Your eyes are an important part of your health. Most people rely on their eyes to see and make sense of the world around them. But some eye diseases can lead to vision loss, so it is important to identify and treat eye diseases as early as possible. You should get your eyes checked as often as your health care provider recommends it, or if you have any new vision problems. And just as it is important to keep your body healthy, you also need to keep your eyes healthy.
Eye Care Tips
There are things you can do to help keep your eyes healthy and make sure you are seeing your best:
Eat a healthy, balanced diet. Your diet should include plenty or fruits and vegetables, especially deep yellow and green leafy vegetables. Eating fish high in omega-3 fatty acids, such as salmon, tuna, and halibut can also help your eyes.
Maintain a healthy weight. Being overweight or having obesity increases your risk of developing diabetes. Having diabetes puts you at higher risk of getting diabetic retinopathy or glaucoma.
Get regular exercise. Exercise may help to prevent or control diabetes, high blood pressure, and high cholesterol. These diseases can lead to some eye or vision problems. So if you exercise regularly, you can lower your risk of getting these eye and vision problems.
Wear Transition lenses.Sun exposure can damage your eyes and raise your risk of cataracts and age-related macular degeneration. Protect your eyes by using sunglasses that block out 99 to 100 percent of both UV-A and UV-B radiation.
Wear protective eye wear. To prevent eye injuries, you need eye protection when playing certain sports, working in jobs such as factory work and construction, and doing repairs or projects in your home.
Avoid smoking. Smoking increases the risk of developing age-related eye diseases such as macular degeneration and cataracts and can damage the optic nerve.
Know your family medical history. Some eye diseases are inherited, so it is important to find out whether anyone in your family has had them. This can help you determine if you are at higher risk of developing an eye disease.
Know your other risk factors. As you get older, you are at higher risk of developing age-related eye diseases and conditions. It is important to know you risk factors because you may be able to lower your risk by changing some behaviors.
If you wear contacts, take steps to prevent eye infections. Wash your hands well before you put in or take out your contact lenses. Also follow the instructions on how to properly clean them, and replace them when needed.
Give your eyes a rest. If you spend a lot of time using a computer, you can forget to blink your eyes and your eyes can get tired. To reduce eyestrain, try the 20-20-20 rule: Every 20 minutes, look away about 20 feet in front of you for 20 seconds.
Eye Tests and Exams
Everyone needs to have their eyesight tested to check for vision and eye problems. Children usually have vision screening in school or at their health care provider’s office during a checkup. Adults may also get vision screenings during their checkups. But many adults need more than a vision screening. They need a comprehensive dilated eye exam.
Getting comprehensive dilated eye exams is especially important because some eye diseases may not have warning signs. The exams are the only way to detect these diseases in their early stages, when they are easier to treat.
The exam includes several tests:
A visual field test to measure your side (peripheral) vision. A loss of peripheral vision may be a sign of glaucoma.
A visual acuity test, where you read an eye chart about 20 feet away, to check on how well you see at various distances
Tonometry, which measures your eye’s interior pressure. It helps to detect glaucoma.
Dilation, which involves getting eye drops that dilate (widen) your pupils. This allows more light to enter the eye. Your eye care provider examines your eyes using a special magnifying lens. This provides a clear view of important tissues at the back of your eye, including the retina, macula, and optic nerve.
If you have a refractive error and are going to need glasses or contacts, then you will also have a refraction test. When you have this test, you look through a device that has lenses of different strengths to help your eye care professional figure out which lenses will give you the clearest vision.
At what age you should start getting these exams and how often you need them depends on many factors. They include your age, race, and overall health. For example, if you are African American, you are at higher risk of glaucoma and you need to start getting the exams earlier. If you have diabetes, you should get an exam every year. Check with your health care provider about if and when you need these exams
Dr. Dr. Steven E.N., Eyeupdate clinic & optical supplies, 01 Ajuwon junction, beside BPNL filling station, Ajuwon, off Elliot bus stop, Iju-Ishagah, Lagos. Tel: 08107531046, 08034971582.
Eye exam/test consists of series of tests that your eye doctor will perform in order to determine your ocular status.
An eye exam involves a series of tests to evaluate your vision and check for eye diseases/vision defects. Your eye doctor may use a variety of instruments, shine bright lights directly at your eyes and request that you look through an array of lenses. Each test during an eye exam evaluates a different aspect of your vision or eye health.
Why it’s done
An eye exam helps detect eye problems at their earliest stage — when they’re most treatable. Regular eye exams give your eye care professional a chance to help you correct or adapt to vision changes and provide you with tips on caring for your eyes.
When to have an eye exam
Several factors may determine how frequently you need an eye exam, including your age, health and risk of developing eye problems. General guidelines are as follows:
Children 3 years and younger
For children under 3, your pediatrician will likely look for the most common eye problems — lazy eye, crossed eyes or misaligned eyes. If there are eye concerns or symptoms, an examination is appropriate at that time regardless of age. Your child could undergo a more comprehensive eye exam between the ages of 3 and 5.
School-age children and adolescents
Have your child’s vision checked before he or she enters first grade. If your child has no symptoms of vision problems and no family history of vision problems, have his or her vision rechecked every one to two years. Otherwise, schedule eye exams based on the advice of your eye doctor.
Adults
In general, if you are healthy and you have no symptoms of vision problems, have your eyes checked on this schedule:
Every five to 10 years in your 20s and 30s
Every two to four years from 40 to 54
Every one to three years from 55 to 64
Every one to two years after age 65
Have your eyes checked more often if you:
Wear glasses or contact lenses
Have a family history of eye disease or loss of vision
Have a chronic disease that puts you at greater risk of eye disease, such as diabetes
Take medications that have serious eye side effects
How you prepare
There are three different types of eye specialists. Which specialist you choose may be a matter of personal preference or will depend on the nature of your eye problem.
