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________________________________ Q and A ArchivesPlease read the following two paragraphs to find a possible answer to your question. You should always consult with an Ophthalmologist or Optometrist about eye disease or eye problems. It is recommended that children receive a professional eye exam by an eye doctor at birth, 6 months, 3 years and before entering school. In general, older children and adults should receive a complete eye exam every 1 - 2 years. This section contains answers to questions compiled from 1999 to 2003. Also see the dictionary for terms and further information and review the past featured articles. This information is provided for personal use only and is not meant to be "medical advice." To help you find a specific word or topic, at the top of the page under Edit click-on "Find" within your browser and then type in the word or topic to search. If the Find stops at one of the hyperlinks below, click on the hyperlink to go to the topic. Please note that topics may have been discussed several times, so you may need to do several "Finds" to collect all the available information on the topic within this web page. If you find this information helpful, please consider a tax deductible donation to the Ohio LIONS Eye Research Foundation. Thank You
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Topics: Cone-rod degeneration Retinal Detachment Turning-in of Eyes Stye Bright red spots Red eye Best's Disease Optic Atrophy Pink eye Conjunctivitis Floaters Toxoplasmosis Anterior Chamber Dysgenesis Dry eye CRVO Corneal abrasion Blind spot Esophoria vs Esotropia Ozone treatment Macular hole Halos Spot on iris Back-and-forth eye movements Swollen eye lids Optometrist vs Ophthalmologist Sharp pain in eye Wine and Macular Degeneration Cysticercosis Toxocara Canis Patches of light in both eyes Amblyopia in an older child Niacin and blurred vision Normal pressure and glaucoma surgery Eye removal in glaucoma Color blindness Needs Dyslexia Vision therapy for Amblyopia Dilated pupils Choroideremia vs Chorioretinitis Flashing light(s) Computer Eye strain Histoplasmosis Dark circles under eyes Recurrent corneal abrasion Chronic Blepharitis Photophobia Delayed Visual Maturation Cortical Visual Impairment Vitamin A and Floaters Retinitis Pigmentosa Half of Eye Red Swollen Eyes and Feet Broken blood vessel in eye Coats' Disease Wife's swollen eye Yellow Eyes Why Eye Tests? Stationary Black Spots in Eye Twitching Eye(s) Watering Eyes Sclera scar Uveitis Tan Spot on Eye Best Pterygium Viagra Eye Clinic Rod-Cone Specialist Blepharospasm Scotoma Eye Color and Vision Synesthesia(Mixing-up of Sensory info) Episcleritis Bi-focals and Burning Eyes MSG Scleritis REM(Nystagmus) Double Vision Color Blindness Unequal Pupils Contacts Cataract Surgery and Floaters Optic Nerve Drusen Central Serous Retinopathy Niemann-Pick Disease Pseudophakia Seeing Dots Head Trauma and Diplopia Blocked Tear Duct Watery Eyes and Upper Lid Swelling Something in Eye(s) Blurry Streaks Constantly Red Eye Strings in Eye Prones Loss of Side Vision in Histo Bubbles on Lid Margin Busted Vein in Eye Holes in the Macula Flashes in Eye Best Patterns for Seniors PIC Disease Pars Planitis Blufferitis (see Blepharitis) Blood in Eye Stinging Eye Distorted Vision Grave's Disease Adie's Pupil Diplopia Mucus in Eye Lazy eye Lights Dimmer than Normal 1/2 Red Eye Herbal Products Tunnel Vision Stargardt's Disease Different Pupil Size Upper Eye Lid Swelling Sensitivity to Light Heal Macular Degeneration Transplant Worries Dark Circles and Bags Under Eye Florescent Lights Eyelid Cysts Jumping or Twitching Eye Poor Side Vision and Nausea Red Hue Black Spots Fuch's Dystrophy Adie's Syndrome Glasses to Correct Color Vision Blind Spots in Visual Field Film-like Growth on Eye Lightening Bolts Blood Spots on Eye Lights hurt at Night Iritis and Autoimmune Disorders Retinoschisis Pengweckula(Pterygium) Retinitis Pigmentosa (RP) Scales Holme-Adie Disease Can't Open Eyes Sparkly Wavy Lines Rolling Eyes Central Serous Retinopathy Bubbles Stargard (Stargardt's) disease Post Chiasmal Vision Loss Nightlights and Vision Problems Painful Burning Eyes Pin Prick in Eye Thyroid Eye problem Red Itchy Eye Lids Treatment for Older Amblyopic Child Test Your Eyes for Floaters Sty (Stye) Blindness at Night Itchy, Red Eyes Looking Through Curtain Sore Eyes Floopy Eyelid Syndrome Wandering Eye High Blood Pressure and Floaters Small Triangular Area of Flashing Prisms in Periphery Meniere's disease Serpiginous Choroiditis Vogt-Koyanagi-Harada (VKH) disease Epiretinal Membrane Pavement Stone or Paving Stone degeneration Laurence-Moon-Bardet-Biedl Syndrome ERVAN'S [Eales] Disease Nearsightedness Steroid use in a Child Pseudotumor Cerebri and Papilledema Stigmatism (Astigmatism) Retinal Implants Diabetic Eye or Retinopathy Congenital Hypertrophy of the Retinal Pigment Epithelium Eye Disease vs Defect Wearing a Patch to Avoid Diplopia Rings Around Lights Marcus Gun (Gunn) Pupil Birdshot Retinochoroidopathy Lattice Degeneration Loss of the Ability to Focus Fuchs' Heterochromic Iridocyclitis Eye Replacement in Coats Nystagmus Broken Glass Blind Spots Floaters, Halos and Dark Flashes Large Pupils Floaters, Halos and Dark Flashes Reply Gray Oval in Eye Congenital Cataract Correction for Eyes that are not Straight Seeing Tracers or Trails Lesion in Eye Funds for Surgery Scerlitis (See Scleritis) Bumps along Lid Margin and Floaters Eyeritis (Iritis) Parafoveolar Telangiectasia Blood in Eye Blurry Eye at Night Fugndris Flarvinoculations (Fundus Flavimaculatus) Yellowness in Corner of Eyes Thrust and Blurry Vision Droopy Eyelid Neurologist What an Amblyope Sees Chalazion Ceratocome (Keratoconus) Pass Ishihara Test Stargartz (Stargardt's) Eye Higher Than Other VDU Eye Problems Panuvitus (Panuveitis) Walleye Sulzmann's (Salzmann's) Nodular Degeneration Yellow Pupils (Iris) % of People Who need Glasses Young Child not Dilating Contacts and Red Ring Radiculopathy, Steroids and Central Serous Retinopathy Oscillatory Potentials Corneal Transplant in Elderly Screen Reader (Text-to-Speech Program) Floating Eye Temporal Field Loss OD and OS Visual Aftereffect Phenomenon Pneumatic Retinoscopy (retinopexy) RP or Usher's Syndrome Eyeritis (see Iritis) Bilateral Reholental Fibvoplasin (Retrolental Fibroplasia) Iristis (see iritis) Mavular Degeneration (see Macular Degeneration) Pale Nerves Celinder Glasses (see astigmatism) Treatment for nystagmus TV and Computer Screen Effect on Eyes Slanted (abnormal shaped) pupil Transient Blurred Vision in One Eye Double Vision in One Eye Thygeson's Duane's Syndrome Bright Spot when Shifting Gaze Crusty and Itchy Eye Lids Exercise-Induced Vision Problem Protruding eyes Pseudomyopia Unable to move eye Seeing Squiggly Lines Constant Watering Eyes Swollen Upper Eye Lid Accutane and Floaters Eyes Focus at Different Points Star guards (see Stargardt's) Eye Hemorrhaging Blisters/Ulsers on Eye Droopy Eyelid Eye Muscle Surgery for Crossed-eyes TV and Eye Problems Losing Sight in One Eye Eyes Feel Pressure and Irritated Eye Dominance Map-Dot-Fingerprint Dystrophy Krukenberg (Spindle) Optic Nerve Atrophy Dark Circles Under Eyes Spelling of a Rare Eye Disease Excessive Blinking Double Vision in the Elderly Red Glasses and Well Being Orbital Cellulitis Blepharitis and Permanent Vision Problem Nevus Tunnel Vision Adie Eye Holm's Adie (Holmes Adie) Torn Retina Diabetic Eye Disease Seeing Flashing Lights when Moving Eyes White Ring Around Iris Seeing an Arc Bump on White Part of Eye Recurrent Swelling of Eyelids and Blepharochalasis Papilledema Flashlight and Eye Damage Treatment for Blepharochalasis Twitching Eye Conjunctival Cyst Amblyopia and No Depth Perception Extreme Myopia and Cataract Surgery Blister on Bottom Lash Fuch's Dystrophy and Corneal Transplant Blind Spot in Right Eye Black and White Spots in Eyes Eyes Feel Pressured and Irritated Eyes Tester Laser Operation for Astigmatism and Myopia Imagry Angioid Streaks Sore Eyes and Inflamed Lids Black Spots and Lines Retrobulbar Neuritis Eyes Swelling Watery Right Eye LIONS Knights for the Blind Oscillopsia Mineral/Herb for Lazy eye L-dopa for Older Child with Amblyopia Myasthenia Gravis and Eye Problems Dry, Crusty Eye Lids Carataconis (Keratoconus) Crescent Scotoma Freckle on Back of Eye Coat's Disease Seeing World as a Series of Slides Eye Sight Changing Too Fast Strabismus and Need for Surgery Spot on Left Eye White Blur in Left Eye Iritis, Why and How to Prevent Macula Degeneration Epiretinal Membrane Choroidal Nevus and Vision Loss Type 2 Diabetes and Eye Problems Cellophane Retinopathy/Maculopathy Halos in Eyes Itchy Eyes Stargartz (Stargardt's) Blurred Vision Different Colored Blubs Blood Spot on Eye Seeing Lines and Circles Bumps on Eye Myopia Loss of Top Visual Field Sty Posterior Vitreous Detachment Lens Surgery Financal Help or Assistance Seeing White Objects as Yellow Fuch's and PTK Dark Spot and Pain/Pressure Flashing Lights at Corner of Eyes Isochromatic Krrytoconus(Keratoconus) Work and Office Lighting Contact Cut Eye Eyes Itch, Burn and Bump on Upper Lid Anisometropia and Vertical Deviation Myopia and Reduced Acuity Nevus Acute Episodic Events Puffy Eye and Sinusitis Red Spots on Iris Devic's Disease Diabetes and (More) Laser Lightening Flashes Floaters Eyeritis (see Iritis) Lattice Degeneration in Child Reinarts (Reiter's) Disease Bumps on the Eye Costs of Esotropia Surgery Rod Cone Dystrophy Night Lights and Myopia Bloodshot Eyes in Morning and Evening Donate Eye Glasses Pale Optic Nerve Small Knot on White of Eye Sudden Los of Visual Field Inocular Degeneration lymphatic anjectasia (Lymphangiectasias) Pingueculoe (Pinguecula) Dry Eye(s) and Floater Car Accident and Pupil Response Surgery for Glaucoma Adult Amblyopia Stargardt's Why No Cure MRI and ? Subretinal Fibrosis Drivers License for Blind More Simulations Infant with Black Pigment Double vision Synechia (Synesthesia) Hyperlinks not available for Q and A Archives after August 1, 2000. Use Find, under Edit on your browser, for your search. Answers: Q. My husband/wife has a cone rod degeneration or dystrophy. Is there any treatment for this disease? There is no known treatment for cone-rod degeneration or dystrophy. Nevertheless, there are certain things that you/your husband or wife with cone rod degeneration should consider:
Q. What causes small red spots on the white part of the eye? Bright red spot(s) on the white part of the eye are probably subconjunctival hemorrhage(s). These are caused by a number of things including injury or may develop spontaneously in older adults. You should see an Ophthalmologist for a diagnosis and treatment if applicable. Q. What causes red eye? Red eye is caused when the blood vessels of the eye swell with more blood than usual. Red eye may be associated with:
A person with red eye should see an Eye Doctor if:
Q. What causes black floating spots in my vision? Floaters are condensations of cells in the gel part of the eye, known as the vitreous. Floaters appear as dark spots, as web-like objects, as a dot with arms, or strings. Floaters are often associated with high myopia (very nearsightedness) and with aging. A lot of floaters my be a sign of serious eye disease such as a retinal break, tear, or retinal detachment. If you see a lot of floaters, suddenly, or see bright dots or flashing lights, you need to see an Ophthalmologist immediately. There is no treatment available for typical, nonpathologic, floaters. Also see Vitamin A and Floaters in this section. Q. What causes a retinal detachment? A retinal detachment usually occurs when fluid accumulates between the retina, that part of the eye that contains the photoreceptors, and the underlying layer of cells, called the retinal pigment epithelium (RPE). A retinal detachment can also occur because of abnormal bonding between the retina and vitreous by bands of fibrous tissue. A retinal detachment my be the result of injury to the eye such as blunt trauma (remember Sugar Rae, the boxer), penetrating injury, or it may result from other things like high myopia or age-related macular degeneration. In certain diseases, retinal breaks and tears occur and these may lead to a retinal detachment. Early warning signs include bright dots or lights or some of your side vision may appear dark. A retinal detachment may be treatable if detected early, so see your Ophthalmologist, immediately. Q. My child's eyes appear to really turn-in when he looks at close objects. Your child may have an accommodative esotropia - this condition occurs when a child looks at near objects and the eyes turn-in too far, making their child appear cross-eyed (esotopic). This may be a sign that your child needs glasses for seeing things close-up. If left untreated the child may develop a lazy-eye. You should see a Pediatric Eye doctor for evaluation and treatment. Q. What is Best's Disease? Best's (not Best) disease, also called Vitelliform macular dystrophy, is an autosomal dominant (i.e., 50% of family members have it) form of generalized retinal pigment epithelium (RPE) dystrophy. The RPE is a layer of cells in the back of the eye that provides nourishment to the retina and photoreceptors. Clinically, Best's disease is characterized by one or more lesions in the back of the eye that sometimes takes on the appearance of a "sunny-side-up egg yolk" in the early stages of the disease and later appears as a "scrambled egg." Depending on the locus of the lesion(s) it may or may not affect vision. If it does not affect vision, then the patient is an asymptomatic carrier of the disease. When it does affect vision, visual acuity may range from 20/30 to 20/200 (legal blindness). There is no treatment available for Best's disease. The diagnostic test for Best's disease is the electro-oculogram (EOG), which takes about one hour to perform, and a complete dilated eye exam. All members of the family should be tested with the EOG to identify carriers of the disease, even if they are asymptomatic. Q. What is optic atrophy? The optic nerve is composed of mostly axons from the millions of ganglion cells within the inner layer of the retina. The optic nerve goes from the eye, crosses at the optic chiasm, ( after which it is called the optic radiation) and innervates the vision centers of the brain. In optic atrophy, some of the ganglion cell axons that make-up the optic nerve have died or are dying. When the eye doctor looks into the eye, the optic nerve looks white or pale instead of the normal pink, healthy color. A large number of things can cause optic atrophy, either things within the eye or things within the brain. Sometimes optic atrophy can occur by itself, but most of the time its associated with or a symptom of another serious disease. Optic atrophy is never a good sign, and often requires a through work-up to identify the cause. Optic atrophy can lead to varying degrees of vision loss; from normal to near-normal vision to complete blindness. Vision can decrease rapidly in some cases. If you're diagnosed with optic atrophy, it is very important to follow-up on all doctor appointments with you Ophthalmologists, Neurologists, etc., your life may depend upon it! Q. What is Toxoplasmosis and how did I/my child get it? Toxoplasmosis is a parasitic infection that humans get from contaminated soil or cat litter, or can get from eating undercooked contaminated meat. From 15% to 30% of North Americans are infected by Toxoplasmosis. Toxoplasmosis can be transmitted from an infected mother to her unborn child, in 30 to 40% of cases, where it can severely affect the infant - called congenital Toxoplasmosis. If it is active, it is called symptomatic congenital Toxoplasmosis. In unborn and new infants Toxoplasmosis can cause numerous vision and neurological problems including; retinochorioditis (inflammation within the eye), seizures, hydrocephalus, microcephaly (small head), fever, glaucoma and ocular palsies. Visually, Toxoplasmosis can lead to retinal tears, retinal detachments and retinal bleeding and blindness. To minimize infection, particularly of pregnant women, meat and eggs should be well heated and contact with cat stools, including cat litter, should be avoided. Q. What is "Anterior Chamber Dysgenesis?" The anterior chamber is the front part of the eye from the cornea to the iris - the color part of the eye. Dysgenesis means underdeveloped or maldeveloped, in other words the anterior chamber did not form completely. If the iris is involved there is a high probability that glaucoma may develop and cause serious vision loss. Sometimes, anterior chamber dysgenesis is associated with other systemic or whole body problems including dental defects, abnormal development of the skull and skeleton, and certain growth problems in the child. The treatment of glaucoma in patients with anterior chamber dysgenesis is very difficult, requiring lots of surgery and eye exams. Because of the serious nature of glaucoma, the patient MUST be seen regularly by an Ophthalmologist. Q. I have a Stye (or Sty) in my eye, why? A Stye (external hordeolum) is caused by bacterial infection, typically Staphylococcus aureus. There is usually painful swelling of the eye lid, that usually becomes localized with outbreaks along the eyelash line. Styes usually respond well to hot moist compresses ( 4 times/day for 15 minutes). Removal of eye lashes in the affected area may promote drainage. Topical ophthalmic antibiotics my be needed. If there are other sites of infection, oral antibiotics may be necessary. In general, styes are caused by poor hygiene whereby the patient goes to the bathroom, changes a diaper, for example, and then touches the eye area thus infecting the eye lid margin. Proper hygiene and washing your hands with soap and water after going to the bathroom, for example, my reduce the chances of future infections. See your eye doctor. Q. What is "pink eye"? Pink eye is a conjunctivitis caused by Koch-Weeks bacillus - a bacterial infection. It is very contagious and causes wide spread epidemics, particularly in warm climates. Once infected, the incubation period is 24 to 48 hours and is followed by an acute onset of inflamed, redness, and discharge of mucus and pus from the eye. The patient often complains, if old enough, of scratchy, burning and pain of the eye and eye lid. Subconjunctival hemorrhages are common and in some cases corneal ulcers may appear. The infection reaches its peak in 3 to 4 days. If you or your child has pink eye, immediate medical attention is needed. Untreated patients often have recurrences of the disease. Attention to personal hygiene is recommended. See your eye doctor. Q. My eyes are very dry. Dry eye disease (Keroconjunctivitis sicca) is a common and very frustrating disease to deal with in the aging population. It typically affects women and symptoms include a dry, gritty sensation as well as foreign body sensation in the eye(s). There are many causes of dry eye disease including the decrease in hormones with advancing age and reduction in eye tear production, sometimes associated with other disease. Unfortunately, treatment options are limited, in part, because of the number of diverse factors that cause the disease. Artificial tears and ointments provide temporary relief. Better treatments will become available through research, some of which is being undertaken at the College of Optometry at The Ohio State University with support from the Ohio LIONS Eye Research Foundation. See funded research. Q. What is CRVO and what can be done about it? CRVO stands for Central Retinal Vein Occlusion. CRVO as well as occlusion of one or more of the central vein branches causes various degrees of vision loss depending on the extent and locus of the occlusion. Upstream from the occlusion venous dilation and mild hemorrhages may be observed by the eye doctor. There also may be swelling and so-called "cotton-wool" spots in the back of the eye (retina). A percentage of patients will also develop neovascularization (i.e., growth of abnormal blood vessels) of the iris and, as a result, develop glaucoma. Most patients with CRVO are elderly and their eye problems are associated with arteriosclerosis. Recovery of vision is dependent on the extent and location of retinal hemorrhages. If glaucoma develops, the eye may have to be enucleated (removed). Although there is no effective cure for CRVO, depending on conditions the eye doctor may use steroids to control edema (swelling) of the central retina (macula). Anticoagulants have also been employed to reduce/prevent the chance of iris neovascularization and associated glaucoma. However, it appears that the use of anticoagulants are no longer considered effective for treatment/prevention. Finally, photocoagulation (i.e., laser surgery) may be used to treat the abnormal blood vessel growth in the retina and to prevent retinal edema and subsequent loss of central vision. The eye doctor may also run certain blood, urine and stool tests tests while the patient is taking anticoagulants. Because of the dangers and seriousness of CRVO, the patient must been seen regularly by the eye doctor and must keep all of his or her appointments. Q. I have a Corneal abrasion (scratched cornea) and it hurts like ...., what can I do about it? A corneal abrasion can be caused by a number of factors and is associated with severe pain, photophobia (light sensitivity), tearing and twitching/closure of the eye. If there is penetration of the eye by a foreign object, very serious complications include cataract, hemorrhages and possible loss of the eye. A person that has a corneal abrasion should by closely examined by their eye doctor for foreign objects. Assessment usually includes the use of fluorescein stain of the cornea to localize the abrasion. Topical antibiotic ointments are often given and patching of the eye may be recommended. Topical corticosteroids and topical anesthetics are not recommended. For severe abrasions the patient is usually reexamined in 24 to 36 hours. Early treatment is essential for a corneal laceration or for penetrating injuries.
