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EYE CONDITIONS

Ambylopia

Amblyopia is a term used to describe an uncorrectable loss of vision in an eye that appears to be normal. It’s commonly referred to as “lazy eye” and can occur for a variety of reasons. A child’s visual system is fully developed between approximately the ages of 9-11. Until then, children readily adapt to visual problems by suppressing or blocking out the image. If caught early, the problem can often be corrected and the vision preserved. However, after about age 11, it is difficult if not impossible to train the brain to use the eye normally. Some causes of amblyopia include: strabismus (crossed or turned eye), congenital cataracts, cloudy cornea, droopy eyelid, unequal vision and uncorrected nearsightedness, farsightedness or astigmatism. Amblyopia may occur in various degrees depending on the severity of the underlying problem. Some patients just experience a partial loss; others are only able to recognize motion. Patients with amblyopia lack binocular vision, or stereopsis – the ability to blend the images of both eyes together. Stereopsis is what allows us to appreciate depth. Without it, the ability to judge distance is impaired.

Astigmatism

Astigmatism means that the cornea is oval like a football instead of spherical like a basketball. Most astigmatic corneas have a steeper curve and a flatter curve. This causes light to focus on more than one point in the eye, resulting in blurred vision at distance or near. Astigmatism often occurs along with or farsightedness.

Blepharitis

Blepharitis is a common inflammatory condition that affects the eyelid. It usually causes burning, itching and irritation of the lids. In severe cases, it may also cause styes, irritation and inflammation of the cornea (keratitis) and conjunctiva (conjunctivitis). Some patients have no symptoms at all. Blepharitis is usually a chronic problem that can be controlled with extra attention to lid hygiene. However, it is sometimes caused by an infection and may require medication.

Artery Occlusion

A retinal artery occlusion occurs when the central retinal artery or one of the arteries that branch off of it becomes blocked. This blockage is typically caused by a tiny embolus (clot) in the blood stream. The occlusion decreases the oxygen supply to the area of the retina nourished by the affected artery, causing permanent vision loss.In this photograph, the affected area of the retina is the pale, whitish-yellow region (blue arrows) that is normally supplied by the blocked artery (white arrow). The surrounding reddish-orange area is healthy retina tissue.

Cataracts

When cataracts are mentioned, people often think of a film that grows on their eyes causing them to see double or blurred images. However, a cataract does not form on the eye, but rather within the eye.

 
Eye without a cataract   Eye with a cataract

A cataract is a clouding of the natural lens, the part of the eye responsible for focusing light and producing clear, sharp images. The lens is contained in a sealed bag or capsule. As old cells die they become trapped within the capsule. Over time, the cells accumulate causing the lens to cloud, making images look blurred or fuzzy. For most people, cataracts are a natural result of aging.

In fact, they are the leading cause of visual loss among adults 55 and older. Eye injuries, certain medications, and diseases such as diabetes and alcoholism have also been known to cause cataracts.

Chalazion

A chalazion (stye) is a small lump in the eyelid caused by obstruction of an oil producing or meibomian gland. Chalazia may occur in the upper or lower lids, causing redness, swelling and soreness in some cases.

Chorodial Nevus

A nevus is typically a flat, benign, pigmented area that may appear inside the eye or on its surface. Nevi commonly appear on the choroid (the layer just behind the retina, the iris, and the conjunctiva. Nevi are similar to freckles, and do not typically change or grow. SIGNS AND SYMPTOMS

Cystoid Macular Edema (CME)

Cystoid macular edema (CME), or swelling of the macula, typically occurs as a result of disease, injury or more rarely, eye surgery. Fluid collects within the layers of the macula, causing blurred, distorted central vision. CME rarely causes a permanent loss of vision, but the recovery is often a slow, gradual process. The majority of patients recover in 2 to 15 months. In this retinal photograph, the swelling is the yellowish spots (arrow) in the macula. SIGNS AND SYMPTOMS

Color Blindness

Color blindness may be a hereditary condition or caused by disease of the optic nerve or retina. Acquired color vision problems only affect the eye with the disease and may become progressively worse over time. Patients with a color vision defect caused by disease usually have trouble discriminating blues and yellows.

Inherited color blindness is most common, affects both eyes, and does not worsen over time. This type is found in about 8% of males and 0.4% of females. These color problems are linked to the X chromosome and are almost always passed from a mother to her son.

Color blindness may be partial (affecting only some colors), or complete (affecting all colors). Complete color blindness is very rare. Those who are completely color blind often have other serious eye problems as well.

