|Dr. Edward Jaoude, M.D.
What is the most important care that parents can provide for their toddlers’ vision? The most critical issue with toddlers is their inability to communicate vision problems. Parents and pediatricians play an important role in identifying issues before they exacerbate. Observant parents will notice that their toddler prefers to watch television from a distance or to play with a smartphone or tablet close to the face. These habits indicate early signs of vision trouble. If your child crosses his or her eyes when tired or trying to read up close, this is also a sign of poor vision in one or both eyes. Observing photographs of your child with uneven red reflexes coming from his or her eyes can indicate possible cataracts, tumors, or crossing of the eyes.
The recommendation of the American Academy of Ophthalmology is that children should have an assessment for eye problems in the newborn period and then at all subsequent routine health visits. The elements of the assessment will vary with the age of the child. By ages 3 to 3 1/2, the child will generally cooperate enough for a fairly accurate assessment of visual acuity and ocular alignment. A pediatrician or other medical practitioner should provide the assessment. Any abnormality or the inability to test is cause for referral to an ophthalmologist.
What vision-related issues do teens and young adults face? School and college-campus environments are where students can become susceptible to a number of vision and eye issues, such as injury, infection and increased nearsightedness. The six tips below from the American Academy of Ophthalmology will help students protect their vision and eyes through college.
1. Go outside. Scholastically inclined students spend much of their time studying indoors, which puts them at risk of becoming nearsighted or myopic. Studies are revealing that the natural light of the outdoor environment, along with the greater viewing distances, is beneficial in helping to stem myopia progression.
2. Avoid showering and swimming with contact lenses. Acanthamoeba is a parasite that lives in water and can cause a rare but serious eye infection. According to the Centers for Disease Control and Prevention, 85 percent of cases occur in contact-lens wearers, with one of the main risks being exposure of lenses to water. Do not wear contact lenses in showers or hot tubs, or when swimming in lakes or pools.
3. Wash your hands. Conjunctivitis, also known as pink eye, spreads easily and quickly in communal environments like daycare, schools and college dormitories. Pink eye makes the whites of your eyes turn red or pink, causing tearing and itching. The infection is often spread from eye to hand to eye, so good hand washing with soap will help to prevent or spread the infection. It is also good practice to avoid sharing facecloths, towels and cosmetics.
4. Give your eyes a break. To help avoid eyestrain, follow the 20-20-20 rule: Look at something 20 feet away every 20 minutes for 20 seconds. Also, blink regularly—dry eyes can become painful. Giving your eyes a needed break by blinking will keep them moist and lubricated.
5. Don’t share makeup. As harmless as it may seem, sharing makeup is a surefire way to spread infection. Infection-causing bacteria grows easily in creamy or liquid eye makeup. Stick to your own makeup, and throw it away after three months. If you develop an eye infection, immediately toss all of your eye makeup.
6. Protect your eyes during the game. Common injuries—such as scratches on the eye surface and broken bones near the eye socket—happen most often during high-risk sports like baseball, basketball and lacrosse. Athletes should consider wearing polycarbonate sports glasses to help keep stray balls and elbows from hitting their eyes.
Why do I suddenly need glasses to see in my 40s? The eye works like a camera. Both the cornea and the lens work like a focusing system, and the retina works like film in a camera. When you are young, the lens in your eye is soft and flexible, changing shape easily to allow you to focus on objects that are both close-up and far away. After age 40, the lens becomes more rigid and unable to take shape as easily, making it more difficult to focus at close range. This normal aging condition is called presbyopia.
Like a camera, when the eyes cannot focus on objects close-up, we put lenses in front of them to help the eyes focus. People who never needed glasses begin to require reading glasses to focus when reading written words on paper and screens. Nearly everyone develops presbyopia. However, if a person also has myopia (nearsightedness), hyperopia (farsightedness) or astigmatism (a problem with how the eye focuses light), the conditions will combine, requiring the use of bifocals or progressive multifocal glasses.
What changes in my eyesight may I face after age 55? As you advance in age, there may be difficulty with eye glare or distinguishing some colors. These changes are a normal part of aging and will not stop someone from enjoying an active lifestyle or maintaining independence. However, after age 55, you are at a higher risk of developing age-related eye diseases and conditions that can affect different parts of the eye. If not detected early and treated, they can lead to vision loss and even blindness. Below are some of the more common conditions.
Dry eye syndrome (DES): Sometimes you do not produce the right quality of tears to keep your eyes healthy and comfortable. This condition is known as DES and is more prevalent as we age. The hormonal changes associated with menopause are one of the main reasons why women are most often affected by dry eye. A wide variety of common medications, both prescription and over-the-counter, can cause dry eye by reducing tear secretion. Exposure to a dry, windy climate, as well as smoke and air conditioning, can exacerbate DES.
Other conditions that predispose a person to DES include: autoimmune diseases (lupus and rheumatoid arthritis), diseases that can affect corneal sensation (diabetes, herpes zoster and herpes simplex), long-term contact-lens wear, and surgery that involves making incisions in or removing tissue from the cornea (LASIK).
Age-related macular degeneration (AMD): AMD is a common eye disease among people age 60 and older. It gradually destroys the macula, the part of the eye that provides the sharp, central vision needed for seeing objects clearly. AMD comes in two forms: dry and wet. Each form requires different techniques used by eye-care professionals to treat the condition.
Cataract: Cataract is a clouding of the eye’s lens and is common in older adults and people with diabetes. Vision loss by cataract can be successfully restored with surgery. Although cataract surgery is one of the most common procedures performed in the United States today, some people may never need it, and others are able to postpone it for years. Your eye-care professional will be able to guide you.
Diabetic retinopathy: Diabetic retinopathy is the most common condition among people with diabetes. It damages the blood vessels in the retina, usually in both eyes. If you have early-stage retinopathy, your eye doctor may suggest controlling your blood sugar, blood pressure and cholesterol to prevent the disease from getting worse. For the more advanced stage, laser surgery may be recommended.
Glaucoma: Glaucoma is not just one disease, but a group of diseases, all caused by fluid building in the eye, which leads to an increase in the pressure inside the eye, which can damage the optic nerve. Your eye doctor can help control glaucoma by prescribing eye drops or medication. Laser surgery is another way to open clogged areas, so that the eye fluid drains, easing the pressure against the optic nerve. When drops and laser surgery fail to control the pressure, surgery is the final option.
Delaware Eye Clinics
Dr. Edward Jaoude, M.D.
28322 Lewes-Georgetown Highway, Milton, DE