Q. We all have a blind spot in our visual field where the optic nerve leaves the eye, yet we don't usually see it. Why don't people that have macular degeneration also compensate for the blind spot in their central vision? A natural blind spot occurs in our visual field because there are no photoreceptors where the optic nerve head is located in the back of the eye or retina. Yet, we are not typically aware of the blind spot in our vision. To demonstrate the normal blind spot do the following; On a piece of paper draw two small dots, separated horizontally by two inches. Close your right eye and fixate on the right dot with your left eye. Now hold the paper about 12 inches from your nose and move the piece of paper slowly straight towards your nose while maintaining fixation of the right dot with your left eye (no peaking). Watch what happens to the LEFT dot when the piece of paper is about 6 inches from your nose - the left dot will actually disappear. This is where your natural blind spot is located or observed. Why don't we "see" the natural blind spot in daily vision? Anatomical and electrophysiological studies on animals have revealed that the visual areas of the brain corresponding to the optic nerve head (and thus the natural blind spot) is filled-in so that there is no brain site that corresponds to the natural blind spot. Anatomically, the brain sort of covers over the natural blind spot in our vision and, as a consequence, we do not see the blind spot in daily living. In other words, there is no brain space devoted to the natural blind spot. People with macular degeneration do not form such an anatomical filling-in process, possibly because the brain is no longer "plastic" or amenable to change in later life (i.e., beyond the critical period of vision development). Important: If you or someone you know actually sees one or more "blind spots" if your vision (other than the natural blind spot as described above), see an Ophthalmologist immediately! The presence of blind spots in vision may be a sign of a very serious eye or/and neurological disease. See Simulations for a few examples of diseases that cause blind spots, also called scotomas. Q. What is the difference between an "esophoria" and an "esotropia"? "Eso" is a prefix meaning that the eyes turn-in toward the nose, as opposed to an "exo" meaning that the eyes appear to turn-out). A "phoria" means that the eyes are misaligned a little (usually defined as less than 10 prism diopters). A "tropia" means that the eyes turn-in a lot (10 prism diopters or more) and is very noticeable. So, an esophoria is a small turning-in of the eyes and an esotropia is a large turning-in of the eyes. [Although we refer to "eyes", usually only one eye turns-in] A person with an esophoria may get along fine; use both eyes together and have normal visual acuity in each eye. Depending on the circumstances, a child with an esophoria may need to have some prism in one or both of his or her glasses. A person with an esotropia typically will not use both eyes together and may have a lazy-eye (amblyopia). If the child has a lazy-eye, the standard treatment is patching the good eye and forcing the child to use the lazy-eye until vision becomes normal. Often, a child with an esotropia will need corrective eye muscle surgery to align the eyes - ideally after the lazy-eye is cured and vision in both eyes is similar. Sometimes the child with an esotropia may need glasses and the glasses may correct the esotropia - a condition called accommodative esotropia. Q. I have retinitis pigmentosa (RP) and I recently heard about "ozone" treatment for RP. Does it work? No. There is no valid scientific evidence that shows that ozone treatment works in patients with RP. A few studies have been published showing that ozone treatment improves some aspects of vision in RP patients; however, the ozone studies that we have reviewed were poorly designed, lacked appropriate control groups and were based on very few subjects. For more information about RP and valid research, go to the Web site for The Foundation Fighting Blindness at http://www.blindness.org/
Q. What is a macular hole? A macular hole is a lesion in the fovea - that part of the macula or central part of the retina used for reading. To the eye doctor a macular hole looks like a hole or depressed circular or oval area that typically is reddish in appearance. To the patient a macular hole looks like a dark area or scotoma in which the patient can't see through (see simulations). Prior to a full-blown macular hole, a "pre-macular hole lesion" may be present and these have been referred to by various names including macular cyst, involutional macular thinning or impending macular hole. Depending on the severity, size and location of the macular hole, the patient may have from about 20/50 to 20/400 visual acuity in the affected eye. Some macular holes, about 10%, partially resolve or improve, but the majority are permanent as is the loss of vision. Usually only one eye is affected and women are affected much more than men. Trauma to the eye accounts for about 15% of macular holes, while the rest are typically associated with aging (50 and older). Because a macular hole is difficult to diagnose, some tests that the eye doctor may order include a fluorescein angiogram and a biomicroscopy with a contact lens. A retinal detachment may result from a macular hole and surgery may be needed. Ophthalmologists have tried a number of treatments for macular holes with varying degrees of success. A patient with a macular hole must see the eye doctor on a regular basis.
Q. Halos around lights. Halos are usually caused by light scatter. Light scatter is typically caused by problems with the anterior (front) portions of the eye, such as the cornea, lens or/and lens capsule. People that typically see halos include people with cataracts (or with the early beginnings of a cataract), people that have had "refractive surgery" and people that have had cataract surgery. When a person has a cataract (clouding of the lens of the eye), the cataract scatters light and, as a consequence, when the person looks at on-coming head lights, for example, he or she experiences halos. When a person has had cataract surgery, the lens of the eye has been replaced with an intraocular (inside the eye) lens; however, the lens capsule remains in the eye. Sometimes the lens capsule will become cloudy and will cause light scatter and thus halos. Halos are a common complaint of people that have had refractive surgery - surgery to correct a refractive error and remove the need for corrective lenses.
Q. Small white spot on iris, what is it? The white spot may actually be a foreign body on or in the cornea. If so, you should see your eye doctor immediately, particularly if your eye is red and painful. If you are convinced that it is part of the iris, it is unclear what it could be and you should also see your eye doctor immediately.
Q. I have a 3 month old whose eyes move back-and-forth constantly. Why is she doing this? The technical name for eyes moving back-and-forth constantly is "nystagmus". In an infant, nystagmus may be caused by a number of things - some very serious. Therefore, you should take your infant immediately to a pediatric Ophthalmologist, who will probably have a number of diagnostic tests performed to determine the cause of the nystagmus. Sometimes nystagmus is present at birth, or first noticed in the first few months of life, and occurs by itself. This is called congenital nystagmus (CN). An infant with CN will sometimes be able to slow-down the size and frequency of the nystagmus by looking in a certain direction or turning the head a certain way (i.e., null point). As the infant ages, the CN usually gets smaller in size, but may increase in frequency. CN often gets worse (larger size and more noticeable) when the infant is tired or not feeling well. Children with CN will show some degree of vision loss, and usually have visual acuity in the range of about 20/70 (visually impaired) to 20/200 (legal blindness). Sometimes nystagmus in an infant is a sign of a more serious eye disease, such as a retinal degeneration, that can cause blindness. Other times nystagmus may be a sign of another neurological problem with the brain or/and optic nerve(s). So it is very important that a child with nystagmus be seen by a pediatric Ophthalmologist who is able to have a host of diagnostic tests done to determine the cause of the nystagmus.
Q Swollen eyes. Eye lid swelling may be caused by a number of factors including ocular allergies, infections, neurological disorders and trauma. The eye lids are the most common sites for ocular allergies which may be triggered by drugs, cosmetics, insect bites and even sun light. Even if cosmetics are not applied directly to the eye lids, they may nevertheless cause eye lid inflammation (called Eczema) because of indirect contact via rubbing of the eye lids or during sleep when cosmetics are rubbed-off of the face onto the pillow and onto the lids. Contact allergies are usually caused by cosmetics and drugs. The eye lids reflect diseases which primarily affect the skin, including Psoriasis. More serious neurological problems associated with lid swelling include hyperthyroidism (Graves disease), orbital cellulitis, orbital tumors and syphilis. Individuals may also simply have a predisposition for swollen eye lids which may worsen with sleep, when the head is in a sublime position and blood flow is increased to the facial area. See your eye doctor if you are concerned about swollen eye lids, particularly if the swelling is associated with any other symptom such as redness, pain, double vision, reduced vision or if you feel a lump on the eye lid. Also see Stye in this section.
Q. What is the difference between an Optometrist and an Ophthalmologist? An Optometrist (designated as an O.D.) is an eye doctor whose is trained in the optical correction of the eyes with contacts or glasses, diagnosis and treatment of eye problems and eye diseases, and who may be trained and certified in the use of diagnostic and therapeutic drugs. To become an Optometrist, you need a 4-year bachelors degree and three to four years of post graduate work at a college or department of Optometry. An Ophthalmologist is a medical doctor (designated as an M.D.) or Osteopathic doctor (designated as a D.O.) whose is trained in the optical correction of the eyes with contacts or glasses or surgery, diagnosis and treatment of diseases of the eye and body, uses diagnostic and therapeutic drugs, and performs surgery. To become an Ophthalmologist, you need a 4-year bachelors degree, 4-year medical degree, 1-year internship and three to four years of residency training specifically in Ophthalmology. Optometrists and Ophthalmologists may have additional year(s) of training in a specialty area such as pediatrics.
Q. My father complains periodically of sharp pains in his eye, almost like that caused by a needle. Can you explain? Sharp pains in the eye may be an early sign of glaucoma - abnormally increased pressure in the eye that can lead to blindness. The presence of glaucoma increases with age. Your father should see an eye doctor ASAP for a complete eye exam which should include the measurement of the pressure of the eye. If caught early, medicines and/or surgery may prolong sight.
Q. Does drinking a glass of wine every day slowdown macular degeneration? We are not aware of any scientific evidence that drinking a glass of wine every day slows any type of macular degeneration. However, the is some evidence of a relation between antioxidants (related to those nasty free radicals) and age-related macular degeneration; the higher the level of antioxidants in the blood the lower the risk of macular degeneration. Excessive alcohol consumption (and cigarette smoking) appear to decrease the amount of antioxidants in the blood. Therefore, drinking (too much) wine may actually make the macular degeneration worse! So, if you have macular degeneration DON'T SMOKE and LIMIT ALCOHOL CONSUMPTION. For a great booklet on age-related macular degeneration and the dos and don'ts, go to Cool Links and the Web site for the Alliance for Aging Research.
Q. What is cysticercosis? Cysticercosis (Cysticercus cellulosae) is a larva of pork tapeworm. The parasite is usually ingested by eating raw or undercooked pork, vegetables or even water that is infected by the larva. The parasite is easily found in Africa, Central and South America and Eastern Europe as well as southeast Asia. In humans the parasite seems to prefer the eye and/or brain. In the eye the parasite mostly affects the rectus muscles of the eye, but other eye sites include the retina, usually the macula, and sometimes even the anterior chamber (just behind the cornea) where the eye doctor can sometimes see the parasite. Not all patients infected with the parasite show eye damage. Early in the course of the infection the patient may have no symptoms. Later in the course of the infection the patient may experience floaters, blind spots in central vision (scotomas), wide spread inflammation of the eye (panuveitis) and permanent loss of vision. In rare cases, in which the parasites invade the brain, coma and even death occur. If a patient is infected by the parasite, there are medical measures that can be taken to remove (via surgery), or kill (via photocoagulation or antiparasitic drugs), the parasite and to control the inflammation.
Q. What is Toxocara canis and how the heck did [my kid] get it? Toxocara canis is a roundworm parasite that lives in the intestines of puppies. Parasites and their eggs are excreted into the soil or anywhere that the puppy "goes." Patients can become infected by the parasite by ingesting the eggs in soil (eating with dirty hands) or from direct contact with the infected puppies. The parasite can travel to the many parts of the body including the eye, where it causes inflammation and possible loss of sight. Toxocara canis is described as "self limiting"; meaning that most people have limited problems with being infected. Some doctors caution that trying to "kill" the parasite may actually cause more damage because of the toxins that are released into the body or eye when the parasites die.
Q. Every once-in-a-while I see a type of kaleidoscope effect of moving streaks of light that temporarily block-out my vision. Sometimes it is directly in front and at other times it is off to the side. I see the patches of light with both eyes at the same time and even see the lights with my eyes closed. Otherwise my vision is 20/20. Any ideas? Regarding your question about binocular (seen with both eyes) patches of light, we would recommend that you see a Neuro-ophthalmologist. Because you see the patches of light with both eyes at the same time means that the site of the effect is probably cortical – in the brain. That the patches of light cover parts of your visual field is analogous to what are medically referred to as "scotomas." The most common cause of transitory scotomas made-up of so-called flashing lights (fortification phenomena) is migraines. Typically, migraines that cause scotomas are also associated with subsequent headaches, but not always. Migraines can also be associated with other symptoms including ringing in the ears, loss of balance, light headedness, sensitivity to lights and other body sensations. However, temporary scotomas may be due to other, more serious, medical problems and this is why you really need to be evaluated by a Neuro-ophthalmologist; a medical doctor trained in both Ophthalmology and Neurology.
Q. My 15 yr old son was just diagnosed with refractive amblyopia, even though he had previously passed all his eye tests. The Ophthalmologist said that nothing could be done [since he is too old]. Is there any new treatment that could correct this? We generally agree with your Ophthalmologist that your son is too old to be effectively treated, by conventional means, for his amblyopia. By the age of 15 yrs the brain is no longer plastic or adaptive to change by, for example, occlusion of the dominant eye - the standard treatment for amblyopia. Nevertheless, your son should be prescribed corrective lenses to correct the refractive error and, more importantly, to protect his remaining good eye. And, he'll need to actually wear the glasses - no easy task for a teenager. Scientists at Children's Hospital in Columbus, Ohio as well as other sites around the World have been studying the use of L-dopa (Levodopa/Carbidopa) in combination with part-time occlusion of the dominant eye in older children such as your son. The results show that a 4 to 7 week treatment with L-dopa and part-time occlusion improves vision by about 1.5 lines on the eye chart or about 25% or so. However, this is still an experimental treatment and requires further work. See recent breakthroughs for additional information.
Q. I've been taking a lot of iron [Niacin] tablets for ... and I've noticed lately that my vision is blurred. Any connection? Yes, there my be a connection between your blurred vision and Niacin. About 10 years ago several case reports were published (Millay et al, 1988 in the journal Ophthalmology) about patients who were on large (3 - 4.5 grams per day) amounts of Niacin and complained about blurred vision. Most of the patients were found to have swelling of the central part of the retina - the macula. Stopping the Niacin cleared-up the vision problem. If you are taking large amounts of Niacin and experience any vision problems, please see your eye doctor.
