue or eye strain.
Myopia is a refractive error caused by an irregular shaped cornea that affects the way light is focused on the retina. For clear vision, light should come to a focus point directly onto the retina. In myopia, the cornea is longer than usual, resulting in a focus point that falls in front of the retina, causing distant objects to appear blurry, while close objects can be seen normally.
Myopia typically has a genetic component as it often appears in multiple members of a family and it usually begins to show signs during childhood, often getting progressively worse until stabilizing around age 20. There may also be environmental factors that contribute to myopia such as work that requires focusing on close objects for an extended period of time and spending too much time indoors.
Diagnosis of Myopia
Myopia is diagnosed by an eye examination with an qualified optometrist. During the exam the optometrist will determine the visual acuity of the eye to prescribe eye glasses or contact lenses. A prescription for myopia will be a negative number such as -1.75.
Treatment for Myopia
Myopia is typically treated with corrective eyeglasses or contact lenses and in certain cases refractive surgery such as LASIK or PRK is an option. Surgery is the most risky treatment as it requires permanently changing the shape of the cornea. Other treatments involve implanting a lens that reshapes the cornea called a phakic intra-ocular lens or vision therapy. A treatment called Ortho-k, in which the patient wears corneal reshaping contact lenses at night to see without correction during the day can be another option.
While some people require vision correction throughout the day, others may only need it only during certain tasks such as driving, watching television or viewing a whiteboard in school. The type of treatment depends on the overall health of your eye and your eye and vision needs.
The term Ocular Hypertension refers to higher than normal pressure in one or both eyes. When the intraocular pressure (IOP) in your eye is higher than normal it can cause nerve damage and vision loss if an eye disease like glaucoma goes untreated.
Ocular Hypertension on its own does not mean you will definitely develop glaucoma, but it does make you a “glaucoma suspect” Having a diagnosis of Ocular Hypertension does mean that more eye health evaluations will be required to monitor and regulate your intraocular pressure.
Studies estimate that about 2% to 3% of the general population may have ocular hypertension.
Signs and Symptoms of Ocular Hypertension
There are no apparent signs such as eye redness or pain associated with ocular hypertension. That is why it’s so important to see your eye doctor for regular eye health evaluations.
Eye care professionals determine the intraocular pressure (IOP), the fluid pressure inside your eye, with a device called a tonometer. They may numb your eye first with eye drops before using a small probe that gently rests against your eye’s surface. Another type of tonometer utilizes a puff of air directed onto your eye’s surface. This method does not require numbing drops.
There are two primary mechanisms that can cause ocular hypertension. Either inadequate drainage or excessive production of aqueous fluid may cause the intraocular pressure (IOP) to become elevated.
Ocular Hypertension Treatment
People with elevated intraocular pressure (IOP) are thought to be at risk for the development of glaucoma. If there are additional risk factors including family history, diabetes or hypertension, or being of African or Hispanic heritage, doctors will often consider prescribing medications to lower the pressure to prevent any vision loss.
The price of eye drops can be costly in some cases, and they may occasionally cause some adverse side effects. Your eye care professional will consider many factors before deciding to either monitor your IOP more often, or to prescribe ocular hypotensive medications if s/he detects that you may be developing glaucoma.
Since ocular hypertension and glaucoma have no obvious symptoms until vision has been lost, regular eye health examinations with IOP measurements are recommended, especially if you have a family history of glaucoma or any of the other risk factors for developing the disease.
All types of light, ranging from interior lighting fixtures to streetlights and to the bright rays of the sun, have the potential to cause eye discomfort or pain. Photophobia refers to this ocular sensitivity to light.
An eye irritation or infection may cause photophobia. Other culprits include albinism, migraines, recent eye surgery or a variety of vision problems. In rare incidences, a congenital disease or certain medications may increase your sensitivity to light. The retina, which is the light-sensitive tissue at the back of your eye, is responsible for processing images. Treatment for photophobia involves treating the underlying cause that is disturbing the retina.
