General Vision

What is the difference between an ophthalmologist, an optometrist and an optician?

• An Ophthalmologist (MD) has a medical degree and is licensed to practice medicine and perform eye surgery. An ophthalmologist has had at least 12 years of education and training beyond high school and is qualified to diagnose and treat all eye diseases; perform surgery; prescribe and fit glasses and contact lenses.

• An Optometrist (OD) has a degree in optometry and is licensed to practice optometry. An optometrist has had at least six years of education and training beyond high school and is qualified to determine the need for glasses and contact lenses; prescribe optical correction; and screen for some eye conditions.

• An Optician usually has a combination of college (or two years of opticianry school) and on-the-job training. An optician is trained to fit and dispense eyeglasses or contact lenses based upon a prescription from a licensed ophthalmologist or optometrist.

 

How does normal vision develop?

Newborn infants are able to see, but as they use their eyes during the first months of life, vision improves. During early childhood years, the visual system changes quickly and vision continues to develop. If a child cannot use his or her eyes normally, vision does not develop properly and may even decrease. After the first nine years of life, the visual system is usually fully developed and usually cannot be changed.

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The development of equal vision in both eyes is necessary for normal vision. Many occupations are not open to people who have good vision in one eye only. If the vision in one eye should be lost later in life from an accident or illness, it is essential that the other eye have normal vision. Without normal vision in at least one eye, a person is visually impaired.

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How does the eye work (eye anatomy)?

When you take a picture, the lens in the front of the camera allows light through and focuses that light on the film that covers the back inside wall of the camera. When the light hits the film, a picture is taken. The eye works in much the same way. The front parts of the eye (the cornea, pupil and lens) are clear and allow light to pass through. The light also passes through the large space in the center of the eye called the vitreous cavity. The vitreous cavity is filled with a clear, jelly-like substance called the vitreous or vitreous gel. The light is focused by the cornea and the lens onto a thin layer of tissue called the retina, which covers the back inside wall of the eye. The retina is like the film in a camera. It is the seeing tissue of the eye. When the focused light hits the retina, a picture is taken. Messages about this picture are sent to the brain through the optic nerve. This is how we see. 

 

Eye Examinations

When should my child's eyes be examined?

Most physicians test vision as part of a child's medical examination. They may refer a child to an ophthalmologist (a medical eye doctor) if there is any sign of an eye condition. The American Academy of Ophthalmology and the American Academy of Pediatrics recommend the first vision screening occur in the hospital as part of a newborn baby's discharge examination. Visual function (including ocular alignment, etc.) also should be checked by the pediatrician or family physician during routine well-child exams (typically at two, four and six months of age). Later amblyopia and alignment screenings should take place at three years of age and then yearly after school age.

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If you suspect your child suffers from decreased vision - amblyopia (poor vision in an otherwise normal appearing eye), refractive error (nearsightedness or farsightedness) or strabismus (misalignment of the eye in any direction) - or if there are hereditary factors that might predispose your child to eye disease, please make an appointment with an ophthalmologist as soon as possible. New techniques make it possible to test vision in infants and young children. If there is a family history of misaligned eyes, childhood cataracts or a serious eye disease, an ophthalmologist can begin checking your child's vision at a very early age.

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When should an adult's eyes be examined?

Adult examinations of the eyes should be performed on a regular basis.

• Young adults (ages 20 - 39) should have their eyes examined every three-five years.

• Adults ages (ages 40 - 64) should have their eyes examined every two-four years.

• Seniors (over 65 years of age) should have their eyes examined every one-two years.

 

High risk adults include:

• People with diabetes

• People with glaucoma or strong family history of glaucoma

• People with AIDS/HIV  

 

Is pink-eye contagious?

Yes, viral conjunctivitis (pink-eye) is very common and is extremely contagious. Avoid touching eyes with your hands, wash hands frequently, do not share towels, and avoid work, school or daycare activities for a least five days or as long as discharge is present.

 

Why Does My Eye Twitch?

Why did my eyelid start to twitch?

