Physiologically the lens of the eye changes its shape and that shape change results in focus, or “accommodation”. The two eyes must also simultaneously point to the object, also called “converging”. Although convergence and accommodation are separate functions, they are tied together. Challenges with one create challenges with the other.
Difficulty focusing your eyes can result in blur, eye strain, headaches, reduced vision, double vision, trouble seeing at near, intermittent focusing difficulties and eyestrain and fatigue.
The causes of accommodative problems include over or under focusing, over or under convergence of the eyes, eye muscle imbalnances and a host of other things. Also, the ability to change focus for near is reduced with age. Presbyopia (as the aging change that historically is know to result in a need for bifocals is called), affects all people, usually after the age of 42, however this is an age related change and not technically an “accommodative” dysfunction, which plagues people of younger ages generally. Other things that can cause focusing problems include neurological diseases, emotional disorders, incorrect eyeglass or contact lens prescriptions, stress or side effects of certain medications.
Treatment for focusing issues can include specially prescribed lenses, which supplement the focusing power necessary to see clearly. In many cases, specially prescribed visual therapy may be needed to teach the eyes to change focus comfortably. Frequently, both therapy and glasses are necessary.
In order to look at near (reading, hobbies etc) each eye must change focus using a process called accommodation. Accommodative insufficiency means the eyes lack the ability to sustain this focus or to change focus efficiently from near to far and back.
Accommodative insufficiency causes of blurred vision, headaches, and eyestrain. It also can cause difficulties in transitioning clear vision from distance focus to near and back (fluctuating vision). Treatment for accommodative difficulties may include specially prescribed lenses, and in some, cases vision therapy training.
Symptoms can include trouble performing near vision tasks, blurred vision at varying distances, the holding of reading material or other work closer than expected, headaches, eye strain and possible double vision. People with these spasms frequently will have rapidly advancing prescriptions in their eyeglasses.
Treatment might involve the prescription of lenses to reduce the overstimulation and/or specifically prescribed visual therapy procedures. If this condition is left unresolved, increases in nearsightedness may occur.
Treatment of allergic conjunctivitis may include anti-inflammatory, antihistamine and decongestant eye drops. Doctors might recommend cool compresses and, of course if an option, removal of the offending allergen. There are many effective mast cell stabilizer/antihistamine combination medications that can help resolve symptoms with as few as one drop per day, so be sure to see your doctor if you suffer from seasonal allergies and/or seasonal allergic conjunctivitis. The contact form of allergic conjunctivitis usually affects only one eye while the non-contact form affects both.
The most common causes of amblyopia due to conditions like strabismus (the eyes not pointing in the same direction) where they never develop the ability to see together and by favoring one eye cause the other to wither in a manner analogous to a leg in a cast. They can be congenital, meaning it is the way someone is born, or it can develop for many reasons where one eye is deprived of vision while the other eye continues to be used.
A young child has a much better chance at gaining normal vision than that of an older child, adolescent or adult. Treatment includes eyeglasses, patching or occluding the normal eye to force the amblyopic eye to work, and sometimes vision therapy. Eye doctors used to think amblyopia treatment had little benefit after the visual system matures, but recent research has shown even adults can benefit from amblyopia therapy to some extent. Amblyopia is best treated before age 8, although treatment can help in older children and adolescents
Uncorrected or incorrect prescriptions for astigmatism cause blurred and tilted vision, and may lead to eyestrain, headaches, fatigue, sensitivity to light, and trouble concentrating
When one is diagnosed with astigmatism and gets new eyeglasses, objects can appear tilted and/or distorted. This perception of distortion will decrease steadily with time as one adapts, unless the prescription is inaccurate. It may take up to two weeks in some cases to adapt. Astigmatism prescriptions change over time, so regular eye examinations are important to monitor these changes and correct eyewear appropriately. Eyeglasses, and/or, special astigmatic (toric) contact lenses are available to correct astigmatism. LASIK can correct astigmatism as well. Around 87% of all eyeglass prescriptions contain some correction for astigmatism.