With light-sensitivity, the retina sends signals to the brain that are interpreted as discomfort or pain. The level of discomfort is in direct proportion with the strength of the light source, and it doesn’t matter if the light is man-made or natural.
Signs of Photophobia
When exposed to bright light, symptoms of itching, burning, wincing and squinting may all be experienced. Excessive tear production is another sign of photophobia.
Diagnosis and Treatment
If you suffer from light-sensitivity, you should schedule a consultation with your eye care professional.
People with lighter-colored eyes generally have more of a tendency towards photophobia, and intense light is likely to bother them. If you have light eyes, the lower quantity of pigment is less efficient at diffusing the light beams.
Photophobia may be temporary, or it can appear as a permanent side-effect of an underlying eye condition. The only way to treat photophobia is therefore to get to the root of the problem with a comprehensive eye exam. It’s important to mention any current medications to your eye doctor, as they may be associated with photophobia.
PINGUECULAE & PTERYGIA
Pingueculae and Pterygia are both benign growths that develop on the surface of the eye. While often grouped together, there are some differences in expression, symptoms, causes and treatment so here is an explanation of each condition and the differences between them.
Pingueculae (pinguecula in singular) are growths that occur on the conjunctiva or the thin clear layer that covers the white part of the eye known as the sclera. They can be diagnosed on patients of any age, but tend to be more common in middle age. Pingueculae are typically yellowish in color and appear as a small, raised, sometimes triangular protrusion close to the cornea.
Causes of Pinguecula
Pinguecula occur when bumps, typically containing fat and/or calcium, form on the tissue of the conjunctiva. The exact cause of pinguecula is not known but there is a correlation between unprotected exposure to sunlight, wind, excessive dryness and dust.
Symptoms of Pinguecula
Pingueculae may have no symptoms or they can cause feelings of dryness, irritation or feeling like there is a foreign body in your eye. In more severe cases they may become itchy, inflamed, red and sore.
Treatment of Pinguecula
Often, there is no treatment necessary other than to protect the eye from the sun and other elements. If however, the pinguecula is causing discomfort or other issues, there are treatments available depending on the symptoms. Dryness, irritation and itchiness can sometimes be treated with eye drops or ointment and in cases where there is swelling, steroid eye drops along with anti-inflammatory medication may be prescribed. In rare cases that the pinguecula is causing serious problems such as vision problems, untreatable discomfort or preventing blinking, or the patient is unhappy with the way it looks, it may have to be removed surgically.
Pytergia (pytergium in singular) are wedge-shaped growths on the surface of the cornea (the sclera), made of fibrous conjunctival tissue and containing blood vessels, which sometimes make it appear pink. Pytergia often grow out of pinguecula and tend to be more visible.
Causes of Pytergia
Like pinguecula, pytergia are believed to be caused by extended exposure to UV rays from the sun and are sometimes called “surfer’s eye”. They are more common in adults (ages 20 – 50) who live in dry, sunny climates and spend significant time outdoors. Risks increase in those who do not properly protect their eyes by using sunglasses and hats when they are outdoors.
Symptoms of Pytergia
Pytergia may occur in one or both eyes and usually grow in the corner of the eye closest to the nose in toward the cornea. Very often there are no symptoms however some people may experience dry eyes, redness, irritation, the feeling that something is in their eye and inflammation. Pytergia may also cause discomfort for contact lense wearers. If the pytergium is serious it could grow far enough into the cornea to obstruct vision or cause the cornea to change shape resulting in astigmatism.
Treatment for Pytergia
If necessary, treatment for symptoms of pytergia may be similar to those used for pytergia such as lubricating eye drops or steroidal drops or creams to reduce inflammation. Surgery is more common for pytergia because of the more obvious change in appearance and because of the potential for vision disturbances. Sometimes a conjunctival graft is performed to prevent recurrence which is when a small piece of tissue is grafted onto the area where the pytergia was removed.
