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All About Vision

Forms of Macular Degeneration

There are two forms of macular degeneration, dry (non-neovascular) or wet (neovascular). The term neovascular refers to the growth of new blood vessels.

Dry AMD (non-neovascular)

Dry AMD is the most common form of the disease, making up about 85%-90% of all cases of AMD. It is characterized by blurred central vision or blind spots, as the macula begins to deteriorate. Dry AMD is an early stage of the disease and is less severe than the wet form,.

Dry AMD occurs when the aging tissues of the macula begin to thin out and break down. Tiny pieces of white or yellowish protein called drusen begin to appear, which are thought to be deposits from the macular tissue as it deteriorates. The appearance of these drusen are often what leads to a diagnosis of AMD during an eye exam.

With dry AMD vision loss happens gradually, however, the dry form can progress to wet AMD rapidly. There is currently no cure for dry AMD, however there is research that shows that some people can benefit from supplemental vitamin therapy including antioxidants, lutein and zeaxanthin.

Wet AMD (neovascular)

Wet AMD is less common occurring in only about 10 percent of those with AMD. AMD is classified as Wet AMD when abnormal blood vessels begin to grow under the retina and leak fluid and blood into the macula, resulting in blind spots and a loss of central vision. Wet AMD can cause more damage to vision and permanent scarring if not treated quickly, so any sudden blur in vision should be assessed immediately, especially if one is aware that they have AMD. Usually vision loss happens faster and is more noticeable than in dry AMD so the quicker it is treated, the more vision you can preserve.

Farsighted (Hyperopia)

Farsightedness or hyperopia is a refractive error in which distant objects are clear, while close objects appear blurry. A refractive error occurs when the eye is not able to refract (or bend) the light that comes in into a single point of focus, therefore not allowing images to be seen clearly. Nearsightedness, farsightedness and astigmatism are the most common types of refractive error.

What Causes Hyperopia?

Hyperopia is usually caused when the shape of the eye is shortened or the cornea (which is the clear front surface of the eye) is flatter than normal. This prevents light that enters the eye from focusing properly on the retina, and rather focuses behind it. This condition causes close objects to appear blurry, while typically objects at a distance remain clear.

Farsightedness, which is less common than nearsightedness, is often an inherited condition. It is common in children who experience some amount of hyperopia during development which they will eventually grow out of as the eye continues to grow and lengthen. Sometimes these children don’t even have symptoms as their eyes are able to accommodate to make up for the error.

Symptoms of Hyperopia

Symptoms of hyperopia vary. As mentioned, sometimes people with hyperopia don’t experience any symptoms while others will experience severe vision difficulties. In addition to blurred near vision, often squinting, eye strain and headaches will occur when focusing on near objects.

Treatment for Farsightedness

Farsightedness is easily treated with prescription eyeglasses or contact lenses. These lenses, will correct for the refractive error by changing the way the light bends upon entering the eyes. Refractive eye surgeries such as LASIK or PRK that reshape the cornea may also be options for vision correction. Treatment for farsightedness depends on a number of factors including your age, lifestyle, eye health and overall health.

Farsightedness vs. Presbyopia

Farsightedness is not the same as presbyopia, an age-related condition that also affects one’s ability to see near objects clearly. Presbyopia is caused when the natural lens of the eye begins to age and stiffens, causing difficulty focusing.

Farsightedness or hyperopia is a common refractive error that is easily treated. If you are experiencing difficulty seeing close objects it’s worth having an eye exam to determine the cause, ensure your eyes are healthy and to find a solution to improve your vision and quality of life.

Eye Floaters and Spots

Eye floaters are spots, squiggles or flecks that appear to drift into your visual field. Usually they are harmless, a benign, albeit annoying sign of aging. If however, your floaters are accompanied by a sudden loss of vision, pain or flashes, they could be a sign of an underlying serious eye condition and should be checked out by an eye doctor as soon as possible.

What are Eye Floaters and Spots?

Floaters, like their name, are specks or spots that float in and out of your visual field. Usually they move away when you try to focus on them. They can appear as dark dots, threads, squiggles, webs, or even rings.

