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Diabetic retinopathy – Eye clinic near Fagba Obawale Iju-Ishagah

Overview

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.

Request an Appointment at Eyeupdate Eye Clinic

Causes

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?
  • Have you had eye surgery?
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High blood pressure & your eyes – Eye clinic near Sango Ota Abule Egba and Fagba

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Smoking and your eyes – Eye clinic near Mowe Ojodu Berger

Eye Disease and Smoking:

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.

  • Age Related Macular Degeneration (AMD)
    • 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.
  • Cataract
    • Heavy smokers (15 cigarettes/day or more) have up to three times the risk of cataract as nonsmokers.
  • Glaucoma
    • There is a strong link between smoking and high blood pressure, cataracts and diabetes all of which are risk factors for glaucoma.
  • Diabetic Retinopathy
    • 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
    • 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.

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Keratitis treatment in Alagbole Akute Ajuwon

Overview

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.

SCHEDULE YOUR EYE TEST

Optical eye clinic in alagbole akute ajuwon matogun olambe lambe koye oke iju ishaga fagba
Schedule your eye test with an eye doctor
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Have an eye check within Omole Akiode Ojodu Berger for detection of Age Related Macular Degeneration (ARMD)

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.

Risk factors include the following:

  • Age

  • Genetic variants (eg, abnormal complement factor H)

  • Family history

  • Smoking

  • Cardiovascular disease

  • Hypertension

  • Obesity

  • Sun exposure

  • A diet low in omega-3 fatty acids and dark green leafy vegetables

     

    PROFESSIONAL /
    … /
    AGE-RELATED MACULAR DEGENERATION (AMD OR ARMD)

    Age-Related Macular Degeneration (AMD or ARMD)

    (Senile Macular Degeneration)

    By

    Sonia Mehta

    , MD, Vitreoretinal Diseases and Surgery Service, Wills Eye Hospital, Sidney Kimmel Medical College at Thomas Jefferson University

    Professional.Manuals.TopicPage.LastRevisionDate| Content last modified Jun 2019
    CLICK HERE FOR PATIENT EDUCATION

     

    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.

     

    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
    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)
    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.

    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)
    Age-Related Macular Degeneration (Drusen)
    PAUL PARKER/SCIENCE PHOTO LIBRARY

    • 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

    • 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

    • 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.

Contact us

Eye clinic locations:

Eye centre Akute Ajuwon Fagba Alagbole Agege Alagbado Matogun Olambe Lambe Obawole Giwa Okearo abule Egba Ogba

01, Ajuwon junction, Ajuwon bus stop, beside BPNL filling station, Akute/Ajuwon road, off Elliot bus stop, Iju-Ishagah. Tel: 08034971582

222, Iju road, Balogun, Ifako Ijaye, Lagos. Tel: 08107531046

01, Itshekiri street, beside M. R. S. Petrol station, Ajuwon, Ifo, Ogun state. Tel: 08068084591.

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Astigmatism

According to American Optometric Association (AOA), Astigmatism is a common vision condition that causes blurred vision. It occurs when the cornea (the clear front cover of the eye) is irregularly shaped or sometimes because of the curvature of the lens inside the eye.

An irregularly shaped cornea or lens prevents light from focusing properly on the retina, the light-sensitive surface at the back of the eye. As a result, vision becomes blurred at any distance. This can lead to eye discomfort and headaches.

Astigmatism frequently occurs with other vision conditions like myopia (nearsightedness) and hyperopia (farsightedness). Together these vision conditions are referred to as refractive errors because they affect how the eyes bend or “refract” light.

There are many causes to astigmatism. It can be hereditary and is usually present from birth. It can decrease or increase over time.

A comprehensive optometric examination will include testing for astigmatism. If necessary, your optometrist can provide eyeglasses or contact lenses that correct the astigmatism by altering the way light enters the eyes.

Another option for treating astigmatism is a corneal procedure called orthokeratology (ortho-k). In this painless, noninvasive procedure, the patient wears a series of specially designed rigid contact lenses to gradually reshape the curvature of the cornea.

Laser surgery can also treat some types of astigmatism. The laser changes the shape of the cornea by removing a small amount of eye tissue.

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What causes astigmatism?