Q. I've had glaucoma for five years and although my pressures have been normal [ with medicine], my Ophthalmologist wants to do a trabeculectomy. Is this really of any use with normal pressures? Yes. Even though your intraocular pressures may be normal (defined as below 22 mm Hg), there may be continuing damage occurring to the eye; for example, further loss of visual field or/and further damage (cupping) to the optic nerve head. There is also a condition called "normal pressure glaucoma" - where the pressures are in the normal range even without medicine and, yet, there is damage to the eye. So, even though your pressures are in the normal range, say 16 mm Hg, you may need to have your pressures lowered further, say 8 or 9 mm Hg, and this is probably why your Ophthalmologist wants to do the surgery. A trabeculectomy. is one of several filtering operations and is preferred because of the chance for less complications.
Q. Why is the eye sometimes removed in glaucoma? An eye is sometimes removed (enucleated) in glaucoma because there is little or no vision remaining in the eye (the eye is "shot") AND the eye is very painful. The eye is enucleated only as a last resort and, typically, to alleviate the pain.
Q. "This @*#@ sucks u don't have what I need!!!! If you describe exactly what you need and if it is of general interest to our Web site visitors, we will attempt to address your needs.
Q. What is dyslexia and can anything be done about it? See Past Featured Article on Dyslexia.
Q. My 6 year old daughter's amblyopia has not fully responded to patching, although we have been patching full time for a year. I am considering vision therapy for her. Are there any scientific studies validating the use of vision therapy (eye exercises)? "Vision therapy" is a highly controversial issue that pits Ophthalmologists with Optometrists. On the one hand, Ophthalmologists argue that vision therapy is appropriate for very few things and Optometrists, for the most part, swear that vision therapy is good for a wide range of problems from learning disabilities to amblyopia. One underlying problem is that 'vision therapy' is a catch-all phrase that has no specific meaning. Depending on the practitioner, vision therapy may refer to orthoptics, which has been shown to be beneficial for certain eye coordination problems (e.g., double vision, eye strain), or it may refer to watching flashing lights through colored filters, which has no scientific basis. If you search some of our cool links sites, compare what the American Academy of Ophthalmology says about vision therapy and what the American Optometric Association says about vision therapy. For example, the AAO states that vision therapy should not be confused with orthoptics while the AOA states that vision therapy includes orthoptics. Back to your question however, yes there are a host of studies that have reported that vision therapy works to improve visual acuity in children who do not respond well to conventional patching therapy. Unfortunately, most of the studies have been poorly designed, lack appropriate controls or are simply case reports that this or that type of vision therapy worked for this or that kind of amblyope. The lack of valid and reliable studies on vision therapy and the fact that vision therapy is not a clearly definable treatment modality is probably why there is such controversy in the area and also why most insurance companies do not pay for "vision therapy." Before one considers vision therapy for a 6 year old you must ask if the child AND you have been good about the patching therapy. A major reason why patching does not work in amblyopic children is because of noncompliance. Also, ask your eye doctor what he/she thinks about vision therapy. Also review the AAO and AOA Web sites about "vision therapy". If you decide to do vision therapy watch out for the following warning signs:
Whatever you decide to do for your daughter remember that the success of accepted forms of therapy, including patching and penalization therapy (e.g., dilating eye drops in the stronger eye), is dependant on age: The younger the child the more plastic and adaptive the brain and the more rapid the improvement with appropriate therapy. If you delay effective therapy for amblyopia the harder it will become to cure it and the greater the chance that she will have a permanent loss of vision in the lazy eye. One must always be careful not to delay a proven treatment method by undertaking a less than proven method.
Q. I am a 21 year old male and for the past week or so my eyes have been dilated even during the light of day. I don't do drugs or alcohol but I do smoke cigarettes. I'll probably go to see an eye doctor, but what do you think? Dilated pupils is most commonly the result of legal or illegal drug use. Any of a large number of drugs that you take by mouth or inhale or inject can have a side-effect of dilating the pupils. We are not aware of any relation between cigarette smoking and dilated pupils. A less likely possibility includes closed-angle glaucoma, in which the pupils are sometimes "fixed" in a mid position, say about 4-5mm. If you have any pain or redness in one or both eyes you see an eye doctor immediately because if you have closed-angle glaucoma you could permanently loss your vision real fast. Whatever the cause for your dilated pupils, we suggest an immediate eye exam - ASAP.
Q. What is the difference between Choroideremia and Chorioretinitis - symptoms, causes,diagnosis, prognosis and treatments? Choroideremia is a progressive retinal degeneration that males get from their mothers, who are the carriers of this X-linked disease. The mothers who carry this gene may show mild signs of the disease. Because Choroideremia is an X-linked disease, it will appear to skip generations and will affect 50% of the male off-spring of the carrier mother. The signs of Choroideremia include poor night vision, visual field constriction and loss of visual acuity. There are no known treatments for Choroideremia and the vision loss progresses to light perception by about 50 years of age. Choroideremia is diagnosed based on the dilated eye exam, and special tests include the electroretinogram, electro-oculogram and fluorescein angiogram. Chorioretinitis implies an inflammation of the choroid - that layer of cells between the sclera (white part of the eye) and neural retina that contains the photoreceptors. Chorioretinitis may be caused by a number of factors including blunt trauma to the eye (Chorioretinitis sclopetaria), fungal infections (e.g., candidiasis), or due to a congenital infection such as Rubella. Chorioretinitis sclopetaria may be due to a high velocity projectile, such as a BB, hitting the eye and causing internal bleeding and retinal tears. Chorioretinitis may be due to a fungal infection or due to other types of infections the involve the whole body (systemic) such as viral or bacterial infections. Vision loss will vary depending on the site of the inflammation in the eye and whether the inflammation includes the macula - the central reading part of the eye. The presence of Chorioretinitis may be a sign or the result of immunosuppression, although the literature is divided on this point. The treatment for Chorioretinitis depends on the cause and type of Chorioretinitis. Vision loss, whether permanent or temporary, also depends on the type and cause of the chorioretinitis. Chorioretinitis is usually diagnosed by a dilated comprehensive eye exam and medical history. Special blood work and other tests may be required depending on the specifics of the case.
Q. I see flashing lights in my right eye when I walk into a dark room. What is this? Q. Occasionally I get flashes of light like lightening bolts...they subside after a while...what causes this? You are probably having flashing lights in your right eye all the time but only "see" them when you go into a dark room. In older persons, zigzag flashes of light in one eye that occur in darkness may be associated with vitreous tags. These flashes of light have been named "Moore's lighting streaks." Flashing lights also may be a sign of a serious eye problem, possibly involving the retina or optic nerve of the eye. Retinal holes, tears and retinal detachments can cause a person to see flashing light(s). Certain optic nerve diseases also can cause flashing lights. If you see flashing lights, streaks of light or a bunch of little dots that are bright and moving through your field of vision you need to see an eye doctor for a complete dilated eye exam ASAP. If the flashing lights are due to a retinal problem such as a retinal tear, it may be treatable if caught early. If you wait to late you could have a permanent loss of vision in the affected eye. Play it safe and see your eye doctor.
Q. My son surfs the internet for 4 hrs/day. Now he complains of eye problems. What's the problem and can anything be done? Q. I would like to know it TV or computers will make my eyes bad? Extended close viewing of a computer monitor (or TV) can cause eye strain and fatigue as reflected by neck and shoulder problems, headache, blurred vision, double vision, red or watery or dry eyes and pain around the eyes and face. Extended close work can also cause a person to become more near-sighted (myopic), requiring the need for stronger corrective lenses. Problems are usually two-fold; due to poor ergonomics and due to extended accommodation and convergence to a near object, in this case a computer screen. Ergonomics can be improved by having the top of the monitor screen close to eye level - don't look down or up at the monitor, have the monitor straight-ahead. The monitor should also be at arms length, or about 62cm (about 25 inches) from the face. At 62 cm, the eyes are close to their resting (ideal) state of accommodation and convergence - minimizing both eye eye muscle strain as well as accommodative strain. If you use glasses, the monitor should be positioned to minimize eye strain and your eye doctor may be able to tell you your ideal monitor viewing distance. Avoid glare or light reflections of the screen - if this is not possible use a screen filter (neutral density filter or Polaroid filter or micromesh filter) to reduce glare. Don't tilt the screen up - it will create more glare problems. Take frequent rest breaks, say about 15 minutes per 45 minutes of work and, importantly, during the rest break try to look at objects in the distance - 20 ft or more. Finally, have your eye doctor evaluate you/your son for corrective lenses that may be required for only near work.
Q. Can a person have ocular histoplasmosis but have no symptoms of chronic or acute histoplasmosis, like lung problems? Can ocular histoplasmosis be treated? Go to Past Featured Article #2 for answer
Q. I've been working with the computer a lot for the past three years and now I have dark circles under my eyes. What can I do about them? Dark circles under the eyes or darker appearing skin under the eyes can be due to a number of factors. The lack of adequate sleep will cause the eyes to appear swollen or puffy and darker than normal. In women, hormonal changes can cause the skin under the eyes to darken. As part of the aging process, small wrinkles under the eyes will also cause the appearance of dark skin under the eyes. Finally, the skin under the eyes will appear dark because of shadow. What can you do about it? See an Ophthalmologist that specializes in cosmetic surgery or reconstruction surgery for an opinion. Although surgery is not typically an option, the Ophthalmologist will diagnose the problem. If the skin is indeed darker than normal certain bleaching agents can be used to lighten the skin. If the eyes appear darker because of wrinkling of the skin, certain laser surgery can be used to remove the wrinkles. Certain cosmetics, even for men, can be used to cover-up the darker appearing skin. Finally, be sure to get enough sleep and take regular rest breaks every hour when using the computer.
Q. My cornea was scratched two months ago and it healed after a few days. Since then, however, it has recurred several times, always in the late evening or early morning. Can you give me more information? Corneal abrasions, typically caused by fingernails or twigs, can cause pain, photophobia, reduced vision, watering of the eye and blepharospasm (twitching). Corneal abrasions usually heal after a few days; however, some patients may experience recurrences for up to a year. The patient often reports that he/she awakens in the morning with a painful eye that is difficult to open. The problem is that the epithelium, the very front of the cornea, has been more or less rubbed-off (debrided) during the night. Recurrent erosions of the epithelium may be due to dry eyes and this is why it recurs in the late evening and during the night. To reduce the chance of recurrence of the corneal abrasion some eye doctors will suggest an eye ointment applied in the evening or before bedtime. For more serious corneal abrasions, the excimer laser has also been used for treatment. If you have a corneal abrasion it is very important to keep your eye doctor appointments to ensure that the wound heals properly.
Q. After months of burning in my eyes and not being able to wear my contacts, a doctor finally told me that I have chronic bletharitis [blepharitis]. I know there isn't a cure but is there anything that can be done so that I can wear contacts again? Blepharitis is a common condition that can be controlled but not cured. Blepharitis is caused by several things including Staphylococcal infection and Seborrhea (excessive secretion of lipid from glands). Blepharitis may also be associated with dandruff, eczema, allergy, drugs and Acne rosacea. Signs of Blepharitis include scales on the lashes, red swollen lids, burning and itchy eyes and discharge (e.g., serum-like or mucus like) from the eyes. Staphylococcal blepharitis typically is an acute inflammation and occurs mostly in females. It is also associated with Dry eye. Seborrhea blepharitis is reflected by oily,greasy scales around the lashes and there may be excessive secretions or the glands may become plugged. Treatment often includes the following:
Will you be able to wear contacts again? That is a good question for your eye doctor. Blepharitis waxes and wanes over the years and if you're able to control the outbreaks by following the above recommendations you may be able to wear contacts again. Unfortunately, since blepharitis is associated with dry eye in some cases, be careful - blepharitis can lead to complications including corneal ulcers and conjunctivitis. See an eye doctor for diagnosis and possible treatment. Good luck
Q. I am looking for information on photophobia with bilateral vision loss. Any help? Photophobia is defined as a severe aversion to light. Photophobia would include problems with glare, including glare aversion and glare disability. A normal person experiences photophobia when, for example, one exits a movie theater into bright sunlight. The eyes hurt, you squint and cover your eyes until you get used-to the light. A person with photophobia always experiences the pain and discomfort with bright lights but they never "adapt" to the light. Photophobia is associated with certain retinal diseases that may be progressive or stationary. Photophobia is also associated with a cataract, even before the cataract "ripens." If the photophobia is associated with decreased vision, typically defined as decreased visual acuity, in a younger person then we're probably talking about a retinal disease that is either stationary or progressive. If the photophobia is stationary; that is, has been steady and has not been getting worse, the patient may have albinism, Leber's congenital amaurosis or monochromatism (rod or blue cone). These conditions are present from birth and can be distinguished with the electroretinogram (ERG). In these patients, visual acuity is usually 20/200 or worse. Visual acuity is more or less stationary in patients with albinism and monochromatism and gradually worsens in patient's with Leber's. If the photophobia is associated with decreasing visual acuity and the patient does not have cataracts, then we're probably looking at a progressive retinal disease such as a cone dystrophy or cone-rod degeneration. Patients with cone dystrophies have visual acuities that decrease over time and stabilize around 20/200 - legal blindness. They also may have nystagmus (eyes move back-and-forth), color vision defects and retinal changes, depending on the stage and specific type of cone dystrophy. Patients with cone-rod degenerations or dystrophies have visual acuities that decrease significantly, often worse than 20/200. They may also show visual field losses and have poor night vision (late in the disease process). Finally, some patients with macular degeneration, such as Stargardt's disease, may also have photophobia, decreased visual acuity in the range of 20/30 - 20/200 and a central scotoma or blind spot in central vision. Most cone dystrophies and cone-rod degenerations start to appear before the age of 20 years or so. Although the vast majority of retinal diseases have no treatment, photophobia can be reduced by the use of sunglasses or special light filters such as the Corning Photochromic filters (CPF 511, 527, 550). Wearing a hat with a brim also decreases photophobia. A person with a retinal disease should be assessed by a retinal specialist who can also perform or refer the patient for specialized testing (e.g., ERG, EOG) as well as for genetic counseling.
Q. What is Delayed Visual Maturation? See Featured Article or past featured articles.
Q. What is Cortical Visual Impairment?
Q. I've been wanting to tell someone about my experience with floaters in my eyes. I was taking vitamins and eating a healthy diet, dried fruit and vegetables and fruit juices. The skin on my feet started to crack, my skin became dry and I developed floaters in both eyes so bad that the nurse sent me to a specialist....I was consuming three to four times the recommended vitamin A. I stopped taking vitamins. It's taken two years and the floaters are gone. I seriously believe the vitamin A was to blame. I would like to see a study done on this, since so many drinks are adding vitamin A to fruit drinks our children are consuming. Vitamin A is the active principle in carotene which has three types; alpha, beta and gamma. Beta carotene is about twice as strong as alpha and gamma. Vitamin A is essential in retinal function since the rod photoreceptors are made-up of vitamin A (retinene, retinal) and a protein substance called opsin. A vitamin A deficiency can cause nightblindness and xerophthalmia (drying of the conjunctiva and cornea). Deficiencies of vitamin A are rare, and usually occur as a result of malabsorption (due to intestinal surgery for Chrone's disease or Cystic fibrosis), liver disease (alcohol cirrhosis) or excessive intake of vitamins C or E. Too much vitamin A, called hypervitaminosis A, causes symptoms similar to a brain tumor including increased intracranial pressure, blurred vision and swelling of the optic nerve (papilladema), headaches, dizziness, vomiting, diarrhea and a protruding of the front of the head. Hypervitaminosis A occurs when daily intake exceeds about 50,000 IUs/day. However, the dosage that causes hypervitaminosis A depends on body weight and may be substantially less if you're a female, child or are of small stature. Can hypervitaminosis A cause floaters? We were unable to uncover any scientific evidence about such a link. However, since hypervitaminosis A can cause papilledema it is possible that it could also cause excessive floaters. Also, it is interesting that it took almost two years for the floaters to disappear. Since vitamin A is stored in the liver in relatively large amounts, it can take years for excessive amounts of vitamin A to leave the body or, conversely, for a vitamin A deficiency to develop after absorption is reduced. For example, in Crohn's disease large amounts of the intestines are removed and about 7 - 9 years later patients sometimes develop nightblindness due to vitamin A deficiency. So the time frame of a few years for the elimination of excessive amounts of vitamin A to leave the body and for the floaters to disappear is the ball park. Can hypervitaminosis A cause cracked feet? The scientific literature is also moot on this point. Vitamin A is essential for epithelial (skin) function so we would not eliminate the possibility that excessive amounts of vitamin A could cause epithelial dysfunction - including cracking feet and dry skin. We do agree that more research is needed in the adverse consequences of excessive vitamin intake, particularly since Americans consume large amounts of vitamins. Web site visitors, if you have any personal experiences with problems associated with supplemental vitamins please send us your comments and we'll tabulate the comments in a future Featured Article on the subject of supplemental vitamins and your vision.
Q. I would like to know whether there is a cure for retinitis pigmentosa (RP). There is no cure for RP. There is a controversial treatment for RP, vitamin A palmitate therapy, that may slow the progression of the disease. However, there is much controversy over this treatment, which involves taking 15,000 IUs of vitamin A palmitate (a special form of vitamin A) per day. Pregnant women or women that may become pregnant should NOT take vitamin A. Treatments that have not been proven effective include panretinal laser photocoagulation, Encad, Ozone and "the Cuba cure."
Q. What could cause half of my eye to [become] red? No itchiness, soreness or irritation. If you wear contacts you could have contact lens induced keratopathy, which may first involve the upper part of the eye. If so, you need to stop wearing contacts immediately and see an eye doctor. If left untreated or/and you continue to wear contacts you could permanently loss vision in the affected eye. See an eye doctor.
