Eye Conditions

Cataracts

What is a Cataract? cataract-eye-conditions-eyeworksolney A Cataract is the clouding of the lens of the eye. Normally, light passes through the clear lens and is focused onto the Retina. However, the natural aging process can cause the lens to become cloudy. The Cataract or cloudy lens blocks the passage of light through the eye and causes distorted or blurred vision, glare, or difficulty seeing in poor lighting conditions. With the formation of a cataract, activities like reading, bowling, or driving can be difficult. Fortunately, vision can be restored quickly, allowing the patient to return home within a few hours. With new advances in cataract surgery, vision improvement begins almost immediately, and an eye patch isn’t even needed. Cataract surgery is the most common operation in the world. In the United States, more than 2.7 million procedures are performed annually. (National Institutes of Health)

Detached Retina

Detached Retina The retina is the light-sensitive tissue at the back of the eye that sends images to the brain. Normally, the retina lies against the back of the eye where blood vessels furnish it with oxygen and nutrients. Tears in the retina may impair vision and lead to a detached retina. A detached retina occurs when the retina pulls away from the inside wall of the eye. When this happens vision becomes blurred, shaded or distorted. Left untreated, retinal detachment almost always causes permanent sight loss in the affected eye. Retinal detachment and tears may be caused by eye injury, the aging process, tumors, cataract surgery, eye disease or extreme nearsightedness. Several early symptoms may indicate a detached or torn retina: Light flashes in one eye Floaters A dark shadow over part of the field of vision Blurred vision or blind spots Watery vision These symptoms do not always indicate retinal detachment, but if you’re experiencing them, you should go to an emergency room, call us or see one of our doctors as soon as possible.

 

Diabetic Retinopathy

Diabetic Retinopathy
(REH-tih-NOP-uh-thee)

is the medical term for the most common diabetes eye problem.

Diabetic retinopathy is the leading cause of blindness in American adults. It damages the blood vessels in the retina, the light-sensitive nerve tissue in your eye that sends visual images to your brain.

Blurred vision or temporary blindness can occur when blood vessels weaken, bulge and leak fluid into surrounding tissue, causing swelling – a condition called macular edema. Abnormal new blood vessels grow on the retina, where they can bleed into the eye and block vision.

As the disease progresses, the retina can detach from the eye, resulting in permanent blindness. But irreversible vision loss can be prevented with early detection and treatment. This is just one of the reasons it is so important to have your eyes checked on a regular basis. In addition to testing your vision, we will look for any symptoms of eye disease.

Retina damage happens slowly. Your retinas have tiny blood vessels that are easy to damage. Having high blood glucose and high blood pressure for a long time can damage these tiny blood vessels. 

First, these tiny blood vessels swell and weaken. Some blood vessels then become clogged and do not let enough blood through. At first, you might not have any loss of sight from these changes. This is why you need to have a comprehensive eye exam once a year even if your sight seems fine.

 

One of your eyes may be damaged more than the other. Or both eyes may have the same amount of damage.

As diabetic retina problems get worse, new blood vessels grow. These new blood vessels are weak. They break easily and leak blood into the vitreous of your eye. The leaking blood keeps light from reaching the retina.

You may see floating spots or almost total darkness. Sometimes the blood will clear out by itself. But you might need surgery to remove it.

Over the years, the swollen and weak blood vessels can form scar tissue and pull the retina away from the back of the eye. If the retina becomes detached, you may see floating spots or flashing lights.

You may feel as if a curtain has been pulled over part of your vision. A detached retina can cause loss of sight or blindness if you don’t take care of it right away.

Call us right away if you are having any vision problems or if you have had a sudden change in your vision.

 

Dry Eye

What is a Dry Eye?

We have all experienced it: the feeling that something is irritating our eyes. It usually happens if the wind blows dust, an allergen or a foreign body into our eye or under an eyelid. You should not take this kind of irritation lightly, the reason being that while for many the feeling of grittiness, dryness, burning or stinging or even excessive tearing can be relieved simply with over the counter methods, for others, it may be the sign of a chronic condition known as dry eye syndrome. Yes, even tearing eyes are a sign of dry eye.

