Thyroid Associated Orbitopathy
Thyroid Associated Orbitopathy is characterized by enlargement of the extraocular muscles as well as an increase in the orbital fat volume.
What is a cataract?
A cataract forms when the clear lens inside your eye becomes cloudy. It can affect vision and generally develops as people get older. Cataracts can develop slowly over many years or rapidly progress over a few months. In Canada, when a cataract is “ripe”, it can be easily treated with cataract surgery. Cataracts may affect vision in the following ways: Blurry or foggy vision (for example it feels like there is a film covering the eye that does not go away with repeated blinking), Double vision, Halos or ghost images, Dull or faded colour vision, Increased sensitivity to light and glare (for example to sunlight or oncoming headlights), Trouble with night driving, Trouble seeing and reading at night (You need for extra lighting).
What causes cataracts?
There are many causes to cataracts, of which the most common is age. Cataracts are a part of the normal aging process and are most often found in those over the age of 60. When the proteins in the lens of the eye are disrupted and break down, it causes the lens to become cloudy leading to a cataract. Other causes of cataracts include UV damage, trauma, systemic conditions, certain medications, and congenital conditions. Prolonged UV light damage from not wearing sunglasses while being outdoors is a common cause of cataracts. Trauma to the eye including injuries, surgeries or radiation treatments can cause cataracts. Systemic conditions such as diabetes can cause cataracts as a buildup of sorbitol results in cloudiness of the lens. Individuals with diabetes should keep tight blood sugar control. Other systemic conditions that can cause cataracts include hypertension, obesity, chronic kidney disease, and autoimmune disease. Certain medications can cause cataracts to develop early, such as corticosteroids, chlorpromazine, amiodarone, phenytoin. In some cases, people are born with cataracts. These are called congenital cataracts. They may be inherited or result from an underlying health condition.
How do you prevent cataracts and how are they detected?
Wearing UV protective glasses has been shown to be helpful in slowing down the development of cataracts. In individuals with diabetes, it is important to maintain tight blood sugar control. Some research evidence suggests taking antioxidants may be helpful in preventing cataract progression. Examples of antioxidant-rich food are berries, beans, pecans, prunes, and dark green vegetables. Quitting smoking may also prevent cataract development as smoking has been linked to cataracts. Cataracts are diagnosed with an eye exam. Contact us to schedule your routine eye exam.
How do you treat cataracts?
In the early stages of a cataract, symptoms are generally mild and vision is minimally affected. Your optometrist may prescribe updated glasses or contacts to give you the sharpest vision possible. As the cataract progresses, it may start to interfere with your daily activities and glasses may no longer work to improve your vision. At this time, your optometrist will refer you to an ophthalmologist who may recommend surgical removal of the cataracts. In Canada, cataract surgery is one of the most common surgical procedures performed. It is an effective low-risk procedure. The process involves removing the cloudy lens from the eye and replacing it with a new clear lens implant. Generally, the lens implant will provide you with clear distance vision. Your near vision may still be blurry and will likely require reading glasses.
What is age-related macular degeneration (AMD)?
Age-related macular degeneration is an eye disease that affects central vision. As the name suggests, age is a major risk factor for this disease and it is the leading cause of blindness in North American adults over the age of 50. Other risk factors include smoking, extensive UV light exposure, family history of AMD, and cardiovascular disease.The central vision is affected as a result of waste build up at the center part of the back of the eye called the macula. The macula is responsible for detailed vision necessary for activities such as reading, driving, and recognizing people’s faces. AMD can progress slowly in some individuals and rapidly in others. Therefore, it is important to get routine eye exams to detect it early on. There are two types of AMD, dry and wet. Dry AMD is the most common form of AMD accounting for 90% of all cases. It is the milder form resulting in degeneration of the central macular tissue that generally develops slowly over time. Dry AMD can develop into wet AMD at any time. Wet AMD is less common and accounts for 10% of all cases. It is characterized by leakage and bleeding of weak blood vessels under the macula and symptoms progress rapidly.
What are the symptoms of AMD?
AMD is a progressive disease, often accompanied by worsening symptoms over time. In the early stages, AMD may be symptom-free and can only be detected in an eye exam. As the disease progresses, the most common initial symptoms include blurred central vision, particularly noticeable while performing tasks that require seeing detail, such as reading. Glasses cannot correct for this blurred spot. In the intermediate stages, the blurred area may increase in size and interfere with various daily activities such as driving. Other symptoms of AMD include straight lines appearing wavy or distorted, and dark spots or missing areas in vision. In its later stages, there is a complete loss of central detailed vision. Patients experience no pain with AMD.
