Eye Complications FAQ’s

Aging and the Eyes

Eight Ways to Protect Your Eyesight

Sight-threatening eye problems affect one in six adults age 45 and older, and the risk for vision loss increases with age. In fact, a recent American Academy of Ophthalmology (AAO) report estimates that more than 43 million Americans will develop age-related eye diseases by the year 2020. To protect your eyesight and keep your eyes healthy as you age, follow these guidelines:

Be aware of your risk for eye disease.

Know your family’s health history.

Do you or any of your family suffer from diabetes or have high blood pressure?

Are you over the age of 65?

Are you an African-American over the age of 40?

All of these factors increase your risk for sight-threatening eye diseases.

Have regular exams to check for diabetes and high blood pressure. If left untreated, these diseases can cause eye problems. In particular, diabetes and high blood pressure can lead to diabetic retinopathy, macular degeneration, glaucoma and ocular hypertension. Regular eye exams can detect problems early and help preserve your eyesight. Look for changes in your vision. If you start noticing changes in your vision, see your eye doctor immediately.

Trouble signs include:

double vision

hazy vision and difficulty seeing in low light conditions.

Other signs to look for include:

frequent flashes of light

floaters

eye pain and swelling.

All of these signs and symptoms can indicate a potential eye health problem that needs immediate attention. Exercise frequently. According to the AAO, some studies suggest that regular exercise – such as walking – can reduce the risk of macular degeneration by up to 70 percent. Protect your eyes from the sun’s UV rays. Overexposure to ultraviolet (UV) radiation is associated with an increased risk of cataracts and other eye damage. When outdoors, wear sunglasses that provide 100 percent UV protection to shield your eyes from the sun’s harmful rays. Eat a healthy and balanced diet. Numerous studies have shown that a diet high in antioxidants may reduce the risk of cataracts. Antioxidant-rich foods include colorful fruits and vegetables. Eating fish that contain plenty of omega-3 fatty acids (salmon and herring, for example) also may help prevent macular degeneration.

Get your eyes checked at least every two years. A thorough eye exam, including pupil dilation, can detect major eye diseases such as diabetic retinopathy, which has no early warning signs or symptoms. A comprehensive eye exam also can ensure that your prescription for eyeglasses or contact lenses is accurate and up-to-date. Don’t smoke. The many dangers of smoking have been well documented. When it comes to eye health, people who smoke are at greater risk of developing age-related macular degeneration and cataracts. Following these steps is no guarantee of perfect vision throughout your lifetime. But maintaining a healthy lifestyle and having regular eye exams will certainly decrease your risk of sight-stealing eye problems and help you enjoy your precious gift of eyesight to the fullest.

Allergies & the Eyes

Eye allergies are overreactions of the body’s immune system when certain substances come in contact with the eyes of sensitive individuals. These allergy-causing substances (called allergens) can include dust, pollen, mold and animal dander. Certain ingredients in cosmetics and eye drops also can cause eye allergies in some individuals.

Eye allergy signs and symptoms

The most common signs and symptoms of eye allergies include red eyes, swollen eyelids, itchy eyes and excessive tearing. Eye allergy treatment :

Avoidance. The best way to handle eye allergies is to avoid exposure to known allergens that are causing your problems. For example, if animal dander appears to be the problem, don’t allow your pet in your bedroom and avoid touching your eyes after handling your pet. Also, purchase a high-quality furnace filter that traps airborne pet dander.

Medications. If you’re not sure what’s causing your eye allergies, or you’re not having any luck avoiding known allergens that are causing problems, use doctor-recommended medication to alleviate your eye allergy symptoms. Over-the-counter and prescription medications each have their advantages; for example, over-the-counter products often are less expensive, while prescription ones usually are stronger and might be more effective. Eye drops are available as simple eye washes, or they may have one or more active ingredients such as antihistamines, decongestants or mast cell stabilizers to relieve allergy symptoms or reduce the severity of allergic reactions. Antihistamines relieve many symptoms caused by airborne allergens, such as itchy, watery eyes, runny nose and sneezing. Decongestants clear up redness. They contain vasoconstrictors, which make the blood vessels in your eyes smaller, lessening the apparent redness. They treat the symptom, not the cause. In fact, with extended use, the blood vessels can become dependent on the vasoconstrictor to stay small. When you discontinue the eye drops, the vessels might actually get bigger than they were in the first place. This process is called rebound hyperemia, and the result is that your red eyes worsen over time. Some products have ingredients called mast cell stabilizers, which alleviate redness and swelling. Mast cell stabilizers are best taken prior to allergy symptoms to reduce your sensitivity to problematic allergens and can provide long-lasting relief. Other medications used for eye allergies include non-steroidal anti-inflammatory drugs (NSAIDs) or corticosteroids. In some cases, combinations of medications may be used.

Immunotherapy. You also might benefit from immunotherapy, in which an allergy specialist injects you with small amounts of allergens to help your body gradually build up immunity to them. Eye allergies and contact lenses Even if you are a successful contact lens wearer, allergy season can make your contacts uncomfortable. Airborne allergens can get on your lenses, causing discomfort. Allergens also can stimulate the excessive production of natural substances in your tears that bind to your contacts, adding to your discomfort and allergy symptoms. Ask your eye doctor about eye drops that can help relieve your symptoms and keep your contact lenses clean. Certain drops can discolor or damage contact lenses, so ask your doctor first before trying out a new brand. Another alternative is daily disposable contact lenses, which are designed to be worn once, and then discarded at the end of the day. Because you replace them daily, these lenses are unlikely to develop irritating deposits that can build up over time and cause or heighten allergy-related discomfort.

Amblyopia & the Eyes

Amblyopia is reduced vision in an eye caused by abnormal visual development. Commonly called “lazy eye,” amblyopia usually occurs in just one eye, but both eyes can be affected. Left untreated, amblyopia can cause legal blindness in the affected eye. About 2 to 3 percent of the American population has amblyopia.

What causes amblyopia?

The most common cause of amblyopia is strabismus, which is misalignment of the eyes. To avoid double vision caused by strabismus, the visual part of the brain suppresses visual information provided by one eye, causing that eye to be amblyopic. Another cause of amblyopia is a significant difference in the refractive errors (nearsightedness, farsightedness and/or astigmatism) in the two eyes. It’s important to correct amblyopia as early as possible to enable proper visual development and normal visual acuity in both eyes. Amblyopia signs and symptoms Amblyopia generally starts at birth or during early childhood.

Because the vision in one eye usually remains normal, sometimes there are no symptoms of amblyopia until the “good” eye is covered. If amblyopia is caused by strabismus, it is the misalignment of the eyes that often leads to the diagnosis of amblyopia after vision testing of each eye is performed.

