Many normal, age-related problems affecting vision can be addressed with practical solutions, such as extra lighting for reading recipes or tinkering with garage projects.
In fact, after about age 60, you may find you need additional illumination for most tasks performed indoors or in darker conditions outdoors. This is because your eye’s pupil no longer opens as widely as it once did to allow light to enter. Because less light is reaching your retina, where vision processing occurs, images are no longer as sharp as they once were.
To help offset this problem, you might consider extra steps such as:
- Installing task lighting underneath kitchen cabinets or above stoves to help illuminate darker corners.
- Making sure you have enough lighting to brighten work surfaces in your garage, sewing room or other areas where you need to see fine details.
- Asking your employer to install additional lighting, if needed, at your work space.
Also, make sure you have regular eye exams that include critical tests for older eyes to rule out potentially serious age-related eye diseases that may affect vision quality. Your eye doctor also can advise you about the best vision correction options to reduce the effects of normal age-related declines in near vision, color vision and contrast sensitivity.
Cataracts, which are very common in the over-60 age group, also can cause cloudy or hazy vision. Cataracts usually are easily remedied with surgery that removes the eye’s cloudy lens and replaces it with an artificial one.
What Can You Do About Permanent Vision Loss?
Unfortunately, some age-related eye diseases — including glaucoma, advanced macular degeneration and diabetic retinopathy — can cause serious vision loss and blind spots.
Many low vision devices are available to assist people with permanent vision loss so they can perform daily living tasks more easily. These devices include:
- Strong magnifying lenses with extra illumination for reading and other near vision work.
- Audio tapes, specially adapted computer or television screens, and telescopes.
- Lens filters and shields to reduce glare.
Vision Loss and the Elderly
One disturbing trend noted in recent years has been an increased tendency in our society to overlook or neglect the vision correction needs of elderly citizens, including those living in nursing homes.
As an example, researchers say almost one third of older Americans diagnosed with glaucoma receive no treatment for this potentially blinding eye disease.
Consequences of delaying vision correction or needed treatment, especially in elderly people, can be severe. Uncorrected vision problems can contribute to falls that seriously injure elderly people and greatly reduce their confidence in their ability to live independently.
If you have older relatives or friends living alone or in a nursing home, consider serving as their advocate to make sure they receive appropriate vision care and treatment of age-related eye diseases, to maximize their quality of life.
Article ©2015 Access Media Group LLC. All rights reserved.
LASIK, short for laser-assisted in situ keratomileusis, is the most popular refractive surgery available today. Each year, more than one million LASIK procedures are performed in the United States.
LASIK has become the premier surgery for vision correction because it’s quick and painless, there is little or no discomfort after the procedure and vision recovery is rapid – some patients already see 20/20 the following day.
LASIK can correct nearsightedness, farsightedness and astigmatism. With a special technique called monovision, it can also reduce the need for reading glasses among patients over age 40 who wear bifocals.
Am I a Good Candidate for LASIK?
To be a good candidate for LASIK, you should be at least 18 years old, have healthy eyes, and have adequate corneal thickness, since LASIK corrects your vision by removing tissue from your cornea to reshape your eye.
Chronic dry eye problems, corneal diseases and other abnormalities may disqualify you from having LASIK surgery. In order to know for sure if you are a good candidate, a comprehensive eye exam is required. For your convenience, we are happy to provide LASIK pre-operative exams and consultations at our office. Call us for details.
Important considerations when deciding whether to have LASIK are your expectations and your ability to accept a less-than-perfect outcome. LASIK can reduce your dependence on glasses and almost always gives you the ability to function well without the need for glasses or contact lenses. But there are no guarantees, and LASIK doesn’t always create perfect vision. In some cases, your vision after LASIK may be permanently less clear than it was with glasses before the procedure. You have to ask yourself if you’re willing to accept the risk of such an outcome before you decide to have LASIK surgery.
Remember: LASIK is an elective procedure, not a required one.
The LASIK Procedure
LASIK is an ambulatory procedure. You walk into the surgery center, have the procedure and walk out again. The actual surgery usually takes less than 15 minutes for both eyes, but expect to be at the surgery center for an hour or more.
