Eye Care
Eye Care
Vision is one of the most precious but least understood functions of the human body. While many common eye disorders or diseases may be attributed to an individual's family or personal health history, visual deterioration also occurs naturally in people during the aging process.
Environmental, medical or lifestyle factors may determine how drastically a condition may develop or how rapidly it may progress. Because vision fluctuations and the onset of eye diseases are usually painless and develop gradually, they are often more difficult to detect.
In order to keep the eyes in optimal condition, it is recommended that individuals of all ages (beginning as early as two or three years old) receive routine medical eye examinations. They are the best means of preventing, detecting and, usually, curing visual deterioration.
Eye examinations should occur minimally every two years for individuals not requiring prescriptive eye wear. However, considering the unique nature of each person's health history, a qualified eye doctor is the best source to assess an individual's eye health and offer an appropriate examination schedule.
To access information about certain eye disorders, diseases or treatments, please see the appropriate categories below.
The Importance of Routine Eye Exams
Routine eye exams are important in maintaining good vision. Many diseases can silently cause irreversible damage to your eyes, but can be controlled if diagnosed and treated early.
A child not showing any evidence of eye problems should have a complete eye exam by the time he or she reaches grade-school age at the latest, and then after that about every three years, unless an eye condition, including the need for glasses, is discovered, in which case more frequent exams may be indicated. Adults without symptoms and in good health, without a family history of eye problems, should receive a thorough eye exam at least every 2 years through the age of 55, and then more frequently after that, as determined by your eye care professional.
Complete Eye Examinations Include:
- Measuring visual function and acuity
- Measuring for new glasses or contacts
- Tests to detect cataracts, glaucoma, macular degeneration, diabetic eye problems, etc.
- Patient education
Astigmatism
If you experience a distortion or blurring of images at all distances -- nearby as well as far -- you may have astigmatism. Even if your vision is fairly sharp, headache, fatigue, squinting and eye discomfort or irritation may indicate a slight degree of astigmatism. A thorough eye examination, including tests of near vision, distant vision and vision clarity, can determine if astigmatism is present. Astigmatism is not a disease nor does it mean that you have "bad eyes". It simply means that you have a variation or disturbance in the shape of your cornea.
Astigmatism is one of a group of eye conditions known as refractive errors. Refractive errors cause a disturbance in the way that light rays are focused within the eye. Astigmatism often occurs with nearsightedness and farsightedness, conditions also resulting from refractive errors.
Cataracts
While a comprehensive eye examination can determine for certain if you have a cataract forming, there are a number of signs and symptoms that may indicate a cataract. Among them are:
- Gradual blurring or hazy vision where colors may seem yellowed
- The appearance of dark spots or shadows that seem to move when the eye moves
- A tendency to become more nearsighted because of increasing density of the lens
- Double vision in one eye only
- A gradual loss of color vision
- A stage where it is easier to see without glasses
- The feeling of having a film over the eyes
- An increased sensitivity to glare, especially at night
Cataracts may develop slowly over many years, or they may form rapidly in a matter of months. Some cataracts never progress to the point that they need to be removed. Usually, you will be ready to have the cataract removed when it is having a significant adverse effect on your lifestyle.
Our office will arrange a consultation with a surgeon who will decide on the appropriate time for removal. Most people wait until the cataracts interfere with daily activities before having them removed.
Hyperopia (Farsightedness)
If you can see objects at a distance clearly but have trouble focusing well on objects close-up, you may be farsighted.
Farsightedness or long-sightedness is often referred to by its medical names, hypermetropia or hyperopia. Hyperopia causes the eyes to exert extra effort to see close-up. After viewing near objects for an extended period, you may experience blurred vision, headaches and eyestrain. Children who are farsighted may find reading difficult.
Hyperopia is not a disease, nor does it mean that you have "bad eyes". It simply means that you have a variation in the shape of your eyeball. The degree of variation will determine whether or not you will need corrective lenses.
Hyperopia is seldom diagnosed in school eye-screening tests, which typically test only the ability to see objects at a distance. A comprehensive eye examination that checks both near and far vision is necessary to diagnose farsightedness. In some cases it may be necessary for the practitioner to use drops during the examination to relax the eye muscles and ensure that the full degree of hyperopia is detected. This is necessary because the muscles which focus the eye are so accustomed to being used to compensate for the hyperopia that the muscles go into "spasm" and cannot relax without being forced to do so.
Glaucoma
The most frightening thing about glaucoma is that it can steal your vision gradually and without your noticing. The best defense against glaucoma is a regular eye examination. Glaucoma most often strikes people over age 50. But it is recommended that during adult life everyone be tested at least every two years.
