Common eye emergencies and how to react

Courtesy of Brandon Koger on Flickr

Courtesy of Brandon Koger on Flickr

Many people don’t give their eyes much thought until an eye emergency happens. Chances are, it happens on a holiday weekend at midnight when all doctors’ offices are already closed. What should you do and can it wait until Monday morning?

Below are the most common emergent symptoms that you need to pay attention to.

Eye Pain: If you have extreme pain that burns, stings and causes your eyes to water, it’s usually from a foreign object or a corneal abrasion. If rinsing the eyes out with artificial tears or contact lens solutions doesn’t help and the pain is just as intense after 20 minutes, you need to be seen by an eye doctor. Try to keep your eye closed until then.

Boring eye pain with headache, nausea, blurry vision: If you are experiencing a boring pain in one eye with a severe headache, haloes around lights, foggy or steamy vision, and/or nausea, you need to be seen immediately. You may be experiencing a spike in the intraocular pressure of your eye caused by a disease called narrow angle glaucoma.

Change in vision: If you notice a drastic change in your vision such as a shower of floaters or flashes of lights followed by a curtain or veil over one area of your vision, you may be experiencing a retinal tear or detachment and need to be seen. If your vision change is a gradual dimming of vision that doesn’t improve, you may be experiencing a central retinal artery occlusion where a large clot blocks the flow of blood to the eye resulting in gradual vision loss. This may be reversible within a narrow window of a few hours, so it is important to find adequate treatment immediately.

Chemical injury to the eye: If you are splashed in the eyes with a chemical, immediately rinse them out with saline solution (contact lens solutions are okay), artificial tears, or tap or bottled water. If possible, rinse them for 15 minutes with a steady stream of water. Do not use high speeds of water to avoid further injury. If your vision is reduced or you still experience extreme pain after 15 minutes of rinsing, you should be seen by an eyecare physician. Depending on the chemical you are exposed to, the eye may be at risk for further damage.

Physical injury to the eye: If you have been hit in the eye or head, always check your vision and compare the vision in each eye. If one eye is uncharacteristically more blurry than the other, you should be checked to make sure the structures in the eye are intact. If you experience unbearable pain that does not improve within five minutes, you should see your eye doctor immediately.

If you are a contact lens wearer and are experiencing pain with and without contact lenses plus a reduction in vision, you also need to check in with your eye doctor. This is especially important if you have been exposed to water such as oceans, lakes, and water parks which can cause a severe eye infection resulting in vision loss.

The more important question is, “Do you have someone you can call in emergencies?” Emergency rooms see a good deal of patients for ocular emergencies. However, some of the above scenarios require a retinal or corneal specialist, which may be more difficult to find in a timely manner. In emergencies, call your optometrist first. They may have an on-call line or emergency services available. If they are not available to see you or believe you need the services of a specialist, they may be able to find one more quickly for you than the emergency room can.

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

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School is out! How to keep your child’s eyes healthy during summer

Photo courtesy of Andrew Eick on Flickr

Photo courtesy of Andrew Eick on Flickr

A few weeks ago we published a blog about how important it is for our children to spend time outdoors to prevent myopia. ‎

Being outdoors is great for helping to prevent nearsightedness and for exercising our eye focusing muscles, but you may wonder what else you need to do to make sure your child’s eyes stay healthy through the summer.

A few things come to mind.  It has become very common practice to never let our children leave the house with out sun protection: Sunblock, hats, UV blocking clothes and bathing suits. But, what is less common is remembering sunglasses for UV protection for the eyes.  Kids playing outdoors in the sun are exposing the lenses of their eyes and their retinas to harmful UV radiation.  Additionally, their lenses are so young that they do not block UV as well as adult lenses thus sending more UV to the retina.  UV damage to the lens and retina can by a cause of early cataracts and Macular Degeneration.  When buying sunglasses for kids, make sure that they are UV blocking and polarized if possible to reduce glare when around water. More information about children and sunglasses can also be found here.

Next, swim goggles are a good idea for the pool to help keep chlorine out of the eyes.  Chlorine can cause redness, burning, and blurry vision as well.  An added bonus would be swim goggles with a little tint or UV protection as well. If your child experiences these symptoms after playing in the pool, ask your eye doctor what eye drops are right to use to help.

Lastly, the use of sports goggles for eye protection during sports activities is also a must for eye injury prevention while playing soccer, baseball and any other outdoor sports.  For more information about preventing eye injury this summer, here is another great resource.