The curvature of the cornea and lens bends the light entering the eye in order to focus it precisely on the retina at the back of the eye. In astigmatism, the surface of the cornea or lens has a somewhat different curvature.

the surface of the cornea is shaped more like a football instead of round like a basketball, the eye is unable to focus light rays to a single point. Vision becomes out of focus at any distance.

In addition, the curvature of the lens inside the eye can change, resulting in an increase or decrease in astigmatism. This change frequently occurs in adulthood and can precede the development of naturally occurring cataracts.

Sometimes astigmatism may develop following an eye injury or eye surgery.

Astigmatism also occurs due to a relatively rare condition called keratoconus in which the cornea becomes progressively thinner and cone-shaped. This results in a large amount of astigmatism, which causes poor vision that cannot be clearly corrected with eyeglasses. People with keratoconus usually need contact lenses for clear vision and eventually may need a corneal transplant.

An optometrist can diagnose an astigmatism through a comprehensive eye examination. Testing for astigmatism measures how the eyes focus light and determines the power of any optical lenses needed to improve vision. This examination may include:

Visual acuity-When you read letters on a distance chart, you are measuring your visual acuity. Visual acuity is given as a fraction (for example, 20/40). The top number is the standardized testing distance (20 feet) and the bottom number is the smallest letter size read. A person with 20/40 visual acuity would have to get within 20 feet to read a letter that should be seen clearly at 40 feet. Normal distance visual acuity is 20/20.

Keratometry/Topography-A keratometer is the primary instrument used to measure the curvature of the cornea. By focusing a circle of light on the cornea and measuring its reflection, it is possible to determine the exact curvature of that area of the cornea’s surface. This measurement is particularly critical in determining the proper fit for contact lenses. A corneal topographer, which is gaining use, generates a contour map of the cornea and provides even more detail of the cornea’s shape.

Refraction-Using an instrument called a phoropter, your optometrist places a series of lenses in front of your eyes and measures how they focus light. This is performed using a handheld lighted instrument called a retinoscope or an automated instrument that evaluates the approximate focusing power of the eye. Based on your responses, the power is then refined to determine the lenses that allow the clearest vision. Despite improved technology, patient input remains integral in determining vision needs.
With the information from these tests, your optometrist can determine if you have astigmatism. Your optometrist will use these findings, combined with those of other tests performed, to determine the power of any lens correction you need to provide clear, comfortable vision. Once testing is complete, your optometrist can discuss treatment options.

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How is astigmatism treated?

People with astigmatism have several options to regain clear vision. They include:

Eyeglasses. People with astigmatism primarily choose eyeglasses to improve their vision. The eyeglasses contain a special cylindrical lens prescription that compensates for the astigmatism. This provides additional power in specific parts of the lens.

Generally, a single-vision lens is prescribed to provide clear vision at all distances. However, patients over age 40 who have presbyopia may need a bifocal or progressive addition lens.

Contact lenses. Some people will have better vision with contact lenses rather than eyeglasses. Contact lenses may provide clearer vision and a wider field of view. However, since contact lenses are worn directly on the eyes, they require regular cleaning and care to safeguard eye health.

Standard soft lenses may not be effective in correcting astigmatism. However, special toric soft contact lenses can correct for many types of astigmatism. Because rigid gas-permeable contact lenses maintain their regular shape while on the cornea, they can compensate for the cornea’s irregular shape and improve vision for people with astigmatism.

Orthokeratology. Orthokeratology (ortho-k) involves the fitting of a series of rigid contact lenses to reshape the cornea. The patient wears contact lenses for limited periods, such as overnight, and then removes them. People with moderate astigmatism may be able to temporarily obtain clear vision without lenses for most of their daily activities. Orthokeratology does not permanently improve vision. If patients stop wearing the retainer lenses, their vision may return to its original condition.

Laser and other refractive surgery procedures. Astigmatism can also be corrected by reshaping the cornea through LASIK (laser in situ keratomileusis) or PRK (photorefractive keratectomy). PRK removes tissue from the superficial and inner layers of the cornea. LASIK removes tissue only from the inner layer of the cornea.
If you have an astigmatism, you have a wide range of options to correct your vision problem. In consultation with your optometrist, you can select the treatment that best meets your visual and lifestyle needs

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Hyperopia/hypermetropia (longsightedness or farsightedness): How to correct for it

Hyperopia, or farsightedness, is a common vision problem, affecting about a fourth of the population. People with hyperopia can see distant objects very well, but have difficulty focusing on objects that are up close. The condition is sometimes referred to as “hypermetropia” rather than hyperopia.

