Tag: contact lens

  • Astigmatism

    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.

    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.

    Astigmatism

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    What causes astigmatism?

    Possible view through an astigmatic eye -- Image courtesy of Eyemaginations™

    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?

    Eyeglasses are the primary choice for persons with astigmatism.

    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

  • BILATERAL RETINITIS FOLLOWING TYPHOID FEVER

    Abstract

    Background

    Post typhoid fever immune related reactions affecting the eye is a rare finding which can have various presentations in which typhoid retinopathy is not a well recognized sequelae.

    Case presentation

    Here we present a case of 59 year old male who presented with right eye sudden painless loss of vision 4 weeks after typhoid fever which was diagnosed and treated successfully. His BCVA was 2/60 in right eye and 6/6 in left eye. Fundus examination showed retinitis along with macular serous detachment in right eye and retinitis in left eye. Significant improvement in BCVA in right eye was observed after treatment with oral steroid with resolving retinitis lesions. Diagnosis of post typhoid immune mediated retinitis was made with good resolution following treatment.

    Conclusions

    Immune mediated retinitis is a rare sequelae to typhoid infection which can be successfully treated with systemic steroids with good resolution of the lesions.

    Keywords: Post typhoid fever, Immune mediated, Typhoid retinopathy, Retinitis

    Background

    Typhoid or enteric fever is a systemic disease which is characterized by fever and abdominal pain caused due to dissemination of Salmonella typhi or paratyphi. It is transmitted by food or water due to fecal contamination by ill or asymptomatic chronic carriers. A high incidence of typhoid fever in developing countries correlates with poor sanitation and lack of access to clean drinking water []. Ocular manifestations of typhoid fever are rare and include lid edema or abscess, dacryoadenitis, conjunctival petechiae or chemosis, corneal ulceration, uveitis, vitreous haemorrhage, retinal haemorrhage and detachment, stellate maculopathy, pigmentary retinopathy, optic neuritis, internal or external ophthalmoplegia, orbital haemorrhage or abscess. These complications are caused either by direct invasion of the organisms into the ocular tissue, or by hypersensitivity reaction such as vitreous haemorrhage after typhoid vaccination []. Here we are presenting a case of retinitis with macular serous detachment developing post typhoid fever.

    Case report

    A 59 year old male presented to our hospital 1 week after experiencing diminution of vision in the right eye. He gave a history of typhoid fever 4 weeks prior to presentation for which Widal test was performed to confirm diagnosis. The test results showed significant titres for ‘O’ antigen (>1:80) and ‘H’ antigen (>1:160) and negative for ‘AH’ and ‘BH’ antigens. He was subsequently started on oral Ofloxacin 400 mg twice daily for 2 weeks following which fever subsided. There was no known history of diabetes mellitus or hypertension. On ocular examination his best corrected visual acuity was 2/60 in the right eye and 6/6 in left eye. Anterior segment findings were unremarkable with IOP being within normal range for both eyes. Fundus examination of right eye showed white fluffy lesions along the superior and inferior arcades with superficial haemorrhages in around the macula with a macular star suggestive of retinitis (Fig. 1a). Left eye fundus showed few dispersed retinitis lesions with superficial haemorrhage along the superior arcade with intact foveal reflex (Fig. 1b). On optical coherence tomography of right eye underlying macular serous retinal detachment was noted (Fig. 2a). Blood tests were done to rule out VDRL and HIV status. X-cyton analysis of the anterior chamber aspirate was negative for organisms like Mycobacterial Tuberculosis, Toxoplasma Gondii, Hepes Simplex Virus, Cytomegalovirus and Varicella Zoster Virus. After analysis of the reports diagnosis of post typhoid retinitis in both eyes was made. Patient was started on oral prednisolone 1 mg/kg body weight which was tapered over 2 months along with monitoring of systemic and ocular health. Patient came for follow up every 2 weeks for 3 months. Every visit fundus photo was documented. After 2 months of initiating treatment there was an improvement in the BCVA in right eye to 6/6 which was maintained on further visits. Fundus examination revealed resolving lesions in both eyes (Fig. 3a, b) and OCT of the right eye showed resolution of the serous detachment (Fig. 2b).