Mild twitching of the eyelid is a common phenomenon. Although these involuntary contractions of muscles are annoying, they are almost always temporary and completely harmless. The medical name for this kind of twitching is ocular myokymia. It is quite common and most often associated with fatigue. When your eye is twitching, it is not visible to anyone else.

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How can I make it stop?

Ophthalmologists often are asked what causes the twitching and what can be done to stop it. Lack of sleep, too much caffeine or increased stress seem to be root causes. Often, gently massaging your eye will relieve the symptoms. Usually, the twitch will disappear after catching up on your sleep.

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My eyes don't hurt and my vision is okay. Why should I have an exam?

Regular eye exams are an invaluable tool in maintaining your eyes’ health by detecting and preventing disease. Some diseases, such as glaucoma, often develop gradually without causing pain or vision loss – so you may not notice anything wrong until significant and irreversible damage has been done. Early detection of any problems can allow for a choice of treatment options and a reduced risk of further harm.

 

Visual Acuity, Vision Impairments and Low Vision

What are the medical terms for nearsightedness and farsightedness?

• The medical term for nearsightedness is myopia, correctable with glasses, contact lenses or, in some cases, refractive surgery (LASIK or Corneal Ring Implants).

• The medical term for farsightedness is hyperopia, correctable with glasses, contact lenses or, in some cases, refractive surgery

• Related conditions (also correctable with glasses or contact lenses) include astigmatism and presbyopia.

 

What is visual acuity?

Acuity is the measure of the eye's ability to distinguish the smallest identifiable letter or symbol, its details and shape, usually at a distance of 20 feet. This measurement is usually given in a fraction. The top number refers to the testing distance measured in feet and the bottom number is the distance from which a normal eye should see the letter or shape. So, perfect vision is 20/20. If your vision is 20/60, that means what you can see at a distance of 20 feet, someone with perfect vision can see at a distance of 60 feet.  

 

What is legal blindness?

You are legally blind when the best corrected central acuity is less than 20/200 (perfect visual acuity is 20/20) in your better eye, or your side vision is narrowed to 20 degrees or less in your better eye. Even if you are legally blind, you may still have some useful vision. If you are legally blind, you may qualify for certain government benefits.  

 

What is visual impairment?

If neither of your eyes can see better than 20/60 without improvement from glasses or contacts, you may be defined as visually impaired. In addition, poor night vision, limited side vision, double vision and loss of vision in one eye may also determine visual impairment.

 

What is low vision?

Low vision is a term describing a level of vision below normal (20/70 or worse) that cannot be corrected with conventional glasses. Low vision is not the same as blindness. People with low vision can use their sight. However, low vision may interfere with the performance of daily activities, such as reading or driving.

 

Can eyes be transplanted?

No. Currently, there is no way to transplant a whole eye. However, corneas have been successfully transplanted for many years.

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Genetic Research

What is human genetic research?

The basis for many, if not most, diseases can be found in our genes. Genes and their protein products determine how we look and develop, how efficiently we process foods, how effectively we detoxify poisons and how vigorously we respond to infections. It is thought that more than 4,000 diseases arise from changed or mutated genes that are inherited from one's mother and/or father. Common disorders such as age-related macular degeneration, diabetes, heart disease and most cancers arise from a complex communication between multiple genes and between genes and factors in our environment. Genetic research studies are aimed at identifying these genes and understanding how changes in these genes lead to disease.

The benefits of human genetic research include medical breakthroughs made possible because of the combined commitment of participants and researchers. Identifying a gene opens many new diagnostic and treatment possibilities including earlier diagnosis of inherited eye diseases. Researchers also work to determine exactly what causes a particular eye disease and why the same disease does not effect everyone in the same way. As a result, researchers hope to develop improved treatment for specific eye diseases such as glaucoma and inherited retinal diseases including AMD. These discoveries will lead to improved eye care for future patients.

 

What is genetic testing?

Genetic tests, also called DNA-based tests, are some of the newest and most sophisticated techniques that we can use to test for genetic diseases. Most tests involve looking directly at the DNA in a specific disease-associated gene. The actual information of each gene is carried within the DNA itself. The DNA can be taken from cells in a sample of blood or, occasionally, from other body fluids or tissues. Testing allows ophthalmologists to confirm diagnoses and help patients understand their risks for certain inherited eye diseases.