But what causes them to appear? Floaters are shadows from clumps of fibers within the vitreous, the jelly-like substance in your eye, that are cast on the retina at the back of the eye. Usually, floaters don’t go away, but you tend to get used to them and eventually notice them less. Patients usually see them more when they are looking at a plain background, like the blue sky or a white wall.

In most cases, there is no treatment for floaters, people just get used to them, however if there are more serious symptoms that accompany them, there could be an underlying problem such as inflammation, diabetes or a retinal tear that needs to be addressed and treated. If the floaters are so serious that they are blocking your vision, a surgical procedure to remove the clumps may be performed.

What Causes Floaters?

Age: Although floaters may be present at any age, they are often more apparent as a result of aging. With time, the fibers in the vitreous begin to shrink and clump up as they pull away from the back of the eye. These clumps block some of the light passing through your eye, causing the shadows which appear as floaters. You are also more likely to develop floaters if you are nearsighted.

Eye Surgery or Injury: Individuals who have previously had an injury, trauma or eye surgery are more susceptible to floaters. This includes cataract surgery and laser surgery as well as other types of eye surgery.

Eye Disease: Certain eye diseases such as diabetic retinopathy, eye tumors or severe inflammation can lead to floaters.

Retinal Tears or Detachment: Retinal tears or detachments can be a cause of floaters. A torn retina can lead to a retinal detachment which is a very serious condition where the retina separates from the back of the eye and if untreated can lead to permanent vision loss.

When to See a Doctor

There are some cases where seeing spots is accompanied by other symptoms that could be a sign that there is a more serious underlying problem. The most common of these is seeing flashes of light. This often happens when the vitreous is pulling on the retina which would be a warning sign of a retinal detachment. Retinal detachment must be treated immediately or you can risk a permanent loss of vision. Flashes of light sometimes also appear as symptoms of migraine headaches.

If you experience a sudden onset or increase in floaters, flashes of light, pain, loss of side vision or other vision disturbances, see a doctor immediately. Further, if you have recently had eye surgery or a trauma and you are experiencing floaters during your recovery, it is advised to tell your doctor.

Generally, floaters are merely a harmless annoyance but keep an eye on your symptoms. As with any sudden or serious change in your health, it is worth having them checked out if they are really bothering you. In some cases, they may be an early warning sign of a serious problem that requires swift treatment to preserve your vision.

Eye Allergies

Along with congestion, runny nose, coughing, sneezing, headaches and difficulty breathing, individuals with allergies often suffer from eye allergies or allergic conjunctivitis resulting in red, watery, itchy and sometimes swollen eyes. Just as irritants cause an allergic response in your nasal and respiratory system, your eyes also react with an oversensitive immune response, triggered by an environmental substance that most people’s immune systems ignore. Most individuals with allergies also suffer from eye allergies which affect millions of North Americans, particularly with seasonal allergic conjunctivitis (SAC) which is common during the spring, summer and fall.

What Causes An Eye Allergy?

Eye allergies, or any allergies for that matter, occur when the immune system is hypersensitized to a stimulus in the environment that comes into contact with the eye. The allergen stimulates the antibodies in the cells of your eyes to respond by releasing histamine and other chemicals that cause the eyes and surrounding tissue to become inflamed, red, watery, burning and itchy.

Eye allergens can include:

  • Airborne substances found in nature such as pollen from flowers, grass or trees.
  • Indoor allergens such as pet dander, dust or mold.
  • Irritants such as cosmetics, chemicals, cigarette smoke, or perfume.

Tips for Coping With Eye Allergies

Allergies can go from mildly uncomfortable to debilitating. Knowing how to alleviate symptoms and reduce exposure can greatly improve your comfort and quality of life, particularly during allergy season which can last from April until October.