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    a Fundus photo of right eye with white fluffy lesions suggestive of retinitis in the superior and inferior temporal arcades with macular star. b Fundus photo of left eye with white fluffy retinitis lesions in the superior temporal arcade

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    a Pre treatment OCT of right eye suggestive of macular edema. b A normal OCT photo of right eye post treatment

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    a Post treatment fundus photo of right eye showing resolved retinitis lesions with few dispersed hard exudates. b Post treatment fundus photo of left eye with resolved retinitis lesions

    Retinitis is characterized by confluent areas of retinal whitening which progresses along the retinal blood vessels, often associated with intraretinal hemorrhages and hard exudates. A significant number of retinitis cases are thought to be idiopathic in etiology but a small proportion of cases are infectious in etiology such as Toxoplasma gondii (toxoplasmosis), Leptospira spp. (leptospirosis), Mycobacterium tuberculosis (tuberculosis) and other viral and fungal etiologies []. Non infectious causes of retinitis include sarcoidosis, Behcet’s disease. Infectious causes are usually unilateral and may be associated with mild vitritis. Patients can present with Neuroretinitis like picture with optic disc edema and macular hard exudates []. The macular star becomes prominent over first 3 weeks with neuroretinitis resolving over 6–8 weeks []. Leakage from the optic nerve head can lead to retinal swelling, exudation and edema, whereas retinal venous occlusion due to vasculitis results in intraretinal haemorrhage, cotton wool spots and retinal and optic nerve head edema []. It was postulated that microbial pathogens may be responsible for immune mediated ocular and systemic pathology through postinfectious immunological effects. These may be due to molecular mimicry eliciting an immune response that cross react with self antigens. Even though active infection is an unusual cause of retinal vasculitis, it is possible that many idiopathic and systemic disease associated cases are precipitated by previous encounters with microbes bearing DNA sequence homologous to retinal and vascular autoantigens. Similarity between S-antigen and peptides derived from yeast, E. coli, and Hepatitis B virus was found and there was an ability of these microbial peptides to elicit an immune response post infection []. Immune mediated retinitis is a clinical diagnosis most often when there is past history of infection few weeks or days prior to the onset of ocular manifestations. In this case, treatment with oral steroids was initiated due to inflammation of the retina, especially the macula which caused decrease in vision. By taking into consideration the time of onset of ocular presentation, previous history of typhoid fever and the response to oral steroids; the most likely diagnosis was post typhoid fever immune mediated retinitis with macular neurosensory detachment in the right eye and retinitis in left eye. In our case as the disc edema was not prominent, neuroretinitis was not considered as the diagnosis. Similar case reports by Relhan et al. [] and Laul et al. [] showed immune mediated response post typhoid fever presenting with neuroretinitis, vasculitis and macular detachment. Successful treatment with steroids was seen in them. Fusco et al. [] reported a case of bilateral chorioretinitis and stellate maculopathy post typhoid fever. However, in our case Xcyton analysis was done to rule out possible infectious retinitis before initiating steroid therapy, as it could exacerbate non immune mediated retinitis. Xcyton multiplex PCR analysis even though has the advantage of increasing the diagnostic yield it has certain disadvantages like false positive and negative results due to cross reactivity and preferential amplification, negative internal control if there is high amount of a particular target causing exhaustion of reagents and high cost.

    Conclusion

    Immune mediated retinitis can occur following systemic infection and can be managed with steroids followed by good resolution of the lesions. PCR analysis of the aqueous is a rapid diagnostic tool wherein multiple organisms can be detected and sight threatening bacterial and viral infections can be ruled out before initiation of steroid therapy.

    Authors’ contributions

    PM carried out AC tap for Xcyton analysis, did the manuscript editing and review, TT did the data acquisition, literature search and manuscript preparation, GG did the data acquisition and analysis and manuscript review, SA did the data acquisition and analysis. All authors read and approved the final manuscript.

    Acknowledgements

    None.

    Competing interests

    The authors declare that they have no competing interests.

    Contributor Information

    M. Prabhushanker, moc.liamg@reknahsuhbarprd.

    Tasneem T. Topiwalla, moc.liamg@spotsat.

    Geetha Ganesan, moc.liamg@nasenageeg.

    Sripal Appandaraj, moc.liamg@rd.lapirs.

