Eye Diagram showing the macula and fovea
How can you keep your eyes healthy?
Incorporate your eye health as part of your regular health check-ups. Having a comprehensive dilated eye exam is one of the best things you can do to make sure that you're seeing the best you can and that you're keeping your eyes healthy.
Millions of people have problems with their vision every year. Some of these problems can cause permanent vision loss and even blindness, while others are common problems that can be easily corrected with glasses or contact lenses.
Common Vision Problems
What is myopia?
Myopia, also known as nearsightedness, is a common type of refractive error where close objects appear clearly, but distant objects appear blurry.
What is high myopia?
High myopia is a severe form of the condition. In high myopia, the eyeball stretches and becomes too long. This can lead to holes or tears in the retina and can also cause retinal detachment. Abnormal blood vessels may grow under the retina and cause changes in vision. People with high myopia need comprehensive dilated eye exams more often. Early detection and timely treatment can help prevent vision loss.
What is refraction?
Refraction is the bending of light as it passes through one object to another. Vision occurs when light rays are bent (refracted) as they pass through the cornea and the lens. The light is then focused on the retina. The retina converts the light-rays into messages that are sent through the optic nerve to the brain. The brain interprets these messages into the images we see.
How does myopia develop?
Myopia develops in eyes that focus images in front of the retina instead of on the retina, which results in blurred vision. This occurs when the eyeball becomes too long and prevents incoming light from focusing directly on the retina. It may also be caused by an abnormal shape of the cornea or lens.
Who is at risk for myopia?
Myopia can affect both children and adults. The condition affects about 25 percent of Americans. Myopia is often diagnosed in children between 8 and 12 years of age and may worsen during the teen years. Little change may occur between ages 20 to 40, but sometimes myopia may worsen with age. People whose parents have myopia may be more likely to get the condition.
What are refractive errors?
Refractive errors occur when the shape of the eye prevents light from focusing directly on the retina. The length of the eyeball (longer or shorter), changes in the shape of the cornea, or aging of the lens can cause refractive errors.
What are the different types of refractive errors?
The most common types of refractive errors are myopia, hyperopia, presbyopia, and astigmatism.
Myopia: (nearsightedness) is a condition where objects up close appear clearly, while objects far away appear blurry. With myopia, light comes to focus in front of the retina instead of on the retina.
Hyperopia: (farsightedness) is a common type of refractive error where distant objects may be seen more clearly than objects that are near. However, people experience hyperopia differently. Some people may not notice any problems with their vision, especially when they are young. For people with significant hyperopia, vision can be blurry for objects at any distance, near or far.
Astigmatism: is a condition in which the eye does not focus light evenly onto the retina, the light-sensitive tissue at the back of the eye. This can cause images to appear blurry and stretched out.
Presbyopia: is an age-related condition in which the ability to focus up close becomes more difficult. As the eye ages, the lens can no longer change shape enough to allow the eye to focus close objects clearly.
Who is at risk for refractive errors?
Presbyopia affects most adults over age 35. Other refractive errors can affect both children and adults. Individuals that have parents with certain refractive errors may be more likely to get one or more refractive errors.
What are the signs and symptoms of refractive errors?
Blurred vision is the most common symptom of refractive errors. Other symptoms may include:
|Glare or halos around bright lights|
How are refractive errors diagnosed?
An eye care professional can diagnose refractive errors during a comprehensive dilated eye examination. People with a refractive error often visit their eye care professional with complaints of visual discomfort or blurred vision. However, some people don't know they aren’t seeing as clearly as they could.
How are refractive errors treated?
Refractive errors can be corrected with eyeglasses, contact lenses, or surgery.
Eyeglasses: are the simplest and safest way to correct refractive errors. Your eye care professional can prescribe appropriate lenses to correct your refractive error and give you optimal vision.
Contact Lenses: work by becoming the first refractive surface for light rays entering the eye, causing a more precise refraction or focus. In many cases, contact lenses provide clearer vision, a wider field of vision, and greater comfort. They are a safe and effective option if fitted and used properly. It is very important to wash your hands and clean your lenses as instructed in order to reduce the risk of infection. If you have certain eye conditions you may not be able to wear contact lenses. Discuss this with your eye care professional.
