Answers to Common Questions About Your Eyes

What is 20/20 Vision???

'20/20 vision' is a term used to describe normal distance vision.

What does the '20' stand for?

The '20' is a distance of 20 feet, which is a standard testing distance for eyesight, used by Optometrists and Doctors.

How does that indicate how my vision is?

If you have 20/20 vision, you can see clearly at 20 feet what should be seen at that distance with normal vision. If you have 20/40 vision, it means that you must be as close as 20 feet to see what a person with normal vision can see at 40 feet.

If I can see 20/20, does that mean I have perfect vision?

No. It means you have normal vision. Some people are born with exceptional vision which has been measured at 20/10 (which means that a person with normal vision would have to stand 10 feet away to see what they can see at 20 feet)!

I have trouble reading, but my Optometrist told me I have 20/20 vision?

That could be right. The 20/20 scale of vision only refers to distance vision, and is not an indicator of near vision.

Do I have to have 20/20 vision to drive?

No. In the United States, the minimum requirement to drive a car is 20/40 vision with both eyes open. Check your vision now, with the online eye test at the left.

Longsightedness (Hyperopia)

What is it?

Hyperopia, also known as long-sightedness or far-sightedness, is the condition in which close objects appear blurry. A longsighted person may have good distance vision but will have trouble with close objects.

What problems might a person with longsightedeness experience?

The signs and symptoms of longsightedness can vary greatly between individuals, and often occur when a person is involved in a lot of close work (eg computers, reading, studying, etc.), or immediately after undertaking a lot of near work.

Low levels: generally the early signs and symptoms of long-sightedness are vague and occasional, and may involve any of:

• Headache
  
• Eye strain
  
• Occasional difficulty reading
  
• Fatigue
  
• Dislike or avoidance of reading
  
• Difficulty changing focus from near to far
  
• Dislike or avoidance of computer work
  
• Watery, uncomfortable eyes
  
• Excessive blinking
  
• Squinting to read
  

Medium Levels: most of the signs and symptoms here are more pronounced, and tend to be constantly present:

• Headache
  
• Inability to read small print
  
• Inability to work on a computer
  

Higher Levels: constantly present

• Reading becomes impossible
  
• Distance vision may become blurred (even though this is a contradiction with the definition of longsightedness!)
  

Who develops long sightedness?

Anyone can develop long sightedness at any age. Long sightedness can remain dormant for years, causing problems only when a person engages in a considerable amount of near work or changes occupation to one which involves more reading. Longsighted people generally become a little more longsighted as they grow older.

What causes long sightedness?

No-one is sure, however there is believed to be a hereditary component.

With hyperopia, light entering the eye focuses in behind the retina. This occurs because either the eye is too short (in length), or the focusing components of the eye are too weak.

Can longsightedness be cured?

No. Because long sightedness is a developmental problem with an hereditary basis, there doesn't appear to be a much likelihood of a cure.

What should I do if I think I might be long sighted?

You should arrange for an eye examination with your local Optometrist. Eye examinations in Australia are supported by the Medicare system for all Australian residents. Referrals are not required for an eye examination with an Optometrist. Your Optometrist will advise you if you have developed hyperopia, and will be able to recommend the best form of treatment if it is required.

What options do I have if I am long sighted?

The safest and easiest options for a long sighted person are to have glasses or contact lenses. Laser surgery has also been tried for long sightedness, however, the results have been only moderately successful.

What is myopia?

Myopia, also known as short sightedness or near sightedness, is the condition in which distant objects appear blurry. A shortsighted person may have good vision at close range, but will usually experience difficulties seeing details or objects that are far away.

What problems might a person who is shortsighted experience?

A person who has developed myopia may experience:

• Difficulty seeing distant objects
  
• Squinting frequently
  
• Difficulty seeing writing on signs or television
  
• Difficulty with driving (particularly at night)
  

It is worth noting that a shortsighted person may still cope through a lot of situations. In the example above, the shortsighted person would be aware that the view is of boats on water, with buildings in the background, but is unable to see any of the finer details.

Who develops shortsightedness?

Anyone can develop myopia at any age; however the great majority of cases of people developing myopia occur between the ages of 10 to 30, with a high prevalence in teenage years. It is estimated that 15% of the Australian population has some degree of myopia.

What causes shortsightedness?

No-one can give an exact answer to this question. There is believed to be both a genetic component (myopia can run in families), and an environmental component, related to the amount of reading and near work undertaken.

With myopia, light entering the eye focuses in front of the retina. This occurs because either the eye has grown too long, or the focusing components of the eye are too strong.

Can shortsightedness be cured?

At this stage - no. But scientists are continuously working on ways to slow or prevent the development of myopia.

What should I do if I think I might be shortsighted?

You should arrange for an eye examination with your local Optometrist. Eye examinations in Australia are supported by the Medicare system for all Australian residents. Referrals are not required for an eye examination with an Optometrist. Your Optometrist will advise you if you have developed myopia, and will be able to recommend the best form of treatment if it is required.

What options do I have if I am shortsighted?

The safest and easiest option for a shortsighted person is to have glasses. Contact lenses are also very popular with shorsighted people, and recently, laser eye surgery has become an attractive option.

What are floaters?

Floaters are small greyish or transparent spots or blobs that float across the field of vision from time to time. Floaters move around with eye movements, and are most commonly noticed against plain backgrounds, such as a white page or a blank wall. Floaters can also appear as fine threads, webs, and clumps.

What causes floaters?

Floaters are caused by small specks or clumps that form within the fluid of the eye. When light enters the eye, these clumps cast a shadow onto the retina. The floater that you notice is the shadow that is cast onto the retina.

What problems might a person with floaters experience?

Floaters are an annoying phenomenon that get in the way. Mostly they are harmless. In a small number of cases, floaters can be a sign of more serious damage that is taking place.

Who is at risk of developing floaters?

Floaters can occur in anyone, at any time.

How will I know if I have floaters?

Floaters appear on occasions in the visual field

What should I do if I think I might have floaters?