    References

    1. Pegeus DA, Miller SI. Salmonellosis. In: Fauci AS, Braunwald E, Isselbacher KJ, Wilson JD, Martin JB, Kasper DL, editors. Harrison’s principles of internal medicine. 18. New York: McGraw Hill; 2012. pp. 1274–1285. []
    2. Curtis TH, Whealer DT. Infectious diseases. In: Roy FH, Fraunfelder FW, Fraunfelder FT, editors. Current ocular therapy. 6. London: Elsevier Saunders; 2008. pp. 92–94. []
    3. Jacobs DA, Guercio JR, Balcer LJ. Inflammatory optic neuropathies and neuroretinitis. In: Yanoff M, Duker JS, editors. Ophthalmology. 4. London: Elsevier Saunders; 2014. pp. 879–883. []
    4. Houghton OM, Brown GC, Brown MM. Coexistent optic nerve and macular abnormalities. In: Yanoff M, Duker JS, editors. Ophthalmology. 4. London: Elsevier Saunders; 2014. pp. 632–637. []
    5. Hughes EH, Dick AD. The pathology and pathogenesis of retinal vasculitis. Neuropathol Appl Neurobiol. 2003;29:325–340. doi: 10.1046/j.1365-2990.2003.00499.x. [PubMed] [CrossRef[]
    6. Relhan N, Pathengay A, Albini T, Priya K, Jalali S, Flynn HW, et al. A case of vasculitis, retinitis and macular neurosensory detachment presenting post typhoid fever. J Ophthalmic Inflamm Infect. 2014;4:23. doi: 10.1186/s12348-014-0023-y. [PMC free article] [PubMed] [CrossRef[]
    7. Laul R, Atif Ali MIR, Shafi S. Typhoid aftermath: presenting as vasculitis, neuroretinitis and macular neurosensory detachment. Int J Med Res Health Sci. 2015;4:737–739. doi: 10.5958/2319-5886.2015.00143.5. [CrossRef[]
    8. Fusco R, Magli A, Guacci P. Stellate maculopathy due to Salmonella typhiOphthalmologica. 1986;192:154–158. doi: 10.1159/000309629. [PubMed] [CrossRef[
  • Eye twitching: 8 causes and remedies

    What is eye twitching?

    Eye twitching — which actually is twitching of an eyelid — is common and harmless.

    Most eye twitching lasts only a few minutes, but sometimes an eyelid twitch can persist for days or longer. If you have an eye twitch that doesn’t go away relatively quickly, see an eye doctor.

    The medical term for eye twitching is myokymia.

    If you experience eye twitching that doesn’t go away, this could signal a serious neurological condition affecting the eyelid — such as blogs to spasm or hemifacial spasm.

    These relatively rare conditions are more obvious and severe than common eye twitching and should be evaluated immediately by an eye doctor.

    What causes eye twitching?

    Triggers of eye twitching include:

    • Stress
    • Fatigue
    • Eye strain
    • Caffeine
    • Alcohol
    • Dry eyes
    • Nutrition problems
    • Allergies

    If you experience eye twitching, take a close look at this list and note which of these potential triggers might apply to you. Sometimes, making minor changes to your diet and lifestyle can significantly reduce your risk of eye twitching or help make an eyelid twitch disappear.

    Eye twitching causes and fixes

    1. Stress

    Stress is probably the most common cause of eye twitching. Yoga, breathing exercises, spending time with friends or pets and getting more down time into your schedule are ways to reduce stress that may be causing your eyelid twitch.

    2. Fatigue

    Lack of sleep, whether because of stress or some other reason, can trigger eye twitching. Catching up on your sleep and having a consistent sleep schedule can help.

    3. Eye strain

    Eye strain — particularly digital eye strain from overuse of computers, tablets and smartphones — also is a common cause of eyelid twitching.

    Follow the “20-20-20 rule” when using digital devices: Every 20 minutes, look away from your screen and allow your eyes to focus on a distant object (at least 20 feet away) for 20 seconds or longer. This reduces fatigue that may trigger eye twitching.

    Also, ask your eye doctor about computer eyeglasses to relieve digital eye strain.

    EYE CARE

    Eye twitching: 8 causes and remedies

    Woman rubbing her eyes to deal with eyelid twitching.
    Advertisement

    What is eye twitching?

    Eye twitching — which actually is twitching of an eyelid — is common and harmless.

    Most eye twitching lasts only a few minutes, but sometimes an eyelid twitch can persist for days or longer. If you have an eye twitch that doesn’t go away relatively quickly, see an eye doctor.

    The medical term for eye twitching is myokymia.

    If you experience eye twitching that doesn’t go away, this could signal a serious neurological condition affecting the eyelid — such as blepharospasm

    or hemifacial spasm

    . These relatively rare conditions are more obvious and severe than common eye twitching and should be evaluated immediately by an eye doctor.

