Take a look at some of these important articles regarding healthy eyecare.
What is a Cataract?
A cataract occurs when the normally clear lens of the eye becomes cloudy and interferes with light passing through the eye. Cataracts are a process of aging and usually begin developing around midlife. Approximately 70% of people over the age of 60 and 90% of people over 70 will develop cataracts. The process is generally gradual, and people often do not realize what is happening until they have an eye exam. Common symptoms of cataracts may include blurry vision, glare and reduced vision in bright light, halos around light, poor night vision or fading of colors. Untreated, cataracts are a common cause of blindness.
How is a Cataract Removed?
Modern surgical techniques have made cataract removal one of the safest and most successful surgeries today. The virtually painless procedure takes about 10 minutes and is usually performed in a hospital on an outpatient basis. The eye is anesthetized using eyedrops, and a small incision (about one-eighth of an inch) is made in the white of the eye or through the outer edge of the cornea. An ultrasonic instrument is inserted and used to emulsify, or break up, the cataract and then vacuum away the damaged material. After the cataract has been removed, the surgeon inserts an intraocular lens to replace the natural lens that was removed. The day after surgery you will return for a checkup and your doctor may ask you to return later for one or more follow-up examinations and vision tests. Most patients notice an improvement in their vision during the first few days after surgery.
What is an Intraocular Lens?
An intraocular lens (IOL) is usually implanted during cataract surgery to replace the clouded natural lens that is being removed. A comprehensive eye examination prior to surgery and discussion with your doctor will determine what type, size and power of IOL is needed. The prescription lens implants are made from a flexible plastic that can be folded and inserted into the same small incision used to remove the cataract. The IOL is held in place inside the eye by tiny wires attached to the implant. Once the lens is implanted, it functions similarly to a natural lens and usually is not detectable to the patient.
Cornea and External Disease
The cornea is the eye’s outermost layer. It is the clear, dome-shaped surface that covers the front of the eye. Although the cornea is clear and seems to lack substance, it is actually a highly organized group of cells and proteins. Unlike most tissues in the body, the cornea contains no blood vessels to nourish or protect it against infection. Instead, the cornea receives its nourishment from the tears and aqueous humor that fills the chamber behind it. The cornea must remain transparent to refract light properly, and the presence of even the tiniest blood vessels can interfere with this process. To see well, all layers of the cornea must be free of any cloudy or opaque areas.
Because the cornea is as smooth and clear as glass but is strong and durable, it helps the eye in two ways:
Conjunctivitis (Pink Eye)
Conjunctivitis describes a group of diseases that cause swelling, itching, burning and redness of the conjunctiva, the protective membrane that lines the eyelids and covers exposed areas of the sclera, or white of the eye. Conjunctivitis can spread from one person to another and affects millions of Americans at any given time. Conjunctivitis can be caused by a bacterial or viral infection, allergy, environmental irritants, a contact lens product, eye-drops, or eye ointments.
At its onset, conjunctivitis is usually painless and does not adversely affect vision. The infection will clear in most cases without requiring medical care. But for some forms of conjunctivitis, treatment will be needed. If treatment is delayed, the infection may worsen and cause corneal inflammation and a loss of vision.
The continuous production and drainage of tears is important to the eye’s health. Tears keep the eye moist, help wounds heal, and protect against eye infection. In people with dry eye, the eye produces fewer or less quality tears and is unable to keep its surface lubricated and comfortable. The main symptom of dry eye is usually a scratchy or sandy feeling as if something is in the eye. Other symptoms may include stinging or burning of the eye; episodes of excess tearing that follow periods of very dry sensation; a stringy discharge from the eye; and redness of the eye.
Dry eye can occur in climates with dry air, as well as with the use of some drugs, including antihistamines, nasal decongestants, tranquilizers, and anti-depressant drugs. People with dry eye should let their health care providers know all the medications they are taking, since some of them may intensify dry eye symptoms. Artificial tears, which lubricate the eye, are the principal treatment for dry eye. They are available over-the-counter as eye-drops. Sterile ointments are sometimes used at night to help prevent the eye from drying. Using humidifiers, wearing wrap-around glasses when outside, and avoiding outside windy and dry conditions may bring relief. For people with severe cases of dry eye, temporary or permanent closure of the tear drain may be helpful.