Ophthalmologists. Ophthalmologists are medical doctors who provide full eye care, such as giving you a complete eye exam, prescribing corrective lenses, diagnosing and treating complex eye diseases, and performing eye surgery.
Optometrists. Optometrists provide many of the same services as ophthalmologists, such as evaluating your vision, prescribing corrective lenses, diagnosing common eye disorders and treating selected eye diseases with drugs. If you have a complex eye problem or need surgery, your doctor can refer you to an ophthalmologist.
Opticians. Opticians fill prescriptions for eyeglasses, including assembling, fitting and selling them. Some opticians also sell contact lenses. Opticians do not provide eye health evaluations.
Bring your prescription eyewear
If you wear contact lenses or glasses, bring them to your appointment. Your eye doctor will want to make sure your prescription is the best one for you.
Other precautions
If your eyes are dilated as a part of your eye exam, you may want to bring sunglasses to wear after your eye exam is complete, as daylight or other bright lights may be uncomfortable or cause blurred vision. Also, consider having someone else drive you home.
What you can expect
Before the exam
If you’re seeing a new eye doctor or if you’re having your first eye exam, expect questions about your vision history. Part of the examination, such as taking your medical history and the initial eye test, may be performed by a clinical assistant or technician.
Your answers help your eye doctor understand your risk of eye disease and vision problems. Be prepared to give specific information, including:
Are you having any eye problems now?
Have you had any eye problems in the past?
Do you wear glasses or contacts now? If so, are you satisfied with them?
What health problems have you had in recent years?
Were you born prematurely?
Are you taking any medications?
Do you have any allergies to medications, food or other substances?
Have you ever had eye surgery?
Does anyone in your family have eye problems, such as macular degeneration, glaucoma or retinal detachments?
Do you or does anyone in your family have diabetes, high blood pressure, heart disease or any other health problems that can affect the whole body?
During the exam
An eye exam usually involves these steps:
You’ll be asked about your medical history and any vision problems you might be experiencing.
Your eye doctor measures your visual acuity to see if you need glasses or contact lenses to improve your vision.
You’ll be given a numbing drop in your eyes. Then your eye pressure is measured. To make it easier for your doctor to examine the inside of your eye, he or she will likely dilate your eyes with eyedrops.
After waiting for the dilating drops to take effect, your eye doctor checks the health of your eyes, possibly using several lights to evaluate the front of the eye and the inside of each eye.
Several different tests may be performed during the eye exam. The tests are designed to check your vision and to examine the appearance and function of all parts of your eyes.
After the exam
At the end of your eye exam, you and your doctor will discuss the results of all testing, including an assessment of your vision, your risk of eye disease and preventive measures you can take to protect your eyesight.
Different types of eye exams
Eye muscle test
This test evaluates the muscles that control eye movement. Your eye doctor watches your eye movements as you follow a moving object, such as a pen or small light, with your eyes. He or she looks for muscle weakness, poor control or poor coordination.
Visual acuity test
This test measures how clearly you see. Your doctor asks you to identify different letters of the alphabet printed on a chart (Snellen chart) or a screen positioned some distance away. The lines of type get smaller as you move down the chart. Each eye is tested separately. Your near vision also may be tested, using a card with letters similar to the distant eye chart. The card is held at reading distance.
Refraction assessment
Light waves are bent as they pass through your cornea and lens. If light rays don’t focus perfectly on the back of your eye, you have a refractive error. Having a refractive error may mean you need some form of correction, such as glasses, contact lenses or refractive surgery, to see as clearly as possible.
Assessment of your refractive error helps your doctor determine a lens prescription that will give you the sharpest, most comfortable vision. The assessment may also determine that you don’t need corrective lenses.
Your doctor may use a computerized refractor to estimate your prescription for glasses or contact lenses. Or he or she may use a technique called retinoscopy. In this procedure, the doctor shines a light into your eye and measures the refractive error by evaluating the movement of the light reflected by your retina back through your pupil.
Your eye doctor usually fine-tunes this refraction assessment by having you look through a masklike device that contains wheels of different lenses (phoropter). He or she asks you to judge which combination of lenses gives you the sharpest vision.
Visual field test (perimetry)
Your visual field is the full extent of what you can see to the sides without moving your eyes. The visual field test determines whether you have difficulty seeing in any areas of your overall field of vision. The different types of visual field tests include:
Confrontation exam. Your eye doctor sits directly in front of you and asks you to cover one eye. You look straight ahead and tell the doctor each time you see his or her hand move into view.
Manual testing, including tangent screen and Goldmann exams. You sit a short distance from a screen and focus on a target at its center. You tell the doctor when you can see an object move into your peripheral vision and when it disappears.
Automated perimetry. As you look at a screen with blinking lights on it, you press a button each time you see a blink.
Using your responses to one or more of these tests, your eye doctor determines the fullness of your field of vision. If you aren’t able to see in certain areas, noting the pattern of your visual field loss may help your eye doctor diagnose your eye condition.
Color vision testing
You could have poor color vision and not even realize it. If you have difficulty distinguishing certain colors, your eye doctor may screen your vision for a color deficiency. To do this, your doctor shows you several multicolored dot-pattern tests.
If you have no color deficiency, you’ll be able to pick out numbers and shapes from within the dot patterns. If you do have a color deficiency, you’ll find it difficult to see certain patterns within the dots. Your doctor may use other tests, as well.
Slit-lamp examination
A slit lamp is a microscope that magnifies and illuminates the front of your eye with an intense line of light. Your doctor uses this device to examine the eyelids, lashes, cornea, iris, lens and fluid chamber between your cornea and iris.