    What causes eye twitching?

    Triggers of eye twitching include:

    • Stress
    • Fatigue
    • Eye strain
    • Caffeine
    • Alcohol
    • Dry eyes
    • Nutrition problems
    • Allergies

    If you experience eye twitching, take a close look at this list and note which of these potential triggers might apply to you. Sometimes, making minor changes to your diet and lifestyle can significantly reduce your risk of eye twitching or help make an eyelid twitch disappear.

    Eyelid twitching animation

    When your eyelid is twitching, you might think everyone else can see it. But most eye twitches are subtle and are not easily seen by others.

    Eye twitching causes and fixes

    1. Stress

    Stress is probably the most common cause of eye twitching. Yoga, breathing exercises, spending time with friends or pets and getting more down time into your schedule are ways to reduce stress that may be causing your eyelid twitch.

    2. Fatigue

    Lack of sleep, whether because of stress or some other reason, can trigger eye twitching. Catching up on your sleep and having a consistent sleep schedule can help.

    3. Eye strain

    Eye strain — particularly digital eye strain from overuse of computers, tablets and smartphones — also is a common cause of eyelid twitching.

    Follow the “20-20-20 rule” when using digital devices: Every 20 minutes, look away from your screen and allow your eyes to focus on a distant object (at least 20 feet away) for 20 seconds or longer. This reduces fatigue that may trigger eye twitching.

    Also, ask your eye doctor about computer eyeglasses to relieve digital eye strain.

    Infographic: How To Stop  Eye Twitching [Enlarge]

    4. Caffeine

    Too much caffeine can trigger eye twitching. Try cutting back on coffee, tea and soft drinks (or switch to decaffeinated versions) for a week or two and see if your eye twitching disappears.

    5. Alcohol

    If you experience eye twitching after drinking beer, wine or liquor, try abstaining for a while, since alcohol consumption may cause eyelids to twitch.

    6. Dry eyes

    Many adults experience dry eyes, especially after age 50. Dry eyes also are very common among people who use computers, take certain medications (especially antihistamines and some antidepressants), wear contact lenses and consume caffeine and/or alcohol.

    If you have a twitching eyelid and your eyes feel gritty or dry, see your eye doctor for a dry eye evaluation. Restoring moisture to the surface of your eye may stop the eye twitching and decrease the risk of twitching in the future.

    7. Nutrition problems

    Some reports suggest a lack of certain nutritional elements, such as magnesium, can trigger eyelid spasms. Although these reports are not conclusive, this may be another possible cause of eye twitching.

    If you are concerned that your diet may not be supplying all the nutrients you need for healthy vision, discuss this with your eye doctor before purchasing over-the-counter nutritional supplements.

    8. Allergies

    People with eye allergies can have itching, swelling and watery eyes. Rubbing your eyes because of allergy symptoms releases histamine into your eyelid tissues and tear film, which may cause eye twitching.

    Sometimes, over-the-counter eye drops formulated to reduce allergy symptoms can be helpful. But antihistamines in these drops can cause dry eyes. It’s best to consult your eye doctor to make sure you’re doing the right thing for your eyes if you experience allergy symptoms and eye twitching.

    Another way to stop eye twitching: Botox

    In rare cases, some eye twitching just won’t go away, despite applying the remedies above.

    Persistent eyelids twitches can be treated with Botox injections to stop the involuntary muscle contractions in the eyelid that cause the twitching.

    When to see an eye doctor

    See an eye doctor immediately if you experience persistent eye twitching, sudden changes in appearance or movement of half your face (including your eyelids), or if both eyelids clamp down so tight it’s impossible to open your eyes. These can be signs of a serious condition.