LASIK is a two-step procedure. In the first step, the surgeon creates a thin, hinged flap of tissue on your cornea with an instrument called a microkeratome or with a laser. This flap is folded back and the second step – the laser reshaping of your eye – begins. After the laser treatment, which usually takes less than a minute, the flap is repositioned and the surgeon moves on to your other eye.
What Is Wavefront LASIK?
Wavefront LASIK (also called wavefront-assisted, wavefront-guided or custom LASIK) means the laser treatment (or “ablation”) is determined by a computerized mapping of the power of your eye called wavefront analysis. Wavefront-guided procedures are more precise than ablations determined by using only an eyeglasses prescription, and they can correct subtle optical imperfections of the eye called “higher-order aberrations” that regular ablations can’t treat. Several studies show wavefront-guided ablations provide sharper vision than conventional, non-wavefront LASIK and may reduce the risk of nighttime glare and halos.
After LASIK Surgery
After the procedure, your surgeon or an assistant will apply medicated eye drops and clear protective shields over your eyes. You can open your eyes and see well enough to walk without glasses, but you must have someone drive you home.
You will be expected to use medicated eye drops several times a day for a week or so to protect your eyes from infection and help them heal properly. You will also be told to use artificial tears frequently to keep your eyes moist and comfortable.
You should rest and not use your eyes much when you get home from surgery that day. You may also be more comfortable if the lights in your house are dimmed.
The following day, you should be seeing well enough to drive and can resume most activities. Be careful, however, not to rub your eyes until your eye doctor tells you it is safe to do so.
Usually, you will be asked to return to the surgery center the following day so your surgeon or another eye doctor at the center can check your vision and make sure your eyes appear as they should. At this visit, you typically will be given additional instructions about using eye drops and artificial tears, and you will be able to ask the doctor any questions you have.
From this point forward (and sometimes for this “day one” visit as well), your post-operative care may be performed by an eye doctor other than your LASIK surgeon. When your post-operative care is provided by a doctor other than your surgeon or another doctor at the surgery center, it’s called co-management. We are happy to provide post-operative care for you at our office through a co-management agreement with your surgeon. Call our office for details.
What If My Vision Is Still Blurry After LASIK?
Though most patients see quite clearly in a matter of days after LASIK, it can take several months before your eyes are completely stable. Until then, improvements in your vision can still occur. But if several months pass and your vision is still blurred, see your LASIK surgeon. Usually a second LASIK surgery (called an enhancement) can sharpen your eyesight further.
If for some reason an enhancement is not indicated or desired, eyeglasses or contact lenses may help. We will be happy to examine your eyes and discuss the different options with you.
Eyewear After LASIK
Keep in mind that, even if your vision seems perfect after LASIK, you still need eyewear.
When outdoors, it’s important to protect your eyes from the sun’s harmful rays with sunglasses that provide 100% UV protection. If you play sports when wearing sunglasses, make sure the lenses have polycarbonate lenses for extra protection. And anytime you’re working with power tools or doing anything else when an eye injury is possible, you should wear safety glasses with polycarbonate lenses.
If you’re over 40 (or soon will be), it’s likely you’ll need reading glasses after LASIK. Also, many LASIK patients can benefit from a pair of prescription eyeglasses for night driving. Though these lenses may have only a mild prescription, they often can make your vision sharper for added safety and comfort.
Eye Care After LASIK
And don’t forget to continue to have routine eye exams after LASIK. Even if your vision is perfect, you still need to have your eyes checked for glaucoma and other potential problems on a regular basis. Routine exams also help you make sure your vision stays stable after LASIK.
Article ©2015 Access Media Group LLC. All rights reserved.
Regardless of your age or physical health, it’s important to have regular eye exams.
During a complete eye exam, your eye doctor will not only determine your prescription for eyeglasses or contact lenses, but also check your eyes for common eye diseases, assess how your eyes work together as a team and evaluate your eyes as an indicator of your overall health.
Who Should Get Their Eyes Examined?
Eye examinations are an important part of health maintenance for everyone. Adults should have their eyes tested to keep their prescriptions current and to check for early signs of eye disease. For children, eye exams can play an important role in normal development.
Vision is closely linked to the learning process. Children who have trouble seeing or interpreting what they see will often have trouble with their schoolwork. Many times, children will not complain of vision problems simply because they don’t know what “normal” vision looks like. If your child performs poorly at school or exhibits a reading or learning problem, be sure to schedule an eye examination to rule out an underlying visual cause.