Your doctor may use a dye, most commonly fluorescein (flooh-RES-een), to color the film of tears over your eye. This helps reveal any damaged cells on the front of your eye. Your tears wash the dye from the surface of your eye fairly quickly.
Retinal examination
A retinal examination — sometimes called ophthalmoscopy or funduscopy — allows your doctor to evaluate the back of your eye, including the retina, the optic disk and the underlying layer of blood vessels that nourish the retina (choroid). Usually before your doctor can see these structures, your pupils must be dilated with eyedrops that keep the pupil from getting smaller when your doctor shines light into the eye.
After administering eyedrops and giving them time to work, your eye doctor may use one or more of these techniques to view the back of your eye:
Direct exam. Your eye doctor uses an ophthalmoscope to shine a beam of light through your pupil to see the back of the eye. Sometimes eyedrops aren’t necessary to dilate your eyes before this exam.
Indirect exam. During this exam, you might lie down, recline in a chair or sit up. Your eye doctor examines the inside of the eye with the aid of a condensing lens and a bright light mounted on his or her forehead. This exam lets your doctor see the retina and other structures inside your eye in great detail and in three dimensions.
Screening for glaucoma
Tonometry measures the fluid pressure inside your eye (intraocular pressure). This is one test that helps your eye doctor detect glaucoma, a disease that damages the optic nerve.
Several methods to measure intraocular pressure are available, including:
Applanation tonometry. This test measures the amount of force needed to temporarily flatten a part of your cornea. You’ll be given eyedrops with fluorescein, the same dye used in a regular slit-lamp examination. You’ll also receive eyedrops containing an anesthetic. Using the slit lamp, your doctor moves the tonometer to touch your cornea and determine the eye pressure. Because your eye is numbed, the test doesn’t hurt.
Noncontact tonometry. This method uses a puff of air to estimate the pressure in your eye. No instruments touch your eye, so you won’t need an anesthetic. You’ll feel a momentary pulse of air on your eye, which can be startling.
If your eye pressure is higher than average or your optic nerve looks unusual, your doctor may use a pachometer. This instrument uses sound waves to measure the thickness of your cornea. The most common way of measuring corneal thickness is to put an anesthetic drop in your eye, then place a small probe in contact with the front surface of the eye. The measurement takes seconds.
You may need more-specialized tests, depending on your age, medical history and risk of developing eye disease.
Results
Normal results from an eye exam include:
20/20 vision
Good peripheral vision
Ability to distinguish various colors
Normal-appearing structures of the external eye
Absence of cataract, glaucoma or retinal disorders, such as macular degeneration
Your doctor may give you a prescription for corrective lenses. If your eye exam yields other abnormal results, your doctor will discuss with you next steps for further testing or for treating an underlying condition.
Diabetic retinopathy (die-uh-BET-ik ret-ih-NOP-uh-thee) is a diabetes complication that affects eyes. It’s caused by damage to the blood vessels of the light-sensitive tissue at the back of the eye (retina).
At first, diabetic retinopathy may cause no symptoms or only mild vision problems. Eventually, it can cause blindness.
The condition can develop in anyone who has type 1 or type 2 diabetes. The longer you have diabetes and the less controlled your blood sugar is, the more likely you are to develop this eye complication.
Symptoms
You might not have symptoms in the early stages of diabetic retinopathy. As the condition progresses, diabetic retinopathy symptoms may include:
Spots or dark strings floating in your vision (floaters)
Blurred vision
Fluctuating vision
Impaired color vision
Dark or empty areas in your vision
Vision loss
Diabetic retinopathy usually affects both eyes.
When to see a doctor
Careful management of your diabetes is the best way to prevent vision loss. If you have diabetes, see your eye doctor for a yearly eye exam with dilation — even if your vision seems fine. Pregnancy may worsen diabetic retinopathy, so if you’re pregnant, your eye doctor may recommend additional eye exams throughout your pregnancy.
Contact your eye doctor right away if your vision changes suddenly or becomes blurry, spotty or hazy.
Over time, too much sugar in your blood can lead to the blockage of the tiny blood vessels that nourish the retina, cutting off its blood supply. As a result, the eye attempts to grow new blood vessels. But these new blood vessels don’t develop properly and can leak easily.
There are two types of diabetic retinopathy:
Early diabetic retinopathy. In this more common form — called nonproliferative diabetic retinopathy (NPDR) — new blood vessels aren’t growing (proliferating).When you have NPDR, the walls of the blood vessels in your retina weaken. Tiny bulges (microaneurysms) protrude from the vessel walls of the smaller vessels, sometimes leaking fluid and blood into the retina. Larger retinal vessels can begin to dilate and become irregular in diameter, as well. NPDR can progress from mild to severe, as more blood vessels become blocked.Nerve fibers in the retina may begin to swell. Sometimes the central part of the retina (macula) begins to swell (macular edema), a condition that requires treatment.
Advanced diabetic retinopathy. Diabetic retinopathy can progress to this more severe type, known as proliferative diabetic retinopathy. In this type, damaged blood vessels close off, causing the growth of new, abnormal blood vessels in the retina, and can leak into the clear, jelly-like substance that fills the center of your eye (vitreous).Eventually, scar tissue stimulated by the growth of new blood vessels may cause the retina to detach from the back of your eye. If the new blood vessels interfere with the normal flow of fluid out of the eye, pressure may build up in the eyeball. This can damage the nerve that carries images from your eye to your brain (optic nerve), resulting in glaucoma.
