Vision problems

The most common vision problems are called refractive errors. Refractive errors occur when the shape of the eye prevents entering light from focusing directly on the back of the eye (retina). The length of the eye (longer or shorter), the shape of the cornea (clear part of the eye, too steep or too flat), or aging of the eye’s internal lens can cause refractive errors.

Types of refractive errors

Myopia (nearsightedness) is a condition where objects that are close to you appear clear, while distant objects appear blurry. With myopia, light comes to focus in front of the retina either because the eye is too long or the cornea is too steep, or both. Corrective lenses are needed to push the image back into focus on the retina.

Hyperopia (farsightedness) is a common type of refractive error where distance objects may be seen more clearly than at near. However, some people may not notice any problems with their vision, especially when they are younger. It may not present with symptoms until the mid-30’s or later. For people with significant hyperopia, vision can be blurry for any distance, but always worse at near. Sometimes, if the hyperopia is high enough a correction is needed to alleviate the strain.

Astigmatism is not a disease as many people think that it is. It is merely a condition in which the eye does not focus light evenly on the retina. It can be caused by differing curvatures of the cornea or the eyes internal lens. Despite the cause it can cause images to seem ghosty, “doubled”, or stretched out. The eye cannot compensate for this on it’s own so a correction is needed for precise vision.

Presbyopia is purely an age related condition in which the ability of our natural lens to shift focus from distance viewing to viewing something up close steadily declines. When younger, our lens can flex to allow a quick shift in focusing at any distance. As we age this flexing diminishes as the lens stiffens, making it hard to focus on near objects, especially small or detailed objects.

Eye Health Problems

Amblyopia

Is the medical term used when the vision in one eye is reduced because the eye and he brain are not working together properly. The eye itself looks normal, but it is not being used normally because the brain is favoring the other eye. This condition frequently referred to as lazy eye. It can be caused by the two eyes being misaligned and the brain ignores the eye that turns, or by a large difference in prescription between the two eyes where again, the brain ignores the blurrier of the two eyes.

Blepharitis

An inflammation of the eyelids and lashes causing red, irritated, itchy eyelids. It can be hard to manage because it tends to be chronic. Complications can be a stye (red, tender/painful bump) on the lid caused by an acute infection of the oil glands of the eyelid. A chalazion can follow the development of a stye and is usually a painless firm lump caused by the chronic inflammation of the oil glands of the eyelid. It is frequently associated with scalp dandruff and acne rosacea.

Cataract

A cataract is a generic term for any type of clouding of the normally clear internal lens of the eye. It is not a film that grows over the surface of the eye that is peeled off during surgery. Most types of cataracts are simply related to aging. Most people over 60 will have some degree of cataract formation. Although most types are related to aging, some cataracts can result from eye surgery for other eye problems, diabetes, and steroid use for inflammatory conditions. Some can result from eye trauma. The symptoms, cloudy/blurry vision, faded colors, glare from lights or bright sunlight, may initially be improved with a change in glasses prescription, improved lighting for reading, anti reflection coatings on lenses, or magnifying lenses. However, if these do not help, surgery is the only effective option. Surgery involves removing the cloudy lens and replacing it with a new, clear, artificial lens. Although surgery, and not without risks, it takes only about ten minutes for the procedure. You will have to take medicated drops for several weeks after surgery, but generally, most patients notice the improvement in vision within just a few days, and most are much less dependent on glasses to see than before the surgery.

Conjunctivitis

Commonly referred to as “pink eye”, conjunctivitis is a generic term for a group of diseases that cause swelling, and redness of the conjunctiva, the thin protective membrane that lines the inside of the eyelids and the sclera, or white of the eye. It can be caused by a bacterial or viral infections, allergy, inflammatory conditions, or some eye medications.

Diabetic Eye Disease

Diabetic retinopathy is the most common diabetic eye disease and a leading cause of blindness in American adults. It is caused by changes in the small blood vessels of the retina, the light-sensitive tissue at the back of the eye, which needs to be healthy for good vision.
In some diabetic people, the blood vessels, because of the damage caused by chronic high blood sugar levels, swell and begin to leak blood and serum into the tissues of the retina. In others,abnormal new vessels grow on the surface of the retina. Theses new vessels are very fragile and frequently break, causing major hemorrhaging which can be very damaging, potentially causing scarring and vision loss.
Unfortunately, in the beginning stages of diabetic retinopathy, there are no symptoms. The disease typically has to reach advanced stages before visual changes are noticed. That is why it is very important for diabetic people to get eye exams every year, even if you are seeing well.
Treatment for diabetic retinopathy consists of several methods. There are different types of laser surgery that may help reduce the leaking vessels, while other types help to cause the shrinkage of the new, abnormal and fragile vessels before they can break. There are also injectable medications that have been shown to reduce fluid leakage and interfere with the growth of new vessels.