Photoreceptors called cones allow us to appreciate color. These are concentrated in the very center of the retina and contain three photosensitive pigments: red, green and blue. Those with defective color vision have a deficiency or absence in one or more of these pigments. Those with normal color vision are referred to as trichromats. People with a deficiency in one of the pigments are called anomalous trichromats (the most common type of color vision problem.) A dichromat has a complete absence in one cone pigment.

Computer Vision Syndrome

Computer vision syndrome (CVS) is a term that describes eye-related problems and the other symptoms caused by prolonged computer use. As our dependence on computers continues to grow, an increasing number of people are seeking medical attention for eye strain and irritation, along with back, neck, shoulder, and wrist soreness.

 
Magnified view of a letter on a computer screen   Magnified view of a printed letter

These problems are more noticeable with computer tasks than other near work because letters on the screen are formed by tiny dots called pixels, rather than a solid image. This causes the eye to work a bit harder to keep the images in focus.

There is no scientific evidence that computer screens are harmful to the eyes. A common myth is that eye strain caused by reading and close work is damaging to the eyes. This is not true; however, those who work at computers often experience many frustrating symptoms.

St. Luke's Cataract & Laser Institute provides this on-line information for educational and communication purposes only and it should not be construed as personal medical advice. Information published on this St. Luke's website is not intended to replace, supplant, or augment a consultation with an eye care professional regarding the viewer/user's own medical care. St. Luke's disclaims any and all liability for injury or other damages that could result from use of the information obtained from this site.

Conjunctivitis

Conjunctivitis, commonly known as pink eye, is an infection of the Conjunctiva (the outer-most layer of the eye that covers the Conjunctivitis ( pink eye ) sclera). The three most common types of conjunctivitis are viral, allergic, and bacterial. Each requires different treatments. With the exception of the allergic type, conjunctivitis is typically contagious. The viral type is often associated with an upper respiratory tract infection, cold, or sore throat. The allergic type occurs more frequently among those with allergic conditions. When related to allergies, the symptoms are often seasonal. Allergic conjunctivitis may also be caused by intolerance to substances such as cosmetics, perfume, or drugs. Bacterial conjunctivitis is often caused by bacteria such as staphylococcus and streptococcus. The severity of the infection depends on the type of bacteria involved.

Corneal Erosion

Recurrent corneal erosion is a condition affecting the outermost layer of corneal cells called the epithelium. The problem is caused when the bottom layer of epithelial cells adhere poorly to the cornea, causing them to slough off easily. The pain and discomfort is often quite intense, and similar to a corneal abrasion. There is usually an underlying disorder that causes recurrent corneal erosions to occur. The most common are: previous corneal injury (corneal abrasion), corneal dystrophy (Map Dot Fingerprint Dystrophy), or corneal disease resulting in recurrent breakdown of the epithelial cells.

Upon awakening, patients often experience severe pain, blurred vision, and light sensitivity when the eyelid pulls the loosened epithelial cells off the cornea. After the cornea heals, the problem recurs as the name implies unless the condition is treated. Recurrent corneal erosion may affect one or both eyes, depending on the underlying cause.

Signs and Symptoms

  • Severe pain (especially after awakening)
  • Blurred vision
  • Foreign body sensation
  • Dryness and irritation
  • Tearing
  • Red eye
  • Light sensitivity

Corneal Neovascularization

New (neo) blood vessel growth (vascularization) on the cornea. Often caused by contact lens complications. The blood vessels in this photograph (arrows) are abnormal in size, shape, and location, indicating corneal neovascularization.

 

St. Luke's Cataract & Laser Institute provides this on-line information for educational and communication purposes only and it should not be construed as personal medical advice. Information published on this St. Luke's website is not intended to replace, supplant, or augment a consultation with an eye care professional regarding the viewer/user's own medical care. St. Luke's disclaims any and all liability for injury or other damages that could result from use of the information obtained from this site.

Corneal Ulcer

A corneal ulcer forms when the surface of the cornea is damaged or compromised. Ulcers may be sterile (no infecting organisms) or infectious. The term infiltrate is also commonly used along with ulcer. Infiltrate refers to an immune response causing an accumulation of cells or fluid in an area of the body where they don't normally belong.

Whether or not an ulcer is infectious is an important distinction for the physician to make and determines the course of treatment. Bacterial ulcers tend to be extremely painful and are typically associated with a break in the epithelium, the superficial layer of the cornea. In some cases, the inflammatory response involves the anterior chamber along with the cornea. Certain types of bacteria, such as Pseudomonas, are extremely aggressive and can cause severe damage and even blindness within 24-48 hours if left untreated.