You should arrange for an eye examination with your local Optometrist or Ophthalmologist to rule out more serious underlying problems. You should seek immediate attention if you notice any of the following symptoms:

• An increase in the number of floaters noticed
  
• Decrease in vision in one or both eyes
  
• Flashes or sparkles in vision
  
• Your Optometrist will advise you if you have floaters, and whether or not they are potentially dangerous to your vision.

How am I tested for floaters?

Your Optometrist will carefully examine the inside of your eyes, noting the extent of any floaters and stuff. And will ensure that the retina is free from defects.

Is treatment required for floaters?

No. Floaters are annoying. But no treatment is required (provided there are no underlying problems).

Can floaters be cured?

No. There is no treatment available to make floaters go away. Often, people find that the brain learns to ignore floaters after some time.

Cataracts

These days, cataract is common yet easily treated condition. Approximately 20% of Americans over the age of 50 have some form of cataract.

What is a cataract?

Cataract is a condition where the clear lens inside the eye gradually becomes opaque (like a frosted window). Cataracts prevent some of the light reaching the retina, and result in blurred and washed out vision. Cataracts usually develop slowly, and cause a general loss of vision.

What causes cataract?

Most cataracts are a degeneration associated with age. However, cataracts can also be associated with:

• Diabetes
  
• Ultraviolet light exposure
  
• Smoking
  
• Certain medications
  
• Other diseases
  

What problems might a person with cataracts experience?

A person who has developed cataracts will experience the same sort of vision you would experience lookingthrough a somewhat misty window: vision is blurred, colours are a little faded. In addition glare can be a significant problem.

Who is at risk of developing cataracts?

Anyone can develop cataracts, however you are at an increased risk of developing cataracts if:

• You are over the age of 40
  
• You have diabetes
  
• You are exposed to ultraviolet light over a long period of time
  

Longsightedness (Hyperopia)

What is it?

Hyperopia, also known as long-sightedness or far-sightedness, is the condition in which close objects appear blurry. A longsighted person may have good distance vision but will have trouble with close objects.

What problems might a person with longsightedeness experience?

The signs and symptoms of longsightedness can vary greatly between individuals, and often occur when a person is involved in a lot of close work (eg computers, reading, studying, etc.), or immediately after undertaking a lot of near work.

Low levels: generally the early signs and symptoms of long-sightedness are vague and occasional, and may involve any of:

Headache
Eye strain
Occasional difficulty reading
Fatigue
Dislike or avoidance of reading
Difficulty changing focus from near to far
Dislike or avoidance of computer work
Watery, uncomfortable eyes
Excessive blinking
Squinting to read
Medium Levels: most of the signs and symptoms here are more pronounced, and tend to be constantly present:

Headache
Inability to read small print
Inability to work on a computer
Higher Levels: constantly present

Reading becomes impossible
Distance vision may become blurred (even though this is a contradiction with the definition of longsightedness!)
Here is an example of Normal Vision vs. Long-Sightedness:

Who develops long sightedness?

Anyone can develop long sightedness at any age. Long sightedness can remain dormant for years, causing problems only when a person engages in a considerable amount of near work or changes occupation to one which involves more reading. Longsighted people generally become a little more longsighted as they grow older.

What causes long sightedness?

No-one is sure, however there is believed to be a hereditary component.

With hyperopia, light entering the eye focuses in behind the retina. This occurs because either the eye is too short (in length), or the focusing components of the eye are too weak.

This is a diagram of a normal eye vs. a long-sighted eye:

As you can see, in the diagram of the normal eye, light enters the eye, and focusses perfectly onto the back of the eye (the retina). With a longsighted eye, the light focusses in beyond the retina, and causes the image that forms on the retina to be blurred. This causes near vision to become blurred.

Can longsightedness be cured?

No. Because long sightedness is a developmental problem with an hereditary basis, there doesn't appear to be a much likelihood of a cure.

What should I do if I think I might be long sighted?

You should arrange for an eye examination with your local Optometrist. Eye examinations in Australia are supported by the Medicare system for all Australian residents. Referrals are not required for an eye examination with an Optometrist. Your Optometrist will advise you if you have developed hyperopia, and will be able to recommend the best form of treatment if it is required.

What options do I have if I am long sighted?

The safest and easiest options for a long sighted person are to have glasses or contact lenses. Laser surgery has also been tried for long sightedness, however, the results have been only moderately successful.

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Shortsightedness (Myopia)

What is myopia?

Myopia, also known as short sightedness or near sightedness, is the condition in which distant objects appear blurry. A shortsighted person may have good vision at close range, but will usually experience difficulties seeing details or objects that are far away.

What problems might a person who is shortsighted experience?

A person who has developed myopia may experience:

Difficulty seeing distant objects
Squinting frequently
Difficulty seeing writing on signs or television
Difficulty with driving (particularly at night)
Here is an example of Normal Vision vs. Short-Sightedness:

It is worth noting that a shortsighted person may still cope through a lot of situations. In the example above, the shortsighted person would be aware that the view is of boats on water, with buildings in the background, but is unable to see any of the finer details.

Who develops shortsightedness?

Anyone can develop myopia at any age; however the great majority of cases of people developing myopia occur between the ages of 10 to 30, with a high prevalence in teenage years. It is estimated that 15% of the Australian population has some degree of myopia.

What causes shortsightedness?

No-one can give an exact answer to this question. There is believed to be both a genetic component (myopia can run in families), and an environmental component, related to the amount of reading and near work undertaken.

With myopia, light entering the eye focuses in front of the retina. This occurs because either the eye has grown too long, or the focusing components of the eye are too strong.

Here is a diagram of a Normal Eye vs. a Short-Sighted Eye:

As you can see, in the diagram of the normal eye, light enters the eye, and focusses perfectly onto the back of the eye (the retina). With a shortsighted eye, the light focusses in front of the retina, and causes the image that forms on the retina to be blurred. Thus, causing distance vision to be blurred.

Can shortsightedness be cured?

At this stage - no. But scientists are continuously working on ways to slow or prevent the development of myopia.

What should I do if I think I might be shortsighted?