How can I prevent AMD?
~Lifelong UV protection by wearing UV protective glasses and smoking cessation can reduce the risk of developing AMD. ~Living a healthy lifestyle with healthy diet and routine exercise will reduce the risk of AMD. ~Keep your blood pressure in control and reduce your intake of fatty foods. A diet rich in antioxidants such as vitamins C, vitamin E, zinc, copper, lutein, zeaxanthin, and omega 3 fatty acids may help prevent AMD. These antioxidants can be found in fruits and leafy green vegetables. ~Routine eye exams are important in the early detection and prevention of AMD. Early signs of AMD can be found during an eye exam even if no symptoms are noticed. Upon detection, your Optometrist will discuss ways to minimize the possibility of vision loss.
How can I treat AMD?
In the early stages of AMD, treatment options include dietary supplements, self-monitoring of vision at home with an Amsler grid, and routine eye exams to monitor for progression. An Amsler grid is a test provided by you Optometrist that allows you to monitor for vision changes at home between routine eye exams. AMD is an eye disease that can cause sudden changes in vision when it turns into the wet form. If changes in vision are noticed, contact your Optometrist, as timely treatment can limit the extent of vision loss. In the later stages of AMD, treatment options include eye injections to prevent further leakage of blood vessels in order to minimize vision loss. Patients with vision loss due AMD can benefit from low vision aids. Your Optometrist can prescribe magnifying devices to enhance your distance and near vision. These aids will not restore sight, but will allow people to maximize their remaining vision and provide improved functional vision to help people go about their daily activities.
How does diabetes affect the eye?
Diabetes is a chronic disease that prevents the body from making or using insulin, which leads to high sugar levels in the bloodstream. Diabetes can affect the eye in many ways. People with diabetes may experience the following ocular signs and symptoms: ~Blurry, fluctuating, double, and/or loss of vision ~Changes in glasses prescription (nearsightedness, farsightedness) ~Premature presbyopia (inability to focus on close objects) ~Early cataracts ~Glaucoma ~Paralysis of nerves in the eye (decreased corneal sensitivity) ~Retinal detachments (may be accompanied by flashes and floaters) ~Diabetic retinopathy (bleeding and swelling at the back of the eye)
What is diabetic retinopathy?
The high blood sugar levels in diabetes can affect the blood vessels on the retina, which is the light-sensitive tissue at the back of the eye that allows us to see. This can result in diabetic retinopathy which causes bleeding, swelling, abnormal blood vessel growth, and other changes on the retina. Risk factors for developing diabetic retinopathy include high blood sugar, high blood pressure, high cholesterol, longer duration of having diabetes, and pregnancy. If diabetic retinopathy is left untreated, permanent vision loss may result.
How is diabetic retinopathy treated?
Keeping blood sugar levels under control remains the cornerstone in preventing and treating diabetic retinopathy. In the early stages, diabetic retinopathy is monitored through routine eye exams. If necessary, it may be treated by eye injections with anti-VEGF (Avastin, Lucentis, Elyea) to prevent new abnormal blood vessel growth on the retina. Laser surgery may be used to help seal off leaking blood vessels. These treatments reduce swelling at the back of the eye which help to slow vision loss. Early detection and intervention of diabetic retinopathy is crucial, as treatment is much more likely to be successful at its initial stage.
Can vision loss from diabetes be prevented?
Yes. Early signs of diabetes can be detected in a routine eye exam and timely management can prevent sight-threatening complications. However, uncontrolled blood sugar can lead to irreversible vision loss. It is important to monitor and control diabetes as much as possible to minimize the risk of developing diabetic retinopathy. See your physician regularly and follow instructions regarding diet, exercise and medication. Visit your optometrist for routine eye exams on a yearly basis and more frequently if recommended. Take the Canadian Diabetes Association CANRISK test.
What is presbyopia?
Presbyopia is an eye condition that makes it hard to focus on objects up close. It is a natural consequence of aging that happens when the lens of your eye loses its elasticity and flexibility. Presbyopia usually becomes noticeable to people between the ages of 40 and 45 and progresses until the late 40s to early 50s.
What are the signs and symptoms of presbyopia?
Some signs and symptoms of presbyopia include: the need to hold reading materials at arm’s length, blurred vision at normal reading distance, and difficulty reading in dim light.
How is presbyopia diagnosed and treated?