Risk factors
Anyone who has diabetes can develop diabetic retinopathy. Risk of developing the eye condition can increase as a result of:
Duration of diabetes — the longer you have diabetes, the greater your risk of developing diabetic retinopathy
Poor control of your blood sugar level
High blood pressure
High cholesterol
Pregnancy
Tobacco use
Being African-American, Hispanic or Native American
Complications
Diabetic retinopathy involves the abnormal growth of blood vessels in the retina. Complications can lead to serious vision problems:
Vitreous hemorrhage. The new blood vessels may bleed into the clear, jelly-like substance that fills the center of your eye. If the amount of bleeding is small, you might see only a few dark spots (floaters). In more-severe cases, blood can fill the vitreous cavity and completely block your vision.Vitreous hemorrhage by itself usually doesn’t cause permanent vision loss. The blood often clears from the eye within a few weeks or months. Unless your retina is damaged, your vision may return to its previous clarity.
Retinal detachment. The abnormal blood vessels associated with diabetic retinopathy stimulate the growth of scar tissue, which can pull the retina away from the back of the eye. This may cause spots floating in your vision, flashes of light or severe vision loss.
Glaucoma. New blood vessels may grow in the front part of your eye and interfere with the normal flow of fluid out of the eye, causing pressure in the eye to build up (glaucoma). This pressure can damage the nerve that carries images from your eye to your brain (optic nerve).
Blindness. Eventually, diabetic retinopathy, glaucoma or both can lead to complete vision loss.
Prevention
You can’t always prevent diabetic retinopathy. However, regular eye exams, good control of your blood sugar and blood pressure, and early intervention for vision problems can help prevent severe vision loss.
If you have diabetes, reduce your risk of getting diabetic retinopathy by doing the following:
Manage your diabetes. Make healthy eating and physical activity part of your daily routine. Try to get at least 150 minutes of moderate aerobic activity, such as walking, each week. Take oral diabetes medications or insulin as directed.
Monitor your blood sugar level. You may need to check and record your blood sugar level several times a day — more-frequent measurements may be required if you’re ill or under stress. Ask your doctor how often you need to test your blood sugar.
Ask your doctor about a glycosylated hemoglobin test. The glycosylated hemoglobin test, or hemoglobin A1C test, reflects your average blood sugar level for the two- to three-month period before the test. For most people, the A1C goal is to be under 7 percent.
Keep your blood pressure and cholesterol under control. Eating healthy foods, exercising regularly and losing excess weight can help. Sometimes medication is needed, too.
If you smoke or use other types of tobacco, ask your doctor to help you quit. Smoking increases your risk of various diabetes complications, including diabetic retinopathy.
Pay attention to vision changes. Contact your eye doctor right away if you experience sudden vision changes or your vision becomes blurry, spotty or hazy.
Remember, diabetes doesn’t necessarily lead to vision loss. Taking an active role in diabetes management can go a long way toward preventing complications.
Diagnosis
Diabetic retinopathy is best diagnosed with a comprehensive dilated eye exam. For this exam, drops placed in your eyes widen (dilate) your pupils to allow your doctor to better view inside your eyes. The drops may cause your close vision to blur until they wear off, several hours later.
During the exam, your eye doctor will look for:
Abnormal blood vessels
Swelling, blood or fatty deposits in the retina
Growth of new blood vessels and scar tissue
Bleeding in the clear, jelly-like substance that fills the center of the eye (vitreous)
Retinal detachment
Abnormalities in your optic nerve
In addition, your eye doctor may:
Test your vision
Measure your eye pressure to test for glaucoma
Look for evidence of cataracts
Fluorescein angiography
With your eyes dilated, your doctor takes pictures of the inside of your eyes. Then your doctor will inject a special dye into your arm vein and take more pictures as the dye circulates through your eyes’ blood vessels. Your doctor can use the images to pinpoint blood vessels that are closed, broken down or leaking fluid.
Optical coherence tomography
Your eye doctor may request an optical coherence tomography (OCT) exam. This imaging test provides cross-sectional images of the retina that show the thickness of the retina, which will help determine whether fluid has leaked into retinal tissue. Later, OCT exams can be used to monitor how treatment is working.
Treatment
Treatment, which depends largely on the type of diabetic retinopathy you have and how severe it is, is geared to slowing or stopping progression of the condition.
Early diabetic retinopathy
If you have mild or moderate nonproliferative diabetic retinopathy, you may not need treatment right away. However, your eye doctor will closely monitor your eyes to determine when you might need treatment.
Work with your diabetes doctor (endocrinologist) to determine if there are ways to improve your diabetes management. When diabetic retinopathy is mild or moderate, good blood sugar control can usually slow the progression.
Advanced diabetic retinopathy
If you have proliferative diabetic retinopathy or macular edema, you’ll need prompt surgical treatment. Depending on the specific problems with your retina, options may include:
Photocoagulation. This laser treatment, also known as focal laser treatment, can stop or slow the leakage of blood and fluid in the eye. During the procedure, leaks from abnormal blood vessels are treated with laser burns.Focal laser treatment is usually done in your doctor’s office or eye clinic in a single session. If you had blurred vision from macular edema before surgery, the treatment might not return your vision to normal, but it’s likely to reduce the chance the macular edema may worsen.
Panretinal photocoagulation. This laser treatment, also known as scatter laser treatment, can shrink the abnormal blood vessels. During the procedure, the areas of the retina away from the macula are treated with scattered laser burns. The burns cause the abnormal new blood vessels to shrink and scar.It’s usually done in your doctor’s office or eye clinic in two or more sessions. Your vision will be blurry for about a day after the procedure. Some loss of peripheral vision or night vision after the procedure is possible.
Vitrectomy. This procedure uses a tiny incision in your eye to remove blood from the middle of the eye (vitreous) as well as scar tissue that’s tugging on the retina. It’s done in a surgery center or hospital using local or general anesthesia.
