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Diseases

 

  • Amblyopia
  • Color Vision
  • Flashes and Floaters
  • Meibomian Gland Dysfunction
  • Blepharitis
  • Conjunctivitis
  • Glaucoma
  • Pterygium
  • Cataract
  • Dry Eye
  • Macular Degeneration
  • Vision Problems

 

Amblyopia

What is amblyopia?

Amblyopia is poor vision in an eye that did not develop normally during early childhood. It is sometimes called “lazy eye”. The condition is relatively common and if detected early can be treated. The best time to correct amblyopia is during infancy or early childhood.


How does normal vision develop?

Newborn infants are able to see fairly well, however, as they use their eyes during the first months of life their vision improves quickly. During early childhood years, the visual system continues to change rapidly as their brain and eyes develop. If a child cannot use his or her eyes normally, vision does not develop properly and as a result the brain doesn’t “learn” to process perfect vision. After the first nine years of life, the visual system is usually fully developed and typically cannot be changed. The development of equal vision in both eyes is necessary for normal vision and certain visual tasks like depth perception. There are many occupations where equal vision from both eyes is critical. In addition, an accident or illness involving the good eye later in life may leave the individual visually impaired.


When should vision be tested?

It is recommended that all children have their vision checked by their family eye doctor on or before their third birthday. There are many techniques that your family eye doctor will utilize to gather necessary information to determine the status of your childs’ visual development…even if the child can’t talk! It is especially important to have your child’s vision checked at an early age if there is a family history of amblyopia, misaligned eyes, childhood cataracts or any other eye diseases.


What causes amblyopia?

Amblyopia is caused by any condition that affects normal use of the eyes and visual development. In many cases, the conditions associated with amblyopia may be inherited. Children in a family with a history of amblyopia or misaligned eyes should be checked by your family eye doctor early in life. Amblyopia has three major causes:

  • Strabismic Amblyopia (misaligned or crossed eyes). Amblyopia occurs most commonly with misaligned or crossed eyes. As the child develops, the brain “turns off” the crossed eye to avoid double vision and preferentially the child uses the better eye. When the brain consistently ignores the crossed eye, it does not learn to process good vision.
  • Refractive Amblyopia (refractive error). Refractive errors are eye focusing problems that are corrected by wearing glasses. Amblyopia occurs when one eye is out of focus because it is more nearsighted, farsighted, or astigmatic than the other eye. The unfocused (blurred) eye is “turned off” and never learns to see perfect vision and becomes amblyopic. This is the most difficult type of amblyopia to detect because the eyes look normal. Amblyopia can occur in both eyes if both eyes if they are affected with large refractive errors like high astigmatism.
  • Diseases of the eye. An eye disease such as a cataract (a clouding of the eye’s natural lens) and retinal disease may lead to amblyopia. Any factor that prevents a clear image from being focused inside the eye can lead to the development of amblyopia in a child. This can often be the most severe form of amblyopia. A comprehensive dilated eye exam by your family eye doctor can detect these vision threatening types of diseases.


How is amblyopia diagnosed?

It is typically not easy to recognize amblyopia without a comprehensive eye exam. A child may not be aware of having one strong eye and one weak eye and oftentimes may not be able to verbalize what they are seeing. Unless the child has an obviously misaligned eye or other abnormality, there is often no way for parents to tell that something is wrong.


How is amblyopia treated?

The overall goal in treating amblyopia is to encourage the child to use the weaker eye. To correct strabismic amblyopia surgery is often necessary to correct the misaligned muscles of the eye. In some cases patching will be utilized to encourage further development of the amblyopic eye.


In refractive amblyopia, sometimes simply prescribing glasses can correct the problem. However, if glasses alone do not improve vision, then patching may be necessary. Patching may be done for weeks and in most cases months. Even after vision has been restored in the weak eye, part-time patching may be required over a period of years to maintain the improvement. Another way to encourage the child to use the weak eye is to blur the vision of the good eye with the use of drops or lenses. Your family eye doctor will discuss which of these treatments is best for your child.


Depending upon the disease found in the eye, surgery may be performed to correct the problem. One of the most common diseases found in young children are cataracts. Once cataract surgery is performed, glasses or contact lenses can be used to further restore focusing.


If amblyopia is not treated several problems may occur:

  • The amblyopic eye may develop a serious and permanent visual defect.
  • Depth perception (seeing in three dimensions) may be lost.
  • If the good eye becomes diseased or injured, the patient may be permanently visually disabled.


