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All About Vision

Causes of Cataracts

Cataracts are part of the natural aging process of the eye and therefore, if you live to an old age, you will likely eventually develop one. While most cases of cataracts develop as part of this process, there are instances of congenital cataracts which are present at birth. Further, secondary or traumatic cataracts can occur at any age as a result of an eye injury, surgery or disease.While the risk of developing a cataract does increase as you age, it is not the only risk factor. Research shows that there are environmental, health and behavioral risk factors that can also play a role in cataract development. Many of these risk factors are avoidable and preventable. These risk factors include:

  • Smoking and excessive alcohol consumption
  • Prolonged exposure to ultraviolet (UV) radiation from the sun or other sources
  • Obesity
  • Diabetes
  • Hypertension
  • Certain medications such as steroids or statin medications
  • History of eye injury or eye surgery
  • Family history

Since they are largely a part of the the natural aging process of the eye, cataracts can’t necessarily be avoided, however knowing if you have additional risk factors can help you to take preventative steps to delay the onset of the condition.

Specialty Eyewear Overview

You may think that you are set with your everyday eyewear, but there are a lot more options than just sun and ophthalmic glasses. Whether it’s water sports, a construction job or even working around the home, there are many circumstances which require specialty eyewear to add extra protection, prevent injury, and improve vision and performance. Here is an overview of some of the different types of specialty eyewear to consider.

Sports Eyewear

Typical eyewear is not made to hold up to the safety and performance standards required for sports and athletic use. Sports eyewear is made of stronger materials and design for ultimate impact resistance and durability. Sports eyewear is also designed for ultimate comfort, fit and coverage to protect from elements such as sun, water or wind. The lenses are also made with impact resistant materials such as innovative plastics such as Trivex or Polycarbonate. Most lenses will also include 100% UV protection, anti-glare and anti-scratch properties to further protect the lenses. Polarized lenses will also aid your sports eyewear to improve vision in outdoor environments. Depending on your sport there may be a specific type of eyewear suited to your needs such as sports goggles, shooting glasses or ski goggles. Speak to your optician about your sport of choice to determine the safest and most effective eyewear for you.

Computer Glasses

If you sit for extended periods of time at a computer or in front of a handheld screen you are at risk for computer vision syndrome, eye strain, eye fatigue, headaches and muscle strain. This is largely because your eyes view a computer screen differently than they view the world around you. Glare from the screen can also exacerbate these issues. Computer glasses are designed to reduce the strain and to create a more comfortable visual experience when looking at your screen.

Reading Glasses

As we approach the age of 40, our near vision begins to weaken – a condition called presbyopia. This can be corrected by wearing reading glasses when reading or doing close work. There are a number of options for reading glasses depending on your vision needs. People with distance vision correction needs may prefer bifocal or multifocal lenses that allow you to see at a distance as well with the same pair of glasses. It is worthwhile to speak to your optometrist to find the best solution for your vision near and far.

Safety Glasses and Goggles

Whether you are working with power tools in construction, mowing your lawn or using harsh cleaning products, there are plenty of household projects and hobbies that can pose a serious risk to your eyes and vision. Whether it is the danger of debris being projected toward your eyes or a chemical splash, safety goggles or glasses should be worn whenever dealing with dangerous materials or machinery.

Specialty eyewear manufacturers are always developing new innovations to protect your eyes and improve your vision during the activities that you enjoy. Ask your optometrist about the specialty eyewear that is suitable for your interests and hobbies.

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.

Reading Glasses After 40

Once we reach the age of 40, its common to start noticing the natural effects of our aging eyes, such as having to hold your phone at arm’s length to read text messages. Medically, this normal change in our vision is called presbyopia and refers to the weakening of the lens inside the eye which is responsible for sharp focus and clear near vision.

You may begin to notice presbyopia setting in when reading starts to become difficult and the words begin to lose focus. You might also experience eye strain or headaches when trying to read fine print. This is where reading glasses come in. Reading glasses are non-prescription eyeglasses that magnify text (or any object you are viewing) to allow your eye to focus better at a close distance.

