Vision Problems and Eye Health

How Do the Eyes Work?

To understand how the eyes work, it's helpful to compare the eyes to a camera. Cameras use a lens and film to produce an image, and in a way, so do the eyes.

Light comes in through the cornea, a clear tissue that covers the front of your eye. The pupil is the dark spot in the middle of your eye. It works like a camera shutter, controlling the amount of light that enters our eyes. When it's dark, the pupil dilates, or widens. When it's bright, the pupil gets smaller. Surrounding the pupil is the iris. This is the colored ring of muscle fibers that help the pupil change size.

When you look at an object, light rays enter your eyes. These light rays are bent and focused by the cornea, lens, and vitreous. The vitreous is a clear jelly-like fluid that fills the inside of your eye. The lens' job is to make sure the rays come to a sharp focus on the retina at the back of the eye. Think of the retina as the film in the camera. It's lined with light-sensitive cells, called photoreceptors, that capture, upside-down, the images in our visual field. The sensitive macula, critical for sharp focus, is the most active part of the retina. A healthy macula helps us read small print and see the images in our direct line of vision. When light rays reach the retina, they're converted into electrical pulses that travel through the optic nerve to your brain. It is there that the image gets flipped right-side up.

Vision Screening Guidelines

Guidelines for Adults

• At least one test between ages 20 and 29 and at least two between ages 30 and 39
• Vision tests every two to four years between ages 40 and 65 and every one to two years after age 65.

Guidelines for Children

• Children five years and younger should have their eyes checked each time they see their pediatrician. Teens should be examined once a year.

If you are experiencing any vision problems, it's a good idea to get checked more often.

Protecting the Eyes & Vision

While we can't control the risk factors that make us more vulnerable to vision problems, it's important to exercise caution:

• Know your family's medical history;
• Protect your eyes with sunglasses that absorb 100 percent of damaging ultra violet rays;
• Stay away from cigarettes which contain chemicals that can damage the eyes; and
• Eat a healthful diet.

Types of Vision Problems

It's normal for our vision to deteriorate as we age. Here are some very common vision problems that can usually be corrected with glasses or contacts:

• Farsightedness. This occurs when you can see well at a distance, but not close up.
• Nearsightedness. This is also called myopia. It occurs when you can see well close up, but not at a distance.

There are some vision problems that are much more serious and can even lead to blindness.

If you have a family history of eye disease, you'll have a higher risk of developing vision problems. You may also have other risk factors like previous eye injury, premature birth, diseases that affect the whole body, like diabetes, high blood pressure, heart disease, or AIDS. The only way for you to know for sure if you have serious eye problem is by having an eye exam given by an Optometrist (O.D.) or an Ophthalmologist (M.D.).

• Glaucoma. This occurs when the pressure of the fluid inside your eyes damages the fibers in your optic nerve, and causes vision loss. If left untreated, you can lose your eyesight altogether.
• Cataracts. A cataract means a 'clouding' of all or part of the normally clear lens within your eye, which results in blurred or distorted vision.
• Conjunctivis. This is commonly known as Pink Eye. It is caused by an inflammation of the conjunctiva. This is the thin, transparent layer that lines the inner eyelid and covers the white part of the eye. The inflammation is usually caused by a virus, and will resolve without any treatment. But, sometimes pink eye is caused by a bacterial infection and will require antibiotics.
• Eye Floaters. These may look like small dots or lines moving through your field of vision. They're actually tiny clumps of gel or cells inside the vitreous fluid in the eye. They may be a sign of retinal detachment and you should call your doctor right away.
• Macular Degeneration. This results from changes to the macula portion of the retina. The macula is responsible for clear, sharp vision. This condition can cause a blind spot in the middle of your sight line.
• Retinal Tears and Detachment. These affect the thin layer of blood vessels that supplies oxygen and nutrients to your retina. Initial symptoms are eye floaters. This condition must be treated immediately. If it isn't, it can lead to permanent vision loss.

Early detection is key to fixing problems with your sight. Don't take your eyes for granted. Get them checked regularly, and tell your doctor if you notice anything unusual.

Sources

Age Related Macular Degeneration. Bethesda, MD.: National Institute of Health, 2009. (Accessed October 18, 2009 at http://www.nei.nih.gov/health/maculardegen/index.asp.)

Vision Not Improved By Surgery for Complications of Age Related Macular Degeneration. Bethesda, MD.: National Institute of Health, 2008. (Accessed October 18, 2009 athttp://www.nei.nih.gov/news/statements/surgery_amd.asp.)