Treatment of amblyopia

If amblyopia is caused only by unequal refractive error, sometimes full-time wear of glasses or contact lenses will be sufficient for vision to develop properly in the amblyopic eye. But in most cases, eye patching or some other technique to temporarily reduce the visual acuity of the “good” eye is needed to stimulate the visual development of the amblyopic eye. Eye patching may be required for several hours each day or even all day long, and may continue for weeks or months. If you have a lot of trouble with your child taking the patch off, you might consider a prosthetic contact lens that is specially designed to block vision in one eye and is colored to closely match the other eye. Another alternative to patching is the use of atropine eye drops in the non-amblyopic eye. The drops blur the vision of the good eye to force greater use of the amblyopic eye.

Studies have shown use of atropine eye drops is comparable to eye patching for treating amblyopia and doesn’t require constant vigilance to make sure your child wears an eye patch. In cases when the amblyopia is caused by a large eye turn, strabismus surgery is usually required to straighten the eyes. The surgery corrects the muscle problem that causes strabismus so the eyes can focus together and see properly. In many cases, a program of active vision therapy also is recommended to speed the development of normal vision and visual skills in an eye with amblyopia. Vision therapy exercises the eyes and helps both eyes work as a team. Vision therapy for someone with amblyopia forces the brain to use the amblyopic eye, thus restoring vision. Amblyopia does not go away on its own, and untreated amblyopia can lead to permanent visual problems and poor depth perception. If your child has amblyopia and his or her “good” eye develops disease or is injured later in life, this could cause a permanent disability.

For best results, amblyopia should be treated as soon as possible during childhood. If amblyopia is detected and aggressively treated before the age of 8 or 9, in many cases normal 20/20 vision can be achieved.

AMD & the Eyes

Macular degeneration —also called age-related macular degeneration or AMD — is a degenerative condition in which the most sensitive part of the retina (the macula) starts to break down, causing a loss of central vision. Though macular degeneration does not affect peripheral vision, loss of central vision from AMD can be devastating and make it impossible to drive, read, see faces, watch television, use a computer or do many other routine daily activities. AMD is the leading cause of vision loss and blindness in Americans aged 65 and older. And because older people represent an increasingly larger percentage of the general population, vision loss associated with macular degeneration is a growing problem.

It’s estimated that more than 1.75 million U.S. residents currently have significant vision loss from AMD, and that number is expected to grow to almost 3 million by the year 2020.

Types of macular degeneration

There are two forms of macular degeneration — dry AMD and wet (or neovascular) AMD. Neovascular refers to the growth of new blood vessels in an area, such as the macula, where they are not supposed to be. The dry form of AMD is more common – about 85% to 90% of all cases of macular degeneration are the dry variety. Dry AMD. Dry macular degeneration is an early stage of the disease. It may result from the aging and thinning of macular tissues, depositing of pigment in the macula or a combination of the two processes.

Dry macular degeneration is diagnosed when yellowish spots called drusen begin to accumulate in the macula. Drusen are believed to be deposits or debris from deteriorating macular tissue. Gradual central vision loss may occur with dry AMD. Vision loss from this form of the disease usually is not as severe as that caused by wet AMD. A major study conducted by the National Eye Institute looked into the risk factors for developing macular degeneration and cataracts. The study, called the Age-Related Eye Disease Study (AREDS), showed that taking a daily nutritional supplement containing high levels of vitamins A, C and E and the mineral zinc reduced the risk of advanced dry AMD and its associated vision loss by about 25 percent. There are now a number of eye vitamins on the market that replicate or improve upon the AREDS vitamin formula.

Wet AMD. Neovascular (wet) macular degeneration is the more advanced and damaging stage of the disease. About 10 percent of dry AMD cases progress to wet macular degeneration. With wet AMD, new blood vessels grow beneath the retina and leak blood and fluid. This leakage causes permanent damage to light-sensitive cells in the retina, causing blind spots or a total loss of central vision. The abnormal blood vessel growth in wet AMD is the body’s misguided attempt to create a new network of blood vessels to supply more nutrients and oxygen to the macula. But the process instead creates scarring and central vision loss. Signs and symptoms of AMD Macular degeneration usually produces a slow, painless loss of vision.

Early signs of vision loss associated with AMD can include seeing shadowy areas in your central vision or experiencing unusually fuzzy or distorted vision. In rare cases, AMD may cause a sudden loss of central vision.Your eye doctor often can detect early signs of macular degeneration during a comprehensive eye exam before symptoms occur. What causes macular degeneration? Many forms of macular degeneration appear to be linked to aging and related deterioration of eye tissue crucial for good vision. Research also suggests a gene deficiency may be associated with almost half of all potentially blinding cases of macular degeneration.

Macular degeneration risk factors

Besides advancing age, risk factors for macular degeneration include smoking, obesity, high blood pressure and cardiovascular disease. Caucasians with light eye color appear to have a higher risk of AMD than others, and some researchers believe that over-exposure to sunlight over the course of a person’s lifetime also may be a contributing factor. A poor diet that is high in unhealthy fats also appears to be a risk factor, as is a family history of macular degeneration. How is macular degeneration treated? Currently there is no cure for macular degeneration, but some AMD treatments may delay its progression or even improve vision.

There are no FDA-approved treatments for dry AMD, although nutritional intervention may be valuable in preventing its progression to the more advanced, wet form. In particular, a diet high in omega-3 fatty acids found in salmon and other cold-water fish may reduce one’s risk of developing macular degeneration. For wet AMD, there are several FDA-approved drugs aimed at stopping abnormal blood vessel growth and vision loss from the disease. In some cases, laser treatment of the retina may be recommended. Ask your eye doctor for details about the latest treatment options for wet AMD.

Testing and low vision devices

Although much progress has been made recently in macular degeneration treatment research, complete recovery of vision lost to AMD probably is unlikely. Your eye doctor may ask you to check your vision regularly with an Amsler grid – a small chart of thin black lines arranged in a grid pattern. AMD causes the line on the grid to appear wavy, distorted or broken. Viewing the Amsler grid separately with each eye helps you monitor your vision loss. If you have already suffered vision loss from AMD, low vision devices including magnifiers —such as high magnification reading glasses and hand-held devices —and small, hand-held telescopes for distance viewing may help you achieve better vision than regular prescription eyewear.

Astigmatism & the Eyes

Astigmatism is a very common and often misunderstood condition. Like nearsightedness and farsightedness, astigmatism is a refractive error, not an eye disease, and it is easily treated with eyeglasses or contact lenses. What causes astigmatism? Astigmatism usually is due to unequal curves of the cornea, the clear front surface of the eye. In astigmatism, the cornea isn’t perfectly round, but instead is more football- or egg-shaped. In some cases, astigmatism is caused by unequal curves in the lens inside the eye, which is located directly behind the pupil. In both types of astigmatism, the unequal curves of the cornea and/or lens prevent light from being focused to a clear, single image on the retina of the eye. Signs and symptoms of astigmatism In addition to blurred vision, common signs and symptoms of astigmatism include headaches, fatigue and eyestrain. Astigmatism is common and usually develops in childhood. A study at the Ohio State University School of Optometry found that more than 28 percent of schoolchildren have astigmatism. Because astigmatism can cause headaches and eyestrain during reading, children with uncorrected astigmatism sometimes avoid reading or have a short attention span when reading, which can affect their school performance. How is astigmatism treated? In most cases, astigmatism is treated with full-time wear of glasses or contact lenses. Rigid gas permeable (RGP or GP) contact lenses often provide the best correction for astigmatism. But special soft contact lenses for astigmatism, called toric contact lenses, also are available. Hybrid contact lenses — contacts with a GP optical center surrounded by a skirt of soft lens material for greater wearing comfort — are another option for astigmatism correction. LASIK and other types of refractive surgery also can be performed to correct astigmatism.

