Amblyopia, also known as a “lazy eye”, is described as a reduced vision in one eye compared to the other. There are some rare forms of amblyopia that involve both eyes. Amblyopia is the most common cause of partial or total blindness in one eye in children.
The term lazy eye is misleading because the eye is not actually lazy. In fact, it is a developmental problem in the nerve connecting the eye to the brain, affecting the brain’s ability to use both eyes together. It is not a problem in the eye itself, but in the brain which actively ignores the visual input from the misaligned eye, leading to amblyopia in that eye.
In addition to poor visual acuity, people with amblyopia are more prone to having difficulties with depth perception, eye movements related to reading, and visual decision making while driving.
Astigmatism is a refractive error-a condition related to the shape and size of the eye that causes blurry vision. It is caused by an irregular-shaped cornea, the clear front surface of the eye. A typical eye is basketball-shaped, whereas an astigmatic cornea is shaped more like a football or egg. In some cases, the lens inside the eye may be irregular, causing astigmatism.
The irregularity of the cornea or lens causes light rays to form two images in the back of the eye instead of one clear one. This is because, like a football, an astigmatic eye has one steep curve and one flat curve.
Astigmatism can be fully corrected with glasses or contact lenses.
Blepharitis is inflammation of the eyelids occurring at the lid margins. It occurs in two forms:
Anterior Blepharitis affects the front of the eyelids near the lashes. Bacteria and seborrheic dermatitis are common causes.
Posterior Blepharitis affects the inner surface of the eyelid that contacts the eye. It is usually caused by problems with the glands at the lid margin.
Symptoms include irritation, burning, tearing, foreign body sensation, crusty debris, dryness, and red lid margins.
Blepharitis can be difficult to manage and often reoccur. Warm compresses to the eyelids, cleaning your eyelids frequently, and using an antibiotic, or massaging the lid margins with your fingertips are several of the treatment options. Artificial tears or ointments may be used to reduce irritation.
A cataract is a clouding of the eye’s natural lens which sits behind the iris. This lens focuses our eye to whichever distance we are viewing allowing us to see clearly at all distances. The clouding is due to an aggregation of lens proteins that grow over time, making it more difficult to see.
These lens changes usually do not become noticeable until after age 55. At that time, you may notice your vision is blurred slightly. As cataracts worsen, you may notice some or all of these problems:
Blurred vision that cannot be corrected with an updated prescription
Ghost images or double vision
Glare from light
Colors appear faded
When stronger vision correction fails to provide adequate benefit, it is time for cataract surgery. Surgery is a very successful and low-risk procedure. 90% of people who have cataract surgery regain very good vision. During the procedure, the surgeon removes your old, clouded lens, and replaces it with a plastic lens. There is a wide variety of lenses that can correct refractive error and presbyopia post-surgery. Talk with your eye doctor about your options.
Cytomegalovirus (CMV) is a sight-threatening disease associated with late-stage AIDS. This virus does not cause eye pain, but you may see floaters, experience decreased visual acuity, flashes of light, distorted vision, or decreased peripheral vision beginning in one eye, but eventually involves both.
If left untreated, CMV retinitis can cause retinal detachment and blindness in less than six months. Treatment includes anti-virals to slow down the progression. There is no cure. It is essential to see a retinal specialist if you have AIDS and are experiencing the above symptoms.
A corneal transplant replaces central corneal tissue, damaged due to disease or injury, with healthy corneal tissue donates from an eye bank. This procedure is now done routinely, and it is necessary when your cornea becomes so damaged or scarred that a transplant is the only way to restore vision.
A new version of this procedure called Descemet’s Stripping Endothelial Keratoplasty (DSEK) uses only a thin portion of the cornea for transplant. This may be a more advantageous option.
Who needs a corneal transplant? Those patients who suffer from diseases or injuries such as:
Scarring from infections
Eye diseases such as keratoconus
Hereditary factors or corneal failure from previous surgeries
Thinning of the cornea and irregular shape
Complications from LASIK
Chemical burns or damage from injury
Most transplants are successful. Prevent corneal transplant rejections by recognizing the warning signs such as redness, sensitivity to light, decreased vision, and pain. If your transplant should fail, it may be repeated. However, overall rejection rates increase with the number of corneal transplants.