Pytergia and pingueculae are often completely benign conditions but should be monitored by a doctor to ensure they do not get worse and pose a threat to vision. Nevertheless, these growths go to show how important it is to protect your eyes from the harmful UV rays of the sun.
PINK EYE (CONJUNCTIVITIS)
Pink eye, or conjunctivitis, is one of the most common eye infections, especially in children. The infection is an acute inflammation which causes redness and swelling of the conjunctiva, which is the clear mucous membrane that lines the eyelid and the surface of the eye. Pink eye can be caused by a virus, bacteria or even allergies such as pollen, chlorine in swimming pools, and ingredients in cosmetics or other products that come in contact with the eyes. Some forms of pink eye can be highly contagious and easily spread in schools and at home.
Symptoms of Pink Eye
Pink eye develops when the conjunctiva or thin transparent layer of tissue that lines the eyelid and the white part of the eye becomes inflamed. Symptoms can occur in one or both eyes and include:
- Redness in the white part of the eye
- Itching or burning
- Swollen eyelids and
- Crusty eyes in the morning
Causes of Pink Eye
There are three main types of pink eye infections: bacterial, viral and allergic conjunctivitis.
Viral Conjunctivitis is usually caused by an adenovirus, the same virus that produces the recognizable red and watery eyes, sore throat, cough and runny nose of the common cold or upper respiratory infection. Viral conjunctivitis is highly contagious usually spread because of poor hygiene especially a lack of hand washing.
Symptoms of viral conjunctivitis usually last from five days to a week but may last longer. Since there is generally no medical treatment for a viral infection you have to wait for the infection to run its course. To avoid spreading the infection to others, it is recommended to stay home from school or work until the symptoms disappear which is usually after 3-5 days or up to a week.
Viral conjunctivitis typically causes a light discharge and very watery, red eyes. To relieve discomfort, you can apply cool compresses to the eyes and artificial tears.
BACTERIAL PINK EYE
Bacterial pink eye is usually caused by Staphylococcus or Streptococcus bacteria and is often characterized by a significant amount of yellow, sticky discharge. Also contagious, bacterial pink eye can be picked up from bacteria found anywhere and often spread to the eye by touching them with unclean hands. Contact lens wearers are at a higher risk for bacterial pink eye due to the handling of lenses and unclean contact lens cases.
Treatment is usually administered by antibiotic eye drops which should begin to show improvement after three or four days, however the infection can also resolve itself after a week to 10 days without treatment. If you do use antibiotic drops, you can return to work or school 24 hours after you being treatment.
Allergic conjunctivitis is not infectious or contagious as it is an allergic reaction to something in the environment such as pollen, pet dander or smoke. Symptoms, which occur in both eyes, include redness, itching and excessive tearing.
The first step in treating allergic conjunctivitis is to remove or avoid the irritant, if possible. Applying cool compresses and artificial tears can help to relieve discomfort in mild cases. In more severe cases, non-steroidal anti-inflammatory medications and antihistamines might be
prescribed. In cases of persistent allergic conjunctivitis, topical steroid eye drops are used.
Pink Eye Prevention
In all cases of pink eye, practicing good hygiene is the best way to prevent from catching and spreading the infection. Wash your hands thoroughly and frequently and don’t touch your eyes with your hands, especially if you work with or around small children.
If you have allergies, try to stay indoors on days with a high pollen count and to keep doors and windows closed. Inside the house, clean air duct filters, vacuum and dust frequently to reduce the presence of allergens.
As we reach middle age, particularly after age 40, it is common to start to experience difficulty with reading and performing other tasks that require near vision. This is because with age, the lens of our eye becomes increasingly inflexible, making it harder to focus on close objects. This condition is called presbyopia and eventually it happens to everyone who reaches old age to some extent.
