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Monthly Archives: July 2014

Cataracts

Cataract is a clouding of the eye’s lens. When we look at something, light rays travel into our eye through the pupil and are focused through the lens onto the retina, a layer of light-sensitive cells at the back of the eye. The lens must be clear in order to focus light properly onto the retina. If the lens has become cloudy, this is called a cataract.

cataract

Vision problems with cataracts

If your vision has become blurry, cloudy or dim, or things you see are not as bright or colorful as they used to be, a cataract may have developed in one or both of your eyes. Many people say that their vision with cataracts is similar to the effect of looking through a dirty car windshield.

As a cataract slowly begins to develop, you may not notice any changes in your vision at first.  But as the cataract progresses, you may begin to find that it interferes with your daily activities.  Performing a complete eye exam, your ophthalmologist (Eye M.D.) can tell you whether cataract or another problem is the cause of your vision loss.

While cataracts are one of the most common causes of vision loss, especially as we age, they are treatable with cataract surgerySince most cataracts are part of the normal aging process, they cannot be reversed.  There are no medications or eye drops that will make cataracts go away—surgery is the only treatment.

A cataract may not need to be removed right away if your lifestyle isn’t significantly affected.  In some cases, simply changing your eyeglass prescription may help to improve your vision. Contrary to popular belief, a cataract does not have to be “ripe” to be removed. However, once you are diagnosed with a cataract, your ophthalmologist needs to monitor your vision regularly for any changes. 

Cataract surgery for clearer vision

When a cataract causes bothersome vision problems that interfere with your daily activities, your ophthalmologist may recommend surgery to remove the cataract. With cataract surgery, your eye’s cloudy natural lens is removed and replaced with a clear artificial lens implant (called an intraocular lens or IOL).

You and your ophthalmologist can discuss the cataract surgery procedure, preparation for and recovery after surgerybenefits and possible complications of cataract surgery, cataract surgery costs and other important information.  Together, you can decide if cataract surgery is appropriate for you.

Cataract symptom progression

Gradually, as cataracts progress, you may have symptoms such as:

  • Painless cloudy, blurry or dim vision
  • More difficulty seeing at night or in low light
  • Sensitivity to light and glare
  • Seeing halos around lights
  • Faded or yellowed colors
  • The need for brighter light for reading and other activities
  • Frequent changes in eyeglass or contact lens prescription
  • Double vision within one eye

See a simulation of what vision with cataract looks like.

The only way to know for certain if you have cataracts is to have a dilated eye exam (where your pupil is widened with eye drops). Your ophthalmologist can detect early signs of cataract development by looking at your eye’s lens.

Get a baseline exam at age 40 when early signs of disease and changes in vision may start to occur. Your ophthalmologist (Eye M.D.)  will let you know how often you should return for follow-up exams. At any point, if you have symptoms or risks for eye disease, see your Eye M.D. Because your risk for cataracts and other eye diseases increases as you get older, starting at age 65 you should see your Eye M.D. every year. A complete eye examination will rule out any other condition that may be causing blurred vision or eye problems. Early detection and treatment of cataracts is critical to preserving sight.

 

 

Culled from: geteyesmart: http://www.geteyesmart.org/eyesmart/diseases/cataracts/index.cfm

Image: AAPOS.org: http://www.aapos.org/terms/conditions/31

Glaucoma

Glaucoma is a disease that damages the eye’s optic nerve. The optic nerve is connected to the retina — a layer of light-sensitive tissue lining the back of the eye — and is made up of many nerve fibers, like an electric cable is made up of many wires. It is the optic nerve that sends signals from your retina to your brain, where these signals are interpreted as the images you see.

eyes_glaucoma

In the healthy eye, a clear fluid called aqueous (pronounced AY-kwee-us) humor circulates inside the front portion of your eye. To maintain a constant healthy eye pressure, your eye continually produces a small amount of aqueous humor while an equal amount of this fluid flows out of your eye. If you have glaucoma, the aqueous humor does not flow out of the eye properly. Fluid pressure in the eye builds up and, over time, causes damage to the optic nerve fibers.