Styles of Reading Glasses

Single vision (as opposed to bifocal or trifocal) reading glasses come in two lens styles – full and half. Full readers offer a uniform magnification (the entire lens is the same focus) and you need to remove them to see clearly at a distance. These are ideal for individuals that spend a lot of time reading and don’t often have to look up during that time. Half readers are also uniform magnification but offer smaller frames that allow you to look over the lens when you want to see further away rather than removing the frame from your face.

Bifocal reading glasses offer two zones of vision within one less. The upper part of the lens allows for distance vision, while the lower part is for reading. Bifocals have a visible line across the midline which divides the two zones. You simply look into the part of the lens that offers the vision you desire.

Custom Made Vs. Over the Counter Reading Glasses

Over the counter or ready made reading glasses may be cheaper and more convenient than custom made glasses but they don’t take into account your individual needs. If you have no previous prescription and a light presbyopia, they may sufficiently suit your needs however in many cases, they can cause eye strain, dizziness and headaches when they are not the right fit for your vision.

Having an eye exam and ordering custom made lenses can meet your exact visual needs in each eye to create a comfortable and optimal correction for your eyes. You can also select the style and shape of the glasses that look and feel the best for you.

Even though presbyopia is a common condition that eventually affects most people at some point after 40, any time you experience vision changes you should see an eye doctor for an exam. Even if you decide that you want to start with ready made reading glasses, you should get an eye exam to ensure that your eyes and vision are healthy. Many serious and vision-threatening eye diseases can be stopped and prevented with early detection, so routine check-ups, especially when there is a change in vision, are critical for optimal eye and vision health.

LASIK

LASIK or laser-assisted in situ keratomileusis is a refractive surgery that is used to correct myopia (nearsightedness), hyperopia (farsightedness) and astigmatism as an alternative to eyeglasses or contact lenses. LASIK is currently the most common of the refractive eye surgeries, largely because of the relatively low risk and the quick recovery and improvement in eyesight.

Also known as laser eye surgery or laser vision correction, LASIK uses a laser to reshape the cornea which is responsible for clear vision. The procedure is quick and relatively painless and eyesight is usually improved to 20/20 vision within one day of the surgery.

How Does LASIK Work?

LASIK is an outpatient procedure, which takes about 15 minutes for the actual surgery on both eyes and an hour total with recovery. A topical anesthetic drop is used and there is no need for bandaging or stitches following the procedure. The doctor will start by stabilizing the eye and then making a small flap in the outer layer of the cornea. Then with access to the underlying tissue, he uses a laser to reshape the corneal tissue and re-closes the flap, which will heal on its own. The nature of the corneal reshaping depends on the type of refractive error.

Wavefront LASIK

Wavefront LASIK uses computer mapping technology to guide the laser treatment based on the precise shape of the cornea. This can correct very precise issues, provide much sharper vision than non-wavefront LASIK and can reduce complications such as halos, glare and problems seeing at night.

What to Expect During and After LASIK?

During the procedure you may feel some pressure on your eye while the laser is working. Immediately following you will likely experience some blurriness and may feel burning or itching (be sure not to rub your eyes!). For your journey home you will be given protective shields to guard your eyes and will need someone to drive you. You will also be prescribed medicated eye drops for a week or so to aid in healing and prevent infection. Your doctor may also recommend artificial tears to moisten the eyes and keep them comfortable in the days following the procedure.

The day after the surgery you will be asked to visit your eye doctor (or the surgeon) for a checkup and to evaluate whether you are able to drive. Most people experience an improvement in vision by then, although for some it can take a few days or even a week. Your eyes may be sensitive to light for a day or two as well. You will likely be advised to rest for a day or two and to refrain from strenuous physical activity for about a week until further healing has taken place.