The tears your eyes produce are necessary for overall eye health and clear vision. Dry eye means that your eyes do not produce enough tears or that you produce tears that do not have the proper chemical composition. Often, dry eye is part of the natural aging process. It can also be caused by blinking or eyelid problems, medications like antihistamines, oral contraceptives and antidepressants, a dry climate, wind and dust, general health problems like arthritis or Sjogren’s syndrome and chemical or thermal burns to your eyes.

If you have dry eye, your symptoms may include irritated, scratchy, dry, uncomfortable or red eyes, a burning sensation, excessive tearing, blurred vision, or a feeling of something foreign in your eyes. Excessive dry eyes may damage eye tissue, scar your cornea (the front covering of your eyes) and impair vision and make contact lens wear difficult.

If you have symptoms of dry eye, see us immediately for a comprehensive examination. Dry eye cannot be cured, but we may be able to prescribe treatment so your eyes remain healthy and your vision is unaffected. Some treatments that we might prescribe include blinking more frequently, increasing humidity at home or work, using artificial tears and using a moisturizing ointment, especially at bedtime. In some cases, small plugs are inserted in the corner of the eyes to slow tear drainage. Sometimes, surgical closure of the drainage ducts may be recommended.

 

Floaters and Flashes

Floaters & Flashes

As we get older we expect to have problems with our eyes, so we tend to ignore them.

One minor symptom that can cause a bigger problem if not treated is the occurrence of floaters and flashes. These are those tiny lights that seem to blink through your vision and that you can never catch when you direct your focus toward them.

Almost everyone sees floaters at some time, but they can occur more frequently and become more noticeable as we get older.

Floaters caused by posterior vitreous detachment are more common in people who:

Are nearsighted
Have undergone cataract surgery
Have had certain types of laser surgery
Have had inflammation of the eye

In most cases no serious problems are found, but a complete eye examination is important. If there is damage to the retina, it needs to be diagnosed and treated immediately to prevent vision loss.

Age Related Macular Degeneration

Macular Degeneration

Adult macular degeneration is traditionally described as a form of the disease which affects individuals over the age of 55 years.

However, we have recently discovered that a significant number of these individuals may have a major genetic component that contributes to the disease.

Dry macular degeneration, in which the cells of the macula slowly begin to break down, is diagnosed in 90 percent of the cases. Yellow deposits called “drusen” form under the retina between the retinal pigmented epithelium (RPE) and Bruch’s membrane, which supports the retina. Drusen deposits are “debris” associated with compromised cell metabolism in the RPE and are often the first sign of macular degeneration. Eventually, there is a deterioration of the macular regions associated with the drusen deposits resulting in a spotty loss of “straight ahead” vision.

Wet macular degeneration occurs when abnormal blood vessels grow behind the macula, then bleed. There is a breakdown in Bruch’s membrane, which usually occurs near drusen deposits. This is where the new blood vessel growth occurs (neovascularization). These vessels are very fragile and leak fluid and blood (hence wet), resulting in scarring of the macula and the potential for rapid, severe damage. “Straight ahead” vision can become distorted or lost entirely in a short period of time, sometimes within days. Wet macular degeneration accounts for approximately 10% of the cases, however it results in 90% of the legal blindness.

What does macular degeneration do to your vision?
Macular degeneration is the imprecise historical name given to that group of diseases that causes sight-sensing cells in the macular zone of the retina to malfunction or lose function and results in debilitating loss of vital central or detail vision.

What are the Symptoms of Macular Degeneration?
Macular degeneration can cause different symptoms in different people. Sometimes only one eye loses vision while the other eye continues to see well for many years. The condition may be hardly noticeable in its early stages. But when both eyes are affected, reading and close up work can become difficult.

What can you or your loved one do if diagnosed with macular degeneration?
First it is important to modify those environmental risk factors that we know about. You should:
Detail a low-fat, low cholesterol diet.
If you are post-menopausal, you should consult with your physician concerning estrogen replacement therapy. This may have a favorable impact upon cholesterol lipid levels that play a role in worsening the disease.
Wear sunglasses with UV protection.
Try to consume at least two servings of leafy dark green vegetables per day.
Do not smoke and avoid exposure to secondhand smoke.
Eat food and or supplements rich in vitamin E,C and Lutein. Lutein is a plant antioxidant found in high quantities in spinach, kale and other dark green, leafy vegetables.