Glaucoma can cause blindness if it is left untreated. Only about half of the estimated three million Americans who have glaucoma are even aware that they have the condition. When glaucoma develops, usually you don’t have any early symptoms and the disease progresses slowly. In this way, glaucoma can steal your sight very gradually. Fortunately, early detection and treatment (with glaucoma eyedrops, glaucoma surgery or both) can help preserve your vision.

There are several types of glaucoma:

Open-angle glaucoma

The most common form of glaucoma is called primary open-angle glaucoma. It occurs when the trabecular meshwork of the eye gradually becomes less efficient at draining fluid. As this happens, your eye pressure, called intraocular pressure (IOP), rises. Raised eye pressure leads to damage of the optic nerve. Damage to the optic nerve can occur at different eye pressures among different patients. Your ophthalmologist (Eye M.D.) establishes a target eye pressure for you that he or she predicts will protect your optic nerve from further damage. Different patients have different target pressures.

Typically, open-angle glaucoma has no symptoms in its early stages and your vision remains normal. As the optic nerve becomes more damaged, blank spots begin to appear in your field of vision. You usually won’t notice these blank spots in your day-to-day activities until the optic nerve is significantly damaged and these spots become large. If all the optic nerve fibers die, blindness results.

Half of patients with glaucoma do not have high eye pressure when first examined. Some such individuals will only occasionally have high eye pressures on repeat testing; thus, a single eye pressure test misses many with glaucoma. In addition to routine eye pressure testing, it is essential that the optic nerve be examined by an ophthalmologist for proper diagnosis.

Normal-tension glaucoma

Eye pressure is expressed in millimeters of mercury (mm Hg), the same unit of measurement used in weather barometers.

Although normal eye pressure is considered a measurement less than 21 mm Hg, this can be misleading. Some people have a type of glaucoma called normal-tension, or low-tension glaucoma. Their eye pressure is consistently below 21 mm Hg, but optic nerve damage and visual field loss still occur. People with normal-tension glaucoma typically receive the same methods of treatment used for open-angle glaucoma.

Conversely, ocular hypertension is a condition where someone has higher eye pressure than normal, but does not have other signs of glaucoma, such as optic nerve damage or blank spots that show up in their peripheral (side) vision when tested. Individuals with ocular hypertension are at higher risk for developing glaucoma later relative to those with lower, or average, eye pressure. Just like people with glaucoma, people with ocular hypertension need to be closely monitored by an ophthalmologist to ensure they receive appropriate treatment.

Closed-angle glaucoma, narrow-angle glaucoma or angle-closure glaucoma

A less common form of glaucoma is closed angle (or narrow-angle glaucoma or angle-closure glaucoma). Closed-angle glaucoma occurs when the drainage angle of the eye becomes blocked. Unlike open-angle glaucoma, eye pressure usually goes up very fast. The pressure rises because the iris — the colored part of the eye — partially or completely blocks off the drainage angle. People of Asian descent and those with hyperopia (farsightedness) tend to be more at risk for developing this form of glaucoma.

If the drainage angle becomes completely blocked, eye pressure rises quickly resulting in a closed-angle glaucoma attack. Symptoms of an attack include:

  • Severe eye or brow pain
  • Redness of the eye
  • Decreased or blurred vision
  • Seeing colored rainbows or halos
  • Headache
  • Nausea
  • Vomiting

A closed-angle glaucoma attack is a medical emergency and must be treated immediately. Unfortunately, people at risk for developing closed-angle glaucoma often have few or no symptoms before the attack.

People at risk for closed-angle glaucoma should avoid over-the-counter decongestants and other medications where the packaging states not to use these products if you have glaucoma.

Congenital glaucoma

Congenital glaucoma is a rare type of glaucoma that develops in infants and young children and can be inherited. While uncommon relative to the other types of glaucoma, this condition can be devastating, often resulting in blindness when not diagnosed and treated early.

Secondary glaucoma

Secondary glaucoma is glaucoma that results from another eye condition or disease. For example, someone who has had an eye injury, someone who is on long-term steroid therapy or someone who has a tumor may develop secondary glaucoma.