You should arrange for an eye examination with your local Optometrist. Eye examinations in Australia are supported by the Medicare system for all Australian residents. Referrals are not required for an eye examination with an Optometrist. Your Optometrist will advise you if you have developed myopia, and will be able to recommend the best form of treatment if it is required.

What options do I have if I am shortsighted?

The safest and easiest option for a shortsighted person is to have glasses. Contact lenses are also very popular with shorsighted people, and recently, laser eye surgery has become an attractive option.

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I See Floaters!!!

What are floaters?

Floaters are small greyish or transparent spots or blobs that float across the field of vision from time to time. Floaters move around with eye movements, and are most commonly noticed against plain backgrounds, such as a white page or a blank wall. Floaters can also appear as fine threads, webs, and clumps.

What causes floaters?

Floaters are caused by small specks or clumps that form within the fluid of the eye. When light enters the eye, these clumps cast a shadow onto the retina. The floater that you notice is the shadow that is cast onto the retina.

What problems might a person with floaters experience?

Floaters are an annoying phenomenon that get in the way. Mostly they are harmless. In a small number of cases, floaters can be a sign of more serious damage that is taking place.

Who is at risk of developing floaters?

Floaters can occur in anyone, at any time.

How will I know if I have floaters?

Floaters appear on occasions in the visual field

What should I do if I think I might have floaters?

You should arrange for an eye examination with your local Optometrist or Ophthalmologist to rule out more serious underlying problems. You should seek immediate attention if you notice any of the following symptoms:

An increase in the number of floaters noticed
Decrease in vision in one or both eyes
Flashes or sparkles in vision
Your Optometrist will advise you if you have floaters, and whether or not they are potentially dangerous to your vision.

How am I tested for floaters?

Your Optometrist will carefully examine the inside of your eyes, noting the extent of any flo

What problems might a person with glaucoma experience?

Glaucoma is known as a "silent disease". In most cases it causes no pain or discomfort. The vision loss caused by glaucoma starts at the very side of our vision (peripheral vision). Most us do not pay much attention to the sides of our vision - so the disease can cause significant loss before being noticed. The loss of peripheral vision, in glaucoma, can lead to great difficulties with tasks such as driving and getting about. Glaucoma, if left untreated, can lead to total blindness.

How will I know if I have glaucoma?

Generally you won't. Glaucoma is an insidious and sneaky disease. By the time a person realises something is wrong, most of the damage is done.

What should I do if I am concerned?

You should arrange for an eye examination with your local Optometrist or Ophthalmologist. Eye examinations in Australia are supported by the Medicare system for all Australian residents. Referrals are not required for an eye examination with an Optometrist. Your Optometrist will advise you if you have developed glaucoma, and if so, will be able to refer you to an eye specialist for treatment.

How am I tested for glaucoma?

Glaucoma testing is made up of:

Measurement of the pressure within the eye
Inspection of the retina (checking for any early signs of damage)
Checking the sensitivity of peripheral vision (Visual Field test)
What treatment options do I have if I have glaucoma?

Extensive research has been carried out on this disease, with new treatements being developed almost every year. Nowadays, most treatments invlove the daily use of eye drops, which lower the pressure level within the eye (to prevent further damage). Occasionally, eye surgery is required, usually with laser. Generally, this surgery is performed when eye drops fail to reduce the pressure within the eye.

Can glaucoma be cured?

At this stage - no. Any damage that has occurred as a result of glaucoma is permanent. All treatment options are aimed at preventing further damage. That's why its important to have regular checks for glaucoma with your Optometrist.

What is macula degeneration?

Macula degeneration is a condition where the central part of the retina becomes damaged. This means that the retina cannot properly transmit images to the brain, and vision is consequently reduced.

What causes macula degeneration?

Macula degeneration is considered to be an age related problem which comes aboout because the retina loses its ability to properly maintain itself.

What problems might a person with macula degeneration experience?

The vision loss associated with macula degeneration affects central vision. Often this makes great difficulty with tasks such as reading or looking at peoples faces.

Who is at risk of developing macula degeneration?

Macula degeneration is often referred to as 'age related maculopathy'. Hence, those most at risk of developing macula degeneration are those over the age of 50. The prevalence of macula degeneration increases significantly with each decade. You will have an increased risk of developing macula degeneration if:

You are over the age of 50
You have high blood pressure
You smoke
You have a family history of macula degeneration
How will I know if I have macula degeneration?

In the earliest of stages, macula degeneration can be without symptoms. However, as the retina begins to break down, symptoms such as BULLET LIST TO GO HERE

What should I do if I think I might have macula degeneration?

You should arrange for an eye examination with your local Optometrist or Ophthalmologist. Eye examinations in Australia are supported by the Medicare system for all Australian residents. Referrals are not required for an eye examination with an Optometrist. Your Optometrist will advise you if you have developed macula degeneration, and if so, will be able to refer you to an eye specialist for treatment.

Why is good vision necessary for driving?

This might sound like a silly questions, but good vision is essential to the safe operation of any motor vehicle. It has been estimated that 90% of the sensory information required for driving is visual. A driver with reduced vision may take longer to perceive and react to a hazard ahead, or even fail to see another vehicle or pedestrian, especially in demanding conditions such as rain, highway speeds, or night driving.

What standard of vision is required to hold a drivers licence?

Every state's requirements are different, but in Ohio, it is required that you have 20/40 vision with both eyes open (see 'What is 20/20 vision' for an explanation). The driver also needs to have satisfactory peripheral vision.

In addition to these standards, some less common conditions, such as double vision, eye patching, sudden loss of vision in one eye, and glaucoma, can also affect driving. Your optometrist can provide further advice.

What about commercial drivers licences (e.g. truck, bus, taxi)?

Again, the laws are different in each state, but commercial drivers must have complete peripheral vision.

There is also a color vision requirement for commercial drivers. Some studies have suggested that drivers with certain types of color vision deficiency are more likely to be involved in a rear-end collision. These drivers are excluded from holding a commercial drivers licence.

Does deteriorating vision with age affect driving?

The effects of ageing on vision are well known and include:

Difficulty seeing at night or in poor light
Glare, whether from headlights at night, or from the sun, becomes more troublesome
Colour vision may diminish
Changing focus to different distances becomes slower
The formation of any cataracts intensifies the above problems.

