Frequently Asked Questions About Vision Care
What is a Cataract?
A cataract is a cloudy or opaque area in the normally clear lens of the eye. Depending upon its size and location, it can interfere with normal vision. Most cataracts develop in people over age 55, but they occasionally occur in infants and young children. Usually cataracts develop in both eyes, but one may be worse than the other.
The lens is located behind the colored part of the eye called the iris. The lens helps to focus light on the retina, the back of the eye. Clouding of the lens occurs due to changes in lens proteins and fibers.
The lens is composed of layers like an onion. The outermost is the capsule. The layer inside the capsule is the cortex, and the innermost layer is the nucleus. A cataract may develop in any of these areas and is described based on its location in the lens.
There is no clinically established treatment to prevent or slow their progression of a Cataract. In age-related cataracts, changes in vision can be very gradual. Some people may not initially recognize the visual changes. However, as cataracts worsen vision symptoms tend to increase in severity.
Cataracts generally form very slowly. Signs and symptoms of a cataract may include:
- Blurred or hazy vision
- Reduced intensity of colors
- Increased sensitivity to glare from lights, particularly when driving at
- Increased difficulty seeing at night
- Change in the eye’s refractive error
Why Should I wear Sunglasses?
Sunglasses should be worn to protect your eyes first, and as a fashion statement second. Even on an overcast day, harmful ultraviolet (UV) rays can damage both the skin and the surface of the eye. Over time, unprotected exposure to the sun can increase the risk of certain types of cataracts and cancers of the eyelids.
Over exposure to the UV can cause pingueculas and pterrigiums leading to dry eyes and possible surgery. UV, as well as blue light, has the potential to damage the retina, the light-sensitive lining at the back of the eye, which could lead to significant loss of vision. UV damage is cumulative, so it’s never too late to begin protecting your eyes from the sun’s harmful rays. UV is just as strong when reflected from sand, water, or even pavement.
The following tips can help prevent eye damage from exposure to UV radiation:
- Wear a wide-brimmed hat or cap. It can block up to half of the UV radiation, reducing the amount that may enter from above or around sunglasses.
- Wear sunglasses any time your eyes are exposed to UV radiation, even on cloudy days and during winter months.
- Look for quality sunglasses that offer good protection. Sunglasses should block out 99 to 100 percent of both UVA and UBB radiation and screen out 75 to 90 percent of visible light. Look for the AOA Seal of Acceptance for Nonprescription Sunglasses.
What can I do to prevent possible eye disease and vision Loss in the Future?
There’s no substitute for the quality of life good vision offers. Adding certain nutrients to your diet every day – either through foods or supplements – can help save your vision. Researchers have linked eye-friendly nutrients such as lutein/zeaxanthin, vitamin C, vitamin E, and zinc to reducing the risk of certain eye diseases, including macular degeneration and cataract formation. Make sure you ask your doctor before taking these supplements.
- wash your hands before handling contact lenses.
- See your optometrist for your regularly scheduled contact lens and eye examination.
- Regularly clean contact lenses, as directed by your optometrist or staff. Rub the contact lenses with fingers and rinse thoroughly before soaking lenses overnight in sufficient multi-purpose solutions if told to do so by staff.
- Store lenses in the proper lens storage case and replace the case at a minimum of every three months. Clean the case after each use and keep it open and dry between cleanings.
- Only fresh solution should be used to clean and store contact lenses. Never Re-use old solution. Contact lens solution must be changed according to the manufacturer’s recommendations, even if the lenses are not used daily.
- Always follow the recommended contact lens replacement schedule prescribed by your optometrist.
- Remove contact lenses before swimming or entering a hot tub.
- Avoid tap water to wash or store contact lenses or lens cases.
- Use cream soaps because they can leave a film on your hands that can transfer to the lenses.
- Use homemade saline solutions. Improper use of homemade saline solutions has been linked with a potentially blinding condition among soft lens wearers.
- Put contact lenses in your mouth or moisten them with saliva, which is full of bacteria and a potential source of infection.
- Use tap water to wash or store contact lenses or lens cases.
- Share lenses with others.
- Use products not recommended by your optometrist to clean and disinfect your lenses. Saline solution and rewetting drops are not designed to disinfect lenses.
Are there bifocal Contact lenses?
The first approach to dealing with patients who are typically age 40 and over dealing with presbyopia is a technique called monovision. Presbyopia occurs when, as part of the natural aging process, the eye’s crystalline lens loses its ability to become more power when objects are brought closer towards ones face.
Monovision means wearing a contact lens for near vision on one eye and, if needed, a lens for distance vision on the other eye.Most people who try monovision are able to adjust to it.
Alternative treatments for presbyopia include a combination of contact lenses and reading glasses, or your doctor may also prescribe bifocal contact lenses.
How do I treat my dry eyes?
The primary approaches used to manage and treat dry eyes include adding tears, conserving tears, increasing tear production, and treating the inflammation of the eyelids or eye surface that contributes to the dry eyes.