Injecting medicine into the eye. Your doctor may suggest injecting medication into the vitreous in the eye. These medications, called vascular endothelial growth factor (VEGF) inhibitors, may help stop growth of new blood vessels by blocking the effects of growth signals the body sends to generate new blood vessels.Your doctor may recommend these medications, also called anti-VEGF therapy, as a stand-alone treatment or in combination with panretinal photocoagulation. While studies of anti-VEGF therapy in the treatment of diabetic retinopathy are promising, this approach is not yet considered standard.Surgery often slows or stops the progression of diabetic retinopathy, but it’s not a cure. Because diabetes is a lifelong condition, future retinal damage and vision loss are still possible.
Even after treatment for diabetic retinopathy, you’ll need regular eye exams. At some point, additional treatment may be recommended.
Clinical trials
Explore Mayo Clinic studies testing new treatments, interventions and tests as a means to prevent, detect, treat or manage this disease.
Alternative medicine
Several alternative therapies have suggested some benefits for people with diabetic retinopathy, but more research is needed to understand whether these treatments are effective and safe.
Be sure to let your doctor know if you are taking any herbs or supplements. They have the potential to interact with other medications, or cause complications in surgery, such as excessive bleeding.
It’s vital not to delay standard treatments to try unproven therapies. Early treatment is the best way to prevent vision loss.
Coping and support
The thought that you might lose your sight can be frightening, and you may benefit from talking to a therapist or finding a support group. Ask your doctor for referrals.
If you’ve already lost vision, ask your doctor about low-vision products, such as magnifiers, and services that can make daily living easier.
Preparing for your appointment
The American Diabetes Association (ADA) recommends that anyone who’s older than 10 with type 1 diabetes have his or her first eye exam within five years of being diagnosed with diabetes.
If you have type 2 diabetes, the ADA advises getting your initial eye exam at the time of your diagnosis, because you may have had diabetes for some time without knowing it.
If there’s no evidence of retinopathy on your initial exam, the ADA recommends that people with diabetes get dilated and comprehensive eye exams at least every two years. If you have any level of retinopathy, you’ll need eye exams at least annually. Ask your eye doctor what he or she recommends.
The ADA recommends that women with diabetes have an eye exam before becoming pregnant or during the first trimester of pregnancy and be closely followed during the pregnancy and up to one year after giving birth. Pregnancy can sometimes cause diabetic retinopathy to develop or worsen.
Here’s some information to help you get ready for your eye appointment.
What you can do
Write a brief summary of your diabetes history, including when you were diagnosed; medications you have taken for diabetes, now and in the past; recent average blood sugar levels; and your last few hemoglobin A1C readings, if you know them.
List other medications, vitamins and supplements you take, and the dosage.
List your symptoms, if any. Include any that may seem unrelated to potential eye problems.
Ask a family member or friend to go with you, if possible. Someone who accompanies you can help remember the information you receive. Also, because your eyes have been dilated, a companion can drive you home.
List questions for your doctor.
For diabetic retinopathy, some basic questions to ask your doctor include:
How is diabetes affecting my vision?
Do I need other tests?
Is this condition temporary or long lasting?
What treatments are available, and which do you recommend?
What side effects might I expect from treatment?
I have other health conditions. How can I best manage them together?
If I control my blood sugar, will my eye symptoms go away?
What do my blood sugar goals need to be to protect my eyes?
Can you recommend services for people with visual impairment?
Don’t hesitate to ask other questions you have.
What to expect from your doctor
Your doctor is likely to ask you a number of questions, including:
Do you have eye symptoms, such as blurred vision or floaters?
How long have you had symptoms?
In general, how well are you controlling your diabetes?
What was your last hemoglobin A1C?
Do you have other health conditions, such as high blood pressure or high cholesterol?
Smoking has long been known to cause heart disease and lung cancer; however many people don’t realize that smoking can lead to vision loss. Studies show smoking increases the risk of age-related macular degeneration, cataracts, glaucoma and diabetic retinopathy and Dry Eye Syndrome.
One way to reduce the risk of developing AMD is by NOT smoking. Smokers are three to four times more likely to develop AMD than nonsmokers. Nonsmokers living with smokers almost double their risk of developing AMD.
Smoking can increase your chances of getting diabetes. It can also make managing diabetes more difficult for those who already have it. Complications of diabetes made worse by smoking include retinopathy, heart disease, stroke, vascular disease, kidney disease, nerve damage, foot problems and many others.
Dry Eye Syndrome is more than twice as likely to impact smokers as non-smokers.
What You Can Do to Prevent Vision Loss:
Healthy habits can lead to healthy eyes. The risk of eye disease and vision loss can be lowered if you::
Quit smoking!
Eat healthy foods (including green leafy vegetables, fruits and foods high in vitamins C, E, and beta carotene).
Control blood pressure and cholesterol.
Stay active.
Visit your eye care professional regularly.
Are You Ready to Quit?
To get started, visit the How to Quit page on the NYS Smokers’ Quitline website ( www.nysmokefree.com ) or call the NYS Smokers’ Quitline for help <( 1-866-NY-QUITS or 1-866-697-8487).
See your doctor. He or she may prescribe a nicotine replacement therapy or other medication.
Description of Eye Diseases Associated with Smoking:
1. Age Related Macular Degeneration (AMD):
AMD begins as a loss of central vision which makes it difficult to read and see fine details. Over time, vision loss increases significantly. Of the two types of AMD, “dry” and “wet,” dry AMD is the most common. In dry AMD, fatty deposits form under the light-sensing cells in the back of the eye (retina). Vision loss in dry AMD usually gets worse slowly. In wet AMD, tiny blood vessels under the retina leak or break open. This changes vision and causes scar tissue to form. Wet AMD is less common, but more quickly harmful to vision.
