Community

Some New Year's resolutions are easier to fulfill than others. Even if you aren't able to add a checkmark to "soar over the Italian countryside in a hot air balloon" this year, but you can certainly improve your vision with a visit to the optometrist in 2020.

How Poor Vision Can Affect Your Life

Even small changes in your vision can have an impact on your life. When you can't see words, images, and objects clearly, you may:

• Develop Uncomfortable Physical Symptoms. Eyestrain, eye pain, headaches, fatigue, and dizziness can occur if you must squint to read or view objects in the distance.

• Have Trouble Driving. Driving safely becomes difficult if you can't read the road signs or tell when the car ahead of you slows down.

• Miss Crucial Information. When you can't see clearly, it's easy to mistake one word for another when you're reading an email, text or recipe. From cooking mistakes to miscommunications with family and co-workers, poor vision can complicate your life.

• Experience Academic Problems. Good vision is an essential aspect of the learning process. Without it, schoolwork can become unnecessarily challenging.
   

But My Vision Was Fine Last Year!

Vision changes often occur so gradually that you may not be aware that you have a problem until you can't read a line on the eye chart during an eye exam. If you review the past year, you may realize that you compensated for your vision problem by squinting or holding books and papers closer or farther away than normal.

Yearly Eye Exams Help You Improve and Protect Your Vision

Regular eye exams are important no matter what your age. The exams not only detect refractive errors that affect your ability to see clearly but also provide important information regarding the health of your eyes and your general health.

During your eye exam, your optometrist will measure your visual acuity, or ability to see images sharply, by asking you to read an eye chart. If you have a refractive error, you may have difficulty reading some lines on the chart. Common refractive errors include:

• Myopia (Nearsightedness). If you have myopia, close images are clear but far objects look blurry. More than 40 percent of Americans have myopia, according to the American Optometric Association.

• Hyperopia (Farsightedness). The opposite is true if you have hyperopia. Far objects are clear while close images are blurry.

• Astigmatism. Astigmatism makes your vision blurry when you look at objects close up and at a distance and occurs due to an irregularly shaped cornea. Astigmatism can occur in addition to hyperopia or myopia.

• Presbyopia. The age-related condition makes it difficult to see near objects clearly and affects nearly everyone eventually. You can develop presbyopia even if you never needed glasses before. Fortunately, reading glasses, bifocals, trifocals or progressive lenses can help you read and perform close work easily again.
   

Comprehensive eye exams also include a thorough examination of the structures of your eyes and involve several different types of tests, including glaucoma testing.

Some general health problems cause changes in your eyes that can be detected during a comprehensive eye exam. For example, changes in the appearance in blood vessels in your retina at the back of your eye may mean that you have high blood pressure or diabetes.

Improve Your Vision with Eyeglasses or Contacts

You'll be amazed at the difference in the sharpness of your vision once you receive your new eyeglasses or contact lenses. Even small tweaks to your prescription can make the world around you look much clearer.

When you're ready to choose your new eyeglasses, you'll find plenty of lens and frame options from impact-resistant polycarbonate lenses to ultra-thin high-index lenses to special UV-blocking and anti-reflective coatings, today's lenses are designed to enhance your vision and comfort.

If you plan to wear contacts, you'll need a special exam in addition to your comprehensive eye exam. During the contact lens exam, your optometrist will measure your eyes to determine the lens size you'll need and evaluate your tear film to ensure that you'll be able to wear contact lenses comfortably. Thanks to new types of lenses that retain moisture longer, contacts can be a good choice even if your eyes tend to be a little dry.

Is it time for your eye exam? Contact our office to schedule an appointment.

Sources:

American Optometric Association: Visual Acuity: What is 20/20 Vision?

All About Vision: Eye Exams

American Academy of Ophthalmology: What is Presbyopia?, 2/21/19

American Optometric Association: With Childhood Myopia Rates on the Rise, the American Optometric Association Highlights the Importance of Early Intervention through Annual Eye Exams, 3/1/19

With cataract surgery, your ophthalmologist removes the cataract-diseased lens of your eye. The ophthalmologist then replaces your natural lens with an artificial one.

