Cataracts

What is a cataract?
When the normally clear lens within your eye becomes cloudy or opaque, it is call ed a cataract. Cataracts vary from extremely small areas of cloudiness to large opaque areas that cause a noticeable loss of vision.

Who gets cataracts?
Cataracts most often develop in persons over the age of 55, but they are also occasionally found in younger people, including newborns.

What causes cataracts?
Many factors can contribute to the development of cataracts. Chemical changes can occur within the lens in your eye that cause it to become cloudy. This may be due to advancing age or it may be the result of heredity, an injury or a disease. Excessive exposure to ultraviolet radiation present in sunlight, cigarette smoking or the use of certain medications are also risk factors for the development of cataracts.

Can cataracts be prevented?
Currently, there are no proven methods to prevent cataracts from forming. However, reducing exposure to sunlight, decreasing or discontinuing smoking and eating a balanced diet may be helpful in preventing their development.

What are signs/symptoms of cataracts?
Cataracts usually develop slowly and without pain. Some indications that a cataract may be forming include blurred or hazy vision, decreased color perception, or the feeling of having a film over the eyes.

How are cataracts diagnosed?
A comprehensive eye examination by a doctor of optometry can determine if you have a cataract forming.

How are cataracts treated?
If a cataract develops to a point that your daily activities are affected, you will be referred to an eye surgeon who may recommend the surgical removal of the cataract. The surgery can generally be done in the surgeon's office using a local or topical anesthesia. Using a small incision, the surgeon will remove the clouded lens and, in most cases, replace it with an intraocular lens implant. A medication is generally placed in the eye after surgery and the eye may be patched.

What happens after cataract surgery?
You will need to have several follow-up evaluations by the eye surgeon and/or your optometrist to monitor the healing process. When completed, eyeglasses or contact lenses may be prescribed to provide the most effective post-cataract vision.

Is surgery the only way to treat cataracts?
Your optometrist can prescribe changes in your eyewear that will help you see more clearly until surgery is necessary. When eyewear no longer provides adequate eyesight, surgery is the only proven means of effectively treating cataracts. Surgery is relatively uncomplicated and has an excellent success rate.

When will I need to have cataracts removed?
Cataracts may develop slowly over many years or they may form rapidly in a matter of months. Some cataracts never progress to the point that they need to be removed. Your optometrist can help you decide on the appropriate time for removal. Most people wait until the cataracts interfere with daily activities before having them removed.

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Glaucoma

What is glaucoma?
Glaucoma is an eye disease in which the internal fluid pressure of your eye rises to a point that the optic nerve is damaged. The pressure that builds up is usually due to inadequate drainage of fluid normally produced in your eyes. Glaucoma is one of the leading causes of blindness in the U.S.

What causes glaucoma?
The exact cause of glaucoma is not known. For some reason, the passages that normally allow fluid within your eye to drain out become clogged or blocked. This results in fluid building up within your eye and increasing pressure on the optic nerve. The nerve fibers and blood vessels in the optic nerve can easily be damaged by this pressure, resulting in loss of vision. An injury, infection or tumor in or around the eye can also cause the pressure to rise.

Who gets glaucoma?
Glaucoma most frequently occurs in individuals over the age of 40, and there is a hereditary tendency for the development of the disease in some families. It is estimated that over 2 million Americans have glaucoma and this number is expected to rise as more of our population grows older. Primary open-angle glaucoma is the most common form of the disease. It occurs more frequently in African Americans than in Caucasians, causes damage at an earlier age and leads to blindness at a much greater rate. There is also a greater tendency for glaucoma to develop in individuals who are nearsighted or who have diabetes. For those over 35, regular optometric exams are particularly important as a preventive eye care measure.

How is glaucoma harmful to vision?
The optic nerve, at the back of the eye, carries visual information to the brain. As the fibers that make up the optic nerve are damaged, the amount and quality of information sent to the brain decreases and a loss of vision occurs.

Will I go blind from glaucoma?
If diagnosed at an early stage, glaucoma can often be controlled and little or no further vision loss may occur. If left untreated, first peripheral vision and then central vision will be affected and blindness may result.

How can I tell if I have glaucoma?
The signs or symptoms of glaucoma can vary depending on the type. Primary open angle glaucoma often develops slowly and painlessly, with no early warning signs. It can gradually destroy your vision without you knowing it. The first indication my occur after some vision has already been lost. Acute angle closure glaucoma, which results from a sudden blockage of drainage channels in your eye, causes a rapid build up of pressure accompanied by blurred vision, the appearance of colored rings around lights and pain and redness in the eyes.

How is glaucoma detected?
A comprehensive optometric exam will include tests for glaucoma. A simple, painless procedure called tonometry measures the internal pressure of your eye. Your optometrist will also look into your eye to observe the health of the optic nerve and measure your field of vision.