Parents play a vital role in determining the success of amblyopia treatment. Children do not like to have their eyes patched, especially if they have been depending on their good eye for clear vision. As a parent, the ability to creatively get your child to cooperate is a challenge. However, it is the key to successful treatment.


Amblyopia is preventable!

Early detection and treatment is critical in correcting amblyopia. Having your child’s vision checked at an early age by your family eye doctor is the first step in assuring normal visual development.

 


Color Vision (Color Blindness)

Color vision difficulty is most often hereditary. It is a sex-linked recessive trait and is usually passed form an affected male via his daughter to his grandson. It is estimated that 1 of 12 boys and 1 of 200 girls have the problem. This deficiency may also be acquired through injury or disease, but this is less common. There are various degrees of color vision impairment. Color vision deficiency does not usually interfere with visual acuity and correction of this deficiency is limited at present. Educational referral is recommended if the color deficiency interferes with the child’s ability to use the educational materials in his/her classroom.


Color deficiency is defined as the absence of or defect in the perception of colors. The most frequently used class of color deficiency is based on the perception of red, green and blue (termed the 1st, 2nd and 3rd color factors, respectively). If there is a defect in the perception of one of these colors, a color will be perceived as if it were composed only of the other two colors. Based on the color or colors for which there is defective perception, a person may suffer from red, green or blue deficiency.


People who have such deficiencies cannot distinguish between certain colors or shades of colors. The most common deficiency is red-green. And since most road, marine and air-borne traffic positions use these colors for signaling, knowledge of a color deficiency is important.


Color deficiency in which all colors are perceived as gray is termed monochromasia.


Colored plate help determine a person’s ability to perceive color. Persons with normal color vision will see geometric shapes. Those with a color deficiency will see a different shape or none at all. Mild to moderate color deficiency is seldom a handicap.

 


Flashes, Floaters, and Vitreous Detachment

Floaters are small and semi-transparent or cloudy particles that float within the vitreous, the clear, jelly-like fluid that fills the inner portion of your eyes. Floaters are usually harmless and are seen by many patients at one time or another. They generally look like translucent specks of various shapes and sizes or like cobwebs. They are frequently visible when you are looking at a plain lighted background like a blank pastel wall, a blue sky or the white pages of a book. Floaters become visible when they fall within the line of sight and cast a shadow on the retina (the light sensitive portion of the back of the eye).


What causes floaters?

There are a number of possible causes for floaters. They may be small flecks of protein or other matter that were trapped during the formation of your eyes before birth and remain suspended in the clear fluid of the vitreous.


Deterioration of the vitreous fluid may also cause floaters to develop. This can be a part of the natural aging process and is often not serious, though it can be very annoying. Certain eye diseases or injuries can also cause floaters.


Sometimes flashes or streaks of light may appear. This may be happening because the jelly-like vitreous is shrinking and pulling on the retina. The retinal receptor cells are stimulated to fire by this tugging action and cause the perception of light flashes.


Vitreous shrinkage can continue and result in a part of the vitreous becoming detached or peeled away from the back of your eye. Vitreous detachments are common and only infrequently lead to serious eye problems.


On rare occasions, the pulling action of the vitreous can cause small tears or holes in the retina. If untreated, retinal tears or holes can continue to worsen and severe vision loss can result if the retina becomes detached.


What is the treatment for floaters?

There is no treatment for floaters. Although they can be annoying, surgical removal of floaters is far more risky than simply monitoring your vision. It is important to have a comprehensive eye health examination as soon as possible after experiencing flashes or if you become aware of an increase in the number or intensity of flashes or floaters. In a comprehensive examination, your family eye doctor will dilate your eyes and use a variety of special instruments to look at the vitreous, the retina and the other parts inside your eyes to determine the causes of the flashes and floaters that you see.

 


Meibomian Gland Dysfunction

Meibomian gland dysfunction can be a chronic or long-term condition of the eyelids and eyelashes. It can affect people of all ages. Among the most common causes of meibomian gland dysfunction are:

  • Hormones
  • Age
  • Medications
  • Allergies

 

Meibomian glands produce oils, which are a critical component of your tear function, comfort and vision. Signs of meibomian gland dysfunction often exhibit in dry eye symptoms; scratchiness, burning, stinging, achiness, fluctuating vision.


Meibomian gland dysfunction is usually not serious and can often be treated easily, but if left untreated, can be very uncomfortable and lead to more serious problems.