Sterile infiltrates on the other hand, cause little if any pain. They are often found near the peripheral edge of the cornea and are not necessarily accompanied by a break in the epithelial layer of the cornea.

There are many causes of corneal ulcers. Contact lens wearers (especially soft) have an increased risk of ulcers if they do not adhere to strict regimens for the cleaning, handling, and disinfection of their lenses and cases. Soft contact lenses are designed to have very high water content and can easily absorb bacteria and infecting organisms if not cared for properly. Pseudomonas is a common cause of corneal ulcer seen in those who wear contacts.

Bacterial ulcers may be associated with diseases that compromise the corneal surface, creating a window of opportunity for organisms to infect the cornea. Patients with severely dry eyes, difficulty blinking, or are unable to care for themselves, are also at risk. Other causes of ulcers include: herpes simplex viral infections, inflammatory diseases, corneal abrasions or injuries, and other systemic diseases.

Diabetic Retinopathy

Diabetes is a disease that occurs when the pancreas does not secrete enough insulin or the body is unable to process it properly. Insulin is the hormone that regulates the level of sugar (glucose) in the blood. Diabetes can affect children and adults.



How does diabetes affect the retina?

Patients with diabetes are more likely to develop eye problems such as cataracts and glaucoma, but Diabetic retinopathy vision the effect of the disease on the retina is the main threat to vision. Most patients develop diabetic changes in the retina after approximately 20 years.The effect of diabetes on the eye is called diabetic retinopathy.

Over time, diabetes affects the circulatory system of the retina. The earliest phase of the disease is known as background diabetic retinopathy. In this phase, the arteries in the retina become weakened and leak, forming small, dot-like hemorrhages. These leaking vessels often lead to swelling or edema in the retina and decreased vision.

The next stage is known as proliferative diabetic retinopathy. In this stage, circulation problems cause areas of the retina to become oxygen-deprived or ischemic. New, fragile, vessels develop as the circulatory system attempts to maintain adequate oxygen levels within the retina. This is called neovascularization. Unfortunately, these delicate vessels hemorrhage easily. Blood may leak into the retina and vitreous, causing spots or floaters, along with decreased vision.

In the later phases of the disease, continued abnormal vessel growth and scar tissue may cause serious problems such as retinal detachment and glaucoma.

Dry Eye Syndrome

Dry eye syndrome is one of the most common problems treated by eye physicians. Over ten million Americans suffer from dry eyes. It is usually caused by a problem with the quality of the tear film that lubricates the eyes.

Tears are comprised of three layers. The mucus layer coats the cornea, the clear outer window of the eye, forming a foundation so the tear film can adhere to the eye. The middle aqueous layer provides moisture and supplies oxygen and other important nutrients to the cornea. This layer is made of 98 percent water along with small amounts of salt, proteins and other compounds. The outer lipid layer is an oily film that seals the tear film on the eye and helps to prevent evaporation.

Tears are formed in several glands around the eye. The water layer is produced in the lacrimal gland, located under the upper eyelid. Several smaller glands in the lids make the oil and mucus layers. With each blink, the eyelids spread the tears over the eye. Excess tears flow into two tiny drainage ducts in the corner of the eye by the nose. These ducts lead to tiny canals that connect to the nasal passage. The connection between the tear ducts and the nasal passage is the reason that crying causes a runny nose.

In addition to lubricating the eye, tears are also produced as a reflex response to outside stimulus such as an injury or emotion. However, reflex tears do little to soothe a dry eye, which is why someone with watery eyes may still complain of irritation.

Dry eye syndrome has many causes. One of the most common reasons for dryness is simply the normal aging process. As we grow older, our bodies produce less oil - 60% less at age 65 then at age 18. This is more pronounced in women, who tend to have drier skin then men. The oil deficiency also affects the tear film. Without as much oil to seal the watery layer, the tear film evaporates much faster, leaving dry areas on the cornea.

Many other factors, such as hot, dry or windy climates, high altitudes, air-conditioning and cigarette smoke also cause dry eyes. Many people also find their eyes become irritated when reading or working on a computer. Stopping periodically to rest and blink keeps the eyes more comfortable.

Contact lens wearers may also suffer from dryness because the contacts absorb the tear film, causing proteins to form on the surface of the lens. Certain medications, thyroid conditions, vitamin A deficiency, and diseases such as Parkinson's and Sjogren's can also cause dryness. Women frequently experience problems with dry eyes as they enter menopause because of hormonal changes.