Some people with glaucoma do experience symptoms, but symptoms vary depending on the type of glaucoma.
Tests for glaucoma are part of a comprehensive eye examination. A simple and painless procedure called tonometry measures the internal pressure of your eye. Ophthalmoscopy examines the back of the eye to observe the health of the optic nerve. A visual field test, a very sensitive test that checks for the development of abnormal blind spots, may also be completed.
Myopia (Nearsightedness)
If you can see objects nearby with no problem, but reading road signs or making out the writing on the board at school is more difficult, you may be near- or shortsighted.
This condition is known as myopia, a term that comes from a Greek word meaning "closed eyes". Myopia is not a disease, nor does it mean that you have "bad eyes". It simply refers to a variation in the shape of your eyeball. The degree of variation determines whether or not you will need corrective eyewear.
Myopia is often suspected when a teacher notices a child squinting to see a blackboard or a child performs poorly during a routine eye screening. Further examination will reveal the degree of the problem.
A comprehensive eye examination will detect myopia. Periodic examinations should follow after myopia has been discovered to determine whether the condition is changing, and whether a change in prescriptive eyewear is needed. Eye exams also help to ensure that vision impairments do not interfere with daily activities.
Corrective concave (minus) lenses are prescribed to help focus light more precisely on the retina, where a clear image will be formed.
Depending on the degree of myopia, glasses or contact lenses may be needed all of the time for clear vision. If the degree of impairment is slight, corrective lenses may be needed only for activities that require distance vision, such as driving, watching TV or in sports requiring fine vision.
What Are the Risks of Lasik Surgery?
The risks outlined below apply to both PRK and LASIK procedures. The chances of having a serious vision-threatening complication are minimal, and there have been no reported cases of blindness following either PRK or LASIK, says James Salz, M.D., clinical professor of ophthalmology. However, the FDA is aware of a few instances of severe eye injury requiring corneal transplant.
Infection and delayed healing: There is about a 0.1 percent chance of the cornea becoming infected after PRK, and a somewhat smaller chance after LASIK. Generally, this means added discomfort and a delay in healing, with no long-term effects within a period of four years.
Undercorrection / Overcorrection: It is not possible to predict perfectly how your eye will respond to laser surgery. As a result, you may still need corrective lenses after the procedure to obtain good vision. In some cases, a second procedure can be done to improve the result.
Decrease in Best-Corrected Vision: After refractive surgery, some patients find that their best obtainable vision with corrective lenses is worse than it was before the surgery. This can occur as a result of irregular tissue removal or the development of corneal haze.
Excessive Corneal Haze: Corneal haze occurs as part of the normal healing process after PRK. In most cases, it has little or no effect on the final vision and can only be seen by an eye doctor with a microscope. However, there are some cases of excessive haze that interferes with vision. As with undercorrections, this can often be dealt with by means of an additional laser treatment. The risk of significant haze is much less with LASIK than with PRK.
Regression: In some patients the effect of refractive surgery is gradually lost over several months. This is like an undercorrection, and a re-treatment is often feasible.
Halo Effect: The halo effect is an optical effect that is noticed in dim light. As the pupil enlarges, a second, faded image is produced by the untreated peripheral cornea. For some patients who have undergone PRK or LASIK, this effect can interfere with night driving.
Flap Damage or Loss (LASIK only): Instead of creating a hinged flap of tissue on the central cornea, the entire flap could come off. If this were to occur it could be replaced after the laser treatment. However, there is a risk that the flap could be damaged or lost.
Distorted Flap (LASIK only): Irregular healing of the corneal flap could create a distorted corneal 
shape, resulting in a decrease of best-corrected vision.
Incomplete Procedure: Equipment malfunction may require the procedure to be stopped before completion. This is a more significant factor in LASIK, with its higher degree of complexity, than in PRK.
Problems with a Perfect Procedure: Even when everything goes perfectly, there are effects that might cause some dissatisfaction. Older patients should be aware that they can't have both good distance vision and good near vision in the same eye without corrective lenses. Some myopic patients rely on their myopia (by taking off their glasses, or by wearing a weaker prescription) to allow them to read. Such a patient may need reading glasses after the myopia is surgically corrected. Another consideration is the delay between eye treatments. If one eye is being done at a time, then the eyes may not work well together during the time between treatments. If a contact lens is not tolerated on the un-operated eye, work and driving may be awkward or impossible until the second eye has been treated.
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