Directions for a Warm Soak of the Eyelids:

  • Wash your hands thoroughly.
  • Moisten a clean washcloth with hot water (not scalding).
  • Close eyes and place the washcloth on eyelids for about 5 minutes. Reheat as needed.
  • Repeat at least twice daily. 

 

Directions for an Eyelid Scrub:

  • Wash your hands thoroughly.
  • Moisten a clean washcloth with hot water (not scalding hot!). No soap!
  • Wrap the washcloth around your middle and index finger and with your eyes closed, gently rub the washcloth back and forth across the eyelashes and the edge of the eyelid for approximately one minute on each eye. 

 

Lubrication:
The doctor will often recommend a drop that is thicker to help supplement the tear component that is missing. When you instill the drops, it is important to know that your vision will be temporarily blurred and you should wait until your vision is cleared before you drive or engage in other activities.


Meibomian gland dysfunction is a chronic condition and does not clear overnight! It often takes several weeks of treatment to notice improvement. It is also important to make this routine a daily part of your hygiene throughout your life.

 


Blepharitis

Blepharitis is a chronic or long-term inflammation of the eyelids and eyelashes. It affects people of all ages. Among the most common causes of blepharitis are:

  • A bacterial infection (often staphylococcal)
  • Poor eyelid hygiene
  • Excess oil produced by the glands in the eyelids
  • An allergic reaction

 

There are two ways in which blepharitis may appear. The most common and least severe is often associated with dandruff of the scalp or skin conditions like acne. It usually appears as greasy flakes or scales around the base of the eyelashes and as a mild redness of the eyelid. It may sometimes result in a roughness of the normally smooth tissue that lines the inside of the eyelids or chalazia, which are nodules on the eyelids and can lead to poor tear function. If an acute infection occurs, a stye may occur.


Ulcerative blepharitis is a less common, but more severe condition that may be characterized by matted, hard crusts around the eyelashes, which, when removed, leave small sores that may bleed or ooze. There may also be a loss of eyelashes, distortion of the front edges of the eyelids and chronic tearing.


In cases where bacterial infection is the cause, eyelid hygiene may be combined with various antibiotics and other medications; and if the cause is an allergic reaction, the source of the reaction (eye makeup, for example) should be removed. Blepharitis is usually not serious and can often be treated easily, but if left untreated, can be very uncomfortable, unattractive and lead to more serious problems.


Directions for a Warm Soak of the Eyelids:

  • Wash your hands thoroughly.
  • Moisten a clean washcloth with hot water (not scalding).
  • Close eyes and place the washcloth on eyelids for about 5 minutes. Reheat as needed.
  • Repeat at least twice daily. 

 

Directions for an Eyelid Scrub:

  • Wash your hands thoroughly.
  • Moisten a clean washcloth with hot water (not scalding hot!). No soap!
  • Wrap the washcloth around your middle and index finger and with your eyes closed, gently rub the washcloth back and forth across the eyelashes and the edge of the eyelid for approximately one minute on each eye. 

 

Blepharitis is a chronic condition and does not clear overnight! It often takes several weeks of treatment to notice improvement. It is also important to make this routine a daily part of your hygiene.

 


Conjunctivitis (Pink Eye)

What is conjunctivitis?
Conjunctivitis is the term used by eye doctors to describe inflammation of the conjunctiva, the white part of the eye. In ordinary terms, conjunctivitis is simply the most common cause of red or “pink” eye.


What causes conjunctivitis?

The most common causes of conjunctivitis are:

  • Infections
  • Allergies
  • Environmental irritants

 

Infectious causes of conjunctivitis include bacteria and viruses. Bacterial infections, such as staphylococcus or streptococcus, cause a red eye which is associated with considerable amounts of discharge. If the amount of discharge from the eye is significant, an acute infection is likely, and prompt consultation with your family eye doctor is advisable.


Some bacterial infections are more chronic (long-term) and may produce little or no discharge except for some mild crusting of the eyelashes in the morning. There are different treatment regimens depending on the severity of the bacterial infection.


Viruses are also common causes of conjunctivitis. Some viruses produce the familiar red eyes, sore throat, and runny nose of a common cold. Viral conjunctivitis usually produces a watery discharge and lasts from one to two weeks.


Infectious conjunctivitis, whether bacterial or viral, can be quite contagious, so contact with the patient’s tears through handkerchiefs and towels should be avoided. Handwashing after contact with the patient helps to prevent spread of the infection.


Allergies, like hay fever, make the eyes very itchy, while others may merely produce a chronic redness. Finally, environmental irritants such as smoke or fumes may cause more short-term episodes of conjunctivitis.