Glaucoma

Glaucoma

Glaucoma is actually a group of eye diseases that lead to damage of the optic nerve (the bundle of nerve fibers that carries information from the eye to the brain), which can then lead to vision loss and the possibility of blindness. 

Optic nerve damage usually occurs in the presence of high intraocular pressure. Glaucoma can occur with normal or even below-normal eye pressure. In the United States, approximately 2.2 million people age 40 and older have glaucoma, and of these, as many as 120,000 are blind due the disease. The number of Americans with glaucoma is estimated to increase to 3.3 million by the year 2020. Vision experts estimate that half of those affected may not know they have it because symptoms may not occur during the early stages of the disease.

 

Glaucoma is a leading cause of blindness among African Americans and Hispanics in the United States. African Americans experience glaucoma at a rate of three times that of Caucasians and experience blindness four times more frequently. Between the ages of 45 and 64, glaucoma is fifteen times more likely to cause blindness in African Americans than in Caucasians. 

 

There are two main forms of glaucoma: open-angle (which is the most common form and affects approximately 95% of individuals) and closed-angle. High-risk factors for open-angle glaucoma include being an African American and over 40, having a family history of the disease, and being over 60 for the general population. Those who are very nearsighted, have a history of diabetes, have experienced eye injury or eye surgery, or take prescription steroids also have an increased risk of developing glaucoma. It has also been suggested that individuals with Japanese ancestry may be at a greater risk for normal-tension glaucoma, and that those of Asian and Eskimo descent may have a greater risk for closed-angle glaucoma.

Open-angle glaucoma, by far the most common form, has no symptoms at first. At some point, side vision (peripheral vision) is lost and without treatment, total blindness will occur.

Closed-angle glaucoma (acute glaucoma) results from a sudden, complete blocking of the fluid flowing out of the eye. Symptoms may include severe pain, nausea, vomiting, blurred vision, and seeing a rainbow halo around lights. Closed-angle glaucoma is a medical emergency and must be treated immediately or blindness could result in one or two days.

Currently, there is no cure for glaucoma; however, early diagnosis and treatment can control glaucoma before vision loss or blindness occurs.There are several tests that can help your eye care professional detect glaucoma; these include a visual acuity test, visual field test, dilated eye exam, tonometry (which measures the pressure inside of the eye), and pachymetry (which uses ultrasonic waves to help determine cornea thickness). Individuals at high risk for glaucoma should have a dilated pupil eye examination, including a visual field test, at least every two years.

 

Computer Vision Syndrome

Computer Vision Syndrome (CVS) is the complex of eye and vision problems related to near work which are experienced during or related to computer use. CVS is characterized by visual symptoms which result from interaction with a computer display or its environment. In most cases, symptoms occur because the visual demands of the task exceed the visual abilities of the individual to comfortably perform the task.

Computer vision syndrome (CVS) affects three out of four computer users. It is a series of symptoms related to extended periods of computer usage. Though it is no cause for panic, measures can be taken to relieve symptoms of CVS.

CVS can appear as a variety of symptoms. Headaches, eye strain, neck and back aches, sensitivity to light, blurred vision, double vision, and dry or irritated eyes are all possible problems related to CVS.

Any computer user can develop CVS. Your vision, your computer, and the environment where you use your computer are all factors that can lead to CVS.

There are many aspects of computers and the work environment in which they are used which may cause or contribute to the development of eye or vision difficulties. To obtain optimum visual comfort and work efficiency, all computer operators who could benefit from a visual correction should wear it. One way to help ensure this is to remove financial barriers to the employee for obtaining an eye examination and, when needed, treatment for eye and vision problems. This can often be accomplished by having an employer or third party sponsored program which provides eye care services for employees who work at computers.

  

As part of an eye care program for computer operators, it may be necessary to determine whether any treatment, usually in the form of eyeglasses, is specific to the computer task or whether the same glasses or treatment would be required for general vision needs. This may establish whether the employee is eligible to receive occupationally related eye care services under the program.

