Common Eye Conditions

Cataracts

The crystalline lens of the eye is naturally clear. It focuses light onto the retina to provide clear vision at many distances. If this lens becomes foggy, a person is said to have a cataract. This can impair or distort vision, even when a person is wearing their glasses. Depending on the pattern of fogginess of the lens, a person may also notice glare around lights, doubled vision in one eye, or rapidly changing spectacle prescription. Although cataracts most often affect people over 65 years old, certain types can affect infants, children, or may appear as a result of trauma to the eye. Your doctor can examine the lens of the eye with a special microscope to see if there are any signs of cataracts. If necessary, cataracts can be treated with eye surgery to replace the foggy crystalline lens of the eye with a clear implant lens (IOL). Your doctor can refer you to an appropriate specialist to do this procedure if it becomes necessary.

Glaucoma

The eye is filled with two types of fluid. The aqueous fluid fills the anterior chamber, and the vitreous fills the posterior part of the eyeball. The aqueous fluid is normally produced in the eye and drains from the eye at a steady rate. If the steady rate is disrupted, the amount of fluid filling the eye can increase or decrease. It is possible for the amount of fluid to increase to a level that can damage the fine nerves in the retina of the eye. Damage to these nerves causes loss of vision, which starts with the mid-peripheral vision. This is called glaucoma. During an eye examination, the amount of fluid in the eye, or eye pressure is measured, and the nerve layer is looked at. If there is suspicion that either of these two tests or anomalous, a sensitive peripheral vision test may be administered. Early detection of glaucoma is key to preventing vision loss. If necessary, eye pressure can be lowered with the use of eye drops or surgery. Vision loss due to glaucoma can be prevented, but not restored. If you have a family history of glaucoma it is important you have regular eye exams to monitor your eye pressure and eye health.

Macular Degeneration

The area of the retina that has the highest sensitivity and gives us our discriminating central vision is called the macula. Loss of function of this area, called age-related macular degeneration, can affect individuals in their 60's or later. It is the most common cause of vision loss in this age group. The highly active retina cells in this area produce waste products which are normally eliminated or recycled. Damage to these cells impairs their ability to eliminate waste. As the waste (called drusen) accumulates, the retina above becomes irregular, giving patients distorted central vision. This can progress slowly and is called dry macular degeneration. In some people, a space is formed under the retina, in which unwanted blood vessels are prone to develop. These blood vessels tend to leak which causes a rapid loss of central vision. This is wet macular degeneration. During an eye examination, the macular is inspected using a specialized microscope, or ophthalmoscope, or both. Treatment options include self monitoring with a grid chart to look for early distortions, protection from ultraviolet sunlight that can cause further damage, and occasionally laser surgery to seal leaking blood vessels. *Include combination therapy?* Anti-oxidant vitamins formulated for the eye have been shown to slow the degenerative process. Smoking and a positive family history are thought to be the biggest associated risk factors.

Myopia

What causes myopia? Myopia is a multi-factorial condition. The strong link to parental myopia indicates genetics plays an important role. Myopia is more commonly found in urban

areas, among professionals, computer users, individuals with high education, and increases the most during winter. These all indicate that environment also play an important role. The CORE study was the first to examine the general population using cycloplegic refraction.


    • The study foung 6% of children aged 6 - 8 were myopic and 29% of children aged 11 - 13 were myopic.
    • Children were 2.5 times more likely to have myopia if at lease one parent is myopic.
    • For one additional hour of outdoor time per week, the odds of developing myopia is reduced by 14.3%.
    • 30% of the myopic children identified in the study were uncorrected.
    • Refraction increase had a significant correlation with axial length increase (eye ball lengthens faster for children with more myopia).


Laser Eye Surgery

Laser surgery is a form of vision correction for nearsightedness (myopia), farsightedness (hyperopia), and astigmatism. Our doctors are experienced in the co-management of laser correction with ophthalmologists (eye surgeons), who perform the surgery. Co-management includes patient counseling, comprehensive pre and post-operative care, and yearly follow-up afterwards.

Patient counseling is one of the most important steps in the decision on laser surgery. Many factors can influence the decision. Important considerations include:

    • The degree of the initial prescription.
    • The effect of laser surgery on near vision.
    • Stability of the prescription preceding surgery.
    • Pupil size (can influence night vision).
    • Realistic patient expectations.
    • Eye health – some eye conditions make it not possible to perform surgery.
    • General health.
    • Alternative vision correction techniques.
    • Type of laser surgery (LASIK or PRK).
    • Experience and skill of the surgeon performing surgery.

During a laser surgery consultation, the doctor will evaluate these factors so that a patient can make the most well-informed decision possible.


Sunglasses and UV Light

What you should know about UV Light

The summer sun may feel good, but did you know that its ultraviolet (UV) waves can harm your eyes? Damage can add up over the years and lead to various serious eye problems. Here’s a quick run-down of the dangers of UV exposure, and what you can do to avoid them.

The dangers:

    • Increased risk of developing cataracts, a clouding of the lens of your eye.
    • Increased risk of developing macular degeneration, a leading cause of blindness.
    • Photokeratitis, or “snow blindness”; you can also develop it from the intense sun glare off oceans, lakes, sand, and pavement.
    • Skin cancer, which can affect the eyelids and areas around the eye as well as the rest of your body.
    • Pterigia, an overgrowth of blood vessels and fibrous tissues in the white of your eye. This condition can damage vision and sometimes requires surgery.
    • Pingueculum, a degenerative condition of the lubricated surface of your eye (the conjunctiva).

How you can protect yourself:

    • Wear sunglasses with special coatings that block 100% of UV light.
    • Wear contact lenses with UV-blocking polymers. Remember to wear sunglasses over them to protect the parts of the eye not covered by the contact lens.
    • Wear a hat with a brim.
    • Don’t be fooled by cloudy days; dangerous rays can pass through haze and think clouds, so you still need protection.
    • Be especially careful between 10:00 a.m. and 2:00 p.m. – the most dangerous time for exposure to UV light because the sun is strongest then.



Blue Light (380nm - 500nm)

What you should know about Blue Light

Exposure to blue photons (cell phones, blue sky, some car headlights) can cause photo clinical damage. Long term exposure can lead to long term irreversible damage.

Damage = Exposure = Intensity X Time

Children should have good sunglasses, a brown or amber lens would be best. Children who read with prescription eye wear will get an extra 20% - 30% of blue light reduction if blue light filter lenses are used.

Computers:

To lessen the amount of blue light set the monitor to a lower color temperature or set the digital device to night mode 24 hours/day.


Computers and Sleep:

Digital devices reduce the wavelengths 460nm to 480nm causing a reduction in the production of melanopsin (melatonin). This can upset the circadian rhythm cycle and lead to restless sleep patterns. Staying off all digital devices  hours before bed or incorporate specific blue blocking tints in glasses can help.