Vision Problems. Atlanta, GA.: A.D.A.M., 2008. (Accessed October 18, 2009 athttp://www.nlm.nih.gov/medlineplus/ency/article/003029.htm.)

HealthiNation offers health information for educational purposes only; this information is not meant as medical advice. Always consult your doctor about your specific health condition.

Reviewed by: Dr. Supriya Jain, Dr. Preeti Parikh and Dr. Holly Atkinson

Last Review Date: 08/29/2012

Host Reviewer: Dr. Roshini Raj

Author: Ms. Audra Epstein

Copyright © 2013-2014 HealthiNation, Inc. All rights reserved.

DemandForce is alive and well at SkyVision! Thank You to our patients for our 5 Star reviews!

"What does that mean, you ask?  As you know, the global online community becomes more robust with each passing day. It’s hard to imagine life without cell phones and computers because communicating has become so easy, efficient, and effective."    source:   DemandForce Dish Newsletter, August 2012. 

SkyVision  adopted the new online system about one year ago to help improve the quality and timeliness of communication to its patients.   The staff and patients have responded to it very well.   On a daily basis Demandforce notifies patients of upcoming appointments and patients can confirm via their cell phone or computer.  After a patient visits they also receive a thank you for visiting and are asked to complete an online review if they wish.   In addition, they can also submit a survey where their opinions are polled.

Our patients have responded with such enthusiasm to this that we have received well over 450 reviews in less than a year.  In addition, we have received over 475 surveys.   For our reviews, we have achieved the highest overall rating of 5 Star  ***** over the long haul.   We have received many comments, opinions, suggestions, etc through the surveys.    We appreciate the patients taking the time to respond to either the surveys and reviews and they can be done anonymously or with their names.    

SkyVision not only is at the top of its class in its practice of the very best eye care by highly experienced doctors and staff, it is also committed to the advancement of communication with the patient and by keeping pace with the latest in current trends and lifestyles.

Find out more about SkyVision by liking our Facebook page and Click on the link here:

SkyVision Facebook Page

When Blindness Comes Too Soon - A Story About Macular Degeneration

When Blindness Comes Too Soon

When 24-year-old Amy Bower sat down for a routine eye exam, she never expected that her blurry vision was actually the onset of a disease that would leave her legally blind.

A graduate student at the University of Rhode Island, Bower feared she may be forced to abandon her dreams and the exciting oceanographic career she loved.

Now, more than 20 years later, Bower is an oceanographer at the Woods Hole Oceanographic Institute in Massachusetts -- and a poster child for vision rehabilitation.

"When I first heard that I had macular degeneration, I thought, 'What's that?'" she said. "I had never heard of anyone with this disease.

"When I heard that my vision was going to continue to degenerate with no real prediction of how far, I was pretty scared... and quite sad."

Age-related macular degeneration or AMD is among the leading causes of blindness in the United States, and the number one cause of blindness among Caucasians. About 1.8 million Americans suffer from AMD, and another 7 million are at a significant risk of developing the disease, according to the National Eye Institute at the National Institutes of Health.

Amy Bower and the Woods Hole Oceanographic Institute

Oceanographer Amy Bower began losing her vision in her teens -- but she has not let her impending blindness ruin her career goals.

"The disease slowly destroys the central portion of a person's vision, affecting their ability to read, drive and recognize faces," explained Dr. Gerald Friedman, a Boston low vision specialist who treated Bower when she was first diagnosed.

What sets Bower apart is that she has the rarer juvenile form of the disease, which strikes earlier than most. Currently, there are no approved drugs or therapies that can help her.

The signs were there. Bower had suffered blurry vision since her teens. But shortly after the official diagnosis in her early twenties, her vision took a very rapid turn for the worse.

"Before I knew it, I couldn't read the text in a paperback book," Bower said. "Then, within two years, even by adjusting the text on a computer screen, I couldn't read the words on the computer."

That's when she turned to Friedman, one of the few specialists in the country who focus solely on low vision rehabilitation.

Working Through Macular Degeneration

"Most people who are legally blind have some degree of vision left, so my job is to find where that vision is and design a method to use it," Friedman said.

In Amy's case, she also suffered from a condition called retinitis pigmentosa, which degrades the peripheral vision, leaving her with just a thin ring of usable vision.