The Procedure

This outpatient procedure is generally safe and takes less than an hour. Your ophthalmologist will dilate your pupil with eye drops and administer local anesthetic eye drops. You may also be prescribed a sedative to counter anxiety.

Once your eye surgeon has made a small, self-sealing incision in the eye, he or she performs a step called phacoemulsification. During this step of the procedure, the ophthalmologist inserts a thin probe into the cataractous lens and uses ultrasound waves to break it up, before suctioning out the pieces.

Once your eye surgeon removes your cataract, he or she implants an intraocular lens (IOL). IOLs come in a wide variety of materials and functions. Some help with both near and distant vision, similar to bifocals. Others block ultraviolet light. You and your doctor will discuss the best type for you.

If you need cataract surgery in both eyes, your doctor will likely recommend doing one at a time, with a healing period in between.

Recovery

Usually, you can go home on the day of your surgery. However, you’ll need to arrange for somebody to drive you home from the surgical facility. You might also need help around the house, as your doctor may restrict bending and lifting for a few days.

Expect mild discomfort, light sensitivity, fluid discharge and itching for a few days after surgery. For a short period of time after surgery, you may need to wear a patch or eye shield while sleeping or take medications that control eye pressure.

Your eye doctor will schedule follow-up visits to monitor your progress. Once healed, you’ll get a new prescription for eyeglasses, if necessary.

After surgery, some people develop a secondary cataract, also called posterior capsule opacification. Eye surgeons can usually treat a secondary cataract with a quick, painless outpatient procedure.

Risks

Cataracts are usually treated safely and successfully. However, risks — while uncommon — do exist. These include swelling, infection, inflammation, retinal detachment, glaucoma and loss of vision. People with serious medical conditions or other eye diseases are at increased risk of complications.

If you suspect you need cataract surgery, call us today to discuss your options.

While keratoconus can happen at any stage of life, young people between the ages of 10 and 25 are most likely to develop this disorder. For individuals with keratoconus, their cornea, the clear layer in the front of your eye, gradually thins and begins to bulge outward. Keratoconus typically causes nearsightedness and astigmatism in both eyes.

The first signs of keratoconus are rapid changes in vision that require frequent adjusting of prescription lenses. Other symptoms include increased sensitivity to light, eyes strain and irritation, halos around lights at night, headaches and an incessant urge to rub your eyes. Eventually, the corneas become noticeably cone shaped.

Keratoconus is the most common type of corneal dystrophy, or degenerative corneal disorder. It affects one in every 2,000 Americans, according to the National Eye Institute.

Diagnosis

Many symptoms of keratoconus are similar to those of other corneal disorders, especially during the onset of the condition. This makes keratoconus difficult to diagnose.

Nonetheless, to diagnose keratoconus, ophthalmologists use a slit lamp to inspect your cornea at the microscopic level. Telltale signs of keratoconus include corneal thinning, an iron-colored ring around the cone-shaped cornea, stress lines and scarring at the top of the cone. Your eye doctor will also use instruments and lights to measure the curvature of your cornea.

Causes and Risk Factors

Researchers are not exactly sure why some people develop keratoconus. Leading theories center on genetics, environment and hormones. Some scientists have noted a slightly higher chance of developing keratoconus if a family member has it, but this correlation has not been proven with absolute certainty. Possible environmental causes include allergies that lead to excessive eye rubbing or poorly fitted contact lenses. Some researchers hypothesize that keratoconus is related to the endocrine system (the collection of glands that secrete certain hormones), because the onset often happens at puberty and worsens during pregnancy.

Treatment

Usually, the cornea stabilizes, so vision can be corrected with glasses or contacts. But between 10 and 20 percent of people with keratoconus will have more severe problems that require an alternative form of treatment, such as the following

Corneal Crosslinking. Healthy corneas keep their shape because cross-linked collagen fibers serve as supports. Corneal collagen cross-linking (CXL) involves saturating the cornea with riboflavin drops and activating them with an ultraviolet light. This strengthens the cornea by increasing the amount of collagen cross-linking. While CXL doesn’t cure keratoconus, it can arrest the progress of the disorder.