Presbyopia can make other vision conditions like nearsightedness, farsightedness, and astigmatism more challenging. Your optometrist will check for presbyopia during a comprehensive eye exam. Treatment options for presbyopia include: reading glasses, progressive, bifocal, or trifocal lenses, contact lenses, laser surgery, and medication.
Will I have to wear glasses all the time? Can I wear contact lenses?
This will depend on several factors, including any other vision conditions you may have. You may only need your glasses for up-close work like reading and using a computer. However, wearing glasses all the time could be more beneficial if you multitask at different distances. In this case, multifocal or progressive lenses may work best for you. Your optometrist will find the right type of lens to help you see clearly. If you like using contact lenses, you will likely be able to wear contact lenses part-time or full-time, depending on your prescription and your daily visual needs. In your 40s, presbyopia gradually makes it more difficult for your eyes to focus properly. This typically happens over a 10-year period. To ensure clear vision between the ages of 40 and 55, it's usually necessary to update your eyewear every two to three years.
What is astigmatism?
Astigmatism is not a disease but a common vision condition that causes blurred vision. Most people have some degree of astigmatism. Small amounts of astigmatism do affect vision but may not require treatment. Larger amounts can cause distorted vision, eye discomfort and headaches. This refractive error occurs when the front surface of the eye (cornea) or the lens inside the eye is slightly irregular or cylindrical in shape. An irregularly shaped cornea or lens prevents light from focusing properly on the retina, resulting in vision being blurred or distorted at all distances. Astigmatism often occurs with other vision conditions like nearsightedness (myopia) and farsightedness (hyperopia). Collectively, these vision conditions are referred to as refractive errors because they affect how the eyes bend or "refract" light.
What causes astigmatism?
Astigmatism occurs when the front surface of the eye (the cornea) or the lens inside the eye is more oval or cylindrical than round. The cornea and lens are mostly responsible for properly focusing light entering your eyes. This allows you to see things clearly. Astigmatism is caused by small differences in the growth and alignment of the components of the eye. Genetics may play a role in the development of refractive error. Astigmatism may also result from such factors as pressure of the eyelids on the cornea. Sometimes astigmatism develops following an eye injury or eye surgery. In rare cases there is also a condition called keratoconus that may occur. Keratoconus is a condition in which the cornea becomes progressively thinner and cone shaped. This causes a large amount of astigmatism resulting in poor vision that cannot be effectively corrected with glasses. In these cases, the clearest vision is achieved with contact lens wear. Corneal transplants or other corneal treatments may be considered, depending on the case Astigmatism often occurs early in life, so it is important to schedule children for a comprehensive eye exam with an optometrist to avoid vision problems in school from uncorrected astigmatism.
How is astigmatism diagnosed?
Astigmatism is detected using the same instruments and tools used to detect farsightedness and nearsightedness. The optometrist can determine the amount of astigmatism present by measuring how the eyes focus light. They can then determine the power of any optical lenses needed.
How is astigmatism corrected?
Almost all levels of astigmatism can be optically corrected. There are several corrective options available including: properly prescribed and fitted eyeglasses, contact lenses, laser and other refractive surgery, or orthokeratology (Corneal Refractive Therapy). Laser surgery works by changing the shape of the cornea and therefore the way light is focused as it enters the eye. Orthokeratology does the same thing but without surgery. Orthokeratology is the fitting of specially designed gas permeable (highly oxygen permeable) contact lenses to be worn overnight. The lenses gently and temporarily reshape the front surface of the eye (cornea), resulting in clear vision the following day. These lenses are not worn during the day. This therapy works best for people with low levels of astigmatism.
Eye-cyclopedia
Eyes are important indicators of overall health, and comprehensive eye care goes beyond a prescription for glasses or contact lenses. It’s important to have regular eye exams whether or not you wear glasses or contacts, and even if your vision is sharp. The articles below explain what problems can be spotted with an eye exam and what’s involved in a comprehensive exam. Information courtesy of the CAO's Eye Library.
What is a crossed eye or strabismus?
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What causes strabismus?
Coordination of your eyes and their ability to work together as a team develops in your first six to eight years. Failure of your eyes, or more precisely, your eye muscles, to work together properly can lead to strabismus. It has a tendency to be hereditary, but may also be acquired secondary to an eye injury or disease. Children under age six are most affected by strabismus, but it usually first appears between birth and age 21 months. It is estimated that five per cent of all children have some type or degree of strabismus. Although rare, strabismus can sometimes begin in adulthood; this is usually the result of a stroke, tumor or other vascular disease.