Dry Eye

Dry eye occurs when the eye does not produce tears properly, or when the tears are not of the correct consistency, or evaporate too quickly.

Continuous productions and drainage of tears is important to the eye’s health. The tear film basically consists of three layers – an outer oily (lipid ) layer that keeps the tears from evaporating too quickly; a middle watery (aqueous) layer that nourishes the eye tissues; and a bottom mucus layer that helps the rest of the tears to “stick” and spread across the surface, keeping it moist. Symptoms of dry eye are numerous, ranging from a “sandy, gritty” feeling, to burning and excessive tearing as the brain tries to compensate for the dysfunctional tear layer(s).

Dry eye is more common in women, especially after menopause. It is also common in patients taking certain medications such as antihistamines, hormone replacements, diuretics (“water pills” for high blood pressure), acne medication, and some antidepressants. It is also frequently seen in people with health issues like rheumatoid arthritis and Sjogren’s syndrome

Floaters

Floaters are little “cobwebs” or specks that float in your field of vision. They move as your eyes move and seem to dart away when you try to look at them. They occur when the vitreous – a gel like fluid that fills about 80% of the eye, slowly shrinks with time. As it shrinks, it becomes stringy, and the strands cast shadows on the retina. So, most are just part of the aging process. However, some may signal infection, inflammation, internal eye hemorrhaging, or retinal tears and detachment. Any sudden increase in the amount of floaters, possibly accompanied by the onset of light flashes and development of a blind spot in the peripheral (side) vision, could indicate a retinal detachment. This is a serious condition and should be considered a medical emergency. You need to call your eye doctor immediately, because left untreated, RD can lead to permanent vision impairment within days.

Glaucoma

Glaucoma is actually a group of diseases that permanently damage the optic nerve, the “cord that plugs the eye into the brain” and can result in vision loss. While many times associated with an increase in the eyes’ internal fluid pressure, it in some cases is not. That is why at every exam, your doctor will want to check the pressure in the eye. High pressure does not mean you have glaucoma, it is merely a risk factor for developing glaucoma. Some people have what is clinically considered normal pressure, yet still develop glaucoma. That is why it is important to have a dilated pupil exam, so you doctor can clearly see the appearance of the optic nerve. Unfortunately, glaucoma, in most instances, has no symptoms. You do not feel the increase in pressure in the eyes. It can only be detected by examination. There is no cure for glaucoma, but can usually be managed with eye drop medications , and in some cases surgery. It is important to detect it early before irreversible vision loss occurs.

Macular Degeneration

Macular Degeneration (also known as AMD or age-related macular degeneration), is the leading cause of vision loss among people 50 and older. It does not lead to complete blindness, with no ability to see, but the loss of central vision in AMD can severely interfere with simple everyday tasks such as driving, reading, writing or to do other close work.
The macula is a very small, yet critical part of the retina, made up of many light-sensitive cells that provide sharp, central vision with the ability to see fine details. When damaged, the center part of your vision appears blurry, distorted or dark.

The number one risk factor for developing AMD is age. It is mostly seen in people over 60. Other risk factors are smoking (it doubles the risk), race (more common in Caucasians than among African-Americans or Hispanics/Latinos), and family history of the disease.

Since you can’t control your age, your race, or your family history, what can you do to hopefully reduce your risk? Avoid smoking, exercise regularly, maintain a normal blood pressure and cholesterol levels, and eat a diet rich in green, leafy vegetables (think kale and spinach) and fish. Sounds just like what your M.D. would tell you for a healthy heart doesn’t it? Ask your eye doctor about potential treatments for AMD if you are diagnosed.

Vitreous Detachment

This is a common condition that usually affects people over 50, and very common over 80. AS mentioned under Floaters, most of the eye’s interior is filled with a gel-like fluid. Within this gel are many fine fibers that are attached to the surface of the retina. With age the vitreous shrinks and the fibers pull on the retina. Usually the fibers break allowing the vitreous to separate and shrink from the retina. This is a vitreous detachment, or posterior vitreous detachment (PVD). Although annoying because of the increase in floaters and the size of the new floater, it is not sight-threatening and requires no treatment. However, sometimes some of the fibers, as they shrink, pull so hard on the retina that a PVD may cause a retinal tear or hole to develop, which can progress to a retinal detachment, which is considered a medical emergency and needs to be repaired before permanent vision loss can occur. The only way to diagnose a PVD and to look for complications is to have a comprehensive dilated eye examination.