You may have cataracts?

Courtesy of entirelysubjective on Flickr

Courtesy of entirelysubjective on Flickr

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.

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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

 

What did my doctor just say? Common terms your eye doctor will use and what they mean

Courtesy of riekhavoc (caughtup?) on Flickr

Courtesy of riekhavoc (caughtup?) on Flickr

Have you ever felt like you were not quite sure what just happened at your optometrist’s office? It is difficult enough to answer the “which is better, one or two?” questions and then at the end of the exam to try and understand the doctor’s explanations with difficult optometry terms without secretly worrying that you might have said something wrong!

Hopefully this blog will help you better understand some of the more common terms we use in our examinations.

1) First of all, most comprehensive exams will include a detailed case history. The doctor will want to know your family medical and ocular (eye) history. Some terms you may hear include the most common eye diseases – cataracts, glaucoma and macular degeneration.

  • Cataract is the term used when the natural lens of your eye becomes cloudy, causing blurred and distorted vision.
  • Glaucoma is the eye disease that causes your eye to have excessively high pressure, which can lead to long-term damage of the nerve in the eye.
  • Macular degeneration is a disease that affects your central or straight ahead vision.

Not only will the optometrist ask you about a family history of any of these conditions, they will also assess your eye health and your possible risk for developing any of them.

2) Next, the optometrist will perform a refraction to get you the best possible glasses or contacts that will correct your vision.

  • A refraction is just the process of determining for each individual what are the best lenses to give you maximum visual clarity and comfort at both distance and near.
  • Myopia – nearsightedness or the ability to see better at near than at far.
  • Hyperopia or farsightedness, really means that it is more difficult to focus at near and at far distances.
  • Astigmatism: this refers to the shape of the front surface of the eye being more football shaped rather than basketball shaped.

3) There are a few terms you might hear specifically in an child’s exam.

  • Pursuits: slow, smooth eye tracking.
  • Saccades: fast reading eye tracking.
  • Accommodation: focusing.
  • Binocularity: the ability of the eyes to work together as a team.

4) Finally, there are some terms regarding glasses that it might help to define.

  • Progressive lenses are the kind of “no line bifocal” that you might hear about on TV. But, unlike a bifocal, where there are two areas of vision, near and far, progressives have an unlimited amount of areas as you look from distance to near in the lens.
  • Transition lenses are the kind that change to dark outside. They undergo an anti-reflective treatment, which eliminates all glare and allows for crisper vision, especially at night.

Hopefully, this quick explanation helps with some of the confusing terms in an eye exam. As for any others, always ask your optometrist to explain something that does not make sense.

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

Health care reform & vision coverage for your children

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Children’s vision now covered by most plans
If your child is covered by an individual or group health insurance plan in California, their annual eye exam and eye glasses are covered with no out-of-pocket cost until the child reaches age 19. This is required for health plans purchased through or outside Covered California.

Legal residents of California will be able to get health coverage through a new marketplace established by Covered California. Starting in 2014, there will be several new and expanded government programs, including Medi-Cal, that offer financial assistance to reduce the cost of health insurance.

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  1. Premium assistance — Federal help will be available to reduce the cost of an individual’s or family’s monthly health insurance payments.
  2. Cost-sharing assistance — Cost-sharing subsidies reduce the amount of health care expenses an individual or family has to pay at the time of medical care.
  3. Medi-Cal assistance — Starting in 2014, Medi-Cal will cover more people under age 65, including people with disabilities and those with incomes $15,856 or less a year for a single individual and $32,499 or less for a family of four. Medi-Cal is free for those who meet the requirements and is part of the changes included in the Patient Protection and Affordable Care Act (Affordable Care Act).

An online calculator at the Covered California website helps estimate how much it will cost to purchase health insurance in 2014 and the amount of financial assistance available to qualified individuals. In addition, by completing a Covered California application, an individual will learn whether he or she qualifies for financial assistance.