Blepharitis & the Eyes

Blepharitis is inflammation of the eyelids, characterized by red, itchy eyelids and the formation of dandruff-like scales at the base of the lashes. It is a common disorder and affects people of all ages. Blepharitis is not contagious and generally does not cause permanent vision problems. There are two forms of blepharitis: anterior blepharitis and posterior blepharitis. Anterior blepharitis affects the front of the eyelids, usually near the eyelashes. The two most common causes of anterior blepharitis are bacteria and a skin disorder called seborrheic dermatitis, which causes itchy, flaky red skin. Posterior blepharitis affects the inner surface and edge of the eyelid that comes in contact with the eye. It usually is caused by problems with the oil (meibomian) glands in the lid margin, leading to excessive bacterial growth. Posterior blepharitis also can be associated with acne rosacea and dandruff of the scalp. Blepharitis signs and symptoms Signs and symptoms of blepharitis include eye irritation; redness at the eyelid margins; burning; tearing; foreign body sensation (feeling something is “in” your eye); dry eyes; and the formation of crusty debris on your eyelashes, in the corner of your eyes or on your eyelids. If you have any signs or symptoms of blepharitis, see your eye doctor for an exam and possible treatment. Left untreated, blepharitis can lead to unsightly and uncomfortable styes, eye infections and even corneal ulcers. Blepharitis treatments The treatment your eye doctor prescribes will depend on the type of blepharitis you have. Blepharitis treatment may include simple measures such as applying warm compresses to your eyelids, cleaning your eyelids more frequently, and massaging your lids to help express oil from the meibomian glands. If blepharitis makes your eyes feel dry, artificial tears or lubricating ointments also may be recommended. In some cases, anti-bacterial or steroid eye drops or ointments may be prescribed. When treating blepharitis, always wash your hands before and after touching your eyelids. Your eye doctor will provide instructions on the products and techniques to use to relieve symptoms and get your blepharitis under control. Some research suggests nutritional supplements such as fish oil and flaxseed oil that contain omega-3 fatty acids may help prevent or reduce the severity of posterior blepharitis. Be sure to discuss any supplement use with your doctor. Blepharitis typically is a chronic condition, and diligent daily eyelid hygiene may be needed to prevent reoccurrences. If you normally wear contact lenses, you may need to discontinue wearing them until all signs and symptoms of blepharitis have been eliminated. Sometimes, changing from soft contact lenses to rigid gas permeable (GP) contacts can be helpful, since GP lenses are less likely to accumulate bacteria-containing deposits that can cause blepharitis. Other blepharitis prevention measures include replacing soft contact lenses more frequently or changing to one-day disposable contacts.

Cataracts &The Eyes

A cataract is a clouding of the natural lens inside the eye. The lens and cornea (the clear front surface of the eye) work together to focus light onto the retina at the back of the eye. The lens also acts much like a camera lens to adjust the eye’s focus and enable clear vision both up close and far away. The lens is made mostly of water and protein. The protein is arranged in a precise way that keeps the lens clear and allows light to pass through it. As we age, some of the protein may clump together and start to cloud a small area of the lens. This is a cataract, and over time, it may grow larger and cloud more of the lens, making it harder to see. Cataract signs and symptoms A cataract starts out small, and at first has little effect on your vision. You may notice that your vision is blurred a little, like looking through smudged eyeglass lenses.

However, as cataracts worsen, you are likely to notice some or all of these problems:

Blurred vision that cannot be corrected with a change in your glasses prescription.

Colors appear faded and less vibrant.

Ghost images or double vision in one or both eyes.

Glare from sunlight and artificial light, including headlights when driving at night.

What causes cataracts?

The exact cause of cataracts is unknown. Most cataracts occur gradually as we age and don’t become bothersome until after age 55. However, cataracts also can be present at birth (congenital cataracts) or occur at any age as the result of an injury to the eye (traumatic cataracts). Diseases such as diabetes and long-term use of certain medications such as steroids and some antidepressants also can cause cataracts. Some studies suggest that excessive exposure to ultraviolet (UV) light is associated with cataract development; so many eye care practitioners recommend wearing sunglasses and a wide-brimmed hat to lessen your exposure. Other risk factors for cataracts include smoking, exposure to air pollution and excessive alcohol consumption.

Cataract treatment

When symptoms of cataracts begin to appear, you may be able to improve your vision for a while with new glasses or stronger bifocals, and using more light when reading. But when these remedies fail to provide enough benefit, it’s time for cataract surgery. Cataract surgery is the most frequently performed surgery in the United States, with nearly 3 million cataract surgeries done each year. More than 90% of people who have cataract surgery regain very good vision, somewhere between 20/20 and 20/40, and sight-threatening complications are relatively rare. During surgery, the surgeon will remove your clouded lens and replace it with a clear, plastic intraocular lens (IOL). New IOLs are being developed all the time to make the surgery less complicated for surgeons and the lenses more helpful to patients. Presbyopia-correcting IOLs not only improve your distance vision, but can decrease your reliance on reading glasses as well. If you need cataracts removed from both eyes, surgery usually will be done on only one eye at a time. An uncomplicated surgical procedure lasts only about 10 minutes. However, you may be in the outpatient facility for 90 minutes or longer because extra time will be needed for preparation and recovery.

Cataract prevention

Diet may play a key role in cataract prevention. Though no clear cause-and-effect relationship between diet and cataracts has been proven, some studies have found eating a healthy diet rich in antioxidants and certain vitamins is associated with a reduced risk of cataracts or their progression. Other research shows diets high in carbohydrates or salt may increase cataract risk. Potentially helpful nutrients and vitamins to reduce your risk of cataracts include omega-3 fatty acids and antioxidant vitamins (such as vitamins A, C and E) found in colorful fruits and vegetables. Lutein, zeaxanthin and other plant pigments with antioxidant properties also may be helpful.

CVS & the Eyes

Computer vision syndrome (CVS) is a group of temporary physical and visual symptoms that many people experience after prolonged computer use. Eye-related symptoms of CVS include eye strain, blurred vision, double vision, focusing problems, eye twitching and dry, irritated eyes. Other physical symptoms include headache, neck strain and backache. These symptoms may occur after a full day of computer use or in as little time as an hour or two of concentrated computer work. According to the American Optometric Association (AOA), 50 to 90 percent of computer workers experience some degree of computer vision syndrome, and each year 10 million Americans have eye exams because of CVS symptoms. Computer vision syndrome symptoms can occur among all computer users, including children, students, office workers and retired seniors.