 

Whether a particular vision condition requires correction with eyeglasses or other treatment depends upon the clinical findings and the judgment of the examining doctor. However, the following criteria are recommended to help determine whether the care provided is computer related. These criteria are based upon the individual diagnosis and/or prescribed treatment. Since it is necessary for computer operators to have an eye and vision examination to determine whether these criteria are met, it is recommended that an examination be provided as part of the computer eye care program.

Vision problems occur frequently among video display terminal (VDT) workers. Most worker health surveys show that the most frequent health related complaints among workers at VDTs are visually related. However, more public and professional attention is currently being directed towards the avoidance of musculoskeletal disorders such as wrist problems (e.g., Carpal Tunnel Syndrome), bursitis, muscle strains (e.g., neck tension syndrome), tendon disorders (e.g., de Quervain’s disease), and tenosynovitis (e.g., trigger finger) among others. These disorders are generally classified as Cumulative Trauma Disorders (CTD) or as Repetitive Strain Injuries (RSI).

VDT related vision problems are at least as significant a health concern as the musculoskeletal disorders. Most studies indicate that visual symptoms occur in 50-90% of VDT workers, while a study released by NIOSH showed that 22% of VDT workers have musculoskeletal disorders. A survey of optometrists indicated that 10 million primary eye care examinations are provided annually in this country primarily because of visual problems at VDTs – not a small public health issue. Vision problems are pervasive among computer workers and are the source of worker discomfort and decreased work performance.

  

There appears to be a communication gap regarding the nature and extent of vision problems related to VDT use. The vision problems experienced by VDT workers are varied and are difficult to grasp and understand by those who don’t specialize in vision. The misunderstanding may also be the result of unfounded reports of cataracts caused by VDTs, exaggerated manufacturer claims about the need for UV and other radiation protections, and misleading statements about the effects of specialty tinted and coated lenses (e.g., computer glasses) among other products.

 

In order to improve communication and understanding of the vision problems at computers, the American Optometric Association supports the use of the term “Computer Vision Syndrome” (CVS) to broadly encompass the visual problems experienced at VDTs. CVS can be used to refer to the entirety of visual problems experienced by computer users and therefore improve communication and understanding of these problems. However, since there is not a single factor or visual disorder which causes the visual problems at computers, CVS encompasses many different symptoms, disorders and treatments.

Impact of Computer Use on Children’s Vision
When first introduced, computers were almost exclusively used by adults. Today, children increasingly use these devices both for education and recreation. Millions of children use computers on a daily basis at school and at home.

Children can experience many of the same symptoms related to computer use as adults. Extensive viewing of the computer screen can lead to eye discomfort, fatigue, blurred vision and headaches. However, some unique aspects of how children use computers may make them more susceptible than adults to the development of these problems.
The potential impact of computer use on children’s vision involves the following factors:
Children often have a limited degree of self-awareness

Many children keep performing an enjoyable task with great concentration until near exhaustion (e.g., playing video games for hours with little, if any, breaks). Prolonged activity without a significant break can cause eye focusing (accommodative) problems and eye irritation.

Accommodative problems may occur as a result of the eyes’ focusing system “locking in” to a particular target and viewing distance. In some cases, this may cause the eyes to be unable to smoothly and easily focus on a particular object, even long after the original work is completed.

Eye irritation may occur because of poor tearflow over the eye due to reduced blinking. Blinking is often inhibited by concentration and staring at a computer or video screen. Compounding this, computers usually are located higher in the field of view than traditional paperwork. This results in the upper eyelids being retracted to a greater extent. Therefore, the eye tends to experience more than the normal amount of tear evaporation resulting in dryness and irritation.
Children are very adaptable

Although there are many positive aspects to their adaptability, children frequently ignore problems that would be addressed by adults. A child who is viewing a computer screen with a large amount of glare often will not think about changing the computer arrangement or the surroundings to achieve more comfortable viewing. This can result in excessive eye strain. Also, children often accept blurred vision caused by nearsightedness (myopia), farsightedness (hyperopia), or astigmatism because they think everyone sees the way they do. Uncorrected farsightedness can cause eye strain, even when clear vision can be maintained.