Most people achieve at least 20/20 vision following the surgery, although this can vary and there are cases where 20/40 vision is obtained or where people continue to wear glasses or contacts with a much lesser prescription. Some patients have light sensitivity, particularly when driving at night, also suffering from seeing halos around lights or glare. There are glasses and lenses available to reduce this glare and assist with night driving.

For some, it can take weeks or even months until the vision completely stabilizes. Occasionally, after a few months, patients who do not experience perfect results will schedule an enhancement or touch up surgery to correct the vision even further.

Am I a Candidate for LASIK?

The ideal LASIK candidate is a patient over 18 with generally healthy eyes. Since the procedure involves shaping the cornea by removing some of the tissue, it is not ideal for individuals with a thin cornea or any sort of corneal condition or disease. Patients with chronic dry eyes might also be disqualified as LASIK can often exacerbate these symptoms.

During a comprehensive eye exam your eye doctor will assess your eligibility by looking at the general health of your eye including your cornea, your pupil, the moisture in your eye, the type of refractive error you have and whether you have any other eye conditions of concern.

For the right candidate, LASIK can offer a lifestyle improvement in giving clear vision without the need for glasses or contact lenses, however, the results are not guaranteed. You and your eye doctor need to weigh the benefits and the potential risks based on your personal needs.

Why are Eye Exams Important?

For both adults and children alike, eye exams are an important part of one’s general health maintenance and assessment. Your eyes should be checked regularly to ensure that you are able to see as best as possible. Regular eye health exams will also check for signs of eye disease or conditions that can affect not only your vision but your overall health. Vision and eye health is such a critical part in learning and development, therefore, we highly recommend eye exams for infants and children.

Vision Screening vs. an Eye Exam

When we recommend regular eye exams, this should not be confused with a vision screening. A vision screening is a basic test that indicates if you have difficulty seeing and require further assessment and corrective measures. It can be performed by anyone, whether it is a school nurse, a pediatrician or even a volunteer at a vision clinic. A vision screening usually only checks vision, it does not check eye health. Also, most vision screenings for kids only check for nearsightedness (when you can not see far), but what happens when the majority of children are farsighted? Most of the time many of these kids get overlooked.

A comprehensive eye exam on the other hand, can only be performed by an eye doctor as it requires special knowledge and equipment to look around and into your eye to check your eye and vision health. Such an exam can assess whether there are underlying causes for vision problems and whether there are any signs of disease which can threaten your site and the health of your eye. A comprehensive eye examination can also diagnose symptoms of diabetes, high blood pressure, high cholesterol, tumors, cancer, autoimmune disorders, and thyroid disorders. A comprehensive eye examination will also provide an accurate prescription for eyeglasses or contact lenses.

Eye Exams for Eye Health

Eye exams are critical because many vision threatening eye diseases such as glaucoma, macular degeneration, cataracts, or diabetic retinopathy have no or minimal symptoms until the disease has progressed. In these cases, early detection and treatment is essential to halting or slowing down the progression of the disease and saving eyesight. During a comprehensive eye examination, your eye doctor will be looking for initial signs of these diseases. If a problem with your eyes arises such as red eyes, eye allergies, dry eyes, eye swelling,eye pain, always seek an eye doctor as your first doctor to call since they are specifically trained to treat eye diseases.

Eye Exams and Children

If your child is having developmental delays or trouble in school there could be an underlying vision problem. Proper learning, motor development, reading, and many other skills are dependent upon not only good vision, but your eyes functioning together. Children that have problems with focusing 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. Many conditions are much easier to treat when they are caught early while the eyes are still developing, so it is important to diagnose any eye health and vision issues as early as possible.

Eye Exams Over 40

Just like the rest of our bodies, our eyes begin to weaken as we age. There are a number of common age-related eye conditions such as presbyopia, cataracts, and age-related macular degeneration that can begin to affect your vision and your daily life. While some of these conditions are more of an inconvenience, others could lead to vision loss and dependency.