Over-the-counter artificial tear solutions can be used to manage mild cases of dry eyes and be used as needed. However some people may have persistent dry eyes that don’t respond to artificial tears alone. Additional steps need to be taken to treat their dry eyes. An additional approach to reducing the symptoms of dry eyes is to keep natural tears in the eyes longer. By blocking the tear duct with a tiny silicone or gel-like plug, tears are more likely to stay in the eye.
A surgical procedure to permanently close tear ducts can also be used. In either case, the goal is to keep the available tears in the eye longer to reduce problems related to dry eyes. Lastly, there are prescription eye drops that help to increase production of tears can be recommended by your optometrist, as well as omega-3 fatty acid nutritional supplements.
If dry eyes are due to an increase in surface inflammation of the eyelids, prescription eye drops or ointments, warm compresses and lid massage, or eyelid cleaners may be recommended to help decrease inflammation around the surface of the eyes.
What is Glaucoma and who is at risk?
Primary open-angle glaucoma is associated with an increase in the fluid pressure inside the eye. This increase in pressure may cause progressive damage to the optic nerve and loss of nerve fibers. Vision loss may result.
Glaucoma is the second leading cause of blindness in the U.S. It most often occurs in people over age 40, although a congenital or infantile form of glaucoma exists.
People with a family history of glaucoma, African Americans over the age of 40, and Hispanics over the age of 60 are at an increased risk of developing glaucoma. Other risk factors include thinner corneas, chronic eye inflammation, and using medications that increase the pressure in the eyes.
Many people do not become aware they have the condition until significant vision loss has occurred. It initially affects peripheral or side vision, but can advance to central vision loss. If left untreated, glaucoma can lead to significant loss of vision in both eyes, and may even lead to blindness.
Glaucoma cannot currently be prevented, but if diagnosed and treated early it can usually be controlled. Medication or surgery can slow or prevent further vision loss. However, vision already lost to glaucoma cannot be restored. That is why the American Optometric Association recommends an annual dilated eye examination for people at risk for glaucoma as a preventive eye care measure.
I think I have Pink Eye (Conjunctivitis) what should I do?
Conjunctivitis is an inflammation or infection of the conjunctiva, the thin transparent layer of tissue that lines the inner surface of the eyelid and covers the white part of the eye. Conjunctivitis may be caused by a viral or bacterial infection and may affect one or both eyes. It can also occur due to an allergic reaction to irritants in the air like pollen and smoke, chlorine in swimming pools, and ingredients in cosmetics or other products that come in contact with the eyes.
Bacterial Conjunctivitis- an infection most often caused by staphylococcal or streptococcal bacteria from your own skin or respiratory system. The eye is usually red with a green/yellow discharge. Other symptoms are a gritty feeling in one or both eyes and swollen eyelids. It is treated by means of antibiotic eye drops or ointments.
Viral Conjunctivitis- most commonly caused by contagious viruses associated with the common cold. The primary means of contracting this is through exposure to coughing or sneezing by persons with upper respiratory tract infections. It can also occur as the virus spreads along the body’s own mucous membranes connecting lungs, throat, nose, tear ducts, and conjunctiva. The main symptoms are red eye and mucoid discharge. There are no treatments from viral conjunctivitis. Artificial tears can be used to make the eye more comfortable.
Allergic Conjunctivitis- occurs more commonly among people who already have seasonal allergies. At some point they come into contact with a substance that triggers an allergic reaction in their eyes. The eyes will have a watery discharge. Treatment consists of avoiding the irritant, and cool compresses. In more severe cases, antihistamines may be prescribed.
Myopia (Nearsightedness) is a vision condition in which close objects are seen clearly, but objects farther away appear blurred. Nearsightedness occurs if the front of the eye has too much curvature, or the eyeball is too long. As a result, the light entering the eye isn’t focused correctly on the retina and distant objects look blurred. Because the eye continues to grow during childhood, myopia typically progresses until about age 20. However, nearsightedness may also develop in adults due to visual stress or health conditions such as diabetes.
It is not knows specifically why myopia occurs but it is thought that heredity and visual stress are two main factors. If one or both parents are nearsighted, there is an increased chance their children will be nearsighted. Also, individuals who spend considerable time reading, working at a computer, or doing other intense close visual work may be more likely to develop nearsightedness.
Nearsightedness may also occur due to environmental factors or other health problems such as night myopia or “pseudo” myopia meaning false myopia. Night myopia occurs due to the low level of light making it hard for the eyes to focus. Pseudo Myopia occurs due to over use of the eyes’ focusing mechanism. After long periods of near work, their eyes are unable to refocus to see clearly in the distance. The symptoms are usually temporary and clear distance vision may return after resting the eyes. However, over time constant visual stress may lead to a permanent reduction in distance vision.
People with nearsightedness have a variety of options to correct their vision problem. In consultation with your optometrist, you can select the treatment that best meets you visual and lifestyle needs.