What Is the Eye Doctor Checking for?
In addition to evaluating whether you have nearsightedness, farsightedness or astigmatism, your eye doctor will check your eyes for eye diseases and other problems that could lead to vision loss. Here are some examples of the conditions that your eye doctor will be looking for:
- Amblyopia. This occurs when the eyes are misaligned or when one eye has a much different prescription than the other. The brain will “shut off” the image from the turned or blurry eye. If left untreated, amblyopia can stunt the visual development of the affected eye, resulting in permanent vision impairment. Amblyopia is often treated by patching the stronger eye for periods of time.
- Strabismus. Strabismus is defined as crossed or turned eyes. Your eye doctor will check your eyes’ alignment to be sure that they are working together. Strabismus causes problems with depth perception and can lead to amblyopia.
- Eye diseases. Many eye diseases, such as glaucoma and diabetic eye disease, have no obvious symptoms in their early stages. Your eye doctor will check the health of your eyes inside and out for signs of early problems. In most cases, early detection and treatment of eye diseases can help reduce your risk for permanent vision loss.
- Other diseases. Your eye doctor can detect early signs of some systemic conditions and diseases by looking at your eye’s blood vessels, retina and so forth. They may be able to tell you if you are developing high blood pressure, high cholesterol or other problems. For example, diabetes can cause small blood vessel leaks or bleeding in the eye, as well as swelling of the macula (the most sensitive part of the retina), which can lead to vision loss. It’s estimated that one-third of Americans who have diabetes don’t know it; your eye doctor may detect the disease before your primary care physician does, especially if you’re overdue for a physical.
What’s the Difference Between a Vision Screening and a Complete Eye Exam?
Vision screenings are general eye tests that are meant to help identify people who are at risk for vision problems. Screenings include brief vision tests performed by a school nurse, pediatrician or volunteers. The eye test you take when you get your driver’s license renewed is an example of a vision screening.
A vision screening can indicate that you need to get an eye exam, but it does not serve as a substitute for a comprehensive eye exam.
A comprehensive eye examination is performed by an eye doctor and will involve careful testing of all aspects of your vision. Based upon the results of your exam, your doctor will then recommend a treatment plan for your individual needs. Remember, only an eye doctor can provide a comprehensive eye exam. Most family physicians and pediatricians are not fully trained to do this, and studies have shown that they can miss important vision problems that require treatment.
Treatment plans can include eyeglasses or contact lenses, eye exercises or surgery for muscle problems, medical treatment for eye disease or simply a recommendation that you have your eyes examined again in a specified period of time.
No matter who you are, regular eye exams are important for seeing more clearly, learning more easily and preserving your vision for life.
Article ©2015 Access Media Group LLC. All rights reserved.
Not everyone is well suited to the most common types of contact lenses. If you have one or more of the following conditions, contact lens wear may be more challenging:
- dry eyes
- giant papillary conjunctivitis (GPC)
- post-refractive surgery (such as LASIK)
But “challenging” doesn’t mean impossible. Often, people with these conditions can wear contacts quite successfully. Let’s take a closer look at each situation – and possible contact lens solutions.
Contact Lenses for Astigmatism
Astigmatism is a very common condition where the curvature of the front of the eye isn’t round, but is instead shaped more like a football or an egg. This means one curve is steeper or flatter than the curve 90 degrees away. Astigmatism won’t keep you from wearing contact lenses – it just means you need a different kind of lens.
Lenses specially designed to correct astigmatism are called “toric” lenses. Most toric lenses are soft lenses. Toric soft lenses have different corrective powers in different lens meridians, and design elements to keep the lens from rotating on the eye (so the varying corrective powers are aligned properly in front of the different meridians of the cornea).
In some cases, toric soft lenses may rotate too much on the eye, causing blur. If this happens, different brands that have different anti-rotation designs can be tried. If soft lens rotation continues to be a problem, gas permeable (GP) lenses can also correct astigmatism.
Contact Lenses for Dry Eyes
Dry eyes can make contact lens wear difficult and cause a number of symptoms, including:
- a gritty, dry feeling
- feeling as if something is in your eye
- a burning sensation
- eye redness (especially later in the day)
- blurred vision
If you have dry eyes, the first step is to treat the condition. This can be done in several ways, including artificial tears, medicated eye drops, nutritional supplements, and a doctor-performed procedure called punctal occlusion to close ducts in your eyelids that drain tears away from your eyes.
