You may have cataracts?

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Cataracts are common

Not a day goes by in the office when I don’t tell a patient that he or she has a cataract, which is any kind of clouding in the crystalline lens of our eye. Some patients have heard of the term and understand that it’s a common occurrence as one ages. Other patients are terrified of the term and think it’s a disease that will make them blind. But the patients I relate to are the ones who hear the word cataract, and think “I’m old.”

Cataracts can affect your vision

If it helps, most cataracts develop over decades, from young adulthood onward. As early as 40 years old, we can start to notice the effects of this change over time. The crystalline lens in our eye, which is responsible for focusing light onto our retinas, begins to change shape and chemical structure over time. These changes result in more light scatter and dimming of vision. Usually, a patient will begin noticing glare from car headlights, double or ghost images around letters and lights or that night vision is not as clear or bright.

These are often initial symptoms and do not require treatment. As the cataracts continue to develop, patients’ eyeglass prescriptions may begin to change and they will also experience blurry or cloudy vision with worsening of the above symptoms. When they reach this point, which is about half of patients over the age of 65, cataract surgery may be indicated.

Cataract surgery – not as bad as you’d think

Cataract surgery is the most common surgery performed in the world. Nowadays, it can be a 15 minute out-patient procedure. The cataract is removed from the eye and replaced with an artificial lens implant, called an intraocular lens. With many advancements in this field, the lens implant can also have specialty optics which can correct for astigmatism or for both distance and reading.

What many don’t know is that cataract surgery is an optional procedure. A cataract is not malignant and does not always have to be removed. However, a patient’s vision will improve significantly with a successful cataract surgery. They will notice a much brighter and clearer environment. Some patients who have glaucoma or have a crowding of the internal structures of the eye would benefit from having cataract surgery.

Photo courtesy of Community Eye Health on Flickr

Types of cataracts

There are many different forms of cataracts. In fact, I found a cataract in a 9-month old baby when his mom brought him in for a well-visit eye examination. In such a case where the eye is still developing, clouding of the lens can interfere with visual development and needs to be removed. Other congenital form of cataracts may simply be a cloudy spot on the lens which doesn’t interfere with vision. In this case, there is no need for cataract surgery.

Cataracts can also develop from trauma, use of certain medications and diabetes. Depending on the type, a cataract can slowly worsen over years, or change rapidly requiring surgical intervention within months. For patients whose vision is changing rapidly, I often like to follow them every few months to monitor for vision and cataract changes.

People often ask what can be done to prevent cataracts. Unfortunately, genetics plays a factor so if your parents required cataract surgery, you will most likely need one also. If you’re outdoors, wear a good quality pair of sunglasses that block UVA/UVB rays. This goes for kids as well since exposure to ultraviolet radiation is cumulative. If you’re outdoors for long periods of time, throw on a hat for added protection. Smoking has been shown to cause cataracts also, so limit your exposure to cigarette smoke. If you are currently being treated for diabetes or using steroid medications, be sure to see your internist regularly.

Why wait for your vision to blur? See your optometrist every year!

Most importantly, see your optometrist annually for an eye examination. They can check for cataracts but also determine if there are other factors that may be contributing to a reduction in your vision. It’s not just the lens that helps you to see but a whole network of related structures that work as a team to provide you with optimal vision.  If you require a new pair of glasses, always opt for an anti-glare coat on the lenses, which would further reduce disabling glare symptoms.

~Cindy P. Wang, OD, FAAO
http://eyehelp.org
http://www.coavision.org

 

Traumatic Brain injury: A rising concern in youth sports

Photo courtesy of K8tilyn on Flickr

Spring is almost here, and soon spring sports such as soccer, baseball and softball are going to be in full swing for our kids.

And while we encourage participation in outdoor activities and sports, it is good to be aware of the possible injuries and what to look out for.  According to the Centers for Disease Control and Prevention, emergency department visits for sports related traumatic brain injury (TBI) and concussions have increased by 60% for children and teens in the last ten years. The most common activities that can cause injury are bicycling, football, playground, basketball and soccer.  With this increase, there is also an increased awareness of safety in sports and signs and symptoms related to a TBI that can occur during play. This allows for steps to be taken to improve safety and reduce risk for our kids.

A TBI can occur if a person receives a blow to the head or a jolt to the body the causes quick head movement.  Some signs and symptoms of TBI include:

• confusion
• dizziness
• memory and concentration loss
• clumsy movement
• change in mood, behavior, or personality
• double or blurry vision
• light and noise sensitivity

Once and injury like this has occurred, symptoms can last up to months and it is important to not go back to sports too quickly as the brain needs time to heal.

Optometrist’s role in treatment

Photo Courtesy of Fitness Hospital on Flickr

Optometrists can play a large roll in the healing process from a TBI.