What are the effects and how is strabismus diagnosed?
Children with strabismus may initially have double vision. This occurs because both eyes are not focusing on the same object. In an attempt to avoid double vision, the brain will eventually disregard the image from one eye. This is referred to as suppression. In time, the ignored eye will become unable to function normally and will become largely unused. This may result in the development of lazy eye (amblyopia). Parents may be the first to notice a slight wandering of one or both of a child’s eyes. A comprehensive eye examination by a doctor of optometry is recommended at six months of age and then yearly after age three. The examination can determine if strabismus is present.
How is strabismus treated?
Treatment for strabismus can include eyeglasses (single vision or bifocal), prisms, vision therapy, and in some cases, surgery. Strabismus can be corrected with excellent results if detected and treated early.
What is Glaucoma?
Glaucoma is a group of diseases that affect the optic nerve in the eye which can result in irreversible vision loss. It is one of the leading causes of blindness, affecting more than 450,000 Canadians. There are several types of glaucoma that present different symptoms. By far, the most common type of glaucoma is called primary open-angle glaucoma. It is known as the silent theft of sight because there are no symptoms in its early stages.
Who is at risk of developing Glaucoma and what are the symptoms?
Individuals with the following are at an increased risk for developing glaucoma: Elevated eye pressure, increased age, family history of glaucoma, physical injury or surgery to the eye, cardiovascular conditions (such as high blood pressure, low blood pressure, heart conditions, etc.), certain eye-related conditions (such as decreased optic nerve tissue, retinal detachment, eye tumors, eye inflammation, etc.). People with early stage glaucoma are often not aware of it themselves until it progresses to the later stages. However, early stage glaucoma can be detected during a routine eye exam. Early detection and treatment is crucial in preventing progression towards vision loss. As the condition progresses, it leads to a loss of side vision or peripheral vision and eventually tunnel vision which may interfere with daily activities such as driving. If left untreated, permanent vision loss may occur. Depending on the type of glaucoma, other symptoms include: blurry vision, eye redness, eye pain, light sensitivity, halos around lights, tearing, nausea, vomiting, headache, rapid progression to vision loss.
How is Glaucoma detected?
Without telling symptoms, a routine eye exam is often the only way to detect glaucoma. During an eye exam, the pressure inside the eyes is measured. Using special equipment, the optometrist looks directly inside the eye to inspect for any damage to the optic nerve and retinal layers. Other imaging and testing may be conducted to measure any functional vision loss and structural changes in the eye.
How is Glaucoma treated?
Medication - A number of medications are available to treat glaucoma. Generally, it is in the form of eye drops intended to reduce the elevated eye pressure. A single medication may be prescribed or a combination of medications. The type of medication may change if it is not providing enough pressure reduction or due to its adverse effects. Surgery - A number of procedures are available to reduce eye pressure. Surgery may help lower eye pressure when treatment with medication is not enough. Some surgical options include laser trabeculoplasty, trabeculectomy, drainage implants and laser peripheral iridotomy.
What is amblyopia?
Amblyopia, commonly referred to as lazy eye, is reduced vision in one eye that is not immediately correctable as a result of abnormal visual development during childhood. In some cases, amblyopia can also affect both eyes. Regardless of whether it affects one or both eyes, amblyopia is preventable with early detection and timely treatment during childhood. Untreated amblyopia can lead to permanently reduced vision and blindness in the affected eye. It is estimated 2.4% of the North American population have amblyopia.
What causes amblyopia?
Amblyopia may result from several causes. Most frequently, it results from not correcting a glasses prescription or being crossed eyed (strabismus). For example, amblyopia may occur in the case of a child with a large difference in the prescription between the two eyes. Not correcting for this difference in prescription with glasses will cause the eye with less prescription to detect all the visual information to be sent to the brain, while the eye with more prescription will see blurry and the brain will ignore the information coming from the affected eye. Over time, the connect between the affected eye and the brain weakens resulting in amblyopia in that eye. This lack of connection from the eye to the brain is why glasses alone cannot correct the problem immediately. Similarly, in the case of a child with crossed eye, the eye that is looking straight will relay all the visual information to the brain while the eye that is crossed will be ignored and develop amblyopia. Other less common causes of amblyopia include congenital cataracts, corneal injures, corneal dystrophies, and other forms of visual deprivation, which all result from one or both eyes not receiving enough visual information leading to a poor connection to the brain.