To reduce exposure to allergens:

  1. Stay indoors and keep windows closed when pollen counts are high, especially in the mid-morning and early evening.
  2. Wear sunglasses outside to protect your eyes, not only from UV rays, but also from airborne allergens.
  3. Avoid rubbing your eyes, this can intensify symptoms and increase irritation. When the eyes get itchy, it is difficult not to rub and scratch them. However, rubbing the eyes can aggravate the allergic cascade response, making them more swollen, red, and uncomfortable.
  4. Check and regularly clean your air conditioning filters.
  5. Keep pets outdoors if you have pet allergies and wash your hands after petting an animal.
  6. Use dust-mite-proof covers on bedding and pillows and wash linens frequently.
  7. Clean surfaces with a damp cloth rather than dusting or dry sweeping.
  8. Remove any mold in your home.
  9. Reducing contact lens wear during allergy season or switch to daily disposable contact lenses.

Treatment for the uncomfortable symptoms of allergic conjunctivitis include over-the-counter and prescription drops and medications. It is best to know the source of the allergy reaction to avoid symptoms. Often people wait until the allergy response is more severe to take allergy medication, but most allergy medications work best when taken just prior to being exposed to the allergen. Consult your eye doctor about your symptoms and which treatment is best for you.

Non-prescription medications include:

  • Artificial tears (to reduce dryness)
  • Decongestant eyedrops
  • Oral antihistamines

Prescription medications include eyedrops such as antihistamines, mast-cell stabilizers, or stronger decongestants as well as non-steroidal anti-inflammatory drugs (NSAIDs) or corticosteroids.

Immunotherapy which are allergy injections given by an allergist are sometimes also helpful to assist your body in building up immunity to the allergens that elicit the allergic response.

If no allergy medicine is on hand, even cool compresses and artificial tears can help alleviate symptoms.

Finding the right treatment for your allergies can make all the difference in your quality of life, particularly during the time of year when most of us like to enjoy the outdoors.

Dry Eye Syndrome

Dry eye syndrome (DES or dry eye) is a chronic lack of sufficient lubrication and moisture on the surface of the eye. Its consequences range from minor irritation to the inability to wear contact lenses and an increased risk of corneal inflammation and eye infections.

Signs and Symptoms of Dry Eye

Persistent dryness, scratchiness and a burning sensation on your eyes are common symptoms of dry eye syndrome. These symptoms alone may be enough for your eye doctor to diagnose dry eye syndrome. Sometimes, he or she may want to measure the amount of tears in your eyes. A thin strip of filter paper placed at the edge of the eye, called a Schirmer test, is one way of measuring this.

Some people with dry eyes also experience a “foreign body sensation” – the feeling that something is in the eye. And it may seem odd, but sometimes dry eye syndrome can cause watery eyes, because the excessive dryness works to overstimulate production of the watery component of your eye’s tears.

What Causes Dry Eyes?

In dry eye syndrome, the tear glands that moisturize the eye don’t produce enough tears, or the tears have a chemical composition that causes them to evaporate too quickly.

Dry eye syndrome has several causes. It occurs:

  • As a part of the natural aging process, especially among women over age 40.
  • As a side effect of many medications, such as antihistamines, antidepressants, certain blood pressure medicines, Parkinson’s medications and birth control pills.
  • Because you live in a dry, dusty or windy climate with low humidity.

If your home or office has air conditioning or a dry heating system, that too can dry out your eyes. Another cause is insufficient blinking, such as when you’re staring at a computer screen all day.

Dry eyes are also associated with certain systemic diseases such as lupus, rheumatoid arthritis, rosacea or Sjogren’s Syndrome (a triad of dry eyes, dry mouth, and rheumatoid arthritis or lupus).

Long-term contact lens wear, incomplete closure of the eyelids, eyelid disease and a deficiency of the tear-producing glands are other causes.

Dry eye syndrome is more common in women, possibly due to hormone fluctuations. Recent research suggests that smoking, too, can increase your risk of dry eye syndrome. Dry eye has also been associated with incomplete lid closure following blepharoplasty – a popular cosmetic surgery to eliminate droopy eyelids.

Treatment for Dry Eye

Dry eye syndrome is an ongoing condition that treatments may be unable to cure. But the symptoms of dry eye – including dryness, scratchiness and burning – can usually be successfully managed.

Your eyecare practitioner may recommend artificial tears, which are lubricating eye drops that may alleviate the dry, scratchy feeling and foreign body sensation of dry eye. Prescription eye drops for dry eye go one step further: they help increase your tear production. In some cases, your doctor may also prescribe a steroid for more immediate short-term relief.