Recovery time may be up to one year or more to recover. Your vision will initially be blurry but will continue to improve. You will still need glasses or contacts due to the curvature of the transplant.
When blood sugar gets too high, it can damage the blood vessels in your eyes. In advances stages of diabetes, new, leaky blood vessels can grow over your retina and break causing scar tissue to develop. This tissue may lead to a retinal detachment. In another case, blood vessels can grow onto the iris and lead to glaucoma.
Not all diabetics will develop diabetic retinopathy, but anyone with the condition is at risk. That is why routine eye exams are essential. Your doctor can detect subtle signs of diabetes in your eyes even before you notice any visual symptoms, and early detection and treatment can prevent vision loss.
Diabetic retinopathy can be treated with a laser to seal off leaking blood vessels and inhibit the growth of new vessels.
Fortunately, you can significantly reduce your risk of developing diabetic retinopathy by taking good care of yourself:
Keep your blood sugar under good control
Maintain a healthy diet
Follow your doctor’s instructions
Dry Eye Syndrome
Dry eye is the chronic lack of sufficient moisture on the surface of the eye. Persistent dryness, itching, and burning are common symptoms. These complaints along with a measurement of the number of tears in your eye can lead to a diagnosis.
There are several causes:
Side effects of medications such as antihistamines, antidepressants, blood pressure medicines, and birth control pills
Dry, dusty, or windy climates with low humidity
Diseases such as lupus, rheumatoid arthritis, rosacea, Sjogren’s Syndrome
Long term contact lens wear
Treatments are unable to cure dry eye syndrome, but the symptoms can be managed. Artificial tears, prescription eye drops, punctual plugs, fish oil, and steroid eye drops are utilized in many dry eye treatments.
Many allergens in the air come into contact with your eyes and nose. Some of these allergens include pollen, mold, dust, and pet dander. Food allergies and bee stings do not typically affect your eyes as the previous airborne allergens do.
Common signs include: red, swollen, tearing, itching, runny nose, sneezing, coughing, itchy nose, and headache from sinus congestion.
Try to avoid what may be causing your eye allergy. If you are unsure of what it may be or are having difficulty avoiding it, over-the-counter and prescription medications are available to alleviate your symptoms.
Floaters & Spots
Floaters are actually tiny clumps of gel or cells inside the clear, jelly-like fluid that fills your eye (vitreous). These can look like specks, strands, or webs. These opacities move around within the vitreous, and as they pass in front of your field of new, you will see them. These can occur as the vitreous gel pulls away from the back wall of the eye. Floaters are very common, and, although annoying, they will fade and become less bothersome.
Flashes of light occur more often in older people and are caused by mechanical stimulation of the photoreceptors with the vitreous tugs on the retina. These flashes may be a warning sign of a detached retina, which must be treated quickly to prevent blindness. Migraines can also cause flashes in the form of jagged lines or "heat waves.”
The sudden appearance of a significant number of floaters and flashes could indicate a serious problem in the eye. If you suddenly see new floaters, see your eye doctor immediately.
Glaucoma is a failure of the eye to maintain a balance between fluid being produced and fluid leaving the eye resulting in high pressure within the eye. This high pressure can damage the eye’s optic nerve.
Glaucoma is a silent disease because it produces no pain and no symptoms. This is why glaucoma is often undetected until damage to the optic nerve has already occurred and vision is irreversibly damaged. However, certain forms of the disease may cause symptoms of sudden blurry vision, haloes around lights, intense eye pain, nausea, and vomiting. The prevalence of these symptoms requires an immediate visit to your eye doctor or the emergency room.
Depending on the severity and type of glaucoma, topical medications may be used to lower eye pressure. Other treatment options include conventional surgery and laser surgery. The goal of any of the above treatment options is to lower IOP and prevent vision loss.
Early detection is the best way to prevent vision loss from glaucoma. Glaucoma testing is done at each routine eye exam, so it is important to see your eye doctor regularly.
Hyperopia, also known as farsightedness, can see distant objects well but have difficulty with objects up close. This happens due to light rays focusing behind the retina rather than directly on it either due to a shorter than normal eye or the optics of the front of your eye.
GEyeglasses or contact lenses can correct hyperopia.
Refractive surgery may be another treatment option.
