Eye Problems

Age-Related Macular Degeneration

Age-related Macular Degeneration (commonly abbreviated as AMD) is very common. As many as 16 million people in the United States have AMD. AMD is a leading cause of blindness in people over the age of 65.

AMD is a condition that affects the macula - the center of the retina. The macula is responsible for acute vision, which is critical for driving, reading, and performing activities that require sharp vision. Typically, changes that affect the macula from AMD are gradual, but in some cases, vision loss occurs rapidly

Different types of AMD:

Dry macular degeneration: Dry AMD constitutes about 90% of people diagnosed with AMD, when the tissues of the macula begin to age and thin. Tiny yellow deposits called drusen that form beneath the retina begin to form. People with dry AMD generally experience a less severe extent of vision loss, that develops more slowly. In early stages, AMD always starts out as the Dry variant, but in about 10% of cases it can develop into wet AMD.

Wet macular degeneration:  Wet AMD occurs when irregular blood vessels form under the retina. These delicate vessels begin to leak blood and fluid, causing the retina to distort or scar. This leads to loss of sharp vision in people with wet AMD. Wet AMD advances far more quickly than dry AMD, with more drastic consequences—potentially including total vision loss. Although Wet AMD affects only about 10% of people with AMD, it is accountable for 90% of severe vision loss linked to AMD.

Risk factors for AMD

-Age,

-Family history of AMD

-Skin/eye color: people with light-colored skin and eyes are more likely to develop AMD

-Smoking - smokers are three to four times more likely to develop AMD

-Diet - diets low in certain antioxidants such as vitamins C and E, lutein, and zinc may be a risk factor

-Obesity

-High blood pressure and high cholesterol

-Excessive, unprotected exposure to sunlight

Symptoms of AMD

Due to damage to the macula, objects up close or at a distance may be blurry or hazy. Brighter than normal light may be required when reading. It may be difficult to adapt from bright to low light. As AMD advances, there may be dark, or blank spots in vision. Other symptoms include visual distortions, such as straight lines appearing wavy or objects appearing larger or smaller than they are.

Management of AMD

Wet macular degeneration Treatment for Wet AMD involves injected medications and/or laser surgery to seal off leaking blood vessels. These are usually brief and painless outpatient procedures that decrease and sometimes reverse the progression of the disease. A small permanent dark spot may be left where the laser makes contact.

Dry macular degeneration Given that peripheral vision is not impaired, people with dry AMD maintain their normal, healthy lifestyles with the aid of low-vision optical devices, such as magnifiers. However, there currently no cures for dry AMD.

Cataracts

Cataracts are hazy areas that develop in the lens of the eye. A healthy lens is completely clear. Light passes through the lens to the retina -- the back of the eye where images are processed. Once it reaches the retina, light is transformed into nerve signals that are then sent to the brain. The lens must be clear for the retina to receive a sharp image. If the lens is cloudy from a cataract, the image will be blurred.

What causes Cataracts?

Cataracts often form gradually over time. They don't produce symptoms like pain, redness, or tearing. Some cataracts stay small and don't have a significant impact on vision clarity. If they do progress to the extent where they affect vision significantly, routine surgery almost always resolves the problem.

Colorblindness

When you can't see certain colors, or can't tell the difference between them (usually reds and greens), you may be colorblind. It happens when the color cells in your eye (the doctor will call them cone cells) are absent or don't work. When it's most severe, you can only see in shades of gray, but this is rare. Most people who have it are born with it, but you can get it later in life from certain drugs and diseases. Men are much more likely to be born with it than women. There's no treatment if you're born with it, but special contacts and glasses can help some people tell the difference between certain colors.

Conjunctivitis (Pinkeye)

In this condition, tissue that lines the back of your eyelids and covers your sclera gets inflamed. It can cause redness, itching, burning, tearing, discharge, or a feeling that something is in your eye. People of all ages can get it. Causes include infection, exposure to chemicals and irritants, or allergies. Wash your hands often to lower your chance of getting it.

Corneal Diseases - The cornea is the clear, dome-shaped "window" at the front of your eye. It helps to focus the light that comes in. Disease, infection, injury, and exposure to toxins can damage it. Signs include: Red eyes Watery eyes Pain Reduced vision, or a halo effect The main treatment methods include: A new eyeglasses or contacts prescription Medicated eye drops Surgery

Cross Eyes (Strabismus)

Strabismus, also called crossed eyes, is a condition in which the eyes do not properly align with each other when looking at an object. Which eye is focused on the object in question can switch. It may also be present occasionally or constantly. If present during a large part of childhood amblyopia may result and depth perception may be lost. Adults may have double vision.

Strabismus can occur due to muscle dysfunction, farsightedness, problems in the brain, trauma, or infections. Risk factors include premature birth, cerebral palsy, and a family history of the condition. Types include esotropia where the eyes are crossed; exotropia where the eyes diverge; and they have hypertropia where they are vertically misaligned. Diagnosis may be made by observing the light reflecting from the person's eyes and finding that it is not centered on the pupil

Diabetic Eye Disease 

Diabetic eye disease is a complication of diabetes and a leading cause of blindness. The most common form is diabetic retinopathy which occurs when diabetes damages the tiny blood vessels inside the retina. Learn more about Diabetic Eye Disease.

Nystagmus

If your eyes aren't lined up with each other when you look at something, you could have strabismus. You might also hear it called crossed eyes or walleye. This problem won't go away on its own. You'll need to get an ophthalmologist, or eye specialist, to correct it. With nystagmus, the eye moves or "jiggles" all the time on its own. There are many treatments, including vision therapy, to make your eyes stronger. Surgery is also an option. 