Q. I have painful, itchy, swollen eyes. Also, probably unrelated, swollen, itchy feet. The two are, in fact, possibly related and may be signs of an allergic reaction. If you are taking medicine(s), ask your doctor if the medicine(s) can cause an allergic reaction. Cosmetics, environmental irritants, dyes, certain foods, etc., can cause an allergic reaction as you described. Whenever there is pain involved see your eye doctor ASAP. Also see "Swollen eyes" in this section.
Q. Is there anything you can do for a broken blood vessel in the eye? Go to small red spots. Also, if the broken blood vessel causes blood to accumulate in the front of the eye, between the cornea and pupil/iris, this condition is called a hyphema and warrants immediate medical attention. If the broken blood vessel is inside the eye, for example related to diabetes (diabetic retinopathy) or to another retinal condition such as age-related macular degeneration, treatment may be available and immediate medical attention needed so see your eye doctor ASAP.
Q. I have recently been through a divorce and haven't been able to eat or sleep for the past four months... Now I am seeing tracers - trails after moving objects. Have you ever heard of anybody seeing tracers before? Do you think that this is a permanent condition or do you think that it may correct itself after I take better care of myself? Any references or Web sites about tracers...? So-called tracers are not discussed at any great length in the medical literature. Tracers may be thought of as a series of afterimages to a moving object and, as a consequence, appear to trail the real image. Certain prescribed drugs as well as hallucinogens (e.g., LSD), are known to cause visual disturbances including tracers. The elderly and sometimes patients with psychiatric problems complain of afterimages interfering with their vision and peace of mind. Given your physical and mental exhaustion, the tracers that you are experiencing may be more psychological than physiological. Rest and recuperation may go a long way in alleviating the tracers. Also, see your general practitioner or internist for his/her opinion.
Q. My 3 year old son has recently had his right eye removed due to retinal detachment, the cause of this has been diagnosed as "Coats" disease. I am seeking further information on this disease and any related effects, as he also has behavioral problems, poor coordination, obsessive tendencies and is very clumsy. We are having difficulty finding any information and any help would be appreciated. Coats' disease, either congenital retinal telangiectasia or Leber's military aneurysms, is a developmental abnormality of the retinal blood vessels and is associated with lipid (fat) deposits within and beneath the retina. Although most common in preteenage boys, Coats' disease has been found in infants as young as four months and in adults in their 70s. Coats' disease usually involves only one eye of otherwise healthy patients. No hereditary pattern has been found and it does not appear to be in specific ethnic or racial lines. Therefore, the cause of Coat's disease is not known. Coats' disease is usually progressive and leads to lipid accumulation in or/and underneath the retina, the development of subretinal masses, retinal hemorrhages and detachment, neovascular glaucoma, cataract formation and uveitis. Enucleation or removal of the eye may be indicated if there is pain associated with the glaucoma. An early sign of Coats' disease may be the turning-in of the affected eye (esotropia), particularly in preverbal children. Coats' disease is an ocular, usually monocular, problem. As a consequence, other problems or conditions may not be directly associated with the Coats' disease, per se. Nevertheless, the loss of one eye will cause a patient to be clumsy and have poor coordination because of the loss of binocular vision and loss of depth perception. When a patient has one eye it is very important that the patient wear protective glasses with polycarbonate lenses to protect the remaining eye. Psychological and behavioral problems are common in patients that have experienced a loss - in this case a loss of an eye. Whole family psychological counseling may be necessary for THE WHOLE FAMILY to deal with the loss (as well as with the guilt). Children are very adaptive; however, the affected child will react to how his/her parent(s) and sibs handle the loss. If the parents and sibs avoid the issue or are repulsed by the sight of the child, particularly before a prosthesis (artificial eye) is fitted, the child will have a difficult time with adjustment. Also, lack of knowledge about Coats' disease may cause parents to attribute other problems to the disease or for the parents to become too analytical and attribute normal childhood behaviors as pathological and associated with the disease.
Q. One of my wife's eyes is swollen, and pulling down the eyelid revealed a small clear cylindrical substance inside the lid. Using a cotton swab, I removed it carefully and some bleeding is also present. I have done this twice, and she has rinsed her eye, but the substance returns. What could it be? DO NOT MESS WITH YOUR WIFE'S EYES. She should be seen by an eye doctor for the problem ASAP, particularly since bleeding is involved. See the previous question about swollen eyes. A swollen eye may be a sign of an allergic reaction, typically to cosmetics, a reaction to a foreign body or a sign of a more serious problem. The substance inside the lid may be drainage and an attempt by the eye to decrease the irritant. Don't mess with it - you could make the problem a lot worse.
Q. The whites of my eyes are a very yellow color. What's the cause? Yellow eyes and/or skin may be a sign of jaundice and the deposition of excessive bilirubin in those tissues. If the white parts of your eyes are yellow, it may be a sign of jaundice and associated liver disease. You should see a medical doctor (Ophthalmologist, internist or general practitioner) ASAP to evaluate you for liver disease ( a simple blood test). Numerous diseases can cause jaundice in adults including hepatitis and alcohol cirrhosis.
Q. Why is it recommended that you get an eye test? For infants and children, it is very important to have periodic eye tests in order to detect treatable eye diseases such as lazy-eye (amblyopia) or large refractive errors. If caught early, many eye problems can be corrected. If parents wait too long, until the child has problems with reading for example, much harm will have been done. Eye problems can lead to other problems, including developmental problems, learning problems and behavioral problems. Also, children do not know what they're suppose to see and can go for years without knowing that they can't see as well as others of their age. For adults, periodic eye exams, say every two or three years, are necessary to detect eye disease that also could be treatable. There are numerous eye diseases, including glaucoma, that an adult is not aware of until it is too late and the disease has caused irreversible harm. The eyes are also a window into the brain and central nervous system. A comprehensive eye exam, including pupil dilation, can also uncover other diseases of the body and brain, such as diabetes. If you think that you only need an eye exam when you experience an eye problem - you could be in for the shock of your life.
Q. I have black spots in my right eye and they are not floaters since they are in a constant pattern. I've seen an eye doctor and he thinks they are caused by cholesterol. They are increasing in number and I'm afraid I will lose total vision in that eye. Please comment. Numerous things can enter the vasculature of the eye and block blood flow (ischemia) and result in sudden loss of vision. If the block only lasts a few minutes vision usually returns to normal. However, if the block lasts longer then permanent loss of vision will result. The most common blockers are small crystals of cholesterol, which are usually thrown off by the carotid artery. These usually don't cause permanent damage. The cholesterol crystals, however, are accompanied by adhesive white emboli made-up of fibrin and platelets - these do cause permanent blockage and vision loss as in your case. Other things within the body that can cause occlusion include calcium, bacteria, parasites and tumors, among others. Retinal vasculature occlusion is often seen in the elderly, who also suffer from arteriosclerosis. Since your doctor has diagnosed cholesterol as the problem, you need to ask him/her about ways to reduce the impact of others occlusive episodes; for example, use of finger massage of the globe to dislodge the cholesterol crystals/fibrin-platelet emboli when they first occur. Also, one must be aware that these emboli may also be occurring in the brain and/or heart. You should ask your internist about evaluating your carotid arteries for excessive blockage - if present, you may need surgery to clean-out the carotid on the affected side. Finally, you should ask your eye doctor about possible surgical or nonsurgical options to manage your condition. Be sure to write-down all your questions before you see your doctor. Good luck
Q I'm having trouble with my eyes twitching. Several years ago it was only the left eye, but now it is both. Can you tell me what this is? I had my eyes tested last time and nothing was detected. Q. My eye appears to be jumping or twitching and it is driving me crazy. What is it and can anything be done? Q. My right eye keeps twitching every few minutes. This has been going on for 5 days, what's wrong? Lid twitching of one eye or the corner of an eye, as well as facial tics, is a common complaint in patients and seems to be exacerbated by mental or physical stressful situations, lack of sleep and possibly by stimulates such as caffeine/coffee. The literature is sparse on this topic, however, as it appears to be a benign and fleeting problem. Only rarely does eye twitching reflect a more serious neurological problem. If the eye twitching is more like a facial spasm such that the eyes close, you may have blepharospasm. Blepharospasm is an involuntary contraction of the muscles around the eyes. It is a progressive disorder that sometimes starts with one eye but almost always involves both eyes as the disorder progresses. Interestingly, the spasms do not occur during sleep and are exacerbated by stress and fatigue. The cause of blepharospasm is not known and treatments are limited. If the eye twitching is possibly a blepharospasm, see an Ophthalmologist since there are some surgical treatments that may be considered. Sometimes, but rarely, facial spasms may be a sign of a more serious condition and need to be evaluated by a Neuro-Ophthalmologist.
Q. My eyes water quite a bit, especially when I first wake up, or while I'm going to sleep. If I'm indoors for quite a while and go outside on a sunny day, my eyes really water and I need to close my eyes for a while. What causes this? Excessive tearing is sometimes a way for the eyes to "flush-out" irritants, including cold, light, cosmetics and foreign bodies. Particular attention should be placed on anything that can cause corneal irritation, including foreign bodies and even eye lashes that turn inward. Excessive tearing is sometimes also caused by certain drugs, such as pilocarpine. Finally, patients with anterior uveitis sometimes complain about excessive tearing, particularly when exposed to bright lights - like going from indoors to the outdoors. See an eye doctor to rule-out a potentially treatable problem.
Q. Several years ago I was poked in the eye and a scar developed on the white part. Lately, the scar has grown more red (blood vessels are larger and more pronounced). Should I be concerned? We assume that you had medical intervention for the ocular trauma/scar and that you are in no pain or that there is no vision loss in that eye. It thus appears that the scar is simply needing more blood supply and this is why it appears more red, so you probably need not be too concerned. However, to be on the safe side (why take any chances?), see an eye doctor for further evaluation and reassurance.
Q. I have uveitis. I know traditional ways of curing this disease with corticosteroids, but I wanted to avoid side effects. Do you know any alternative ways to cure uveitis? Uveitis is a generic term that covers inflammation of any part of the uveal tract - iris, ciliary body and choroid. Depending on the exact site of the inflammation, the name given to the disease will vary. For example, if the inflammation is localized to the iris it is referred to as iritis, to the ciliary body and vitreous - cyclitis, to the anterior chamber and anterior vitreous - iridocyclitis, and to the choroid - choroiditis. If all parts are involved - panuveitis. Symptoms depend on what part of the eye is affected and may include red eye, watery discharge, sensitivity to light, decreased vision, floaters, pain and even abnormal pupils. The causes of uveitis are numerous, and include sources within the eye itself as well as sources from other parts of the body (e.g., fungal , viral and bacterial infections). The purpose of treatment is to eliminate the cause of the inflammation, suppress the inflammation and, hopefully, avoid complications of treatment. In general, the earlier the treatment the better. Unfortunately, due to the multifactorial nature of uveitis, the specific type of treatment depends on the cause. This is why a through medical history is probably one of the most important parts of the diagnostic evaluation. As you suggest, corticosteroids, which can be considered a type of nonspecific anti-inflammatory therapy, have numerous and sometimes very serious complications. As a consequence, new therapies are being developed which involve focused anti-inflammatory therapies as well as specific antimicrobial therapies - again, depending on the cause. There is an ongoing clinical trial on the effects of cyclosporine on noninfectious uveitis (for further information see the NIH Web site: http://www.nei.nih.gov/neitrials_script/studydtl.asp?ID=69). Also, there has been a clinical trial on the use of acetazolamide (but with significant side effects) for uveitis associated with cystoid macular edema (for more information see NIH Web site: http://www.nei.nih.gov/neitrials_script/studydtl.asp?ID=11 ). Due to the complex nature of uveitis - your eye doctor would know the best and most prudent therapy for your type of uveitis. Ask your eye doctor if there are alternatives to corticosteroids but remember; uveitis can be a real nasty disease, don't avoid therapy - your sight may depend upon it.
Q. I am a 26 yr old male and I have a light tan spot on the white part of my right eye with the diameter about the size of a small pea. It has been there for 10+ years. I have never given it much thought but my wife seems to think that it is getting bigger. What could this be? You've had this spot on the sclera for 10+ years and you've never seen an eye doctor in that time? Well, it's about time you saw one, don't you think? The spot may be several things; most likely a dermoid cyst. A dermoid cyst is a noncancerous tumor about the size of a pea that is usually present since birth. A dermoid typically looks yellowish-white (tan would be in the ball park) and is usually on the white part of the eye - sclera. Dermoids do tend to increase in size during puberty. So the size, color and the increasing (?) size appear to fit the picture. Removal of a dermoid is usually done in the first 5 or so years of life. Another possibility is that the spot is a nevis - a collection of darker pigment on the sclera. However, a nevis is usually darker in appearance than that which you describe, although a nevis can be caused by a thinning of the sclera which allows the darker choroid to show through. Depending on your complexion, the choroid can be tan to darker tan. A nevis, however, does not increase in size. You need to see an ophthalmologist, who can evaluate the spot and perform surgery, if needed. Less likely, but always possible, the spot could be something worse so see the ophthalmologist and let us know what it turns-out to be. [Turned-out to be a pterygium, see next Q.]
Q. I submitted a question about a tan spot on my sclera... I saw a doctor and he told me it was a [pterygium]. I tried to look this up on the internet but found nothing. Do you have any additional information you could give? A pterygium, after the Greek word meaning "wing", is a triangle shaped spot on the conjunctiva (thin membrane that covers the exposed area of the sclera) and it usually, but not always, occurs on the side of the eye near the nose. Pterygiums often occur in people who work outside in dusty, windy climates. Sometimes they can increase in size and affect the cornea and vision. If so, it can be surgically removed under local anesthesia. If not affecting vision it is best to just leave it alone.
Q. Does Viagra cause any vision problems? Yes. Viagra is known to cause color vision (blue-green) problems, including objects taking-on a bluish tinge. Some patients have also noted an increased sensitivity to bright lights. Overall minor vision disturbances compared to the benefits...
Q. My mother-in-law has glaucoma and is rapidly losing her sight. She has asked me to find a site on the internet that could give her information on eye clinics in the USA. Can you help? We cannot give you information about all the eye clinics in the USA. However, if you have a particular city/state in mind we can offer a particular eye clinic in the general area.
Q. Who is the specialist on rod-cone dystrophy? The is no ONE specialist in the USA on rod-cone dystrophy. There are numerous Retinal Specialists, who are Ophthalmologists, who diagnose and treat, if possible, retinal diseases including rod-cone dystrophy. Look for a Retinal Specialist in your area who has available diagnostic testing (e.g., ERGs, EOGs, Fluorescien Angiography) and who works with Rehabilitation Specialists in vision (or at least can refer you to the appropriate sites). If you have a rod-cone dystrophy, you should also see a geneticist to determine whether your children can be affected. Note; there are a lot of different types of rod-cone dystrophies. An accurate diagnosis will help you in knowing how bad it can get and whether or not your children might be affected. Q. What is a scotoma? A scotoma is an area of visual field in which the patient cannot see objects. A scotoma may be absolute, such that you can't see anything within the area of the scotoma, or it can be an area of reduced vision sensation such that only dimmer or low contrast objects are not seen. A "central" scotoma is one that affects the very center of vision, such that when you look at a person's face only the outside edges are seen. Scotomas can also affect only half of your visual field (hemianopsia) or multiple scotomas may be present throughout the visual field. In general, scotomas are a sign of a very serious medical condition and warrant immediate medical attention. See Simulations for several examples of scotomas.
Q. Is there a specific eye color that sees better? Eye color typically refers to the color of the iris - blue, green, brown and even red. There is no evidence that people with certain eye colors see better than others, at least in terms of visual function tests such as visual acuity. However, eye color is associated with other variables associated with vision or ophthalmology. For example, in general, people with lighter eye colors (e.g., blue) have been shown to have a higher incidence of age-related macular degeneration than people with darker eye color. Also, sensitivity of the cornea and ones' tolerance with contacts for example, appears related to eye color - lighter eyes appear to be more sensitive than darker eyes.
Q. I have a question about a condition I heard about a few years ago. The condition consisted of people seeing things normally perceived by other senses. For example, when a door bell goes off the person seeing a distinct pattern of colors. Or, if the person detected the smell of chicken a different set of colors would appear to him. What is the name of this condition? The condition is called "Synesthesia" and is as you describe. Synesthesia is the mixing-up of sensory information such that a person sees what others hear and hears what others see. It can involve any of the six senses and their combinations. See the December, 1999 issue of Discover magazine for a great article on the subject.
Questions and Answers, Aug 1.- Dec 30, 2000 Q. For the past month or so my eyes, particularly the left eye, has been very red. I wear disposable toric contact lenses and when I put the lenses in the redness was sharply increased. My eye was alarmingly red... I went to the eye doctor and she dilated my eyes with something that constricted the blood vessels in my eyes and they became perfectly white. She told me I have episcleritis... She said that this usually corrects itself and if it doesn't she will prescribe a mild steroid. I don't see any improvement and I was wondering if you have any additional information? As you describe, episcleritis. is an inflammation of the episclera - the outer most layers of the sclera, or white part of the eye. In addition to redness and discomfort there is sometimes a nodule present in the area of redness. Episcleritis is sometimes associated with rheumatoid arthritis, ulcerative colitis and gout, but most of the time the cause is unknown. Wearing contacts will aggravate the condition and make the eye more red and painful. The reason the eye is red is because of the swelling of the blood vessels and this is why certain eye drops will constrict the blood vessels and the eye will appear white, at least while the eye drops are still working. Given that you've had the condition for a month and you're in pain, you may want to ask the eye doctor for the steroid eye drops, which is the usual treatment for the condition. Until your eyes clear, wearing contacts will only aggravate the condition.