Floaters

The space between the crystalline lens and the retina is filled with a clear, gel-like substance called vitreous. In a newborn, Floaters the vitreous has an egg-white consistency and is firmly attached to the retina. With age, the vitreous thins and may separate from the back of the eye. This is called posterior vitreous detachment (PVD), a very common, usually harmless condition.

As the vitreous pulls free from the retina, it is often accompanied by light flashes or floaters. Floaters are caused by tiny bits of vitreous gel or cells that cast shadows on the retina. Flashes occur when the vitreous tugs on the sensitive retina tissue.

There are other more serious causes of flashes and floaters, however. Retinal tears retinal detachment, infection, inflammation, hemorrhage, or an injury such as a blow to the head may also cause floaters and flashes. (Have you ever seen stars after bumping your head?) Occasionally, flashes of light are caused by neurological problems such as a migraine headache. When related to a headache, the flashes of light are seen in both eyes and usually lasts 20-30 minutes before the headache starts.

Foreign Body

Anyone who has felt as if there was a grain of sand in his or her eye has probably had a foreign body. Foreign bodies might be superficial, or in more serious injuries, they may penetrate the eye. Fortunately, the cornea has such an incredible reflex tearing system that most superficial foreign bodies are naturally flushed out with our natural tears. But if the object is more deeply embedded, medical attention is required.

This photo-illustration shows a foreign body in the iris tissue. The patieint was hammering a nail (without wearing eye protection) and was struck in the eye by a chip from the nail. Note how the nail chip tore the iris.

Glaucoma

Glaucoma is a disease caused by increased intraocular pressure (IOP) resulting either from a malformation or malfunction of the eye's drainage structures. Left untreated, an elevated IOP causes irreversible damage the optic nerve and retinal fibers resulting in a progressive, permanent loss of vision. However, early detection and treatment can slow, or even halt the progression of the disease.

What causes glaucoma?

The eye constantly produces aqueous, the clear fluid that fills the anterior chamber (the space between the cornea and iris). The aqueous filters out of the anterior chamber through a complex drainage system. The delicate balance between the production and drainage of aqueous determines the eye's intraocular pressure (IOP). Most people's IOPs fall between 8 and 21. However, some eyes can tolerate higher pressures than others. That's why it may be normal for one person to have a higher pressure than another.

Common types of glaucoma

Open Angle

Open angle (also called chronic open angle or primary open angle) is the most common type of glaucoma. With this type, even though the anterior structures of the eye appear normal, aqueous fluid builds within the anterior chamber, causing the IOP to become elevated. Left untreated, this may result in permanent damage of the optic nerve and retina. Eye drops are generally prescribed to lower the eye pressure. In some cases, surgery is performed if the IOP cannot be adequately controlled with medical therapy.

Acute Angle Closure

Only about 10% of the population with glaucoma has this type. Acute angle closure occurs because of an abnormality of the structures in the front of the eye. In most of these cases, the space between the iris and cornea is more narrow than normal, leaving a smaller channel for the aqueous to pass through. If the flow of aqueous becomes completely blocked, the IOP rises sharply, causing a sudden angle closure attack.

While patients with open angle glaucoma don’t typically have symptoms, those with angle closure glaucoma may experience severe eye pain accompanied by nausea, blurred vision, rainbows around lights, and a red eye. This problem is an emergency and should be treated by an ophthalmologist immediately. If left untreated, severe and permanent loss of vision will occur in a matter of days.

  • Secondary Glaucoma
  • This type occurs as a result of another disease or problem within the eye such as: inflammation, trauma, previous surgery, diabetes, tumor, and certain medications. For this type, both the glaucoma and the underlying problem must be treated.

  • Congenital
  • This is a rare type of glaucoma that is generally seen in infants. In most cases, surgery is required.

    Signs and Symptoms

    Glaucoma is an insidious disease because it rarely causes symptoms. Detection and prevention are only possible with routine eye examinations. However, certain types, such as angle closure and congenital, do cause symptoms.

    Angle Closure (emergency)

    • Sudden decrease of vision
    • Extreme eye pain
    • Headache
    • Nausea and vomiting
    • Glare and light sensitivity

    Congenital

    • Tearing
    • Light sensitivity
    • Enlargement of the cornea

    Hyperopia

    Farsightedness or hyperopia, occurs when light entering the eye focuses behind the retina, instead of directly on it. This is caused by a cornea that is flatter, or an eye that is shorter, than a normal eye. Farsighted people usually have trouble seeing up close, but may also have difficulty seeing far away as well.