The cornea copes very well with minor injuries or abrasions. If the highly sensitive cornea is scratched, healthy cells slide over quickly and patch the injury before infection occurs and vision is affected. If the scratch penetrates the cornea more deeply, however, the healing process will take longer, at times resulting in greater pain, blurred vision, tearing, redness, and extreme sensitivity to light. These symptoms require professional treatment. Deeper scratches can also cause corneal scarring, resulting in a haze on the cornea that can greatly impair vision. In this case, a corneal transplant may be needed.
Keratoconus, a progressive thinning of the cornea, is the most common corneal dystrophy in the U.S., affecting one in every 2,000 Americans. It is more prevalent in teenagers and adults in their 20s. Keratoconus arises when the middle of the cornea thins and gradually bulges outward, forming a rounded cone shape. This abnormal curvature changes the cornea’s refractive power, producing moderate to severe distortion (astigmatism) and blurriness (nearsightedness) of vision.
Keratoconus usually affects both eyes. At first, vision can be corrected with glasses. But as the astigmatism worsens, a specially fitted contact lens must be used to reduce the distortion and provide better vision. Although finding a comfortable contact lens can be an extremely frustrating and difficult process, it is crucial because a poorly fitting lens could further damage the cornea and make wearing a contact lens intolerable.
In most cases, the cornea will stabilize after a few years without ever causing severe vision problems. But in about 10 to 20 percent of cases, the cornea will eventually become too scarred or will not tolerate a contact lens. If either of these problems occur, a corneal transplant may be needed. This operation is successful in more than 90 percent of those with advanced keratoconus.
A corneal transplant involves replacing a diseased or scarred cornea with a new one. In corneal transplant surgery, the surgeon removes the central portion of the cloudy cornea and replaces it with a clear cornea, usually donated through an eye bank. A trephine is used to remove the cloudy cornea. The surgeon places the new cornea in the opening and sews it with a very fine thread. The thread stays in for months or even years until the eye heals properly. Following surgery, eye-drops to help promote healing will be needed for several months.
Corneal transplants are very common in the United States; about 40,000 are performed each year. The chances of success of this operation have risen dramatically because of technological advances, such as less irritating sutures, or threads, which are often finer than a human hair; and the surgical microscope. Corneal transplantation has restored sight to many, who a generation ago would have been blinded permanently by corneal injury, infection, or inherited corneal disease or degeneration.
What Is Diabetic Eye Disease (Diabetic Retinopathy)?
With diabetes, the body can’t use or store sugar properly. Diabetes damages the blood vessels in the eye. The damage of the blood vessels causes diabetic retinopathy. In later stages, the disease may lead to new blood vessel growth over the retina. The new blood vessels can cause scar tissue to develop, which can pull the retina away from the back of the eye. This is known as retinal detachment, and it can lead to blindness if untreated. The presence and severity of diabetic retinopathy is related to the duration of diabetes. However, severe and significant diabetic retinopathy can be present at the time of diagnosis especially with adult onset diabetes.
Signs And Symptoms Of Diabetic Retinopathy
Everyone who has diabetes is at risk for developing diabetic retinopathy. In the early or advanced stages of diabetes, symptoms may be absent or minimal. Therefore, regular diabetic screening evaluations are recommended. The symptoms of diabetic retinopathy can include floaters, blurred vision or double vision. Sometimes difficulty reading or doing close work can indicate that fluid is collecting in the macula, the most light-sensitive part of the retina. This fluid buildup is called macular edema.
