The Eyes Have It

Most of us open our eyes each morning and expect to see. We can’t imagine a world without sight, but just because our vision is good doesn’t mean our eyes are healthy. Some diseases can progress without being noticed and cause serious damage. Knowing about eye safety and common eye problems and making eye care a priority can help protect your vision.

Caring for Our Windows to the World

By Marcia Swearingen

Caring for Common Eye Problems

“Although the condition of your eyes is largely determined by genetics, when it comes to your vision, avoiding excessive sun exposure, UV light, wind and pollen can help guard against common eye problems that may be experienced by anyone,” notes Dr. Charles Kirby of the Chattanooga Eye Institute.

Dry, Itchy, Watery Eyes: According to Dr. Troy White of Drs. Kapperman & White Eyecare, dry eyes are the most common eye problem he sees. Dry eyes can occur from allergies, viral infections, and everyday dryness. In older adults, hormones and medication may be the culprit. “Often,” Dr. White says, “watery eyes are a symptom of dry eyes. When our eyes get dry and irritated, reflex tears will be produced to help flush out the irritants.”

According to the Allergy and Asthma Foundation of America (AAFA), Chattanooga ranked 5th among the worst cities in the country for spring allergies. When exposed to an allergen, our eyes release histamines that cause inflammation. Rubbing the eye only makes this worse. Instead, apply cool compresses frequently and close all windows and doors. HEPA filters in the home and wearing sunglasses outside can help. Over-the-counter allergy eye drops can also provide relief. If symptoms persist, a physician can help make a plan of action which may include allergy shots. Patients with only ocular allergies can be helped with prescription eyedrops.

Tired Eyes: Humans blink about 18 times a minute, but studies show that that number is cut in half when we use computers and other digital screens. This can result in a common form of eye strain known as computer vision syndrome. If you wear glasses or contacts, make sure your prescription is tweaked for computer work. Many lenses are fitted for reading print and may not be optimal for digital screens. In addition, the American Academy of Ophthalmology recommends these actions:

• Sit about 25 inches from the computer screen and position the screen so your eye gaze is slightly downward.

• Reduce glare from the screen by lighting the area properly

• Every 20 minutes, shift your eyes to look at an object at least 20 feet away for at least 20 seconds.

• Use artificial tears to refresh your eyes when they feel dry.

• Take regular breaks. Apply a washcloth soaked in warm water to eyes.

• Maintain stringent cleaning practices for contact lenses and occasionally switch to glasses.

• Get enough rest. During sleep, eyes are replenished with nutrients.

Conjunctivitis: Commonly referred to as pink eye, conjunctivitis is an inflammation of the tissue around the eyelid and eyeball. It causes red, watery, itching eyes that burn and may feel gritty. Eyes are often matted shut with a crusty discharge in the morning. Two forms of pink eye are caused by viruses and bacteria. Both viral and bacterial conjunctivitis can be associated with colds or with symptoms of a respiratory infection, such as a sore throat. Bacterial conjunctivitis can be treated with antibiotic eye drops or ointments. After 24 hours on medication, it is no longer considered contagious. Viral pink eye must run its course and will continue to be contagious. Warm compresses and steroid eye drops can give some relief.

Stye: A stye is a red bump along the edge of the eyelid caused by a bacterial infection. It causes the eyelid to become swollen and painful. Most styes swell for about 3 days but are rarely serious and usually go away in about a week. A warm, wet compress three to six times a day helps them heal faster. Over-the-counter remedies are also available. Avoid rubbing the eye and wearing make-up or contact lenses until the stye has healed. Dr. Kirby notes that severe styes may require surgical drainage.

When Vision is Impaired

“Determined by genetics, vision may be impaired as early as infancy, or it may deteriorate as we age,” notes Dr. Kirby. By mid 40s, adults begin to experience presbyopia, difficulty with near vision. Cataracts may begin to develop over time, particularly after age 60. For most conditions, treatment will depend on the severity and may range from glasses to surgery.

Myopia, or Nearsightedness: People who are affected by myopia can see objects that are near but not those in the distance. The elongated shape of their eyeball causes light to be focused in front of the lightsensing retina instead of on it. This causes blurred vision. It also causes headaches, eyestrain, squinting and fatigue. Children often cannot see the board at school. A simple eye exam can diagnose the problem, which can be corrected with glasses, contact lenses or refractive surgery.

Hyperopia, or Farsightedness: Instead of an elongated eyeball, people with this problem have eyes that are shorter than normal. This causes light entering the eye to focus behind the retina, resulting in blurred vision of near objects but clear vision of distant objects. This condition also causes headaches, eyestrain, squinting and fatigue, and like nearsightedness, it is easily diagnosed by an eye doctor and corrected with glasses, contact lenses or refractive surgery.

Astigmatism: Astigmatism is characterized by an irregular curvature of the cornea, and it affects most people to one degree or another. A person’s eye should be a spherical shape. Under normal circumstances, when light enters the eye, it refracts evenly, creating a clear view of the object. However, the eye of a person with astigmatism is shaped more like a football or the back of a spoon. For this person, when light enters the eye it is refracted more in one direction than the other, allowing only part of the object to be in focus at one time. Objects at any distance can appear blurry and wavy. Astigmatism can be corrected with glasses, contacts or refractive surgery.