     

    Young people with mild to moderate hyperopia are often able to see clearly because their natural lens can adjust, or accommodate to increase the eye's focusing ability. However, as the eye gradually loses the ability to accommodate (beginning at about 40 years of age), blurred vision from hyperopia often becomes more apparent.

    Iris Atrophy

    A thinning or total loss of iris pigment, often displacing the pupil. This image, in which the iris is backlighted by bouncing light through the pupil and off the orange retina on the back of the eye, reveals thinning of the pigment in the iris (arrow).

    St. Luke's Cataract & Laser Institute provides this on-line information for educational and communication purposes only and it should not be construed as personal medical advice. Information published on this St. Luke's website is not intended to replace, supplant, or augment a consultation with an eye care professional regarding the viewer/user's own medical care. St. Luke's disclaims any and all liability for injury or other damages that could result from use of the information obtained from this site.

       

    Keratoconus

    Keratoconus is a degenerative disease of the cornea that causes it to gradually thin andKeratoconus bulge into a cone-like shape. This shape prevents light from focusing precisely on the macula As the disease progresses, the cone becomes more pronounced, causing vision to become blurred and distorted. Because of the cornea's irregular shape, patients with keratoconus are usually very nearsighted and have a high degree of astigmatism that is not correctable with glasses.

    Keratoconus is sometimes an inherited problem that usually occurs in both eyes.

    Lymphoma

    A tumor on the conjunctiva (outer skin of the eyeball). In this photograph, the lymphoma is the salmon colored protrusion above the cornea (arrows).

    St. Luke's Cataract & Laser Institute provides this on-line information for educational and communication purposes only and it should not be construed as personal medical advice. Information published on this St. Luke's website is not intended to replace, supplant, or augment a consultation with an eye care professional regarding the viewer/user's own medical care. St. Luke's disclaims any and all liability for injury or other damages that could result from use of the information obtained from this site.

    Macular Degeneration

    Age-related macular degeneration (ARMD) is a degenerative condition of the macula (the central retina). It is the most common cause of vision loss in the United States in those 50 or older, and its prevalence increases with age. AMD is caused by hardening of the arteries that nourish the retina. This deprives the sensitive retinal tissue of oxygen and nutrients that it needs to function and thrive. As a result, the central vision deteriorates.

    This example demonstrates what a patient with advanced macular degeneration sees. Macular degeneration varies widely in severity. In the worst cases, it causes a complete loss of central vision, making reading or driving impossible. For others, it may only cause slight distortion. Fortunately, macular degeneration does not cause total blindness since it does not affect the peripheral vision.

    AMD is classified as either wet (neovascular) or dry (non-neovascular). About 10% of patients who suffer from macular degeneration have wet AMD. This type occurs when new vessels form to improve the blood supply to oxygen-deprived retinal tissue. However, the new vessels are very delicate and break easily, causing bleeding and damage to surrounding tissue.

     

      Patient with wet macular degeneration develop new blood vessels under the retina. This causes hemorrhage, swelling, and scar tissue but it can be treated with laser in some cases.

     

      Dry macular degeneration, although more common, typically results in a less severe, more gradual loss of vision.

      The dry type is much more common and is characterized by drusen and loss of pigment in the retina. Drusen are small, yellowish deposits that form within the layers of the retina.

    Macular Hole

    Macular hole is a problem that affects the very central portion of the retina. It happens for a variety of reasons such as: eye injuries, certain diseases, and inflammation inside the eye. However, the most common cause is related to the normal aging process. The vitreous gel inside the eye is firmly attached to the macula. With age, the vitreous becomes thinner and separates from the retina. Sometimes this creates traction on the macula, causing a hole to form.

    Macular holes often begin gradually and affect central vision depending on the severity and extent of the problem. Partial holes only affect part of the macular layers, causing wavy, distorted, blurred vision. Patients with full-thickness macular holes experience a complete loss of central vision.

    Myelinated Nerve Fibers (MNF)

    Nerve fibers in the retina, which are covered with patches of a fat like substance (arrows) called myelin. This condition is congenital and rarely causes loss of vision or requires treatment.

    St. Luke's Cataract & Laser Institute provides this on-line information for educational and communication purposes only and it should not be construed as personal medical advice. Information published on this St. Luke's website is not intended to replace, supplant, or augment a consultation with an eye care professional regarding the viewer/user's own medical care. St. Luke's disclaims any and all liability for injury or other damages that could result from use of the information obtained from this site.