Keratoconus is a progressive eye disease. A normally round cornea thins and begins to bulge into a cone shape. This cone deflects the light entering your eye resulting in distorted vision.
As the cornea enlarges, it causes an increase in blurred vision at distance, glare, and light sensitivity.
Treatments for keratoconus include an array of specialty contact lenses that are custom designed for your exact eye. Because it is a progressive disease, keratoconus patients often have a change in prescription at every eye doctor visit.
Other treatments can include corneal reshaping procedures and a corneal transplant.
Macular degeneration (AMD) is an age-related condition involving the most sensitive part of the retina, called the macula. The macula begins to break down and no longer create clear images. There are two forms:
The early stage of the disease resulting in macular thinning increased pigment, drusen or a combination. Gradual vision loss occurs at this stage of AMD.
Progression to wet AMD may be reduced by taking nutritional supplements specifically for retinal health.
The more advanced and damaging stage of the disease. At this stage, new blood vessels grow beneath the retina and lead blood and fluid. The leakage causes permanent retinal damage resulting in total loss of vision.
There is no cure for macular degeneration, but some treatments may delay the progression and even improve vision.
Myopia, also called nearsightedness, results in difficulty seeing far away, but near vision remains clear. This condition occurs when the eye is slightly longer than most eyes. Thus, the entering light rays focus in front of the retina rather than directly on it.
This condition can be corrected with glasses, contact lenses, or refractive surgery.
Ocular hypertension means that your IOP is higher than normal. High IOP is also associated with glaucoma, but without optic nerve damage and vision loss, it is called ocular hypertension.
There are no signs or symptoms associated with this condition, so it is important to get regular eye examinations to monitor the pressure within your eye.
Treatment options include topical medications used to prevent the risk of developing glaucoma. Other doctors may choose to monitor your IOP and begin drops only when he/she sees signs of developing glaucoma.
Conjunctivitis (Pink Eye)
Conjunctivitis is the acute, contagious inflammation of the clear membrane that lines the inner eyelids and white portion of the eye (sclera). The cause can be bacterial or viral.
The hallmark sign of "pink eye” is a pink or reddish appearance of the sclera. Other signs and symptoms include:
Treatment usually involves topical eye drops to reduce inflammation and discomfort.
Wash hands frequently and encourages children to do the same.
Never share personal items such as hand towels
Encourage children to use tissues and cover their mouths and noses when they sneeze or cough.
Discourage eye rubbing and touching
Those with a pink eye should avoid crowded conditions for three to five days to prevent the spread of infection.
After the age of 40, you may notice increasing difficulties focusing on near targets. This is due to presbyopia. It happens to everyone at some point in life, even those who have never had vision problems before.
Presbyopia is an age-related loss of the flexibility of the lens inside the eye. When the lens becomes harder and less elastic, it can no longer focus up close.
The treatment for presbyopia includes reading glasses, bifocals, progressive lenses, monovision contact lenses, and multifocal contact lenses.
Ptosis is the term for "droopy eyelid”. It can be present at birth, develop due to aging, injury or an effect of eye surgery. This condition can also be caused by a problem with the muscles that control lid movement, and eye tumor, neurological disorder, or systemic disease.
The degree to which the lid droops vary. In some severe cases, you may have difficulty seeing. If the ptosis is affecting your vision, a lid surgery is warranted.
A retinal detachment is a serious and sight-threatening condition. It occurs when the retina is separated from the underlying tissue. Once it is detached, the retina loses function, and vision is lost.
Sudden onset of spots, floaters, and flashes may be a sign of retinal detachment. Another common symptom is the appearance of a shadow or curtain coming down or across your eye. No pain is associated with a detachment, so if you experience any of the above symptoms, contact your eye doctor immediately.
Surgery is the only effective treatment for a torn or detached retina, and it is performed by an ophthalmologist.
A stye occurs when a gland of the eyelid becomes infected. It can grow on the inside or the outside of the lid and result in pain, redness, tenderness, and swelling. Styes are not harmful to your vision, and they can occur at any age.
Most styes heal on their own within a few days. Hot compresses can speed up the healing process. Never pop a stye as it may lead to a secondary infection of the lid or eye itself.
Uveitis is the inflammation of the area consisting of the iris, ciliary body, and choroid. It can be caused by:
Uveitis commonly causes red eyes, pain, light sensitivity, blurred vision, and floaters.