To avoid eyestrain, people with untreated presbyopia tend to hold books, magazines, newspapers, and menus at arm’s length in order to focus properly. Trying to performing tasks at close range can sometimes cause headaches, eye strain or fatigue in individuals who have developed this condition.
Causes of Presbyopia
During our youth, the lens of our eye and the muscles that control it are flexible and soft, allowing us to focus on close objects and shift focus from close to distant objects without difficulty. As the eye ages however, both the lens and the muscle fibers begin to harden, making near vision a greater challenge.
Presbyopia is a natural result of the aging process and not much can be done to prevent it. Its onset has nothing to do with whether you already have another vision impairment such as nearsightedness, farsightedness or astigmatism. Everyone will notice some degree of loss of near vision focusing power as they age, although for some it will be more significant than others.
Symptoms and Signs of Presbyopia
Presbyopia is characterized by:
- Difficulty focusing on small print
- Blurred near vision
- Experiencing eyestrain, fatigue or headaches when doing close work or reading
- Needing to hold reading material or small objects at a distance to focus properly
- Requiring brighter lighting when focusing on near objects
Presbyopia can be diagnosed in a comprehensive eye exam.
Treatment for Presbyopia
There are a number of options available for treating presbyopia including corrective eyewear, contact lenses or surgery.
Reading glasses or “readers” are basically magnifying glasses that are worn when reading or doing close work that allow you focus on close objects.
Eyeglasses with bifocal or multifocal lenses such as progressive addition lenses or PALs are a common solution for those with presbyopia that also have refractive error (nearsightedness, farsightedness or astigmatism). Bifocals have lenses with two lens prescriptions; one area (usually the upper portion) for distance vision and the second area for near vision. Progressive addition lenses or PALs similarly provide lens power for both near and distance vision but rather than being divided into two hemispheres, they are made with a gradual transition of lens powers for viewing at different distances. Many individuals prefer PALs because unlike bifocals, they do not have a visible division line on the lens.
Bifocal and Multifocal Contact Lenses
For individuals that prefer contact lenses to glasses, bifocal and multifocal lenses are also available in contact lenses in both soft and Rigid Gas Permeable (RGP) varieties.
Multifocal contact lenses give you added freedom over glasses and they allow you to be able to view any direction – up, down and to the sides – with similar vision. People wearing progressive lenses in glasses on the other hand have to look over their glasses if they want to view upwards or into the distance.
Another option for those that prefer contact lenses is monovision. Monovision splits your distance and near vision between your eyes, using your dominant eye for distance vision and your non-dominant eye for near vision. Typically you will use single vision lenses in each eye however sometimes the dominant eye will use a single vision lens while a multifocal lens will be used in the other eye for intermediate and near vision. This is called modified monovision. Your eye doctor will perform a test to determine which type of lens is best suited for each eye and optimal vision.
There are surgical procedures also available for treatment of presbyopia including monovision LASIK eye surgery, conductive keratoplasty (CK), corneal inlays or onlays or a refractive lens exchange (RLE) which replaces the hardened lens in the eye with an intraocular lens (IOL) similar to cataract surgery.
Since it affects so much of the older population, much research and development is going into creating more and better options for presbyopes. Speak to your eye doctor about the options that will work best for you.
Ptosis is a pathological eye condition in which the eyelid falls or droops. It is a condition that can affect adults and children (although it is most common in the elderly) and the degree to which the eyelid droops can vary from barely noticeable to completely covering the pupil (the black spot in the middle of your eye that allows light to enter). Fortunately, there is treatment for the condition.
Symptoms and Signs of Ptosis
Ptosis can be identified by an abnormal drooping of one or both of the upper eyelids. When it only affects one lid, you can notice that the two lids are not in alignment. Often an individual with ptosis will tilt their head backward or raise their eyebrows to see more clearly, which can eventually result in headaches or neck issues. Sometimes when the eyelid droops below the pupil, it is accompanied by obscured vision or causes other eye and vision problems.