Hyperopia symptoms

Farsighted people sometimes have headaches or eye strain and may squint or feel fatigued when performing work at close range. If you get these symptoms while wearing your eyeglasses or contact lenses, you may need an eye exam and a new prescription.

What causes hyperopia/hypermetropia

  1. Signs
  2. Causes
  3. Treatment

hyperopia eyeglasses on top of a book

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FIND EYE DOCTOR

Hyperopia, or farsightedness, is a common vision problem, affecting about a fourth of the population. People with hyperopia can see distant objects very well, but have difficulty focusing on objects that are up close. The condition is sometimes referred to as “hypermetropia” rather than hyperopia.

Hyperopia symptoms

Farsighted people sometimes have headaches or eye strain and may squint or feel fatigued when performing work at close range. If you get these symptoms while wearing your eyeglasses or contact lenses, you may need an eye exam and a new prescription.

What causes hyperopia/hypermetropia?

Watch this video on what causes blurry vision and how we can correct it.

This vision problem occurs when light rays entering the eye focus behind the retina, rather than directly on it. The eyeball of a farsighted person is shorter than normal.

Many children are born farsighted, and some of them “outgrow” it as the eyeball lengthens with normal growth.

Sometimes people confuse hyperopia with presbyopia, which also causes near vision problems but for different reasons.

Hyperopia treatment

Farsightedness can be corrected with glasses or contact lenses to change the way light rays bend into the eyes.

If your glasses or contact lens prescription begins with plus numbers, like +2.50, you are farsighted.

You may need to wear your glasses or contacts all the time or only when reading, working on a computer or doing other close-up work.

When selecting eyeglasses for the correction of farsightedness, choose aspheric high-index lenses — especially for stronger prescriptions. These lenses are thinner, lighter, and have a slimmer, more attractive profile. Aspheric lenses also reduce the magnified “bug-eye” appearance eyeglasses for hyperopia often cause.

Be aware, though, that high-index aspheric lenses reflect more light than standard plastic lenses. For the best comfort and appearance, make sure the lenses include anti-reflective coating, which eliminates distracting lens reflections.

High-index aspheric lenses for children should be made of lightweight polycarbonate lens material for superior comfort and impact resistance.

Also, photochromic lenses that automatically darken in response to sunlight are highly recommended for kids and anyone who spends a significant amount of time outdoors.

Refractive surgery, such as LASIK or CK, is another option for correcting hyperopia. Surgery may reduce or eliminate your need to wear glasses or contact lenses.

Investigational procedures involving corneal implants may be a future option for correcting hyperopia.

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Myopia, Short-sight or Near-sight

Myopia (also called nearsightedness) is the most common cause of impaired vision in people under age 40. In recent years, its prevalence is growing at an alarming rate.

Globally, research suggests that in the year 2000, roughly 25 percent of the world’s population was nearsighted but by the year 2050, it’s expected that roughly half the people on the planet will be myopic.

Myopia symptoms

If you are nearsighted, you will have difficulty reading road signs and seeing distant objects clearly, but will be able to see well for close-up tasks such as reading and computer use.

Other signs and symptoms of myopia include squinting, eye strain and headaches. Feeling fatigued when driving or playing sports also can be a symptom of uncorrected nearsightedness.

If you experience these signs or symptoms while wearing your glasses or contact lenses, schedule an eye exam with your optometrist or ophthalmologist to see if you need a stronger prescription.

NEED AN EYE EXAM? Find an eye doctor near you and make an appointment.

What causes myopia?

Myopia occurs when the eyeball is too long, relative to the focusing power of the cornea and lens of the eye. This causes light rays to focus at a point in front of the retina, rather than directly on its surface.

Nearsightedness can also be caused by the cornea and/or lens being too curved for the length of the eyeball. In some cases, myopia occurs due to a combination of these factors.