"Most people define successful rehabilitation as being able to read their favorite book, or recognize their family members," Friedman said. "But Amy's particular needs were a huge challenge because she was going to be on board research vessels and using all kinds of equipment -- so we threw everything we had at her in terms of technology and she just absorbed it."

Today, Bower travels the world, leading scientific missions on sea currents -- and she does it all by using adaptive equipment and other resources.

Large video magnifiers allow Bower to read data printouts and graphics mapping deep sea temperatures. Meanwhile, powerful computer voice and magnification software allow her to use the computer just as well, if not better than most fully sighted people.

"If it weren't for these powerful programs, I wouldn't be able to do my job."Bower is currently looking forward to new adaptive technologies that would make data readouts more tactile, possibly eliminating the need for video magnifiers. She is also hopeful about new retinal transplant studies, for which the first clinical human trials are currently underway in Europe.

"The stem cell trials are the most promising hope for a treatment," said Dr. Marc Gannon, director of the Low Vision Institute in Fort Lauderdale, Fla. "Not only might we be able to repair vision that's already been lost, but this research could help identify the genetics that cause the early or juvenile forms of the disease, helping us to stop the vision loss before it even begins."For now, Bower, who is also a married mother of one, said support from her family and her employers at the institute, who helped purchase most of her equipment, has been key.

"For anyone who finds themselves in the situation I was in 25 years ago, they need to learn to become a very strong self-advocate," Bower said. "And hopefully, you want to pursue something that you're passionate about, because you're going to need the energy that comes from such a passion to push through the challenges."

By JAMIE BLANCO
ABC News Medical Unit

Oct. 19, 2009

Macular Degeneration and the iPad

Consumer electronics are making inroads into eyecare! Patients with Macular Degeneration (AMD) now have the option of using electronic devices like the iPad from Apple to assist them in using the vision that they still have, and also to help monitor the progress of their disease.

Traditionally individuals with vision loss have had to use specialty visual aids in order to improve their vision. Magnifiers and CCTV's have been a godsend for folks who have trouble reading because of AMD. Many of these devices are difficult to use or very expensive. About 3 years ago the doctors at Skyvision Centers in Westlake, just outside of Cleveland, started to experiment with electronic reading devices like the Kindle, the Sony Reader, the Nook, and then the iPad. All four have the ability to magnify reading material, and nowadays you have access to not only books but also magazines and newspapers on all of them.

The iPad 2 from Apple is now equipped with a camera. Programs called "apps" are coming out which should allow you to scan a written page or picture and then magnify it automatically on the iPad screen. In upcoming posts we will do reviews of these apps as well as offer some tips on their use.

The SightBook app is a tool that allows patients to evaluate their vision at home and share that information with their eye doctor. A series of up close vision tests is taken by a patient using an iPad connected to the internet. Any changes will then be sent to the eye doctor. This is a free app available through the iTunes store. We'll check it out and report back soon!

Patient Education Comes in Many Forms at Skyvision

We are committed to our patients here at Skyvision and part of that committment includes their education.   Education here at Skyvision comes in many forms.   In could be through face to face communication with one or more of our experienced staff members, or it could be through some take home literature we feel will help give you more information or help you share with a family member.   Another way we communicate is through the use of educational videos.  

Skyvision also uses videos in several ways. We show videos to our patients in our exam rooms through the use of LUMA by Eyemaginations. We also send home videos by Eyemaginations via email so patients and family members can view them together in the comfort of their own home.  This type of visual education has proven extremely effective.

Let's take a disease such as Macular Degeneration. If a patient needs to be started on supplements or see our retina specialist, it is much easier for the patient to understand after viewing the animation that explains the disease process. This creates a big “wow” factor for patients because it shows that we are technologically savvy while at the same time making it easier for them to understand their disease.

Our very own Dr. Darrell White has made many, many educational videos in a casual and entertaining setting titled The Doctor Whiteboard. His very latest videos "just out" from The Doctor Whiteboard are a series of 6 videos about Macular Degeneration. The Doctor Whiteboard videos are frequently posted to Skyvision Centers on facebook or are available on SkyvisionCenters105 - YouTube .

We are always striving to provide our patients with the latest information regarding their eye conditions or interests in a variety of ways!

Omega 3 Fatty Acids

Are you getting yours? Omega-3 fatty acids, that is. It turns out that almost everyone doesn't get enough of these essential fatty acids in their diet.