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What is genetic counseling?

Genetic counseling is a communication process which deals with the human problems associated with the occurrence, or the risk of occurrence, of a genetic disorder or birth defect in a family. As part of this process, the patient obtains information regarding diagnosis, treatment, prognosis and inheritance of the genetic condition or birth defect of concern to the family. In some cases genetic testing is available for specific genetic diseases.

 

Contact Lenses

Can my child wear contact lenses during sports activities?

Yes, contact lenses provide excellent vision for most sports. However, they do not protect the eyes from injury. Therefore, contact lens wearers should use polycarbonate sports safety goggles or glasses when participating in sports. Also see information about preventing eye injuries.

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Do contact lenses prevent nearsightedness (myopia) from getting worse?

No, there is no evidence that wearing contact lenses improves vision or prevents myopia from getting worse. Also see information about contact lenses.

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Can I use my eyeglass prescription to buy over-the-counter contact lenses?

No, because it does not provide the specifications for lens diameter, thickness and base curve. A new prescription must be carefully fitted by an eye care specialist to avoid serious adverse reactions.

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Is it safe for me to clean my contact lenses with a homemade solution?

Using commercial saline solutions is the safest method of cleaning lenses. Some studies have shown that homemade solutions may lead to corneal infections. Also see information about contact lenses.

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Computers, TVs, Lighting and Glasses

Will working at a computer screen hurt my eyes?

No, there is no evidence that working at a computer damages the eyes. However, long hours of work can be fatiguing to the eyes, neck and back. Monitor glare from various light sources can also be a problem. It is often helpful to take periodic breaks, looking off in the distance and adjusting your work station (angle of the monitor, height of the chair, changing the lighting, etc.).

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Will sitting too close to the television set hurt my child's eyes?

No, there is no scientific evidence that TV sets emit rays that are harmful to the eyes.

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Why have I gradually found it harder to read without glasses?

The ability to focus on near objects decreases steadily with age and is referred to as presbyopia. Presbyopia is a natural aging of the lens. It is usually near the age of 40, when glasses or bifocals are prescribed to correct this condition.

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Are sunglasses good for my eyes?

There is a benefit to wearing UV protective lenses--wearing them may protect against cataract formation. Clear lenses with UV protection may offer greater protection than dark lenses because they allow the eyes to be exposed to more light. This causes greater constriction of the pupil which lets less light enter the eyes.

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Is my child likely to inherit my need for glasses?

Possibly. If both the biological parents wear glasses, your children are likely to need them as well.

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Will reading in dim light hurt my eyes?

No, but most people are more comfortable reading with proper lighting which is bright enough to provide good illumination but not so bright as to cause glare.

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How often do I need to get my prescription changed?

There is no predetermined schedule for changing glasses or contacts. It is necessary to change your prescription only when it no longer provide adequate correction. However, it is still a good idea to have regular eye examinations.

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What materials are available for glasses?

Some of the newest materials for frames include titanium (virtually indestructible) and polycarbonate materials (recommended for high impact sports). Lenses are also made from polycarbonate materials, other types of light weight plastics and glass. Coatings include UV protection (recommended for all types of lenses), scratch-resistant protection, polarization, anti-glare and others. See the Kellogg Optical Shop for more information about glasses.

 

Glaucoma

What is Glaucoma?

One of the leading causes of blindness in the United States, glaucoma occurs when the pressure inside the eye rises high enough to damage the optic nerve. It cannot be prevented, and vision lost to it cannot be restored. The high eye pressure associated with glaucoma is caused by blockages in the eye’s fluid drains. No one knows yet why the blockages form. People at the greatest risk include those who are over the age of 40, diabetic, near-sighted, African-American, or who have a family history of glaucoma.

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Does glaucoma have any symptoms?

Glaucoma often develops over many years without causing pain – so you may not experience vision loss until the disease has progressed. Symptoms are occasionally present and should be taken as warning signs that glaucoma may be developing; these include blurred vision, loss of peripheral vision, halo effects around lights and painful or reddened eyes.