Another option for dry eye treatment involves a tiny insert filled with a lubricating ingredient. The insert is placed just inside the lower eyelid, where it continuously releases lubrication throughout the day.

If you wear contact lenses, be aware that many artificial tears cannot be used during contact lens wear. You may need to remove your lenses before using the drops. Wait 15 minutes or longer (check the label) before reinserting them. For mild dry eye, contact lens rewetting drops may be sufficient to make your eyes feel better, but the effect is usually only temporary. Switching to another lens brand could also help.

Check the label, but better yet, check with your doctor before buying any over-the-counter eye drops. Your eye doctor will know which formulas are effective and long-lasting and which are not, as well as which eye drops will work with your contact lenses.

To reduce the effects of sun, wind and dust on dry eyes, wear sunglasses when outdoors. Wraparound styles offer the best protection.

Indoors, an air cleaner can filter out dust and other particles from the air, while a humidifier adds moisture to air that’s too dry because of air conditioning or heating.

For more significant cases of dry eye, your eye doctor may recommend punctal plugs. These tiny devices are inserted in ducts in your lids to slow the drainage of tears away from your eyes, thereby keeping your eyes more moist.

If your dry eye is caused by meibomian gland dysfunction (MGD), your doctor may recommend warm compresses and suggest an in-office procedure to clear the blocked glands and restore normal function.

Doctors sometimes also recommend special nutritional supplements containing certain essential fatty acids to decrease dry eye symptoms. Drinking more water may also offer some relief.

If medications are the cause of dry eyes, discontinuing the drug generally resolves the problem. But in this case, the benefits of the drug must be weighed against the side effect of dry eyes. Sometimes switching to a different type of medication alleviates the dry eye symptoms while keeping the needed treatment. In any case, never switch or discontinue your medications without consulting with your doctor first.

Treating any underlying eyelid disease, such as blepharitis, helps as well. This may call for antibiotic or steroid drops, plus frequent eyelid scrubs with an antibacterial shampoo.

If you are considering LASIK, be aware that dry eyes may disqualify you for the surgery, at least until your dry eye condition is successfully treated. Dry eyes increase your risk for poor healing after LASIK, so most surgeons will want to treat the dry eyes first, to ensure a good LASIK outcome. This goes for other types of vision correction surgery, as well.

Corneal Transplant

A cornea transplant, also known as keratoplasty or a corneal graft, replaces damaged tissue on the clear front surface of the eye.

When disease or injury damages the cornea, eyesight is affected. Light that enters the eye becomes scattered, resulting in blurred or distorted vision. When the cornea is extremely scarred or damaged, a corneal transplant is needed to restore functional vision.

Keratoplasty is performed routinely and is regarded as the most successful of all tissue transplants. According to the National Keratoconus Foundation, over 40,000 cornea transplants are done annually in the United States.

In recent years, an innovative type of corneal transplant has gained popularity. Known as Descemet’s Stripping Endothelial Keratoplasty (DSEK), this new procedure removes a smaller and thinner portion of the cornea. In 2009, DSEK was declared by the American Academy of Ophthalmology as superior to the conventional surgery because it may provide better vision outcomes and more eye stability. It is also associated with less risk factors. However, when the majority of the cornea is damaged, a more comprehensive removal may still be necessary to facilitate a successful transplant.

Criteria for a Corneal Transplant

A multitude of reasons indicate candidacy for a corneal transplant. Possible reasons include:

  • Eye diseases, such as keratoconus
  • Complications from laser surgery, such as LASIK
  • Extreme inflammation on the cornea
  • Scarring as a result of infections, such as eye herpes or fungal keratitis
  • Thinning of the cornea and an irregular shaped cornea
  • Hereditary factors
  • Corneal failure due to previous surgical procedures
  • Chemical burns or injuries that damaged to the cornea

Cornea Transplant Procedure

Once a patient has been recommended and approved for a corneal transplant to restore vision, the patient’s name is added to a list at an eye bank. The United States has a very advanced eye bank system, and the general wait time for a donor eye is one to two weeks. The tissue of donor corneas is checked for clarity and screened meticulously for disease before it is released for transplant.