CAUSES

A clear fluid called aqueous humor circulates inside the front portion of our eyes. To maintain a constant healthy eye pressure, the eye continually produces a small amount of aqueous humor while an equal amount of this fluid flows out of the eye. The fluid flows out through a very tiny drain called the trabecular meshwork, a complex network of cells and tissue in an area called the drainage angle.

If the drainage angle is blocked, excess fluid cannot flow out of the eye, causing the fluid pressure to increase.
If the drainage angle is blocked, excess fluid cannot flow out of the eye, causing the fluid pressure to increase.

If you have glaucoma, the aqueous humor does not flow through the trabecular meshwork properly. If the drainage angle is become less efficient at draining fluid, as in the common open-angle glaucoma, excess fluid cannot flow out of the eye properly, causing the intraocular pressure (IOP) to increase. Over time, raised IOP causes damage to the nerve fibers. If the drainage angle becomes completely blocked, eye pressure rises quickly, resulting in a narrow-angle glaucoma or angle-closure glaucomaattack, with severe eye and brow pain, nausea and vomiting. This kind of glaucoma attack is a medical emergency and must be treated immediately.

Damage to the optic nerve can occur at different eye pressures among different patients. Your ophthalmologist (Eye M.D.) establishes a target eye pressure for you that he or she predicts will protect your optic nerve from further damage. Different patients have different target pressures.

Some people have a type of glaucoma called normal tension, or low tension glaucoma. Their eye pressure is consistently below 21 mm Hg, but optic nerve damage and visual field loss still occur.

Congenital glaucoma is a rare type of glaucoma that develops in infants and young children. It can be hereditary, and it happens when the eye’s drainage system doesn’t develop fully or correctly before birth.

Glaucoma can often be caused by another eye condition or disease. This is known as secondary glaucoma. For example, someone who has a tumor or people undergoing long-term steroid therapy may develop secondary glaucoma. Other causes of secondary glaucoma include:

  • Eye injury;
  • Inflammation of the eye;
  • Abnormal blood vessel formation from diabetes or retinal blood vessel blockage;
  • Use of steroid-containing medications (pills, eyedrops, sprays); or
  • Pigment dispersion, where tiny fragments or granules from the iris (the colored part of the eye) can circulate in the aqueous humor (the fluid within the front portion of the eye) and block the trabecular meshwork, the tiny drain for the eye’s aqueous humor.

 

If you have received a glaucoma diagnosis from your Eye M.D., your doctor will talk about possibletreatment options, such as glaucoma eyedrops and/or glaucoma surgery.

SYMPTOMS

Symptoms of glaucoma

In its early stages, open-angle glaucoma has no obvious signs. As the disease progresses and more damage occurs, blind spots develop in your peripheral (side) vision. These spots may not be noticeable until the optic nerve has become severely damaged — or until detected by an ophthalmologist during a complete exam.

See a simulation of what vision with glaucoma looks like.

People at risk for closed-angle glaucoma (also called narrow-angle or angle-closure glaucoma), where the eye’s drainage angle becomes blocked, usually have no symptoms before the attack, though some early symptoms can include blurred vision, halos, headache or mild eye pain or redness. At the time of a closed-angle glaucoma attack, symptoms include:

  • Severe eye or brow pain
  • Redness of the eye
  • Decreased or blurred vision
  • Seeing colored rainbows or halos
  • Headache
  • Nausea
  • Vomiting

People with “normal-tension glaucoma” may have eye pressures within normal ranges, but have glaucoma signs and symptoms, such as blind spots in their field of vision and optic nerve damage.

Some people may not have glaucoma symptoms, but may have higher than normal eye pressure (calledocular hypertension). They are considered “glaucoma suspects,” and should be monitored carefully by an ophthalmologist.