Dry Eyes

Dry eyes happen when your eyes can't make enough good-quality tears. You might feel like something is in your eye or like it's burning. Rarely, in severe cases, extreme dryness can lead to some loss of vision. Some treatments include: Using a humidifier in your home Special eye drops that work like real tears Plugs in your tear ducts to lessen drainage Lipiflow, a procedure that uses heat and pressure to treat dry eyes Testosterone eyelid cream Nutritional supplements with fish oil and omega-3

Excess Tearing

Excess Tearing has nothing to do with your feelings. You might be sensitive to light, wind, or temperature changes. Try to protect your eyes by shielding them or wearing sunglasses. Tearing may also signal a more serious problem, like an eye infection or a blocked tear duct. 

Eyelid Problems

Your eyelids do a lot for you. They protect your eyes, spread tears over its surface, and limit the amount of light that can get in. Pain, itching, tearing, and sensitivity to light are common symptoms of eyelid problems. You might also have blinking spasms or inflamed outer edges near your eyelashes. Treatment could include proper cleaning, medication, or surgery.

Eyestrain

Anyone who reads for hours, works at a computer, or drives long distances knows about this one. It happens when you overuse your eyes. They get tired and need to rest, just like any other part of your body. If your eyes feel strained, give them some time off. If they're still weary after a few days, check with your doctor to make sure it isn't another problem.

Floaters

These are tiny spots or specks that float across your field of vision. Most people notice them in well-lit rooms or outdoors on a bright day. Floaters are usually normal, but they sometimes can be a sign of a more serious eye problem, like retinal detachment. That's when the retina at the back of your eye separates from the layer underneath. When this happens, you might also see light flashes along with floaters or a dark shadow comes across the edge of your sight. If you notice a sudden change in the type or number of spots or flashes you see or a new dark "curtain" in your peripheral vision, go to your eye doctor as soon as possible.

Glaucoma

Your eye is like a tire: Some pressure inside it is normal and safe. But levels that are too high can damage your optic nerve. Glaucoma is the name for a group of diseases that cause this condition. A common form is primary open angle glaucoma. Most people who have it don't have early symptoms or pain. So it's important to keep up with your regular eye exams. It doesn't happen often, but glaucoma can be caused by: An injury to the eye Blocked blood vessels Inflammatory disorders of the eye

Lazy Eye

Lazy eye, or amblyopia, happens when one eye doesn't develop properly. Vision is weaker in that eye, and it tends to move "lazily" around while the other eye stays put. It's found in infants, children, and adults, and rarely affects both eyes. Treatment needs to be sought immediately for infants and children. Lifelong vision problems can be avoided if a lazy eye is detected and treated during early childhood. Treatment includes corrective glasses or contact lenses and using a patch or other strategies to make a child use the lazy eye.

Night Blindness

Is it hard to see at night, especially while driving? Is it tough to find your way around in dark places, such as movie theaters? That sounds like night blindness. It's a symptom, not a problem in its own right. Nearsightedness, cataracts, keratoconus, and a lack of vitamin A all cause a type of night blindness that doctors can fix. Some people are born with this problem, or it might develop from a degenerative disease involving the retina, and that usually can't be treated. If you have it, you'll need to be extra careful in areas of low light.

Presbyopia

Presbyopia happens when you lose the ability, despite good distance vision, to see close objects and small print. After age 40 or so, you may have to hold a book or other reading material farther away from your eyes to make it easier to read. Sort of like your arms are too short. Reading glasses, contact lenses, LASIK, which is laser eye surgery, and other procedures can be used to restore good reading vision.

Problems With Contact Lenses

They work well for many people, but you need to take care of them. Wash your hands before you touch them. Follow the care guidelines that came with your prescription. And follow these rules: Never wet them by putting them in your mouth. That can make an infection more likely. Make sure your lenses fit properly, so they don't scratch your eyes. Use eye drops that say they're safe for contact lenses. Never use homemade saline solutions. Even though some lenses are FDA-approved for sleeping in them, doing so raises the risk of a serious infection.

Red Eyes

The surface of your eyes is covered in blood vessels that expand when they're irritated or infected. That gives your eyes a red look. Eyestrain can do it, and so can a late night, a lack of sleep, or allergies. If an injury is a cause, get it checked by your doctor. Red eyes could be a symptom of another eye condition, like conjunctivitis or sun damage from not wearing shades over the years. 

Retinal Disorders

The retina is a thin lining on the back of your eye that is made up of cells that collect images and pass them on to your brain. Retinal disorders block this transfer. There are different types: Age-related macular degeneration refers to a breakdown of a small portion of the retina called the macula. Diabetic retinopathy is damage to the blood vessels in your retina caused by diabetes. Retinal detachment occurs when the retina separates from the layer underneath.

Uveitis

This is the name for a group of diseases that cause inflammation of the uvea. That's the middle layer of the eye that contains most of the blood vessels. These diseases can destroy eye tissue, and even cause eye loss. People of all ages can have it. Symptoms may go away quickly or last for a long time. People with immune system conditions like AIDS, rheumatoid arthritis, or ulcerative colitis may be more likely to have uveitis. Symptoms may include: Blurred vision Eye pain Eye redness Light sensitivity

Vision Changes

As you get older, you may find that you can't see as well as you once did. That's normal. You'll probably need glasses or contacts. You may choose to have surgery (LASIK) to correct your vision. If you already have glasses, you may need a stronger prescription. Other, more serious conditions also happen as you age. Eye diseases like macular degeneration, glaucoma, and cataracts, can cause vision problems. Symptoms vary a lot among these disorders, so keep up with your eye exams. Some vision changes can be dangerous and need immediate medical care. 

Sources:

American Optometric Association: "Eye and Vision Problems." CDC: "Common Eye Disorders." American Association for Pediatric Ophthalmology and Strabismus: "Amblyopia."

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