Enjoy your summer, enjoy the outdoors and the sunshine and stay eye healthy and safe!

~Lisa Weiss, OD, FAAO
California Optometric Association
http://eyehelp.org

http://www.coavision.org

 

 

 

 

Eye Injury- It’s more common than you think

Courtesy of Geoffrey Fairchild on Flickr

Courtesy of Geoffrey Fairchild on Flickr

Injuries can happen to anyone at any time. You can scratch your cornea with your fingernail or have a fractured eye socket from being hit by a baseball. Some are more drastic, but they are all more common than you think.

The most common eye injuries include:

1.  Scratches to the cornea (Corneal Abrasion). This can result from something like a fingernail in the eye or even from a foreign object such as dirt or sand.  Abrasions can also happen if something falls into the eye during home improvement projects or working out in the garage. Symptoms of a corneal abrasion include tearing, pain, the sensation that something is in the eye and often extreme light sensitivity. If you suspect you have scratched your cornea, call your optometrist immediately.  Scratched corneas are more prone to infection and depending on where the scratch is located, can cause scarring and loss of vision if not treated urgently.

2. Chemical Burns from household items. Many household cleaners can burn the eyes if the product splashes in the eye. These burns can range from mild to severe depending on the product used. Alkali burns from cleaners can be less painful but more damaging than acid burns. Symptoms  of both burns include redness, pain and swelling. If something splashes in your eye, rinse it under copious amounts of water for 15 minutes and call your eye doctor or visit urgent care. You will want to let the doctor know what the substance was that got in the eye. This will help your eye doctor with the appropriate treatment.

3.  Penetrating eye injury. Metallic objects and things such as fishhooks can certainly cause severe damage to the eye structures.  This is a potentially very dangerous situation. A metallic object can lodge itself in the cornea and cause a great amount of scarring if not removed.  Do not attempt to remove the item yourself. Call your eye doctor and go to urgent care.

4.  Orbital Fractures. This can happen if a moving object hits the eye at a high speed. For example, a baseball, a bat, a fist, or similar trauma.  This type of injury can be very serious and involve the eye as well as the surrounding bones and tissues.  This is an emergency and should be treated urgently.

Eye injuries can happen anytime and anywhere.  We can use some common sense precautions to help limit damage to the eye and surrounding structures.  As much as possible, use safety glasses or goggles when working with chemicals or any items that may cause a scratch or penetration to the eye. Sports safety goggles are a good choice for both children and adults to help prevent injuries while participating in sports.

A little protection will go along way in preventing eye injuries.

Stay safe!

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

Traumatic Brain injury: A rising concern in youth sports

Photo courtesy of K8tilyn on Flickr

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

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.

Vision therapy to improve academic & athletic performance

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Vision therapy (VT) is a high effective type of physical and perceptual therapy that works on improving eye muscle control and coordination, eye-hand and eye-body coordination, as well as visual processing/understanding and visual cognitive skills.

Seeing takes place in the brain instead of the eyes. The eyes are the instruments which transmit visual images to the brain. The brain then processes and integrates visual information with other systems such as the vestibular system to affect balance and spatial localization, as well as affecting understanding of what is seen or read. VT uses neuroplasticity to improve visual functioning and the activities that require vision.

When most people think of good vision, they think of seeing clearly– that is, having 20/20 vision. While seeing clearly is important, it is only one aspect of vision.

Having good vision involves much more than seeing 20/20. Being a good reader, a good driver, or a good athlete requires mastering a complex set of vision skills, such as eye tracking, eye teaming, visual perception and visual memory. Unfortunately, many children and adults have problems with these types of visual skills. Although they may see 20/20, they do not have good vision. They may have trouble reading or working on a computer. They may have difficulty driving or excelling in sports.

It is estimated that as many as 20 percent of people may suffer from these types of problems. Please click here to see if you may have a treatable vision problem that is interfering with your work, reading or sports performance.

Vision therapy can treat many problems including:

  • Strabismus
  • Amblyopia
  • Visually-related learning problems
  • Visual Impairment after Brain Injury (such as stroke, craniotomy)
  • Double vision
  • Sports Vision – to enhance athletic performance through faster and more accurate visual motor skills
  • Computer Vision Syndrome (headaches, eyestrain, decreased productivity)

Here are the most frequently asked questions about VT:

1. How do I know that I may need VT?

A: There are many symptoms that indicate a need for VT. Some of the more common symptoms are: eyestrain associated with reading or computer use, not performing to potential at school or work, poor eye-hand coordination with sports or handwriting, double vision, print that appears to “move” on the page, and losing your place while reading.