In addition to regular yearly eye exams, it is important to be aware of any changes in your eye health and vision. Also know your potential risk factors as well as your family ocular and medical history. Over half of the vision loss worldwide is preventable with proper treatment and care.

Pingueculae & Pterygia

Pingueculae and Pterygia are both benign growths that develop on the surface of the eye. While often grouped together, there are some differences in expression, symptoms, causes and treatment so here is an explanation of each condition and the differences between them.

Pinguecula

Pingueculae (pinguecula in singular) are growths that occur on the conjunctiva or the thin clear layer that covers the white part of the eye known as the sclera. They can be diagnosed on patients of any age, but tend to be more common in middle age. Pingueculae are typically yellowish in color and appear as a small, raised, sometimes triangular protrusion close to the cornea.

Causes of Pinguecula

Pinguecula occur when bumps, typically containing fat and/or calcium, form on the tissue of the conjunctiva. The exact cause of pinguecula is not known but there is a correlation between unprotected exposure to sunlight, wind, excessive dryness and dust.

Symptoms of Pinguecula

Pingueculae may have no symptoms or they can cause feelings of dryness, irritation or feeling like there is a foreign body in your eye. In more severe cases they may become itchy, inflamed, red and sore.

Treatment of Pinguecula

Often, there is no treatment necessary other than to protect the eye from the sun and other elements. If however, the pinguecula is causing discomfort or other issues, there are treatments available depending on the symptoms. Dryness, irritation and itchiness can sometimes be treated with eye drops or ointment and in cases where there is swelling, steroid eye drops along with anti-inflammatory medication may be prescribed. In rare cases that the pinguecula is causing serious problems such as vision problems, untreatable discomfort or preventing blinking, or the patient is unhappy with the way it looks, it may have to be removed surgically.

Pytergia

Pytergia (pytergium in singular) are wedge-shaped growths on the surface of the cornea (the sclera), made of fibrous conjunctival tissue and containing blood vessels, which sometimes make it appear pink. Pytergia often grow out of pinguecula and tend to be more visible.

Causes of Pytergia

Like pinguecula, pytergia are believed to be caused by extended exposure to UV rays from the sun and are sometimes called “surfer’s eye”. They are more common in adults (ages 20 – 50) who live in dry, sunny climates and spend significant time outdoors. Risks increase in those who do not properly protect their eyes by using sunglasses and hats when they are outdoors.

Symptoms of Pytergia

Pytergia may occur in one or both eyes and usually grow in the corner of the eye closest to the nose in toward the cornea. Very often there are no symptoms however some people may experience dry eyes, redness, irritation, the feeling that something is in their eye and inflammation. Pytergia may also cause discomfort for contact lense wearers. If the pytergium is serious it could grow far enough into the cornea to obstruct vision or cause the cornea to change shape resulting in astigmatism.

Treatment for Pytergia

If necessary, treatment for symptoms of pytergia may be similar to those used for pytergia such as lubricating eye drops or steroidal drops or creams to reduce inflammation. Surgery is more common for pytergia because of the more obvious change in appearance and because of the potential for vision disturbances. Sometimes a conjunctival graft is performed to prevent recurrence which is when a small piece of tissue is grafted onto the area where the pytergia was removed.

Pytergia and pingueculae are often completely benign conditions but should be monitored by a doctor to ensure they do not get worse and pose a threat to vision. Nevertheless, these growths go to show how important it is to protect your eyes from the harmful UV rays of the sun.

Signs & Symptoms

Cataracts don’t suddenly develop overnight. They generally start off small and only begin to noticeably affect your vision as they grow. The first symptom is usually that your vision becomes blurred, hazy or cloudy. Additionally, you may become sensitive to light, making sunlight, oncoming headlights or indoor lighting appear exceptionally glaring or bright. Colors may seem dim and you may notice halos around lights or double vision.

The symptoms people experience from cataracts may vary. Some individuals even report a temporary improvement in near vision when a cataract first develops, a phenomenon known as “second sight”.