What Causes Ptosis?
In adults, ptosis is most frequently a condition related to aging when the muscles responsible for controlling the eyelid, called the levator muscles, become weakened. Ptosis can also be a result of an eye injury or an after-effect of certain types of eye surgery.
In children, ptosis can be a congenital condition in which the levator muscles do not develop properly. If not treated this can lead to problems with the development with the child’s visual system and may cause amblyopia (lazy eye), astigmatism or strabismus (crossed eyes).
Treatment for Ptosis
Prior to a treatment plan, your doctor will complete a comprehensive eye exam along with some other tests to determine the cause of the ptosis. While the treatment does depend on the cause of the condition, surgery to repair the eyelid function is the most common treatment.
The surgical procedure, called blepharoplasty, repairs the levator muscle of the eyelid or attaches the lid to other muscles that can lift the eye (such as the forehead). In mild cases, small adjustments might be made to repair the muscle while other times additional procedures might be done such as removing some of the skin from the lid. The surgeon will determine what needs to be done to tighten the levator muscles or otherwise return the eyelids to their normal position. As with any surgical procedure there are risks to this surgery and in the most serious cases, movement may not return fully or at all to the eyelids.
In children, surgery is usually recommended to avoid potential or existing vision problems. This may come along with additional treatment for amblyopia or strabismus to strengthen the weak eye such as wearing an eye patch, eyeglasses or using eye drops. Any child diagnosed with ptosis will need to have regular evaluations with an eye doctor to monitor the condition and the child’s vision.
If you suspect you or a loved one may have ptosis, try looking at some old pictures to see if there is a noticeable change and of course make an appointment with your eye doctor as soon as possible to assess if there is a problem.
A retinal detachment is a serious eye emergency in which the retina (the lining of the back of the eye) becomes separated and pulls away from the surrounding tissue. When the retina is out of place, the eye cannot properly process incoming light and if not fixed quickly, permanent vision loss can result.
The retina contains the light sensitive cells of the eye that convert light into neural impulses that communicate with the optic nerve and the brain, enabling visual processing. When the retinal cells become detached from the supportive tissue they no longer get the nourishment and support they need to function and in a relatively short period of time can suffer permanent damage.
Signs and Symptoms
A retinal detachment doesn’t hurt and can happen very suddenly with little warning. Signs that you may be experiencing this condition include sudden onset of floaters, spots, or flashes of light in the visual field. These symptoms may be accompanied by blurred vision, reduced peripheral or side vision and the sensation that there is a curtain coming down over your visual field from the top or side.
Causes and Risk Factors
Retinal detachment can be caused by an injury to the eye or face, as a result of diabetic retinopathy or very high nearsightedness (in which the retina is thinner than in normal eyes). It can also result from changes in the vitreous of the eye due to aging, eye or other systemic diseases or following an eye surgery.
Factors that put you at risk increased include:
- Age- a retinal detachment is more common in adults 50 and over
- Diabetes or Sickle Cell
- Extreme nearsightedness
- Eye surgery (such as cataract removal)
- Eye or face injury
- Family history
- Eye disease or inflammation
Treatment for Retinal Detachment
Retinal detachment can be treated by a number of surgical procedures, the type of surgery depending upon the type and severity of the detachment. These procedures include:
Pneumatic retinopexy: In this procedure the doctor injects gas or silicone oil into the eye to push the retina back into place. This is usually done when the detachment is just started and is very mild in nature. The surgeon may then need to use other procedures to secure the retina into place such as photocoagulation which is a laser procedure or cryopexy which uses a frozen probe to reattach the tissue. While the gas will absorb into the body, the oil needs to be removed following the procedure.