The ergonomics behind CVS Computer use is much more likely to cause eye strain, fatigue and other symptoms associated with CVS than reading, sewing and other near vision tasks. This is because it is more visually demanding to focus for long periods of time on images created by illuminated pixels on a computer screen than focusing on static, non-illuminated images, such as the print on pages of a book. Ergonomic factors —how you interact with your computer at your desk or workstation — also play a role. The position of your computer screen may force you to adopt unnatural postures that can cause muscle strain and fatigue, especially in the neck and shoulders. Also, your seating and the position of your arms and hands at your keyboard may cause backaches and other physical discomfort that contribute to computer vision syndrome.

Also, studies have shown that people tend to blink far less frequently when working at a computer. This can cause dry eye problems, including blurred vision and red, irritated eyes after prolonged computer use. Improper lighting and dry, stale air also can contribute to CVS symptoms. Reducing your risk of computer vision problems One of the best things you can do to reduce your risk of computer vision syndrome is to take frequent breaks from your computer. Some eye care professionals recommend the “20-20-20 rule” when working at a computer: every 20 minutes, look away from your computer screen and look at an object that is at least 20 feet away for at least 20 seconds. This simple measure relaxes the focusing muscle inside the eye, reducing the risk of eyestrain and eye fatigue. It also relaxes the muscles responsible for keeping your eyes in a converged position for near work, which can become fatigued during computer use.

When taking these breaks, stand up and stretch to relieve muscle tension in your back and shoulders, and blink fully and frequently to remoisten your eyes. Keep a bottle of artificial tears handy and use lubricating eye drops whenever your eyes feel tired or dry during or after computer work. Have a ‘computer vision’ eye exam If you work at a computer, it’s essential to have routine eye exams to make sure your eyes are functioning properly and your eyeglasses or contact lens prescription is up-to-date and accurate. In addition to making sure any refractive error (nearsightedness, farsightedness and/or astigmatism) is fully corrected, your eye doctor can perform special tests to evaluate visual skills required for comfortable computer use.

If problems in these areas are found, vision therapy or other eye exercises may be recommended to make your eyes more comfortable. Your eye doctor also may recommend wearing eyeglasses rather than contact lenses during computer work or switching to a different brand of contacts if your lenses are drying out. In some cases, special computer eyeglasses may be recommended. These glasses are designed to reduce focusing fatigue and help your eyes maintain comfortable alignment during computer use to decrease your risk of computer vision problems. Computer eyewear can be especially helpful if you are over age 40 and currently wear bifocals or progressive lenses. Special multifocal lens designs for computer use can help you maintain better posture when working at a computer. Computer glasses also can widen your field of view and eliminate the need to tilt your head back to comfortably see your computer screen.

Diabetes & the Eyes

Diabetic retinopathy is damage to the light-sensitive retina at the back of the eye due to Type 1 or Type 2 diabetes. It is the leading cause of blindness among Americans under the age of 65. Currently more than 5 million Americans age 40 and older have diabetic retinopathy, and that number will grow to about 16 million by 2050, according to the U.S. Centers for Disease Control (CDC) and other researchers. Complications of diabetic retinopathy include retinal detachment and glaucoma. Signs and symptoms of diabetic retinopathy

Signs and symptoms of diabetic retinopathy include:

Fluctuating, blurry and/or distorted vision

Eye floaters and spots

Development of shadows or blind spots in your field of view

Double vision

Near vision problems unrelated to presbyopia

If you experience any of these symptoms, see your eye doctor immediately. If you are diabetic, you should see your eye doctor at least once a year for a dilated eye exam, even if you have no visual symptoms. If your eye doctor suspects diabetic retinopathy, a special test called fluorescein angiography may be performed. In this test, dye is injected into the body and then gradually appears within the retina due to blood flow. Your eyecare practitioner will photograph the retina as the dye passes through the blood vessels in the retina. Evaluating these pictures tells your doctor or a retina specialist if signs of diabetic retinopathy exist, and how far the disease has progressed.

What causes diabetic retinopathy?

Diabetes damages delicate blood vessels in the retina, causing them to bleed or leak fluid. It also can cause swelling of the retina, leading to blurred and distorted vision. These early changes are called non-proliferative diabetic retinopathy (NPDR). In the advanced stage of the disease, called proliferative diabetic retinopathy (PDR), new blood vessels grow on the surface of the retina. These abnormal blood vessels can lead to serious vision problems because they can break and bleed into the interior of the eye. PDR is much more serious than non-proliferative diabetic retinopathy and can lead to blindness. The risk of both forms of diabetic retinopathy increase the longer you have diabetes. According to the American Academy of Ophthalmology, all diabetics who have the disease long enough eventually will develop at least some degree of diabetic retinopathy, though less advanced forms of the eye disease may not lead to vision loss. As soon as you’ve been diagnosed with diabetes, you need to have a dilated eye exam at least once a year.

How is diabetic retinopathy treated?

In most cases, significant vision loss from diabetic retinopathy can be avoided if treated in time. Diabetic retinopathy can be treated with a laser to seal off leaking blood vessels and inhibit the growth of new vessels. Called laser photocoagulation, this treatment is painless and takes only a few minutes. In severe cases of diabetic retinopathy where blood has leaked into the interior of the eye and is obscuring vision, a surgical procedure called a vitrectomy may be performed to remove the blood from the eye. Recent research shows that certain medications injected directly into the eye may be able to slow or prevent vision loss from diabetic retinopathy. These medicines, called anti-VEGF drugs, are designed to stop or reduce the formation of abnormal retinal blood vessels and prevent or reduce swelling of the retina. Prevention of diabetic retinopathy You can significantly reduce your risk of diabetic retinopathy by using common sense and taking good care of yourself:

Maintain a healthy diet.

Exercise regularly.

Have routine physical exams and eye exams.

If you have diabetes, monitor your blood sugar regularly and keep it under control.

Following these simple guidelines can prevent many cases of Type 2 diabetes and diabetic retinopathy.

Dry Eyes

Dry eye syndrome (or “dry eye”) is the chronic lack of sufficient lubrication and moisture on the surface of the eye, causing discomfort, contact lens intolerance and increased risk of eye infections. Dry eye is common, with some studies reporting that 10 to 20 million Americans experience some degree of dry eye syndrome. Common risk factors for dry eye include increasing age, a dry environment and use of certain medications.

Signs and symptoms of dry eye:

Red, irritated eyes

A burning or scratchy sensation

Feeling something is “in” your eye (called a foreign body sensation)

Fluctuating or blurred vision

Eye pain

Contact lens discomfort

It may seem odd, but another symptom of dry eye syndrome is a watery eye. This is because, as a reaction to dry eye irritation, the tear glands sometimes secrete very watery tears as a protective mechanism to prevent eye damage from a dry eye condition.

What causes dry eyes?

Dry eye is caused by the tear glands failing to secrete an adequate amount of tears or producing a tear film that, because of insufficient oiliness, evaporates too quickly. These problems can be due to aging or a side effect of many medications, such as antihistamines, antidepressants, certain blood pressure medicines and birth control pills.