Presbyopia: Presbyopia is a natural part of aging that usually begins around age 40. This blurred vision is not caused by the shape of the eyeball but by a loss in lens flexibility which makes the eye unable to change focus and see close objects clearly. This requires bifocals – a dual lens with a prescription for nearsightedness or farsightedness on the top and a stronger lens for close work at the bottom. Bifocal contacts are also available. LASIK and photorefractive keratectomy (PRK) both use lasers to reshape the cornea of the eye. Laser surgery cannot give you both distance and near vision in the same eye, but your doctor can correct one eye for distance vision and the other eye for near vision. Another option is clear lens extraction with an intraocular lens implant, in which the natural lens is removed and an artificial multifocal is implanted to replace it.

Amblyopia, or Lazy Eye: Lazy eye is the leading cause of decreased vision in children, and according to Dr. White, it is the number one vision problem treated in children. Amblyopia usually starts when one eye has much better focus than the other eye. For example, one eye might be very nearsighted, while the other is not. Or, one eye may turn inward or outward, preventing the eyes from focusing together on an image. Under these conditions, a child’s brain stops processing signals from the weak eye or misaligned eye. Early diagnosis is important because permanent vision loss can occur in the weak eye. A patch worn over the good eye forces the child’s brain to learn to see with the weak eye, and in time the patch will no longer be necessary. Drops that dilate the good eye may also be used.

Cataracts: Cataracts are painless but progressive, created by a gradual build-up of proteins in the lenses of the eye. They cause a clouding of vision since less light can get through the lens to the retina. Sensitivity to bright sunlight during the day and difficulty with night vision are early symptoms along with frequent changes in eyeglass or contact lens prescription and fading or yellowing of colors. More than half of Americans over 65 have cataracts. Mild vision loss due to cataracts can be corrected with glasses or contact lenses, but eventually safe and effective outpatient surgery will be needed to replace the cloudy lens with an artificial one.

Glaucoma: Glaucoma is the name for a group of diseases that damage the optic nerve. Glaucoma is usually associated with elevated pressure in the eye. This pressure can damage the optic nerve that transmits visual messages from the eye to the brain. The result can be blind spots beginning with peripheral or side vision but later can progress to total blindness. Glaucoma can damage your vision gradually so you may not notice any loss of vision until the disease is at an advanced stage. The most common type of glaucoma, primary open-angle glaucoma, has no noticeable signs or symptoms except gradual vision loss. If you are over 40, you should be screened for glaucoma. Those at an increased risk are people over 60, African Americans, diabetics, and people with a family history of this disease. Glaucoma cannot be reversed, but it can be controlled with medication, laser therapy or surgery. Drops are the most common treatment according to Dr. Kirby, but laser treatment or surgical procedures are often used for more severe glaucoma.

Macular Degeneration: Macular degeneration occurs when the macula, the part of the retina responsible for the center of your field of vision begins to deteriorate. This may cause a dimming or distortion of vision, when reading, gradual haziness of your overall vision, or a blind spot right in front of your eye. There are two kinds of macular degeneration, dry and wet. Most patients with macular degeneration have the dry form of the disease and may lose central vision. However, the dry form can lead to the wet form. Although only about 10 percent of people with macular degeneration develop the wet form, they make up the majority of those who experience rapid, serious vision loss from the disease. The dry form is characterized by the presence of yellow deposits, called drusen, in the macula. The “wet” form is characterized by the growth of abnormal blood vessels that leak blood and fluid into the retina. Age, heredity, smoking, high blood pressure, high cholesterol, obesity, and being Caucasian are risk factors. If there are any changes in your central vision, call your doctor right away.

Diabetic Retinopathy: This disease of the retina, which can lead to poor vision and even blindness, is caused by high blood sugar levels that damage the tiny blood vessels lining the retina. High blood pressure tends to make it worse. There are no symptoms until vision starts to deteriorate, and by then it is already severe. Dr. White notes that the best defense is to minimize diabetic complications by keeping blood sugar, blood pressure, and cholesterol levels near normal and not smoking. A dialated eye exam every year can catch this disease early and help avoid vision loss and blindness. Severe cases may require laser treatment, says Dr. Kirby, or newer medicines that can be injected are available.

Retinal Detachment: A serious condition that can cause permanent vision loss if not repaired within 24 to 48 hours, retinal detachment happens when the retina pulls away from its supporting tissues. Those most at risk are extremely nearsighted adults, those who’ve had an eye injury or previous eye surgery such as cataract removal, and people with a family history of retinal detachment. The main symptom, according to Dr. White, is an unmistakable curtain or veil in the vision. There is no pain, but if these symptoms appear, contact your eye doctor immediately. As with many other eye conditions, the risk of retinal detachment increases with age.

Regular eye care by a licensed professional is an important part of preserving vision and protecting health. Even for asymptomatic children, an eye exam is recommended at 6 months of age, at 3 years and before first grade. If your eyes are healthy and vision is good, have a complete exam by your eye doctor once in your 20s and twice in your 30s. If you experience an infection, injury, eye pain or unusual flashes or patterns of light, or another condition, visit your eye doctor for treatment and follow his or her recommendations for follow-up exams. If you wear contact lenses, see your eye specialist annually. If you have a family history of eye disease, talk with your eye doctor regarding how frequently your eyes should be examined. Diabetics should have an annual detailed eye examination.

Marcia Swearingen has lived in Chattanooga for 30 years. She has a Bachelor of Science degree in journalism from the University of Tennessee at Knoxville and is currently a board member of the Chattanooga Writers Guild. Marcia and her husband, Jim, have one daughter and live in Hixson, Tenn.

 

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