The actual surgery is generally performed as an outpatient procedure that does not require hospitalization. General or local anesthesia may be used, depending upon the patient’s preference, age and health condition. Local anesthesia is injected into the skin surrounding the eye, which relaxes the muscles that control movement and blinking. Eye drops numb the eye itself.

Once the anesthesia has taken effect, the surgeon inspects and measures the damaged corneal area in order to decide upon the size of the transplantation. Eyelids are held open during this time. The surgeon then removes a round, button-shaped piece of the corneal tissue and replaces it with a nearly identical sized button of donor tissue. The new, healthy tissue is sutured into place. The entire procedure takes approximately one to two hours.

Following the surgery, a plastic shield must be worn over the eye in order to protect it against any inadvertent bumps or rubbing.

Rejection of the Corneal Graft

Although the vast majority of cornea transplants are successful, sometimes the new tissue is rejected. Warning signs of rejection include:

  • Extreme sensitivity to light
  • Redness
  • Pain
  • Decreased vision

These symptoms may be experienced as soon as one month after the surgery, or as delayed as five years later. Medications can be prescribed to reverse the rejection process. If the corneal graft fails completely, the transplant can be repeated and the outcome is generally positive. Yet the total rejection rates do increase with the total number of corneal transplants.

Recovery and Healing

It can take up to a year or longer to heal completely from a corneal transplant. At the beginning, vision is blurry and the transplant site is often swollen and thicker than the rest of the cornea. As vision returns, patients are able to return to normal daily tasks and most people can return to work within three to seven days after surgery. However, heavy lifting and exercise must be avoided for the first few weeks.

To help the body accept the corneal graft, steroid eye drops must be applied for several months. A pair of eyeglasses or a protective shield must also be worn for eye safety. Depending upon the health of the eye and the healing rate, stitches may be removed at any time from three months to more than a year later. Astigmatism often occurs as a result of an irregular corneal surface, and adjustments may be made to the sutures around the new cornea in an effort to reduce this problem.

Vision after a Cornea Transplant

Vision improvement after a cornea transplant is a process that can last up to one year later. Eyeglasses or contact lenses must be worn immediately after the surgery, since the curvature of the corneal transplant will not precisely match the natural corneal curve.

When healing is complete and stitches are removed, laser surgery may be indicated to correct vision. LASIK or PRK are both procedures that can help decrease dependence on eyeglasses or contacts. An irregular corneal surface may point to the need to wear rigid gas permeable (GP) contact lenses for vision correction.

CMV Retinitis

CMV or cytomegalovirus retinitis is a vision threatening virus that causes inflammation of the retina, primarily in individuals with a compromised immune system, such as those with AIDS (Acquired Immunodeficiency Syndrome).

Symptoms of CMV Retinitis

Symptoms of CMV retinitis often appear relatively suddenly. They include general blurriness, seeing flashes or floaters, sudden loss of peripheral (side) vision, or blind spots in central vision. These symptoms all appear as the virus attacks the retina, the light-sensitive layer of nerves at the back of the eye. If left untreated, the virus can cause retinal detachment and will eventually destroy the retina and damage the optic nerve, causing permanent vision loss. Usually there is no pain felt as the retinal damage is taking place. Symptoms usually start in one eye and but can spread to the other eye as well.

Causes of CMV Retinitis

Cytomegalovirus is a herpes type virus that is actually present in most adults. However, most healthy adults never experience any symptoms or problems from the virus. Individuals with a weakened immune system however, such as those with AIDS, chemotherapy or leukemia patients, newborns or the elderly are at greater risk of the virus being activated and spreading throughout the body, including the retina.

Treatment for CMV Retinitis

Treatment includes antiviral medications such as ganciclovir, foscarnet or cidofovir, which can be administered orally, via injection through a vein or directly into the eye or through a time-release implant the releases the medication at intervals. Laser surgery to improve the damaged area of the retina, such as in a retinal detachment, may also be prescribed.

Immune strengthening is also a critical part of preventing and treating CMV retinitis. Individuals with HIV or AIDS may be put on a regimen of highly active antiretroviral therapy (HAART) to boost the immune system and fight the virus. This has been shown to be highly effective in reducing the incidence of CMV retinitis in AIDS patients and reducing the damage for those that are affected.

