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Eye Health FAQ

Our focus is on preventive care with the goal of keeping our patients and their eyes healthy. Since our patients include aging, developmentally and physically disabled individuals, we also work closely with the facilities to ensure that the overall health care regimen includes proper eye and vision care.

On this page you will find some common and not-so common questions and answers on various eye conditions and treatments focused on maintaining healthy eyes.

Please click on each question to expand/ collapse answers

I work on a computer all day. Can this hurt my eyes?
 Computer monitors emit levels of radiation that are considerably lower than the maximum allowed for safety, according to a study by the National Institute for Occupational Safety and Health. NIOSH compared the maximum radiation levels in a group of monitors with the safety standards.

I'm interested in having LASIK done. What information do I need to know?
lasikLASIK, or Laser Assisted In-Situ Keratomileusis is a surgical procedure for myopia (nearsightedness), hyperopia (farsightedness) and astigmatism correction. LASIK eye surgery is performed using a laser to gently reshape the cornea under a protective flap of tissue.LASIK vision correction utilizes two proven surgical procedures to correct vision errors; the creation of a corneal flap and the use of the computer-controlled excimer laser. The creation of the corneal flap was first introduced more than 30 years ago and has been successfully performed and perfected by surgeons worldwide. Using a femtosecond laser, a protective flap of corneal tissue is created which covers the area to be reshaped by the laser. This protective flap facilitates rapid vision recovery and reduces discomfort after LASIK eye surgery.

What can I expect after the LASIK procedure?
You may be sensitive to light and have a feeling that something is in your eyes. Sunglasses may make you more comfortable. You may experience some discomfort, but the drops will help to alleviate this without the use of pain medication. If needed, you may take Tylenol, Ibuprofen or Aspirin.
Some patients experience small fluctuations or blurriness in their vision in the first week to a few months after LASIK surgery. Some patients experience their best-corrected vision in the first week after the surgery, while others may improve over time.

What exactly does 20/20 vision mean?
“20/20 vision” is commonly accepted as the standard of normal distance vision for a human being. Basically it means “good visual acuity at 20 feet.” So if your vision is 20/20, you can read certain sizes of letters on a Snellen chart clearly at 20 feet or closer. But if your friend has 20/15 vision, his visual acuity is better than yours: you would have to stand 15 feet away from the chart to read the smaller letters that he can read while standing 20 feet away. Conversely, someone with 20/30 vision has worse distance vision than you.By the way, visual acuity at a distance isn’t the only measure of how good your vision is. You could have 20/20 distance vision but still have difficulty seeing at night because of poor contrast sensitivity. Or you could have near vision problems because you’re over 40 and experiencing presbyopia.

What is Macular Degeneration?
macularAge-related macular degeneration (AMD) is an eye disease that directly affects the macula, the small area of the retina that is responsible for central vision. AMD occurs in two forms:

  • DryAge-Related Macular Degeneration (common): Tiny yellow deposits, called drusen, develop beneath the macula, signaling degeneration and thinning of nerve tissue.
  • Wet Age-Related Macular Degeneration (less common): Abnormal blood vessels grow beneath the macula, leaking blood and fluid onto and underneath the retina. This kills retinal cells, causing blurring, distortion, and blank spots in your field of vision.

Interesting Macular Degenerations Facts & Statistics:

  • More than 13 million Americans are affected by AMD.
  • Nearly 90% of all diagnosed AMD is the dry form.
  • About 10% of cases of dry macular degeneration develop into the wet, or neovascular, form of AMD.
  • Globally, AMD is the leading cause of vision loss and is responsible for some 50% of visual impairment.
  • AMD is uncommon in people younger than 55.
  • Women are slightly more likely than men to develop AMD.
  • Studies show that obesity, smoking, and exposure to UV rays may also be risk factors for developing AMD.

Signs and Symptoms of Macular Degeneration:

In its early stages, AMD may not present any signs or symptoms. As the eye disease progresses, however, signs and symptoms become much more prevalent and include:

  • The distortion or blurring of central vision
  • Difficulty performing everyday tasks like driving or reading
  • Inability to see small details or fine print
  • Difficulty recognizing faces
  • Need for more light while reading or working
  • Dark or blurry areas in the center of vision (blind spots)
  • Changed color perception
  • Inability to focus properly on a single point within a grid

If you experience any of these signs or symptoms, contact your eye doctor – optometrist or ophthalmologist – at your earliest convenience. The early detection of macular degeneration is critical to the long-term treatment of the eye disease.
Recent innovations in AMD treatment can slow or even halt the progression of retinal changes.