Symptoms of bacterial conjunctivitis include redness, irritation and a discharge (mucous) that may build up along the eyelashes. Eyes with bacterial conjunctivitis have a tendency to stick together, especially in the morning, and there is rarely any pain. Bacterial conjunctivitis is highly contagious, yet easily treated. Most bacterial infections are treated with antibiotic eye drops. Contact lenses cannot be worn until the treatment has successfully completed.
All corneal ulcers require immediate treatment and monitoring and have the potential to permanently reduce sight. Treatment usually involves antibiotics, and sometimes anti-inflammatory medications. Scarring to the cornea may result despite treatment. Frequent examination by an eye doctor is necessary until the ulcer is completely healed. Contact lenses must be discontinued in most cases and treatment can take 2 weeks or more.
Your eye doctor will monitor these pigmentations to ensure they don’t change in shape, size or coloration. If they are stable, they are of as much concern as a freckle. However, a change in any of these features should be observed as soon as possible by a doctor and can indicate a serious condition generally successfully treated if caught early.
Eyes that are turned slightly inward and require a small muscle tension to keep the distance parallel alignment are said to have an “eso” posture. Eso postured eyes that turn in too much might converge too much when looking at near objects and this is termed convergence excess.
Eyes with convergence excess might experience eyestrain, difficulty focusing on distance objects and/or rapidly increasing nearsightedness. Convergence excess is generally treated by prescribing reading glasses or bifocals, which help to align the eyes and reduce symptoms and in some cases worsening nearsightedness.
Eyes that are turned slightly outward and require a small muscle tension to keep the distance parallel alignment are said to have an “exo” posture. Exo postured eyes that turn out too much might have trouble turning in to view near objects and this is termed convergence insufficiency. It is a type of eye muscle imbalance.
Convergence insufficients can have eyestrain when attempting to sustain near vision in activities like reading and studying. Some are prone to headaches from near point activities and others may experience intermittent blurry vision when trying to read. Some convergent insufficients must cover one eye to read as both eyes won’t efficiently turn in together, or they will find other ways of compensating so they reduce eyestrain and double vision.
Treatment of convergence insufficiency generally takes the form of vision therapy to strengthen the muscles that “turn in” the eyes.
Corneal abrasions are treated with bedrest, non-steroidal anti-inflammatories (for pain), patching of the eye or a contact lens that is used like a bandaid (bandage contact lens). Some abrasions are treated with antibiotics as well to prevent infection. The cornea heals rapidly and most symptoms are resolved within a 24 hour period of obtaining the scratch.
Treatment of dellen includes moisturing eye drops, anti-inflammatories and gels that keep the eye moist while one sleeps.
Causes of corneal edema include but are not limited to infections, surgery, injury and insult, contact lens over-wear, poor fitting contact lenses, old contact lenses or contact lens complications, increased eye pressure and exposure to toxins.
Early symptoms of corneal edema may be distorted or blurred vision, halos around light, eye discomfort and sensitivity to light.
Treatment varies based on the cause of the condition. When contact lenses are the culprit, reduced wear time, discontinuation of wear or change in lens type may be required. Corneal edema caused by increased eye pressure is an emergency and must be treated by lowering the eye pressure.
If corneal swelling is restricted to the outer layer of the cornea, it can be treated by using a saline eye drop or gel (Muro, Bausch & Lomb) which helps to remove excess fluid accumulation in the cornea.
Eyes that are turned slightly inward and require a small muscle tension to keep the distance parallel alignment are said to have an “esophoric” posture. Eyes with esophoria which turn in too much might converge too much when looking at near objects and this is termed convergence excess.
Eyes with esophoria might experience eyestrain, difficulty focusing on distance objects and/or rapidly increasing nearsightedness. Esophoria is generally treated by prescribing reading glasses or bifocals, which help to align the eyes and reduce symptoms and in some cases worsening nearsightedness.
Eyes that are turned slightly outward and require a small muscle tension to keep the distance parallel alignment are said to have exophoria. Exophoric eyes that turn out too much might have trouble turning in to view near objects; extreme exophoria is termed convergence insufficiency.