    Myopia

    Nearsightedness or myopia, occurs when light entering the eye focuses in front of the retina instead of directly on it. This is caused by a cornea that is steeper, or an eye that is longer, than a normal eye. Nearsighted people typically see well up close, but have difficulty seeing far away.

    This problem is often discovered in school-age children who report having trouble seeing the chalkboard. Near-sightedness usually becomes progressively worse through adolescence and stabilizes in early adulthood. It is an inherited problem.

     

    • Blurry distance vision
    • Vision seems clearer when squinting

    Nearsightedness is detected with a vision test and refraction.

    The treatment for nearsightedness depends on several factors such as the patient's age, activities, and occupation. Vision can corrected with glasses, contacts, or surgery. Refractive procedures such as LASIK can be considered for adults when the prescription has remained stable for at least one year.

    St. Luke's Cataract & Laser Institute provides this on-line information for educational and communication purposes only and it should not be construed as personal medical advice. Information published on this St. Luke's website is not intended to replace, supplant, or augment a consultation with an eye care professional regarding the viewer/user's own medical care. St. Luke's disclaims any and all liability for injury or other damages that could result from use of the information obtained from this site.

    Nevus

    A nevus is typically a flat, benign, pigmented area that may appear inside the eye or on its surface. Nevi commonly appear on the choroid (the layer just behind the retina), the iris, and the conjunctiva. Nevi are similar to freckles, and don't typically change or grow.

    Ocular Rosacea

    Ocular rosacea is associated with a chronic skin condition known as acne rosacea. The problem usually affects those with light skin, and is characterized by redness and bumps concentrated on the forehead, nose and cheeks. One of the earliest symptoms of rosacea (often experienced during puberty) is facial flushing brought on by changes in body temperature, emotion, or hot drinks. Eventually, the skin may become chronically red, irritated and inflamed.

    Approximately 60% of patients with rosacea develop related problems affecting the eye (ocular rosacea). Patients with ocular rosacea most commonly experience irritation of the lids and eye, occurring when the oil-producing glands of the lids become obstructed. Styes, blepharitis, episcleritis, and chronically red eyes are also typical conditions. Ocular rosacea may also affect the cornea, causing neovascularization (abnormal blood vessel growth), infections, and occasionally ulcers.

    Neovascularization of the Optic Nerve Head

    New blood vessel growth on the optic nerve head. In this photograph, abnormal new blood vessels (arrows) can be seen growing off of the disc and into the vitreous (the clear gel inside the eye). This condition is common in patients with proliferative diabetic retinopathy.

    St. Luke's Cataract & Laser Institute provides this on-line information for educational and communication purposes only and it should not be construed as personal medical advice. Information published on this St. Luke's website is not intended to replace, supplant, or augment a consultation with an eye care professional regarding the viewer/user's own medical care. St. Luke's disclaims any and all liability for injury or other damages that could result from use of the information obtained from this site.

    Pinguecula

    A pinguecula (pin gwe' cue la) is a benign, yellowish growth that forms on the conjunctiva They usually grow near the cornea on the nasal side. Pingueculae (plural form of pinguecula) are thought to be caused by ultraviolet light and are most common among people who spend a great deal of time outdoors.

    This growth does not affect vision, but may cause irritation if it becomes elevated. In rare cases, the pinguecula may gradually extend over the cornea, forming a pterygium.

    Presbyopia

    Presbyopia, also known as the "short arm syndrome", is a term used to describe an eye in which the natural lens can no longer accommodate. Accommodation is the eye's way of changing its focusing distance: the lens thickens, increasing its ability to focus close-up. At about the age of 40, the lens becomes less flexible and accommodation is gradually lost. It's a normal process that everyone eventually experiences.

    Most people first notice difficulty reading very fine print such as the phone book, a medicine bottle, or the stock market page. Print seems to have less contrast and the eyes become easily fatigued when reading a book or computer screen. Early on, holding reading material further away helps for many patients. But eventually, reading correction in the form of reading glasses, bifocals, or contact lenses is needed for close work. However, nearsighted people can simply take their glasses off because they see best close-up.

    Pterygium

    Pterygium is a raised, wedge-shaped growth of the conjunctiva. It is most common among those who live in tropical climates or spend a lot of time in the sun. Symptoms may include irritation, redness, and tearing. Pterygiums are nourished by tiny capillaries that supply blood to the tissue. For some, the growth remains dormant; however, in other cases it grows over the central cornea and affects the vision. As the pterygium develops, it may alter the shape of the cornea, causing astigmatism. If the pterygium invades the central cornea, it is removed surgically.