Ways to become 20/20 again via correction are by;
- contact lenses
- laser and other refractive surgery procedures
- vision therapy for persons with stress-related nearsightedness.
Eyeglasses are the primary choice of correction for persons with nearsightedness, farsightedness and presbyopia. Eyeglass frame materials have evolved with the advent of new plastics and various types of metals such as titanium making them lighter. Certain frames are made with highly flexible metal alloys, which reduce the possibility of breakage. Spring hinges are also for added durability, and are a great option for children’s eyewear.
There have been many advances in eyeglass lenses to make them lighter, thinner and optically superior.
Polycarbonate lenses are thinner, lighter and up to 10 times more impact-resistant than regular plastic lenses. These lenses are great for safety glasses, children’s eyewear, and for anyone who wants lightweight, durable lenses.
Aspheric lenses, which have a slimmer, more attractive profile than other lenses. They also eliminate that magnified, “bug-eye” look caused by some prescriptions.
High index lenses, which are made of new materials that enable the lenses to be noticeably thinner and lighter than regular plastic lenses.
Photochromic lenses are sun-sensitive lenses that quickly darken in bright conditions, and quickly return to a clear state in ordinary indoor lighting. It is important to note that they will not change into sunglasses in the car because they use ultraviolet light to change and the windshield blocks that light.
Polarized lenses diminish glare from flat, horizontal reflective surfaces like water and glare from the road. It can also be used to reduce eye stress.
Anti-reflective coatings are among the most popular add-ons for lenses. They can dramatically improve the look and comfort of your glasses by minimizing the amount of light that reflects off the surface of your lenses, which also has the added benefit of reducing glare and thus easing eye fatigue.
Other lens coatings include scratch-resistant, ultraviolet treatment, mirror coatings and gradient tints.
Multifocal eyeglass lenses available for presbyopia correction include:
- Bifocals: Lenses with two powers – one for distance and one for near – separated by a visible line consisting of different lengths.
- Trifocals: Lenses with three powers for seeing at varying distances – near, intermediate and far – separated by two visible lines.
- Progressive lenses: These lenses have many advantages over bifocals and trifocals because they allow the wearer to focus at many different distances, not just two or three. Because they have no lines, progressive lenses allow a smooth, comfortable transition from one distance to another. They allow for comfortable computer viewing, as well as any other intermediate viewing.
Known as corneal refractive therapy, involves the fitting of a series of rigid contact lenses to reshape the cornea, the front outer surface of the eye. The contact lenses are worn daily for limited periods, such as overnight, and then removed. Persons with moderate amounts of nearsightedness may be able to temporarily obtain clear vision for most of their daily activities. New Ortho K lenses are now able to combat individuals with astigmatism.
Both methods use laser light to change the corneal surface the eyes in order to correct myopia (nearsightedness). In PRK (photorefractive keratectomy), a laser is used to remove a thin layer of tissue from the surface of the cornea in order to change its shape and refocus light entering the eye. There is a limit to how much tissue can safely be removed and therefore the amount of nearsightedness that can be corrected.
With LASIK removes tissue from the corneas inner layers. To do this, a section of the outer corneal surface is cut and folded back to expose the inner tissue. Then a laser is used to remove the precise amount of corneal tissue needed to reshape the eye, and then the flap of outer tissue is placed back in position to heal. The amount of nearsightedness that LASIK can correct is limited by the amount of corneal tissue that can be removed in a safe manner. Optometrists are involved with LASIK in that they manage the patient before and after surgery.
Vision Therapy for Myopia
Vision therapy can be used for multiple eye problems such as Convergence insufficiency and accommodative dysfunction. With regards to myopia, it is an option for people whose blurred distance vision is caused by a spasm of the muscles which control eye focusing. Various eye exercises can be used to improve poor eye focusing ability and regain clear distance vision.
People who are highly nearsighted or whose corneas are too thin to allow the use of laser procedures now have another option. They may be able to have their nearsightedness surgically corrected by implanting small lenses in their eyes. These intraocular lenses look like small contact lenses and they provide the needed optical correction directly inside the eye.
What is vision therapy?
Vision therapy (also called vision training) is an individualized program of eye exercises and other methods to correct vision problems other than nearsightedness, farsightedness and astigmatism. Problems treated with vision therapy include amblyopia (‘lazy eye”), eye movement and alignment problems, focusing problems, and certain visual-perceptual disorders. Vision therapy is usually performed in an optometrist’s office, but most treatment plans also include daily vision exercises to be performed at home.
How often should children have their eyes examined?
According to the American Optometric Association (AOA), infants should have their first comprehensive eye exam at 6 months of age. After that, kids should have routine eye exams at age 3 and again at age 5 or 6 (just before they enter kindergarten or the first grade).
For school-aged children, the AOA recommends an eye exam every two years if no vision correction is needed. Children who need eyeglasses or contact lenses should be examined annually.
• Information courtesy of the American Optometric Association