What is Glaucoma?
GlaucomaGlaucoma, the leading cause of blindness and visual impairment in the United States, is an eye disease that can lead to a permanent loss of vision. This disease has been labeled the “Sneak Thief of Sight” because in its most typical form, there are no symptoms. No pain, no swelling, no redness. Patients with glaucoma may not notice symptoms until vision has been permanently lost.

Simply, glaucoma is elevated intraocular pressure of the eye. Every eye has fluid, called aqueous humor, which is constantly being produced as well as constantly being drained. In a glaucomatous eye, this fluid does not drain properly resulting in an increase in the pressure inside the eye. This increased pressure destroys vision gradually, usually starting with the peripheral (side) vision, and if left untreated, will lead to eventual blindness by destroying the optic nerve. With early diagnosis and treatment, useful vision may be preserved. There are four types of glaucoma:

Chronic – This is the most common type of glaucoma, and occurs slowly over time. There is no pain, redness or swelling or other symptoms.

Acute – This happens suddenly and is very painful. Victims of an acute glaucoma attack may complain of serious headache and vomiting. Medical intervention is needed immediately to bring the pressure under control to prevent further vision loss.

Congenital – Present at birth, congenital glaucoma is a rather rare condition.

Secondary – Occurring as a result of systemic disease such as diabetes, from medications such as steroid, or from an eye injury.

The following factors increase your risk of developing glaucoma:

  • Age (at least 45 years old without regular eye examinations)
  • Family history of glaucoma
  • African American or Asian descent
  • Diabetes
  • Nearsightedness
  • Steroid use
  • Past eye injury

Your doctor will check for the presence of glaucoma during a routine eye examination. The test is essentially pain-free, and takes only seconds.


What is Cataracts?
cataracts

Most people have some clouding of their eye’s natural crystalline lens after the age of 60. This clouding is more commonly referred to as a cataract. About 50% of Americans in the age group of 65-74 have at least one cataract, and about 70% of those age 75 and over have cataracts. Simply stated, when the eye’s lens becomes cloudy, light cannot be properly focused on the retina; thus, visual acuity decreases. The only “cure” for poor vision due to cataract is removal of the eye’s lens and implantation of a new, man-made focusing device called an intraocular lens (IOL).

 

Many people with cataracts may experience symptoms such as:

  • Cloudy, fuzzy, foggy vision
  • Difficulty in seeing to drive, especially at night
  • Trouble seeing to do close work
  • Problems seeing television
  • Colors that seem dull, faded, not as bright
  • Frequent changes and a stronger glasses prescription
  • Haloes around lights
  • Bothersome glare
  • A milky white spot or cloudy spot visually apparent in the center of the eye

Diagnosing a cataract:

Most cataracts develop as part of the aging process, but may be present at birth (congenital) or result from an injury, systemic disease (diabetes), or steroid use. Using specialized equipment, cataracts as well as other eye diseases are diagnosed during a complete eye examination by your optometrist. Some cataracts may be slow growing, and stronger glasses may correct vision for a period of time. Some cataracts develop more rapidly than others, and your eye doctor can monitor changes in vision and cataracts with periodic eye examinations.


How does Diabetes affect the Eye?
Diabetes causes changes in the blood vessels in the retina, the back layer of the eye that contains nerve cells responsible for transmitting light images to the brain. Diabetes makes the blood vessels balloon and form pouches, which makes them faulty and leaky. This can severely affect a person’s vision, especially if the leaking fluid occurs in the macula, the center part of the retina responsible for detail vision. If the damage to the blood vessels continues untreated, the vessels then close off and new, weaker blood vessels grow back in these areas. Bleeding occurs and scar tissue forms, which can lead to retinal detachment and further loss of vision.

Your retina can be badly damaged before you notice any change in vision. Several factors can increase your risk of developing diabetic retinopathy: poor blood sugar control, high blood pressure levels, amount of time you have had diabetes, and genetic factors. A person with diabetes should have a complete dilated exam once a year to determine if there are any signs of retinopathy.


What is Diabetic Retinopathy?
diabeticDiabetic Retinopathy is a complication of diabetes that is caused by changes in the blood vessels of the eye. The retina is a nerve layer at the back of the eye that senses light and helps to send images to your brain. When blood vessels in the retina are damaged, they may leak fluid or blood, and grow fragile, brush-like branches and scar tissue. This can blur or distort the images that the retina sends to the brain.

Diabetic Retinopathy is the leading cause of new blindness among adults in the United Stated. People with untreated diabetes are said to be 25 times more at risk for blindness than the general population. The longer a person has diabetes, the more the risk of developing diabetic retinopathy increases. People with Type 1, or juvenile diabetes are more likely to develop diabetic retinopathy at a younger age.