Culled from: geteyesmart – http://www.geteyesmart.org/eyesmart/diseases/glaucoma/symptoms.cfm

Image: http://abileneadvancedeyecare.com/eye-insights/glaucoma.html

Age-Related Macular Degeneration

Age-related macular degeneration (AMD) is a deterioration or breakdown of the eye’s macula. The macula is a small area in the retina — the light-sensitive tissue lining the back of the eye. The macula is the part of the retina that is responsible for your central vision, allowing you to see fine details clearly.

macula

The macula makes up only a small part of the retina, yet it is much more sensitive to detail than the rest of the retina (called the peripheral retina). The macula is what allows you to thread a needle, read small print, and read street signs. The peripheral retina gives you side (or peripheral) vision. If someone is standing off to one side of your vision, your peripheral retina helps you know that person is there by allowing you to see their general shape.  

Many older people develop macular degeneration as part of the body’s natural aging process. There are different kinds of macular problems, but the most common is age-related macular degeneration.

SYMPTOMS

With macular degeneration, you may have symptoms such as blurriness, dark areas or distortion in your central vision, and perhaps permanent loss of your central vision. It usually does not affect your side, or peripheral vision. For example, with advanced macular degeneration, you could see the outline of a clock, yet may not be able to see the hands of the clock to tell what time it is.

CAUSES

Causes of macular degeneration include the formation of deposits called drusen under the retina, and in some cases, the growth of abnormal blood vessels under the retina. With or without treatment, macular degeneration alone almost never causes total blindness. People with more advanced cases of macular degeneration continue to have useful vision using their side, or peripheral vision. In many cases, macular degeneration’s impact on your vision can be minimal.

TYPES

There are two types of macular degeneration:

1. Dry, or atrophic, macular degeneration (also called non-neovascular macular degeneration) with drusen

Most people who have macular degeneration have the dry form. This condition is caused by aging and thinning of the tissues of the macula. Macular degeneration usually begins when tiny yellow or white pieces of fatty protein called drusen form under the retina. Eventually, the macula may become thinner and stop working properly.

With dry macular degeneration, vision loss is usually gradual. People who develop dry macular degeneration must carefully and constantly monitor their central vision. If you notice any changes in your vision, you should tell your ophthalmologist (Eye M.D.) right away, as the dry form can change into the more damaging form of macular degeneration called wet (exudative) macular degeneration. While there is no medication or treatment for dry macular degeneration, some people may benefit from a vitamin therapy regimen for dry macular degeneration.

2. Wet, or exudative, macular degeneration (also called neovascular macular degeneration)

About 10 percent of people who have macular degeneration have the wet form, but it can cause more damage to your central or detail vision than the dry form.

Wet macular degeneration occurs when abnormal blood vessels begin to grow underneath the retina. This blood vessel growth is called choroidal neovascularization (CNV) because these vessels grow from the layer under the retina called the choroid. These new blood vessels may leak fluid or blood, blurring or distorting central vision. Vision loss from this form of macular degeneration may be faster and more noticeable than that from dry macular degeneration.

The longer these abnormal vessels leak or grow, the more risk you have of losing more of your detailed vision. Also, if abnormal blood vessel growth happens in one eye, there is a risk that it will occur in the other eye. The earlier that wet macular degeneration is diagnosed and treated, the better chance you have of preserving some or much of your central vision. That is why it is so important that you and your ophthalmologist monitor your vision in each eye carefully.

Culled from EyeSmart: http://www.geteyesmart.org/eyesmart/diseases/age-related-macular-degeneration/index.cfm

Image: visivite.com

Contact Lens-Related Eye Infections

While contact lenses are safely used by millions of people every day, they do carry a risk of eye infection. The most common infection related to contact lens use is keratitis, an infection of the cornea (the clear, round dome covering the eye’s iris and pupil). Keratitis can have multiple causes, including herpesbacteriafungus and microbes (such as acanthamoeba—a very difficult infection to treat). Keratitis is the most serious complication of contact lens wear. In severe cases, it can lead to corneal scarring that impairs vision, and may lead to the need for a cornea transplant.

contact-lens

Symptoms of contact lens-related infections may include blurry vision, unusual redness of the eye, pain in the eye, tearing or discharge from the eye, increased light sensitivity or the sensation of something in your eye. It is important to remember that some contact lens-related eye infections can cause serious vision loss or even blindness, so it is important to see your Eye M.D. as soon as possible for treatment.