2. Glaucoma
Glaucoma causes a gradual break down of the cells that make up the nerve in your eye that sends visual information to your brain (optic nerve). As the nerve cells die, vision is slowly lost, usually beginning with side vision. Often the loss of vision is not noticeable until a large amount of nerve damage has occurred. This is the reason why as many as half of all people with glaucoma may be unaware that they have it.
3. Cataract
Cataract is a clouding of the eye’s naturally clear lens. It usually gets worse as we get older. Most cataracts are related to aging. Cataracts are very common in older people. By age 80, more than half of all Americans either have a cataract or have had cataract surgery.
4. Diabetic retinopathy
Diabetic retinopathy is a common complication of diabetes. It affects the tiny blood vessels of the retina in the eye. Retinal blood vessels can break down, leak or become blocked and this can affect vision over time. In some people with diabetic retinopathy, serious damage to the eye can occur when new blood vessels grow on the surface of the retina.
5. Dry Eye Syndrome
Dry Eye Syndrome is an eye disease that appears as damaged blood vessels in the eye. This can lead to eye irritation, itchy and scratchy eyes, and burning sensation of the eyes.
Keratitis is an inflammation of the cornea — the clear, dome-shaped tissue on the front of your eye that covers the pupil and iris. Keratitis may or may not be associated with an infection. Noninfectious keratitis can be caused by a relatively minor injury, by wearing your contact lenses too long or by a foreign body in the eye. Infectious keratitis can be caused by bacteria, viruses, fungi and parasites.
If you have eye redness or other symptoms of keratitis, make an appointment to see your doctor. With prompt attention, mild to moderate cases of keratitis can usually be effectively treated without loss of vision. If left untreated, or if an infection is severe, keratitis can lead to serious complications that may permanently damage your vision.
Symptoms
Signs and symptoms of keratitis include:
Eye redness
Eye pain
Excess tears or other discharge from your eye
Difficulty opening your eyelid because of pain or irritation
Blurred vision
Decreased vision
Sensitivity to light (photophobia)
A feeling that something is in your eye
When to see a doctor
If you notice any of the signs or symptoms of keratitis, make an appointment to see your doctor right away. Delays in diagnosis and treatment of keratitis can lead to serious complications, including blindness.
Causes
Causes of keratitis include:
Injury. If any object scratches or injures the surface of your cornea, noninfectious keratitis may result. In addition, an injury may allow microorganisms to gain access to the damaged cornea, causing infectious keratitis.
Contaminated contact lenses. Bacteria, fungi or parasites — particularly the microscopic parasite acanthamoeba — may inhabit the surface of a contact lens or contact lens carrying case. The cornea may become contaminated when the lens is in your eye, resulting in infectious keratitis. Over-wearing your contact lenses can cause keratitis, which can become infectious.
Viruses. The herpes viruses (herpes simplex and herpes zoster) may cause keratitis.
Bacteria. The bacterium that causes gonorrhea can cause keratitis.
Contaminated water. Bacteria, fungi and parasites in water — particularly in oceans, rivers, lakes and hot tubs — can enter your eyes when you’re swimming and result in keratitis. However, even if you’re exposed to these bacteria, fungi or parasites, a healthy cornea is unlikely to become infected unless there has been some previous breakdown of the corneal surface — for example, wearing a contact lens too long.
Risk factors
Factors that may increase your risk of keratitis include:
Contact lenses. Wearing contact lenses — especially sleeping in the lenses —increases your risk of both infectious and noninfectious keratitis. The risk typically stems from wearing them longer than recommended, improper disinfection or wearing contact lenses while swimming.Keratitis is more common in people who use extended-wear contacts, or wear contacts continuously, than in those who use daily wear contacts and take them out at night.
Reduced immunity. If your immune system is compromised due to disease or medications, you’re at higher risk of developing keratitis.
Corticosteroids. Use of corticosteroid eyedrops to treat an eye disorder can increase your risk of developing infectious keratitis or worsen existing keratitis.
Eye injury. If one of your corneas has been damaged from an injury in the past, you may be more vulnerable to developing keratitis.
Complications
Potential complications of keratitis include:
Chronic corneal inflammation and scarring
Chronic or recurrent viral infections of your cornea
Open sores on your cornea (corneal ulcers)
Temporary or permanent reduction in your vision
Blindness
Prevention
Caring for your contact lenses
If you wear contact lenses, proper use, cleaning and disinfecting can help prevent keratitis. Follow these tips:
Choose daily wear contacts, and take them out before going to sleep.
Wash, rinse and dry your hands thoroughly before handling your contacts.
Follow your eye care professional’s recommendations for taking care of your lenses.
Use only sterile products that are made specifically for contact lens care, and use lens care products made for the type of lenses you wear.
Gently rub the lenses during cleaning to enhance the cleaning performance of the contact lens solutions. Avoid rough handling that might cause your lenses to become scratched.
Replace your contact lenses as recommended.
Replace your contact lens case every three to six months.
Discard the solution in the contact lens case each time you disinfect your lenses. Don’t “top off” the old solution that’s already in the case.
Don’t wear contact lenses when you go swimming.
Preventing viral outbreaks
Some forms of viral keratitis can’t be completely eliminated. But the following steps may control viral keratitis occurrences:
If you have a cold sore or a herpes blister, avoid touching your eyes, your eyelids and the skin around your eyes unless you’ve thoroughly washed your hands.
Only use eyedrops that have been prescribed by an eye doctor.
Washing your hands frequently prevents viral outbreaks.