    Since pterygiums are most commonly caused by sun exposure, protecting the eyes from sun, dust and wind is recommended. Instilling artificial tears liberally is also helpful to decrease irritation. In some cases, steroid drops are prescribed to reduce inflammation.

    St. Luke's Cataract & Laser Institute provides this on-line information for educational and communication purposes only and it should not be construed as personal medical advice. Information published on this St. Luke's website is not intended to replace, supplant, or augment a consultation with an eye care professional regarding the viewer/user's own medical care. St. Luke's disclaims any and all liability for injury or other damages that could result from use of the information obtained from this site.

    Ptosis

    Ptosis (pronounced toe' sis), or drooping of the upper eyelid, may occur for several reasons such as: disease, injury, birth defect, previous eye surgery and age. In most cases, it is caused by either a weakness of the levator muscle (muscle that raises the lid), or a problem with the nerve that sends messages to the muscle.

    Children born with ptosis may require surgical correction of the lid if it covers the pupil. In some cases, it may be associated with a crossed or misaligned eye (strabismus). Left untreated, ptosis may prevent vision from developing properly, resulting in amblyopia, or lazy eye.

    Patients with ptosis often have difficult blinking, which may lead to irritation, infection and eyestrain. If a sudden and obvious lid droop is developed, an ophthalmologist should be consulted immediately.

    Retinal Detachment

    Retinal tears commonly occur when there is traction on the retina by the vitreous inside the eye. In a child's eye, theRetinal detachment vitreous has an egg-white consistency and is firmly attached to certain areas of the retina. Over time, the vitreous gradually becomes thinner, more liquid and separates from the retina. This is known as a posterior vitreous detachment (PVD).

    PVDs are typically harmless and cause floaters in the eye; but in some cases, the traction on the retina may create a tear. Retinal tears frequently lead to detachments as fluids seep underneath the retina, causing it to separate and detach.

    A retinal detachment occurs when the retina's sensory and pigment layers separate.Because it can cause devastating damage to the vision if left untreated, retinal detachment is considered an ocular emergency that requires immediate medical attention and surgery. It is a problem that occurs most frequently in the middle-aged and elderly.

    There are three types of retinal detachments. The most common type occurs when there is a break in the sensory layer of the retina, and fluid seeps underneath, causing the layers of the retina to separate. Those who are very nearsighted, have undergone eye surgery, or have experienced a serious eye injury are at greater risk for this type of detachment. Nearsighted people are more susceptible because their eyes are longer than average from front to back, causing the retina to be thinner and more fragile.

    The second most common type occurs when strands of vitreous or scar tissue create traction on the retina, pulling it loose. Patients with diabetes are more likely to experience this type.

    The third type happens when fluid collects underneath the layers of the retina, causing it to separate from the back wall of the eye. This type usually occurs in conjunction with another disease affecting the eye that causes swelling or bleeding.

    Retinitis Pigmentosa

    Retinitis pigmentosa (RP) is a rare, hereditary disease that causes the rod photoreceptors in the retina to gradually degenerate. The rods are located in the periphery of the retina and are responsible for peripheral and night vision. Cones, another type of photoreceptor, are densely concentrated in the macula. The cones are responsible for central visual acuity and color vision.

    The disease may be X-linked (passed from a mother to her son), autosomal recessive (genes required from both parents) or autosomal dominant (gene required from one parent) trait. Since it is often a sex-linked disease, retinitis pigmentosa affects males more than females.

    People with RP usually first notice difficulty seeing in dim lighting and gradually lose peripheral vision. The course of RP varies. For some, the affect on vision may be mild. Others experience a progression of the disease that leads to blindness.

    In many cases, RP is diagnosed during childhood when the symptoms begin to become apparent. However, depending on the progression of the disease, it may not be detected until later in life.

    Retinopathy of Prematurity (ROP)

    Retinopathy of Prematurity (ROP), also known as retrolental fibroplasia, is a potentially blinding condition affecting the retina of newborns. In the 1950's it was associated with the use of high amounts of oxygen in neonatal units. Today, modern neonatal care has curbed the incidence, yet because the survival rate of low birth weight infants is much higher, the exposure of surviving babies to required oxygen levels is increasing. The factors that put infants at greatest risk of developing ROP are low birth weight (less than 3.5 pounds) and premature delivery (26-28 weeks).