Q. I have been wearing bi-focals for 3 years, my most recent pair purchased just one year ago. Lately, I have been finding my eyes to be terribly tired and burning by mid afternoon. Is it possible that my vision can deteriorate this quickly and that I could require a new and stronger prescription already? Most people over the age of 40 or so will develop presbyopia - or a decreasing ability of the lens of the eye to change (accommodate) for near viewing. As a consequence, the person requires bi-focals to see clearly near and distant objects. Presbyopia has a gradual onset and progression, so over the course of a year or more the eyes may require different corrective lenses in order to see clearly. Bi-focals are very difficult to fit and there are large variations in the ability of people to adjust to bi-focals. Some people never do adjust and this is way you may see people wearing (on their head or neck) several pairs of glasses - one for near computer work and one for distance viewing. One question you'll have to ask yourself is whether the bi-focals are the problem. Burning eyes may actually be a sign of dry eye disease or other eye problem other than a wrong prescription. Your work environment may also be the cause of your burning eyes; for example, do you work near a fan or blower that can cause your eyes to become dry? Do you still have the tired eyes or burning sensation when you don't wear the bi-focals? Does the eye problems only occur at work, during the week, and not on the weekend? Before you pay-out hundreds of dollars for another prescription, you may want to try a cheap pair (only about $5.00 each) of over-the-counter "reading" glasses ( try several different strengths) for your near work. If you experiment a little with your working conditions, different reading glasses and when and where, exactly, your eyes burn, you may uncover the reason for the burning eyes. Also, eye pain is a warning sign - so if you continue to have burning eyes and you can't discover the cause, see another eye doctor for his/her opinion.
Q. What is this information about MSG [monosodium glutamate] and retinal lesions...diabetes? I know MSG, a neuro toxin, is being put in many foods under other names for flavor. But what about our eyes and health? I found this information on NOMSG.com and truthinlabeling.org. A review of the Web sites that you mentioned say that MSG is the cause or contributing factor in a LOT of health problems, including glaucoma, diabetes and macular degeneration - we take these claims very seriously. The web sites, however, lacked any scientific evidence for their claims that MSG causes or is associated with any human eye disease. A review of the medical and scientific data related to MSG and any eye disease or condition failed to uncover any association between MSG and eye disease IN HUMANS (see below about animal research on MSG). Our review, however, is continuing. If any reader can cite a reference about MSG and any human eye disease, please let us know and we'll evaluate the evidence. A review of the animal literature on the effects of MSG has made it quite clear that MSG is associated with retinal, optic nerve and lens abnormalities - particularly in the developing animal (rats and mice). AND some of the abnormal findings in animals of the adverse effects of MSG do seem to have parallels to human conditions. For example, it has been shown that MSG can cause abnormally small optic nerves in developing animals. Interestingly, a leading cause of vision loss and blindness in newborn human infants is optic nerve hypoplasia - A condition that has been increasing in incidence since the 1970s. Optic nerve hypoplasia now accounts for about 25% of blindness in newborn infants and the cause or reason is unknown. In addition, MSG has been shown to cause cataracts in young animals - Again, hundreds of human infants are born every year with congenital cataracts, of unknown cause, that must be removed soon after birth or else blindness will result. Until more is known about the adverse effects of MSG on the developing human - it would seem prudent to avoid foods with MSG, particularly if you are pregnant or about to get pregnant. Unfortunately, as the question states, many foods contain MSG but are not labeled as such and, instead, list other names for "flavor." Check-out the Web sites noted above for additional information about MSG and how it is "hidden" in many foods.
Q. What is scleritis and how does one get it and what is the cure? Q. I have a bump on the white part of my eye. What is it? Q. I have a clear bubble like formation on the white part of my left eye. It does’nt hurt or bleed or impair my sight, and some day’s i don’t even notice it and others it rubs my top eyelid making my eye itch. What could it be? A bump on the white (sclera) part of the eye is usually either (nodular) scleritis, episcleritis or conjunctivitis. Scleritis, or inflammation of the sclera (white part of the eye) is a condition that mostly affects women and is fairly rare. It can affect the front of the eye, making the eye look red and it can be very painful. It can also be restricted to the back part of the eye, so the eye appears white but it is still very painful. In about half of the cases it is related to other diseases including rheumatoid arthritis, ankylosing spondylitis, acute herpes, and connective tissue disease. The other half of the time the cause is unknown. Scleritis can also be associated with uveitis, cataracts and glaucoma. If you have the scleritis that affects the front of the eye steroid eye drops are prescribed for treatment. If you have the scleritis that affects the back of the eye, oral medicines are prescribed, including ibuprofen. For information on episcleritis, go to Episcleritis. For information about conjunctivitis, go to Conjunctivitis. Note: all three conditions may respond to topical or sometimes systemic (e.g., taken by mouth) steroids. However, all three conditions require a visit to the eye doctor.
Q. What is pseudophakia? Pseudophakia refers to an eye that has an artificial, intraocular lens. When the natural lens is removed because of a cataract, typically, an artificial lens is put into the eye so the patient can see.
Q. I have an eye problem, I'm not sure of the name. Basically, it is REM [Rapid Eye Movements] but I get it when my eyes are open. I would like to know if there is any corrective surgery for this? REM is a particular sleep state in which the eyes make rapid movements and is associated with dreaming. I suspect that you're trying to describe "nystagmus" - a condition in which the eyes make rapid back-and-forth movements (if horizontal nystagmus). Such a condition is often present since birth and is referred to as "congenital nystagmus". Nystagmus is also associated with other eye (e.g., retinal degeneration) problems and neurological problems. A person with nystagmus almost always has reduced vision. We assume that you've had the nystagmus since birth or since you were very young. If you just developed nystagmus you need to see an ophthalmologist or neurologist ASAP. A person with nystagmus will sometimes be able to stop the eyes from beating by looking in a certain direction, such as to the left or right. If the person is able to stop his/her eyes from beating by looking a certain way this is called a "null point". If the eyes slowdown but don't completely stop - this is called a "semi null point". If you have a null point, you might benefit from eye muscle surgery. The ophthalmologist can move your eye muscles (and the eyes) so that your brain, more or less, thinks that you're looking in the direction of the null point when, in fact, you're looking straight-ahead. With such surgery your eyes will not beat as long as your looking straight-ahead. However, your eyes will still beat if you look to the sides.
Q. I have double vision. If I close one eye things look fine but with both eyes open there are two images, one over the other. Double vision, or diplopia, is sometimes associated with an eye misalignment or strabismus. If one image looks like it is above the other than the eyes would have a vertical misalignment or vertical strabismus. Sometimes diplopia is the result of the eyes failing to maintain alignment (and binocular single vision) due to fatigue or/and age factors; when the person was younger he/she was able to maintain single vision with some effort and eye strain. Diplopia is also sometimes caused by an inability to converge the eyes for close work (accommodative insufficiency) resulting in double vision for close objects. Diplopia is also a sign of a possible serious eye or neurological problem. You should see an eye doctor about the diplopia ASAP, particularly if it is a recent development.
Q. Is there a test or way to tell if my 3 year old is color blind? The standard test for color blindness is the Ishihara color plates that require the patient to read numbers embedded in a set of colored dots. So, if your 3 year old knows his numbers your eye doctor could use the Ishihara plates. If your 3 year old doesn't read yet, sometimes color vision can be tested in 3 and 4 year olds with a color vision test called the Farnsworth Panel 15 test - a color test that requires the patient to arrange colored caps in a certain way. About 8% of boys are color deficient, particularly for red-green colors. Only about 0.5% of females have color vision problems. And, because color blindness does run in families, if the boy's father is color blind for particular colors then the chances are increased that the boy will have color vision problems. It is rare for a person to be totally color blind or achromatic. Patients that are achromatic (achromatopia) also have reduced visual acuity and often nystagmus.
Q. What does it mean if one pupil is smaller than the other one? One pupil smaller (larger) than the other is called anisocoria. Some people have different pupil sizes since birth and it is a congenital problem that means only that you have different pupil sizes, nothing more. If the pupils recently became different in size then this could be a sign of a more serious eye problem or neurological problem. Damage to the eye can also result in different pupil sizes and even differently shaped pupils, although the cause would be obvious. If your pupils recently became unequal in size, see your eye doctor ASAP as you may need a medical work-up to uncover the cause and obtain treatment, if necessary.
Q. Are contact lenses harmful to the eyes? As long as you follow the directions for proper use of the contact lenses and follow your doctor's orders then contacts are very safe. Problems arise when patients do not follow proper use and care directions for the contacts and when they ignore the doctor's orders. Because the corneas need to breath and have oxygen, some problems arise when patients wear contacts for too long. Problems also arise when patients do not follow proper cleaning and sanitary instructions and infections develop. These can be nasty infections that cause permanent loss of sight. DO NOT put contacts in your month to clean them and DO NOT remove contacts from your eyes and then put them back in unless they have been cleaned. Also, always wash your hands before handling your contacts. Finally, not everybody can wear contacts; particularly people with dry eye disease. Q. [Why do I have] floaters in eye that make cataract operation almost worthless? If you have had a cataract operation recently and have floaters so bad that it seems that the cataract operation was worthless, you need to see your ophthalmologist ASAP. Although some floaters are common in the elderly and in people with high refractive errors, sometimes a lot of floaters are a sign of a serious eye problem. Cataract surgery can result in retinal tears and retinal detachments and one sign of these conditions are a lot of floaters. If you have a retinal tear or retinal detachment you may need eye surgery to prevent the condition from getting worse and causing a permanent loss of vision. Cataract surgery is very traumatic for the eye and sometimes the surgery will generate quite a bit of floaters, but these should clear-up after a while.
Q. My friend has drusen of the optic nerve. She has been having regular headaches and is fatigued a lot. She is 34 years old and does not have a family history of genetic eye problems. What can she do to help this condition? Nothing. Drusen of the optic nerve are little whitish or translucent bodies of various size that are in the nonmyelinated part of the optic nerve head. Both eyes are usually affected. In general they are not associated with any systemic or eye conditions, so your friend's headaches and fatigue are probably unrelated. Typically, drusen of the optic nerve cause no problems unless they're big and/or start to interfere with blood flow or compress the optic nerve fibers (rare conditions). Their size tends to increase with age. Since no one knows what causes drusen of the optic nerve or how they occur, your friend can probably do nothing to help the condition.
Q. I am a 50 year old female and have been recently diagnosed with Central Serous Retinopathy. My doctor seems to think cause is long term use of topical steroids. I have suffered from psoriasis for more than 20 years and have always used various creams and ointments containing steroids. I have seen very little of this problem. Can you offer me more info? Central Serious Retinopathy, also called Central Serious Chorioretinopathy (CSC), usually occurs in women between 20 and 45 years of age. Visual symptoms include decreased vision, objects appearing smaller than usual, color vision changes, poor vision for low contrast objects, poor night vision and blind spots (scotoma) just outside of one's central vision. Patients with CSC generally have a good prognosis and most recover from any vision loss in about 3 - 12 months, although episodes can reoccur. However, about 25% may have serious vision loss in the range of legal blindness (20/200 or worse visual acuity). Patients that seem to do worse are those with retinal detachments, macular swelling and choroidal neovascularization (abnormal blood vessel growth). Sometimes, particularly in patients over the age of 50 years, it is difficult to differentiate between CSC and age-related macular degeneration (ARMD). The typical tests for CSC are a dilated eye exam and fluorescein angiography. In both diseases however, there are choroidal neovascularization and detachment of the retinal pigment epithelium. It appears that stress and psychological variables of the patient may play a role in CSC. Finally, we are not aware of any published data on the relation between topical steroids and CSC.
Q. Do you have any information on Neimann-Pick disease? Niemann-Pic disease is a characterized by an excessive accumulation of lecithin and sphingomyelin in cells of the spleen, liver, bone marrow and lymph nodes. Vision is significantly reduced by progressive optic atrophy and degenerative changes in the macula with the occurrence, sometimes, of a cherry-red spot in the macula. Niemann-Pic disease is associated with skin pigmentation, deafness, mental retardation and epileptic seizures. There is progressive physical deterioration and death usually occurs in the first few years of life. Patients often are seen in the hospital, first, because of a failure to thrive. There are also variants of Niemann-Pic disease in which there is progressive mental deterioration and cerebellar ataxia, but the eye exam is usually normal except for paralysis of the vertical gaze (patients can't look down). Patients with Niemann-Pic variants usually survive longer and do not show degenerative changes until two to eight years of age.
Q. My cousin was in a car accident recently and most likely hit her head on the steering wheel. Ever since the accident she has had double vision. She can see fine if she turns her head to either side. The problem occurs when she looks straight ahead. The doctors have beat-around-the-bush. Do you have any suggestions on how severe this is or how it can be fixed? Head trauma can lead to damage to the nerves that innervate the eye muscles and result in an inability for the eyes to move together or point in the same direction. As a consequence, patients will complain, sometimes, of double vision (diplopia) when they look in a certain direction, like straight ahead. If you look closely at your cousin's eyes when she says she sees double - you'll probably notice that the eyes are not pointed in the same direction (point a small flashlight at the eyes and notice the reflection on the two corneas - they will not strike the same part of each eye). The most common type of nerve damage is to the sixth nerve (sixth nerve palsy) and the patient will have one eye that turns in toward the nose. Often, after about 3 - 6 months, the damaged nerve(s) will regenerate and lead to single vision in all directions of gaze. Sometimes, however, eye muscle surgery is needed to correct the problem or, at the very least, to allow the patient to see single in straight ahead gaze. If the problem does not fix itself in about 6 months or so, have your cousin see an ophthalmologist (an eye doctor that can perform eye muscle surgery - often a pediatric ophthalmologist will have the most experience in eye muscle surgery) about the diplopia and recommendations for treatment.
Q. On the bottom eye lid nearest the nose in the corner where the eye lashes end, there is a small, very small bump. On my right eye this bump became large and swollen. It's been there so long now that it's become hard. What is it and how can I get rid of it? You describe what appears to be a blocked tear duct. These occur often in young infants, but anybody can get them. In infants, usually a warm compress applied 2-3 times per day for about 15 minutes will fix the problem. Rewarm the compress as needed. Also, gently massage the lump during and immediately after the warm compresses may help the tear duct to open. If the tear duct does not reopen after a week or two, the infant may need to see an ophthalmologist for a tear duct probe (minor surgery where a wire is inserted into the tear duct to clean it out). In older children and adults, however, a tear duct probe is usually required. A tear duct probe can be done in the doctor's office. Because a blocked tear duct is often the result of infection, antibiotics may be needed. Less likely, the lump may be a sign of a more serious condition. So if the problem doesn't get fixed with the compresses and massage, if an infant, or if your an adult please visit an ophthalmologist for further evaluation and treatment.
Q. My eyes are always watery and the top lid is also swollen. The eyes often water because of irritants and eye lid swelling may be a sign of an allergic reaction - typically to cosmetics. So, if you avoid cosmetics or at least change brands, the watery eyes and lid swelling may disappear. However, if only the upper lid(s) swell AND the swelling is off to the side a little bit toward the side of the face, you may have an acute or chronic inflammation of the lacrimal gland(s) - a condition called dacryocystitis. (A more rare,but similar in terms of symptoms, condition is called dacryoadenitis and is sometimes associated with TB and Gonorrhea, for example). Dacryocysitis is sometimes caused by certain infections (staphylococci), trauma to the lacrimal gland and is associated with conjunctivitis, but most of the time the cause is unknown. Symptoms include swelling of the lacrimal sac, which is located underneath the upper eye lids toward the side of the face and watering eyes. Sometimes pus may be seen and conjunctivitis may be present. See an eye doctor for evaluation and treatment.
Q. What causes the feeling of bugs in the eye? Q. For the past two months, on and off, I have the feeling in my left eye that there is something in it. Sometimes it is really bad and goes on all day and sometimes it lasts just a couple of hours. I have tried to use clear eyes solution, but it doesn't work. My eyes water a lot when I get this and it is very irritating. Is there a name for this and is there anything that I can do? When the eyes are dryer than normal, they will feel like something is in the eyes like sand, or I guess bugs, and sometimes the eyes will water a lot - a condition called hyperlacrimation. Patients with trichiasis, blepharitis, chronic conjunctivitis and iritis also frequently have hyperlacrimation. You need to see an eye doctor to evaluate your condition since it my be treatable.
Q. I see blurry streaks across my field of vision when I move my eyes from side-to-side, or when I turn my eyes to look at something. The level of blurry areas has increased rapidly... I went to the eye doctor and he said that it was probably protein build-up and nothing could be done. He also said that he wanted me to return for a check-up for glaucoma in my left eye... What are these blurry streaks? Since an eye doctor has examined you and believes that the streaks are the result of protein build-up, we will not second guess someone who has actually examined you. Another possibility for the streaks, however, is that they are an early sign of glaucoma since he also suspects glaucoma in your left eye. The following test may help clarify whether the streaks are a sign of glaucoma. As you stated, first get a feeling about where in your visual field you see the streaks when you more your eyes back-and-forth. Are the streaks only in the left eye or in both eyes? Once you have an idea of where in your visual field the steaks are do the following: Tune a large (27 inch or larger is ideal) TV to an empty channel that only contains "snow". It will appear that the snow is moving in all directions. View the TV from about 2 feet and with each eye (i.e., close one eye) fixate on the middle of the screen and pay attention to the rest of the TV; that is, pay attention to your side vision in all directions. When you pay attention to the sides of the screen DO NOT MOVE YOUR EYES. Do you notice any area of the TV screen that looks different than the rest of the screen? Are there areas on snow that don't seem to be present or "moving"? If yes, do the blank or different areas match the location of the streaks? The snow test is very sensitive and very specific for glaucoma. If the steaks are in the general area of any missing or blank parts of the TV snow pattern then it is very likely that the streaks are in fact early signs of a visual field loss - probably due to the glaucoma. To evaluate or test for damage related to glaucoma, in addition to measuring the pressure of your eyes, your eye doctor will also probably do a visual field test to discover any loss of side vision - an early sign of glaucoma damage and also an indication that medicine or/and surgery may be needed. By all means, follow-up with your eye doctor and follow his/her directions for treatment, if necessary. If the streaks are in the right rather then the left eye, or if the location of the streaks does not match at all the location of any missing parts of the TV snow pattern, or if you do not notice any missing parts of the snow pattern then the streaks are most likely protein accumulation and nothing can be done about them.