Refractive Surgery: aims to change the shape of the cornea permanently. This change in eye shape restores the focusing power of the eye by allowing the light rays to focus precisely on the retina for improved vision. There are many types of refractive surgeries. Your eye care professional can help you decide if surgery is an option for you.
Eye Surgery for Correcting or Improving Refractive Errors
Clear vision depends on how well the cornea and lens permit light rays to fall onto the retina. Light rays must be refracted (bent) to focus on the retina. The retina is the light-sensitive nerve layer that lines the back of the eye, which creates impulses from the light rays that are sent through the optic nerve to the brain.
If the cornea or eye shape is abnormal, vision can become blurry because light does not fall properly on the retina. Called a refractive error, an abnormal cornea shape can often be corrected by refractive eye surgery, which, in turn, corrects the vision problem. Refractive errors can include myopia (nearsightedness), hyperopia (farsightedness), astigmatism (an irregularly shaped cornea which causes blurring), and presbyopia (similar to hyperopia, but mainly causes blurring for near or close vision tasks).
The goal of most refractive eye surgery is to reduce or eliminate a person's dependency on eyeglasses or contact lenses. Refractive eye surgery is not for everyone. One type of surgery may be more suitable for one person than another. Always consult an eye surgeon for a diagnosis and to discuss which type of surgery, if any, may be appropriate for you.
Historically, there are have been many types of corrective eye surgery procedures for refractive errors, including, but not limited to:
|Laser In-Situ Keratomileusis (LASIK)|
|Wavefront-Guided LASIK (Custom LASIK)|
|Photorefractive Keratectomy (PRK)|
|Radial Keratotomy (RK)|
|Astigmatic Keratotomy (AK)|
|Automated Lamellar Keratoplasty (ALK)|
|Laser Thermal Keratoplasty (LTK)|
|Conductive Keratoplasty (CK)|
|Intracorneal Ring (Intacs)|
What is LASIK surgery?
LASIK, or Laser In-Situ Keratomileusis, surgery may be used to correct nearsightedness, farsightedness and astigmatism. When a person has any of these eye conditions, his or her eye is too long (nearsightedness), or too short(farsightedness) or the cornea is the wrong curvature resulting in an incorrect focusing power. This results in light rays entering the eye coming into focus without precisely hitting the retina, resulting in blurry vision when looking in the distance.
The LASIK surgery procedure, which should be performed by an experienced LASIK surgeon, involves a type of laser eye surgery which reshapes the cornea using an excimer laser. LASIK has replaced most of the other refractive eye surgery techniques because it provides minimal discomfort and a quick visual recovery. For those patients with more complex refractive errors a newer LASIK technology, called Wavefront-Guided LASIK or Custom LASIK, provides an advanced method for measuring optical distortions in the eye. The Eye Surgery Education Council states that LASIK surgeons can now use this technology as a roadmap to evaluate the eye by measuring how light is distorted as it passes into the eye and then is reflected back. This creates an optical map of the eye, highlighting individual imperfections. In addition, the wavefront technology allows the surgeon to tailor the laser beam settings for a more precise procedure. This provides a patient sharper, better quality vision as well as a reduction in nighttime vision difficulties.
How is LASIK eye surgery performed?
Although each procedure varies slightly, in general, LASIK eye surgery involves using a computer-controlled excimer laser (a cold, ultraviolet laser) and a microkeratome (a surgical instrument). With these instruments, the surgeon creates a thin flap in the center of the cornea to allow the laser to remove a microscopic layer of tissue. By removing the tissue, the cornea is reshaped in order to correct the refractive error. The flap, which is replaced without using sutures, adheres back to the cornea within minutes.
Recovery after LASIK eye surgery
In most cases, recovery from LASIK surgery is fast and involves minimal discomfort. Mild pain relievers may be recommended by your LASIK surgeon to relieve discomfort during the first day after surgery. Patients typically use eyedrops for a week after the procedure.