Scleral buckling: This procedure involves indenting the outer surface of the eye toward the retina by attaching a soft piece of silicone around the sclera or white part of the eye. If necessary, this allows the surgeon to drain the fluids that have accumulated between the retina and the supportive tissue and then the retina is reattached using laser photocoagulation or cryopexy.
Vitrectomy: In this procedure the doctor removes the vitreous fluid in your eye which is the gel-like substance that may be causing the retina to detach. The retina can then be flattened using air, gas or oil. This procedure is often combined with scleral buckling as mentioned above.
Successful treatment for retinal detachment depends on a lot of factors including the severity of the detachment, the location and how quickly it was diagnosed and treated. Sometimes full vision is not restored. If you have risk factors for retinal detachment you should make sure that you get frequent eye exams and see your eye doctor immediately if you experience any changes in your vision.
Retinitis pigmentosa (RP) is an eye disease that is inherited, and very rare. About one in four thousand Americans are affected by this disease. The retina, which is the light-sensitive portion of the eye, degenerates progressively over time. The result of this degeneration is the loss of peripheral vision, loss of central vision, night blindness, and sometimes blindness.
Retinitis Pigmentosa Symptoms
Childhood is when the first symptoms of retinitis pigmentosa generally appear. Usually both eyes are implicated in the disease. Sometimes RP doesn’t appear until older age, at age 30 or even older.
The main symptom of RP in the beginning stages is night blindness. Tunnel vision may develop in the later stages of the disease, where central vision is affected, and only a small portion of sight is available.
One study of patients suffering from RP revealed that, in patients 45 years and older, 52% had at least 20/40 central vision in one eye, 25% had 20/200 vision or below, and 0.5% were completely blind.
Causes of Retinitis Pigmentosa
Very little is known about the causes behind RP, beyond that it is an inherited disease. Scientists believe that defective molecules in our genes cause RP. This explains why the disease affects patients so differently.
If one parent carries the defective gene, it’s possible to get RP, even if your parents do not have the disease. Approximately one percent of the population are carriers of the RP recessive gene. Sometimes this recessive gene is passed on to the child, who will then develop retinitis pigmentosa.
RP affects the retina in the eye. The disease causes the light-sensitive cells that are located in the retina to die gradually. Most often, the cells that are used for night and peripheral vision, called rod cells, are affected. Sometimes the cells that are used to see color and for central vision, called cones, are also affected.
Diagnosis and Treatment
The main diagnostic tool employed is visual field testing. This test determines how much peripheral vision loss has occurred. Other diagnostic tools may be used to test night vision and color vision.
Few treatments exist for RP. What is available helps conditions associated with RP, not the disease itself. For patients older than 25, there is a prosthesis system that was recently approved. This system captures images via glasses, and transmits the signal captures to an implanted device located on the retina.
Most treatments center around helping the patient learn to deal with their vision loss. Psychological counseling, and occupational therapy, may be recommended. Technological instruments that help with low vision, such as illuminated magnifiers, can help patients with RP see as well as possible with their limited vision. Some doctors recommend vitamin A supplements as there is some evidence that vitamin A might help delay the progression of the disease.
For the future, scientists are hopeful that there will be additional treatments for RP, including new drug treatments and retinal implants.
A stye (known by eye doctors as a hordeolum) is an infection of an oil gland which forms a pimple-like bump on the base of the eyelid or within the eyelid itself. Sytes can be uncomfortable, causing swelling, pain, redness, discomfort, and sometimes excessive tearing. If the stye is large and it distorts the front surface of the eyes, it can cause blurred vision.
What causes a stye?
The oil glands on the eyelid sometimes become blocked with dirt, dead skin, or a buildup of oil. When this occurs, bacteria can grow inside. Blockage is also commonly from eye cosmetics that block the orifices within the lid. This blockage causes the gland to become infected and inflamed, resulting in a stye. A stye can form on the inside or the outside of the eyelid and can cause swelling around the eye, sometimes affecting the entire eyelid.