Evidence suggests that if older drivers are prepared to compensate for ageing eyesight by adjusting their driving habits, then deteriorating vision is not necessarily a barrier to safe driving. Changing habits may include:

Driving only in daylight or on well-lit roads
Driving only in fine weather
Driving only in the familiar local area
How do I know whether I will meet the standard?

An eye examination with an optometrist is easily arranged, and will provide you with a full assessment of whether your vision meets the legal standards before actually applying for your licence. If you need a commercial drivers licence, be sure to mention this to the optometrist so that the appropriate tests can be carried out.

If you have only a mild eyesight problem and can pass the legal standards without glasses, your optometrist may still suggest wearing glasses at night time anyway, for additional safety.

What can I do if I don’t meet the standard?

Often a pair of driving glasses, or a change in the strength of an existing pair, is all that’s needed to have you driving legally. If well-developed cataracts are limiting your vision, they can usually be removed surgically – in this case your optometrist will refer you to an eye surgeon.

If a temporary problem is affecting your vision, it may simply be a matter of not driving until the condition has resolved.

In other situations, a restricted licence may be a possibility. For example, your optometrist may recommend a licence restricted to daylight driving only, or within a certain radius of home.

Remember that if your vision does not meet a safe legal standard, by driving you are putting the lives of others at risk, and that your insurance may be void in the event of an accident.

Sunglasses and Driving

Generally the best sunglasses are those that wrap around and protect the eyes from the side as well as the front. A neutral grey tint is best, as it doesn’t alter the colour of traffic signals. Polarising sunglasses are great for fishing and other water sports, but in a car they sometimes create distracting spotted patterns in laminated windscreens.

Never wear any type of sunglasses or tinted lenses for driving at night – while they may seem to reduce glare from headlights, they also make everything else darker too. At night your eyes need more light, not less.

Other Hints:

Make sure your windshield is clean and scratch-free, both inside and out, at all times.
Ask your mechanic to check that your headlights are correctly aligned to provide good road illumination while not causing glare for other road users.
Look slightly to the left of oncoming traffic at night to avoid suffering from glare which can take some time to recover from.
If you need to wear glasses for driving, a spare pair is a good idea in case you lose or break your main pair.
Any scratches or smudges on your driving glasses (or sunglasses) will increase glare – keep them clean!
Remember to have regular eye examinations – every two years, or as advised by your optometrist.

What is astigmatism?

Although the name sounds awful, astigmatism is a simple condition whereby the cornea (the clear front of the eye) is oval in shape, rather than round (ie like a football rather than a soccer ball). This causes objects at any distance to appear unclear, as light will not focus to a point onto the retina. People with myopia or hyperopia can also have astigmatism.

Above is a demonstration of how astigmatism affects the focusing of the eye. A person with no astigmatism will see all of the lines of the above picture in focus. A person with astigmatism will see one or more lines in focus, whilst others appear blurry.

In our example above, the horizontal lines are perfectly clear, and become progressively blurry as they reach vertical. You can check for astigmatism now by covering one eye, standing three metres from the screen, and checking to see if any of the lines on the first picture appear more blurry. Or, try an online eyetest at your left!

What problems might a person with astigmatism experience?

Astigmatism, because of its irregular focusing, has a myriad of possible signs and symptoms. These include:

Difficulty seeing distant objects
Difficulty seeing close objects
Difficulty with computer screens
Headaches
Fatigue
Ghosting (a faint overlapping second image)
Lights tend to appear spread out
Who develops astigmatism?

Anyone can develop astigmatism at any age.

What causes astigmastism?

No-one is sure. There may be a weak hereditary component, although this link has not been confirmed.

Can astigmatism be cured?

No. Because astigmatism is a structural problem of the eye, there doesn't appear to be a much likelihood of a cure.

What should I do if I think I might have astigmatism?

You should arrange for an eye examination with your local Optometrist. Eye examinations in the US are supported by the Medicare system for all American residents. Referrals are not required for an eye examination with an Optometrist. Your Optometrist will advise you if you have developed astigmatism, and will be able to recommend the best form of treatment if it is required.

What options do I have if I have astigmatism?

The safest and easiest options for a person with astigmatism are to have glasses or contact lenses. Laser surgery has also been tried for astigmatism.

What is presbyopia?

Presbyopia is a normal aging process of the eyes that causes close vision to become difficult. Its onset is usually between the ages of 40 and 50, and it affects the majority of people. People with presbyopia usually require reading glasses.

What problems might a person who has presbyopia experience?

A person who has developed presbyopia will have difficulty with reading and close tasks.

Who develops presbyopia?

Almost everyone will develop some degree of presbyopia in their lifetime, with the majority of people developing the problem between ages 40 and 50.

What causes presbyopia?

Through a series of muscles and structures, the eye has its own auto-focus system, which works when we look at things up close. With age, this auto-focus system stiffens up and loses its ability to focus. Presbyopia is a natural aging change.

Can presbyopia be cured?

At this stage - no. But scientists are searching for a means to halt or slow the stiffening process.

What should I do if I think I might have presbyopia?

You should arrange for an eye examination with your local Optometrist. Eye examinations in the US are supported by the Medicare system for all American residents. Referrals are not required for an eye examination with an Optometrist. Your Optometrist will advise you if you have developed presbyopia, and will be able to recommend the best form of treatment if it is required.

What options do I have if I have presbyopia?

The safest and easiest option for a person with presbyopia is to wear reading glasses.

Alternately, contact lenses and laser surgery can be used to reduce the symptoms of prebyopia. This is managed with 'monovision' where one eye is corrected for normal vision, and the other eye is partially corrected for near vision. Monovision is relatively successful, but can cause problems with depth perception and judgement.

What is amblyopia?

Amblyopia (lazy eye) is a condition where one has poor vision because it has failed to develop properly from an early age. 2 - 5% of all children have this condition.

What causes a lazy eye?

In amblyopia, one eye fails to develop properly. Usually this is because of an underlying problem, such as a turned eye or uncorrected refractive error. Over time, the eye loses its ability to compensate for its underlying problem and the brain decreases its control and usage of the "lazy eye". This results in permanently reduced vision in the lazy eye.

