Is a vision screening at my yearly physical, health fairs, school nurse, or DMV the same as a "comprehensive eye examination"?
No. A comprehensive eye examination consists of several components. First is a series of "pre-tests". These can include visual acuity, color vision, eye muscle function, depth-perception testing, and others. Next a refraction is performed, where the doctor evaluates your need for glasses or contact lenses. The last component is monitoring the eye health by testing the pupils, vision field, and eye pressures, followed by evaluating the internal structures of the eye. We recommend dilation of the eyes every 1-2 years or more often if needed. See our next issue for more on dilation.
What does dilating the eyes mean, and why is it important?
During dilation, an eye drop is used to enlarge the central dark pupil, which is actually an opening into the deeper parts of the eye. With the enlarged pupil, specialized equipment is used to examine structures deep within the eye. Dilation is used during routine eye examinations to check for any signs of early eye disease such as glaucoma, macular degeneration, or other disorders. It is also used to monitor different stages of eye disease. Interestingly, advanced stages of diabetes, high blood pressure, or high cholesterol can often be detected during the dilated eye exam.
I work at the computer all day and by the end of the day my eyes are blurry and tired, what can I do?
Computer vision syndrome can cause eye strain, fatigue, burning, and headaches. Computers do not, however, damage the visual system. First, you should have a comprehensive eye exam to evaluate your vision. This could find that you simply have an uncorrected refractive error (need for glasses). You may need computer glasses that would alleviate the strain on your eyes. Special occupational lenses, anti-reflection lens coatings, or glare free computer screens may help. Also, it is helpful to take 3-5 minutes out of every hour to rest your eyes, looking at objects more than 20 feet from you.
I was recently diagnosed with diabetes. Do I need an eye exam?
Yes, we recommend a comprehensive eye exam including dilation of the eyes yearly for diabetics as long as blood sugar is controlled and there is no evidence of diabetes-related damage to the eyes. If blood sugar is under poor control or any damage is present, more frequent eye exams are necessary. Diabetes can cause abnormalities in the tiny blood vessels nourishing the retina within the eye. These blood vessels can weaken, leak fluid and blood, and can damage the retina and lead to vision loss or possibly blindness. If you have diabetes, be sure to see your eye doctor regularly.
Can high blood pressure affect my eyes?
Yes. High blood pressure can affect your eyes if uncontrolled or untreated. If you are under observation for high blood pressure, it is important to follow your doctor's orders and take your medication. High blood pressure can cause sight threatening eye disease. The retinal vessels within the eye can develop local closures leading to bleeding or lack of oxygen to the eye. It is important to have your eyes examined and dilated regularly to detect early signs of hypertensive retinal disease. If your eye doctor discovers signs of high blood pressure, don't delay. Seek care from your medical doctor.
My vision is clear without glasses or contacts; do I really need to get my eyes checked?
Absolutely! Having routine comprehensive eye exams is a part of your eye and body health maintenance even if you have good vision. Certain diseases may be detected and treated long before any noticeable vision changes occur. A person with glaucoma may not notice changes until it has progressed far enough along to cause permanent nerve damage and vision loss. Other diseases such as, diabetes, high blood pressure, and high cholesterol can show signs detected during an eye exam. Even with great vision, having a routine eye exam every 1-2 years is always good health maintenance for your eyes and body.
Why do I need reading glasses after age 40?
This is a natural part of the aging process in which the previously flexible lens inside your eye loses its flexibility, making it difficult for you to focus on close objects. It is not a disease and it cannot be prevented. First symptoms usually become noticeable in the early 40's and progress until 55-60 years of age. Signs include the tendency to hold reading materials at arm's length, blurred vision, and eye fatigue or headaches at near, reading, or computer distances. To correct this, your eye doctor can prescribe reading glasses, bifocals, progressive (no-line) lenses or possibly contacts.
When should my child have his / her first eye exam?
The American Optometric Association recommends the first comprehensive eye exam at 6 months of age, then age 3, and every 1 to 2 years thereafter. About 80% of what a child learns during the first 12 years is obtained through vision. It is very important to have regular comprehensive eye exams, even though your child may not complain of any problems. Signs that there may be vision problems may include squinting, holding books close, losing place while reading, headaches, excessive clumsiness, one eye turning in or out, head tilting, using a finger to read, performing below potential, or frequent eye rubbing.