To treat this condition, your doctor may prescribe a steroid to reduce your eye’s inflammation. Additional medications may be prescribed if an infection is the suspected cause of your uveitis. With proper treatment, the condition can clear up in a matter of days to weeks. Episodes of uveitis can recur, so contact your doctor immediately if signs and symptoms return after treatment.
Vision Over 40
If you are among the 85 million Baby Boomers in the United States and Canada, you have probably noticed that your eyes have been changing. The most noticeable difference is most likely the inability to focus on near targets or presbyopia. Presbyopia usually becomes an issue in our 40’s, requiring vision correction. Here are some measures you can take to keep seeing clearly for years to come:
Multifocal Contact Lenses
In the past, reading glasses were the only available option to presbyopic contact lens wearers who wanted good near vision. Today, a number of multifocal contact lens options are available. Multifocal contact lenses offer the best of both worlds: no glasses along with good near and distance vision.
Multifocal contacts are available in soft and rigid gas-permeable lens materials and are designed for daily or extended wear.
Monovision may be a good alternative if multifocal lenses do not work for you. With monovision, you will use your dominant eye for distance vision and your non-dominant eye for near vision. Your eye doctor will perform tests to determine your dominant eye.
Bifocals are available to allow both distance and near vision. This design offers a generous field of view for reading, yet keeps the near segment small enough to be cosmetically pleasing. All bifocals, however, limited in that they do not provide clear intermediate vision.
Trifocals are similar to bifocals in that they have a segment for near and an area for distance, but they have an additional segment directly above the near portion for seeing at intermediate distances.
Progressive Multifocal Lenses gradually change in power from the top of the lens to the bottom instead of have only two or three powers. This option offers clear vision at all distances. There are no visible lines as in conventional bifocals and trifocals, so vision is more natural and comfortable.
Occupational Bifocals and Trifocals
The Double-D Bifocal for reading and overhead near work is great for those people in auto maintenance and repair. It has a segment for near the bottom of the lens AND the top of the lens with distance in the middle. This allows workers to be able to see well up close while looking down and when looking up to work on a car on a lift.
The E-D Bifocal is great for when you need to see everywhere, but especially at arm’s length. This lens has the distance correction in the top half of the lens and intermediate distance correction in the lower half. Within the lower half where intermediate distances can be seen, a small D shaped segment is embedded for near vision.
Reading all day at work? A common multifocal lens can become occupations by changing the position of certain segments or progressive lens characteristics.
What about golfing? Multifocal lenses on the golf course can be a problem. The near vision zones can interfere with your view of the ball, requiring you to tilt your head uncomfortably. There is a solution! An occupational multifocal called a "golfer’s bifocal” has a small near segment in the low, outside corner of only one lens. This removes the near portion completely out of your line of sight when you are looking at your ball but still gives you enough near vision to read your scorecard.
A simple solution to correcting presbyopia is a pair of reading glasses. Single vision reading glasses are used only for near vision and come in two sizes: full, like normal glasses, and half-eyes which are smaller and sit low on the nose.
Although many people purchase ready-made readers at a pharmacy or convenience store, these lenses are essentially one-size-fits-all. Most people do not have exactly the same vision in each eye, so these lenses have the potential to cause headaches, eyestrain, and even nausea if they are too far off from your actual prescription. Custom-made reading glasses purchased at a doctor’s office or optical store will be made to fit your eyes.
Dry Eye After Menopause
According to multiple studies, more than 14% of older Americans suffer from dry eye. Females age 50 and older have an even greater chance of developing dry eye due to hormonal changes. Menopause can cause an unstable tear film lying over your eyes resulting in inflammation, decreased tear production, and dry eye.
Certain things can exacerbate your dry eye. These include hormone therapy, refractive surgery, medications, and systemic disease.
Vision Over 60
How Your Vision Changes
Just as physical strength decreases with age, our eyes exhibit a decline in performance. Some of these changes are very common and do not signify any disease process. Others, however, will experience more serious diseases that have greater potential for affecting your quality of life including macular degeneration, glaucoma, and diabetic retinopathy.