What problems might a person with a lazy eye experience?

A true lazy eye will result in decreased vision in one eye only. This will make certain tasks, such as judging distances, and depth perception difficult.

In addition, because a person with a lazy eye is relying on only one eye for almost all vision, they must be very cautious about the possibility of damage to this eye.

Who is at risk of developing a lazy eye?

Almost all lazy eyes develop between birth and age 6. Lazy eyes can develop relatively quickly, and must receive treatment as soon as possible to avoid the damage becoming more permanent. A child will have a much higher risk of developing a lazy eye if there is a family history of lazy eyes or turned eyes.

How will I know if I my child has a lazy eye?

In many cases, it is very difficult to tell if a child has a lazy eye, because the 'good' eye compensates for the slowly deteriorating lazy eye. In more severe cases, an obvious turned eye develops. Other symptoms to look for include:

Clumsiness
Poor vision
A difference in eye appearance in photographs taken with a flash

What should I do if I think my child might have a lazy eye?

You should arrange for your baby, infant, or child to have an eye examination with your local Optometrist or Ophthalmologist. Lazy eyes can be detected at a very early age, and it is important not to delay detection.

Eye examinations in the US are supported by the Medicare system for all American residents. Referrals are not required for an eye examination with an Optometrist. Your Optometrist will advise you if you have developed macula degeneration, and if so, will be able to refer you to an eye specialist for treatment.

What treatment options do I have if my child has a lazy eye?

Most cases of lazy eye require one or more of:

Glasses to bring the eye back to a normal level of focus
Patching of the good eye, to encourage the lazy eye to work
Vision Training: Eye exercises to stimulate the lazy eye, and make it work in conjunction with the good eye.
In many cases, all three techniques are required to correct the problem, and in some cases, surgery is required to straighten the eyes.

It is important that lazy eye is treated whilst the child is young, and the visual system is still developing. Once the child reaches the age of 6-8, there is very little that can be done. If the lazy eye is treated later in life, the brain cannot interpret the images effectively, and the picture appears blurred.

Can lazy eye be cured?

Provided that the lazy eye is detected early and Vision Training is utilized, there is a good prognosis for lazy eye to be nearly completely fixed.

What is color blindness?

Color blindness is a condition in which a person has trouble telling the difference between various shades of colour. Color blindess does not mean that a person sees things in black and white. Generally, Optometrists and Doctors refer to the condition as 'color vision deficiency.'

Who is affected by color vision deficiency?

Almost all color vision problems are inherited, and present at bith. It is estimated that 1 in every 12 males, and one in every 200 females, are born with some form of color vision deficiency.

In later life, some serious eye diseases, and certain medications can cause colour vision deficiencies to appear.

How is a color vision deficiency inherited?

The 'colorblindness gene' is passed down through the mother's side of the family.

A colorblind male will have inherited the condition through his mother's genes (although she will probably not be colorblind).

A colorblind female will have inherited the condition through a combination of her mother's genes (probably not colorblind) and her father's genes (colorblind).

Who should be tested for color vision deficiency?

People who should have there colour vision checked:

All Boys
Girls in whom colour vision is suspect
Children with a family history of colour blindness (particularly from uncles or grandfather)
Adults considering occupations that require fine colour discrimination
Adults considering occupations that have colour vision standards
Adults who have developed eye disease, such as cataract or macula degeneration
Color vision testing is fairly simple, and can be carried out with little difficulty from the age of 3 years (the child doesn't have to know the names of the colors).

What can be done about color blindness?

Medically, there is no cure for hereditary colorblindness, because the body lacks a given sensor for detecting particular colors.

Colorblind people often look for other cues to determine colour. For example, if you couldn't tell the difference between the red and the green at a traffic light, you could still tell that the top light meant stop!

Other means of compensating for colorblindness have been developed, such as specially tinted glasses. There are even computer programs available to help colorblind people distinguish colors.

What is "NORMAL" in my vision?

It is normal for most eyes to be long-sighted at birth. This usually reduces as the eye grows to full adult size during adolescence. It is then in the teens that short-sightedness tends to develop, if at all.

After a relatively stable time in the 20's and 30's another significant time for change begins in the 40's. This involves a gradual loss in the ability to finely focus the lens inside the eye. The result is a totally normal and expected change called "presbyopia", which continues into the 60's.

After 60, the eye will tend toward less long-sightedness or more short-sightedness as the inner part of the eye lens hardens. Sensitive vision drops and the retina's fine discrimination of colours is dulled. By 70 most eyes show signs of cataract and the older, harder, clouded eye lens scatters light so that glare often becomes more of a problem.

How often should I have my eyes examined?

Your optometrist will advise you of the interval between your full eye & vision examinations which is appropriate for your vision and eye health needs. This time interval does vary for different situations, so we contact our patients when their next routine check is due. Changes in vision and eye health are often quite slow and subtle, and can easily go unnoticed if not checked regularly.

Of course if a problem arises sooner, please make an appointment so that we can assess the situation for you.

Most people become aware of blurred vision, and an increase in glare sensitivity as cataracts develop. However, a thorough eye examination will detect cataracts at a much earlier stage

What should I do if I think I might have cataracts?

You should arrange for an eye examination with your local Optometrist or Ophthalmologist. Eye examinations in America are supported by the Medicare system for all American residents. Referrals are not required for an eye examination with an Optometrist. Your Optometrist will advise you if you have developed cataracts, and if so, will be able to advise you about all of the treatment options.

How am I tested for cataracts?

The lens of the eye is carefully examined with two instruments: an ophthalmoscope, and a slit lamp biomicroscope. The findings from these examination, coupled with the level of vision will give an accurate indication of the whether catarct is present, and, if so, to what degree. Checking for cataract is usually carried out during a regular eye test.

What treatment options do I have if I have cataracts?

In the early stages of cataract, the easiest option is to match the strength of the glasses to an optimum level. With distance vision, glare can become a problem, so it is worth looking at options to counter this (having tinted lenses, having an anti-reflection coating put on your lenses, wearing a peaked hat, etc.). With near vision, contrast can be washed out a littlem, so it is important to use a strong light to maximise close vision.