Treating a stye
Styes are treated with antibiotics, often in moderate and severe cases with a prescription for oral antibiotics to reduce the bacteria responsible for the infection. Treatment for a stye is recommended otherwise there is a likelihood of recurrence. Applying a hot compress to the eye for 10-15 minutes a few times throughout the day will bring some relief and speed up the healing process.
Similar to a pimple, the stye will likely rupture, drain and heal on its own. Occasionally a stye, especially one on the inside of the eyelid will not resolve itself and may require the assistance of an eye doctor for additional treatment. In such a case the stye is surgically opened and drained to reduce the swelling and cosmetic issues associated with the style.
You should never pop a stye! This can cause the bacteria to spread and worsen the infection. The infection can then spread around the top and bottom eyelids and even reach the brain. If a stye is getting worse, painful, or irritated, contact your eye doctor for treatment.
In cases where styes occur frequently, your eye doctor may decide to prescribe topical antibiotic ointment or a cleansing regimen to prevent recurrence.
Chalazia: Another type of bump on the eyelid
Similar to a stye, a chalazion is a blocked oil gland on the eyelid that becomes enlarged. The main difference between a chalazion and stye is that the chalazion is usually non-infectious. A chalazion in most occasions is an old hordeolum that did not resolve. Treatment involves lid hygiene, warm compresses, and lid massage. In most cases, a chalazion requires surgical removal.
Uveitis is a general term for an inflammatory response in the eye that can be caused by a broad range of diseases or conditions. It is called uveitis because the area that is inflamed is the uvea, although the condition can also affect other areas in the eye such as the lens, the optic nerve, the retina and the vitreous. Uveitis can cause swelling and tissue damage and lead to reduced vision or in more serious cases, even blindness.
What is the Uvea?
The uvea is a layer in the middle of the eye containing three main elements including: the choroid, which is a network of small blood vessels which provides nutrients to the retina; the iris, which is the colored layer around the pupil; and the ciliary body which produces fluid to shape the lens and provide nutrients to keep it healthy.
Types of Uveitis
Uveitis is classified by four different types, depending on the location of the inflammation within the eye. Anterior uveitis, which is the most common form, is when the iris is inflamed, sometimes in combination with the ciliary body. Intermediate uveitis is inflammation of the ciliary body and posterior uveitis is when the choroid is inflamed. When the entire uvea is inflamed, this is called diffuse or pan-uveitis.
Symptoms of Uveitis
Uveitis generally affects individuals between the ages of 20 and 50 and can present a variety of symptoms depending on the cause. The condition can affect one or both eyes and sometimes the symptoms can come on very rapidly. They include:
- Blurred vision
- Eye pain
- Red eyes
- Light sensitivity
- Seeing floaters in the field of view
If you experiences these symptoms seek medical attention immediately. Uveitis is usually a chronic disease which can lead to vision loss as well as other eye problems such as glaucoma, retinal detachment and cataracts.
Causes of Uveitis
The cause of uveitis is still somewhat of a mystery. It is often found in connection with eye injuries, viral infections, toxins or tumors in the eye or with systemic autoimmune disorders (such as AIDS, rheumatoid arthritis or psoriasis), or inflammatory disorders (such as Crohn’s disease, colitis or Multiple Sclerosis).
Treatment for Uveitis
Uveitis treatment is designed to reduce and eliminate inflammation and pain and to prevent damage to the tissues within the eye, as well as to restore and prevent vision loss. The inflammation is typically treated with anti-inflammatory steroid eye drops, pills, dissolving capsules or injections, depending on where the condition presents in the eye. Additional medications or treatments may be prescribed depending on the cause of the condition. For example, when the cause is an autoimmune disease, immunosuppressant medications may also be used. If there is a viral infection or elevated intraocular pressure, appropriate medications will be given to treat those issues. Often uveitis is a chronic disease so it’s important to see the eye doctor any time the symptoms appear.