Q. My eyes are constantly red in the outer corners. I have dry eye, but have been told its not that bad. I don't wear my contacts often anymore but my eyes remain red. I have been to 3 doctors and they say my eyes are healthy and that I basically have to live with the redness. I feel that there must be some cause for the redness. Do you have any suggestions? Red eye is one of the symptoms of dry eye disease. Since you've seen 3 eye doctors and all of them say the same thing - you can at least take comfort in knowing that the diagnosis is correct. If you have not already tried ways to reduce the symptoms of dry eye disease then you may want to start now. Standard suggestions include the use of artificial tears, lubricating ointments at night, avoidance of irritants including smoke and contact lenses. The home and work place should have high humidity, if possible, and avoid drafts or blowing wind. New treatments and drugs to fight dry eye disease are in the works, so keep regular eye check-ups and someday a medicine will become available to alleviate your red eye problem.
Q. When I dig into the corner of my eyes, near the nose, (or pull down the lower lid) I pull-out what looks like string. Can you tell me what it is? You may suffer from what is referred to as "mucus fishing syndrome". Some patients will actually cause eye irritation by digging into the conjunctival cul-de-sac with their fingers and "go fishing" and pullout strings of mucus. By repeating the procedure the eyes become more irritated, more mucus is produced, more fishing is done and the cycle repeats itself. If you DO NOT mess with your eyes the irritation will stop and the excessive mucus will go away. So don't mess with your eyes and the problem will resolve. Q. My brother was diagnosed with prones and told he would go blind... We could find no reference to "prones". The closest thing that we could think of is Crohn's disease - but you don't go blind from it. Another possibility is the the doctor said "cone" disease, such as a cone dystrophy. Cone dystrophy is similar to macular degeneration in which the day time vision (e.g., color vision, fine detailed vision, central vision) part of the retina deteriorates. Cone dystrophy does result in legal blindness or about 20/200 visual acuity (only see the top line on the eye chart)in most cases, but it does not lead to total blindness. If you can get the actual name/diagnosis, we would be happy to supply additional information.
Q. Can histoplasmosis cause a loss of peripheral vision? Should I be tested for histo? Histoplasmosis can affect any and all parts of the retina/eye and so it can cause a loss of peripheral vision. However, because patient's don't use peripheral vision for much, patients will often be unaware of the loss of peripheral vision until they have a visual field test done, for example. Patients readily notice losses of central vision so this is why histoplasmosis is usually referred to in the context of affecting central vision. Should you be tested? Like most people, you will probably test positive for histo, particularly if you live in a high incidence area or worked around chickens. So I'm not sure if it would provide any worthwhile data. Ask your eye doctor and review the past featured article section about histoplasmosis. Q. I get small bubbles of serous fluid on the rim around my eye - between lashes and eye. Is this normal? Probably not. Serous or serum-like fluid and drainage is one symptom of blepharitis. The tiny bubbles are probably the result of blinking action and the generation of pockets of air. Go to the Q and A question about blepharitis, symptoms and method of treatment.
Q. My father became blind two weeks ago for the reason that one of the veins in his right eye busted. The doctors keep telling him that he has to wait for the blood to go away. Can you tell me what his problem is? - sweet The eye contains a large number of blood vessels and sometimes, typically because of disease or injury, the blood vessels rupture and leak into the fluid part of the eye - the vitreous. When the vitreous fills with blood it blocks-out light from reaching the retina and therefore the patient becomes almost instantly blind, at least temporarily. In order for the eye doctors to see the site of the leak and the damage it has caused, the blood needs to clear through the normal draining action of the eye. Depending on the severity of the leak it could take a long time for the eye to clear-up enough for the eye doctor to assess the damage. If the leak was off to the side of the eye, and only affected peripheral vision, then your father might make a full recovery, more or less. If the leak involved blood vessels in his central vision (macula) then the prognosis is poor for visual recovery and it would be likely that he will be legally blind or visually impaired in the affected eye. Sometimes an ultrasound will be performed on the affected eye to make sure that the retina is attached. Also, sometimes a bright flash ERG will be performed on the eye to make sure that the retina is still functioning - depending on the circumstances. Blood vessels in the eye leak or hemorrhage for a variety of reasons including diabetes, age-related macular degeneration, hypertension or high blood pressure, among others. So, at the very least, your father should be screened for diabetes and for high blood pressure and any other reason(s) the his doctor may suspect as the cause of the hemorrhage. Sometimes examination of the unaffected eye will provide a clue as to the reason why the other eye hemorrhaged.
Q. What is cyclophoria? A phoria is a small deviation in the alignment of the two eyes, such that the eyes don't point exactly in the same direction. Typical phorias are esophoria (one eye turns-in slightly), exophoria (one eye turns-out slightly) and vertical phorias in which on eye is slightly above (hyper) or below(hypo) the other eye. A cyclophoria is not typically discussed in the literature but would involve the slight rotation along the line of sight of one eye compared to the other eye, and would be detected when one eye is suddenly covered, for instance. As with all phorias, they do not typically cause problems and are often not noticeable except by the eye doctor during an exam.
Q. What colors or patterns are appealing to senior citizens or individuals with diminishing sight? Research has demonstrated that high contrast (difference between the light and dark parts of an object), black and white patterns including stripes and checkered boards, are most easily seen by everybody including infants as well as adults with vision problems. The higher the contrast the better. Regarding size, in general, the larger the pattern the better. For example, people with reduced vision would see better a large print book than a book with print the size of news print. In general, colored patterns are not seen very well by people with reduced vision or by infants who have a "natural" reduced vision, at least compared to adults. [Some brain damaged patients, with cortical visual impairment, will see certain colors better than black and white.] If you know of someone with vision problems regardless of age, they should be evaluated at the Bureau for Services for the Visually Impaired (BSVI), where professionals can evaluate they're visual potential and offer visual aides and further evaluation.
Q. What is [ punctate inner chorioretinopathy] sometimes called PIC disease? Punctate inner chorioretinopathy (PIC) has also been referred to as "multifocal choroiditis and panuveitis" and "recurrent multifocal inner choroiditis", depending on the authors. These names seem to refer to early stages of an advancing disease. Later in the disease process authors have referred to it as "progressive subretinal fibrosis", "multifocal choroiditis with disciform macular degeneration", "progressive subretinal fibrosis and uveitis" and "chorioretinopathy with anterior uveitis." Patients with PIC are often young, healthy females with mild nearsightedness or myopia. Patients often have a sudden vision loss, multiple scotomas (blind spots) and photophobia. Typically both eyes are affected and recurrences do occur. Prognosis is noted to be poor, and most patients have visual acuities as the disease progresses to 20/200 visual acuity - legal blindness. The cause of the disease is not known; however, it is believed to be related to a localized (eyes only) autoimmune antibody inflammation. In other words, it seems that the body turns on itself and attacks cells within the eye at the level of the retinal pigment epithelium. Treatment seems to be limited to the early "acute" phase and involves anti inflammatory drugs such as corticosteroids.
Q. Do you have any current medical information about [ Pars Planitis ]? Pars Planitis refers to a type of intermediate uveitis (see Uveitis) in which an uveitic type disease creates exudates (clumps of what look like fatty deposits or "fluffy snow") as well as membrane formation over the inferior pars plana - the middle part of the eye including the peripheral choroid and ciliary body (far side vision). Some patients will develop swelling of the optic nerve and/or macula. Patients with Pars Planitis usually don't complain of much pain or redness or sensitivity to light. Often they may not even have symptoms and the disease may be discovered on routine exam. Symptoms do include blurred vision, floaters and sometimes, although rarely, bleeding within the eye (vitreous). About 10% of patients with uveitis have Pars Planitis, males and females are equally affected and usually both eyes are affected. Pars Planitis "goes away" in some patients but in many patients it reoccurs over time. Severe complications in advanced cases include cataracts, bleeding in the eye, development of abnormal blood vessels and retinal detachment. However, in the majority of cases the disease is mild and requires no treatment. Patients that smoke, have emotional distress and patients that "hold things in" without ventilating emotions appear to have increased risk for the disease. Pars Planitis is one of those eye diseases in which it is VERY IMPORTANT to make all eye doctor appointments on a regular bases.
Q. Blood in eye. Blood in the front part of the eye between the cornea and the pupil/iris is called a hyphema and warrants immediate medical attention. A hyphema can lead to the sudden onset of glaucoma and permanent loss of vision in the eye.
Q. A stinging sensation in one eye causing tears, wear glasses at present. Whenever there is pain in the eye the person should see an eye doctor ASAP. Stinging may be caused by a number of factors including an allergic reaction, foreign body in the eye, etc. A number of diseases can also cause stinging, such as conjunctivitis and uveitis (see previous Q and A comments).
Q. Why would an older person see print straight on but the news paper appears slopped? You describe what appears to be spatial distortions in your vision. Spatial distortions in an older person may be a sign of age-related macular degeneration or other, sometimes serious, retinal problems. Less likely but possible, spatial distortions are sometimes associated with the optics of the eye; for example, if you have an intraocular lens (have had cataract surgery and a new lens implanted in the eye), a change in the position of the lens can also cause some distortions in vision. If you have a piece of graph paper (cress-crossing lines) or, better yet, an Amsler grid, look in the center of the graph paper with each eye alone and do you see some of the lines as wavy or distorted? See an eye doctor ASAP for further evaluation and treatment, if appropriate.
Q. I have red veins surrounded by yellow in the whites of my eyes from the iris to the inner edge. I have Grave's disease and Fibromyalgia. These veins have been there for two years now. Some days they get real bad and my vision gets fussy for a few hours. I am amblyopic and my good eye is worse than my lazy eye. What causes this? We assume that you're being regularly seen by your eye doctor, if not you should be. Patients with Grave's disease show varying degrees of exophthalmos or protruding eyes. Because the eyes protrude outward there is increased surface area of the eye exposed to air and, as a consequence, the eyes tend to dry-out as in dry eye disease. A sign of dry eye disease is red appearing eyes. The redness is cause by irritation resulting in the blood vessels being gorged with blood and then become more noticeable. If your vision is temporarily being affected as you indicate, this may be due to the excessive drying of the cornea but may also be related to the pressure placed on the eyes by the Grave's disease. See your eye doctor about these problems, particularly about the periods fuzzy vision.
Q. I am a twenty-one year old female. Last Christmas my right pupil became fixed and dilated. I visited two optometrist and two ophthamologists. After many tests including CAT scans and MRI’s of my brain, it was agreed that I had what is called an Adie’s pupil. My question is, what exactly is this condition? The only information I received from my Dr’s was that this condition is common in 20-40 year old females and that it is caused by damage to the optic nerve. The exact pathophysiology is not known and the duration can vary from 1 month to 10 years. Now I am a nursing student getting my BSN, and this is not much information for me to go by. It is very difficult to find any information on Adie’s pupil. I was wondering if you had any more information for me. Thanks. Adie's pupil (or Adie's syndrome), also called tonic pupil syndrome, is a benign condition in which the pupil in one eye is typically larger than the other pupil in light. In darkness the affected pupil may be small than the other, nonaffected, pupil. Usually one eye is affected, although you have about a 4% chance of the other pupil being affected in any given year. Adie's pupil affects more women then men, and the women are often in their 20s. As you stated, the condition can last for years. If you look real close at the affected pupil in a mirror and shine light in the pupil, you might actually see sections of the pupil try to contract while other segments move less or not at all - called worm-like undulations. If you look back and forth at near and distance targets, you may also notice that your vision is also momentarily blurred because accommodation is also slowed in Adie's pupil. The reason for Adie's pupil is unclear, although some evidence suggests that, following injury or disease, nerve fibers that are supposed to innervate the lens of the eye actually end-up innervating the muscles that control the pupil. It is important to note that the diagnosis of Adie's pupil is, in part, a matter of elimination of other potential causes of different pupil sizes (anisocoria.), such as syphilis, Charcot-Marie-Tooth disease to name a few. So it appears that your doctors screened-out those and other causes of asymmetric pupils. A good source of information about Adie's pupil, see Miller's edition of Walsh and Hoyt's Clinical Neuro-Ophthalmology (Vol. 2).
Q. My wife has migraines and she has recently been complaining about light in the room not being bright enough. Even when all the room lights are on, she complains that the room is too dark... Her eye doctor says that her eye pressures are higher than normal. Is there anything that can be done for her? Migraines are most often associated with sensitivity to light (photophobia) and thus her dim vision is most probably not related to migraines. However, glaucoma or abnormally high pressure in the eye(s) will cause vision to dim and glaucoma may be the problem with your wife. We would strongly recommend that your wife's eye pressures be checked AND that she have a visual field test performed to evaluate her side vision, which is first affected in glaucoma - ASAP. Also, try the glaucoma test mentioned in an earlier Q and A answer (Go to Blurry streaks).
Q. Information on lazy eye. Amblyopia, commonly called "lazy-eye", affects about 3% of the childhood population. Amblyopia is the leading cause of vision loss in children. The major causes for amblyopia are; 1. difference in refractive error between the eyes (anisometropia.), 2. crossed-eyes (esotropia), 3. deprivation due to cataract or anything that can disrupt vision to one eye (e.g., a droopy eye lid, matting of an eye during the first year of life). Amblyopia causes decreased visual acuity, distorted vision and produces poor vision for objects that have low contrast. If detected early, say by 4 or 5 years of age, amblyopia can be treated and cured in most cases IF THE PATIENT AND PARENTS ARE COMPLIANT WITH TREATMENT. The standard treatment for amblyopia is to patch the good eye and to force the child to use the amblyopic eye. Through use, the amblyopic eye becomes "stronger" and eventually visual acuity returns to 20/20 – normal vision. Parents must NOT let the child decide if he/she wants to wear the eye patch - he/she will not wear the patch. Parents must give the child NO ALTERNATIVES - he/she must wear the patch. Wearing the patch is NOT an option. When parents and the child are not compliant with occlusion therapy, sometimes the eye doctor will try "penalization" therapy in which the stronger eye is blurred by the use of lenses or certain eye drops. Penalization works, somewhat, if the vision in the amblyopic eye isn't too bad (20/100 or better). Although other treatments have been tried to correct amblyopia, nothing has been found better than occlusion of the dominant eye. Recent research funded by the Ohio LIONS Eye Research Foundation has shown the L-dopa may facilitate occlusion therapy - once the occlusion-only therapy has run its course (See L-dopa under Funded Research). Also see discussion about vision therapy for amblyopia ( Go to vision therapy).
Q. Can herbal medicines taken in large doses cause glaucoma? In particular St. John's Wort and Ginko Biloba? Very little is know about all herbal "medicines", they are not approved by the FDA and one should always be cautious about taking anything in "large doses" no matter the hype surrounding the herb. That said, St. John's Wort (Hypericum Perforatum) has a number of active ingredients that can produce numerous "side-effects". It should not be taken if you're on antipsychotic drugs or CNS depressants or placed on the skin if you're also using an ache product like vitamin A acid. Note that the FDA lists St. John's Wort as UNSAFE. It has a hypotensive action in humans so we doubt that it could cause glaucoma. Any herbal product should be taken with great caution, even in the recommended dose, and as a general rule never take any herbal product if you're on any approved, standard medicine.
Q. I have a very red eye for the last few days. I can see red veins very strong on one side. Can you tell me what to do? Yes, see an eye doctor for diagnosis and treatment. Redness on one side of the eye can be due to a number of disorders. See previous Q and A discussions about red eye.
Q. My left eye is seeing tunnel [vision]. Could this be a detached retina or something more serious? A detached retina is a very serious problem, but it is probably not the problem causing tunnel vision. Several serious eye diseases cause tunnel vision including glaucoma, the most likely, and retinal degenerations such as Retinitis Pigmentosa (RP). You need to see an eye doctor ASAP about the problem. If glaucoma, it may be treatable and it is likely that your other eye is also being affected, just not as bad as the left eye...yet. Q. Is there any possible help for a patient with Stargardt's [disease]? Stargardt's disease is a retina degeneration (focal RPE dystrophy) that causes a loss of central vision, produces a central scotoma or blind spot, abnormal color vision and possible photophobia. Visual acuity usually decreases to 20/200 - legal blindness and then stabilizes. Currently, there is no known treatment for Stargardt's disease. A person with Stargardt's disease should be seen by the Bureau of Services for the Visually Impaired (BSVI), where the person can obtain certain rehabilitation services including visual aides such as magnifiers and telescopic devices.
Q. My right pupil just recently became two times larger than the left one and [my vision] is kind of blurry. What's wrong? You need to see an ophthalmologist ASAP. A difference in pupil size may be an indication of a very serious eye disease or neurological problem. Also, go to Adie's disease also go to Unequal pupils.