In the more advanced stages of cataract, surgery is the most common option. The procedure is a relatively safe operation, although, as with all operations there are some risks. If your cataract is nearing a stage where surgery may be required, your Optometrist will refer you to an Eye surgeon for an opinion and treatment.

Advances in cataract treatment?

Recently, cataract surgery has been refined, and is now being performed using a "stitchless keyhole" approach. This involves the use of local anaesthetic, and a minor incision, to replace the cataract with a 'foldable' lens. The procedure takes only 20 minutes, and the recovery period is around 24 hours.

If you are concerned about ANY aspect of your eyes and vision - please ensure you arrange to have an eye examination. Your optometrist will provide a thorough examination and discuss the options available.

Glaucoma

What is glaucoma?

Glaucoma is a condition where the optic nerve becomes damaged, through a build up of pressure within the eye. The optic nerve damage results in permanent loss of vision. Often, this loss of vision is gradual and without symptoms.

Who is at risk of developing glaucoma?

Anyone can develop glaucoma, however the incidence of glaucoma increases significantly with age. Glaucoma affects approximately 3% at the age of 40, and 5% at 70. Over 300,000 people are estimated to have this condition in Australia, but only 150,000 of these are believed to be as yet undiagnosed. For this reason alone, Optometrists recommend that you have an eye check up every 2 years. You will have an increased risk of developing glaucoma if:

You have a family history of glaucoma
You are shortsighted
You are over the age of 40
What causes glaucoma?

The eye constantly produces a fluid which helps to regulate the shape and structure of the eye. If the eye produces too much fluid, or the fluid cannot drain from the eye, there is a build up of pressure within the eye (like having a basketball that has been over inflated). This excess pressure pushes on the optic nerve (which is responsible for transmitting images to the brain), causing permanent damage.

There are two types of glaucoma: Primary Open Angle Glaucoma and Acute Angle Closure Glaucoma.

Primary open angle glaucoma is generally the result of higher than normal pressure levels over a long period of time. This form of glaucoma is usually without signs or symptoms until significant damage has occurred.

Acute angle closure glaucoma occurs when the drainage channel becomes permanently blocked. This tpe of glaucoma occurs as an 'attack', is characterised by blurred vision, discomfort, headaches, and can result in a rapid loss of vision.

What problems might a person with glaucoma experience?

Glaucoma is known as a "silent disease". In most cases it causes no pain or discomfort. The vision loss caused by glaucoma starts at the very side of our vision (peripheral vision). Most us do not pay much attention to the sides of our vision - so the disease can cause significant loss before being noticed. The loss of peripheral vision, in glaucoma, can lead to great difficulties with tasks such as driving and getting about. Glaucoma, if left untreated, can lead to total blindness.

How will I know if I have glaucoma?

Generally you won't. Glaucoma is an insidious and sneaky disease. By the time a person realises something is wrong, most of the damage is done.

What should I do if I am concerned?

You should arrange for an eye examination with your local Optometrist or Ophthalmologist. Eye examinations in Australia are supported by the Medicare system for all Australian residents. Referrals are not required for an eye examination with an Optometrist. Your Optometrist will advise you if you have developed glaucoma, and if so, will be able to refer you to an eye specialist for treatment.

How am I tested for glaucoma?

Glaucoma testing is made up of:

Measurement of the pressure within the eye
Inspection of the retina (checking for any early signs of damage)
Checking the sensitivity of peripheral vision (Visual Field test)
What treatment options do I have if I have glaucoma?

Extensive research has been carried out on this disease, with new treatements being developed almost every year. Nowadays, most treatments invlove the daily use of eye drops, which lower the pressure level within the eye (to prevent further damage). Occasionally, eye surgery is required, usually with laser. Generally, this surgery is performed when eye drops fail to reduce the pressure within the eye.

Can glaucoma be cured?

At this stage - no. Any damage that has occurred as a result of glaucoma is permanent. All treatment options are aimed at preventing further damage. That's why its important to have regular checks for glaucoma with your Optometrist.

Macula Degeneration

What is macula degeneration?

Macula degeneration is a condition where the central part of the retina becomes damaged. This means that the retina cannot properly transmit images to the brain, and vision is consequently reduced.

What causes macula degeneration?

Macula degeneration is considered to be an age related problem which comes aboout because the retina loses its ability to properly maintain itself.

What problems might a person with macula degeneration experience?

The vision loss associated with macula degeneration affects central vision. Often this makes great difficulty with tasks such as reading or looking at peoples faces.

Who is at risk of developing macula degeneration?

Macula degeneration is often referred to as 'age related maculopathy'. Hence, those most at risk of developing macula degeneration are those over the age of 50. The prevalence of macula degeneration increases significantly with each decade. You will have an increased risk of developing macula degeneration if:

• You are over the age of 50
  
• You have high blood pressure
  
• You smoke
  
• You have a family history of macula degeneration
  

How will I know if I have macula degeneration?

In the earliest of stages, macula degeneration can be without symptoms. However, as the retina begins to break down, symptoms such as BULLET LIST TO GO HERE

What should I do if I think I might have macula degeneration?

You should arrange for an eye examination with your local Optometrist or Ophthalmologist. Eye examinations in Australia are supported by the Medicare system for all Australian residents. Referrals are not required for an eye examination with an Optometrist. Your Optometrist will advise you if you have developed macula degeneration, and if so, will be able to refer you to an eye specialist for treatment.

Why is good vision necessary for driving?

This might sound like a silly questions, but good vision is essential to the safe operation of any motor vehicle. It has been estimated that 90% of the sensory information required for driving is visual. A driver with reduced vision may take longer to perceive and react to a hazard ahead, or even fail to see another vehicle or pedestrian, especially in demanding conditions such as rain, highway speeds, or night driving.

What standard of vision is required to hold a drivers licence?

Every state's requirements are different, but in Ohio, it is required that you have 20/40 vision with both eyes open (see 'What is 20/20 vision' for an explanation). The driver also needs to have satisfactory peripheral vision.