What are the signs and symptoms and how is amblyopia diagnosed?
Amblyopia commonly affects one eye and has no visible signs or symptoms. When one eye is affected, the other unaffected eye usually has reasonably good vision and compensates by taking over all visual tasks. Unless the unaffected eye is intentionally covered, the individual will rarely notice the poor vision in the affected amblyopic eye. Therefore, children with amblyopia may not realize they cannot see properly. Routine eye exams are crucial in the detection of amblyopia in children. Other times, amblyopia may accompany obvious signs such as a turned eye, closing or squinting of one eye, persistent head tilt/turn, or poor depth perception. Routine eye exams are the best way to screen for amblyopia. Early detection and timely treatment will provide the greatest chance for a complete recovery. For children the following timeline is recommended for eye exams: ~First eye exam when the infants is 6-9 months old ~Second eye exam when the child is 2-5 years old ~Yearly eye exams when the child is school aged from 6-19 years old
How is amblyopia treated?
When amblyopia is diagnosed, the optometrist will recommend the best course of treatment depending on the specific case. The first line of treatment is to resolve the root cause of the amblyopia. In the case of uncorrected refractive error causing amblyopia, glasses are given as the treatment to allow the amblyopic eye to gain the most optimal vision. In addition, occlusion therapy may to implemented to strengthen the amblyopic eye. Occlusion therapy is achieved by patching the good eye to forcing the brain to use the amblyopic eye. In the case of strabismus (crossed-eye) causing amblyopia, glasses may be given to help align the eyes. In some cases, vision therapy and surgery may be required to align the eyes. In the case of congenital cataracts causing amblyopia, the cataract is remove with surgery to allow the affected eye to receive proper visual stimulus. Other treatment options include the use of atropine eye drops, fogging, anti-suppression training, perceptual learning, and other vision therapy treatments. When detected and treated before the age of 8, amblyopia will often resolve completely as it is a preventable condition. With increasing age, amblyopia becomes increasingly difficulty to treat. However, there is increasing research evidence suggesting promising prospect in the treatment of adult amblyopia.
What is double vision?
If you see two of whatever you are looking at, you may have a condition known as double vision, also referred to as diplopia. Double and blurred vision is often thought to be the same, but they do differ.
What causes double vision?
There are two possible causes of double vision. The first is a failure of both eyes to coordinate together, a condition referred to as “strabismus.” In normal single vision, both eyes can focus on the same object. The images seen by the two eyes are fused into a single picture by the brain. If the eyes do not point at the same object, the images seen by each eye are different and cannot be fused. The result is double vision. An uncorrected refractive error is the second possible cause of double vision. An object being viewed is split into two images by a defect in the eye’s optical system. Cataracts may cause such a defect, as can uncorrected astigmatism and keratoconus.
What are its implications?
Double vision can be extremely confusing. The brain acts to alleviate the visual discomfort by suppressing, or blanking out, one of the images. In young children, if this suppression persists over a continued length of time, it can lead to an impairment of the development of the visual system. The suppressed eye may get to the point where it is unable to see well, no matter how good the spectacle or contact lens correction. This condition is called amblyopia. Since it is a result of a defect in the interpretive mechanisms of the eye and brain, it is more difficult to treat than a refractive condition (one having to do with the eye’s ability to bend light).
How is it treated?
Treatment of double vision depends on the underlying cause. If the double vision is due to strabismus, it may consist of eye exercises, surgical straightening of the eye or a combination of the two. Therapy is aimed at re-aligning the strabismic eye, where possible, without surgery and re-stimulating the part of the visual pathway to the brain that is not working correctly. If the double vision is due to the presence of cataracts, referral for possible cataract surgery will be undertaken. If it is secondary to astigmatism, corrective lenses will be prescribed to alleviate the double vision.
What is a retinal detachment?
The retina is a thin layer of tissue at the back of the eye. It is made up of tiny cells called photoreceptors, or rods and cones. These cells transmit light signals from the eye to the brain where it is interpreted as vision. During a retinal detachment, the retina partially or completely peels away from the back of the eye. Once it is detached, the retina stops working and light signals cannot get back to the brain to be processed. Retinal detachment can lead to vision loss and even blindness.
What are the causes and how can I prevent retinal detachment?