Treatment Of Diabetic Retinopathy
The severity of diabetic retinopathy can be limited or prevented by close monitoring and control of blood sugars, blood pressures and blood lipids, such as cholesterol. Control of any one of these risk factors can reduce the severity of diabetic retinopathy. According to the American Academy of Ophthalmology, 95% of those with significant diabetic retinopathy can avoid substantial vision loss if they are treated in time. The possibility of early detection is why it is so important for diabetics to have a dilated eye exam at least once a year. Diabetic retinopathy can be treated with laser photocoagulation to seal off leaking blood vessels and destroy new growth. Laser photocoagulation doesn’t cause pain, because the retina does not contain nerve endings. In some patients, blood leaks into the vitreous humor and clouds vision. A procedure called a vitrectomy removes blood that has leaked into the vitreous humor. The body gradually replaces lost vitreous humor, and vision usually improves.
What is Glaucoma?
Glaucoma is a condition that results in slow progressive damage to the optic nerve, which sends information from the eye to the brain. Damage to the optic nerve leads to a slow loss of vision. As a result, glaucoma is often referred to as The Silent Thief of Sight. Rick factors for glaucoma include elevated eye pressure, increased age, African-American heritage, and previous ocular injury. The most important and most treatable risk factor for glaucoma is elevated eye pressure. Inside the eye, there is a constant production of fluid that normally flows out of the eye through a very small drain. In certain individuals, this drain can become blocked for various reasons. The result is an increase in eye pressure, therefore increasing your risk of glaucoma. Glaucoma affects an estimated 3 million Americans and is the second-leading cause of blindness in the United States.
Types of Glaucoma
Open-Angle Glaucoma: Open-angle glaucoma occurs slowly as the drainage area in the eye becomes clogged. Pressure builds up when the fluid inside the eye is unable to drain. Side (peripheral) vision is damaged gradually. Open-angle glaucoma is the most common kind of glaucoma.
Closed-Angle Glaucoma: With closed-angle glaucoma, eye pressure builds up rapidly when the drainage area of the eye suddenly becomes blocked. Blurry vision, rainbow halos around lights, headaches or severe pain may occur with closed-angle glaucoma. This type of glaucoma is less common than open-angle and may cause blindness if it is not treated immediately.
Questions and Answers
Careful examination of the optic nerve coupled with visual field testing and intraocular pressure measurement provides the necessary information to determine if damage from glaucoma is present.
Q. If I am having no visual or ocular problems, can I be certain that I do not have glaucoma?
No. In fact, people with significant levels of damage may not have visual symptoms until most of the optic nerve function is lost. This is because the disease process is generally very slow, giving glaucoma the nickname “The Silent Thief of Sight”. In most cases, damage occurs to side (peripheral) vision first, and one eye may have significant field loss, but the other does not, so with both eyes open a person may not realize the extent of the damage.
Q. What can I do to reduce my risk of further damage?
The two most important things you can do if you are diagnosed with glaucoma are to keep follow-up appointments and faithfully use ocular medications as prescribed. Careful monitoring and consistent treatment can often stabilize this disease process.
What is Macular Degeneration?
Age-related Macular degeneration (AMD) is a disease associated with aging that gradually destroys sharp, central vision. The disease attacks the macula, the central area of the retina that allows a person to see fine detail. Individuals can lose all but the outermost peripheral vision, leaving dim images or black holes at the center of vision. Central vision is needed is needed for seeing objects clearly and for common daily tasks such as reading, driving, identifying faces and watching television. AMD is a leading cause of vision loss and legal blindness in adults over 60 in the United States.
Two Types of Macular Degeneration
Macular degeneration is diagnosed as either dry or wet. Dry AMD is more common than wet AMD, with about 90% of people having the dry type and 10% of people having the wet type. However, even though the wet type is less common, 90% of severe vision loss comes from the wet type and only 10% from the dry type.
Cause of AMD
The cause of AMD is not completely known. However, the greatest risk factor is age. The risk of having AMD increases with age, from 10% at age 50 to about 30% at age 75. Other factors that increase the risk of developing AMD include family history of AMD, smoking, diet, weight and race. Caucasians are much more likely to lose vision from AMD than other races (*NIH). Lifestyle practices like not smoking, eating a healthy diet high in green leafy vegetables and fish, exercising and maintaining normal weight and blood pressure may play a role in reducing the risk of developing AMD.