What are other causes of red eyes?

There are several eye diseases which also produce a red eye and can lead to blindness unless recognized and treated. It is important to avoid confusing them with conjunctivitis, so a thorough evaluation of a red eye is always a good idea. This is especially important if pain, blurred vision, or severe light sensitivity are present, since these symptoms are not typically found in simple conjunctivitis. Pain, blurred vision, or severe light sensitivity may signal the presence of glaucoma, an ulcer of the eye, or an inflammation of the inside of the eye.


How is conjunctivitis treated?

Depending on the cause of the red eye, your family eye doctor may prescribe antibiotics or anti-allergy medication to treat the conjunctivitis. There is no effective treatment for viral conjunctivitis, so your doctor may not prescribe any medications and let nature take its course. The only way to accurately diagnose the cause of conjunctivitis is to see your family eye doctor for a thorough examination.

 


Glaucoma

Glaucoma is an eye disease in which the passages that allow fluid in the eye to drain become clogged or blocked. This results in the amount of fluid in the eye building up and causing increased pressure inside the eye. This increased pressure damages the optic nerve which transmits visual information to the brain. Damage to the optic nerve results in loss of vision.


Cause of Glaucoma

Unfortunately, the cause of glaucoma is not known and it currently cannot be prevented. If detected in the early stages of the disease, the pressures can be controlled to prevent further vision loss. Glaucoma can affect people of all ages, however, some patients are at higher risk of developing glaucoma:

  • Patients over the age of 40
  • Patients with severe nearsightedness
  • Patients who have diabetes
  • Patients who are African American
  • Patients who have a family history of glaucoma

 

Glaucoma is most often managed with eye drops. If eye drops are ineffective in managing your pressures, then surgery may be necessary.


Glaucoma Eye Exams

Regular eye exams are an important way of detecting glaucoma in its earliest stages. In your annual eye exam, your family eye doctor will test the pressures of your eye, observe the optic nerve for signs of damage and perform a visual field test that checks your peripheral vision. Early detection and management enables the majority of patients to continue living and seeing the same way they always have.

 


Pterygium

What is a Pterygium?
A pterygium is a fleshy growth that invades the cornea (the clear front window of the eye). It is an abnormal process in which the conjunctiva (a membrane that covers the white of the eye) grows into the cornea. A pteryguim may be small or grow large enough to interfere with vision and commonly occurs on the inner corner of the eye.


What causes a Pterygium?

The exact cause is not well understood. A pterygium occurs more often in people who spend a great deal of time outdoors, especially in sunny climates. Long-term exposure to sunlight and chronic eye irritation from dry, dusty conditions are the biggest factors in pterygium formation.


How is a Pteryguim Treated?

When a pterygium becomes red and irritated, topical eyedrops or ointments may be used to help reduce the inflammation. If the pterygium is large enough to threaten sight, is growing or is unsightly, it can be removed surgically.

Despite proper surgical removal, the pteryguim may return, particularly in young people. Surface radiation or medications are sometimes used to help prevent recurrences. Protecting the eyes from excessive ultraviolet light with proper sunglasses and avoiding dry, dusty conditions may also help.


What is a Pingueculum?

A pingueculum is a yellowish patch or bump on the white of the eye, most often on the side closest to the nose. It is not a tumor, but an alteration of normal tissue resulting in a deposit of protein and fat. Unlike a pteryguem, a pingueculum does not grow onto the cornea. A pingueculum may also be a response to chronic eye irritation or sunlight.

How is a Pingueculum Treated?
No treatment is necessary unless it becomes inflamed. A pingueculum does not grow onto the cornea or threaten sight. If particularly annoying, a pingueculum may, on rare occasions, be surgically removed, but the post-operative scar may be as cosmetically objectionable as the pingueculum. The best way to prevent the pingueculum from becoming unsightly or growing, is to wear sunglasses with UV protection or lubricate your eyes in dusty, dry environments.

 


Cataract

A cataract is a cloudiness that develops in the lens of the eye. The cloudiness scatters the light as it enters the eye, preventing light from focusing sharply in the eye. This results in a decrease in vision. Contrary to popular belief, it is NOT a film that grows over the surface of the eye.


Who Gets Cataracts?

Cataracts occur most often in people over the age of 55, but are occasionally found in newborns. They may also happen after a significant traumatic blow to the eye. Cataracts typically affect both eyes, however, they tend to grow at different rates in each eye.