Omega-3 fatty acids can be obtained most easily through dietary supplements. Fish oil capsule and Flax Seed oil capsules are probably the most accessible options. Omega-3 fatty acids can help to prevent heart disease and stroke, especially in men. They have been shown to decrease joint and muscle pain in people who suffer from diseases like Fibromyalgia.

In the eye world Omega-3 fatty acids are important in the care of Dry Eye of all kinds, especially EVAPORATIVE Dry Eye caused by problems with the glands in your eyelids that produce the oil in your tears. Also, there is lots of research that suggests that increasing the amount of Omega-3 fatty acids you take in can reduce the severity of Macular Degeneration. Taking Fish Oil, Flax Seed Oil, or a specialty formulation like Doctor's Advantage products can do the trick!

Does it matter what kind you take? What brand or what form of Omega-3 fatty acids you use? Of course it does! Purity of the Omega-3 sources is important, and some forms simply work better than others. The Skyvision Centers doctors have done their homework and we offer the Doctor's Advantage forms of nutritional supplements right here in the office.  You can also opt to have your Omega-3's delivered right to your home!

There are some healthy things that are pretty easy, like making sure you are getting Omega-3 fatty acids every day!

5 Reasons Never to Leave Home Without Your Sunglasses

This is an article found in the recent Oprah magazine.   Enjoy . . . .

By Emma Haak.

Looking cool is just one of many excellent reasons to wear sunglasses.


You slather on SPF 50 to shield your skin from the sun. But what about your naked eyes? In a 2012 survey, less than half of 10,000 Americans polled recognized the health benefits of sunglasses, and 27 percent of respondents reported never wearing them. Yet this simple and stylish accessory* can protect your eyes from a host of conditions caused by ultraviolet rays:

1. Skin Cancer

Up to 10 percent of all skin cancers are found on the eyelid.

2. Cataracts

The World Health Organization reports that, worldwide, approximately 900,000 people are blind because of cataracts—cloudiness in the lens of the eye—triggered by UV exposure.

3. Macular Degeneration

Over time UV light may play a role in damaging the macula lutea (an area of the eye with millions of light-sensing cells, which allow us to see fine details clearly), potentially leading to blurriness and vision loss.

4. Pterygium

This abnormal growth of tissue—also called surfer's eye—may progress slowly from either corner across the white part of the eye, possibly leading to inflammation or disturbance of vision.

5. Photokeratitis

Essentially a sunburn of the eye, it's temporary (healing within 48 hours) but can be painful, causing blurred vision, light sensitivity, and the sensation of having sand in your eye.

*Just not the $5 pair for sale on the corner. Those can do you more harm than good. Our pupils dilate behind dark lenses, meaning cheap shades will actually let more damaging rays into your eyes than if you weren't wearing any sunglasses at all. Shop for a pair that's designed to block 99 to 100 percent of UVA and UVB light.



Read more: http://www.oprah.com/health/Reasons-to-Wear-Sunglasses-Health-Benefits-of-Sunglasses#ixzz216CgDhM0

Vitamins For Macular Degeneration: FAQ

Here are our answers to some of the Frequently Asked Questions about vitamins and Macular Degeneration (AMD):

1) Do I HAVE to take special vitamins?

Of course not! However, taking high doses of anti-oxidant vitamins per the AREDS1 and 2 studies is thus far the only known way to prevent progression and vision loss from AMD

2) If I don't take the vitamins will I go blind?

There is no way to know if any one individual person will lose vision from AMD. Everyone is different, and we can only tell you what the odds are from the research available.

3) If I take the vitamins am I guaranteed to not lose my vision?

Unfortunately the same answer applies here: we can only say that taking the antioxidant vitamins in the AREDS doses will reduce the number of people who lose vision, and the amount of vision lost, when we look at a large group of people.

4) Are there side effects from the vitamins?

Some people have some stomach issues from taking any vitamins, and AMD vitamins are no different. In addition, the pills are rather big, and if you have trouble swallowing pills you may have trouble taking the AMD vitamins.

5) Who SHOULDN'T take AMD vitamins?

Smokers should not take high dosed of beta-carotene, the vitamin A form used in the AREDS vitamins.

6) Any other risks from taking these vitamins?

There are conflicting studies with results that don't agree about the risk of reduced bone density from taking high doses of beta-carotene. You should check with your family doctor if this is a concern.

7) What brand names should I look for?

This is one of the hard questions to answer because there are quite a few name brands, and within those brands there are some confusing choices. In general, if you plan to buy your vitamins at a store, "Preservision", "ICaps", and IVites" are good choices. SkyVision docs have chosen to provide Doctor's Advantage vitamins here in the office.  Look for info regarding these vitamins in upcoming blogs. 
8) What if I am taking a multivitamin? Should/can I keep taking it?