How is glaucoma treated?
Glaucoma is usually effectively treated with prescription eye drops and medicines that must be taken regularly. In some cases, laser therapy or surgery may be required. The goal of the treatment is to prevent loss of vision by lowering the fluid pressure in the eye.

Will my vision be restored after treatment?
Unfortunately, any vision loss as a result of glaucoma is usually permanent and cannot be restored. This is why regular preventive eye exams are so important. Low vision rehabilitation services that include the use of specialized optical devices and training may benefit individuals with severe vision loss.

Can glaucoma be prevented?
No, but early detection and treatment can control glaucoma and reduce the chances of damage to the eye and loss of sight.

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Macular Degeneration

What is macular degeneration?
Macular degeneration is an eye disease that occurs when there are changes to the macula. The Macula is a small portion of the retina that is located on the inside back layer of the eye. It reduces central vision and makes seeing details for close work, like reading/sewing, difficult or impossible. Macular degeneration is the leading cause of vision loss among people over age 50.

What causes macular degeneration?
There are two types of age-related macular degeneration. In the "dry", or atrophic type, the tissue of the macular becomes thin and stops functioning properly. This is thought to occur as part of the aging process and vision loss is usually gradual. "Wet", or exudative macular degeneration is less common and results when fluids leak from newly formed blood vessels under the macula and blur central vision. Vision loss from the "wet" form can be rapid and severe.

What are the signs/symptoms of macular degeneration?
Some signs/symptoms of macular degeneration are:
1) a gradual loss of the ability to see objects clearly
2) objects appear to be distorted in shape and straight lines appear wavy or crooked
3) a loss of clear color vision
4) a dark or empty area appearing in the center of vision

How is macular degeneration diagnosed?
The signs/symptoms of macular degeneration can also indicate other eye health problems, so if you experience any of them, you should contact your doctor of optometry immediately. In a thorough eye examination, your optometrist can perform a variety of tests to determine if you have macular degeneration or other eye health problems.

How is macular degeneration treated?
There is no cure for "dry" macular degeneration; nor can central vision lost to macular degeneration be restored. However, doctors now believe that there is a link between nutrition and the progression of "dry" macular degeneration. They suggest that a low-fat diet, rich in dark green leafy vegetables, including spinach, some types of leaf lettuce and broccoli, can slow vision loss due to macular degeneration. There are also nutritional supplements that may be beneficial. Ask your doctor of optometry about your individual case. Since macular degeneration does not affect side vision, low vision aids such as telescopic and microscopic lenses, magnifying glasses, illuminated magnifiers and closed circuit television systems can be prescribed to help make the most effective use of remaining vision. If it is detected early, the "wet" form of macular degeneration can be treated with laser treatment, often referred to as photocoagulation, in which a highly focused beam of light is used to seal the leaking blood vessels that damage the macula. This is not a permanent cure, but it can be used to slow the rate of central vision loss. Low vision aids can also be prescribed for people with this form of macular degeneration.

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Common Vision Conditions

What is nearsightedness?
Nearsightedness (myopia) is a vision condition in which you can usually see close or near objects clearly, but cannot see distant ones as clearly.

What is farsightedness?
Farsightedness (hyperopia) is a vision condition in which distant objects are usually seen clearly, but close ones appear blurred.

What is astigmatism?
Astigmatism is a vision condition in which light entering the eye is unable to be brought to a single focus, resulting in vision being blurred at all distances.

What is presbyopia?
Presbyopia is a vision condition that occurs when the crystalline lens of the eye gradually loses its ability to bring close objects into clear focus. It usually become noticeable when you reach your early-to-mid-forties and is a natural part of aging.

How are these vision conditions treated?
Nearsightedness, farsightedness, astigmatism and presbyopia are all treated with eyeglasses or contact lenses. In recent years, a number of options to surgically alter the shape of the cornea, the clear front surface of the eye, to correct nearsightedness and low to moderate astigmatism have been developed. These include radial keratotomy (RK) and photorefractive keratotomy (PRK). There is also a procedure called orthokeratology which uses a series of rigid contact lenses to provide improved vision for significant periods of time for some people with nearsightedness or astigmatism. Your doctor of optometry can help you decide if these options are right for you.

What is amblyopia?
Amblyopiea (lazy eye) is the loss or lack of the full development of vision in one eye that is not fully correctable with lenses and is not the result of any identifiable eye health problem. Amblyopia is usually due to conditions such as crossed-eyes (strabismus) or a large difference in the refractive error between the two eyes.

How is amblyopia treated?
In young children, patching the good eye may help the amblyopic eye to improve. In addition, to help improve vision function, vision therapy techniques may be used. Eyeglasses or contact lenses may be prescribed to correct any refractive errors.