Intacs Surgery. Your eye doctor may suggest inserting Intacs, extremely thin plastic semi-circles. These flatten the cornea, improving vision. You may or may not still need to wear prescription lenses after Intacs surgery.

Corneal transplant. If keratoconus progresses until the cornea is too thin or scarred to tolerate contacts, your ophthalmologist may recommend a corneal transplant. According to the National Eye Institute, this operation is successful in more than 90 percent of those suffering from advanced keratoconus.

If you are experiencing signs of keratoconus, call us so we can diagnose your vision condition and suggest an appropriate plan of action for your visual needs.

More than 300,000 sports-related concussions occur each year, according to research. Many more concussions result from motor vehicle accidents, falls, and other non-sports related incidents. In addition to causing cognitive difficulties, concussions may result in a cluster of problems called post-concussive vision syndrome. If you have recently experienced a concussion, consult an optometrist for a full vision exam to identify possible problems.

Most Common Symptoms of Post-Concussive Vision Syndrome

A concussion is simply an injury to the brain following some type of blow to the head. In serious cases, this may cause shearing of nerves in the brain or traumatic damage to certain brain areas. If parts of the visual system are impacted, some of the following symptoms may result:

• Double vision. Seeing two versions of the same object is a sign of double vision, which may result from damage to the eyes, eye muscles, or portions of the brain.

• Blurred vision.

• Light sensitivity or sensitivity to glare.

• Difficulty reading, including words “swimming” on the page

• Problems attending to visual information

• Eye strain, even following relatively minor visual tasks

• Headaches after reading or performing other visual tasks

• Problems focusing on objects (also called accommodative dysfunction)

• Difficulty following moving objects

• Impairment in quickly shifting gaze from one point to another

• Loss of a portion of the visual field.
   

Treatment of Post-Concussive Vision Syndrome

Your optometrist will recommend an individualized treatment program to address your symptoms of post-concussive vision syndrome. This may include corrective lenses to address problems with visual acuity or focusing.

Additionally, your optometrist may recommend vision therapy. Vision therapy is not simply designed to exercise your eye muscles; rather, it involves a series of special exercises supervised by a doctor. These exercises can retrain your eyes to respond differently to visual stimuli. For example, you may practice focusing, viewing objects through special prisms or lenses, using special techniques to track an object with your eyes, or responding to visual stimuli with a particular movement to improve eye-body coordination.

In most cases, vision therapy involves visiting the doctor’s office for 30 to 60 minutes, once or twice per week. Often the eye doctor will recommend that you practice certain exercises at home. This homework gives your eyes additional practice, retraining your eyes and brain to behave as they did before your concussion.

Visual-motor-sensory integration training uses various devices to appeal to a person’s senses, including touch, sound and smell. This type of therapy is particularly useful in children with autism. Devices may include play dough, rubber toys, weighted bells and blankets, water, rice, sand, beans, musical instruments, computer games, talking toys and other items. All of these are used to stimulate the senses as a way of strengthening visual, motor and sensory skills.

These exercises are mainly used at home and range from simple head and eye movements to performing more complex activities like throwing a ball or focusing on a stationary object while the head is moving. While moving one’s head and tossing a ball sounds easy enough, they are not simple tasks for persons with sensory system disorders that affect movement and sense of balance.

This device integrates all of the senses used for learning. It is one of the basic instruments used for visual-motor training, and helps with direction, rhythm, eye-hand coordination, and work and shape recognition. It consists of an aluminum case with illuminated membrane switches organized along a grid. When the user hits one of the membrane switches, it lights up. The device offers an audio feedback tone and the display panel indicates the number of switches that have been pressed. Often the individual will be required to coordinate pressing the switches with the metronome beat, or pattern templates can be put over the membrane switches to help guide the user. If the person presses a switch too early or too late it will not light up and will not be calculated once the timed activity is over.

Amblyopia, commonly called lazy eye, refers to the improper development or significant loss of vision in an eye. It occurs when the brain does not acknowledge the images seen by the amblyopic eye.
 