Another very hard question to answer because we are fans of multivitamins for people of all ages. You need to be careful not to over-do the anti-oxidants with AREDS vitamins + multivitamins. The math (adding up the doses and dividing between vitamins) can be complex, too complex for any doctor's office to do for you with store-bought vitamins. (Again, look for the upcoming post about vitamins from Skyvision). Aim for a total of the AREDS doses of Vitamin C, E, beta-carotene, Zinc and Copper between all your vitamins.

We hope that's helpful!

Comics Day At Skyvision

We are always amazed at how many jokes and puns come up every day in the office. While macular degeneration is nothing to joke about, the term is often mispronounced in very funny ways. Our favorite here at Skyvision used to be"Immaculate Degeneration"! Now, thanks to "Crankshaft", we have a new one.

More Stem Cell News

From the Wall Street Journal Health Blog:

"Very early results from research into embryonic stem cell treatments suggest that the therapy was safe in use against macular degeneration, a major cause of blindness. The findings, though preliminary, are the first published results involving embryonic stem cells in human patients.

In the report, which covered two patients followed over four months, the patients reported some visual improvement that may — or may not  — spring from the treatment. But much more research needs to be done before the therapy can be deemed a success.

Writing in the Lancet, researchers from biotech firm Advanced Cell Technology and the University of California, Los Angeles reported turning human embryonic stem cells into the key cells lost in macular degeneration, known as retinal pigment epithelial cells. Two legally blind patients then had these cells surgically implanted into one eye.

The patients — one with dry age-related macular degeneration and one with a related condition called Stargardt’s macular dystrophy — showed no signs of the safety problems that have been a concern about embryonic-stem-cell-derived therapies. “There were no tumors, and there was no immune rejection” after patients were tapered off of immunosuppressive drugs, said Steven Schwartz, an author of the study and chief of the retina division at UCLA’s Jules Stein Eye Institute.

The patients also reported visual changes that “could be a sign of improvement,” said Dr. Schwartz. For instance, the Stargardt’s patient, in her 50s, went from discerning only hand motions to being able to count fingers. She also reported improved color vision.

But Dr. Schwartz cautioned that the improved vision reported by the patients might be chalked up to the placebo effect, the surgery, the immunosuppressive drugs or “all of the above,” he said. “Objectively, there is no consensus in how to measure vision in low-vision patients,” he said.

The clinical trials studying the drugs in the two different forms of macular degeneration will eventually include 24 patients at different centers, followed intensively for a year and then tracked for years afterwards, said Robert Lanza, an author of the study and chief scientific officer at Advanced Cell Technology, which is developing the therapy and funded the research. He said if studies in these patients with advanced disease pan out, eventually the aim is to target patients at much earlier stages of macular degeneration."

Macular Degeneration is one of the most active areas of research in all of eye care. There are 65 Million Americans in the Baby Boomer generation who are now starting to turn 65 years old. Other research has shown that up to 9.5% of all individuals over 65 may develop Macular Degeneration, almost 6.5 Million people! We will continue to be on top of research at Skyvision Centers so that we can continue to bring you the very latest, cutting edge treatments. 

How Often Should My Eyes Be Examined?

OK...you've graduated from school and now you are an adult. Congratulations! When, and how often, should you have your eyes examined? Well, if you are healthy and you don't need any glasses at all, you can probably be seen every 3 or 4 years until you reach 40 or so. After that once every 2 years is reasonable. At the age of 60 the Skyvision doctors think everyone should have a complete eye exam every year.

If you wear glasses to see near, far, or both it's best to be seen every two years until the age of 60, and then every year after that. For people who wear contact lenses, EVERYONE needs to be seen at least once per year. Contact lenses sometimes have "silent" problems, and the only way to know if you are safe to continue wearing them is by seeing your Skyvision Centers doctor every year.

There are some special rules for  people with specific eye or medical problems. For example, if you have diabetes you need to have a complete, dilated eye exam at least once per year. We will send a note to your treating doctor with the results. Other medical problems or treaments like the use of Plaquenil or treating Hepatitis C have special requirements. Of course, if you have an eye disease like Glaucoma or Macular Degeneration you should follow your doctor's recommedations regarding follow-up exams.

Remember to keep your eyes safe! Don'f forget your eye exams!!