Here are some of the visual symptoms cataracts will cause:

  • Increase in haziness, blurriness or distortion of objects
  • Decrease in color perception
  • A shadowy appearance that seems to move with the eye
  • An increasing dependency on well-lit environments to see well
  • A shift in your glasses prescription to nearsightedness
  • Double vision

 

Preventing Cataracts
There is currently no way to prevent cataracts from forming, however, recent studies have hinted that a good balanced diet, and antioxidant vitamins may contribute to longer eye health. It is also a good idea to wear 100% Ultraviolet sunglasses to promote good eye health.


Treating Cataracts

When the cataract starts to impair your daily activities, it is time for surgery. Cataract surgery is one of the most performed surgeries in the United States and has a 95% success rate.

 


Dry Eye

Dry eye is the term used to describe eyes that do not produce enough tears or tears with an imbalance of the proper composition of the various tear layers. Dry eye is most often a result of eyes’ natural aging process. Most peoples’ eyes tend to become drier as they age, but the degree of dryness varies and some people have more problems than others. In addition to age, dry eye can result from:

  • Problems with normal blinking
  • Certain medications like antihistamines, oral contraceptives and antidepressants
  • Environmental factors like a dry climate and exposure to wind
  • General health problems like arthritis or Sjogren’s syndrome
  • Chemical or thermal burns to the eye

 

Dry eye symptoms are often different in different people, but the following are commonly experienced by those whose tear production is inadequate:

  • Irritated, scratchy, dry or uncomfortable eyes
  • Redness of the eyes
  • A burning sensation of the eyes
  • A feeling of a foreign body in the eye
  • Blurred vision
  • Excessive watering as the eyes try to comfort an overly dry eye
  • Eyes that seem to have lost the normal clear glassy luster

 

If untreated, dry eye can be more than just irritating or uncomfortable. Excessive dry eye can damage eye tissue and possibly scar the cornea, impairing vision. Contact lens wear may be more difficult due to the possibility of increased irritation and a greater chance of eye infection.


If you are experiencing the symptoms of dry eye, your family eye doctor can perform dry eye tests using diagnostic instruments to give a highly magnified view and special dyes to evaluate the quality, amount and distribution of tears. Your family eye doctor will also need to know about your every day activities, your general health, medications you are taking and about environmental factors that may be causing your symptoms.


Unfortunately, dry eye cannot be cured, but your eye’s sensitivity can be lessened and treatment prescribed so that your eyes remain healthy. Possible treatments include:

  • Changing environmental factors like avoiding wind and dust and increasing the level of humidity
  • Using artificial tear or gel solutions
  • Using moisturizing ointment, especially at bedtime
  • Insertion of small plugs in the corner of the eyes to slow drainage and loss of tears
  • In rare cases, surgery may be recommended

 

Whatever treatment is prescribed for you, it is very important that you follow your family eye doctors’ instructions carefully. Dry eye does not go away, but by working together, you and your doctor can keep your eyes healthy and protect your vision.

 


Macular Degeneration

Macular degeneration is the leading cause of central vision loss among older people. Macular degeneration is caused by changes to the macula, the central portion of the retina, responsible for the sharpest possible vision. The macula is many times more sensitive than the rest of the retina and without a healthy macula, seeing details or vivid color is not possible.


There are several causes of macular degeneration. In one type, the tissue of the macula becomes thin and stops working well. This type is thought to be a part of the natural aging process in some people. In another, fluids from newly formed blood vessels leak into the eye and cause vision loss. If detected early, this condition may be managed with laser therapy or other types of treatments. Early detection and prompt treatment is vital in limiting damage to vision.


Macular degeneration develops differently in each person, so the symptoms may vary. But, some of the most common symptoms include:

  • A gradual loss of ability to see objects clearly
  • Distorted vision. Objects appear to be the wrong size or shape or straight lines appear wavy or crooked
  • A gradual loss of color vision
  • A dark or empty area appearing in the center of vision

 

These symptoms can also occur with other eye diseases. If you are experiencing any of these symptoms, you should contact your family eye doctor immediately. In a comprehensive dilated eye examination, your doctor will perform a variety of tests to determine if you have macular degeneration or if another condition is causing your symptoms.


Unfortunately, there is no way to restore sharp vision once it is damaged by macular degeneration. However, since macular degeneration does not damage side vision, visual aids such as telescopic and microscopic lenses, magnifying glasses and electronic magnifiers for close work, can be prescribed to help make the most of remaining vision.


Early detection of macular degeneration is the most important factor in determining if you can be treated effectively and to help maintain visual function.

 


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