How Aging Affects Eye Structures
While we often think of aging-related to certain eye conditions, more subtle changes also take place including:
Reduced Pupil Size- As we age, muscles that control our pupil size and reaction to light lose strength causing the pupil to become smaller and less responsive to light. This may lead to sensitivity to bright light and glare after emerging from a dimly lit area and more light needed for comfortable reading.
Dry Eyes- As we age, our bodies produce fewer tears. This can lead to burning, stinging or other eye discomforts. Artificial tears may be used for comfort. Consult your eye doctor regarding your options.
Loss of Peripheral Vision- As you age, your visual field will decrease by 20-30 degrees. Because of this loss, the risk for automobile accidents increases; therefore, make sure you are more cautious when driving.
Decreased Color Vision- Color becomes less bright and contrast between different colors tends to be less noticeable. While there is no treatment for this normal change in color perception, you should be aware of this loss if your profession requires fine color discrimination.
Vitreous Detachment- Age you age, the gel-like vitreous inside the eye begins to liquefy and pull away from the retina. This causes spots, floaters, and sometimes flashes of light. This detachment is usually harmless, but floaters and light can also signal the beginning of a retinal detachment which is a serious problem. See your doctor if you experience any of these symptoms.
Eight Ways to Protect Your Eyesight
To protect your eyesight and keep your eyes healthy as you age, consider these guidelines:
Beware of your risk for eye disease.
Have regular exams to check for diabetes and high blood pressure.
Look for changes in your vision.
Exercise more frequently.
Protect your eyes from the sun.
Eat a healthy and balanced diet.
Get your eyes checked at least every two years.
Following these steps is no guarantee of perfect vision throughout your lifetime. Maintaining a healthy lifestyle and having regular eye exams with decrease your risk of problems and help you enjoy your eyesight to the fullest.
What Sports Vision Doctors Can Do For You
Seeing 20/20 is not the only measure of good vision. Depth perception, peripheral awareness, and eye-hand coordination are all visual skills that are extremely important in sports.
Sports vision testing can be tailored to the sport you are interested in playing. Some of these tests may include evaluation of how well you see while moving and interacting with other objects. A comprehensive sports vision training program is a great option to help develop your sports vision skills so they become second nature.
Contacts and Glasses that Enhance Performance
In addition to sharp vision, sports eyewear can offer additional benefits to help athletes perform at their highest level:
Protection from impact-related injuries. Sports eyewear offers a primary benefit of superior impact resistance and protection.
Protection from UV. Excessive exposure to UV rays has been associated with eye diseases such as cataracts and ocular tumors along with several other conditions. UV blocking sunglasses should be worn to reduce the penetration of these harmful rays.
Color enhancement. Special tints in sports eyewear can increase contrast, so that "keeping your eye on the ball” is much easier.
Light control. Polarized sports glasses reduce glare from reflective surfaces, making them great for fishing and other water sports. Anti-reflective coating is another glare reducer that reduces lens reflections at night if you are playing under bright lights.
Scuba Diving Masks and Swim Goggles
Swimmers and scuba divers who wear glasses or contact lenses may benefit from prescription swim goggles. These special forms of sports eyewear require a different prescription that regular eyeglasses due to the unique characteristics of an underwater environment.
Depending on the type of underwater correction you need- scuba masks or goggles- they will be specifically designed to give you the same clear vision that your glasses provide you on dry land.
Protective Sports Eyewear
Wearing protective eyewear reduces or eliminates the risk of eye damage. Today, many clubs do not even permit their members to participate without wearing proper eye protection.
Not wearing protective eyewear? Prevent Blindness America reports that hospital emergency rooms treat 40,000 eye injuries every year that are sports-related. Racquetball, tennis, and badminton seem like relatively harmless sports, but they involve objects moving at 60mph or faster.
Flying objects are not the only hazard. Many injuries to the eyes come from pokes and jabs by fingers and elbows, particularly in contact sports.
Ask your eye care professional about the features and considerations when deciding on protective eyewear.
Shooting and Hunting Glasses
All firearms have a certain amount of recoil, and many shooting activities take place outdoors where wind, sun, dust, tree branches, and brush can all cause eye injuries.
Many shooting glasses contain special tints for enhancing the orange of a target against a background of tall trees or enhance colors in foggy or low-light conditions. Polarized lenses reduce glare bouncing off reflective surfaces, making them an excellent choice when hunting near water.
Ask your eye doctor about the right lenses for you.