  • Cataract – Overview

    According to the World Health Organization, cataracts cause a third of worldwide blindness, affecting approximately 12.6 million people. Cataracts additionally cause moderate to severe vision loss to 52.6 million individuals, 99% of whom live in developing countries.
    Although it is a relatively simple condition to treat surgically in the developed world, in many developing countries, access to eye care is extremely limited. Moreover, as populations age and average life expectancy continues to increase worldwide, the number of people with cataracts will only grow more widespread.
    A Healthy Eye and an Eye with A Cataract
    Risk Factors
    Biological aging is the most common cause of cataracts, but exposure to ultraviolet radiation, skin diseases, injury, infection, smoking, and genetic factors are also causes. Some children are even born with the condition.
    Those living in developing countries, particularly those with agrarian societies, are at increased risk. Individuals who spend much of their day working outdoors without eye protection are exposed to UV-B radiation, which can lead to cataracts.
    Prevention
    While there is no way to completely prevent getting cataracts, the following can lessen the likelihood of developing them:
    1. Living a healthy lifestyle by reducing smoking and alcohol consumption
    2. Avoiding eye trauma by wearing safety goggles
    3. Wearing sunglasses to protect eyes from UV radiation
    Treatment
    Cataract removal is a simple, non-invasive surgical process with a high success rate – 90% of patients report a corrected vision of 20/40 or better afterwards. SEE performs three types of cataract surgery: Phacoemulsification (or “Phaco”), Extra Capsular Cataract Extraction (ECCE) and Manual Small Incision Cataract Surgery (MSICS).
    Cataracts in the developing world generally have gone untreated for a longer period of time than in places like the United States. Thus they are usually denser and harder to remove. MSICS is the generally the ideal technique to use, as it allows the doctor to get the more mature cataract out in a shorter amount of time than if they were to use Phaco.
    Doctors most commonly use Phaco in the developed world. The technique utilizes an expensive handheld ultrasonic probe, which emulsifies (turns to liquid) the clouded lens, which surgeons then replace with an artificial (man-made) lens. ECCE uses a larger incision than phaco and generally needs stitches and thus is less commonly used. The Manual Small Incision technique improves upon ECCE, in that it does not require stitches. Find out more about MSICS here .
    SEE International & Cataracts Around the World
    SEE works diligently to reduce the number of cataract cases around the world in the following ways:
    Performing cataract surgery
    Teaching appropriate cataract surgical techniques, such as Manual Small Incision Cataract Surgery.
    Training local eye care personnel in ophthalmology in rural and urban areas.
    Strengthening local health care infrastructure.

  • Cataract surgery – IOL

    hat Is an Intraocular Lens Implant?

    An intraocular lens implant is an artificial replacement for the lens of your eye. It’s part of the surgery to fix cataracts.

    How Your Eye Works

    Each eye has a lens — a window made of clear protein and water that sits behind the pupil. The lens focuses light onto the retina, which sends it to your brain.

    As you get older, the proteins change and parts of your lens turn cloudy. This is known as a cataract. It can make things look blurry or give them a brownish tint.

    Cataracts are a leading cause of blindness, especially in older people. But they can be corrected through surgery — a procedure that’s done more than 2 million times a year in the United States.

    The Implant

    An intraocular lens implant, or IOL, is made of a clear plastic, and it’s about a third the size of a dime. There are several different types:

    Monofocal IOL: This is the most common. Unlike your natural lens, which can stretch or bend to help your eye focus, this implant stays focused at one fixed distance. If yours focuses at a distance, you might be able to see things far away but need glasses to read or see close up.

    CONTINUE READING BELOW

    Multifocal implant: Like glasses with bifocal or progressive lenses, this lens has areas that help you see things at different distances. It could take several months for your brain to adapt so yourvision seems natural.

    Accommodating IOL: This flexible option acts more like your natural lens and focuses at more than one distance. It makes you less likely to need reading glasses.

    Toric IOL: You’ll get this is if you haveastigmatism, or a cornea that’s more football-shaped than round. This can make vision blurry all over, not just close up or far away. This lens lessens astigmatism so you won’t need glasses to correct it after your surgery.

    The Surgery

    If you have a cataract, you’ll see anophthalmologist. This doctor specializes in eye problems. He’ll probably tell you it’s best to wait to remove the cataract until it starts to affect your daily life. He can do the surgery at a hospital or an outpatient clinic.

    To get you ready, your doctor will:

    • Measure your eye. This will help him pick the right implant for you.
    • Give you medicated eye drops to take for a few days ahead of time
    • Ask you to stop taking some medicines or to skip wearing contact lenses for several days beforehand
    CONTINUE READING BELOW

    On the day of surgery, he’ll:

    • Numb your eye
    • Give you a drug to help you relax. You may see light during the procedure, but you should feel nothing or only a gentle pressure.
    • Make a tiny cut through your cornea to get to the lens
    • Break the lens up into pieces and remove it bit by bit
    • Put the implant in place
    • Let the cut heal by itself — no stitches

    You can usually go home in less than an hour, but you’ll need someone else to drive.

    Is It Risky?