Myopia typically begins in childhood, and you may have a higher risk if your parents are nearsighted. In most cases, nearsightedness stabilizes in early adulthood but sometimes it continues to progress with age.

Myopia treatment

Nearsightedness can be corrected with eyeglasses, contact lenses or refractive surgery.

Depending on the degree of your myopia, you may need to wear your glasses or contact lenses all the time or only when you need very clear distance vision, like when driving, seeing a chalkboard or watching a movie.

Good choices for eyeglass lenses for nearsightedness include high-index lenses (for thinner, lighter glasses) and lenses with anti-reflective coating. Also, consider photochromic lenses to protect your eyes from UV rays and high-energy blue light and to reduce the need for a separate pair of prescription sunglasses outdoors.

If you’re nearsighted, the first number (“sphere”) on your eyeglasses prescription or contact lens prescription will be preceded by a minus sign (–). The higher the number, the more nearsighted you are.

Refractive surgery can reduce or even eliminate your need for glasses or contacts. The most common procedures are performed with an excimer laser.

  • In PRK the laser removes a layer of corneal tissue, which flattens the cornea and allows light rays to focus more accurately on the retina.
  • In LASIK — the most common refractive procedure — a thin flap is created on the surface of the cornea, a laser removes some corneal tissue, and then the flap is returned to its original position

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    Home Conditions Refractive Errors |  En Español

    Myopia (nearsightedness): causes, treatment

    By Gretchyn Bailey; reviewed by Gary Heiting, OD

    1. Symptoms
    2. Causes
    3. Treatment

    A young boy wearing glasses gets help with his homework

    Schedule an exam

    FIND EYE DOCTOR

    Myopia (also called nearsightedness) is the most common cause of impaired vision in people under age 40. In recent years, its prevalence is growing at an alarming rate.

    Globally, research suggests that in the year 2000, roughly 25 percent of the world’s population was nearsighted but by the year 2050, it’s expected that roughly half the people on the planet will be myopic.

    Myopia symptoms

    If you are nearsighted, you will have difficulty reading road signs and seeing distant objects clearly, but will be able to see well for close-up tasks such as reading and computer use.

    Other signs and symptoms of myopia include squinting, eye strain and headaches. Feeling fatigued when driving or playing sports also can be a symptom of uncorrected nearsightedness.

    If you experience these signs or symptoms while wearing your glasses or contact lenses, schedule an eye exam with your optometrist or ophthalmologist to see if you need a stronger prescription.

    NEED AN EYE EXAM? Find an eye doctor near you and make an appointment.

    What causes myopia?

    Myopia occurs when the eyeball is too long, relative to the focusing power of the cornea and lens of the eye. This causes light rays to focus at a point in front of the retina, rather than directly on its surface.

    Nearsightedness can also be caused by the cornea and/or lens being too curved for the length of the eyeball. In some cases, myopia occurs due to a combination of these factors.

    Myopia typically begins in childhood, and you may have a higher risk if your parents are nearsighted. In most cases, nearsightedness stabilizes in early adulthood but sometimes it continues to progress with age.

    Myopia treatment

    Nearsightedness can be corrected with eyeglasses, contact lenses or refractive surgery.

    Depending on the degree of your myopia, you may need to wear your glasses or contact lenses all the time or only when you need very clear distance vision, like when driving, seeing a chalkboard or watching a movie.

    Good choices for eyeglass lenses for nearsightedness include high-index lenses (for thinner, lighter glasses) and lenses with anti-reflective coating. Also, consider photochromic lenses to protect your eyes from UV rays and high-energy blue light and to reduce the need for a separate pair of prescription sunglasses outdoors.

    If you’re nearsighted, the first number (“sphere”) on your eyeglasses prescription or contact lens prescription will be preceded by a minus sign (–). The higher the number, the more nearsighted you are.

    Refractive surgery can reduce or even eliminate your need for glasses or contacts. The most common procedures are performed with an excimer laser.

    • In PRK the laser removes a layer of corneal tissue, which flattens the cornea and allows light rays to focus more accurately on the retina.
    • In LASIK — the most common refractive procedure — a thin flap is created on the surface of the cornea, a laser removes some corneal tissue, and then the flap is returned to its original position.