Q. I woke up and my eye lid hurt like I got hit in the eye. Later in the day it got a little swollen and now it is more closed than the other eye. It bothers me and I got a headache. I was wondering what is wrong? If your eye hurts and there is swelling of the upper lid of one eye, you may have an inflammation of the lacrimal gland. The lacrimal gland sits underneath the upper eye lid, just off center toward the side of the face. Some conditions, like dacryoadenitis, are more serious than others, like dacryocystitis. You need to see an eye doctor for evaluation and treatment. Also see More Info.
Q. My optometrist diagnosed me with posterior vitreous detachment in my right eye. Could you tell me all there is to know about this disease and if Lutein can be taken to prevent any further damage to the eye? No and probably not. Although time and space prevent us from discussing all the aspects of a posterior vitreous detachment (PVD), we can tell you that a PVD is caused when the gel in the eye or vitreous liquefies and collapses and pulls away from the back of the eye and retina. This usually occurs when the patient is in his/her 50s and 60s or even younger if you are very nearsighted (myopic). The patient will often complain of floaters as the first sign that something is wrong. PVD is associated with flashes of light, particularly in a darken environment or when making saccadic (i.e., rapid) eye movements, and vitreous bleeding which, in turn, causes more floaters. Treatment is not indicated unless there is a tear of the retina or bleeding requiring surgery. A patient with a PVD needs to be aware that both eyes may become affected and that a retinal tear can occur at any time. If the patient experiences a sudden appearance of a lot of floaters or loss of vision, prompt medical attention is required. We are aware of no scientific evidence that Lutein or anything else helps prevent further damage or the prevention of PVD.
Q. What causes a person to become sensitive to light? Q. Lights hurt my eyes at night. Why? Sensitivity to light or photophobia is caused by a number of factors including the early formation of cataracts or glaucoma, to name a few. Any disease process that affects the front part of the eye; for example, either the cornea or the lens of the eye can cause photophobia. Certain retinal conditions also cause photophobia. See an eye doctor for evaluation and treatment, if applicable.
Q. What can be done to heal macular degeneration? There are many types of macular degeneration. The most common type that mostly affects the elderly (over the age of 50) is age-related macular degeneration (ARMD). Depending on the type of ARMD, dry form or wet form, certain treatments are available although nothing will cure or heal ARMD. Laser surgery and other types of surgery, such as photodynamic therapy, may be indicated. Since surgery is only done by ophthalmologists (MDs), you need to see an ophthalmologist for evaluation and to see if anything can be done. Also see macular degeneration under Dictionary and under Simulations.
Q. Do florescent lights affect the eyes? Yes. Florescent lights flicker at 60 Hz and when the lights become old or the ballast becomes less efficient or old florescent lights will be seen to flicker. Florescent lights can cause eye strain, particularly if you have cataracts or other eye problems. Although florescent lights will not harm the eyes per se, they can cause eye strain and fatigue. There is some question about the frequency of light emitted by florescent lights, and certain special florescent lights can be bought to provide the full daylight spectrum.
Q. Is there a cure for cysts on the eyelid? Yes. There are different types of cysts that can affect the eyelids and surgery can usually be done to remove the cysts. Also, although less common, certain types of tumors can also occur on the eyelids so medical evaluation by an ophthalmologist is necessary. See an ophthalmologist for evaluation and treatment.
Q. I've had this problem with my right eye ball for a year now and it seems to be jumping or twitching in an up and down motion. It comes and goes. I can stop it by closing my eyes and moving them rapidly back-and-forth. I have gone to an eye doctor but he says there is nothing wrong. This is really starting to get on my nerves. Can you tell me what it is? Most likely you're experiencing eye twitching. Go to Twitching Eyes for more information. When you say that its seems that your eye appears to be jumping, do you also experience the visual world as jumping around? For example, close one eye and with the other, open eye take a finger and gently push, back-and-forth, on the corner of the eye (actually on the corner of the eye lid) and you'll notice that the visual world appears to jump around. Is this jumping the same as when you experience your eye jumping? If you experience the visual world as jumping when you have this jumping eye, you're describing a condition called oscillopsia. If yes, you should see a Neuro-ophthalmologist immediately since the oscillopsia may be a sign of a serious neurological condition. Oscillopsia is also sometimes associated with down-beat nystagmus. If your visual world does not jump around when you experience your eye jumping then it is likely that it is a twitching eye.
Q. What should a patient worry about if he is having a transplant? It depends on what type of transplant the patient is having. Everything that you might worry about is usually in the consent for surgery form that you sign before the surgery. The most common eye surgery that involves a transplant is cataract surgery in which an artificial lens is "transplanted" in the eye. Risks include those related to the anesthesia and possible infections. Surgery always carries risks, including the risk of death, although this is extremely rare. Other risks involve the loss of the eye or permanent loss of vision in the eye, but again, these are rare occurrences. Before surgery, ask your doctor to describe all the possible risks and the likelihood of their occurrence. Finally, chose an eye surgeon that has plenty of experience in the type of transplant the you're planning to have - the more experience the better.
Q. In the last year or so my eyes become blurry. I can focus on small objects but the periphery appears blurry and washed-out. It makes it hard to see and can be nauseating some times. What do you think? We think that you need to see an eye doctor ASAP. The symptoms you describe including poor peripheral vision and bouts of nausea are symptoms of glaucoma. How well do you see at night? Other serious eye diseases can also cause a loss of peripheral vision, including retinitis pigmentosa (RP), although RP patients don't complain of nausea. See an eye doctor - at least if the exam comes out normal you can have peace of mind.
Q. I have normal vision during the day and eye sight is excellent. From the evening on until the next day my left eye sees everything in a very red hue. Artificial light is extremely bad and covering the good eye, the light looks blood red. Eye doctor can't find anything and has recommended blood work, EKG and other blood vessel exams. I an 81 in excellent health and not on any prescriptions... Any thoughts? Since it is affecting only one eye it is likely a condition specific to the eye or visual system related to that eye. Your doctor may be on the right track in testing your circulatory, blood vessel, system. Patents with arteriosclerosis or decreased blood supply to an eye or the optic nerve of that eye will complain sometimes of the vision in one eye taking-on a different appearance such as a certain hue. Keep your doctor appointments and if you get the chance let us know what they find-out and we'll pass it on to our Web site visitors. Good Luck
Q. I am 22 and have been having floaters for about a year and a half. My eye doctor felt that it is not serious. I am know seeing pulsating light and dark spots that stretch across the center line of my vision. I see then especially after driving awhile - usually for an hour or so. Is this a symptom of a specific disease? Floaters are very common and usually are not a cause of concern. However floaters, particularly lots of them or when they're present with flashes of light, can be a sign of more serious eye disease. Since you have seen an eye doctor and he/she thinks that the floaters are not serious, it is unlikely that the pulsating light and dark spots are related to the floaters. Patients that have migraines do complain about "pulsating" lights in their central vision. Do you have a headache or other symptoms like ringing in the ears about the same time or within about 30 minutes following the pulsating lights? If so, you may be experiencing migraines. However, please note that headaches do not always occur with migraines. You should consider returning to your eye doctor for a dilated eye exam just to be sure that the floaters and pulsating lights are not related.
Q. I have black spots that look like floaters and are cobwebby. Up close they look like circles outlined in black that connect to form lines and groups. They are in both eyes. It looks like looking through a dirty window. I have been to 8 eye doctors but they say my eyes look healthy and they don't see any floaters. I have had them four 4 years, I'm 33 yr old female in relatively good health. Do you have any idea what is wrong? What you describe, very well by the way, are classic floaters. The question then becomes; are they associated with anything serious? Since you're seen 8 doctors and they all agree that there is nothing seriously wrong with your eyes we must conclude that there is nothing seriously wrong with your eyes. (It is not surprising that the doctors could not see the floaters since they're often difficult to see anyways). It is obvious, though, that these floaters are causing a great deal of stress for you; else way would you see so many doctors and even search the WWW? Patients with certain personality characteristics (e.g., obsessive - compulsive) will tend to focus on certain things in their lives. Unfortunately, as we grow older and older, there are more and more things, healthwise, that occur with us and that we have little control over...such as floaters. Try accepting what your doctors have said and learn to live with your floaters as many of us do.
Q. What is Fuch's Dystrophy? Fuch's dystrophy is a disease of the cornea in which the inner lining of the cornea (endothelium) changes structure and function and results in swelling, pain and loss of vision. Although the cause of Fuch's dystrophy is unknown, there is a hereditary component (dominant trait, mostly affecting females) and the disease usually starts in the patient's 40s and progresses over the course of 25 years or so. Usually both eyes are affected and early in the disease process there is the formation of "drop-like" particles on the endothelium in the absence of swelling. In the middle portion of the disease there is corneal swelling, in which the cornea thickens to about twice its normal thickness, and the patient experiences halos around lights, glare problems and blurred vision. The patient may complain of a foreign body sensation in the eyes, small corneal ulcers or blisters and pain. The final stage of the disease process involves the further deterioration of the cornea, significantly reduced vision and possible growth of blood vessels in the side of the cornea, although the pain sensation decreases. Treatment sometimes starts with techniques to dry-out the cornea as well as the decreasing of the humidity in the environment, lubricants, occlusion or/and a soft contact lens bandage. Finally, penetrating keratoplasty is usually the treatment that provides the most relief for the patient. In penetrating keratoplasty a large section of the cornea is transplanted.
Q. My boss has a form of color deficiency. He recently heard about corrective lenses that allows one to see true colors but we have been unable to find more information on the Web. He saw information about these lenses from reliable sources (a national morning news program and a local news show). However, reliable information seems to be lacking, even his own Ophthalmologist had not heard of these lenses. He was able to track down a clinic in Boston that provides them and to make an appointment, but they canceled and will not reschedule until Spring. Do you have any information or know where we can get it? Thank you. The glasses in question don't work. The FDA, we believe, recently ruled that the glasses do not allow patients with color blindness for certain colors to actually see colors; but rather, simply improves the color discrimination that they already have. Indeed, color vision is based on the presence and ability for three different types of cone photoreceptors in the retina to interact in a very specific way. Color blindness for particular colors involves the loss of certain cones or the miswiring of theses cones; either way, glasses in-of-themselves cannot (read: impossible) cause a patient to see colors. We'll try to uncover more information on this topic in the near future.
Q. I noticed about a year ago that my ability to see objects close up was getting very bad quickly. I had my eyes checked and ended up with progressive lenses. What is still bothering me is that my right eye, which has always been my ‘good’ eye (I’ve had glasses for nearly 30 years, and am 41 now), has ‘blind spots.’ As I close my left eye, I can see much of what there is to see, but in many random places there are blank spots. If I refocus my eyes and look directly at a blank spot, it becomes clear. It is starting to affect my ability to drive, especially in any rain or fog. Can you point me in a direction to investigate? Given your age, it is common to become presbyopic – or need progressive lenses. As for your blind spots, you need to see an eye doctor ASAP. There are numerous conditions that have as a symptom blind spots (scotomas) in the visual field and ALL of the conditions are very serious. Some of the conditions are treatable. See the SIMULATIONS section/page of the web site for a few examples of what can cause blind spots in vision.
Q. My wife’s eye turns red due to this thin film-like growth that has been growing from the small round flesh at end corner of the (near nostrils). I would just like to know what this is and what is the cure for this. The growth has now occupied approx. 35% of the eyeball moving towards the lens. Which as of now has reached a very small portion of the lens. I am really worried of this growth as I don’t want to see my wife suffer from vision impairment. As to the growth in your wife’s eye, she really needs to see an Ophthalmologist for diagnosis and treatment. It is unclear from your description what the growth might be. One possibility is that your wife has episcleritis. (Go to MORE INFO on Episcleritis). Another possibility is that she has a Pterygium - a triangular membrane that has blood vessels which grow from the sclera towards and sometimes into the cornea, causing sensitivity to light and discomfort. It usually occurs on the nasal (nose) side of the eye and is common in dusty and windy climates. Surgery is often necessary. There are several benign tumors that also affect the white part of the eye and can invade the front part of the eye including the lens area. Some of these tumors can be removed by surgery, if necessary. Another concern is that if the disease affects the front of the eye near the colored part of the eye, the iris, that the disease may cause an onset of glaucoma which could lead to blindness in the affected eye very quickly. So take your wife to an ophthalmologist now – kicking and screaming if necessary, she may thank you later. If the ophthalmologist finds that the condition is nothing to worry about, then at least you’ll feel better and have peace of mind.
Q. The doctor recently told me that I should have a physical by my general practitioner because I have iritis and iritis is related to an autoimmune disorder. Is this right? Iritis is a form of uveitis and, yes, iritis is sometimes associated with an autoimmune disorder (as well as trauma). For example, iritis sometimes occurs in rheumatoid arthritis, rheumatoid spondylitis, Reiter's syndrome and herpes simplex, among others. Also, autoimmune suppressive drugs are sometimes employed to fight iritis/uveitis. You doctor is on-the-ball and follow his instructions.
Q. Recently a relative was diagnosed with something called [retinoschisis]. Since I can't locate any information about the disease I can only assume that it is not very common. The physician claims that this causes blindness and there is no cure. Do you have any info? Retinoschisis refers to a splitting of the neural retina -a thin layer of cells in the back of the eye necessary for vision. There are several different kinds of retinoschisis; senile, congenital (from or in early infancy), and secondary to trauma or disease. The senile type is common in the elderly, over the age of 40, and occurs in about 10% or so of the population. The senile form is usually stable for many years and often does not lead to a significant loss of vision. In one study, over 200 eyes with retinoschisis were followed for about 9 years and NO eyes became blind. Congenital retinoschisis, however, is worse and can lead to legal blindness because the splitting of the retina involves the macula - central vision. Infants with retinoschisis that have macular involvement may develop nystagmus (eyes constantly move back-and-forth), eye misalignment (strabismus) and generally poor vision. Often an electroretinogram (ERG) is useful for diagnosis of congenital retinoschisis. Also, it is often necessary to put the infant to sleep to perform a detailed retina exam (EUA). Congenital retinoschisis is often progressive during the first decade of life and usually stabilizes in the third decade.
Q. What is ratinities pignentosa [retinitis pigmentosa], it recovery and form, and where I can get help about this disease? Retinitis Pigmentosa (RP) is an hereditary retinal degeneration that has no proven treatment. Symptoms include night blindness, loss of visual field leading to tunnel vision, cataracts, poor transition for light to dark and vise versa, reduced contrast vision, decreased visual acuity and eventual blindness. Patients often become legally blind from the loss of side vision- when you have only about 10% of visual field remaining (20 degrees of visual angle of field). About nine genetic variants have been identified and they fall into three main categories: recessive, dominant and x-linked. RP usually is autosomal recessive (often no family history and 25% of sibs from the same mother and father are affected), autosomal dominant (50% of all family members are affected) and x-linked (females are carriers and are not affected or are affected only mildly and male offspring have a 50% chance of being affected). There is a controversial treatment that may slow down the progression of the vision loss and the treatment involves vitamin A palmitate - a special form of vitamin A, taken by mouth once per day. If female of child bearing age, the woman MUST be on effective birth control since vitamin A can cause birth defects. For more information about RP, see the LINKS page and go to the Foundation Fighting Blindness web site. Q. What is Holmes-Adie Disease? Holmes-Adie syndrome or disease is a tonic pupil combined with reduced deep tendon reflexes. A tonic pupil is one that does not chance very much with changes with brightness or illumination. Typically, the pupils constrict in brightness and dilate or grow larger in darkness. In Holmes-Adie syndrome, the pupil(s) don't react to changes in illumination. There may also be problems with accommodation - close-up objects may appear blurry. Also see Adie's disease.
Q. What causes my eyes to scale? A common cause of crusting and scaling eye lid margins is blepharitis. blepharitis is usually caused by staphylococcal infection. For more info go to Blepharitis.
Q. When I wake up I can't open my eyes for about two hours. My eyes are red and they hurt. You should see an eye doctor whenever there is pain associated with any eye condition. Your symptoms relate to a number of eye problems, from allergies to dry eye disease. See an eye doctor for evaluation and treatment.
Q. Should I be concerned about sparkly wavy lines that occur in my peripheral vision occasionally? Yes. Sparkly wavy lines can be a sign of serious retinal or optic nerve problems. Migraines can also cause people to see sparkly wavy like lines in peripheral vision. See an eye doctor for a dilated eye exam. Also, see other questions in this section that address such problems.
Q. What is a detached retina and how does it occur? The back of the eye contains a number of different layers of cells or membranes about the thickness of a layer of skin. These layers include the sclera, the white part of the eye, choroid, retinal pigment epithelium and neural retina. When a retinal detachment occurs, a part of the retinal layer separates from the other layers of the eye. A retinal detachment can occur for a number of reasons including age-related macular degeneration, high myopia, blunt trauma or injury to name a few. A retinal detachment is a serious condition and requires surgery to correct. For more information go to retinal detachment.
Q. Can subretinal neovascular membrane be caused by straining heavy lifting, etc., if you already have central serous retinopathy active? Central serous retinopathy refers to a problem with the central (e.g., macular or reading part of the eye) vs peripheral part of the eye. Serous refers to serum-like fluid and retinopathy means a disease or pathology involving the retina. So if you have central serous retinopathy you have a disease that causes serum-like fluid to build up underneath the retina layer of the eye. A subretinal neovascular membrane is a membrane that has a lot of abnormal blood vessels in it and that is located underneath the retina. These occur a lot in older people when the different layers or membranes in the back of the eye start to breakdown - causing blood vessels to grow from one layer to another layer. Can straining or heavy lifting cause subretinal neovascular membranes? Probably not, but then again no one really knows since such research has never been undertaken. We are not aware of any studies that have found a link between heavy lifting, for example, and development of subretinal neovascular membranes. For more information go to Central Serous Retinopathy.