While these treatments can stop further damage to the retina, any vision that is lost cannot be restored. Further, even if the virus is temporarily stopped, further progression may occur in the future. This is why it is critical to see a retinal specialist on a regular basis if you have had the condition or you are at risk.

Blepharitis

Blepharitis is an eye condition characterized by an inflammation of the eyelids which causes redness, itching and irritation. The common eye condition is caused by either a skin disorder or a bacterial infection. Blepharitis is generally not contagious and can affect patients of any age. While it can be very uncomfortable, it usually does not pose any danger to your vision.

There are two types of blepharitis: anterior and posterior.

Anterior blepharitis occurs on the front of your eyelids in the area where the eyelashes attach to the lid. This form is less common and is usually caused by a bacterial infection or seborrheic dermatitis, which is a skin disorder (dandruff) that causes flaking and itching of the skin on the scalp and eyebrows. While it is more rare, allergies or mites on the eyelashes can also lead to this condition.

Posterior blepharitis occurs on the inner eyelid that is closer to the actual eyeball. This more common form is often caused by rosacea, dandruff or meibomian gland problems which affect the production of oil in your eyelids.

Symptoms of Blepharitis

Blepharitis can vary greatly in severity and cause a variety of symptoms which include:

  • Red, swollen eyelids
  • Itching
  • Burning or gritty sensation
  • Excessive tearing
  • Dry eyes
  • Crusting on eyelids

If left untreated, symptoms can become more severe such as:

  • Blurred vision
  • Infections and styes
  • Loss of eyelashes or crooked eyelashes
  • Eye inflammation or erosion, particularly the cornea
  • Dilated capillaries
  • Irregular eyelid margin

Treatment for Blepharitis

Treatment for blepharitis depends on the cause of the condition but a very important aspect is keeping the eyelids clean. Warm compresses are usually recommended to soak the lids and loosen any crust to be washed away. It is recommended to use a gentle cleaner (baby soap or an over the counter lid-cleansing agent) to clean the area.

For bacterial infections, antibiotic drops or ointments may be prescribed, and in serious cases steroidal treatment (usually drops) may be used.

Blepharitis is typically a recurring condition so here are some tips for dealing with flare-ups:

  • Use an anti-dandruff shampoo when washing your hair
  • Massage the eyelids to release the oil from the meibomian glands
  • Use artificial tears to moisten eyes when they feel dry
  • Consider breaking from use of contact lenses during the time of the flare-up and or switching to daily disposable lenses.

The most important way to increase your comfort with blepharitis is by keeping good eyelid hygiene. Speak to your doctor about products that he or she recommends.

Astigmatism

Many people have never heard of astigmatism, although it is an extremely common eye condition.

Astigmatism is one type of refractive error. Nearsightedness and farsightedness are other types of refractive error. Refractive errors are not eye diseases. Refractive error is a result of and imperfection of the size and shape of the eye, which results in blurry or double vision.

If left untreated, astigmatism may cause eyestrain, headaches, and blurry vision. If you have astigmatism you may not see objects in the distance or near without some form of distortion.

Symptoms of Astigmatism

Small amounts of astigmatism can go unnoticed, however, you may be suffering from eye fatigue, eyestrain, and headaches.

Astigmatism is a condition that usually can develops early in childhood. According to a study from The Ohio State University School of Optometry, 28% of school age children suffer from astigmatism. Parents should be aware that their children might not notice that their vision is blurry, not understanding that this is not normal. Nevertheless, astigmatism should be treated because vision problems can lead to learning problems and in extracurricular activities. Make sure to have your child’s eyes examined at an eye doctor’s office at least once a year.

Causes of Astigmatism

Astigmatism is generally caused by a cornea with an irregular shape. The cornea is the front, clear layer of the eye. With astigmatism, the cornea is not round and spherical and is instead irregular having two curves instead of one curve. Astigmatism in some cases could also be caused by the lens located inside the eye that is irregular in shape.