In addition to these standards, some less common conditions, such as double vision, eye patching, sudden loss of vision in one eye, and glaucoma, can also affect driving. Your optometrist can provide further advice.

What about commercial drivers licences (e.g. truck, bus, taxi)?

Again, the laws are different in each state, but commercial drivers must have complete peripheral vision.

There is also a color vision requirement for commercial drivers. Some studies have suggested that drivers with certain types of color vision deficiency are more likely to be involved in a rear-end collision. These drivers are excluded from holding a commercial drivers licence.

Does deteriorating vision with age affect driving?

The effects of ageing on vision are well known and include:

• Difficulty seeing at night or in poor light
  
• Glare, whether from headlights at night, or from the sun, becomes more troublesome
  
• Colour vision may diminish
  
• Changing focus to different distances becomes slower
  
• The formation of any cataracts intensifies the above problems.

Evidence suggests that if older drivers are prepared to compensate for ageing eyesight by adjusting their driving habits, then deteriorating vision is not necessarily a barrier to safe driving. Changing habits may include:

• Driving only in daylight or on well-lit roads
  
• Driving only in fine weather
  
• Driving only in the familiar local area
  

How do I know whether I will meet the standard?

An eye examination with an optometrist is easily arranged, and will provide you with a full assessment of whether your vision meets the legal standards before actually applying for your licence. If you need a commercial drivers licence, be sure to mention this to the optometrist so that the appropriate tests can be carried out.

If you have only a mild eyesight problem and can pass the legal standards without glasses, your optometrist may still suggest wearing glasses at night time anyway, for additional safety.

What can I do if I don’t meet the standard?

Often a pair of driving glasses, or a change in the strength of an existing pair, is all that’s needed to have you driving legally. If well-developed cataracts are limiting your vision, they can usually be removed surgically – in this case your optometrist will refer you to an eye surgeon.

If a temporary problem is affecting your vision, it may simply be a matter of not driving until the condition has resolved.

In other situations, a restricted licence may be a possibility. For example, your optometrist may recommend a licence restricted to daylight driving only, or within a certain radius of home.

Remember that if your vision does not meet a safe legal standard, by driving you are putting the lives of others at risk, and that your insurance may be void in the event of an accident.

Sunglasses and Driving

Generally the best sunglasses are those that wrap around and protect the eyes from the side as well as the front. A neutral grey tint is best, as it doesn’t alter the colour of traffic signals. Polarising sunglasses are great for fishing and other water sports, but in a car they sometimes create distracting spotted patterns in laminated windscreens.

Never wear any type of sunglasses or tinted lenses for driving at night – while they may seem to reduce glare from headlights, they also make everything else darker too. At night your eyes need more light, not less.

Other Hints:

Make sure your windshield is clean and scratch-free, both inside and out, at all times.
Ask your mechanic to check that your headlights are correctly aligned to provide good road illumination while not causing glare for other road users.
Look slightly to the left of oncoming traffic at night to avoid suffering from glare which can take some time to recover from.
If you need to wear glasses for driving, a spare pair is a good idea in case you lose or break your main pair.
Any scratches or smudges on your driving glasses (or sunglasses) will increase glare – keep them clean!
Remember to have regular eye examinations – every two years, or as advised by your optometrist.

Astigmatism

What is astigmatism?

Although the name sounds awful, astigmatism is a simple condition whereby the cornea (the clear front of the eye) is oval in shape, rather than round (ie like a football rather than a soccer ball). This causes objects at any distance to appear unclear, as light will not focus to a point onto the retina. People with myopia or hyperopia can also have astigmatism.

Above is a demonstration of how astigmatism affects the focusing of the eye. A person with no astigmatism will see all of the lines of the above picture in focus. A person with astigmatism will see one or more lines in focus, whilst others appear blurry.

In our example above, the horizontal lines are perfectly clear, and become progressively blurry as they reach vertical. You can check for astigmatism now by covering one eye, standing three metres from the screen, and checking to see if any of the lines on the first picture appear more blurry. Or, try an online eyetest at your left!

Here is another example of Normal Vision vs. your Vision With Astigmatism:

What problems might a person with astigmatism experience?

Astigmatism, because of its irregular focusing, has a myriad of possible signs and symptoms. These include:

• Difficulty seeing distant objects
  
• Difficulty seeing close objects
  
• Difficulty with computer screens
  
• Headaches
  
• Fatigue
  
• Ghosting (a faint overlapping second image)
  
• Lights tend to appear spread out
  

Who develops astigmatism?

Anyone can develop astigmatism at any age.

What causes astigmastism?

No-one is sure. There may be a weak hereditary component, although this link has not been confirmed.

Can astigmatism be cured?

No. Because astigmatism is a structural problem of the eye, there doesn't appear to be a much likelihood of a cure.

What should I do if I think I might have astigmatism?

You should arrange for an eye examination with your local Optometrist. Eye examinations in the US are supported by the Medicare system for all American residents. Referrals are not required for an eye examination with an Optometrist. Your Optometrist will advise you if you have developed astigmatism, and will be able to recommend the best form of treatment if it is required.

What options do I have if I have astigmatism?

The safest and easiest options for a person with astigmatism are to have glasses or contact lenses. Laser surgery has also been tried for astigmatism.

Presbyopia

What is presbyopia?

Presbyopia is a normal aging process of the eyes that causes close vision to become difficult. Its onset is usually between the ages of 40 and 50, and it affects the majority of people. People with presbyopia usually require reading glasses.

What problems might a person who has presbyopia experience?

A person who has developed presbyopia will have difficulty with reading and close tasks.

Who develops presbyopia?

Almost everyone will develop some degree of presbyopia in their lifetime, with the majority of people developing the problem between ages 40 and 50.

What causes presbyopia?

Through a series of muscles and structures, the eye has its own auto-focus system, which works when we look at things up close. With age, this auto-focus system stiffens up and loses its ability to focus. Presbyopia is a natural aging change.

Can presbyopia be cured?

At this stage - no. But scientists are searching for a means to halt or slow the stiffening process.

What should I do if I think I might have presbyopia?