Treatment for Diabetic Retinopathy:

As there are no symptoms to diagnose, the best protection is to have regular eye examinations. You doctor will consider your age, your medical history, your lifestyle, and how much your retina is damaged to determine treatment. In many cases, treatment is not necessary, but you will need to continue regular eye examinations. In other cases and more advanced stages of the disease (proliferative retinopathy), laser surgery is often helpful.


What is a Floater?
floate_flashesA floater may be seen as dots, lines, cobwebs, or spiders and are most often noticed when reading, looking at a blank wall or gazing at a clear sky. They are usually a result of the aging process and are especially common in nearsighted people, in people who have suffered eye injuries, and after eye surgery. A floater is actually a small clump of gel that forms in the vitreous, the clear jelly-like fluid which fills the cavity inside the eye.

 

Treatment for Floaters:

Although annoying, floaters are usually not vision threatening and do not require treatment. Often floaters diminish and become less bothersome over time. If a floater appears directly in the line of the vision, moving the eye around will often help. Looking up and down or back and forth will often allow the floater to move out of the way. In cases where floaters do indicate a more serious condition, lasers can be used to prevent vision loss.


What are Flashes?
floate_flashesFlashes are similar to the sensation of “seeing stars” when one is hit on the head. They are most often noticed at night or in a dark room and appear as flashing light or lightning streaks in the field of vision, although no light is actually flashing. They can also occur in association with migraine headaches, distorting central vision for ten to twenty minutes and appear as jagged lined of “heat waves” in both eyes.

 

Treatment for Flashes:

Similar to floaters, flashes do not require treatment and will eventually stop. However, they may indicate retinal detachment, which needs immediate medical treatment.

Although both floaters and flashes are usually not considered serious vision problems, you should have a complete eye examination to determine their importance.


What is Nearsightedness (myopia)?
If your eye is longer than usual or the cornea and lens have too much focusing power, light rays focus in front of the retina instead of on it. This refractive error is called myopia, or nearsightedness, and means you have a hard time seeing objects at a distance. The image is focused in front of the retina, causing distant objects to appear blurry.

What is Farsightedness (hyperopia)?
If your eye is shorter than usual, or the cornea and lens lack the necessary focusing power, light rays focus beyond the retina. This refractive error is called hyperopia, or farsightedness, and means you can’t see close objects clearly. A young person may be mildly farsighted but unaware of it because the lens is flexible and compensates for the error by bringing the light rays forward and onto the retina.

What is Astigmatism?
astigmatismAstigmatism occurs when the curve of the cornea is uneven – steeper in one direction than in the other – like the back of a spoon. This uneven curve causes light rays to focus on many points on the retina, distorting both near and far vision.

What is Dry Eye Disease?
To keep your eyes comfortable and your vision optimal, a normal, thin film of tears coats your eyes. Three main layers make up this tear film:

The innermost layer is the Mucin. This layer is produced by the cells in the conjunctiva, which is the clear layer with blood vessels, over the white portion of the eye. The mucin layer helps the tear film spread evenly over the eye.

The middle, or aqueous layer, is the largest and thickest. This layer is a very dilute saltwater solution. The lacrimal glands under the upper eyelid produce this watery layer. This layer gives moisture to the eye and flushes out any dust, debris or allergens that may get into the eye.

The most superficial layer is a very thin layer of lipids (fats or oils). These lipids are produced by the meibomian glands (oil glands in the eyelids). The main function of this lipid layer is the help decrease evaporation of the watery layer beneath it.

Dry Eye Syndrome (DES) is a very common eye disorder that results from a deficiency in one or more layers of the tear film. 25-30 million people are estimated to be affected by DES in the United States. It is more common in women than men. Causes of dry eye includes conditions that cause decreased tear production, excessive tear evaporation or an abnormality in the production of the lipids in the tear film. Some causes include hormonal changes, autoimmune diseases such as Sjogren’s Syndrome, rheumatoid arthritis or lupus. Some medications, such as antihistamines, antidepressants, blood pressure medications, and oral contraceptives, may decrease tear production. Insufficient lipid layers are the result of the dysfunction of the Meibomian glands, which is common in rosacea and blepharitis (inflammation of the eyelids).

Symptoms of DES include dry, gritty sensation, or filmy feeling in the eyes. There also may be burning or itching, redness, blurred vision, foreign body sensation and light sensitivity. Sometimes a symptom of Dry Eye Syndrome may actually be intermittent excessive tearing. When the eye becomes irritated, it may initiate reflex tearing with production of a large amount of tears all at once to try to get moist and comfortable again.