Once the dry eye condition is treated and symptoms are reduced or eliminated, contact lenses can be tried. Certain soft contact lens materials work better than others for dry eyes. Also, GP lenses are sometimes better than soft lenses for dry eye sufferers, since these lenses don’t dry out the way soft lenses can.
Replacing your contacts more frequently and reducing your wearing time each day (or removing them for specific tasks, such as computer work) can also reduce dry eye symptoms when wearing contacts.
Contact Lenses for Giant Papillary Conjunctivitis (GPC)
Giant papillary conjunctivitis (GPC) is an inflammatory reaction on the inner surface of the eyelids. One cause of GPC is protein deposits on soft contact lenses. (These deposits are from components of your tear film that stick to your lenses and become chemically altered.)
Usually, changing to a one-day disposable soft lens will solve this problem, since you just throw these lenses away at the end of the day before protein deposits can accumulate on them. Gas permeable lenses are also often a good solution, as protein deposits don’t adhere as easily to GP lenses, and lens deposits on GP lenses are more easily removed with daily cleaning.
In some cases of GPC, a medicated eye drop may be required to reduce the inflammation before you can resume wearing contact lenses.
Contact Lenses for Presbyopia
Presbyopia is the normal loss of focusing ability up close when you reach your 40s.
Today, there are many designs of bifocal and multifocal contact lenses to correct presbyopia. Another option for presbyopia is monovision. This is wearing a contact lens in one eye for distance vision and a lens in the other eye that has a power for near vision.
During your contact lens fitting we can help you decide whether bifocal/multifocal contact lenses or monovision is best for you.
Contact Lenses for Keratoconus
Keratoconus is a relatively uncommon eye condition where the cornea becomes thinner and bulges forward. The term “keratoconus” comes from the Greek terms for cornea (“kerato”) and cone-shaped (“conus”). The exact cause of keratoconus remains unknown, but it appears that oxidative damage from free radicals plays a role.
Gas permeable contact lenses have historically been the treatment option of choice for mild and moderate keratoconus. Because they are rigid, GP lenses can help contain the shape of the cornea to prevent further bulging of the cornea. They also can correct vision problems caused by keratoconus that cannot be corrected with eyeglasses or soft contacts.
The last few years have produced quite a bit of innovation in contact lenses for keratoconus. There are now several soft lenses for keratoconus, as well as many scleral lenses. These are large lenses made of GP material that remain completely above the cornea, with the outer edge of the lens resting on the white of the eye (sclera).
Another option is called “piggybacking,” where soft and GP lenses are worn together on the eye for greater comfort than a GP alone would provide. Hybrid contact lenses that have a GP center surrounded by a soft “skirt” can produce the same effect.
Contact Lenses After Corrective Eye Surgery
Hundreds of thousands of people each year have LASIK surgery to correct their eyesight. Sometimes, vision problems remain after surgery that can’t be corrected with eyeglasses or a second surgical procedure. In these cases, gas permeable contact lenses – including large GP scleral lenses – can often restore visual acuity and eliminate problems like glare and halos at night.
GP lenses are also used to correct vision problems after corneal transplant surgery, including irregular astigmatism that cannot be corrected with eyeglasses.
Problem-Solving Contact Lens Fittings Cost More
Fitting contact lenses to correct or treat any of the above conditions will generally take much more time than a regular contact lens fitting. These “hard-to-fit” cases usually require a series of office visits and multiple pairs of trial lenses before the final contact lens prescription can be determined. Also, the lenses required for these conditions are usually more costly than regular soft contact lenses. Therefore, fees for these fittings are higher than fees for regular contact lens fittings. Call our office for details.
Find Out if You Can Wear Contact Lenses
If you are interested in wearing contact lenses, call our office to schedule a consultation. Even if you’ve been told you’re not a good candidate for contacts because you have one of the above conditions or for some other reason, we may be able to help you wear contact lenses safely and successfully.
Article ©2015 Access Media Group LLC. All rights reserved.
