Myopia (Nearsightedness)

A condition where light from a distant object is focused at a point in front of the retina rather than at the retina. This occurs because the refractive power of the eye is too strong or the length of the eyeball is too long. The main symptom is blurry vision in the distance. Forms of treatment include glasses, contact lenses or possible refractive surgery.

Hyperopia (Farsightedness)

A condition where light rays are focused at a point behind the retina. This occurs because the refractive power of the cornea is too weak or the eyeball length is too short. The main symptom is generally blurry vision of near objects. Forms of treatment include glasses or contact lenses.

Presbyopia

This is a condition where loss of accommodation of the crystalline lens occurs with age. The average age of onset is in the early 40s and continues through to early 60s. This occurs due to the lens is losing elasticity or possible reduced ciliary muscle effectivity. Treatment includes glasses for reading or bifocals or progressives.

Astigmatism

Occurs when light rays are unequally focused producing 2 lines rather than a single point because of the curvature of the cornea or the curvature of the lens varies in different meridians. The main symptom is blurry/distorted vision. The vision appears to be out of focus. Can also cause headaches if uncorrected. In other words, the eye is more oval ‘football’ in shape rather than a perfect circle. Treatment is either glasses or contact lenses with a cylinder component to the prescription.

Amblyopia (Lazy eye)

Unilateral or bilateral loss of best corrected vision in an anatomically normal eye. This condition causes decreased vision that is not corrected by glasses and not due to eye disease. Results from reduced visual input or abnormal binocularity during visual development (generally between ages 6-8 years). The main goal of treatment is to improve vision by removing any obstacle to visual input and forcing the use of the amblyopic eye. Forms of treatment may include glasses, patching or vision therapy.

Strabismus

Failure of the two eyes to maintain proper alignment and work together as a team. Develops in a child when the visual input of a deviated eye is inhibited in order to prevent diplopia and visual confusion. The main symptom is blurry vision out of one eye or double vision. One or both eyes may be turned in or out. Long term cases may develop suppression. Can also develop in adults secondary to systemic disease.

Glaucoma

A progressive condition affecting the optic nerve head caused by increased intraocular pressure in most cases that causes visual field loss if caught later on. This is a condition that if goes untreated can lead to blindness. Any damage done to the optic nerve head is irreversible and permanent. The Risk of developing glaucoma increases with age and is a genetic condition. Multiple testing is recommended for close monitoring of progression. Inconsistently associated risk factors: myopia, cardiovascular disease, diabetes and hypertension. Patients are generally asymptomatic, but may have decreased vision or constricted visual field in late/advanced stages. Routine eye exams are recommended along with visual field testing, retinal imaging, OCT or HRT. In terms of management, the goal is to decrease the intraocular pressure to slow down/stop progression of optic nerve head damage and prevent blindness. Forms of treatment include observation, anti-glaucoma eye drops, laser treatment (ALT/SLT) or surgery.

Age-related macular degeneration (AMD)

A condition that causes the center of your vision to become blurry. The central most part of the retina (back) of the eye is called the macula. This spot is responsible for detailed central vision and is where macular degeneration takes place. This condition is the leading cause of blindness in North America in adults over the age of 55. Risk factors increase with age, genetics, smoking, and female gender. There are two forms of AMD: dry form and wet form. Someone with AMD may have normal or decreased vision, abnormal amsler grid results and may complain of seeing wavy or distorted vision. Routine comprehensive eye exams are recommended along with retinal imaging. OCT (optical coherence tomography) testing may be required depending on the appearance of the macula. This helps to confirm the diagnosis and to monitor macular changes. The best form of treatment is to follow the patient with amsler grid. The patient can also monitor their own vision with the an amsler grid at home. Any damage done to macula is permanent. There is no treatment available for dry form of AMD. However, your optometric physician may recommend ocular vitamins/supplements to maintain macula health and delay progression. Wet form of AMD requires injection (anti-VEGF) depending on severity or laser treatment.

Retinal Detachment

A condition where the layers of the back of the eye (retina) separate which can cause sudden vision loss. Appears like a curtain or spider web over the vision, along with possible flashes of light or many black spots (floaters) in your vision. If the vision is unaffected then the prognosis is relatively good. Generally, depends on how long the retina has been detached. A referral to a retinal specialist must be done as soon as possible for laser treatment where they reattach the retina. Annual eye exams are highly recommended in people with high myopia and diabetes as they are at a higher risk for a retinal detachment. If any of the above symptoms are ever experienced, please see your eye care professional as soon as possible or go to your nearest emergency center.

Cataracts

Age related lens changes where clouding of the lens occurs which eventually leads to decreased vision. Generally, occurs slowly with age. Cataracts are the leading cause of blindness worldwide. This condition is a painless, progressive loss of vision, causing decreased contrast and colour sensitivity (faded colours), glare, starbursts, and halo pattern. A main complaint people with cataracts have is difficulty with bright lights and decreased vision at nighttime. If vision is reduced enough or patient symptomatic then surgical removal of the crystalline lends is recommended and replaced with an intraocular lens (IOL). Wearing sunglasses with polarized lenses to decrease transmission of harmful UV sun rays is important to slow down or prevent progression of cataracts.