Dry eye can also be caused by chronic exposure to a dry, dusty or windy climate with low humidity. Air conditioning and forced air heating systems at home and at work also can dry out your eyes. Another cause is failing to blink your eyes normally to remoisten them. This frequently occurs during computer work. Dry eye syndrome also is associated with certain systemic diseases such as lupus, rheumatoid arthritis, rosacea and Sjogren’s syndrome. 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 also has been associated with incomplete lid closure following blepharoplasty — a popular cosmetic surgery to eliminate droopy eyelids.

Treatment for dry eye

For mild dry eye, your eye doctor might recommend artificial tears, which are lubricating eye drops that are designed to alleviate the dry, scratching feeling and foreign body sensation of dry eye. Prescription eye drops for dry eye go one step further: they help increase your tear production. If you wear contact lenses, be aware that some artificial tears and lubricating eye drops cannot be used during contact lens wear. You may need to remove your lenses before using the drops and wait 15 minutes or longer (check the label) before reinserting them. Use only the brand of artificial tears your eye doctor recommends. Avoid self-medicating a dry eye condition by choosing artificial tears randomly in a drug store. Some products might actually make your symptoms worse. To reduce the effects of sun, wind and dust on dry eyes, wear sunglasses when outdoors. Close-fitting 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 might recommend ehese tiny devices are inserted in the tear drainage ducts in your eyelids to slow the drainage of tears away from your eyes, thereby keeping your eyes more moist. 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. Also, be aware that dry eye is a common side effect of LASIK eye surgery, especially if you have any signs or symptoms of dry eyes prior to surgery.

Glaucoma &The Eyes

Glaucoma refers to a group of related eye diseases that cause damage to the optic nerve that transmits visual information from the eye to the brain. Glaucoma usually, but not always, is associated with increased pressure inside the eye (called intraocular pressure, or IOP). Glaucoma typically affects your peripheral vision first. There typically is little or no discomfort with the onset of glaucoma, and you can lose a great deal of your vision from the disease before you are aware anything is happening. If uncontrolled or left untreated, glaucoma can eventually lead to blindness. Glaucoma currently is the second leading cause of blindness in the United States, with an estimated 2.5 million Americans being affected by the disease. Due to the aging of the U.S. population, it’s expected that more than 3 million Americans will have glaucoma by the year 2020.

Signs and symptoms of glaucoma:

Glaucoma sometimes is called the “silent thief of sight,” because most types typically cause no pain and produce no symptoms. For this reason, glaucoma often progresses undetected until the optic nerve already has been irreversibly damaged, with varying degrees of permanent vision loss. But one type of glaucoma — acute angle-closure glaucoma — has a sudden onset and can be accompanied by symptoms of intense eye pain, nausea, and vomiting. If you have these symptoms, make sure you immediately see an eye care practitioner or visit the emergency room so steps can be taken to prevent permanent vision loss.

What causes glaucoma?

The cause of glaucoma generally is a failure of the eye to maintain an appropriate balance between the amount of fluid produced inside the eye and the amount that drains away. The reason for this imbalance varies, depending on the type of glaucoma you have. The eye needs internal fluid pressure to retain its globe-like shape and ability to see. When glaucoma damages the ability of internal eye structures to properly regulate IOP, eye pressure can rise to dangerously high levels and cause permanent vision loss.

Types of glaucoma

The two major types of glaucoma are primary open-angle glaucoma (POAG) and acute angle-closure glaucoma. The “angle” refers to the structure inside the eye that is responsible for the normal drainage if intraocular fluid, which is located near the junction between the iris and the front surface of the eye near the periphery of the cornea.

Primary open-angle glaucoma (POAG):

About half of Americans with POAG (also called chronic glaucoma) don’t know they have it. POAG gradually and painlessly reduces your peripheral vision. Often by the time you notice it, permanent vision loss already has occurred. If your IOP remains high, the destruction can progress until tunnel vision develops, and you will be able to see only objects that are straight ahead.

Acute angle-closure glaucoma:

Angle-closure or narrow-angle glaucoma produces sudden symptoms such as eye pain, headaches, halos around lights, dilated pupils, vision loss, red eyes, nausea and vomiting. These signs may last for a few hours, and then return again for another round. Each attack takes with it part of your field of vision.

Normal-tension glaucoma:

Like POAG, normal-tension glaucoma (also called normal-pressure glaucoma, low-tension glaucoma, or low-pressure glaucoma) is an open-angle type of glaucoma with little or no discomfort. In normal-tension glaucoma, the eye’s IOP remains in the normal range and damage to the optic nerve may not be detected until significant loss of peripheral vision has occurred. The cause of normal-tension glaucoma is unknown, but some experts believe it is related to poor blood flow to the optic nerve. Risk factors for normal-tension glaucoma include being of Japanese descent, female gender and a history of vascular disease.

Congenital glaucoma:

This inherited form of glaucoma is present at birth, with 80 percent of cases diagnosed in the first year of life. Infants with congenital glaucoma are born with narrow angles or some other defect in the fluid drainage system of the eye. Symptoms include a cloudy, hazy or protruding eye. Congenital glaucoma typically occurs more in boys than in girls. Pigmentary glaucoma: This rare form of glaucoma is caused by pigment from the iris floating freely in the anterior chamber of the eye and eventually clogging the drainage angle, preventing intraocular fluid from leaving the eye. Over time, an inflammatory response to the blocked angle damages the drainage system. Typically there are no early symptoms of pigmentary glaucoma, though some pain and blurry vision may occur after exercise or other physical exertion. This type of glaucoma most frequently affects white males in their mid-30s to mid-40s.

Secondary glaucoma:

This is the term used to describe chronic glaucoma that develops after an eye injury, infection or inflammation, or is caused by some other abnormality such as a tumor in the eye or an enlarged cataract.

How is glaucoma detected?

Routine eye exams are required for the diagnosis and management of glaucoma. The “glaucoma test” during an eye exam actually is just a simple procedure called tonometry that measures your intraocular pressure. Two common methods to measure IOP are Goldmannapplanation tonometry (GAT) and a non-contact tonometry (NCT). For GAT, numbing eye drops are used and a small probe gently rests against your eye’s surface. Because of its direct contact with the eye, Goldmannapplanation tonometry generally is considered the “gold standard” for IOP measurement. With non-contact tonometry, nothing touches your eye but a puff of air.

Many studies have shown NCT measurements are comparable to GAT measurements, without the need for numbing eye drops and touching the eye’s surface. An abnormally high IOP reading indicates a problem with the amount of fluid inside the eye. Either the eye is producing too much fluid, or it’s not draining properly. Additional tests used for the diagnosis and management of glaucoma include retinal photography other imaging techniques such as optical coherence tomography (OCT) to monitor the health and stability of the head of the optic nerve that is visible inside the eye.

Visual field testing also is essential to monitor whether blind spots are developing in your field of vision from glaucoma damage to the optic nerve. Visual field testing involves staring straight ahead into a machine and clicking a button when you notice a blinking light in your peripheral vision. This testing typically is repeated at regular intervals so your eye doctor can determine if there is progressive vision loss from glaucoma. Your eye doctor may also visually inspect the drainage angle of the eye using special lenses that enable him or her to see the angle from different vantage points. This is called gonioscopy.

Glaucoma treatments

Depending on the severity of the disease, treatment for glaucoma can involve the use of topical and oral medicine, conventional (bladed) surgery, laser surgery or a combination of these treatments. Medicated eye drops aimed at lowering IOP usually are tried first to control glaucoma. Since there typically is no eye pain associated with glaucoma, people sometimes become careless about using their glaucoma medicines as directed by their eye doctor. In fact, non-compliance with a program of prescribed glaucoma medication is a major reason for blindness resulting from glaucoma. If you find that the eye drops you are using for glaucoma are uncomfortable or inconvenient, never discontinue them without first consulting your eye doctor about a possible alternative therapy. Glaucoma surgery procedures (whether laser or non-laser) are designed to decrease the production of intraocular fluid or increase the outflow (drainage) of this same fluid. Occasionally, a procedure will accomplish both. Currently the goal of glaucoma surgery and other glaucoma therapy is to reduce or stabilize intraocular pressure (IOP). When this goal is accomplished, progressive damage to the optic nerve and vision loss often can be prevented or halted.

Early detection is key

Early diagnosis and treatment is the best way to prevent vision loss from glaucoma. See your eye doctor routinely for comprehensive eye exams that include a check of your IOP. People at high risk for glaucoma due to elevated intraocular pressure, a family history of glaucoma, advanced age or an unusual optic nerve appearance may need more frequent exams.

Hyperopia &The Eyes

Hyperopia, or farsightedness, is a common refractive error of the eye that makes it difficult to focus on near objects. Distance vision may or may not be affected, depending on the degree of hyperopia present. Approximately 25 percent of the U.S. population is farsighted, according to several studies. Hyperopia frequently is confused with presbyopia, which is an age-related eye change that affects near vision. Farsightedness, on the other hand, typically occurs early in life.

What causes hyperopia?

Hyperopia is caused by the eyeball being too short, the cornea (the clear front surface of the eye) or the lens inside the eye being too flat, or a combination of these factors. The result is that the optical elements of the farsighted eye are not powerful enough to bring light to a clear focus on the retina. Light is focused behind the retina, rather than directly on it. A person with mild hyperopia sometimes can maintain clear reading vision without glasses by using additional focusing effort. But often this leads to headaches, eye strain and blurred vision from focusing fatigue. Some children are born with hyperopia and “outgrow” it as the eyeball lengthens with normal growth. Other farsighted individuals remain farsighted throughout life.

Signs and symptoms of hyperopia

Signs and symptoms of uncorrected farsightedness typically are more severe when a farsighted person is reading, using a computer or doing other near work. These signs and symptoms include:

> Squinting

> Eye strain

> Tired eyes or general fatigue

> Headache

> Fluctuating or blurred vision

If you get these symptoms while wearing your glasses or contact lenses, you may need an eye exam and a new prescription. Hyperopia treatment Eyeglasses and contact lenses can correct farsightedness by converging light rays so they come to a proper focus on the retina. Lenses that correct hyperopia are thicker in the center than at the edge and are called “plus” lenses.

If the lens power designated on your glasses or contact lens prescription begins with a plus sign, like +2.50, you are farsighted. Depending on the amount of farsightedness you have, you may need to wear glasses or contacts all the time, or you might only need glasses part-time for reading, working on a computer or doing other close-up work. Refractive surgery, such as LASIK or PRK, is another option for correcting hyperopia.

Keratoconus &The Eyes

Keratoconus is a progressive eye disease in which degenerative changes occur in the clear front surface of the eye (cornea), causing it to bulge outward in an irregular, cone-like shape, causing distorted vision that cannot be corrected with glasses or soft contact lenses. It can occur in one or both eyes. Keratoconus is relatively rare. Most studies indicate it occurs in less than 0.6 percent of the U.S. population. Onset of the disease usually occurs in people in their teens or early twenties.

What causes keratoconus?

Research suggests the weakening of the corneal tissue that leads to keratoconus may be due to an imbalance of enzymes within the cornea. This imbalance makes the cornea more susceptible to oxidation from compounds called free radicals, which causes it to weaken and bulge forward. Risk factors for oxidative damage and weakening of the cornea include a genetic predisposition, explaining why keratoconus often affects more than one member of the same family. Keratoconus also is associated with overexposure to ultraviolet rays from the sun, excessive eye rubbing, a history of poorly fit contact lenses and chronic eye irritation.

Signs and symptoms of keratoconus

Keratoconus usually appears in a person’s late teens or early twenties, and its onset can be slow and gradual or relatively rapid. As the cornea becomes more irregular in shape, it causes a progressive increase in nearsightedness and irregular astigmatism, creating problems with distorted and blurred vision. Other symptoms include glare and light sensitivity and frequent eyeglass prescription changes.

Keratoconus treatment

In very early and mild keratoconus, vision with eyeglasses or soft contact lenses may remain acceptable. But as the disease progresses and the cornea thins and becomes increasingly more irregular in shape, glasses or soft contacts no longer provide adequate vision correction. Treatments for moderate and advanced keratoconus include:

Gas permeable contact lenses: Because they are rigid, gas permeable (GP) contacts replace the irregular shape of the central cornea of a keratoconic eye with a smooth, uniform refracting surface for better vision correction. In some cases, large-diameter GP lenses called scleral contact lenses may be used to vault over the entire corneal surface to correct vision problems caused by keratoconus.

“Piggybacking” contact lenses: Because fitting a gas permeable contact lens over a cone-shaped cornea can sometimes be uncomfortable for the individual with keratoconus, some eye care practitioners advocate fitting the eye with a soft contact lens, and then fitting a GP contact lens over the soft lens. With this “piggybacking” technique, the underlying soft lens acts as a cushion between the GP lens and the corneal surface for greater comfort.

Hybrid contact lenses: Hybrid contact lenses are premium contacts that have a GP optical center, surrounded by a “skirt” of soft lens material. These lenses are designed to provide the optical clarity of a gas permeable contact lens, combined with wearing comfort comparable to soft contact lenses. Special hybrid lens designs are available for the correction of keratoconus. Intacs: These tiny plastic inserts are surgically placed just under the eye’s surface in the periphery of the cornea, and help re-shape the cornea for clearer vision. Intacs may be needed when keratoconus patients no longer can obtain functional vision with contact lenses or eyeglasses.

CXL: Corneal collagen cross-linking (CXL) is a relatively new procedure that strengthens bonds between connective tissue (collagen) fibers within the cornea to halt the progression of keratoconus. The surface layer of the cornea (epithelium) is gently removed and the underlying corneal tissue is treated with eye drops of riboflavin (vitamin B2) and then exposed to ultraviolet light for several minutes. Within a few days of the brief in-office treatment, the epithelial layer grows back. Early results of CXL research show the procedure can successfully stop the progression of keratoconus, and some patients experience reversal of the condition and vision improvement.

Corneal transplant: In advanced cases of keratoconus that cannot be successfully treated by other means, the last remedy is a cornea transplant, also called a penetrating keratoplasty (PK or PKP). Even after a successful cornea transplant, most keratoconic patients still need glasses or contact lenses for clear vision.

Source: Keratoconus Causes, Symptoms and Treatment by AllAboutVision.com. Article ©2011 Access Media Group LLC. All rights reserved. Reproduction other than for one-time personal use is strictly prohibited.

Myopia &The Eyes

Myopia, or nearsightedness, is a very common vision problem and it’s become more prevalent in recent years. In fact, a recent study found that myopia now affects roughly 42 percent of the U.S. population, up from 25 percent three decades ago.*

Signs and symptoms of myopia

Nearsighted people have difficulty reading road signs and seeing distant objects clearly, but can see well for up-close tasks such as reading and computer use. Other signs and symptoms of myopia include headaches or eyestrain, squinting and feeling fatigued when driving or playing sports.

If you experience these symptoms while wearing your glasses or contact lenses, you may need a stronger prescription.

What causes myopia?

Myopia occurs when the eyeball is slightly longer than usual from front to back. This causes light rays to focus at a point in front of the retina, rather than directly on its surface. Nearsightedness also can be caused by the clear front surface of the eye (cornea) or the lens inside the eye being too curved for an eyeball of normal length. Nearsightedness runs in families and usually appears in childhood. This vision problem may stabilize at a certain point, although sometimes it worsens with age.

Myopia treatment

Depending on the degree of your nearsightedness, you may need to wear eyeglasses or contact lenses all the time, or only when you need sharper distance vision, like when driving, viewing a chalkboard or watching a movie. If your glasses or contact lens prescription begins with minus numbers, like -2.50, you are nearsighted. Refractive surgery options for myopia correction include laser procedures such as LASIK and PRK, and non-laser procedures such as corneal inserts and implantable lenses.

One advantage of the non-laser options is that, although they’re intended to be permanent, they may be removed in case of a problem or change of prescription. For patients who prefer non-surgical correction of myopia, there is orthokeratology. Also called “ortho-k,” this is the fitting of special rigid gas permeable (GP) contact lenses for overnight wear that reshape the cornea to temporarily correct your myopia.

When the GP lenses are removed in the morning, the cornea temporarily retains a new, flatter shape, so you can see clearly without glasses or contacts during the day.

If you think you might be interested in ortho-k (or a related specialty contact lens procedure called Corneal Refractive Therapy, or CRT), ask your eye doctor about these lenses.

*Increased prevalence of myopia in the United States between 1971-1972 and 1999-2004. Archives of Ophthalmology. December 2009.

Ocular Hypertension &The Eyes

Ocular hypertension is elevated intraocular pressure (IOP), which means the pressure inside your eye is higher than normal. High eye pressure also is associated with glaucoma, which is a more serious condition characterized by optic nerve damage and vision loss.

Though ocular hypertension can lead to glaucoma, it also is possible that you can have ocular hypertension that doesn’t damage your vision or eyes. Studies suggest that 2 to 3 percent of the general population may have ocular hypertension.

Signs and symptoms of ocular hypertension

You can’t tell by yourself that you have ocular hypertension, because there are no outward signs or symptoms such as pain or redness. At each eye exam, your eye care practitioner will measure your IOP and compare it to normal levels. The instrument used to measure eye pressure is called a tonometer. Your eye typically is numbed with eye drops, and a small probe gently rests against your eye’s surface. Other tonometers direct a puff of air onto your eye’s surface to indirectly measure IOP.

What causes ocular hypertension?

Anyone can develop ocular hypertension, but it’s most common in African-Americans, people over age 40, those with family history of ocular hypertension or glaucoma, and those with diabetes or high amounts of nearsightedness. High eye pressure can be caused by the body producing too much clear fluid (aqueous) in the eye or inadequate drainage of aqueous from the eye. Certain medications, such as steroids, and trauma can cause higher-than-normal IOP measurements as well.

Treatment of ocular hypertension

People with ocular hypertension are at increased risk for developing glaucoma, so some eye doctors prescribe medicated eye drops to lower IOP in cases of ocular hypertension. Because these medications can be expensive and may have side effects, other eye doctors choose to monitor your IOP and only take action if you show signs of developing glaucoma.

To prevent vision loss from ocular hypertension, be sure to have your IOP measured at the intervals recommended by your eye doctor.

Pink Eye &The Eyes

Pink eye is an acute, contagious form of conjunctivitis – inflammation of the clear mucous membrane that lines the inner surface of the eyelids and overlies the “white” of the eye (sclera). The underlying cause of most cases of pink eye is a bacterial or viral infection.

The term “pink eye” often is used to refer to any or all types of conjunctivitis, not just the acute, contagious form. Pink eye signs and symptoms The hallmark sign of pink eye is a pink or reddish appearance of the eye due to inflammation and dilation of conjunctival blood vessels. Depending on the type of conjunctivitis, other signs and symptoms may include a yellow or green mucous discharge, watery eyes, itchy eyes, sensitivity to light and pain.

Signs and symptoms of pink eye can vary, depending on the underlying cause:

Viral conjunctivitis: usually causes excessive eye watering and a light discharge.

Bacterial conjunctivitis: often causes a thick, sticky discharge that typically is yellow or green in color.

Allergic conjunctivitis: affects both eyes and causes itching, redness, watery eyes and a runny nose.

Giant papillary conjunctivitis (GPC): usually affects both eyes and causes contact lens intolerance, itching, a thick discharge, tearing and red bumps on the underside of the eyelids.

To pinpoint the cause and then choose an appropriate treatment, your eye doctor will ask some questions, examine your eyes and possibly collect a sample on a swab to send out for analysis.

Causes of pink eye

Though pink eye can affect people of any age, it is especially common among preschoolers and school children because of the amount of bacteria transferred among children. Conjunctivitis also may be triggered by a virus, an allergic reaction (to dust, pollen, smoke, fumes or chemicals) or, in the case of giant papillary conjunctivitis, a foreign body on the eye, typically a dirty contact lens. Bacterial and viral infections elsewhere in the body also can induce conjunctivitis.

Treatment of pink eye

Avoidance. Your first line of defense is to avoid the cause of conjunctivitis, such as contaminated hand towels. Both viral and bacterial conjunctivitis, which can be caused by airborne sources, spread easily to others. To avoid allergic conjunctivitis, keep windows and doors closed on days when the airborne pollen count is high. Use high efficiency furnace filters to reduce airborne allergens inside your home.

Stay in well-ventilated areas if you’re exposed to smoke, chemicals or fumes. If you do experience exposure to these substances, applying a cold compress over your closed eyes can be very soothing.

If you’ve developed giant papillary conjunctivitis, odds are that you’re a contact lens wearer. You may need to stop wearing contacts for a period of time to allow the GPC to resolve during treatment. Your eye doctor also might recommend that you switch to a different type of contact lens, to reduce the chance of the conjunctivitis coming back.

Medication. Often viral conjunctivitis will clear up on its own within a few days without the need for medical treatment. Your eye doctor might prescribe an astringent to keep your eyes clean, or an antibiotic eye drop to prevent a bacterial infection from starting. Artificial tears also may be recommended to relieve dryness and discomfort.

Antibiotic eyedrops or ointments will alleviate most forms of bacterial conjunctivitis, while antibiotic tablets are used for certain infections that originate elsewhere in the body.

Antihistamine allergy pills or eyedrops will help control allergic conjunctivitis symptoms. In addition, artificial tears provide comfort and are helpful to dilute or rinse away irritating allergens in the tear film. For giant papillary conjunctivitis, your doctor may prescribe eye drops to reduce inflammation and itching.

Usually conjunctivitis is caused by a minor eye infection. But sometimes it can develop into a more serious condition. See your eye doctor for a diagnosis before using any eye drops in your medicine cabinet that were prescribed for previous infections or eye problems.

Prevention tips

Because young children often are in close contact in day care centers and school classrooms, it can be difficult to avoid the spread of bacteria that causes pink eye. However, these tips can help you reduce the possibility of your child contracting a case of pink eye:

Encourage your child to wash his or hands frequently at home and school
Avoid sharing hand towels and/or wash them frequently
Encourage your child to use tissues and cover his or her mouth and nose when coughing or sneezing
Discourage eye rubbing and touching, to avoid spread of bacteria and viruses
Use antiseptic and/or antibacterial solutions to clean and wipe toys, counter tops, telephones, computer keyboards, television remote controls and other items your children touch frequently.

If your child is diagnosed with pink eye, remove him or her from school (and other crowded environments) for a few days to reduce the risk of spreading conjunctivitis to others.

Presbyopia &The Eyes

Presbyopia is the normal, age-related loss of ability to focus on near objects without reading glasses or bifocals. There’s no getting around it — presbyopia happens to everyone at some point in middle age, even if you’ve never needed glasses before.

Currently an estimated 90 million people in the United States either have presbyopia or will develop it by 2014. Though presbyopia can be frustrating, it is easily corrected with multifocal eyeglasses, contact lenses or vision correction surgery.

Presbyopia signs and symptoms

With the onset of presbyopia, you’ll find you need to hold books, magazines, newspapers, menus and other reading materials farther away in order to see the print clearly. Other symptoms include headaches and eyestrain when reading or performing other near work for prolonged periods after age 40.

What causes presbyopia?

Presbyopia is caused by a hardening of the lens inside the eye. When the lens becomes less elastic, the eye has a harder time focusing up close.

Eyeglasses and contact lenses for presbyopia

Eyeglasses with bifocal or progressive addition lenses (PALs) are the most common correction for presbyopia. “Bifocal” means two points of focus: the main part of the eyeglass lens contains a prescription for nearsightedness, farsightedness and/or astigmatism, while the lower portion of the lens holds the stronger near prescription for close work. Progressive addition lenses are multifocal lenses that contain a number of lens powers for different viewing distances, with no visible lines in the lens.

Reading glasses are another choice. Unlike bifocals and PALs, which most people wear all day, reading glasses are typically worn just during close work. If you wear contact lenses, your eye doctor can prescribe reading glasses that you can wear over your contacts for near vision tasks. Non-prescription “readers” are available at retail stores for the same purpose. Bifocal and multifocal contact lenses are another option for presbyopia correction. Like multifocal eyeglass lenses, these contacts contain two or more lens powers for seeing clearly at multiple distances. Bifocal and multifocal contacts are available both in soft and rigid gas permeable (RGP or GP) lens materials. One U.S. lens manufacturer also makes a multifocal hybrid contact lens that has a GP central optic zone surrounded by a “skirt” of soft lens material.

Another type of contact lens correction for presbyopia is monovision, in which one eye is prescribed a lens power for distance vision and the other wears a prescription lens for near vision. The brain learns to favor one eye over the other for different tasks. Because changes in the lens of your eye continue as you grow older, your prescription for presbyopia will increase over time. Your eyecare practitioner will prescribe a stronger correction for near work as you need it.

Presbyopia correction surgery

Surgical options for the correction of presbyopia also exist. If you also have nearsightedness, farsightedness or astigmatism, monovision LASIK eye surgery can correct these problems and decrease your dependence on reading glasses as well. It’s also expected that multifocal LASIK treatments for presbyopia will soon be available in the United States.

If you only need glasses for reading and close work, conductive keratoplasty (CK) may be a good option.

This surgical technique is less invasive than LASIK and can be performed on one eye for a monovision correction. Other promising surgical treatments for presbyopia include the use of tiny corneal implants and inlays that alter the shape of the central cornea to improve near vision without significantly affecting distance vision.

Still another presbyopia correcting surgery is refractive lens exchange (RLE), a procedure virtually identical to cataract surgery except that the hardened lens is removed before it becomes cloudy with a cataract. The lens can then be replaced with a multifocal intraocular lens (IOL) to restore good vision at all distances without glasses.

RLE also can be performed on both eyes to correct presbyopia using a monovision approach. Because the field of vision correction surgery is changing rapidly, ask your eye doctor for the latest information about surgery for presbyopia correction if you are interested in this treatment option.

Styes&The Eyes

A stye (or hordeolum) on the eyelid occurs when a gland at the base of an eyelash becomes infected. Resembling a pimple, a stye can grow on the inside or outside of the lid.

Styes are not harmful to vision, and they can occur at any age.

Signs and symptoms of styes

A stye typically causes redness, tenderness and swelling at the eyelid margin, and then a small pimple appears. Sometimes just the immediate area is swollen; other times, the entire eyelid swells. In some cases, styes also can cause watery eyes, a feeling like something is in the eye (called a foreign body sensation) or increased light sensitivity.

What causes styes?

Styes are caused by staphylococcal bacteria. This bacterium is commonly found in the nose, and it’s easily transferred to the eye by rubbing first your nose, then your eye.

Treatment for styes

Though styes often heal within a few days on their own, you can speed the process by applying hot compresses for 10 to 15 minutes, three or four times a day over the course of several days. This will relieve the pain and bring the stye to a head, much like a pimple. The stye ruptures and drains, then heals.

Never “pop” a stye like a pimple; allow it to rupture on its own.

If you have frequent styes, your eye doctor may prescribe an antibiotic ointment to prevent recurrences. Some styes that can form deeper inside the eyelid either disappear completely or (rarely) rupture on their own.

This type of stye can be more serious, and may need to be opened and drained by your eyecare practitioner. “Chalazion”: Another type of eyelid bump Often mistaken for a stye, a chalazion (shah-LAY-zee-on) is an enlarged, blocked oil gland in the eyelid. A

chalazion mimics a stye for the first few days, and then turns into a painless hard, round bump later on. Most chalazia develop further from the eyelid edge than styes. Although the same treatment used for styes can speed the healing of a chalazion, the bump may linger for one to several months. If the chalazion remains after several months, your eye doctor may drain it or inject a steroid to facilitate healing.

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