Other Diseases

Presbyopia

Presbyopia, the inability to focus on close objects, typically occurs after age 40, when the lens of the eye becomes more rigid and does not change shape as easily. Close work and reading are affected.

This normal aging process of the lens can also be found in combination with myopia, hyperopia or astigmatism.

Presbyopia is commonly compensated for by using corrective lenses; eyeglasses or contact lenses. Refractive surgery can improve or eliminate presbyopia.

Keratoconus, meaning "cone shaped," describes a condition in which the cornea (the clear front window of the eye) becomes thin, irregular and protrudes. This abnormal shape can cause serious distortion of visual images.

Macular Degeneration

The macula is a small area at the back of the eye that allows us to see fine details clearly. Age-related macular degeneration (ARMD) is a degenerative condition of the macula (the central retina). It is the most common cause of vision loss in the United States in those 50 or older, and its prevalence increases with age. ARMD is caused by a loss in the structure and function of the pigmented cell layer under the retina. This retinal pigment epithelium helps support the specialized cells of the retina. Without these cells, the retina function is diminished. As a result, the central vision deteriorates.

Macular degeneration varies widely in severity. In the worst cases, it causes a complete loss of central vision, making reading or driving impossible. For others, it may only cause slight distortion. Fortunately, macular degeneration does not cause total blindness since it does not affect peripheral vision.

ARMD is classified as either wet (neovascular) or dry (non neovascular). About 10% of patients who suffer from macular degeneration have wet AMD. This type occurs when new vessels form under the retina. These vessels leak and often break, resulting in sub-retinal hemorrhages that result in dramatic loss of vision. Unfortunately, over time, the dry form of macular degeneration may convert to the wet form.

Treatment

For an individual with macular degeneration, it is highly recommended that a regular schedule of eye examinations be maintained. During these examinations, detailed documentation is made through drawings, photographs and fluorescein angiographic scans of the health of the retina. If the wet form of macular degeneration occurs, treatment is often suggested. This treatment can take the form of laser energy, and or injection of medicines to prevent hemorrhages from returning. There is a great deal of research occurring to find a treatment that can improve the vision of patients with macular degeneration.

Diplopia (Double Vision)

If you see two of whatever you are looking at, you may have a condition known as diplopia, also referred to as double vision.

Diplopia may be the result of a refractive error, where light from an object is split into two images by a defect in the eye's optical system. Cataracts might, for example, cause such a defect.

Diplopia may also result from failure of both eyes to point at the object being viewed, a condition referred to as ocular misalignment.

In normal vision, both eyes look at the same object. The images seen by the two eyes are fused into a single picture by the brain. If the eyes do not point at the same object, the image seen by each eye is different and cannot be fused. This results in double vision.

Double vision and blurred vision are often thought to be the same. They are not. In blurred vision, a single image is seen with a blur around it. In double vision, two images are seen at the same time, creating understandable confusion for anyone who has it.

Treatment of double vision depends on its cause. Eye exercises and surgical straightening of the eyes are common treatments. In younger children therapy is aimed at realigning the eyes, when possible, without surgery.

Glaucoma

Glaucoma is a group of eye diseases causing optic nerve damage. The optic nerve carries images from the retina, which is the specialized area of light sensing cells, to the brain. In glaucoma, eye pressure plays a role in damaging the delicate nerve fibers of the optic nerve. When a significant number of nerve fibers are damaged, blind spots develop in the field of vision. Once nerve damage and visual loss occur, it is permanent. Most
people don't notice these blind areas until much of the optic nerve damage has already occurred. If the entire nerve is destroyed, blindness results.

Glaucoma is a leading cause of blindness in the world, especially in older people. Early detection and treatment by your ophthalmologist are the keys to preventing optic nerve damage and vision loss from glaucoma.

Treatment

The treatment for glaucoma depends upon the nature and severity of each case. In general, glaucoma cannot be cured, but it can be controlled. Eye drops, pills, laser procedures, and surgical operations are used to retard further damage from occurring. With any type of glaucoma, regular eye examinations are very important to detect progression and to prevent vision loss. Often your treatment will need to be adjusted over time to achieve a lower "target eye pressure."

Diabetic Retinopathy

Diabetes can affect sight by causing cataracts. The most important visual consequence of diabetes is due to its affect on the blood vessels of the retina. This is known as diabetic retinopathy. Diabetic retinopathy is a complication of diabetes with associated fluid leakage, hemorrhages and ultimately scarring of the retina. Visual affects range from mild blurring to greater levels of distortion or legal blindness.

Diabetic eye disease is a leading cause of blindness in the United States. People with untreated diabetes are said to be 25 times more at risk for blindness than the general population. The longer a person has had diabetes, the higher the risk of developing diabetic retinopathy. Fortunately, with regular, proper eye care and treatment when necessary, the incidence of severe vision loss has been greatly reduced. If you have diabetes, your ophthalmologist can help to prevent serious vision problems.

Treatment

In mild cases, treatment for diabetic retinopathy is not necessary. Regular eye exams are critical, though, to monitor any progression. Strict control of blood sugar and blood pressure levels can greatly reduce or prevent diabetic retinopathy.

In more advanced cases, laser treatment is used in an attempt to stop the progressive damage of diabetic retinopathy and to limit vision loss.

 

Dry Eye Syndrome

A condition known as dry eye syndrome occurs when tear film abnormalities prevent the eyes from being comfortable. Burning, itching and tearing are commonly associated. Excess tearing from dry eye may sound like a contradiction, but your tears must have the right balance of oil, water, and mucus to be able to protect your eyes. Anything that adds to evaporation of the eyes’ lubrication can make dry eyes more bothersome. Some examples are: air conditioning, dry heat, hair dryers, wind and smoke. The air on plane flights is typically quite dry. Although dry eye can occur in both men and women at any age, women are more commonly affected.

Tear production normally decreases as we age. Dry eye can also be associated with other medical conditions. Arthritis is a common associated condition. A dry mouth may also be associated with dry eyes. Medications sometimes cause dry eye by reducing tear production. Since these medications are often necessary, the dry eye condition may have to be tolerated or treated with "artificial tears."

A wide variety of common medications can cause dry eye.
These include: diuretics, beta blockers, antihistamines, sedative or
sleeping pills, pain relievers. Alcohol also aggravates dry eyes. Be sure to tell your ophthalmologist the names of all the medications you are taking.

Your ophthalmologist is often able to diagnose dry eye by simply examining the eyes. Sometimes tests that measure tear production may be necessary.

Dry eye is commonly treated using eye drops called "artificial tears." Artificial tears are available without a prescription. You may want to try several brands to find the one that you like best. Preservative-free eye drops are available if you are sensitive to the preservatives in artificial tears. If you need to use artificial tears more than every four hours, preservative-free brands may be better for you. Patients with moderate to severe discomfort from dry eyes may benefit from treatment with a newer medicine, Restasis.

Conserving the tears in your own eyes is another approach to keeping the eyes moist. Tears drain out of the eye through a small canal into the nose (that is why your nose runs when you cry). Your ophthalmologist may close these canals either temporarily or permanently. This closure conserves your own tears and makes artificial tears last longer.