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Is glaucoma treatable?

Once diagnosed, glaucoma can be controlled. Treatments to lower pressure in the eye include non-surgical methods such as prescription eye drops and medications, laser therapy, and surgery.  

 

Macular Degeneration

What is Macular Degeneration?

Macular degeneration is the number-one cause of blindness in the United States. It occurs when the macula -- a part of the retina in the back of the eye that ensures that our vision is clear and sharp -- degrades or “degenerates,” causing a progressive loss of vision.

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Does macular degeneration have any symptoms?

Yes. They include:

• A gradual loss of ability to see objects clearly

• A gradual loss of color vision

• Distorted vision

• A dark or empty area appearing in the center of vision

 

Can macular degeneration be treated?

The “dry” form of macular degeneration has no treatment, but the “wet” form may be helped by laser procedures if it is detected early. Certain vitamins and minerals may also aid in slowing or preventing vision loss.

 

Cataracts

What is cataract? Who is at risk for developing them?

A cataract is a cloudy area in the normally clear lens in the front of the eye. Cataracts are caused by a chemical change of unknown origin in the eye, and cause blurred or distorted vision. People at risk for developing cataracts are over 55 years old, have had eye injuries or disease, have a family history of cataracts, smoke cigarettes or use certain medications.

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Can cataracts be prevented?

They cannot be prevented from forming, but early detection through regular eye exams can help maintain the clearest vision possible.

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Are there symptoms associated with cataracts?

There is no pain associated with the condition, but there are several symptoms that indicate failing vision due to cataracts. These include:

• Blurred/hazy vision

• Spots in front of the eye(s)

• Sensitivity to glare

• A feeling of “film” over the eye(s)

• A temporary improvement in near vision

 

How can cataracts be treated?

Vision loss from cataracts can often be corrected with prescription glasses and contact lenses. For people who are significantly affected by cataracts, replacement surgery may be the preferred method of treatment. During cataract replacement (the most common surgical procedure in the country), the lens is removed and replaced with an artificial one called an intraocular lens or IOL.

 

Diabetic retinopathy

What is diabetic retinopathy?

Diabetic retinopathy is a complication of diabetes that weakens the blood vessels that supply nourishment to the retina (the light-sensitive lining in the back of the eye where vision is focused). When these weak vessels leak, swell or develop thin branches, vision loss occurs. In its advanced stages, the disease can cause blurred or cloudy vision, floaters and blind spots – and, eventually, blindness. This damage is irreversible.

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Can diabetic retinopathy be prevented?

Yes. People with diabetes are most susceptible to developing it, but your risk is reduced if you follow your prescribed diet and medications, exercise regularly, control your blood pressure, and avoid alcohol and cigarettes. Regular eye exams are an integral part of making sure your eyes are healthy.

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Can diabetic retinopathy be treated?

Although damage caused by diabetic retinopathy cannot be corrected, patients diagnosed with the condition can be treated to slow its progression and prevent further vision loss. Treatment modalities include laser and surgical procedures.

 

Dry eye

What is dry eye?

“Dry eye” is the term for when your eyes are insufficiently moisturized, either because they do not produce enough tears or because the tears have an improper chemical composition. It often occurs during the natural aging process, but it can also form as a result of eyelid or blinking problems, certain medications (antihistamines, oral contraceptives, antidepressants), climate (low humidity, wind, dust), injury, and various health problems (arthritis, Sjogren’s syndrome).

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Symptoms include:

• Irritated, scratchy, dry, uncomfortable or red eyes

• A burning sensation or feeling of something foreign in your eyes

• Blurred vision In addition to being uncomfortable, dry eye can damage eye tissue, scar the cornea and impair vision.

• Dry eye is not preventable, but it can be controlled before harm is done to your eyes.

 

How is dry eye treated?

Treatment for dry eye can take many forms. Non-surgical methods include blinking exercises, increasing humidity at home or work, and use of artificial tears or moisturizing ointment. If these methods fail, small plugs may be inserted in the corners of the eyes to limit tear drainage, or the drainage tubes in the eyes may be surgically closed.