Age-related macular degeneration (AMD) is the most common cause of irreversible central vision loss in older patients. Dilated funduscopic findings are diagnostic; color photographs, fluorescein angiography, and optical coherence tomography assist in confirming the diagnosis and in directing treatment. Treatment is with dietary supplements, intravitreal injection of antivascular endothelial growth factor drugs, laser photocoagulation, photodynamic therapy, and low-vision devices.
, MD, Vitreoretinal Diseases and Surgery Service, Wills Eye Hospital, Sidney Kimmel Medical College at Thomas Jefferson University
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Age-related macular degeneration (AMD) is the most common cause of irreversible central vision loss in older patients. Dilated funduscopic findings are diagnostic; color photographs, fluorescein angiography, and optical coherence tomography assist in confirming the diagnosis and in directing treatment. Treatment is with dietary supplements, intravitreal injection of antivascular endothelial growth factor drugs, laser photocoagulation, photodynamic therapy, and low-vision devices.
AMD is the leading cause of permanent, irreversible vision loss in older adults. It is more common among whites.
Etiology
Pathophysiology
Two different forms occur:
Dry (nonexudative or atrophic): All AMD starts as the dry form. About 85% of people with AMD have only dry AMD.
Wet (exudative or neovascular): Wet AMD occurs in about 15% of people.
Normal Retina
IMAGE PROVIDED BY SUNIR GARG, MD.
Although only 15% of patients with AMD have the wet form, 80 to 90% of the severe vision loss caused by AMD results from wet AMD.
Age-Related Macular Degeneration (Wet)
PAUL WHITTEN/SCIENCE PHOTO LIBRARY
Dry AMD causes changes of the retinal pigment epithelium, typically visible as dark pinpoint areas. The retinal pigment epithelium plays a critical role in keeping the cones and rods healthy and functioning well. Accumulation of waste products from the rods and cones can result in drusen, which appear as yellow spots. Areas of chorioretinal atrophy (referred to as geographic atrophy) occur in more advanced cases of dry AMD. There is no elevated macular scar (disciform scar), edema, hemorrhage, or exudation.
Wet AMD occurs when new abnormal blood vessels develop under the retina in a process called choroidal neovascularization (abnormal new vessel formation). Localized macular edema or hemorrhage may elevate an area of the macula or cause a localized retinal pigment epithelial detachment. Eventually, untreated neovascularization causes a disciform scar under the macula.
Symptoms and Signs
Dry AMD
The loss of central vision occurs over years and is painless, and most patients retain enough vision to read and drive. Central blind spots (scotomas) usually occur late in the disease and can sometimes become severe. Symptoms are usually bilateral.
Funduscopic changes include the following:
Changes in the retinal pigment epithelium
Drusen
Areas of chorioretinal atrophy
Wet AMD
Rapid vision loss, usually over days to weeks, is more typical of wet AMD. The first symptom is usually visual distortion, such as a central blind spot (scotoma) or curving of straight lines (metamorphopsia). Peripheral vision and color vision are generally unaffected; however, the patient may become legally blind (< 20/200 vision) in the affected eye, particularly if AMD is not treated. Wet AMD usually affects one eye at a time; thus, symptoms of wet AMD are often unilateral.
Funduscopic changes include the following:
Subretinal fluid, appearing as localized retinal elevation
Retinal edema
Gray-green discoloration under the macula
Exudates in or around the macula
Detachment of retinal pigment epithelium (visible as an area of retinal elevation)
Subretinal hemorrhage in or around the macula
Age-Related Macular Degeneration (Drusen)
PAUL PARKER/SCIENCE PHOTO LIBRARY
Diagnosis
Funduscopic examination
Color fundus photography
Fluorescein angiography
Optical coherence tomography
Both forms of AMD are diagnosed by funduscopic examination. Visual changes can often be detected with an Amsler grid. Color
Treatment
Dietary supplements for high-risk dry or unilateral wet AMD
Intravitreal antivascular endothelial growth factor drugs or laser treatments for wet AMD
Supportive measures
Dry AMD
There is no way to reverse damage caused by dry AMD. Patients with extensive drusen, pigment changes, and/or geographic atrophy can reduce the risk of developing advanced AMD by 25% by taking daily supplements of the following:
Zinc oxide 80 mg
Copper 2 mg
Vitamin C 500 mg
Vitamin E 400 units
Lutein 10 mg/zeaxanthin 2 mg (or beta-carotene 15 mg or vitamin A 28,000 units for patients who have not smoked)
In current and former smokers, beta-carotene can increase the risk of lung cancer. Recently, substitution of beta-carotene with lutein plus zeaxanthin has been shown to have comparable efficacy (1). Therefore, such a substitution should be considered in current or former smokers. The zinc component of these supplements increases risk of hospitalization for genitourinary tract disorders. Some patients taking beta-carotene also have yellowing of the skin. Reducing cardiovascular risk factors as well as regularly eating foods high in omega-3 fatty acids and dark green leafy vegetables may help slow disease progression; however, recent large trials have not shown that taking supplements of omega-3 fatty acids reduces disease progression.
Wet AMD
Patients with unilateral wet AMD should take the daily nutritional supplements that are recommended for dry AMD to reduce the risk of AMD-induced vision loss in the other eye. The choice of other treatments depends on the size, location, and type of neovascularization. Intravitreal injection of antivascular endothelial growth factor (anti-VEGF) drugs (usually ranibizumab, bevacizumab, or aflibercept) can substantially reduce the risk of vision loss and can help restore reading vision in up to one third of patients. In a small subset of patients, thermal laser photocoagulation of neovascularization outside the fovea may prevent severe vision loss. Photodynamic therapy, a type of laser treatment, also helps under specific circumstances. Corticosteroids (eg, triamcinolone) are sometimes injected intraocularly along with an anti-VEGF drug. Other treatments, including transpupillary thermotherapy, subretinal surgery, and macular translocation surgery, are seldom used.