Especially with the dry form, symptoms may develop gradually. Also if only one eye is affected, a person may not notice changes in vision until the disease gets moderately worse because the unaffected eye helps to compensate for changes in vision. Having an annual eye exam is very important for detecting AMD and other ocular disorders early in their progression.
Symptoms of AMD may include blurred vision, a dark area or “blind spot”, or a distorted appearance of straight lines or other objects. It is important for people with AMD to monitor their vision closely and to call their eye doctor if there is a change in vision. One way to monitor vision or detect a problem is with an Amsler grid. The Amsler grid, which looks similar to a section of graph paper, is a diagnostic tool that aids in the detection of visual disturbances caused by changes in the retina. The Amsler grid is a very sensitive test that can reveal clinical changes before other visual symptoms develop. With new and reliable treatments for wet AMD, this tool is important for the early detection of wet AMD.
Call 1-800-237-5393 or e-mail firstname.lastname@example.org to receive a free Amsler grid.
Oculoplastics deals with disease and surgery of the structures around the eye. This may include the eyelids, the eyebrows, the lacrimal or tear system and the tissues behind the eye, known as the orbit. These structures are critical for vision. Injuries, congenital defects, aging changes and tumors affecting the eyelids as well as the tissues and bones surrounding the eyes can cause pain, eye damage, vision loss and disfigurement.
The position of the eyelid is vital to the health of the eye. Eyelid malposition can occur with aging or certain disease. There are many types of eyelid malpositions including an outward turning or ectropion, an inward turning or entropion and droopiness or ptosis. Oculoplastic surgeons can reconstruct eyelids, correct eyelid-position abnormalities, remove growths and rebuild these critical structures surrounding the eye. Other conditions treated by oculoplastic surgeons include orbital fractures and trauma, orbital tumors and cancer, lacerations and removal of the eye with subsequent reconstruction of the socket.
There are many common childhood eye problems such as infection, injury, disorders such as amblyopia, or “Lazy Eye”, or vision problems like nearsightedness, farsightedness or astigmatism. Observing your child’s eyes and paying attention to how your child behaves is very important. Unusual behavior such as closing one eye or tilting the head to see things can be a warning sign. School-age children may complain of things looking blurry or not being able to see the chalkboard. Fortunately, most childhood eye problems can be corrected if detected early. To help protect your child’s sight, watch for warning signs and take your child to a doctor at the first sign of a problem.
Test your eyesight by performing a visual acuity test using the Interactive Visual Acuity Chart (IVAC).
Guidelines for Childhood Eye Exams
The American Academy of Pediatrics and the American Association for Pediatric Ophthalmology and Strabismus agree that all children should have their eyes examined by the pediatric or family doctor at birth and at all regular check-ups before school. At the age of 3 to 4, the exams should include vision testing using acuity charts. Urgent or more frequent eye exams should take place if you see one or more of the following warning signs:
Children with certain medical or family risk factors should have comprehensive ophthalmic examinations, including:
What to Expect During Your Child’s Exam
Common Childhood Eye Disorders
Child Eye Safety
Each year, thousands of children have eye accidents at home, at play or in the car. These eye injuries can damage a child’s sight and even cause blindness. Parents are urged to acquaint themselves with potentially dangerous situations at home and in school and to insist that their children use protective eyewear when participating in sports or other activities.
To provide the safest environment for your children:
According to Prevent Blindness America, more than 40,000 people each year are treated for eye injuries related to sports activities. For all age groups, sports-related eye injuries occur most frequently in baseball, basketball and racquet sports. Almost all sports-related eye injuries can be prevented. Whatever your game, whatever your age, you need to protect your eyes. While protective eye gear may not be the latest craze in tennis or baseball, think for a moment about what could happen if we fail to protect our eyes. We wear helmets to protect our head and pads or braces to protect our bones and joints. Extra precautions are taken to prevent concussions, broken bones, bruises and chipped teeth, so what about our eyes? What can we do to prevent the possibility of permanent vision loss, a scratched cornea or fractured eye socket? Broken bones and bruises will usually heal, but a serious eye injury can put you on the disabled list for life.
The following guidelines can help you find a pair of eye guards right for you: