Skip to main content
Menu

Home »

All About Vision

Symptoms & Risk Factors of Macular Degeneration

Macular Degeneration can cause low vision and debilitating vision loss, even blindness if not diagnosed and treated in the early stages. Because the disease often has no obvious symptoms early on, it is critical to have regular comprehensive eye exams, particularly if you are at risk.

Symptoms of AMD

Macular degeneration is a disease in which the macula slowly breaks down, resulting in a gradual progressive vision loss, at least in its’ early stages. Frequently there are no symptoms and the disease is only diagnosed when a doctor detects signs such as a thinning macula or the presence of drusen in a comprehensive eye examination. Early vision loss can include blurry, cloudy or distorted central vision or dark spots in your central field of view. With advanced stages, vision loss can be severe and sudden with larger blind spots and total loss of central vision.

Risk Factors for Macular Degeneration

Age is the most prominent risk factor for AMD, as the disease is most common in individuals over the age of 60 (although it can happen in younger individuals as well). Other risk factors can increase your chances of developing the disease such as:

  • Genetics and Family History: Research shows that there are actually almost 20 genes that have been linked to AMD, and they suspect that there are many more genetic factors to be discovered. Family history greatly increases your chances of developing AMD.
  • Race: Caucasians are more likely to get AMD than Hispanics or African-Americans.
  • Smoking: Cigarette smoking can double your likelihood of developing AMD.
  • Lifestyle: Research shows that UV exposure, poor nutrition, high blood pressure, obesity and a sedentary lifestyle can also be contributing factors.
  • Gender: Females have a higher incidence of AMD than males.
  • Medications: Certain medications may increase the chances of developing AMD.

To reduce your risks of developing AMD it is recommended to make healthy choices such as:

    • Regular eye exams; once a year especially if you are 50 or over.
    • Stop smoking.
    • Know your family history and inform your eye doctor.

 

  • Proper nutrition and regular exercise: Research indicates that a healthy diet rich in “Eyefoods” with key nutrients for the eyes such as orange peppers, kale and spinach as well as regular exercise may reduce your risks or slow the progression of AMD.
  • Maintain healthy cholesterol levels and blood pressure.
  • Dietary supplements: Studies by the National Eye Institute called AREDs and ARED2 indicated that a high dosage of supplements of zinc, vitamin C, vitamin E and lutein may slow the progression of advanced dry AMD (it is not recommended for those without AMD or early AMD). Speak to a doctor before taking these supplements because there may be associated risks involved.
  • Wear 99% -100% UV-blocking sunglasses.

 

The first step to eye health is awareness. By knowing your risk, taking preventative measures and visiting your eye doctor on a regular basis, you can greatly reduce your chances of facing this debilitating disease.

Dry Eye Syndrome

Dry eye syndrome (DES or dry eye) is a chronic lack of sufficient lubrication and moisture on the surface of the eye. Its consequences range from minor irritation to the inability to wear contact lenses and an increased risk of corneal inflammation and eye infections.

Signs and Symptoms of Dry Eye

Persistent dryness, scratchiness and a burning sensation on your eyes are common symptoms of dry eye syndrome. These symptoms alone may be enough for your eye doctor to diagnose dry eye syndrome. Sometimes, he or she may want to measure the amount of tears in your eyes. A thin strip of filter paper placed at the edge of the eye, called a Schirmer test, is one way of measuring this.

Some people with dry eyes also experience a “foreign body sensation” – the feeling that something is in the eye. And it may seem odd, but sometimes dry eye syndrome can cause watery eyes, because the excessive dryness works to overstimulate production of the watery component of your eye’s tears.

What Causes Dry Eyes?

In dry eye syndrome, the tear glands that moisturize the eye don’t produce enough tears, or the tears have a chemical composition that causes them to evaporate too quickly.

Dry eye syndrome has several causes. It occurs:

  • As a part of the natural aging process, especially among women over age 40.
  • As a side effect of many medications, such as antihistamines, antidepressants, certain blood pressure medicines, Parkinson’s medications and birth control pills.
  • Because you live in a dry, dusty or windy climate with low humidity.

If your home or office has air conditioning or a dry heating system, that too can dry out your eyes. Another cause is insufficient blinking, such as when you’re staring at a computer screen all day.

Dry eyes are also associated with certain systemic diseases such as lupus, rheumatoid arthritis, rosacea or Sjogren’s Syndrome (a triad of dry eyes, dry mouth, and rheumatoid arthritis or lupus).

Long-term contact lens wear, incomplete closure of the eyelids, eyelid disease and a deficiency of the tear-producing glands are other causes.

Dry eye syndrome is more common in women, possibly due to hormone fluctuations. Recent research suggests that smoking, too, can increase your risk of dry eye syndrome. Dry eye has also been associated with incomplete lid closure following blepharoplasty – a popular cosmetic surgery to eliminate droopy eyelids.

Treatment for Dry Eye

Dry eye syndrome is an ongoing condition that treatments may be unable to cure. But the symptoms of dry eye – including dryness, scratchiness and burning – can usually be successfully managed.

Your eyecare practitioner may recommend artificial tears, which are lubricating eye drops that may alleviate the dry, scratchy feeling and foreign body sensation of dry eye. Prescription eye drops for dry eye go one step further: they help increase your tear production. In some cases, your doctor may also prescribe a steroid for more immediate short-term relief.

Another option for dry eye treatment involves a tiny insert filled with a lubricating ingredient. The insert is placed just inside the lower eyelid, where it continuously releases lubrication throughout the day.

If you wear contact lenses, be aware that many artificial tears cannot be used during contact lens wear. You may need to remove your lenses before using the drops. Wait 15 minutes or longer (check the label) before reinserting them. For mild dry eye, contact lens rewetting drops may be sufficient to make your eyes feel better, but the effect is usually only temporary. Switching to another lens brand could also help.

Check the label, but better yet, check with your doctor before buying any over-the-counter eye drops. Your eye doctor will know which formulas are effective and long-lasting and which are not, as well as which eye drops will work with your contact lenses.

To reduce the effects of sun, wind and dust on dry eyes, wear sunglasses when outdoors. Wraparound styles offer the best protection.

Indoors, an air cleaner can filter out dust and other particles from the air, while a humidifier adds moisture to air that’s too dry because of air conditioning or heating.

For more significant cases of dry eye, your eye doctor may recommend punctal plugs. These tiny devices are inserted in ducts in your lids to slow the drainage of tears away from your eyes, thereby keeping your eyes more moist.

If your dry eye is caused by meibomian gland dysfunction (MGD), your doctor may recommend warm compresses and suggest an in-office procedure to clear the blocked glands and restore normal function.

Doctors sometimes also recommend special nutritional supplements containing certain essential fatty acids to decrease dry eye symptoms. Drinking more water may also offer some relief.

If medications are the cause of dry eyes, discontinuing the drug generally resolves the problem. But in this case, the benefits of the drug must be weighed against the side effect of dry eyes. Sometimes switching to a different type of medication alleviates the dry eye symptoms while keeping the needed treatment. In any case, never switch or discontinue your medications without consulting with your doctor first.

Treating any underlying eyelid disease, such as blepharitis, helps as well. This may call for antibiotic or steroid drops, plus frequent eyelid scrubs with an antibacterial shampoo.

If you are considering LASIK, be aware that dry eyes may disqualify you for the surgery, at least until your dry eye condition is successfully treated. Dry eyes increase your risk for poor healing after LASIK, so most surgeons will want to treat the dry eyes first, to ensure a good LASIK outcome. This goes for other types of vision correction surgery, as well.

Corneal Transplant

A cornea transplant, also known as keratoplasty or a corneal graft, replaces damaged tissue on the clear front surface of the eye.

When disease or injury damages the cornea, eyesight is affected. Light that enters the eye becomes scattered, resulting in blurred or distorted vision. When the cornea is extremely scarred or damaged, a corneal transplant is needed to restore functional vision.

Keratoplasty is performed routinely and is regarded as the most successful of all tissue transplants. According to the National Keratoconus Foundation, over 40,000 cornea transplants are done annually in the United States.

In recent years, an innovative type of corneal transplant has gained popularity. Known as Descemet’s Stripping Endothelial Keratoplasty (DSEK), this new procedure removes a smaller and thinner portion of the cornea. In 2009, DSEK was declared by the American Academy of Ophthalmology as superior to the conventional surgery because it may provide better vision outcomes and more eye stability. It is also associated with less risk factors. However, when the majority of the cornea is damaged, a more comprehensive removal may still be necessary to facilitate a successful transplant.

Criteria for a Corneal Transplant

A multitude of reasons indicate candidacy for a corneal transplant. Possible reasons include:

  • Eye diseases, such as keratoconus
  • Complications from laser surgery, such as LASIK
  • Extreme inflammation on the cornea
  • Scarring as a result of infections, such as eye herpes or fungal keratitis
  • Thinning of the cornea and an irregular shaped cornea
  • Hereditary factors
  • Corneal failure due to previous surgical procedures
  • Chemical burns or injuries that damaged to the cornea

Cornea Transplant Procedure

Once a patient has been recommended and approved for a corneal transplant to restore vision, the patient’s name is added to a list at an eye bank. The United States has a very advanced eye bank system, and the general wait time for a donor eye is one to two weeks. The tissue of donor corneas is checked for clarity and screened meticulously for disease before it is released for transplant.

The actual surgery is generally performed as an outpatient procedure that does not require hospitalization. General or local anesthesia may be used, depending upon the patient’s preference, age and health condition. Local anesthesia is injected into the skin surrounding the eye, which relaxes the muscles that control movement and blinking. Eye drops numb the eye itself.

Once the anesthesia has taken effect, the surgeon inspects and measures the damaged corneal area in order to decide upon the size of the transplantation. Eyelids are held open during this time. The surgeon then removes a round, button-shaped piece of the corneal tissue and replaces it with a nearly identical sized button of donor tissue. The new, healthy tissue is sutured into place. The entire procedure takes approximately one to two hours.

Following the surgery, a plastic shield must be worn over the eye in order to protect it against any inadvertent bumps or rubbing.

Rejection of the Corneal Graft

Although the vast majority of cornea transplants are successful, sometimes the new tissue is rejected. Warning signs of rejection include:

  • Extreme sensitivity to light
  • Redness
  • Pain
  • Decreased vision

These symptoms may be experienced as soon as one month after the surgery, or as delayed as five years later. Medications can be prescribed to reverse the rejection process. If the corneal graft fails completely, the transplant can be repeated and the outcome is generally positive. Yet the total rejection rates do increase with the total number of corneal transplants.

Recovery and Healing

It can take up to a year or longer to heal completely from a corneal transplant. At the beginning, vision is blurry and the transplant site is often swollen and thicker than the rest of the cornea. As vision returns, patients are able to return to normal daily tasks and most people can return to work within three to seven days after surgery. However, heavy lifting and exercise must be avoided for the first few weeks.

To help the body accept the corneal graft, steroid eye drops must be applied for several months. A pair of eyeglasses or a protective shield must also be worn for eye safety. Depending upon the health of the eye and the healing rate, stitches may be removed at any time from three months to more than a year later. Astigmatism often occurs as a result of an irregular corneal surface, and adjustments may be made to the sutures around the new cornea in an effort to reduce this problem.

Vision after a Cornea Transplant

Vision improvement after a cornea transplant is a process that can last up to one year later. Eyeglasses or contact lenses must be worn immediately after the surgery, since the curvature of the corneal transplant will not precisely match the natural corneal curve.

When healing is complete and stitches are removed, laser surgery may be indicated to correct vision. LASIK or PRK are both procedures that can help decrease dependence on eyeglasses or contacts. An irregular corneal surface may point to the need to wear rigid gas permeable (GP) contact lenses for vision correction.

CMV Retinitis

CMV or cytomegalovirus retinitis is a vision threatening virus that causes inflammation of the retina, primarily in individuals with a compromised immune system, such as those with AIDS (Acquired Immunodeficiency Syndrome).

Symptoms of CMV Retinitis

Symptoms of CMV retinitis often appear relatively suddenly. They include general blurriness, seeing flashes or floaters, sudden loss of peripheral (side) vision, or blind spots in central vision. These symptoms all appear as the virus attacks the retina, the light-sensitive layer of nerves at the back of the eye. If left untreated, the virus can cause retinal detachment and will eventually destroy the retina and damage the optic nerve, causing permanent vision loss. Usually there is no pain felt as the retinal damage is taking place. Symptoms usually start in one eye and but can spread to the other eye as well.

Causes of CMV Retinitis

Cytomegalovirus is a herpes type virus that is actually present in most adults. However, most healthy adults never experience any symptoms or problems from the virus. Individuals with a weakened immune system however, such as those with AIDS, chemotherapy or leukemia patients, newborns or the elderly are at greater risk of the virus being activated and spreading throughout the body, including the retina.

Treatment for CMV Retinitis

Treatment includes antiviral medications such as ganciclovir, foscarnet or cidofovir, which can be administered orally, via injection through a vein or directly into the eye or through a time-release implant the releases the medication at intervals. Laser surgery to improve the damaged area of the retina, such as in a retinal detachment, may also be prescribed.

Immune strengthening is also a critical part of preventing and treating CMV retinitis. Individuals with HIV or AIDS may be put on a regimen of highly active antiretroviral therapy (HAART) to boost the immune system and fight the virus. This has been shown to be highly effective in reducing the incidence of CMV retinitis in AIDS patients and reducing the damage for those that are affected.

While these treatments can stop further damage to the retina, any vision that is lost cannot be restored. Further, even if the virus is temporarily stopped, further progression may occur in the future. This is why it is critical to see a retinal specialist on a regular basis if you have had the condition or you are at risk.

Blepharitis

Blepharitis is an eye condition characterized by an inflammation of the eyelids which causes redness, itching and irritation. The common eye condition is caused by either a skin disorder or a bacterial infection. Blepharitis is generally not contagious and can affect patients of any age. While it can be very uncomfortable, it usually does not pose any danger to your vision.

There are two types of blepharitis: anterior and posterior.

Anterior blepharitis occurs on the front of your eyelids in the area where the eyelashes attach to the lid. This form is less common and is usually caused by a bacterial infection or seborrheic dermatitis, which is a skin disorder (dandruff) that causes flaking and itching of the skin on the scalp and eyebrows. While it is more rare, allergies or mites on the eyelashes can also lead to this condition.

Posterior blepharitis occurs on the inner eyelid that is closer to the actual eyeball. This more common form is often caused by rosacea, dandruff or meibomian gland problems which affect the production of oil in your eyelids.

Symptoms of Blepharitis

Blepharitis can vary greatly in severity and cause a variety of symptoms which include:

  • Red, swollen eyelids
  • Itching
  • Burning or gritty sensation
  • Excessive tearing
  • Dry eyes
  • Crusting on eyelids

If left untreated, symptoms can become more severe such as:

  • Blurred vision
  • Infections and styes
  • Loss of eyelashes or crooked eyelashes
  • Eye inflammation or erosion, particularly the cornea
  • Dilated capillaries
  • Irregular eyelid margin

Treatment for Blepharitis

Treatment for blepharitis depends on the cause of the condition but a very important aspect is keeping the eyelids clean. Warm compresses are usually recommended to soak the lids and loosen any crust to be washed away. It is recommended to use a gentle cleaner (baby soap or an over the counter lid-cleansing agent) to clean the area.

For bacterial infections, antibiotic drops or ointments may be prescribed, and in serious cases steroidal treatment (usually drops) may be used.

Blepharitis is typically a recurring condition so here are some tips for dealing with flare-ups:

  • Use an anti-dandruff shampoo when washing your hair
  • Massage the eyelids to release the oil from the meibomian glands
  • Use artificial tears to moisten eyes when they feel dry
  • Consider breaking from use of contact lenses during the time of the flare-up and or switching to daily disposable lenses.

The most important way to increase your comfort with blepharitis is by keeping good eyelid hygiene. Speak to your doctor about products that he or she recommends.

Astigmatism

Many people have never heard of astigmatism, although it is an extremely common eye condition.

Astigmatism is one type of refractive error. Nearsightedness and farsightedness are other types of refractive error. Refractive errors are not eye diseases. Refractive error is a result of and imperfection of the size and shape of the eye, which results in blurry or double vision.

If left untreated, astigmatism may cause eyestrain, headaches, and blurry vision. If you have astigmatism you may not see objects in the distance or near without some form of distortion.

Symptoms of Astigmatism

Small amounts of astigmatism can go unnoticed, however, you may be suffering from eye fatigue, eyestrain, and headaches.

Astigmatism is a condition that usually can develops early in childhood. According to a study from The Ohio State University School of Optometry, 28% of school age children suffer from astigmatism. Parents should be aware that their children might not notice that their vision is blurry, not understanding that this is not normal. Nevertheless, astigmatism should be treated because vision problems can lead to learning problems and in extracurricular activities. Make sure to have your child’s eyes examined at an eye doctor’s office at least once a year.

Causes of Astigmatism

Astigmatism is generally caused by a cornea with an irregular shape. The cornea is the front, clear layer of the eye. With astigmatism, the cornea is not round and spherical and is instead irregular having two curves instead of one curve. Astigmatism in some cases could also be caused by the lens located inside the eye that is irregular in shape.

Eyes with astigmatism distort the light that comes into the eyes because the cornea is irregularly shaped. This causes the light rays entering the eye to create two images in the back of the eye (because of the two curves), instead of one image. This is what causes the distortion in sight.

Treatments for Astigmatism

For most people, their astigmatism is fully corrected using prescription glasses or contact lenses. If you select contact lenses to correct your vision, soft contact lenses are the most common option. If for whatever reason soft contact lenses are not an option, rigid gas permeable (RGP or GP) are also a great choice. Rigid gas permeable lenses usually give the clearest vision but the adaptation process will be significantly longer. Another option are hybrid contact lenses. These contacts have a center made from a rigid gas permeable (RGP) lens and an outer ring made of soft contact lens material. This type of lens provides both excellent clarity and comfort. LASIK could be another option to correct astigmatism. LASIK usually only corrects low levels of astigmatism and some patients with higher levels of astigmatism might not be candidates.

Amblyopia (Lazy Eye)

Amblyopia, which is also called “lazy eye”, is a disorder that affects the visual development in children. Amblyopia is difficult to correct just with the use of contact lenses, or eyeglasses. Ambylopia can cause vision loss if it is not treated early and properly. This vision disorder affects 2-3% of the population.

What are the symptoms of Amblyopia?

Usually children that are born with amblyopia, the symptoms start in early childhood. Some signs of amblyopia in children are squinting, closing one eye in order to see better, poor general vision, headaches, and eyestrain. Usually caretakers such as parents, caregivers, doctors, or nurses notice these symptoms and recommend the child for treatment.

What are the causes of Amblyopia?

Strabismus is usually the cause of amblyopia. Strabismus is the eyes aligning incorrectly. Amblyopia can also be caused when there is a large difference between the eyes in refractive errors (prescription much higher in one eye than the other). For example, one eye is nearsighted, while the other is farsighted. If amblyopia is not treated, the brain will learn to disregard the vision in the eye with amblyopia. The eye that is disregarded does not grow with clear image and vision loss can be permanent. This is why it is very important to get early treatment and take your child to see your eye doctor if any signs are apparent.

How is Amblyopia treated?

There are several treatments for amblyopia, depending on the cause. Often children are treated using vision therapy, which usually includes a patch on the better eye. Other treatments are atropine eye drops, correct prescription eyeglasses, or surgery.

Vision Therapy

Vision therapy consists of eye exercises, which aim to teach the eyes to work together. In cases of amblyopia, the exercises require the brain to recognize the affected eye, which restores vision in that eye. Some doctors place a patch over the more functional eye, which forces the less functional eye to work harder and become stronger. The patch is generally worn for a few hours a day. Depending on the severity of the condition, treatment can last for weeks or months. Some children refuse to wear a patch, in those cases, a prosthetic contact lens is available. These contact lenses look like the regular eye, and are designed to block vision in that eye.

Atropine drops

Some doctors use atropine eye drops to treat amblyopia. These drops blur vision in the child’s better eye, forcing the weaker eye to work harder and get stronger. In the morning, one drop is instilled under eye doctor’s instructions. The advantage to this method of treatment is that the patch is avoided.

Prescription eyeglasses

If your child has developed amblyopia because of uncorrected vision, sometimes all that is needed is a pair of eyeglasses. When there is strong uncorrected prescription, or when there is a large difference in prescription between the two eyes, sometimes amblyopia can result. Your eye doctor may recommend eye patch therapy in addition to corrective lenses.

Surgery

Strabismus surgery is usually required if the amblyopia is due to a large eye turn. This type of surgery aligns the eyes and corrects the problem within the eye muscles. After the surgery the eyes will able to focus better. Additional vision therapy may be required after strabismus surgery.

Amblyopia must be treated as early as possible as there is no chance that it will resolve by itself. Untreated amblyopia can lead to permanent vision loss in that eye and reduced depth perception. Amblyopia needs to be treated promptly so that your child can have the best vision possible in childhood and later in life. When amblyopia is diagnosed and treated before age 9, the weaker eye can often develop significantly better vision. The most critical time to treat amblyopia is from 3 to 6 years of age. If you or anyone sees any signs of amblyopia, go to your eye doctor to find the best treatment for your child.

Cataracts

Cataracts are one of the leading causes of vision loss in people over 45. A condition that commonly develops as the eye ages, by the time we reach 80, more than half of us will have developed a cataract.

A cataract is a clouding of the lens in your eye which is normally transparent. The lens, located inside the eye, behind the iris and the pupil, focuses light onto the retina at the back of your eye, where it is converted to nerve signals that are passed to the brain, allowing you to see. When your lens becomes cloudy, the images projected onto your retina become blurry and unfocused and therefore the signal to the brain is also unclear. You can compare this to looking through a dirty or cloudy window. If the window is not clear, you can’t see well.

Usually cataracts develop slowly over time so your vision gradually worsens. While the majority of cataracts are a result of the aging process, there are also congenital cataracts that are present at birth, secondary cataracts that result from eye surgery or diseases such as glaucoma or diabetes and traumatic cataracts that result at any age from an injury to the eye.

While you may be able to live with mild or moderate cataracts, severe cataracts are treated with surgery. The procedure involves removing the clouded lens and replacing it with an intraocular lens (IOL) implant. Cataract surgery is a common procedure that has a very high success rate of restoring vision to patients. Modern cataract surgery is frequently done as an outpatient procedure. Patients will have greatly improved vision the next day, and will continue to improve over the next few weeks. Surgery is often done in one eye first, and surgery on the second eye, if needed, may be done 2 weeks later.

Learn more about the specifics of Cataracts on the links below:

    Eye Exams for Children

    According to experts, 80% of learning is visual, which means that if your child is having difficulty seeing clearly, his or her learning can be affected. This also goes for infants who develop and learn about the world around them through their sense of sight. To ensure that your children have the visual resources they need to grow and develop normally, their eyes and vision should be checked by an eye doctor at certain stages of their development.

    According to the American Optometric Association (AOA) children should have their eyes examined by an eye doctor at 6 months, 3 years, at the start of school, and then at least every 2 years following. If there are any signs that there may be a vision problem or if the child has certain risk factors (such as developmental delays, premature birth, crossed or lazy eyes, family history or previous injuries) more frequent exams are recommended. A child that wears eyeglasses or contact lenses should have his or her eyes examined yearly. Children’s eyes can change rapidly as they grow.

    Eye Exams in Infants: Birth – 24 Months

    A baby’s visual system develops gradually over the first few months of life. They have to learn to focus and move their eyes, and use them together as a team. The brain also needs to learn how to process the visual information from the eyes to understand and interact with the world. With the development of eyesight, comes also the foundation for motor development such as crawling, walking and hand-eye coordination.

    You can ensure that your baby is reaching milestones by keeping an eye on what is happening with your infant’s development and by ensuring that you schedule a comprehensive infant eye exam at 6 months. At this exam, the eye doctor will check that the child is seeing properly and developing on track and look for conditions that could impair eye health or vision (such as strabismus(misalignment or crossing of the eyes), farsightedness, nearsightedness, or astigmatism).

    Since there is a higher risk of eye and vision problems if your infant was born premature or is showing signs of developmental delay, your eye doctor may require more frequent visits to keep watch on his or her progress.

    Eye Exams in Preschool Children: 2-5

    The toddler and preschool age is a period where children experience drastic growth in intellectual and motor skills. During this time they will develop the fine motor skills, hand-eye coordination and perceptual abilities that will prepare them to read and write, play sports and participate in creative activities such as drawing, sculpting or building. This is all dependent upon good vision and visual processes.

    This is the age when parents should be on the lookout for signs of lazy eye (amblyopia) – when one eye doesn’t see clearly, or crossed eyes (strabismus) – when one or both eyes turns inward or outward. The earlier these conditions are treated, the higher the success rate.

    Parents should also be aware of any developmental delays having to do with object, number or letter recognition, color recognition or coordination, as the root of such problems can often be visual. If you notice your child squinting, rubbing his eyes frequently, sitting very close to the tv or reading material, or generally avoiding activities such as puzzles or coloring, it is worth a trip to the eye doctor.

    Eye Exams in School-Aged Children: Ages 6-18

    Undetected or uncorrected vision problems can cause children and teens to suffer academically, socially, athletically and personally. If your child is having trouble in school or afterschool activities there could be an underlying vision problem. Proper learning, motor development, reading, and many other skills are dependent upon not only good vision, but also the ability of your eyes to work together. Children that have problems with focusing, reading, teaming their eyes or hand-eye coordination will often experience frustration, and may exhibit behavioral problems as well. Often they don’t know that the vision they are experiencing is abnormal, so they aren’t able to express that they need help.

    In addition to the symptoms written above, signs of vision problems in older children include:

    • Short attention span
    • Headaches
    • Frequent blinking
    • Avoiding reading
    • Tilting the head to one side
    • Losing their place often while reading
    • Double vision
    • Poor reading comprehension

    The Eye Exam

    In addition to basic visual acuity (distance and near vision) an eye exam may assess the following visual skills that are required for learning and mobility:

    • Binocular vision: how the eyes work together as a team
    • Focusing
    • Peripheral Vision
    • Color Vision
    • Hand-eye Coordination
    • Tracking

    The doctor will also examine the area around the eye and inside the eye to check for any eye diseases or health conditions. You should tell the doctor any relevant personal history of your child such as a premature birth, developmental delays, family history of eye problems, eye injuries or medications the child is taking. This would also be the time to address any concerns or issues your child has that might indicate a vision problem.

    If the eye doctor does determine that your child has a vision problem, they may discuss a number of therapeutic options such as eyeglasses or contact lenses, an eye patch, vision therapy or Ortho-k, depending on the condition and the doctor’s specialty. Since some conditions are much easier to treat when they are caught early while the eyes are still developing, it is important to diagnose any eye and vision issues as early as possible.

    Following the guidelines for children’s eye exams and staying alert to any signs of vision problems can help your child to reach his or her potential.

    Eye Exams for Contact Lenses

    Contact lenses are a great alternative to wearing eyeglasses. An often unknown fact is that not all patients wear contact lenses as their primary source of vision correction. Each patient is different, with some patients wearing contact lenses only on weekends, special occasions or just for sports. That is the beauty of contact lens wear, the flexibility it gives each individual patient and their lifestyle.

    If you decide to opt for contact lens wear, it is very important that the lenses fit properly and comfortably and that you understand contact lens safety and hygiene. A contact lens exam will include both a comprehensive eye exam to check your overall eye health, your general vision prescription and then a contact lens consultation and measurement to determine the proper lens fit.

    The Importance of a Comprehensive Eye Exam

    Whether or not you have vision problems, it is important to have your eyes checked regularly to ensure they are healthy and that there are no signs of a developing eye condition. A comprehensive eye exam will check the general health of your eyes as well as the quality of your vision. During this exam the eye doctor will determine your prescription for eyeglasses, however this prescription alone is not sufficient for contact lenses. The doctor may also check for any eye health issues that could interfere with the comfort and success of contact lens wear.

    The Contact Lens Consultation

    The contact lens industry is always developing new innovations to make contacts more comfortable, convenient and accessible. Therefore, one of the initial steps in a contact lens consultation is to discuss with your eye doctor some lifestyle and health considerations that could impact the type of contacts that suit you best.

    Some of the options to consider are whether you would prefer daily disposables or monthly disposable lenses, as well as soft versus rigid gas permeable (GP) lenses. If you have any particular eye conditions, such as astigmatism or dry eye syndrome, your eye doctor might have specific recommendations for the right type or brand for your optimal comfort and vision needs.

    Now is the time to tell your eye doctor if you would like to consider colored contact lenses as well. If you are over 40 and experience problems seeing small print, for which you need bifocals to see close objects, your eye doctor may recommend multifocal lenses or a combination of multifocal and monovision lenses to correct your unique vision needs.

    Contact Lens Fitting

    One size does not fit all when it comes to contact lenses. Your eye doctor will need to take some measurements to properly fit your contact lenses. Contact lenses that do not fit properly could cause discomfort, blurry vision or even damage the eye. Here are some of the measurements your eye doctor will take for a contact lens fitting:

    Corneal Curvature

    In order to assure that the fitting curve of the lens properly fits the curve of your eye, your doctor will measure the curvature of the cornea or front surface of the eye. The curvature is measured with an instrument called a keratometer to determine the appropriate curve for your contact lenses. If you have astigmatism, the curvature of your cornea is not perfectly round and therefore a “toric” lens, which is designed specifically for an eye with astigmatism, would be fit to provide the best vision and lens fit. In certain cases your eye doctor may decide to measure your cornea in greater detail with a mapping of the corneal surface called corneal topography.

    Pupil or Iris Size

    Your eye doctor may measure the size of your pupil or your iris (the colored area of your eye) with an instrument called a biomicroscope or slit lamp or manually with a ruler or card. This measurement is especially important if you are considering specialized lenses such as Gas Permeable (GP) contacts.

    Tear Film Evaluation

    One of the most common problems affecting contact lens wear is dry eyes. If the lenses are not kept adequately hydrated and moist, they will become uncomfortable and your eyes will feel dry, irritated and itchy. Particularly if you have dry eye syndrome, your doctor will want to make sure that you have a sufficient tear film to keep the lenses moist and comfortable, otherwise, contact lenses may not be a suitable vision option.

    A tear film evaluation is performed by the doctor by putting a drop of liquid dye on your eye and then viewing your tears with a slit lamp or by placing a special strip of paper under the lid to absorb the tears to see how much moisture is produced. If your tear film is weak, your eye doctor may recommend certain types of contact lenses that are more successful in maintaining moisture.

    Contact Lens Trial and Prescription

    After deciding which pair of lenses could work best with your eyes, the eye doctor may have you try on a pair of lenses to confirm the fit and comfort before finalizing and ordering your lenses. The doctor or assistant would insert the lenses and keep them in for 15-20 minutes before the doctor exams the fit, movement and tearing in your eye. If after the fitting, the lenses appear to be a good fit, your eye doctor will order the lenses for you. Your eye doctor will also provide care and hygiene instructions including how to insert and remove your lenses, how long to wear them and how to store them if relevant.

    Follow-up

    Your eye doctor may request that you schedule a follow-up appointment to check that your contact lenses are fitting properly and that your eyes are adjusting properly. If you are experiencing discomfort or dryness in your eyes you should visit your eye doctor as soon as possible. Your eye doctor may decide to try a different lens, a different contact lens disinfecting solution or to try an adjustment in your wearing schedule.

    Laingsburg Q2 AllThingsSpring email