Children are not the same size as adults.

  

Since children are smaller, computers don’t fit them well. Most computer workstations are arranged for adult use. Therefore, a child using a computer on a typical office desk often must look up further than an adult. Since the most efficient viewing angle is slightly downward about 15 degrees, problems using the eyes together can occur. In addition, children may have difficulty reaching the keyboard or placing their feet on the floor, causing arm, neck or back discomfort.

 

Children often use computers in a home or classroom with less than optimum lighting

The lighting level for the proper use of a computer is about half as bright as that normally found in a classroom. Increased light levels can contribute to excessive glare and problems associated with adjustments of the eye to different levels of light.

Steps to Visually-Friendly Computer Use
Here are some things to consider for children using a computer
Children have different needs to comfortably use a computer. A small amount of effort can
help reinforce appropriate viewing habits and assure comfortable and enjoyable computer use.

Have the child’s vision checked. This will make sure that the child can see clearly and comfortably and can detect any hidden conditions that may contribute to eye strain. When necessary, glasses, contact lenses or vision therapy can provide clear, comfortable vision, not just for using the computer, but for all other aspects of daily activities.

Strictly enforce the amount of time that a child can continuously use the computer. A ten-minute break every hour will minimize the development of eye focusing problems and eye irritation caused by improper blinking.

Carefully check the height and arrangement of the computer. The child’s size should determine how the monitor and keyboard are positioned. In many situations, the computer monitor will be too high in the child’s field of view, the chair too low and the desk too high. A good solution to many of these problems is an adjustable chair that can be raised for the child’s comfort, since it is usually difficult to lower the computer monitor. A foot stool may be necessary to support the child’s feet.

Carefully check the lighting for glare on the computer screen. Windows or other light sources should not be directly visible when sitting in front of the monitor. When this occurs, the desk or computer may be turned to prevent glare on the screen. Sometimes glare is less obvious. In this case, holding a small mirror flat against the screen can be a useful way to look for light sources that are reflecting off of the screen from above or behind. If a light source can be seen in the mirror, the offending light should be moved or blocked from hitting the screen with a cardboard hood (a baffle) attached to the top of the monitor. In addition, the American Optometric Association has evaluated and accepted a number of glare screens that can be added to a computer to reduce glare. Look for the AOA Seal of Acceptance when purchasing a glare reduction filter.

Reduce the amount of lighting in the room to match the computer screen. Often this is very simple in the home. In some cases, a smaller light can be substituted for the bright overhead light or a dimmer switch can be installed to give flexible control of room lighting. In other cases, a three-way bulb can be turned onto its lowest setting.
Children have different needs to comfortably use a computer. A small amount of effort can help reinforce appropriate viewing habits and assure comfortable and enjoyable computer use.

 

Ocular Allergies

Ocular Allergies  

Various allergies affect over 20% of the general population and are on the rise. Experts disagree over the specific reason for the increasing prevalence of allergies; theories range from the effects of pollution in urban areas to the failure of modern lifestyles to allow for enough childhood exposure to allergens.

 

Allergies can take many forms, affecting various organs or tissues. Ocular allergies are among the most bothersome forms of allergic reaction; the characteristic signs and symptoms of which include:
Itching
Redness
Watery eyes
Swelling of the eyes and eyelids

Ocular allergies are often accompanied by nasal symptoms. This is partly due to the fact that the eyes and nose are so closely connected by the tear ducts; substances that enter the eye can then flow downward into the nose. Symptoms include:
Runny nose
Sneezing
Congestion

The Eyes’ Response To Ocular Allergens 

The response to an exposure to allergens is nearly immediate:
First, itching sets in and can become persistent and extremely bothersome if exposure to the allergen is continued. Shortly after itching, redness of the eyes follows.
The swelling of the eyes and eyelids comes to its peak later than the itching, as swelling is also caused by the blood vessels letting fluids out into the tissue around them. Swelling is the sign of ocular allergies slowest to disappear, considering the time it takes for the displaced fluid to be removed.
The itching can be considered the most uncomfortable symptom, whereas the swelling and redness are most bothersome in terms of appearance.