Eyes with astigmatism distort the light that comes into the eyes because the cornea is irregularly shaped. This causes the light rays entering the eye to create two images in the back of the eye (because of the two curves), instead of one image. This is what causes the distortion in sight.

Treatments for Astigmatism

For most people, their astigmatism is fully corrected using prescription glasses or contact lenses. If you select contact lenses to correct your vision, soft contact lenses are the most common option. If for whatever reason soft contact lenses are not an option, rigid gas permeable (RGP or GP) are also a great choice. Rigid gas permeable lenses usually give the clearest vision but the adaptation process will be significantly longer. Another option are hybrid contact lenses. These contacts have a center made from a rigid gas permeable (RGP) lens and an outer ring made of soft contact lens material. This type of lens provides both excellent clarity and comfort. LASIK could be another option to correct astigmatism. LASIK usually only corrects low levels of astigmatism and some patients with higher levels of astigmatism might not be candidates.

Amblyopia (Lazy Eye)

Amblyopia, which is also called “lazy eye”, is a disorder that affects the visual development in children. Amblyopia is difficult to correct just with the use of contact lenses, or eyeglasses. Ambylopia can cause vision loss if it is not treated early and properly. This vision disorder affects 2-3% of the population.

What are the symptoms of Amblyopia?

Usually children that are born with amblyopia, the symptoms start in early childhood. Some signs of amblyopia in children are squinting, closing one eye in order to see better, poor general vision, headaches, and eyestrain. Usually caretakers such as parents, caregivers, doctors, or nurses notice these symptoms and recommend the child for treatment.

What are the causes of Amblyopia?

Strabismus is usually the cause of amblyopia. Strabismus is the eyes aligning incorrectly. Amblyopia can also be caused when there is a large difference between the eyes in refractive errors (prescription much higher in one eye than the other). For example, one eye is nearsighted, while the other is farsighted. If amblyopia is not treated, the brain will learn to disregard the vision in the eye with amblyopia. The eye that is disregarded does not grow with clear image and vision loss can be permanent. This is why it is very important to get early treatment and take your child to see your eye doctor if any signs are apparent.

How is Amblyopia treated?

There are several treatments for amblyopia, depending on the cause. Often children are treated using vision therapy, which usually includes a patch on the better eye. Other treatments are atropine eye drops, correct prescription eyeglasses, or surgery.

Vision Therapy

Vision therapy consists of eye exercises, which aim to teach the eyes to work together. In cases of amblyopia, the exercises require the brain to recognize the affected eye, which restores vision in that eye. Some doctors place a patch over the more functional eye, which forces the less functional eye to work harder and become stronger. The patch is generally worn for a few hours a day. Depending on the severity of the condition, treatment can last for weeks or months. Some children refuse to wear a patch, in those cases, a prosthetic contact lens is available. These contact lenses look like the regular eye, and are designed to block vision in that eye.

Atropine drops

Some doctors use atropine eye drops to treat amblyopia. These drops blur vision in the child’s better eye, forcing the weaker eye to work harder and get stronger. In the morning, one drop is instilled under eye doctor’s instructions. The advantage to this method of treatment is that the patch is avoided.

Prescription eyeglasses

If your child has developed amblyopia because of uncorrected vision, sometimes all that is needed is a pair of eyeglasses. When there is strong uncorrected prescription, or when there is a large difference in prescription between the two eyes, sometimes amblyopia can result. Your eye doctor may recommend eye patch therapy in addition to corrective lenses.

Surgery

Strabismus surgery is usually required if the amblyopia is due to a large eye turn. This type of surgery aligns the eyes and corrects the problem within the eye muscles. After the surgery the eyes will able to focus better. Additional vision therapy may be required after strabismus surgery.

Amblyopia must be treated as early as possible as there is no chance that it will resolve by itself. Untreated amblyopia can lead to permanent vision loss in that eye and reduced depth perception. Amblyopia needs to be treated promptly so that your child can have the best vision possible in childhood and later in life. When amblyopia is diagnosed and treated before age 9, the weaker eye can often develop significantly better vision. The most critical time to treat amblyopia is from 3 to 6 years of age. If you or anyone sees any signs of amblyopia, go to your eye doctor to find the best treatment for your child.

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