    Any surgery has a chance of complications. It’s rare after an intraocular lens implant, but you might notice bleeding or get an infection. Redness or swelling are more common.

    More serious risks include:

    • A detached retina, which happens when that layer of nerve cells separates from the back of your eye. This is a medical emergency.
    • Vision loss
    • Dislocation — when the implant moves out of position

    You may also get an after-cataract anywhere from weeks to years after surgery. This happens when the tissue around your new lens gets cloudy and your eyesight blurs. Your doctor can fix this with a painless laser procedure.

    CONTINUE READING BELOW

    Follow-Up Care

    It’ll take about 8 weeks to fully heal. During that time:

    • Keep your eye covered with a patch or glasses for the first several days — even when you sleep.
    • Don’t rub or press your eye, even if it’s itchy or oozes a bit of fluid.
    • Take the medicated eye drops your doctor prescribes. You’ll use them for several weeks to help your eye heal.
    • Avoid most exercise or heavy lifting. The doctor will tell you when you can do those things again
  • Cataracts

    What Is an Intraocular Lens Implant?

    An intraocular lens implant is an artificial replacement for the lens of your eye. It’s part of the surgery to fix cataracts.

    How Your Eye Works

    Each eye has a lens — a window made of clear protein and water that sits behind the pupil. The lens focuses light onto the retina, which sends it to your brain.

    As you get older, the proteins change and parts of your lens turn cloudy. This is known as a cataract. It can make things look blurry or give them a brownish tint.

    Cataracts are a leading cause of blindness, especially in older people. But they can be corrected through surgery — a procedure that’s done more than 2 million times a year in the United States.

    The Implant

    An intraocular lens implant, or IOL, is made of a clear plastic, and it’s about a third the size of a dime. There are several different types:

    Monofocal IOL: This is the most common. Unlike your natural lens, which can stretch or bend to help your eye focus, this implant stays focused at one fixed distance. If yours focuses at a distance, you might be able to see things far away but need glasses to read or see close up.

    CONTINUE READING BELOW

    Multifocal implant: Like glasses with bifocal or progressive lenses, this lens has areas that help you see things at different distances. It could take several months for your brain to adapt so yourvision seems natural.

    Accommodating IOL: This flexible option acts more like your natural lens and focuses at more than one distance. It makes you less likely to need reading glasses.

    Toric IOL: You’ll get this is if you haveastigmatism, or a cornea that’s more football-shaped than round. This can make vision blurry all over, not just close up or far away. This lens lessens astigmatism so you won’t need glasses to correct it after your surgery.

    The Surgery

    If you have a cataract, you’ll see anophthalmologist. This doctor specializes in eye problems. He’ll probably tell you it’s best to wait to remove the cataract until it starts to affect your daily life. He can do the surgery at a hospital or an outpatient clinic.

    To get you ready, your doctor will:

    • Measure your eye. This will help him pick the right implant for you.
    • Give you medicated eye drops to take for a few days ahead of time
    • Ask you to stop taking some medicines or to skip wearing contact lenses for several days beforehand
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    On the day of surgery, he’ll:

    • Numb your eye
    • Give you a drug to help you relax. You may see light during the procedure, but you should feel nothing or only a gentle pressure.
    • Make a tiny cut through your cornea to get to the lens
    • Break the lens up into pieces and remove it bit by bit
    • Put the implant in place
    • Let the cut heal by itself — no stitches

    You can usually go home in less than an hour, but you’ll need someone else to drive.

    Is It Risky?

    Any surgery has a chance of complications. It’s rare after an intraocular lens implant, but you might notice bleeding or get an infection. Redness or swelling are more common.

    More serious risks include:

    • A detached retina, which happens when that layer of nerve cells separates from the back of your eye. This is a medical emergency.
    • Vision loss
    • Dislocation — when the implant moves out of position

    You may also get an after-cataract anywhere from weeks to years after surgery. This happens when the tissue around your new lens gets cloudy and your eyesight blurs. Your doctor can fix this with a painless laser procedure.