Possible side effects of LASIK surgery
Generally, LASIK has a high success rate. However, side effects do occur. The following are the most common side effects and complications. Each individual may experience side effects differently. Side effects may include:
|Dry eyes (during the healing process)|
|Eye Discomfort (mostly during the first 24 hours following surgery)|
|Irregular astigmatism, which can decrease the corrected vision (astigmatism means blurring caused by an irregularly shaped cornea)|
|Glare, halos or night vision problems|
|Overcorrected or undercorrected vision|
|Inability to wear contact lenses in the future|
|Loss of the corneal flap|
Benefits of LASIK surgery
For most candidates, LASIK surgery usually involves little pain and recovery is rapid. Other benefits may include:
|LASIK can correct a wide range of refractive errors including nearsightedness, farsightedness and astigmatism of varying degrees.|
|LASIK can be repeated to correct the vision further.|
|The eyes stabilize within three months after LASIK surgery.|
|The eye is not structurally weakened.|
|LASIK usually causes little or no scarring of the cornea.|
|Post-operative care is usually limited to using eye drops for a week after surgery|
What is AMD?
It means age-related macular degeneration
AMD is a common eye condition among people age 50 and older. It is a leading cause of vision loss in older adults. It gradually destroys the macula, the part of the eye that provides sharp, central vision needed for seeing objects clearly.
In some people, AMD advances so slowly that vision loss does not occur for a long time. In others, the disorder progresses faster and may lead to a loss of vision in one or both eyes. The vision loss makes it difficult to recognize faces, drive a car, read, print, or do close work, such as sewing or fixing things around the house.
Despite the limited vision, AMD does not cause complete blindness. You will be able to see using your side (peripheral) vision.
What are some low vision devices?
Because low vision varies from person to person, specialists have different tools to help patients deal with vision loss.
They include the following:
|Reading glasses with high-powered lenses|
|Computers with large-print and speech-output systems|
|Large-print reading materials|
|Talking watches, clocks, and calculators|
What is a cataract?
A cataract is a clouding of the lens in the eye that affects vision. Most cataracts are related to aging. Cataracts are very common in older people. By age 80, more than half of all Americans either have a cataract or have had cataract surgery.
A cataract can occur in either or both eyes. It cannot spread from one eye to the other.
What is the lens?
The lens is a clear part of the eye that helps to focus light, or an image, on the retina. The retina is the light-sensitive tissue at the back of the eye.
In a normal eye, light passes through the transparent lens to the retina. Once it reaches the retina, light is changed into nerve signals that are 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 you see will be blurred.
How is a cataract treated?
The symptoms of early cataract may be improved with new eyeglasses, brighter lighting, anti-glare sunglasses, or magnifying lenses. If these measures do not help, surgery is the only effective treatment. Surgery involves removing the cloudy lens and replacing it with an artificial lens.
What is diabetic eye disease?
Diabetic eye disease refers to a group of eye problems that people with diabetes may face as a complication of diabetes. All can cause severe vision loss or even blindness.
Diabetic eye disease may include:
|Diabetic retinopathy: damage to the blood vessels in the retina.|
|Cataract: clouding of the eye's lens. Cataracts develop at an earlier age in people with diabetes.|
|Glaucoma: increase in fluid pressure inside the eye that leads to optic nerve damage and loss of vision. A person with diabetes is nearly twice as likely to get glaucoma as other adults.|
How is diabetic retinopathy treated?
During the first three stages of diabetic retinopathy, no treatment is needed, unless you have macular edema. To prevent progression of diabetic retinopathy, people with diabetes should control their levels of blood sugar, blood pressure, and blood cholesterol.
Proliferative retinopathy is treated with laser surgery. This procedure is called scatter laser treatment. Scatter laser treatment helps to shrink the abnormal blood vessels.
Conjunctivitis, also known as pinkeye, is an inflammation of the conjunctiva. The conjunctiva is the thin clear tissue that lies over the white part of the eye and lines the inside of the eyelid.
What Causes Pinkeye?
Pinkeye has a number of different causes, including:
|Bacteria (such as gonorrhea or chlamydia)|
|Irritants such as shampoos, dirt, smoke, and pool chlorine|
|Allergies, like dust, pollen, or a special type of allergy that affects some contact lens wearers|
Pinkeye caused by some bacteria and viruses can spread easily from person to person, but is not a serious health risk if diagnosed promptly. Pinkeye in newborn babies, however, should be reported to a doctor immediately
How Is Pinkeye Treated?