When you work at a computer for any length of time, it’s common to experience eyestrain, blurred vision and other symptoms of computer vision syndrome (CVS). Viewing computer-generated print and images on a screen or monitor for prolonged periods is harder on the eyes than viewing a similar amount of material on the printed pages of a book or magazine.
If you’re under age 40, blurred vision during computer use may be due to your eyes being unable to remain accurately focused on your screen for sustained periods. Or you may have a hard time quickly and accurately changing focus, such as when you shift your gaze from your monitor to your keyboard and back again. This problem, called lag of accommodation, can cause eyestrain and headaches — two common symptoms of CVS.
If you’re over age 40, the onset of presbyopia — the normal age-related loss of near focusing ability — can make focusing on a computer screen even more difficult, further increasing the risk of eyestrain, headaches and eye fatigue.
So what can you do to make your eyes more comfortable and function more efficiently during computer use? Have your eye doctor prescribe specially designed computer glasses.
Customized computer glasses can make a world of difference. These special-purpose glasses are prescribed specifically to reduce eyestrain and give you the most comfortable vision at your computer.
I Already Wear Glasses. Do I Really Need Computer Glasses?
If you already wear prescription eyeglasses or reading glasses, you may be tempted to dismiss the idea of computer glasses. But eyeglasses prescribed for general-purpose wearing are often not well-suited for prolonged computer work.
Why? When working at a computer, your eyes are generally 20 to 26 inches from your computer screen. This distance is considered the intermediate zone of vision — closer than driving (distance) vision, but farther away than reading (near) vision.
Most young people wear eyeglasses to correct their distance vision. Reading glasses are prescribed to correct near vision only. And bifocals prescribed for those over age 40 with presbyopia correct only near and far. None of these eyeglasses are optimized for the intermediate zone of vision used during computer work.
Even trifocals and progressive lenses, which do include the correct power for intermediate vision, have only a small portion of the lens dedicated to this area — not nearly a large enough area for comfortable prolonged computer work.
Without the appropriate eyewear, computer users can often end up with blurred vision, eyestrain, and headaches — the hallmark symptoms of computer vision syndrome (CVS). Worse still, many people try to compensate for their blurred vision by leaning forward, or by tipping their head to look through the bottom portion of their glasses. These unnatural postures can lead to headaches, neck and shoulder pain, and backaches.
Computer Glasses Reduce Errors and Increase Productivity
Are computer glasses worth the extra cost of a second pair of glasses?
Yes, they are. Research has shown that, in addition to increasing comfort and decreasing the risk of CVS, prescription computer glasses can reduce errors and productivity loss caused by vision problems during computer work.
A study conducted at the University of Alabama School of Optometry found that even minor changes from the optimum lens power for computer work can cause a 38% decrease in accuracy for tasks performed on a computer and a 9% loss in worker productivity. The researchers concluded that, because of productivity gains from workers wearing computer glasses, companies that pay for computer eyewear for their employees could experience a benefit/cost ratio of $18 for every $1 spent.
Computer Lens Designs
There are a number of special purpose lens designs that work well for computer glasses. Because these lenses are prescribed specifically for computer use, they are unsuitable for driving or general-purpose wear.
The simplest computer glasses have single vision lenses with a modified lens power prescribed to give the most comfortable vision at the user’s computer screen. These lenses reduce the amount of focusing the eyes have to do to keep images on the computer screen clear and provide the largest field of view, reducing the need for head tilting and other unnatural posture changes during computer work.
For older computer users, a specially designed occupational progressive lens for computer use is sometimes a better option. Progressive lenses for computer use have a larger intermediate zone than regular progressive lenses for a wider, more comfortable view of the computer screen.
Another option for presbyopic computer users is an occupational lined bifocal or trifocal, with larger intermediate and near zones than regular designs.
Your eyecare professional can help you decide which lens design will best suit your needs.
Lens Coatings and Treatments
Anti-reflective (AR) coating can make your computer glasses even more comfortable. This coating reduces glare caused by reflections of overhead fluorescent lighting that can occur in uncoated eyeglass lenses.
Also, because many office environments are too bright for optimum visual comfort, a light tint is often a good idea as well.
Finally, some of the newer computer lenses are specifically designed to block the short-wavelength, blue light that is emitted from computer screens. Blue light is associated with glare, eyestrain and potentially more serious long-term vision problems.
Article ©2015 Access Media Group LLC. All rights reserved.