What are crossed-eyes?
Strabismus (crossed-eyes) is a vision condition in which your eyes are not properly aligned with each other. One or both eyes may alternately turn in (esotropia), out (exotropia), up (hypertropia) or down (hypotropia).

How are crossed-eyes treated?
Treatment of crossed-eyes often includes use of eyeglasses, prisms and vision therapy. In some cases, surgery may be needed.

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Presbyopia

What is presbyopia?
Presbyopia is a vision condition in which the crystalline lens of your eye loses its flexibility. This results in progressive difficulty in focusing on close objects.

What causes presbyopia?
Your eye stops growing in your early teens. The lens, however, continues to grow and produce more and more cells. This continued growth eventually causes the lens to harden and lose some of its elasticity and therefore some focusing ability.

At what age does presbyopia occur?
It varies from person to person. Although presbyopia may seem to develop suddenly, the actual decline takes place over the course of many years. Presbyopia usually becomes apparent to people in their early to mid-forties.

What are signs/symptoms of presbyopia?
Some signs/symptoms of presbyopia include the tendency to hold reading material at arm's length, blurred vision at normal reading distance and eye fatigue along with headaches when attempting to do close work.

Can presbyopia be prevented?
Unfortunately not. Presbyopia is a natural part of the agin process.

How is presbyopia diagnosed?
A comprehensive eye examination by a doctor of optometry will include testing your near vision. This will determine the extent, if any, of presbyopia.

How is presbyopia treated?
To compensate for presbyopia, doctors of optometry prescribe reading glasses, bifocals, trifocals, progressive addition lenses or contact lenses. Since presbyopia can complicate other common vision conditions like nearsightedness, farsightedness and astigmatism, your optometrist will perform other tests to determine the specific lenses that will allow you to see clearly and comfortably for your daily visual needs. Your optometrist will also ask specific questions about your occupational and recreational activities. This information will aid in determining what type of lenses you need.

Will I have to wear glasses all the time?
This will depend on a number of factors, including any other vision conditions you have. You may only need your glasses for reading, working at your computer, sewing or other close work. However, you may find that wearing your glasses all the time is more beneficial and convenient for your vision needs.

Can I still wear contact lenses?
Great strides continue to be made in contact lenses. New technology is making it possible for doctors of optometry to correct many vision conditions, including presbyopia. You and your optometrist can decide whether contact lenses are right for you.

Why are frequent lens changes necessary after 40?
The effects of presbyopia constantly change the ability of the eye's crystalline lens to focus properly. As a result, periodic changes in your eyeglasses or contact lenses are necessary to maintain good vision.

How will presbyopia affect my lifestyle?
After adjusting to your new eyewear, you should find that you can still do all the things you did before. Presbyopia will probably not have a significant effect on your lifestyle at all. You should, however, continue to have comprehensive optometric exams as recommended by your doctor of optometry.

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Diabetes and Your Vision

What is diabetes?
Diabetes is a disease that prevents your body from making or using insulin to break down sugar in your bloodstream.

How does diabetes affect the eye?
Diabetes and its complications can affect many parts of the eye. Diabetes can cause changes in nearsightedness, farsightedness and premature presbyopia (the inability to focus on close objects with age). It can result in cataracts, glaucoma, strabismus (a lack of eye alignment) and decreased corneal sensitivity. Visual symptoms of diabetes include fluctuating or blurring of vision, occasional double vision, night vision problems and flashes and floaters within the eyes. Sometimes early signs of diabetes are detected in a thorough optometric exam. The most serious eye problem associated with diabetes is diabetic retinopathy.

What is diabetic retinopathy?
Diabetic retinopathy occurs when there is a weakening or swelling of the tiny blood vessels in the retina of your eye, resulting in blood leakage, the growth of new blood vessels and other changes. If diabetic retinopathy is left untreated, blindness can result.

Can vision loss from diabetes be prevented?
Yes, in a routine eye examination, your optometrist can diagnose potential vision threatening changes in your eye that may be able to be treated to prevent blindness. However, once damage has occurred, the effects are usually permanent. It is important to control your diabetes as much as possible to minimize your risk of developing retinopathy.

How is diabetic retinopathy treated?
In the early stages, diabetic retinopathy can be treated with laser therapy. A bright beam of light is focused on the retina, causing a burn which seals off leaking blood vessels. In more advanced cases, surgery inside the eye may be necessary. Early detection of diabetic retinopathy is crucial.

Are there risk factors for developing diabetic retinopathy?
Several factors that increase the risk of developing diabetic retinopathy include poor control of diabetes, smoking, high blood pressure and pregnancy.

How can diabetes related eye problems be prevented?
Monitor and maintain control of your diabetes. See your physician regularly and follow instructions about diet, exercise and medication. See your optometrist as recommended for a thorough eye exam when you are first diagnosed with diabetes. Have a thorough eye examination at least annually thereafter.

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