Here is a list of possible signs and symptoms of developing cataracts:

  • Blurry or cloudy vision (that can’t be corrected with a change in eyeglass prescription)
  • Glare from lamps, sunlight, oncoming traffic when driving at night or indoor lighting
  • Colors appear dim and less vibrant
  • Halos around lights
  • Double vision
  • Poor night vision
  • Sudden improvement in near vision

If you experience any change in your vision, visit your eye doctor immediately.

Eyeglass Frame Materials

It’s time to choose a new pair of eyeglasses, and the current selection of frames is overwhelming. Armed with only your vision prescription, you now need to navigate between different materials, colors, prices and unique features of all the eyeglass frames. Here is a basic guide that explains about the most common types of frames and what they have to offer.

Metal Frames
The most popular material for eyeglass frames, there is a whole array of metals to consider. Each metal comes with a distinctive set of properties and characteristics.

Titanium: Extremely resilient and corrosion-resistant, titanium is also hypoallergenic and weighs in at 40% lighter than other metals. Available in a variety of color tones, titanium is an ideal material for eyeglasses.

Beta titanium: Titanium mixed with small quantities of aluminum and vanadium, this alloy is more flexible than pure titanium. Adjustments to your eyeglass fit are therefore done easily.

Memory metal: Frames made of memory metal are composed of a titanium alloy that has approximately 50% nickel and 50% titanium. These eyeglasses are very bendable and will return to their original shape even after they are twisted and turned. Memory metal frames are superb for kids or anyone who is rough on their eyeglasses.

Beryllium: The primary advantage of beryllium is its corrosion-resistance. A less costly metal than titanium, beryllium doesn’t tarnish. It is an ideal option for anyone who spends a lot of time around salt water, or who possesses high skin acidity. Flexible, durable and lightweight, beryllium comes in a range of colors.

Stainless steel: Manufactured in both matte and polished, glossy finishes, stainless steel is strong, flexible, corrosion-resistant and lightweight. An iron-carbon alloy, it also contains chromium.

Monel: This popular alloy of copper and nickel is less expensive than other metals, yet depending upon the quality of plating used – it sometimes discolors or causes skin reactions after long use.

Aluminum: Lightweight and very resistant to corrosion, aluminum boasts a unique look and is frequently used in high-end, exclusive eyewear.

Plastic Frames
Zyl: Abbreviated from “zylonate” (cellulose acetate), zyl is relatively inexpensive and very popular in plastic eyeglass frames. Lightweight, it is available in a rainbow of colors, including multi-colored versions and layers of different colors within one frame.

Propionate: Often used in sports frames, propionate is extremely durable and flexible. This nylon-based plastic is also lightweight and hypoallergenic.

Nylon: Over recent years, nylon has been replaced largely by more resilient nylon blends, such as polyamides, gliamides and copolyamides. While 100% nylon is lightweight and strong, it tends to weaken with age and become brittle.

Cellulose acetate: A plant-based plastic that is hypoallergenic. This material was first used for eyewear in the late 1940’s because of brittleness and other problems with previously used plastics. Today’s acetates are known for being strong, lightweight, and flexible. Cellulose acetate also has the widest range for transparency, rich colors, and finishes. More complex colorations are able to be produced by layering several colors or transparencies in layers and sandwiching them together.

Combination Frames
The best of both worlds, combination frames offer metal and plastic components in one frame. These styles were trendy in the 1950s and 1960s and have recently been revitalized for a fun comeback in many more colors and tones than the classic versions.

Mix It Up!
Each respective frame material brings unique features and advantages to your eyeglasses. One pair of glasses may not fit every part of your daily routine, in addition to social outings and special occasions. Perhaps a pair of titanium frames is best for your sophisticated, conservative work environment, but on the weekends you’d prefer to show off style with a retro zyl frame in laminated colors? Consider purchasing more than one pair of eyeglasses, and match your frames to your personality and lifestyle.

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.

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