You should arrange for an eye examination with your local Optometrist. Eye examinations in the US are supported by the Medicare system for all American residents. Referrals are not required for an eye examination with an Optometrist. Your Optometrist will advise you if you have developed presbyopia, and will be able to recommend the best form of treatment if it is required.

What options do I have if I have presbyopia?

The safest and easiest option for a person with presbyopia is to wear reading glasses.

Alternately, contact lenses and laser surgery can be used to reduce the symptoms of prebyopia. This is managed with 'monovision' where one eye is corrected for normal vision, and the other eye is partially corrected for near vision. Monovision is relatively successful, but can cause problems with depth perception and judgement.

Lazy Eye (Amblyopia)

What is amblyopia?

Amblyopia (lazy eye) is a condition where one has poor vision because it has failed to develop properly from an early age. 2 - 5% of all children have this condition.

What causes a lazy eye?

In amblyopia, one eye fails to develop properly. Usually this is because of an underlying problem, such as a turned eye or uncorrected refractive error. Over time, the eye loses its ability to compensate for its underlying problem and the brain decreases its control and usage of the "lazy eye". This results in permanently reduced vision in the lazy eye.

What problems might a person with a lazy eye experience?

A true lazy eye will result in decreased vision in one eye only. This will make certain tasks, such as judging distances, and depth perception difficult.

In addition, because a person with a lazy eye is relying on only one eye for almost all vision, they must be very cautious about the possibility of damage to this eye.

Who is at risk of developing a lazy eye?

Almost all lazy eyes develop between birth and age 6. Lazy eyes can develop relatively quickly, and must receive treatment as soon as possible to avoid the damage becoming more permanent. A child will have a much higher risk of developing a lazy eye if there is a family history of lazy eyes or turned eyes.

How will I know if I my child has a lazy eye?

In many cases, it is very difficult to tell if a child has a lazy eye, because the 'good' eye compensates for the slowly deteriorating lazy eye. In more severe cases, an obvious turned eye develops. Other symptoms to look for include:

Clumsiness
Poor vision
A difference in eye appearance in photographs taken with a flash
What should I do if I think my child might have a lazy eye?

You should arrange for your baby, infant, or child to have an eye examination with your local Optometrist or Ophthalmologist. Lazy eyes can be detected at a very early age, and it is important not to delay detection.

Eye examinations in the US are supported by the Medicare system for all American residents. Referrals are not required for an eye examination with an Optometrist. Your Optometrist will advise you if you have developed macula degeneration, and if so, will be able to refer you to an eye specialist for treatment.

What treatment options do I have if my child has a lazy eye?

Most cases of lazy eye require one or more of:

Glasses to bring the eye back to a normal level of focus
Patching of the good eye, to encourage the lazy eye to work
Vision Training: Eye exercises to stimulate the lazy eye, and make it work in conjunction with the good eye.
In many cases, all three techniques are required to correct the problem, and in some cases, surgery is required to straighten the eyes.

It is important that lazy eye is treated whilst the child is young, and the visual system is still developing. Once the child reaches the age of 6-8, there is very little that can be done. If the lazy eye is treated later in life, the brain cannot interpret the images effectively, and the picture appears blurred.

Can lazy eye be cured?

Provided that the lazy eye is detected early and Vision Training is utilized, there is a good prognosis for lazy eye to be nearly completely fixed.

Color Blindness

What is color blindness?

Color blindness is a condition in which a person has trouble telling the difference between various shades of colour. Color blindess does not mean that a person sees things in black and white. Generally, Optometrists and Doctors refer to the condition as 'color vision deficiency.'

Who is affected by color vision deficiency?

Almost all color vision problems are inherited, and present at bith. It is estimated that 1 in every 12 males, and one in every 200 females, are born with some form of color vision deficiency.

In later life, some serious eye diseases, and certain medications can cause colour vision deficiencies to appear.

How is a color vision deficiency inherited?

The 'colorblindness gene' is passed down through the mother's side of the family.

A colorblind male will have inherited the condition through his mother's genes (although she will probably not be colorblind).

A colorblind female will have inherited the condition through a combination of her mother's genes (probably not colorblind) and her father's genes (colorblind).

Who should be tested for color vision deficiency?

People who should have there colour vision checked:

All Boys
Girls in whom colour vision is suspect
Children with a family history of colour blindness (particularly from uncles or grandfather)
Adults considering occupations that require fine colour discrimination
Adults considering occupations that have colour vision standards
Adults who have developed eye disease, such as cataract or macula degeneration
Color vision testing is fairly simple, and can be carried out with little difficulty from the age of 3 years (the child doesn't have to know the names of the colors).

What can be done about color blindness?

Medically, there is no cure for hereditary colorblindness, because the body lacks a given sensor for detecting particular colors.

Colorblind people often look for other cues to determine colour. For example, if you couldn't tell the difference between the red and the green at a traffic light, you could still tell that the top light meant stop!

Other means of compensating for colorblindness have been developed, such as specially tinted glasses. There are even computer programs available to help colorblind people distinguish colors.

What is "NORMAL" in my vision?

It is normal for most eyes to be long-sighted at birth. This usually reduces as the eye grows to full adult size during adolescence. It is then in the teens that short-sightedness tends to develop, if at all.

After a relatively stable time in the 20's and 30's another significant time for change begins in the 40's. This involves a gradual loss in the ability to finely focus the lens inside the eye. The result is a totally normal and expected change called "presbyopia", which continues into the 60's.

After 60, the eye will tend toward less long-sightedness or more short-sightedness as the inner part of the eye lens hardens. Sensitive vision drops and the retina's fine discrimination of colours is dulled. By 70 most eyes show signs of cataract and the older, harder, clouded eye lens scatters light so that glare often becomes more of a problem.

How often should I have my eyes examined?

Your optometrist will advise you of the interval between your full eye & vision examinations which is appropriate for your vision and eye health needs. This time interval does vary for different situations, so we contact our patients when their next routine check is due. Changes in vision and eye health are often quite slow and subtle, and can easily go unnoticed if not checked regularly.

Of course if a problem arises sooner, please make an appointment so that we can assess the situation for you.