    Then there’s orthokeratology a non-surgical procedure where you wear special rigid gas permeable (RGP or GP) contact lenses at night that reshape your cornea while you sleep. When you remove the lenses in the morning, your cornea temporarily retains the new shape, so you can see clearly during the day without glasses or contact lenses.

    Orthokeratology and a related GP contact lens procedure called corneal refractive therapy (CRT) have been proven effective at temporarily correcting mild to moderate amounts of myopia. Both procedures are good alternatives to surgery for individuals who are too young for LASIK or are not good candidates for refractive surgery for other reasons.

    Implantable lenses known as phakic IOLs another surgical option for correcting nearsightedness, particularly for individuals with high amounts of myopia or thinner-than-normal corneas that could increase their risk of complications from LASIK or other laser vision correction procedures.

    Phakic IOLs work like contact lenses, except they are surgically placed within the eye and typically are permanent, which means no maintenance is needed. Unlike IOLs used in cataract surgery, phakic IOLs do not replace the eye’s natural lens, which is left intact.

    Controlling myopia

    With more people becoming nearsighted, there is a lot of interest in finding ways to control the progression of myopia in childhood.

    A number of different techniques have been tried — including fitting children with bifocals, progressive lenses and gas permeable contact lenses. All of these have delivered mixed results.

    Recent clinical trials showed that low-dose atropine eye drops could slow myopia progression in school-age children, with significantly fewer side effects compared with higher concentrations.

    Some kids, though, don’t respond well to atropine drops.

    A dual-focus daily disposable contact lens decreased the progression rate of myopia in children between 8 and 12 years old when compared to a single vision lens, according to a study presented in 2017 at the American Academy of Optometry meeting.

    The specially designed multifocal lenses reduced myopia progression by 59 percent at one year, 54 percent at two years and 52 at three years, compared with the myopia progression experienced by children who wore conventional contact lenses.

    “There were good correlations between change in refractive error and change in eyeball growth,” said Paul Chamberlain, who presented the research and is senior manager of clinical research at CooperVision.

    Degenerative myopia

    In most cases, nearsightedness is simply a minor inconvenience and poses little or no risk to the health of the eye. But sometimes myopia can be so progressive and severe it is considered a degenerative condition.

    Degenerative myopia (also called malignant or pathological myopia) is a relatively rare condition that is believed to be hereditary and usually begins in early childhood. About 2 percent of Americans are afflicted, and degenerative myopia is a leading cause of legal blindness.

    In malignant myopia, the elongation of the eyeball can occur rapidly, leading to a quick and severe progression of myopia and loss of vision. People with this condition have a significantly increased risk of retinal detachment and other degenerative changes in the back of the eye (such as bleeding in the eye from abnormal blood vessel growth).

    Degenerative myopia also may increase the risk of cataracts.

    See your doctor: If you are having trouble seeing near objects or find you are holding books (or your smartphone) farther away to better make out the words, you should see your eye doctor. Nearsightedness can be treated and in some cases slowed in children.

    Notes and References

    Dual focus contact reduces myopia progression. Primary Care Optometry News. October 2017.

    Global prevalence of myopia and high myopia and temporal trends from 2000 through 2050. Ophthalmology. May 2016.

    Increased prevalence of myopia in the United States between 1971-1972 and 1999-2004. Archives of Ophthalmology. December 2009.

    Systemic 7-methylxanthine in retarding axial eye growth and myopia progression: a 36-month pilot study. Journal of Ocular Biology, Diseases, and Informatics. December 2008.

    Photodynamic therapy with verteporfin for choroidal neovascularization of pathologic myopia in Japanese patients: comparison with nontreated controls. American Journal of Ophthalmology. March 2008.

    Infrared thermometers in Alagbole, Akute, Ajuwon, Fagba, Iju-Ishagah, Ogun state, Lagos state. Price: N45,000. Call 08107531046

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Infrared thermometers in Alagbole Akute Ajuwon

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: N45, 000
Tel: 08107531046, 07038125887

Address : Eyeupdate clinic & optical supplies,
01, Ajuwon junction, Ajuwon bus stop, off Elliott bus stop, Iju-Ishagah (beside BPNL Filling station, Ajuwon)