Amblyopia Causes

Amblyopia occurs when an individual cannot use binocular vision (both eyes working together) due to one of three reasons:

1. Strabismus - The most common cause of amblyopia is strabismus, a misalignment of the eyes. To prevent the double vision caused by strabismus, the brain ignores information from one eye.

2. Unequal Refractive Errors - Refractive amblyopia occurs when the brain favors one eye due to extreme nearsightedness, farsightedness, or astigmatism in the other eye.

3. Vision Obstruction - Called deprivation amblyopia, this type of lazy eye is caused when an infant's vision is obstructed and hindered from normal development. Congenital cataracts typically cause this type of amblyopia, and require surgery for treatment.
    

Who is at Risk?

A condition associated with eye development, amblyopia usually begins in infancy or early childhood. For this reason, amblyopia can be difficult to detect. Eye care professionals recommend children have an eye exam at six months, three years, and before starting school to diagnose amblyopia early.
 

Signs and Symptoms of Amblyopia

The primary symptom of amblyopia is the loss of vision in one eye. Since amblyopia does not have many outward symptoms and is often present in infants and young children, it can be difficult to spot.

In some cases, a misalignment of the eyes will be apparent. To test infants at home, a parent can try covering one of the child's eyes at a time while observing behavior. If the infant consistently fusses or cries when one eye is covered, this might indicate a vision problem. Since amblyopia most commonly affects only one eye, children will also consistently bump into objects on the affected side.
 

Diagnosis and Treatment

An eye care provider will diagnose amblyopia with visual acuity and binocular vision tests. Treatment will focus on strengthening the amblyopic eye and retraining the brain to use the weaker eye with eye patches, glasses, vision therapy, and sometimes strabismus surgery.

Treatment is most effective at a young age, but developments in eye care have successfully treated older patients. If left untreated, amblyopia leads to problems with depth perception, blindness in one eye, and if the stronger eye becomes injured, serious problems with visual acuity.

Here, a ball with letters, numbers, colors, pictures, or a combination is hung from the ceiling. In activities used to help focus visual attention, the individual may be asked to concentrate on a figure while bunting the ball with a rod, or hitting or catching it with their thumbs, palms or fists.

Double vision, also known as “seeing double” or the medical term diplopia, is the perception of two images of a single object. This occurs when two nonmatching images are sent to the part of the brain that processes visual input. Over time, the brain eventually begins to compensate for this misinformation by suppressing one signal so that only a single image is perceived. There are many different causes for double vision, ranging from life-threatening to benign. Consequently, when diagnosing double vision and creating a treatment plan, it is critical for a medical professional to determine the specific cause in order to develop an appropriate treatment plan.
 

Symptoms of Diplopia

Common symptoms of double vision include the visual appearance of objects overlapping each other or appearing adjacent to one another. This visual overlap can vary as the affected individual turns or tilts his head or gazes from side to side.

There are two types of double vision: monocular and binocular. With monocular diplopia, double vision is affecting both eyes and does not resolve itself when a single eye is covered. For binocular diplopia, the eyes are simply misaligned and when one eye is covered, the condition is resolved. Each eye is seeing the correct single image when working alone, but when the eyes are working together, the brain perceives two adjacent images.
 

Diagnosis and Treatment

Correctly diagnosing the cause for diplopia is essential to developing an appropriate treatment plan. An eye care professional will start by taking a detailed medical history, including when the problem first began, whether it was a sudden onset or developed gradually, and whether the double vision is a frequent problem or an intermittent concern. The eye care professional will conduct a physical examination to measure visual acuity in each eye. This is necessary to determine whether the double vision is monocular or binocular.

An eye care professional will also examine how shifting the head’s position affects the double vision. If a neurological cause is suspected, close attention will be paid to the pupils and eyelid position when looking for ocular or orbital abnormalities. In some cases specialized imaging, like an MRI, may be necessary.

Treatment for double vision depends on the cause. In the case of monocular diplopia, refractive errors can be corrected with glasses or contact lenses; if cataracts are the cause, surgery can correct this problem. For binocular diplopia, however, a serious condition is typically associated with the eye misalignment. Correctly diagnosing the disease, like diabetes, high blood pressure, or myasthenia gravis is essential to determining the appropriate course of treatment.