Fuch’s is a hereditary disorder which is chronic in nature. There is no totally effective cure, but certain eyedrops and now some surgeries can help some people with Fuchs . Advanced cases may need corneal surgeries involving new donor corneas and grafts.
How well one sees at varying ranges depends on the degree of farsightedness a person has. Farsighted people’s ability to see near gradually diminishes as they move past the age of 40, a condition called Presbyopia.
Eyeglasses, contact lenses and laser vision correction such as PRK and LASIK are available to correct vision in farsighted people.
Symptoms include redness, swelling, light sensitivity, mucous and pain. Treatment of this condition varies depending on the cause but may involve antibiotics, antivirals and/or steroid eye drops.
Nearsightedness is correctable with eyeglasses, contact lenses and refractive surgery such as PRK or LASIK. Most nearsightedness can also be corrected by reshaping the surface of the eye with special medical devices worn only during sleep, a method called Orthokeratology. For adults, refractive surgery such as LASIK, or lens replacements are additional options.
Treatment of narrow angle glaucoma is directed at lowering the pressure inside the eye using medications, but generally, laser treatment, a procedure known as an iridotomy or iridectomy (laser procedure) or surgery is required as well.
Symptoms of ocular-motor dysfunction include losing place while reading, leaving out letters and words when reading or writing and even word reversal. Sometimes poor readers and learners are diagnosed with attention problems when in fact they have an oculomotor dysfunction. OM Dysfunction can cause headaches, blurred vision, double vision, dizziness and eye fatigue. Neurological conditions such as stroke can also affect eye movement skills.
Treatment includes visual therapy techniques to help control the eye movements.
Presbyopia is a result of the loss of elasticity of the natural lens of the eye. The natural lens hardens over time, causing the muscles that focus the lens not to be able to change it’s shape for near vision more and more as we age. Wearing eyeglasses to correct the condition does not weaken the eye; it is necessary to maintain comfortable clear vision as a mature adult.
Presbyopia can be corrected with bifocals eyeglass lenses, multifocal eyeglass lenses, progressive eyeglass lenses and contact lenses. There are some surgeries that claim to offer relief from presbyopia but at this writing the only surgery that might help significantly is monovision treatment (one eye “set” by the laser for near and one eye for far) with LASIK or PRK.
Primary open angle glaucoma (POAG) is the most common form of glaucoma. The eye can be thought of like a sink, with a drain and a faucet. The eyes “faucet” (ciliary body) creates water based fluid that fills up the eye and a structure known as the “angle” is the drain. If too much fluid is entering the eye or not enough leaving through the drain, the pressure in the eye can increase leading to one type of primary open angle glaucoma. Primary open angle glaucoma is a slowly progressive disease that must be diagnosed and treated early to avoid irreversible loss of vision. Treatment usually includes eye drops in the early stages, but can progress to require laser treatment and possible other surgeries. . Glaucoma is a silently blinding eye disease and people often report excellent vision close to end stage. For this reason, and because other eye diseases have a slow and insidious onset as well, regular eye exams are recommended to rule out silently blinding eye conditions like glaucoma so effective, preventive care can be administered by your eye doctor.
Subconj hemes may be brought on by coughing, sneezing or lifting something heavy. It can also be caused by getting poked in the eye. High blood pressure and blood thinner-medications can contribute to the condition.
There is no specific treatment for this condition, but some people advocate cold compresses on the eyes. Aspirin can exacerbate the situation. It may take one to two weeks to completely clear. During this time the hemorrhage may spread and may change color from red, to brown, to yellow.
Treatment may include glasses, prism lenses, eye muscle exercises (vision therapy), steroids or surgery.
Treatment of this condition may include special prismatic eyeglass lenses, eye muscle exercises (vision therapy), and in rare cases, surgery.
These “strands” or floaters as they are commonly called tend to come and go or increase with time. They may be easier viewed against a clear field like the sky or a wall painted one color. Floaters that have been present over a long period of time, or have increased very gradually, are generally harmless. However, new floaters, a sudden increase in the number of floaters, and/or, flashes of light which occur should be examined immediately by an eye doctor to rule out complications of the retina that can lead to a retinal tear or detachment.