Treatment reference
1. Age-Related Eye Disease Study 2 Research Group: Lutein + zeaxanthin and omega-3 fatty acids for age-related macular degeneration: The age-related eye disease study 2 (AREDS2) randomized clinical trial. JAMA 309(19):2005-15, 2013. doi: 10.1001/jama.2013.4997. Clarification and additional information. JAMA 310(2):208, 2013. doi:10.1001/jama.2013.6403.
Supportive measures
For patients who have lost central vision, low-vision devices such as magnifiers, high-power reading glasses, large computer monitors, and telescopic lenses are available. Also, certain types of software can display computer data in large print or read information aloud in a synthetic voice. Low-vision counseling is advised
Key Points
AMD is more common among whites and is the leading cause of permanent vision loss in older adults.
AMD can be dry (nonexudative or atrophic) or wet (exudative or neovascular).
Although 85% of AMD is dry, 80 to 90% of severe vision loss caused by AMD results from the wet type.
Funduscopic changes in dry AMD include drusen, areas of chorioretinal atrophy, and changes to the retinal pigment epithelium.
Funduscopic changes in wet AMD include retinal edema and localized elevation, detachment of the retinal pigment epithelium, a gray-green discoloration under the macula, and exudates in and around the macula.
If patients have AMD on funduscopy, do color fundus photography, fluorescein angiography, and optical coherence tomography.
Prescribe dietary supplements for unilateral wet or high-risk dry AMD.
Treat wet AMD with intravitreal antivascular endothelial growth factor drugs or laser therapy.
You can buy 3 in 1 smart infrared thermometers at Eyeupdate clinic & optical supplies located at 01 Ajuwon junction, Ajuwon bus stop, beside BNPL filling station, Ajuwon near the grailand estate gate.
This is a non contact thermometer which can be used to take temperature measurement of the human body near the forehead, ear or wrist. Other features of the thermometer are:
Fast measurement (1 second)
Fever warning
Measurement range: 32. 0°C – 42. 2°C
Memory recall: 32 readings
Automatic shutdown: 60s
Error Resolution: 0.1°C
Can measure body temperature on human forehead
Can measure body temperature on the wrist
Can measure human temperature on the ear
Manufacturers: Alicn Medical Inc
Price: N35, 000
Tel: 08107531046
Address : Eyeupdate clinic & optical supplies,
01, Ajuwon junction, Ajuwon bus stop, off Elliott bus stop, Iju-Ishagah (beside BPNL Filling station, Ajuwon)
Buy infrared thermometer in Alagbole Akute Ajuwon Matogun
It is possible to do some basic testing of your vision and the vision of your family members and friends at home. Home eye testing is not a substitute for a complete medical eye examination by an ophthalmologist. Testing your vision at home will not be as accurate as what your ophthalmologist can do. But home eye testing could help you discover a problem that requires professional attention.
Children under age 3 should have their vision tested by an optometrist, ophthalmologist or other vision care professional.
What You Need to Test Your Vision at Home
Something to cover the eye, like a paper cup or facial tissue.
Scissors.
Tape or tack to hang the test chart on the wall.
A pencil or pen to record the results.
A yardstick, tape measure, or ruler.
A flashlight, if available.
A well-lighted room at least 10 feet long.
The correct testing chart.
Prepare the Test Area
Select either the child’s or adult’s test chart and print it out.
When printed, the largest letter at the top of the chart should be just under an inch (23 millimeters) tall.
Measure 10 feet from a wall with no windows, and place a chair at this point.
Tape or pin the chart on the bare wall, level with the eyes of the person you will test as he or she sits in the chair.
Testing a Child (Age 3 or Older)
Explain to your child that you are going to play a “pointing game.” Using the practice E card, show him or her how to point in the same direction that the E is “pointing.” Turn the practice E in the four different directions (up, down, right, left). You may hold the practice card as close as the child wants until he or she can point in the four directions without help.
Have your child sit in the chair 10 feet from the chart, holding the cover over one eye without applying any pressure. Do not let the child peek. A second person may be needed to hold the cover in place and watch for peeking. If your child wears glasses, he or she should wear them during the test.
If the chart seems too dark to see clearly, use the flashlight to illuminate the test letters.
Point at each of the Es, starting with the largest. Have your child point in the direction the E is pointing.
Write down the number of the smallest line your child can correctly see (more than half of the Es correctly identified).
Then repeat the test with the other eye covered. If your child is tired, you may wish to test the other eye at a different time.
Testing an Adult or Older Child
Have the person being tested sit in the chair, 10 feet from the chart. Make sure the chart is level with his or her eyes.
Have the person being tested cover one eye. If he or she uses eyeglasses for distance vision, the glasses should be worn during the test.
Shine the flashlight on each line of the chart, while the person you are testing reads the letters out loud. Continue to the bottom row or until the letters are too difficult for the person to see.
Write down the number of the smallest line seen correctly (the line with more than half of the letters correctly identified).
Now repeat the test with the other eye covered and record the results.
What Are Normal Scores for Home Eye Testing?
A child should be able to see the 20/40 line by age 3 or 4 and the 20/30 line by age 5. If you test your child several times on different days and your child cannot see the expected line of print or cannot see the same line with each eye, he or she may have an eye problem. You should have your child evaluated by a physician.
An older child or adult should be reading the 20/20 line. You should arrange for a medical eye examination by an ophthalmologist if there are abnormal results.
Home Vision Test Results
Record the results of your home screening by filling in the number of the smallest line the person could read for each line below. If the test results indicate that you or your child needs to see an ophthalmologist, take the numbers you wrote down with you.