What can I do to keep my eyes healthy and comfortable while wearing contacts?
Always wash your hands before handling your contacts, and check for damage before inserting lenses. Never reuse disinfecting solution; always discard it and air dry your case before the next use. Replace your case every month. Never swim or go into a hot tub with your contacts on. Always rub your lenses with a little solution at night before storing them. Follow your optometrist's instruction on replacement schedule of your lenses and never sleep with your lenses on, unless approved by your optometrist. Remember, contacts are medical devices, so they need to be treated with care and respect.
Sometimes I see little specks floating in my vision. What's causing them?
Your eyeball is filled with gel-like material that shrinks and becomes more liquefied as you age. When light travels through your eye, small clumps of gel can cast a shadow on the inside of the back of your eye (retina), causing dots, lines, or cobwebs to appear in your vision. These floaters are often harmless and need no treatment. Sometimes, this shrinking process can cause a tear or hole in the retina, resulting in numerous floaters, flashes, or shadows. This is an emergency and needs immediate attention. A dilated eye exam can determine whether they are harmless or potentially serious.
What is age-related macular degeneration (AMD)?
The macula is the central portion of the back of your eye (retina) and is responsible for your detailed central vision. Sometimes with age the retina can become diseased, causing loss of vision which cannot be helped with glasses. Occasionally, the disease can become worse if bleeding and swelling occur in the retina. This is called "wet AMD". To reduce your risk, don't smoke. Smoking increases your risk by 1100 times. Also, always wear quality sunglasses when outside. Diets and supplements rich in antioxidants can also reduce your risk. See your optometrist yearly to detect any early signs of AMD.
I was told that I had cataracts. Do I need to have surgery?
Surgery is considered if the cataracts are preventing you from getting satisfactory vision, even with new glasses or contacts. When the cataracts start to affect your quality of life, then you may want to consider surgery. As you age, the natural lens inside your eye can become clouded and yellow in color. The cloudy lens blocks the passage of light through the eye, causing distorted or blurry vision. Most commonly this process occurs gradually. If you need surgery, it will be performed by an ophthalmologist, but your optometrist may do the pre-surgery evaluation and post-surgery appointments.
Are all sunglasses the same?
No. We recommend quality sunglasses which block out 99 to 100% of both UV-A and UV-B radiation, and using baked-on coating. Many cheap sunglasses have sprayed-on coating that can easily come off with cleaning. Exposure to UV from sunlight has been linked to cataracts, abnormal tissue growth on front of the eye, “sunburn to the eye”, and damage to the health of the eye. These conditions can cause blurred vision, irritation, redness, tearing, temporary vision loss, and rarely blindness. Effects of UV radiation are additive, so it's important to develop good protection habits early in life by wearing quality sunglasses.
My eyes get itchy and watery during allergy season.
What can I do to get some relief? During allergy season, many people commonly use over-the-counter allergy pills. Although they can relieve runny nose and sneezing, they can sometimes make your eyes feel worse by making them dry. Try to avoid environments that can trigger your allergies. If you wear contacts don't sleep in them, replace your contacts more often, and clean them thoroughly every night. Improper lens care products or some eye drops can also worsen your allergy symptoms. Many factors need to be considered before starting eye allergy treatments. Visit you eye doctor for an evaluation to determine which treatment is best for you.
What does dilating the eyes mean, and why is it important?
During dilation, an eye drop is used to enlarge the central dark pupil, which is actually an opening into the deeper parts of the eye. With the enlarged pupil, specialized equipment is used to examine structures deep within the eye. Dilation is used during routine eye examinations to check for any signs of early eye disease such as glaucoma, macular degeneration, or other disorders. It is also used to monitor different stages of eye disease. Interestingly, advanced stages of diabetes, high blood pressure, or high cholesterol can often be detected during the dilated eye exam.
What causes dry eyes? There are many causes of dry eyes.