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    Follow-Up Care

    It’ll take about 8 weeks to fully heal. During that time:

    • Keep your eye covered with a patch or glasses for the first several days — even when you sleep.
    • Don’t rub or press your eye, even if it’s itchy or oozes a bit of fluid.
    • Take the medicated eye drops your doctor prescribes. You’ll use them for several weeks to help your eye heal.
    • Avoid most exercise or heavy lifting. The doctor will tell you when you can do those things again
  • Do you smoke more than 20 cigarettes in a day? It may damage your vision

    1. Smoking more than 20
      cigarettes a day may damage your vision by affecting blood vessels and neurons in the retina, a study warns.
      The study, published in the journal Psychiatry Research, included 71 healthy people who smoked fewer than 15 cigarettes in their lives and 63 who smoked more than 20 cigarettes a day, were diagnosed with tobacco addiction and reported no attempts to stop.
      The participants were between the ages of 25 and 45 and had normal or corrected-to-normal vision as measured by standard visual acuity charts, said researchers from the Rutgers University in the US.

    They looked at how participants discriminated contrast levels (subtle differences in shading) and colours while seated 59 inches from a 19-inch cathode-ray tube monitor that displayed stimuli while researchers monitored both eyes simultaneously.

    The findings indicated significant changes in the smokers’ red-green and blue-yellow colour vision, which suggests that consuming substances with neurotoxic chemicals, such as those in cigarettes, may cause overall colour vision loss.
    They also found that the heavy smokers had a reduced ability to discriminate contrasts and colours when compared to the non-smokers.
    “Cigarette smoke consists of numerous compounds that are harmful to health,” said Steven Silverstein, director of research at Rutgers University Behavioral Health Care.
    “it has been linked to a reduction in the thickness of layers in the brain, and to brain lesions, involving areas such as the frontal lobe, which plays a role in voluntary movement and control of thinking, and a decrease in activity in the area of the brain that processes vision,” said Silverstein.
    Previous studies have pointed that long-term smoking doubles the risk for age-related macular degeneration and causes lens yellowing and inflammation.
    “Our results indicate that excessive use of cigarettes, or chronic exposure to their compounds, affects visual discrimination, supporting the existence of overall deficits in visual processing with tobacco addiction,” Silverstein said.
    Although the research did not give a physiological explanation for the results, Silverstein said that since nicotine and smoking harm the vascular system, the study suggests they also damage blood vessels and neurons in the retina.
    He said the findings also suggest that research into visual processing impairments in other groups of people, such as those with schizophrenia who often smoke heavily, should take into account their smoking rate or independently examine smokers versus non-smokers.

  • Importance of regular eye check

    Why are eye tests important?

    Regular eye tests are important because your eyes don’t usually hurt when something is wrong. A sight test is a vital health check for your eyes that can pick up early signs of eye conditions before you’re aware of any symptoms – many of which can be treated if found early enough.
    What your eye test will show
    A sight test will show if you need to:
    get glasses for the first time
    change your current glasses
    A sight test will also include a general health check that can pick up early signs of eye disease before you’re aware of any symptoms. Some health conditions can affect the eyes such as:
    diabetes
    macular degeneration
    glaucoma
    Your sight test
    Optometrists recommend that most people should get their eyes tested every two years. However, in some circumstances, they may recommend more frequent NHS sight tests; for example, if you:
    are a child wearing glasses
    have diabetes
    are aged 40 or over and have a family history of
    glaucoma
    are aged 70 or over
    The way a sight test is carried out is governed by law. A sight test will identify:
    what your level of vision is
    whether you need glasses to correct your sight
    Your eyes and the area around them will be examined, to look for signs of injury, disease or abnormality.
    During your appointment, you may see more than one practitioner, for example:
    an optometrist or ophthalmic medical practitioner, who tests your sight to check the quality of your vision and your eye health
    a dispensing optician, who fits your glasses
    If you already wear glasses or contact lenses, remember to take them with you to your sight test. You may be asked to wear them during the test.
    What happens after a sight test?
    At the end of your sight test, your ophthalmic practitioner will discuss the results with you. They will tell you whether:
    your sight needs correcting
    you need to be referred for further investigation
    They will also give you an optical statement or prescription to say that:
    you don’t need glasses
    your current glasses don’t need changing
    you have been given a new or changed prescription
    you are being referred to your GP or an eye clinic
    You can take your new or changed prescription to any supplier to have your glasses made up.
    If you’re entitled to an NHS optical voucher, this will also be given to you after your NHS sight test. You can also take your voucher to any supplier to buy glasses or contact lenses, providing they accept optical vouchers. For more information, see
    Am I entitled to an NHS optical voucher?
    Children under 16 and individuals who are registered blind or partially sighted can only have their appliances dispensed by or under the supervision of a registered medical practitioner, registered optometrist or registered dispensing optician.