Retinal detachment happens to around one in every 10,000 individuals every year or 0.01% of the population. It can happen to anyone but it is more common among men and older individuals. There are many potential causes of retinal detachement including: injury to the eye, a blow to the head, eye diseases, eye surgery, conditions such as diabetes, and excessive nearsightedness or myopia. A retinal detachment can happen years after and eye injury or a blow to the head. For reasons not fully understood, some individuals may have areas where their retina is thinned. Theses areas might increase the chance of the retina detaching without any other obvious cause. Preventing retinal detachment can be difficult. Often, they occur spontaneously with no warning signs. However, there are some things that you can do to help prevent a retinal detachment: ~Always wear eye protection when performing high-risk activities such as sports and using power or yard tools. ~See your optometrist or ophthalmologist right away if you have any symptoms of retinal detachment. Retinal detachment is considered a medical emergency. ~Get routine eye examinations with your optometrist. Detecting and treating small retinal holes, tears, and detachments as soon as possible can stop them from getting worse.
What are the symptoms of retinal detachment?
Symptoms of retinal detachment include: seeing flashing lights or floating spots in the field of vision, an overall decrease in vision, or a decrease in vision as a "curtain" or veil coming down into the field of vision. Some patients experience no symptoms at all.
How is a retinal detachment treated?
If your optometrist finds a retinal detachment during the eye examination, they will refer you to an ophthalmologist for surgery. The surgery aims to reattach the retina and prevent further vision loss. If there are weak areas in the retina but no detachment, an ophthalmologist may choose to stabilize the retina to prevent a retinal detachment from happening. They can do this by using a freezing or laser treatment. The longer you wait to fix a retinal detachment, the less likely the surgery is to be successful.
What is an ocular migraine?
An ocular migraine is an episode of vision loss in one eye, usually lasting less than one hour and is associated with a headache. Ocular migraines are typically caused by reduced blood flow or spasms of blood vessels in the retina or behind the eye. An ocular migraine can mimic other serious conditions, so it is very important to see an optometrist as soon as possible if experiencing these symptoms.
What are the symptoms of an ocular migraine?
Ocular migraines can start with a visual disturbance and may be followed by a throbbing headache. These disturbances may include seeing zigzags, flickering lights, or enlarging blind spots. If you are driving and experience these symptoms, pull over as a safety precaution until the visual disturbances go away.
How can I prevent ocular migraines?
For people who have frequent migraines, it is recommended to keep a logbook to keep track of things that could trigger a migraine. Common triggers can be food and beverages like cheese, alcohol, smoked meats, chocolate, and caffeinated drinks. Other common triggers include skipping meals, sleep changes, weather changes, hormonal changes, lights, odours, medications, and emotional stress.
How can I treat ocular migraines?
Treatment will vary based on your optometrist's and your physician's reccomendations.
What are floaters and spots?
Floaters (often called floating spots) are small, semi-transparent cobwebs, specks or squiggles that appear in your field of vision. They are actually small particles within the gel inside the eye that become noticeable when they fall within the line of sight. They move when you move your eyes, but tend to drift or lag behind your eye movements. They may also appear along with flashes of light. Almost everyone sees a few floaters at one time or another. They can occur more frequently and become more noticeable as you grow older. If you notice a sudden change in the number or size of floaters, you should contact your Optometrist right away, so you can be sure they are not the result of a more serious problem, such as retinal detachment. Floaters are generally translucent specks of various shapes and sizes. They may also look like bugs, threadlike strands or cobwebs within the eye. Since they are within the eye, they move as the eye moves and seem to dart away when you try to look at them directly.
What causes floaters?
The inner part of your eye is made up of a clear, jelly-like fluid known as the vitreous. Occasionally, small flecks of protein and other matter become trapped in the vitreous during the formation of the eye before birth and remain in the vitreous body. New floaters are caused by the deterioration of the eye fluid or its surrounding structures as we age, or by certain injuries or eye diseases.
Can these floaters cause blindness?
Most floaters are normal and rarely cause problems. But new or a sudden increase in floaters can be indications of more serious problems, such as a retinal hole, tear or detachment, and if you see them you should have a comprehensive optometric examination to determine the cause.
How are floaters detected?
As part of a comprehensive eye examination, your Optometrist will thoroughly evaluate the vitreous and retina of your eyes. Your Optometrist may use eye drops to dilate your pupils to make them larger. They will then look inside your eye with instruments called a biomicroscope and an ophthalomoscope to examine the health of the inside of your eyes. Your Optometrist will observe the floaters within your eye, as well as ensure that a retina problem has not occurred.
What is a stye or hordeolum?