Diabetic retinopathy

Diabetes can affect the retina due to elevated sugar levels in your blood causing the blood vessels in the eye to swell and leak in the retina. Usually starts with bleeding then can become severe enough that leads to macular edema (swelling) that causes decreased vision. Diabetic retinopathy is the most common cause of vision loss in people diagnosed with diabetes. This condition is the leading cause of blindness among the working age population between 20-64. The longer you have diabetes and the less controlled your sugar is, the more likely you are to develop diabetic retinopathy. Generally, there are no symptoms in the early stages of diabetic retinopathy. Symptoms arise when the condition progresses which include: floaters, blurred vision, fluctuation in vision, colour vision changes, vision loss, and parts of vision missing. Once diagnosed with diabetes, annual comprehensive eye exams are highly recommended. Depending on the stage of retinopathy, treatment can vary. If mild, being monitored by your eye care professional every 3-6 months is sufficient.

Certain tests such as retinal imaging, OCT, a dilated fundus exam should be completed. If the diabetic retinopathy is more severe, your optometrist may refer you to a retinal specialist for treatment which may be an injection or laser. Diabetic retinopathy is a progressive condition that if left unmonitored can cause blindness over time due severe vision loss from bleeding/swelling in the macula. Controlling diabetes by taking your prescribed medications daily, maintaining a healthy diet, exercising daily and routinely following up with your family physician/optometrist can prevent/delay vision loss.

Blepharitis

Inflammation of the eyelid margin that appears as flakes or crusting at the base of the eye lashes. Patients are often asymptomatic but may report vision that clears after blinking, burning, itching, foreign body sensation (feels like something is inside the eye), tearing, crusting (especially in the morning), and mild discharge. Commonly occurs when tiny oily glands located near the base of the eyelashes become clogged. This leads to irritation and red eyes. Blepharitis is a chronic condition that’s difficult to treat, however, is not a contagious condition. Lid hygiene is extremely important when managing this condition. Warm compress and lid wipes are highly recommended daily. This condition is also commonly associated with dry eyes. If the stage of blepharitis is advanced, a procedure called blephex which removes the flakes bound at the base of the lashes may be required. This procedure may be required every 3-6 months depending on the severity of the condition.

Conjunctivitis (Pink eye)

An infections or non-infectious swelling of the conjunctiva (transparent tissue that covers the white part of the eye). A viral or bacterial infection can cause conjunctivitis. Common condition especially in children that can affect one or both eyes. Must be careful with this condition as some forms can be highly contagious and spread easily. Common symptoms include sandy, gritty feeling, itching, burning, tearing, discharge, swollen lids, white part of the eyes appear pinkish, and light sensitivity. Treatment depends on cause of the conjunctivitis which is either allergic, bacterial, or viral. Proper cleaning/hygiene is important to prevent spread. Artificial tears and cool compresses are recommended and used for treatment for viral and allergic forms of conjunctivitis. For more severe forms of allergic an anti-inflammatory eye drops may be prescribed. For bacterial conjunctivitis an antibiotic is prescribed for treatment. The most important things to do to prevent spread is to wash your hands, use clean hand and face towels, discard eye cosmetics, and try to not touch eyes with your hands.

Floaters

Specks or squiggles (small semi-transparent) that appear in your field of vision. They are small particles within the gel of your eye (vitreous) that are noticeable when they move into your line of slight. When you move your eyes the floaters also move. Sometimes can appear with flashes of light. Very common and can occur more frequently with older age. The gel turns into more of a liquid and you see the breakdown of the gel protein which becomes floaters. Most floaters are normal and rarely cause problems. If you notice floaters for the first time it is important to see your eye care professional right away to rule out possible conditions causing the floater, such as a retinal detachment. If you notice a sudden increase in floaters along with flashes of light and a cobweb or shadow in your vision see an optometrist right away or proceed to your nearest emergency center to rule out a retinal detachment. The optometrist will thoroughly evaluate the vitreous and back of the eye via dilation. A large floater can also occur which is generally due to a posterior vitreous detachment (PVD). A PVD is when the vitreous sac pulls away from the retina and you see a large floater in your line of sight. This can occur spontaneously or after eye surgery or physical trauma to the eye/head. A posterior vitreous detachment does not have potential of reducing vision/causing damage to the vision like a retinal detachment.

Dry eyes

A condition where your eye(s) does not produce enough tears to coat the front part of your eye(s) or due to over producing tears that does not have the proper nutrients required. Can occur due to normal aging process, hormonal changes, exposure to certain environmental agents/conditions, problems with normal blinking or from medications. Can also be caused by certain health conditions or environmental irritants or from digital screen time/UV exposure. Main symptoms include burning, sandy/gritty, scratchy, discomfort, fluctuation in vision or sensation of something in the eye. The most common complaint is tearing. A thorough case history helps to determine if a patient is suffering from dry eyes due to medications, a systemic condition (such as Sjogren’s syndrome) or prolonged computer use. If all signs and/or symptoms point to dry eye syndrome the doctor will use a special dye to analyze the tear film quality to determine the type of dry eye you have and the best form of treatment. Dry eye is a chronic condition that cannot be cured but we can improve comfort and eye health through the use of artificial tears. Your optometrist may recommend daily use of artificial tears and depending on severity may recommend preservative free solution or gel form of artificial tears. Punctal plugs may be recommended. Your eye care professional may also recommend supplements, specifically omega three fatty acids. There are also medications and eye drops that can be prescribed to help with more severe symptoms. Strict daily compliance with eye drops is very important to manage ocular symptoms. If left untreated can be harmful and lead to tissue damage impairing vision.