The treatment for pinkeye depends on the cause.
|Bacteria: Pinkeye caused by bacteria, including those related to STDs, is treated with antibiotics, in the form of eye drops, ointments, or pills. Eye drops or ointments may need to be applied to the inside of the eyelid three to four times a day for five to seven days. Pills may need to be taken for several days. The infection should improve within a week. Take or use the drugs as instructed by your doctor, even if the symptoms go away.|
|Viruses: This type of pinkeye often results from the viruses that cause a common cold. Just as a cold must run its course, so must this form of pinkeye, which usually lasts from four to seven days. Viral conjunctivitis can be highly contagious. Avoid contact with others and wash your hands frequently.|
|Irritants: For pinkeye caused by an irritating substance, use water to wash the substance from the eye for five minutes. Your eyes should begin to improve within four hours. If the conjunctivitis is caused by acid or alkaline material such as bleach, immediately rinse the eyes with lots of water and call your doctor immediately.|
|Allergies: Allergy-associated conjunctivitis should improve once the allergy is treated and the allergen removed. See your doctor if you have conjunctivitis that is linked to an allergy.|
What Can I Do to Relieve Symptoms of Pinkeye?
To relieve the symptoms of pinkeye:
|Protect your eyes from dirt and other irritating substances.|
|Avoid the use of makeup.|
|Remove contact lenses, if you wear them.|
|Non-prescription "artificial tears," a type of eye drops, may help relieve itching and burning from the irritating substances causing your pinkeye. However, other types of eye drops may irritate the eyes and should not be used, including those promoted to treat eye redness. Note: Do not use the same bottle of drops in an uninfected eye.|
Eye Glasses and Contact Lenses
Lenses for correcting or improving vision:
There are two types of lenses prescribed for correcting or improving vision. These include:
|Eyeglasses (also called spectacles):
Eyeglasses, the most common form of eyewear used to correct or improve many types of vision problems, are a frame that holds two pieces of glass or plastic, which have been ground into lenses to correct refractive errors. Refractive errors can include nearsightedness or myopia (difficulty seeing far away), farsightedness or hyperopia (difficulty seeing close up), and astigmatism (blurring due to an irregularly shaped cornea). Eyeglasses perform this function by adding or subtracting focusing power to the eye's cornea and lens.
Contact lenses are worn directly on the cornea of the eye. Like eyeglasses, contact lenses help to correct refractive errors and perform this function by adding or subtracting focusing power to the eye's cornea and lens.
How to read an eyeglass prescription:
The lens power of eyeglasses is measured in diopters. This measurement reflects the amount of power necessary to focus images directly on to the retina. When looking at an eyeglasses prescription, you will see the following abbreviations:
|O.D. - Oculus dextrous simply refers to the right eye (sometimes the abbreviation RE is used).||O.S. - Oculus sinister refers to the left eye (sometimes the abbreviation LE is used).|
In addition, the eyeglass prescription may also contain the following measurements.
|Sphere||This number measurement reflects the extent of the nearsightedness or farsightedness.|
|Cylinder||This number measurement refers to the amount of astigmatism (an irregularly shaped cornea which causes blurring) in the eye.|
|Axis||This number measurement describes the astigmatism in degrees from the horizontal (most left and right eyes have the same axis in astigmatism) axis.|
Bifocal prescriptions, which correct both nearsightedness and farsightedness, usually have an additional measurement listed on the prescription as "add" to indicate the strength of the lens.
What are the different types of eyeglass lenses?
The type of lenses used in eyeglasses depends on the type of vision problem and may include:
|Concave lenses are thinnest in the center. Used to correct nearsightedness (myopia), the numerical prescription in diopters is always marked with a minus (-) symbol.|
|Convex lenses are thickest in the center, like a magnifying glass. Used to correct farsightedness (hyperopia), the numerical prescription in diopters is always marked with a plus (+) symbol.|
|Cylindrical lenses curve more in one direction than in the other and are often used to correct astigmatism.|
Currently, there are four types of contact lenses in use:
|The soft, water-absorbing lens|
|The rigid, gas-permeable lens|
|Other rigid lenses|
|Other flexible, nonwater absorbing lenses|
Reading a contact lens prescription:
The prescription for contact lenses includes more information than what is available on the prescription for eyeglasses. Special measurements will need to be taken of the curvature of the eye. In addition, the physician will determine if the eyes are too dry for contact lenses, and if there are any corneal problems that may prevent a person from wearing contact lenses. Trial lenses are usually tested on the eyes for a period of time to ensure proper fit.