A small area of redness and pain or a bump on the margin of your eyelid may indicate that you have a stye, known in medical terms as an external hordeolum. A stye is a blocked gland at the edge of the lid that has become infected by bacteria, usually Staphylococcus aureus.
What is the treatment for a stye?
The area of redness and pain will eventually come to a head and be expressed. For this to occur, warm compresses should be applied to the area for 15 minutes, 3-4 times a day. The compresses should be followed by the application of sulphonamide or antibiotic ointment to the stye, available by prescription. Check with your Optometrist. Once the stye has come to a head, it can usually be expressed (squeezed gently to empty its contents), after which the lids should be gently cleaned. Treatment with the ointment should be continued until symptoms have cleared. Sometimes, if the stye is large or under the lid (known as an internal hordeolum), it is necessary for the stye to be lanced to assist with expression of the mucous.
What is conjunctivitis or Pink Eye?
Conjunctivitis – commonly known as Pink Eye – is an inflammation of the conjunctiva, the thin, transparent layer that covers the inner eyelid and the white portion at the front of the eye (the sclera). An irritation will cause the blood vessels contained in the conjunctiva to dilate, which is what causes red or bloodshot eyes. It is often associated with either watery discharge or sticky, mucous discharge). Although conjunctivitis is common among children and may be caused by a minor infection, all ages may be affected. It is important to note that some forms of conjunctivitis may develop into a more serious problem if not diagnosed and treated properly.
What causes conjunctivitis?
There are 3 categories of conjunctivitis which differ in offending agent. Infectious, Allergic, and Chemical. Infectious conjunctivitis is either bacterial or viral. Bacterial Conjunctivitis can be contracted from direct contact with bacteria associated with unclean hands, bacteria transmitted from insects and contaminated eye makeup or facial lotions. This type of conjunctivitis is contagious. Some forms are self-limiting, minor and can be resolved a bit faster with antibiotic treatment. Some forms (gonorrhea) are more severe. Viral Conjunctivitis is most commonly caused by viruses associated with the common cold. It is highly contagious and can be contracted following an upper respiratory infection through the body’s own mucous membranes, which connect the lungs, throat, nose and eyes, or through airborne exposure to the coughing or sneezing of someone with an upper respiratory tract infection. Typically when this type of virus occurs in one eye, it will quickly spread to the other. This spread also happens with bacterial conjunctivitis. Allergic Conjunctivitis is caused by direct contact with eye irritants in those who are susceptible. This type of conjunctivitis can be seasonal (pollen, ragweed, grass, etc), or it may occur year-round (dust, fabrics, animal dander, etc). This form of conjunctivitis is not contagious. Chemical Conjunctivitis is caused by exposure to irritants such as air pollution, noxious chemicals or chlorine in a swimming pool. This form of conjunctivitis is not contagious.
What are the symptoms of pink eye?
Those who have contracted conjunctivitis may experience some of the following symptoms: ~Pink discolouration to the whites of the eye(s) ~Itching or burning sensation ~Swollen eyelid(s) ~Sensitivity to light ~Excessive tearing ~Sticky yellow discharge from the eye(s) or watery discharge, or stringy discharge
How is pink eye treated?
The treatment for pink eye depends on the type that you have contracted. Bacterial conjunctivitis can be treated with antibiotic eye drops or ointments prescribed by your eye doctor. Viral conjunctivitis, unlike bacterial infections, cannot be treated with antibiotics. This form of conjunctivitis is self-limited, which means that the infection will go away on its own anywhere between 7 days to several weeks duration. Some doctors of optometry use off-label treatment for viral conjunctivitis to clear away as much virus as possible in the eye while the immune system has a chance to kick in and help stop the spread of the virus (see Betadine treatment for info). Sometimes (steroid) eye drops are used to prevent scarring of cornea. Artificial tears can be used frequently, and applying a wet, cold washcloth to the infected eye to relieve discomfort from the symptoms. (NOTE: Due to the highly contagious nature of this type of pink eye, be very careful not to share used cloths!) – frequent handwashing, avoid touching eyes, sharing towels, etc. are important. Patients are also advised to stay away from school/work for a full 2 weeks from onset of viral conjunctivitis as it is contagious during this period (10-12 days). Allergy medications (antihistamine) can help provide relief, shorten the length, and sometimes even prevent the onset of allergic conjunctivitis. If you suffer from seasonal allergies, speak with your doctor about beginning these medications early in order to get ahead of the symptoms. The treatment of chemical conjunctivitis depends on the degree of exposure. For minor irritation such as chlorine from swimming in a pool, carefully rinse the eyes and consider purchasing a good pair of goggle for future activities. More acute chemical exposure may be a medical emergency and call for immediate medical attention.