Special tests will determine if your specific vision problems can be treated with VT.

If you have two or more of the following symptoms, you can benefit from VT. It takes energy to compensate for a vision problem, which results in discomfort and loss of productivity. Improving your visual skills can improve your academic, athletic and executive performance.

  • My eyes feel tired or uncomfortable while reading
  • Headaches while reading or studying
  • Reading or computer use makes me sleepy
  • I, or my child, is not performing to my potential in school or work
  • I have difficulty remembering what I have read
  • Frequent loss of concentration while reading
  • Words move, jump, or appear to “swim”
  • Double vision
  • I am a slow reader
  • “Pulling” sensation around eyes while reading
  • Words blur, or go in and out of focus
  • I often lose my place, or jump over letters & words
  • I often re-read the same line over and over
  • I do not like to read for pleasure
  • I have a short attention span while reading compared to other activities
  • I have poor eye-hand coordination while playing sports
  • I have poor depth perception
  • I learn better visually than verbally
  •  I get dizzy reading in the car
  • I have difficulty judging distances such as parallel parking or stopping a car
  • I have difficulty making visual judgments such as the depth of stairs, pouring coffee into a cup

2. What is involved with vision therapy?

A: A vision therapy program incorporates many different exercises that train deficient visual skills. Learning visual skills is like learning to play the piano, or a new sport. VT exercises are performed in our office under the supervision of a vision therapist. We also prescribe home therapy to reinforce and accelerate the development of newly learned skills.

The length of the VT program depends on the nature and severity of your vision problem.

3. What results can I expect?

A: You can expect your vision to improve significantly or completely if you stick to the program as prescribed by the doctor. The amount of your improvement depends on the type of vision problem(s) you have, how well you follow doctor’s orders and how regularly you practice your vision exercises.

4. Will my insurance cover vision therapy?

A: Few insurance plans cover VT, but it depends on your particular insurance coverage. The California Optometric Association has several doctors who specialize in vision therapy who would be happy to help you determine if you have any allowance for vision therapy.

5. What kind of vision problems can be treated with vision therapy?

VT can treat a variety of vision problems including:

  • Strabismus (eye turn)
  • Amblyopia (lazy eye)
  • Oculomotor dysfunction
  • Focusing problems
  • Double vision
  • Convergence insufficiency or excess

Visually-related learning problems

Visual motor or visual perceptual problems can interfere with the input and processing of visual information. This decreases a student’s performance on reading and writing tasks, which are highly dependent on visual skills (see symptom checklist below).

Visual motor problems can occur in these skills: tracking, eye teaming, or focusing.

Visual perceptual delays can occur in: visual-motor integration, visual memory or sequential memory, visual discrimination, visual figure ground, visual form constancy, or speed of visual processing.

Sports performance enhancement therapy

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Photo courtesy of DeusXFlorida on Flickr.com

VT can be used to improve athletic performance through increasing visual accuracy, speed of visual reaction time, depth perception, tracking speed (to follow a target quickly), increasing the span of recognition, and improving eye-hand and eye-body coordination.

Enhancing Executive Performance

VT can be used to improve work productivity by increasing visual stamina, decreasing symptoms such as eyestrain or headaches associated with desk or computer work, improving speed of scanning and reading.

Visual Rehabilitation after Brain Injury

80 percent of the brain is related to visual function; therefore, after an injury to the brain (such as stroke, craniotomy, aneurysm or trauma) visual skills and activities dependent on visual skills (such as walking and driving) are often impaired. VT can be used to train the non-damaged part of the brain to do what the damaged part used to do.

Symptoms of brain injury-related visual impairment include double vision, poor judgment of distance while driving or reaching for objects, hemianopsia or loss of side vision, frequent loss of place while reading, skipping words, sensitivity to light, vertigo, fluctuating vision, bumping into objects, decreased depth perception, leaning to one side, and eyestrain.

Please refer to the section on Brain Injuries for more information.

6. Can Adults benefit from VT?

A: Vision therapy benefits adults. In fact, Dr. Brisco went through VT as an adult, and it has tremendously contributed to her improved reading speed and comprehension, as well as her tennis game!

Vision problems that were not corrected during childhood often persist through adulthood, thus interfering with efficiency and productivity on visual tasks. The majority of vision problems are treatable at any age, but it is better to catch problems early to maximize your potential during your academic and executive career.

~By Elise Brisco, OD, FCOVD, FAAO