Most people 65 and over experience some dryness. Because of hormonal changes, women may experience it at different life stages. Certain medications such as antidepressants, allergy and blood pressure medications can decrease tear production, resulting in symptoms. Rheumatoid arthritis, diabetes, inflammatory eye disorders, and thyroid problems can also cause dry eyes. Windy or dry climates and smoky conditions can increase tear evaporation, resulting worse symptoms. Infrequent blinking while working with computer, watching tv or reading can also contribute to dry eyes.
What are some things that I do to relieve my dry eyes?
Some cases can be managed using over-the-counter artificial tear drops. Implants or surgery to block the tear ducts can keep tears longer on your eyes. Prescription eye drops and nutritional supplements can help increase tear production. For inflammatory eye disorders, drops, ointments, warm compresses, and lid massage can help reduce inflammation. Always remember to blink often when using computer, watching tv, or reading. Consider adding a humidifier to your home or work. Wear quality sunglasses when outdoors and drink plenty of water. Because different causes of dry eyes need different treatments, see your optometrist for a comprehensive eye exam.
I was told that the pressures of my eyes were high and that I may have glaucoma.
What does that mean? High pressures in the eye can damage the inside of your eyes and cause permanent vision loss. Risk factors of glaucoma, aka “sneak thief of sight”, includes being 40 years or older, having a high prescription, diabetes, or family history of glaucoma. The most common type of glaucoma develops slowly and painlessly. A rarer type occurs rapidly and can cause pain, redness, and blurred vision. Treatments include eye drops, medicines, laser treatment, or surgery to lower the pressures. Glaucoma cannot be prevented, but if found and treated early with a comprehensive eye exam, further vision loss can be prevented or slowed.
What is "pink eye"?
Also called conjunctivitis, it's an infection of the conjuctiva, the outer layer of the eye. Three most common causes are bacterial, viral, and allergic. Bacterial conjunctivitis is usually caused by bacteria passing from hands to the eyes and is common in children. Viral conjunctivitis can occur with colds and flu. Allergic conjunctivitis is usually accompanied by other allergy-related symptoms. Viral and bacterial can be very contagious. Symptoms include red and watery eyes, sensitivity to light, and discharge from eye. Your optometrist can determine the cause of the pink eye and its proper treatment.
What causes "lazy eyes"?
Throughout infancy and adolescence, both eyes must receive clear images for proper visual development to occur. Vision reduction caused by an eye turn, significant difference in prescription between eyes, or blockage of an eye from injury or droopy eyelid can cause lazy eye, also called "amblyopia". If only one eye sees clearly, the brain will ignore the blurry eye and favor the good eye. If this persists, the lazy eye may loose potential. Since this often occurs in one eye only, children may be unaware of this. Through comprehensive eye exam, early diagnosis and treatment can improve the lazy eye.
Sometimes, one of my eyelid twitches. What's causing this twitch?
This condition is called "myokymia" and is caused by an involuntary eyelid muscle contraction of usually the lower lid of one eye. Stress, lack of sleep, excessive caffeine, and eye strain can all cause this condition. They usually continue off and on for a few days and resolve on its own. There are other more serious causes of eye twitches. If the twitching doesn't stop within a week, or causes you to completely shut your eyes, or the twitching involves other parts of your face, be sure to see your optometrist to have it evaluated.
If my contacts still feel comfortable, can I wear them longer than recommended?
No. After recommended wear time, lens deteriorates in quality and is no longer safe for your eyes. You're putting your eyes at risk for serious eye infections due to lack of oxygen to your eyes from deteriorated lenses and accumulation of bacteria. We also recommend not sleeping with your contacts. Recent studies have shown increased risk of infection in those sleeping in lenses. The risk increases with number of nights worn. We also recommend that all contact wearers have current prescription eyeglasses as backup in case of infections or to use when your contacts are out of date.
Is it true that wearing glasses will make your eyes worse and lazy?
No. If you've never worn glasses, you're used to seeing blurry and perceive it as normal. However, once vision is corrected with glasses, you see things clearer. If you remove your glasses after few months of wearing them, you see blurry again. It's not that your vision became worse. Its that your perception that has changed and your visual expectations are higher. Now that you know the difference between clear and blurry vision, its more difficult to accept the blurry environment. Also, over time, it is common to experience gradual vision changes, whether you wear glasses or not.