    In babies born prematurely, the growth and development of normal blood vessels in the retina is halted and abnormal vessels may begin to develop. The problem with abnormal vessel growth, known as neovascularization, is that it does not deliver adequate oxygen supply to the retina. In addition, it may cause many secondary problems.

    ROP is classified in 5 stages, depending on the extent of the disease. Progression of the disease to later stages can lead to the formation of scar tissue in the retina and complications such as: retinal detachment, vitreous hemorrhage, strabismus, and amblyopia. Many children with ROP develop nearsightedness

    Strabismus

    Strabismus is a problem caused by one or more improperly functioning eye muscles, resulting in a misalignment of the eyes. Normally, each eye focuses on the same spot but sends a slightly different message to the brain. The brain superimposes the two images, giving vision depth and dimension. Here's an easy way to see how the eyes work together: hold your finger at arm's length. While looking at your finger, close one eye, then the other. Notice how your finger changes position. Even though the images are slightly different, the brain interprets them as one.

    Each eye has six muscles that work in unison to control movements. The brain controls the eye muscles, which keep the eyes properly aligned. It is critical that the muscles function together for the brain to interpret the image from each eye as a single one.

    Strabismus must be detected early in children because they are so adaptable. If a child sees double, his or her brain quickly learns to suppress or block out one of the images to maintain single vision. In a very short time, the brain permanently suppresses vision from the turned eye, causing a weak or amblyopic eye. Children may also develop a head tilt or turn to compensate for the problem and eliminate the double image. Unlike children, adults with a newly acquired strabismus problem typically see double.

    There are many causes of strabismus. It can be inherited, or it may be caused by trauma, certain diseases, and sometimes eye surgery.

    Subconjunctival Hemorrhage

    Subconjunctival hemorrhage occurs when a small blood vessel under the conjunctiva breaks and bleeds. It may occur spontaneously or from coughing, heavy lifting, or vomiting. In some cases, it may develop following eye surgery or trauma. Subconjunctival hemorrhage tends to be more common among those with diabetes and hypertension.

    While it may look frightening, a subconjunctival hemorrhage is essentially harmless. The blood becomes trapped underneath the clear conjunctival tissue, much like a bruise. The blood is visible because it shows through the thin, clear conjunctiva. The blood naturally absorbs within one to three weeks and no treatment is required.

    Vein Occlusion

    Retinal vein occlusion occurs when the circulation of a retinal vein becomes obstructed by an adjacent blood vessel, causing hemorrhages in the retina. Swelling and ischemia (lack of oxygen) of the retina as well as glaucoma are fairly common complications.

    The visual symptoms can vary in severity from one person to the next, and are dependent on whether the central retinal vein or a branch retinal vein is involved. Patients who experience a branch vein occlusion often notice a gradual improvement in their vision as the hemorrhage resolves. Recovery from a central vein occlusion is much less likely.

    Vitreous Detachment

    The vitreous space is located posteriorly between the lens of the eye and the retina. It is filled with a material called vitreous which is similar to clear Jell-O. As we age, the normal jelly-like consistency of the vitreous begins to liquefy. The vitreous may contract and pull away from its natural attachments on the inside surface of the eye. When it pulls free, it is often accompanied by light flashes and the appearance of a new black spot or floater. This is not dangerous, but it can be accompanied by more serious eye conditions such as retinal tears and vitreous hemorrhage. These occur when the strong attachments of the vitreous to the retina do not separate properly, tearing the retina or retinal blood vessels. This often leads to new floaters and persistent light flashes. It is suggested that anyone with symptoms of a vitreous detachment have an eye examination to make certain that a more serious problem is not present.

    Normal floaters are not dangerous and are caused by tiny specks of tissue inside the vitreous. When light hits these pieces of tissue, it creates shadows on the retina that appear to float across your field of vision.

    It may appear that these specks are on the front surface of your eye, but they are actually inside. Except in rare circumstances, floaters are no cause for alarm and no treatment is necessary. However, a sudden increase in new floaters may indicate a problem, and an eye examination is recommended if this occurs.

    St. Luke's Cataract & Laser Institute provides this on-line information for educational and communication purposes only and it should not be construed as personal medical advice. Information published on this St. Luke's website is not intended to replace, supplant, or augment a consultation with an eye care professional regarding the viewer/user's own medical care. St. Luke's disclaims any and all liability for injury or other damages that could result from use of the information obtained from this site.

     
     
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