Because the brain nerves related to vision go everywhere in the brain, almost all TBI patients have some effect to their vision system and visual function in some way.  Issues such as memory and concentration loss, dizziness, double and blurry vision and light sensitivity can affect more than just sports performance. These problems can also affect academic performance even in a child who was succeeding academically prior to the injury.  Neurorehabilitative Optometry can address these problems and help improve brain and visual function though the use of specialized vision therapy techniques, specialized glasses and prisms.

If you suspect that a lingering brain injury is affecting your child’s academic performance, an evaluation by a California Optometric Association optometrist can help determine what can be done to help and refer you the appropriate optometrist specialist that can assess and treat the visual problems associated with the head injury.

Play Hard and Be Safe!

~Lisa M. Weiss, OD, FCOVD
California Optometric Association
http://www.eyehelp.org
http://www.coavision.org

CDC resources for parents and coaches on TBI and concussions can be found here.

Combating eye allergies

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It’s that time when we spring ahead and lose one hour of precious sleep.  As we set our clocks forward, we should also keep in mind that spring is literally just a few weeks away.  Many of our trees start branching out and flowers start blooming in magnificent colors.  As an allergy sufferer, I view spring as a time of burgeoning new life on one hand and of the dreaded allergies on the other.

For my patients with known seasonal eye allergies, I pre-treat them with anti-allergy eye drops from a class of medication called mast cell stabilizers.  In an ideal world, I like to initiate the anti-allergy therapy about one month before the time that their allergies would have set in.  Mast cell stabilizers work by preventing the body from releasing histamines from mast cells that cause the itchy, watery, red, puffy irritated eyes.  For those patients that have a new onset of eye allergies, immediate relief is what they are probably looking for so I turn to my combo medications that contain both antihistamines and mast cell stabilizers.  Antihistamines as the name denotes, blocks histamines from attaching to key sites and activating the course of allergies.

Here are some helpful tips I share with all my patients:

Courtesy of krossbow on Flickr.

• Apply cold compresses on top of closed eyelids. This will shrink down blood vessels and limit the circulation of histamines that cause itching and other eye symptoms.
• If you are a contact lens patient, clean your contacts well. You may want to switch to daily disposables to reduce pollen accumulation. Use anti-allergy eye drops that require once a day instillation. Wear glasses if the allergy is bothersome.
• Wash your hair at night to eliminate all the pollen that collected during the day and to prevent coming into contact on the pillow while sleeping.
• If you own a pet, bathe him more frequently to reduce pollen that is stuck on him. Best to keep your pet strictly indoors or outdoors to prevent transporting pollen into the house and on you.
• Avoid drying clothes or bed sheets naturally outdoors as the pollen can adhere to these items.
• Plan outdoor activities early in the morning and late in the evening as the pollen count is the lowest at these times.
• Pick vacation spots that have low pollen counts such as the beach.
• Get your daily pollen forecast on www.pollen.com. See what is floating around in your neighborhood or place of work.

As a “seasoned” (no pun intended) allergy sufferer, I am ready to combat the upcoming 2014 allergy season.  Are you?  Please make sure you plan ahead and make an appointment with your optometrist.

~Judy Tong, OD, FAAO
California Optometric Association
http://eyehelp.org
http://www.coavision.org

Why 20/20 isn’t perfect-What is visual acuity?

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Measuring normal vision

When patients come to see me, I need to have a way to compare how they see in relation to someone with normal vision.  So, like most eye doctors, I use a number system called Snellen visual acuity.  This measure of the clarity of vision uses black letters on a white background.  If you have ever had an eye examination, it is when the doctor asks you to read the letters on the chart that starts with a big “E”.  The letters are called optotypes and they have a very specific design that takes into account the size of the lines and the space between them.  While there are other types of visual acuity measurements, this is the most common.

20/20 isn’t perfect

The measure most people want to achieve with Snellen visual acuity is 20/20 vision.  While 20/20 is pretty darn good vision, in reality, 20/20 is not exceptional vision so much as it is more like the lowest possible visual acuity a person can have and be considered normal.  In fact, many people have the potential to see somewhere between 20/16 and 20/12 which means that they see even better than 20/20!

Paul B. (Halifax)

What do the numbers mean?

People also ask me to explain what the numbers mean.  As an example, take a person with 20/40 vision.  A person with 20/40 is at a disadvantage compared to a person with normal, 20/20 vision.  In fact, a person with 20/40 vision would have to stand 20 feet away from something that a person with normal vision can stand 40 feet away from and still see.

A number of factors like eye disease, the eye’s length and curvature, and the quality of connection between the eye and the processing centers in the brain come together to determine visual acuity.  Some factors, like nearsightedness, come with easy solutions like glasses.  Others, like macular degeneration, are much more complex and simple solutions like glasses only offer minimal improvement.  If a patient has very poor visual acuity, they may need magnifiers and telescopic lenses to help.

So,  the next time you go to the optometrist, give the 20/15 line a shot.  Good luck!

~David Ardaya, OD
California Optometric Association
http://eyehelp.org
http://www.coavision.org