~Kristine Shultz, Government and External Affairs Director
California Optometric Association

The ABCs of cataracts

CataractCataracts are a fact of life. Anyone who lives long enough will get them and almost everyone knows someone who has had them.  The good news is, with the latest technology available, improving your vision is very safe and will often times leave you with better vision without glasses than you had before the cataract.

Let’s look at the ABCs of cataracts:

A – Age. Remember that cataracts are changes to the lens of our eye as we get older. Different factors can influence when the cataracts start to form. Cataracts tend to develop sooner in folks who spend a lot of time outdoors in the sun without sun protection or sunglasses. They also tend to form earlier if you have diabetes or if you are a smoker. So keeping your eyes out of the sun and staying healthy will help delay the onset.

B – Blurry Vision. The lens of the eye starts changing with cataract formation, making vision blurry. It is like looking out of a blurry window. Usually night driving will be much harder and cataracts can cause difficulty with headlights a night. Cataracts can also cause glasses prescriptions to change as well. It is common to need one or two changes in glasses prescription before the cataract is affecting vision enough to have it removed.

Courtesy of laulau555 on Flickr

Courtesy of laulau555 on Flickr

C – Cure! The good news about this eye disease is that there is a very good treatment option. Cataract surgery involves removing the blurry lens from the eye and inserting a prosthetic lens in its place. This is an outpatient procedure and can take as little as 20 minutes.  The new lens often has a prescription in it that will be very close to your current glasses or contact lens prescription and will allow you to see better without the use of glasses or contacts.  There are even lenses available that can help with near vision as well as far vision. Usually after cataract surgery, vision improvement can be noticed as early as the next day.

Remember, make sure to have routine eye health and vision exams to determine if cataracts are forming or changing.  Your eye care provider can assist you in determining the appropriate time to have them removed.  Until then, stay healthy and wear sunglasses!

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

The three Os – Optometrist, ophthamologist or optician

You’ve probably heard the terms optometrist, ophthamalogist and optician, but do you know what the difference is? You may need to see any one of them in your life time, but we wanted to clarify which you would need and when.

Courtesy of Official U.S. Navy Imagery on Flickr

Courtesy of Official U.S. Navy Imagery on Flickr

Here are the three Os:

Optometrist

Optometrists (OD, Doctors of Optometry) examine and treat eyes for both vision and health problems. Optometrists correct refractive errors by prescribing eyeglasses and contact lenses, some also provide low vision and vision therapy services. Optometrists also diagnose and treat diseases of the eye and are licensed to prescribe medications to treat eye problems and diseases.

Training for an optometrist includes a four-year undergraduate degree and four years of post-graduate professional training in optometry school. An optional one year residency in a specialty (pediatrics, low vision, contact lenses) is sometimes completed.

When you see them: You should visit an optometrist for your annual eye exam  to receive an updated pair of glasses or contact lenses, and if you have any other eye issues, such as dry eyes, allergies, pain etc.

Ophthalmologist 

An ophthalmologist is a medical doctor (MD) or an osteopathic doctor (DO) who specializes in eye and vision care. In addition to the services provided by optometrists, ophthalmologists are trained to perform eye surgery.

Ophthalmologists generally complete four years of college, four years of medical school, one year of internship, and a minimum of three years of hospital-based residency in ophthalmology.

When you see them:  Your optometrist will be able to manage and treat the majority of your eyecare needs.  However, your optometrist may refer you to an ophthalmologist if you require surgical intervention such as cataract surgery or retinal repair, or if you require disease-related specialty care.

Optician

An optician is a specialized practitioner (but not a doctor) who uses prescriptions written by an optometrist or an ophthalmologist to select eyeglasses, contact lenses and other eyewear. Opticians are licensed in the State of California.

When you see them: Once you’ve had your annual eye exam and your prescription updated, you may choose to take your prescription to an optician to have new glasses made.