Common vision problems

Common vision problems

We give you the low down on the symptoms to look out for, causes and treatments with our handy guide…

To see an object clearly, light reflected off the object passes through your eye to focus on your retina. Common vision problems occur when the light fails to focus correctly on your retina, so the object you are looking at appears blurred.

Myopia (nearsightedness)

Myopia, short-sight or nearsightedness are common symptoms to describe a condition in which someone cannot see far objects clearly.

Myopia is the most common refractive error of the eye, and it has become more prevalent in recent years.

In a recent study, National Eye Institute declared growth of numbers of patients with myopia from 25% in the 70’s to around 41% in the last decade.

Through the exact cause for this increase in near-sightedness is unknown, doctors feel it has something to do with eye fatigue from computer use and other extended near vision tasks, coupled with genetic predisposition for myopia.

Myopia:  Symptoms and Signs
Myopes will typically have difficulty reading road signs and distant objects clearly but will be able to see well for close- up tasks such as reading and computer use.

Children with myopia can easily be identified by their parents as they need to come close to objects such as a TV to view more clearly and will have difficulty in seeing school white/black boards, so they may have problems with learning.

Other signs and symptoms of myopia may include squinting, eye strain and headaches.

Feeling fatigue when driving or playing sports can be a symptom of uncorrected myopia.

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

Myopia can also occur by the cornea and/ or the lens being too curved for the length of the eye ball.

Typically, myopia begins in childhood with more risks if the parents are myopes and in most cases, stabilises in early adulthood, however, some cases, especially those with high errors may continue to progress with age.

Myopia Treatment
Myopia can be corrected with glasses, contact lens or refractive surgery. Eyeglasses lenses, high- index lenses (for thinner and lighter glasses) with anti refractive coating is a good choice. Also, photochromatic lenses, that protect your eyes from UV and high-energy blue light, can be used to reduce your need for a separate pair of prescription sunglasses outdoors.

Contact lens are a good option for managing myopia especially for those who are not happy with their glasses, or those whose everyday activity can be interrupted with using glasses as athletes. However, excessive contact lens wear can be dangerous to your eyes, especially for those who were using contact lenses for years as it carries higher incidence of allergies and infections to the eyes.

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

Refractive surgery for myopia started more than 25 years back, and now with the recent advancement in technology, the laser vision correction procedure has become one of the most successful surgeries with a success rate that exceeds 98%, with a very fast recovery (few days) and going back to full normal life activity in less than a week.

The principle concept of laser vision correction is to flatten the cornea with laser to allow high rays to focus directly on the surface of the retina.

Various modalities of laser vision correction are available now like PRK, Lasik, Femto-Lasik, and smile technique.

A computerised analysis of the cornea (Corneal Topography) is a mandatory investigation to be completed before surgery, in addition to a full eye examination, will determine the most suitable procedure to be done for each case.

Laser vision correction is usually done after stabilisation of vision (around the age of 21) and it is not advisable before the age of 18 years except in very rare circumstances.

Laser vision correction can cover a sizable percentage of patients (up to 90% of myopes), however it is contraindicated for some cases such as a keratoconus patient with severe dry eyes or a patient suffering auto-immune disease. Patients who are not good candidates for laser vision correction (thinner than normal cornea, keratoconus and patients with high errors of refraction) can still get an opportunity to get rid of their glasses through many other procedures like implantable lenses (phakic IOLs) that work like contact lens, except they are surgically placed within the eye. It is typically permanent, which means no maintenance is needed. These lenses (unlike IOLs in cataract surgery) do not replace the eye’s natural lens which are left intact.

Hyperopia (far-sightedness)

Hypertropia is a common vision problem affecting about a quarter of the population. Patients with hyperopia can see distant objects very clearly, but have difficulty in focusing on objects that are up-close.

Hyperopia: Symptoms and Signs
Far sighted people usually have eye strain, headache and sometime squinting when performing work at close range.

Causes of Hyperopia
This vision problem occurs when light rays focus behind the retina rather than directly on it.  The eye ball of this person is usually shorter than normal.

Children are usually born farsighted, and some of them outgrow it as the eye ball lengthens with normal growth.
Hyperopia should not be confused with presbyopia (normal difficulty in near-vision after age of 40 years)

Hyperopia Treatment
Hyperopia can be corrected with glasses, contact lenses or laser-vision correction surgery.

For glasses, high-index lenses are a good option as they are thinner, lighter and have a slimmer more attractive profile. Also, aspheric lenses are a good option since they reduce the magnified “bug eye” appearance eye glasses for hyperopia can cause.

Light weight poly carbonate lenses are a good option for children with hyperopia since they are more comfortable and more resistant.

Refractive surgery such as Lasik or CK (conductive-keratoplasty) is a good option for treating hyperopia with the same precautions mentioned for myopic patients.

Corneal implants are under investigation and could be a future option for hyperopia correction.

Presbyopia

According to the American Academy of Ophthalmology, presbyopia is defined as a normal loss of near focusing ability that occurs with age. Most people start noticing the effects of presbyopia after the age of 40, when they start having a trouble seeing small print clearly.

You cannot escape presbyopia, even if you have never had any vision problem before. Even people, who are near sighted will notice that near vision blurs when their wear their usual eye glasses or contact lenses to correct distant vision.

Worldwide around 1.3 billion people had presbyopia in 2011 and these numbers are expected to increase to 2.1 billion by 2020.

Though presbyopia is a normal change in our eyes as we age, it often has a significant and emotional effect because it is a sign of ageing that is impossible to ignore and difficulty to hide.

Causes of Presbyopia
Presbyopia generally is believed to stem from a gradual thickening and loss of flexibility of the natural lens inside the eye.

Symptoms and Signs of Presbyopia
Usually when you became presbyopic, you need to hold your phone and other reading material further from your eyes to see clearly.
Presbyopia can cause headache, eye strain and visual fatigue that makes all near tasks uncomfortable and more tiring.

Presbyopia Treatment
Glass contact lens and refractive surgery are all good options to treat presbyopia.

Reading eyeglasses, bifocal glasses and progressive (multifocal) lenses are all available options to treat presbyopia.
Contact lenses, bifocal and multifocal contact lenses are good options to treat presbyopia without glasses.

Surgery, corneal inlays, near vision conductive keratoplasty (CK) monovision Lasik, presbyLasik and refractive lens exchange are all good options to treat presbyopia.

Laser vision correction has had an enormous impact on treating refractive errors of the eye (myopia-hyperopia-presbyopia) with a great safety and success.

Consult your physician to choose the best and most appropriate way to treat this condition.

With thanks to Medcare Hospitals & Medical Centers. Call 800MEDCARE or visit www.medcare.ae

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