Treatment of Dry Eye Syndrome is multi-tiered. Tips at home include: a humidifier to put more moisture in the air, decrease the use of ceiling fans, and changing the air filter in your home frequently to remove irritating allergens. Other initial treatment options include artificial tears and lubricating eyedrops and gels, as well as lubricating ointments at night while you are asleep. Although no cure for DES exists, many medical treatments are now available including Cyclosporine A 0.5% (Restasis®) used alone or in conjunction with corticosteroid drops. These treatments should be monitored by your Optometrist.


What is Blepharitis?
Blepharitis is an eye disorder that is caused caused by inflammation of the eyelids. Blepharitis occurs in two forms, anterior and posterior. Anterior Blepharitis affects the outside front of the eyelid, where the eyelashes are attached. The two most common causes of anterior Blepharitis are bacteria (Staphylococcus) and scalp dandruff. Posterior Blepharitis affects the inner eyelid and is caused by problems with the oil glands in the eyelid (Meibomian glands). Two skin disorders can cause this form of Blepharitis: rosacea and seborrheic dermatitits. When posterior Blepharitis becomes severe, a blockage of the gland may occur, which is called a Chalazion.

Treatment of Blepharitis includes lid scrubs with a dilute soapy solution, as well as warm lid compresses to soften the lipid contents of the eyelid glands. Various medications such as antibiotic drops, corticosteroid drops and oral antibiotics may be prescribed to control Blepharitis.


What is Fuch’s Corneal Dystrophy?
Fuch’s Dystrophy is an inherited disease of the cornea in which the inner most layer of the cornea, called the endothelium, becomes dysfunctional and may result in decreased vision. The front part of a normal eye is filled with fluid called the aqueous. However, the cornea, which separates the outside air from the aqueous fluid inside the eye, must maintain a proper balance of moisture in order to maintain its clarity. To accomplish this task, the inside of the cornea is lined with a specialized layer of cells called the endothelium. The endothelial cells function as one-way pumps, drawing fluid out of the cornea and pumping it back inside the eye. The cornea, despite being in direct contact with the aqueous eye fluid, doesn’t become overly hydrated and maintains clarity.

In Fuch’s Dystrophy, the endothelial cells are slowly replaced with small collagen bumps called guttata. Guttata may first appear in the cornea in the 20’s and 30’s, though rarely cause any symptoms until later in life. As a person ages, the guttata may slowly increase in number and size. In the process, the endothelial cells surrounding them may slowly die. When a critical number of endothelial cells are lost, usually by the age of 50 or 60 years, the pump function of the endothelium may be overwhelmed and the cornea starts to swell with eye fluid. As the swelling worsens, the vision may start to decrease. In cases where large amounts of guttata exist on the cornea, the vision may also become compromised even without corneal swelling, due to irregular scattering of light passing through the dense guttata layer.

Fuch’s Dystrophy is caused by an inherent malfunction in the way the inner lining of cells behave. The gene is transferred from parent to child in an autosomal dominant fashion, which means that each child of an affected parent has a 50% chance of developing the disease. Though many family members may have Fuch’s Dystrophy, its effects may vary greatly from one family member to the next. As such, some individuals with Fuch’s Dystrophy will have signs of the eye disease visible only to a doctor examining their corneas with a slit lamp, and will never suffer any visual loss from the disorder. Other individuals who have worse forms of the disease may suffer slowly progressive visual loss.


What is Keratoconus?
Keratoconus literally means “cone-shaped cornea”. The normal cornea surface is smooth and dome shaped and aspheric (flattens towards the edges). Keratoconus is an eye disorder characterized by an irregular corneal surface (cone-shaped) resulting in blurred and distorted images. The condition is often progressive, and results in increasing levels of nearsightedness and astigmatism that have to be corrected with special glasses or gas-permeable contact lenses. Since the cornea is responsible for refracting most of the light entering the eye, corneal abnormalities can result in significant visual impairment, making simple tasks difficult like driving or reading.

Symptoms of Keratoconus include mild burning, glare at night, irritable eye, sensitivity to light, and distortion of vision. According to the American Academy of Ophthalmology, about 1/2000 people will develop Keratoconus. Most people will have a mild or moderate form of the disease. Less than 10% of people with Keratoconus will develop the most severe form. It typically is diagnosed in the late teens or twenties, however, many people have been diagnosed in their mid to late thirties. It is common for one eye to progress faster than the other and the eyes may go for long periods of time without any change, and then change dramatically over a period of months. Rubbing the eyes is known to hasten progression, and modern treatments such as Intacs and collagen cross linking may delay progression.