Information Accredited to American Academy of Ophthalmology
After discussing with you any concerns or problems you may have with your eyes, a thorough medical history will be obtained, including a review of your current medications and previous surgical information. Your vision will be checked and if needed, your glasses and/or contact lens prescription will be updated. Through a series of tests and measurements, your eye health will be assessed and your eyes will be checked for diseases such as dry eye, glaucoma, cataracts and macular degeneration. In order to fully assess your eye health, eye drops will be used to check the eye pressure and to dilate the pupils. It takes an average of 20 minutes for the pupils to get big enough for the physician to be able to thoroughly examine the retina and optic nerve.
The lens of the eye, which is normally clear and focuses light onto the retina in the back of the eye, becomes a cataract when it is no longer clear. Cataracts generally occur with age and ultraviolet (UV) light exposure. However, some individuals are born with cataracts or develop them earlier in life because of trauma, disease or certain genetic or environmental factors. The lens imperfections cause the vision to seem blurry, hazy or less colorful. Some cataracts also cause double vision and can increase light sensitivity. Individuals with cataracts also frequently have difficulty seeing well at night and also experience glare or halos around lights.
Glaucoma is a condition that damages the optic nerve in the back of the eye. The optic nerve takes light messages from the retina and sends it to the brain for interpretation, like a fiber-optic cable. With Glaucoma, the nerve fibers are damaged. The peripheral vision is lost first and end-stage glaucoma leads to blindness. Any damage at all that occurs, is irreversible. Usually this damage is caused by uncontrolled eye pressure but about one third of the population have nerve damage even with normal eye pressure. Glaucoma has no symptoms in its early stages so early detection by an eye physician is key to preventing damage. This is why it is so important to have regular eye examinations. Half the people who have Glaucoma have no idea they have it and it is the leading cause of blindness in people over 60 years of age.
There are two types of Macular Degeneration (AMD), Wet AMD and Dry AMD. Macular Degeneration happens when the central part of the retina (the macula) is damaged, resulting in the loss of central vision and the loss of fine details. This damage occurs usually as an aging process and is the leading cause of visual impairments in people over the age of 50. AMD is more prevalent in Caucasian populations, smokers (or former smokers) and those who have a family history of AMD. Having heart disease and/or high cholesterol are other risk factors for Macular Degeneration.
High blood sugar levels can lead to vision loss by affecting the macula and the retina. This is a condition called Diabetic Retinopathy, which occurs when the blood sugar damages the small blood vessels (capillaries) in the retina, causing them to leak or close up, stopping the blood flow. Sometimes Diabetes can cause the retina can grow new blood vessels, a process called neovascularization, but these new vessels are very fragile and often bleed into the vitreous (the jelly-like fluid inside the eye), blocking the vision. The abnormal vessels can also form scar tissue which can lead to a retinal detachment.
Floaters are usually made from little clumps of gel or condensations in the jelly part of the eye (the vitreous). We see small specks, dots/circles or lines or cobwebs or tadpole looking objects in our field of vision as a result of the light casting a shadow of these on the retina. Since this is a shadow that we are seeing, it is most common to notice floaters when looking at something like a white piece of paper, a blank wall in a brightly lit room or when looking up at a bright sky.
Most commonly, watering is actually a sign of dryness. When the eyes get dry, reactive tears are produced, the same tears as when we cry that lack the oil and mucus that are present in lubricating tears. These reactive tears aren't regulated at a slow and steady flow like lubricating tears are regulated. Instead it's an overproduction of tears that floods the eye(s) and sometimes spills over the lids onto the cheeks.
Dry eye occurs when your eyes do not produce enough tears or the right type of tears. Tears are necessary to keep the eyes healthy and comfortable and play an integral role in how well we see. Tears are comprised of three layers: an oily layer that keeps tears from evaporating too quickly, a watery layer that cleans the eye, and a mucus layer that keeps the tears slippery and helps the tears spread over the eye's surface.
People who smoke have an increased risk of developing Cataracts, which leads to multiple vision problems and ultimately, Cataract Surgery (see Q and A for Cataracts for more information). It can also increase the likelihood of acquiring Macular Degeneration, permanently damaging the central part of the retina and therefore affecting the center of the vision. See the Q and A on Macular Degeneration for more information.