The contact lens prescription usually includes the following information:
|Contact lens power (measured in diopters, like eyeglasses)|
|Contact lens base curve|
|Diameter of the lens|
|Contact lens manufacturer|
Eye care specialists are required by federal law to give you a copy of your contact lens specifications.
Eye Safety at the Computer
Eye strain and computer use
The following are the most common symptoms of eye strain, which may be attributed to prolonged computer screen viewing. However, each individual may experience symptoms differently. Symptoms may include:
|Red, watery, irritated eyes|
|Tired, aching, or heavy eyelids|
|Problems with focusing|
|Muscle spasms of the eye or eyelid|
Symptoms of eye strain are often relieved by resting the eyes, changing the work environment, and/or wearing the proper glasses. The symptoms of eye strain may resemble other eye conditions. Consult a physician for diagnosis.
How is eyestrain avoided?
The Occupational Safety and Health Administration (OSHA) has provided the following helpful suggestions for making the appropriate workstation modifications to help avoid eye strain:
|Position the video display terminal (VDT) slightly further away than where you normally hold reading material.|
|Position the top of the VDT screen at or slightly below eye level.|
|Place all reference material as close to the screen as possible to minimize head and eye movements and focusing changes.|
|Minimize lighting reflections and glare.|
|Keep the VDT screen clean and dust-free.|
|Schedule periodic rest breaks to avoid eye fatigue.|
|Keep the eyes lubricated (by blinking or using lubricating eye drops) to prevent them from drying out.|
|Keep the VDT screen in proper focus.|
|Consult your ophthalmologist or optometrist, as some individuals who normally do not need glasses may need corrective lenses for computer work.|
First Aid for Eyes
To lessen the risk of permanent damage caused by eye injuries, it is important to treat eye injuries immediately. Consult your ophthalmologist or optometrist as soon as possible.
First aid for cuts in or around the eye:
|Bandage the eye gently.|
|Do not rub the eye or apply pressure.|
|Do not try to remove any particles.|
|Do not wash out the eye.|
First aid when foreign particles enter the eye:
|Pull the upper lid down onto lower lid and let lower eyelashes sweep away the particle by blinking repeatedly.|
|Let tears wash out the speck or particle, or use an eye wash.|
|Close your eye and seek medical attention immediately if the above procedure does not work.|
|Do not rub the eye.|
First aid for chemical splashes:
|Use fingers to separates lids, then flush the eye with water from a faucet or clean container.|
|Seek medical attention immediately.|
|Cover the eye.|
First aid for physical trauma to the eye:
|Gently apply small cold compresses without pressure immediately to reduce pain and swelling.|
|Contact your ophthalmologist, optometrist, or primary care physician immediately.|
Tips for Keeping the Eyes Healthy
|Have a comprehensive dilated eye exam: A dilated eye exam is the only way to detect many common eye diseases such as glaucoma, diabetic eye disease and age-related macular degeneration in their early stages.|
|Know your family's eye health history: It's important to know if anyone has been diagnosed with a disease or condition since many are hereditary. This will help to determine if you are at higher risk for developing an eye disease or condition.|
|Eat right to protect your sight: Eating a diet rich in fruits and vegetables, particularly dark leafy greens is important for keeping your eyes healthy, too. Research has also shown there are eye health benefits from eating fish high in omega-3 fatty acids.|
|Maintain a healthy weight: Being overweight or obese increases your risk of developing diabetes and other systemic conditions, which can lead to vision loss, such as diabetic eye disease or glaucoma. If you are having trouble maintaining a healthy weight, talk to your doctor.|
|Wear protective eyewear: Protective eyewear includes safety glasses and goggles, safety shields, and eye guards specially designed to provide the correct protection for a certain activity.|
|Quit smoking or never start: Smoking is as bad for your eyes as it is for the rest of your body. Research has linked smoking to an increased risk of developing age-related macular degeneration, cataract, and optic nerve damage, all of which can lead to blindness.|