Factors that contribute to a contact lens-related infection include:

  • Use of extended-wear lenses
  • Sleeping in your contact lenses
  • Reduced tear exchange under the lens
  • Environmental factors
  • Poor hygiene, including poor maintenance of contact lens cases or reusing or topping off contact lens solution

Safe handling, storage and cleaning of your lenses are key steps to reduce your risk of a keratitis infection.

TAKING CARE OF YOUR CONTACT LENSES

The single best way to avoid eye infections is to follow proper lens care guidelines as prescribed by your eye care professional. In particular, including a “rub and rinse” step in the lens cleaning process, minimizing contact with water while wearing contact lenses and replacing the lens case frequently can help reduce the risk of infection.

Taking Care of Your Lenses

The following guidelines for care of contact lenses have been developed in partnership by the American Academy of Ophthalmology, the Contact Lens Association for Ophthalmologists, the Cornea Society and the American Society of Cataract and Refractive Surgery.

Risk of infection varies somewhat depending on the type of contact lens. Single-use daily disposable lenses are the safest type of soft contact lens, in terms of reducing the risk of infection. Rigid gas permeable lenses are a safer alternative than any type of soft contact lens. Your ophthalmologist can help you decide which type of lens is right for you.

Regardless of the type you decide on, proper care of the lenses is essential to eye health.

  • Before handling contact lenses, wash your hands with soap and water, then rinse and dry them with a lint-free towel.
  • Minimize contact with water, including removing lenses before going swimming or in a hot tub.
  • Contact lenses should not be rinsed with or stored in water (tap or sterile water).
  • Do not put your lenses in your mouth to wet them. Saliva is not a sterile solution.
  • Do not use saline solution and rewetting drops to disinfect lenses. Neither is an effective or approved disinfectant.
  • Wear and replace contact lenses according to the schedule prescribed by your eye care professional.
  • Follow the specific contact lens cleaning and storage guidelines from your eye care professional and the solution manufacturer.
  • During cleaning, rub your contact lenses with your fingers, then rinse the lenses with solution before soaking them. This “rub and rinse” method is considered by some experts to be a superior method of cleaning, even if the solution you are using is a “no-rub” variety.
  • Rinse the contact lens case with fresh solution — not water. Then leave the empty case open to air dry.
  • Keep the contact lens case clean and replace it regularly, at least every three months. Lens cases can be a source of contamination and infection. Do not use cracked or damaged lens cases.

Handle your contact lens solution with care:

  • Do not re-use old solution or “top off” the solution in your lens case.
  • Do not transfer contact lens solution into smaller travel-size containers. This can affect the sterility of the solution, which can lead to an eye infection.
  • Do not allow the tip of the solution bottle to come in contact with any surface, and keep the bottle tightly closed when not in use.
  • If you store your lenses in the case for an extended period of time, consult the instructions for the lenses or the contact lens solution to determine if re-disinfecting the lenses is appropriate before you wear them. In no case should you wear your lenses after storage for 30 or more days without re-disinfecting.

Some experts recommend that if you use contact lenses sporadically you consider using single-use daily disposable lenses.

Taking Care of Your Eyes

Eye infections can lead to serious vision loss in some cases. Proper care of your eyes is just as important as proper lens care.

  • Remove the contact lenses and consult an ophthalmologist immediately if you experience symptoms such as redness, pain, tearing, increased light sensitivity, blurry vision, discharge or swelling.
  • If you smoke, stop. Studies show that contact lens wearers who smoke have a higher rate of problems than nonsmokers.
  • Beware of using decorative lenses, such as those often sold at costume shops. These lenses have the potential to damage eyes permanently.
  • Get regular eye exams. If you wear contact lenses, you should be examined by an eye care provider annually, and more often as needed.

As with any prescription, contact lens prescriptions do expire — typically within one year. You should see your eye care professional yearly to ensure they continue to have an accurate and appropriate prescription. These regular exams are also important opportunities for reinforcing proper lens care.

 

 

 

Culled from: egeteyesmart – http://www.geteyesmart.org/eyesmart/glasses-contacts-lasik/contact-lens-care.cfm

Image: http://www.elements4health.com/contact-lenses-increase-the-risk-of-infection.html