What is lagophthalmos and what are the symptoms?
Lagophthalmos is a condition in which the eyes do not fully close. It can be caused by numerous underlying conditions. If lagophthalmos occurs during sleep, it is referred to as nocturnal lagophthalmos. Although lagophthalmos is not a dangerous condition in itself, it can lead to serious eye problems. It can also be indicative of serious medical conditions. Symptoms include: a sensation of a foreign object in the eye, increase in tearing, dry eyes, blurry vision (due to an unstable tear film), irritation and pain (that may be worse in the morning). Nocturnal lagophthalmos may be more difficult to identify, as it only occurs during sleep. If you experience any of the above symptoms, especially after waking up in the morning or after a nap, contact us to schedule an appointment.
What is the cause of lagophthalmos?
Lagophthalmos can be caused by damage to the nerves that control the eyelids, whether by an underlying disease or other condition. This can include: stroke, tumors, Mobius syndrome, Bell's Palsy, trauma, and some autoimmune diseases. Dysfunctional eyelids can also be to blame for lagophthalmos. This may be due to conditions such as floppy eyelid syndrome, scarring due to surgery, injuries or burns, and infections involving the eyelids. Underlying causes of lagophthalmos can be mild or severe. In either case, it is important to see your Optometrist for evaluation.
How is lagophthalmos diagnosed?
During your routine eye examination, your optometrist will carefully review your medical history and conduct a thorough assessment focusing on the eyelids and corneal staining patterns using a slit lamp. To gain a comprehensive understanding of your eye health, they may also perform additional dry eye testing.
How is lagophthalmos treated?
Treatment for lagophthalmos depends on the condition's origin, severity and duration. Your Optometrist may suggest either a surgical or non-surgical approach. Mild cases of lagophthalmos are often treated by targeting its symptoms, such as eye dryness and discomfort. Treatment options include: artificial tears, topical ointment, oral antibiotics, and a sleeping mask. Occasionally, your optometrist may recommend RF treatment. Severe cases of lagophthalmos may require surgery. This can include various procedures from special implantations to facial reanimation. Regular eye exams are critical for those who have conditions such as lagophthalmos in order to monitor any progression.
What is Thyroid Associated Orbitopathy?
Thyroid-associated orbitopathy (TAO) is an autoimmune condition that causes inflammation and swelling in the eye muscles, eyelids, and surrounding tissues. The receptors in the extraocular muscles are the same as found in the thyroid and is why it is linked with Graves Disease. Extraocular muscles and fat increase in size, causing the eyes to protrude forward. This increase in volume can damage tissue and fibrosis, this restricts eye movement and causes symptoms including diplopia (double vision) and pain with eye movements. TAO is the most common cause of proptosis, or bulging eyes, in adults. TAO has two phases: an active phase that lasts about six months to two years, and a stable phase when inflammation and other symptoms subside. Thyroid-associated orbitopathy may precede, coincide, or follow the systemic complications of dysthyroidism. A systematic review of the world literature found that in patients with thyroid-associated orbitopathy 10% were hypothyroid and 8% were euthyroid. Risk factors for thyroid-associated orbitopathy include increased age of onset, duration of Graves hyperthyroidism, and smoking.
What are the symptoms and how is Thyroid Associated Orbitopathy treated?
The most frequent sign of TAO is eyelid retraction, which affects 90–98% of TAO patients. Another common finding in patients with TAO is incomplete eyelid closure (lagophthalmos). Most patients develop exposure symptoms including foreign body sensation, grittiness, sensitivity to light, and excess tearing. These symptoms are secondary to the eyelids not fully closing combined with poor blinking, leading to increased tear evaporation. During a comprehensive eye examination, your Optometrist performs multiple tests that will help to diagnosis and assess the signs. The degree of the disease dictates the management plan required. Although most cases of thyroid-associated orbitopathy do not result in visual loss, this condition can cause vision-threatening exposure keratopathy, troublesome diplopia, and compressive optic neuropathy. Moderate to severe cases will require further testing and pending on stage of the disease may require referral for surgical intervention to alleviate the extra-ocular muscle swelling and possibly even strabismus surgery. Other traditional treatment options for moderate to severe thyroid-associated orbitopathy include pulse glucocorticoids or orbital radiation. Mild cases of TAO can be managed with at home dry eye treatments, allowing for simple at home options for symptom relief.
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