|Be cool and wear your shades: Sunglasses are a great fashion accessory, but their most important job is to protect your eyes from the sun's ultraviolet rays. When purchasing sunglasses, look for ones that block out 99 to 100 percent of both UV-A and UV-B radiation.|
|Give your eyes a rest: If you spend a lot of time at the computer or focusing on any one thing, you sometimes forget to blink and your eyes can get fatigued. Try the 20-20-20 rule: Every 20 minutes, look away about 20 feet in front of you for 20 seconds. This can help reduce eyestrain.|
|Clean your hands and your contact lenses--properly: To avoid the risk of infection, always wash your hands thoroughly before putting in or taking out your contact lenses. Make sure to disinfect contact lenses as instructed and replace them as appropriate.|
|Practice workplace eye safety: Employers are required to provide a safe work environment. When protective eyewear is required as a part of your job, make a habit of wearing the appropriate type at all times and encourage your coworkers to do the same.|
Ayurvedic Guidelines for Eye Health
|The quality of food taken by a person determines his/her health including that of his/her eyes. Easily digestible foods, rich in fiber should be taken. A diet rich in whole grain cereals, sprouted pulses, fresh vegetables and fruits will guarantee a healthy eyesight.|
|Food should be well digested before going to sleep. One should go to sleep only after 3 hours of eating.|
|Regular intake of ghee and buttermilk is advised.|
|Two to three liters of water is to be consumed to keep the body and eyes hydrated.|
|Eyes should be washed regularly with clean and natural water.|
|Eyes must be protected when traveling to avoid direct wind pressure, sunlight, dust, heat.|
|Direct exposure to hot or cold winds must be avoided.|
|It is not advisable to gaze continuously for a long time at an object or at work.|
|Lukewarm or cold water must be used for showering.|
|Regular passing of bowel is important.|
|Reading in the correct posture(sitting upright)with proper lighting on the reading material.|
|Sleeping with many pillows is not good for the eyes.|
|Eye exercises have a major role in maintaining healthy eye sight.|
|Regular eye blinking, palming is recommended to keep the eyes moist and clean.|
|Practice of yoga and pranayama helps in circulation.|
|Proper sleep is very important to maintain eye health. At least 6 to 8 hours of sleep is necessary|
|Triphala powder soaked overnight in warm water and used as a eyewash in the morning after straining the water helps to keep the eyes clean and cool.|
|A slice of aloe or cotton dipped in pure rose water on the eye lids keeps the eyes cool and fresh.|
|Application of pure 'kajal' helps to remove excessive kapha, and improves vision.|
|A shampoo applied on the head by crushing and soaking hibiscus flowers and leaves in water (for about 2 hours) will ensure a relaxed feeling.|
|Soak a teaspoon of crushed coriander seeds in a cup of water overnight. Strain and use the water to wash eyes regularly to soothe tired, sore eyes. This also removes unwanted dirt.|
|Castor oil and coconut oil can be mixed in equal proportions and applied on the head regularly, followed by a gentle massage. This will keep the eyes cool.|
|Application of a drop of pure cold pressed coconut oil on each eye will prevent dryness and reddening of the eyes.|
|Massaging the soles with cold pressed sesame oil before going to bed is useful in case of pain and reddening of eyes, insomnia.|
|Massaging the closed eyelids with pure ghee or cold pressed sesame oil will guarantee good rest.|
|Ayurvedic cleansing and rejuvenating therapies like nasya, shirodhara, akshidhara can also be done regularly under medical supervision.|
|Hip bath or tub bath is also advised to improve circulation|
|Triphala powder (powder of gooseberry, terminalia cebula, terminalia bullerica) should be consumed with honey and pure ghee at nighttime. It will rejuvenate the eye.|
Ayurveda different treatments like Netra dhara, Sekam, Aschyothanam, Anjanam, Tharpanam, Putapakam, Rakthamoksha etc are used for treating various eye disorders.
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