Q. I am seeing a cluster of little clear bubbles in my left eye. What is it? If you think that these bubbles are inside the eye then they're probably floaters - collections of cells in the fluid part of the eye. Go to Floaters. If the bubbles on the outside of the eye then they may be a sign of blepharitis. Go to small bubbles.
Q. What is stargard eye disease? Go to Stargardt's Disease.
Q. My six week old nephew has been diagnosed with post chiasmal vision loss and they think that he is blind. What could have caused this? A post chiasmal vision loss refers to a loss of vision due to something that occurs after the optic chiasm - that area in the brain where the optic nerves from the left and right eyes cross to go, in part, to the other side of the brain. This is a general term and often applies to vision loss that is of a cortical nature (i.e., involves the surface or cortex of the brain). Another term that is sometimes used is cortical visual impairment or cortical blindness. Unfortunately, the reason(s) for a post chiasmal vision loss is often unknown. However, given the age of your nephew, there is hope that he will gain significant vision. Sometimes at that age infants can be misdiagnosed and, instead, have a condition called delayed visual maturation. This assumes that your nephew does not have any other medical condition such as a seizure disorder or other neurological problems. If your nephew has delayed visual maturation he should start to better use his vision by about 6 months of age. If by 6 months he still doesn't fix and follow objects than your concerns are well founded. At the very least, your nephew should have a test called a visual evoked potential (VEP) or also called a visual evoked response (VER) that can evaluate the potential for visual function. Regardless of your nephews condition, he should be referred to an early infant vision stimulation program and rehabilitation services for visually impaired children. - e.g., BSVI. Good luck
Q. Rolling eyes. Rolling eyes is typically a habit that people with certain personality types develop. It is under voluntary control. Although rare, patients with seizure activity also are known to roll their eyes during the seizure.
Q. I heard that the use of certain night lights in young children can lead to vision problems. Any info? A study was published last year (1998 or 1999) that claimed that sleeping with a night light resulted in the development of myopia or nearsightedness. The study was not well controlled however, and the results have been called into question. There is no clear scientific evidence for such a relationship. Recently (3/2000), two scientific studies have been published that refute the claim that night lights cause myopia. As a consequence, it is fairly safe to say that night lights do not cause the development or progression of myopia.
Q. I have been having problems with floaters in both eyes and painful burning in both eyes. Lately, my skin has become real itchy as well. I have seen three eye doctors and they tell me that my vision is normal and so are floaters. Do you have any information on this? Floaters are normal in that as we age and as we become more myopic the more likely it is that we'll develop a few floaters. Burning eyes, however, is not normal. Burning eyes or the sensation that there is a foreign body in the eyes may be a sign of dry eye disease. The fact that your skin has become real itchy my be a sign of an allergic reaction to certain drugs or cosmetics, creams, etc. Thus the burning eyes and itchy skin should be checked-out. If you wear makeup, try another brand or go without for a week or more and see if that helps with the burning eyes and itchy skin. Even if the makeup is not applied to the eye area, when you sleep the makeup can be rubbed-off onto a pillow and then make contact with the eye area. Certain environmental factors can also lead to dry, itchy skin and burning eyes. If you work outside or under conditions in which there is lots of air movement and the humidity is too low can also lead to the conditions that you describe.
Q. I get a pin prick sensation in my eyes - sometimes so severe that it feels as if there's a toothpick actually stuck in my eye. Also, on moving my eyes it feels as if there is something clamped on them around with it. This happens in both eyes and strikes unexpectedly. Whenever pain is involved you should see an eye doctor to have it checked-out. Sharp pain as you describe is one sign of glaucoma, among other things. Less likely, your symptoms also could be a sign of dry eye disease, although the symptoms are usually more constant. See an eye doctor.
Q. My left eye lid has been swollen for 5 months. The area toward the nose is most swollen. I have double vision when I look the least amount toward the left. My left eye vision is very blurry...My eye doctor sent me for a thyroid test. Help, I have already spent $4,000 and still no help. Lately the swelling has gone to the under eye area. My right eye is fine. You describe a potentially very serious condition. The last thing that you should do is stop seeing your ophthalmologist because of costs. First, the development of double vision when you look to the left suggests a restriction of some of your eye muscles. As a consequence, when you try to look to the left your left eye does not move as it should. This causes the eyes to point in different directions and that is why you see double on leftward gaze. Your eye doctors are headed in the right direction in suspecting a thyroid eye disease in which the tissues around the eye(s) swell causing the eyes to look swollen and at the same time restricting the eye movements. Another problem is the blurred vision in the left eye. The blurred vision may be due to several things related to the thyroid eye disease, if that is what you have. The swollen tissue may be putting pressure on the optic nerve - the nerve that runs from the eye to the brain. This is another reason for continuing to see your eye doctor. Finally, there are a number of rather serious eye and neurological or systemic diseases that can cause tissue around the eye to swell. So, don't be surprised if your doctors want to do additional blood, tissue or scan type tests on you as they try to figure-out your problem.
Q. What causes red itchy eye lids? Red itchy eye lids is usually a sign of an allergic reaction to cosmetics, drugs, detergents, soaps, etc. The eye lids are very sensitive and are often the first place where an allergic reaction shows-up. Try changing whatever you put on your face area, even if it is not near the eyes. Cosmetics, for example, can be rubbed-off one part of the face during sleep onto the eye lids via a pillow. For further informetion go to Red itchy eyes.
Q. Please tell me what can be done when a lazy-eye is detected too late. My daughter is 13 years old and I don't want to just give up. Lazy eye is best treated before about 9 years of age. Most expects agree that by, say, 13 years the brain is more-or-less hard wired and less likely to change or improve with generally accepted therapies for lazy eye such as occlusion or penalization therapy. Some optometrists will recommend "vision therapy" to treat lazy eye even in older children and adults; however, the scientific basis for such treatment is absent. Go to Vision Therapy for more information about this type of therapy. Finally, some scientists have found that L-dopa therapy combined with part time occlusion of the dominant eye can lead to some improvement in visual acuity in the lazy eye of older children and adults. However, the improvement is usually about a line or so, probably not significant enough to warrant consideration at this time. Sorry, but until the National Eye Institute - National Institues of Health (NEI-NIH) takes the treatment of amblyopia seriously and funds more research into amblyopia, not much is available or will become available for older children with lazy eye.
Q. How can I be tested for floaters? Floaters are most easily seen when looking at a homogeneous field such the open blue sky without the presence of clouds (away from the sun!). A large white wall, well illuminated, without anything on it will also work. You can test both eyes open then with individual eyes. Because floaters come and go, you must realize that you may not see any floaters at one time and be able to see floaters at another time. If you see a "floater" all the time in the same location that is bigger than a dot or piece of hair, it may not be a floater, but rather, it could be a sign of a retinal/vitreous hemmhorage (if so see an eye doctor ASAP to be on the safe side). To test yourself for floaters, look up at the sky (or wall) and rapidly move your eyes all the way to the left and then all the way to the right, back-and-forth, repeatedly, for about 15 seconds. If you have floaters, as you move your eyes back-and-forth you'll see something that moves with your eyes as the eyes move. If you think that you see a floater then try to look directly at it. What should happen is that as you try to look directly at it the floater will appear to move in the same direction as your eyes and you'll never really be able to look at the floater "dead-on". This is because the floater is inside the eye and, as a consequence, as you move your eyes the floater will also move at the same speed and in the same direction as the eye movements. If you look real closely, you may notice that when you stop moving your eyes the floater(s) actually continues to move, for a little while, in the same direction as the original eye movement. What do you look for and what do floaters look like? Floaters can take-on a number of appearances. If the cells that compose the floater are in focus, then the floater will appear as a well defined single circle or small ring or group of circles stuck together. If the cells that make-up the floater are out-of-focus, the floater may look like a shadow of a small object, a blob, a dull or dark string, or even look like a bug with one or two arms. It is common for people to see floaters particularly older people, over the age of 30 or so. People that have a high refractive error (need thick glasses) are also more prone to floaters earlier in life. In general, floaters come and go and nothing can be done about them - just learn to live with them. However, if you all of a sudden see a lot of floaters or/and have a large dark "shadow" in part of your visual field, you should consult with your eye doctor.
Q. What is blindness at night? Blindness at night is called nyctalopia. It can be due to a number of factors and diseases including retinitis pigmentosa (RP) and other conditions that interfere with storage of vitamin A in the liver (liver disease, alcoholism) or the absorption of vitamin A from the gut (e.g., Chrone's disease, Cystic Fibrosis, jejunum bypass surgery for obesity). True night blindness means that the patient simply cannot see under very low light levels. If there is a street light or a night light or some other light(s) on, the patient can "get by". If you have night blindness see your eye doctor. If you can drive at night you are not night blind. Some patients have "night myopia" - a condition that causes objects to be more blurred than usual at night. Night myopia is caused by the dilation of the pupil at night which, in turn, changes the patient's refractive error. If you notice things are more blurry at night you may need slightly stronger corrective lenses, particularly if you're already myopic (nearsighted).
Q. At once, my eyes started itching and became blood shot. What's the problem? One of the most common causes for itchy eyes, and then them becoming blood shot, is due to allergies or an allergic reaction to cosmetics, drugs, perfume, etc. See earlier questions about itchy eyes, swllon eyes or/and red eyes in this section.
Q. Curtain in front of eye? Sometimes patients will describe their vision as though they're looking through a curtain - things will appear washed-out, slightly blurred and "just not clear". This may be a sign of several eye diseases including cataracts, cloudy corneas, and could even be a sign of glaucoma. See an eye doctor for his/her opinion.
Q. I have been diagnosed with "floppy eye lid syndrome" and I'm looking for any articles about it. Any help? Floppy eyelid syndrome is characterized by very loose, even rubbery, eyelids that often lose contact with the eyeball during sleep, and all-of-a-sudden the upper lid can evolve or turn inside-out. Because of increased exposure to air and irritants, a patient with floppy eyelid syndrome can develop chronic conjunctivitis and meibomian gland (tear gland) dysfunction. It usually affects older, obese men and is sometimes associated with hyperglycemia or sleep apnea. Treatments include the use of eye patches at night to control the conjunctivitis, and surgery to tighten the upper eyelid to prevent loss of eyelid to eyeball contact at night.
Q. My six year old daughter has esotropia (crossed-eyes), that I noticed at two years of age. At four months of age she had a head injury. Is her esotropia caused by a head injury? If the head injury caused the esotropia it would have been evident shortly after the head injury. Since the two events were 1 1/2 years apart it seems very unlikely that the two are related. It is common for children to become esotropic. The age of two years suggests that the condition my be related to accommodation (accommodative esotropia), which is sometimes fixed with glasses.
Q. Reasons for having sore eyes, the whole eyeball is sore, dull ache when the eyes are moved left-to-right or up-and-down. Irritants (e.g., dust, pollen, pollutants) and anything that causes the eyes to become dry (e.g., blowing air) can cause the sore, achy eyes during movement. Your symptoms also match dry eye disease. Since pain and discomfort are involved you should see an eye doctor for evaluation and treatment.
Q. Any information on wandering eye? Wandering eye is a popular term often used to describe an eye that does not maintain alignment with the fellow eye, it wanders. A wandering eye can be caused by a number of conditions including an eye muscle imbalance, lazy eye or if the wandering eye has very poor vision due to a number of diseases and conditions. In a child, a wandering eye is a warning sign and the child should see an eye doctor ASAP for evaluation and treatment.
Q. All of a sudden, last couple of days, I am seeing flashing prisms of the whole color spectrum on the left side of my visual field... No headache, vision loss or blurryness. Just a smallish triangular or sometimes star shaped flashing prism. This will last a few minutes and then go away, several times per day... I am going to see about this but thought that you might have some info? You may have a potentially serious condition and we're very glad that you have plans to see an eye doctor. We would recommend a neuro ophthalmologist. Your description is similar to what is referred to as a "pie-in-the-sky" scotoma. Sometimes these may be associated with a neurological or "brain" problem on the right side of the brain. Good luck.
Q. About a year ago I was diagnosed with high blood pressure. At the time I also experienced flashing lights when in the dark and bright dots and flashes. I also developed floaters in both eyes. My doctor thought that I may have a small hemorrhage from the retina...Could the flashing lights be the result of high blood pressure or is a detached retina a possibility? A retinal hemorrhage can cause the flashing lights and floaters that you are experiencing. High blood pressure can also lead to a retinal hemorrhage, although you should also be checked for diabetes. A retinal hemorrhage can also lead to a retinal detachment so all of your conditions warrant close medical supervision.
Q. Do you have any information on serpiginous choroiditis? I am a 39 yr old female and I've been told that there is no treatment. Is this correct? Serpiginous choroiditis is a disease that usually affects both eyes, reoccurs over time (several months or even years) and is considered a chronic, noncureable, condition. Patients usually complain of blurring of vision with no pain or discomfort. Blurred vision may occur suddenly and reach the level of only being able to count fingers; that is, not even see the big E on the top of the eye chart. Scotomas or blind spots in vision occur and patients often have a lot of floaters.Patients may also develop anterior uveitis or inflammation on the front parts of the eyes. A number of treatments for serpiginous choroiditis have been tried with very limited success, although some authors believe that maintenance on steroids may reduce the number of recurrences. Some of the complications associated with the disease are amenable to treatment including retinal detachments and retinal hemorrhages. To monitor the disease an Amsler grid is usually employed to map the blind spots in vision and to assess the success of treatment.
Q. I had a meniere's disease attack two weeks ago, was sensitive to light... and see peripheral flashing lights. What could be the problem? Meniere's disease is a rather rare condition in which patients have episodes of balance problems and hearing problems. Patients complain of dizziness and loss of balance, ringing in the ears and even fluctuating deafness. Pateints are usually in their 40s or 50s when they first experience the attacks which can last for up to 24 hours. Headaches with stomach nausea and vomiting have been reported, and several authors believe that there is a link between Meniere's disease and migraines. Therefore, your sensitivity to light and flashing lights in the periphery may indeed be related to migraines since both are classic symptoms of a migraine. It has been reported that a low salt diet and certain drugs can reduce the occurance and severity of attacks.
Q. What can you tell me about Amniotic Membrane Transplantation. The doctor recommended this for my mother who is 78 and has an infection in both eyes that won't clear up. She is in poor health and I was wondering if this type of surgery is stressful and difficult? Amniotic Membrane Transplantation is a procedure to help in the reconstruction of the cornea of the eye. Amniotic membrane transplantation allows for a substrate for new cells to migrate and adhere to the membrane in order to provide a clear cornea for seeing. This is a rather long recovery process. All surgeries carry risks and are stressful for the patient and family. Even though your mother is old and in poor health, the surgery is probably necessary for her to regain useful vision. Please discuss your concerns with the doctor.
Q. My wife has been diagnosed as having Vogt-Koyanagi-Harada disease. Do you have any info or advice? Vogt-Koyanagi-Harada (VKH) disease is a whole body inflammatory disease that also involves the eyes. VKH often affects people in their 20s through 50s. The disease may affect the eyes as well as the ear and skin and also includes neck stiffness, headache, ringing in the ears and balance problems. Early in the disease patients may be very sensitive to the touching of their skin or hair. Unfortunately, there are a number of potentially serious complications with VKH including cataracts, glaucoma, development of abnormal blood vessels in the iris,uveitis, and retinal detachment. Although it should be noted that patients usually have a favorable outcome, in terms of vision, with therapy. The main treatment includes the use of steroids to control the inflammation and other immunosuppressive drugs if steroids are counterindicated.
Q. What is Epi Retinal Membrane? An epiretinal membrane is a thin layer of scar tissue that can develop on top of the retina and/or macula - the reading part of the retina. It leads to reduced visual acuity and can cause distortions in vision. There are a number of causes of epiretinal membrane, but it usually occurs in very nearsighted patients that have what is called a posterior vitrious detactment. If vision is only mildly reduced it is best to leave the epiretinal membrane alone. If vision is significantly affected, surgery can be performed to remove the membrane, although there are always risks with surgery particularly when the surgeon has to go inside the eye. There is also a possibility that the membrane will grow back and lead to vision loss.
Q. What is pavementstone? Pavement stone or, more precisely, paving stone degeneration of the retina is a very common condition in the elderly population. To the eye doctor, it appears as well defined, yellowish-whitish spots (lesions) inside the eye along the periphery of the retina. The loss of some photoreceptors and thinning of the retina causes the blood vessels in the back of the eye to become easily visible, thus the name. Paving stone degeneration usually does not affect vision and never requires treatment. In fact, some evidence suggests that the paving stone actually can prevent or reduce the size and extent of a retinal detachment.
Q. What is Laurence-Moon-Bardet-Biedl Syndrome? Laurence-Moon-Bardet-Biedl Syndrome is a rare genetic syndrome characterized by mental retardation, blindness due to retinitis pigmentosa (usually described as the inverse type of RP), polydactyly (more than 5 fingers) obesity, and hypogonadism. Some patients may have the disease without mental retardation or/and multiple fingers. Pateints may also be affected by renal disease. There is a 25% chance that other sibling from the SAME PARENTS will also have the disease.
Q. I was diagnosed with ERVAN'S [Eales] disease seven years ago (UK)) but have been unable to find anyone with the same disease or any information. It causes inflammation behind the veins in the eye that lead to aneurysms which then burst leaking fluid. I have lost all central vision in the left eye. London specialists offers no hope but learn Braille now - blind in about 18 months - any help? We could find no disease called "Ervan's" disease but a similar disease to what you describe is called Eales disease. In Eales disease there is focal inflammation and occlusion or blocking in mostly peripheral retinal vessels leading to large areas of nonperfusion and loss of tissue. As the disease progresses, the disease moves toward the central (macular) part of the eye. There is a large amount of neovascularization (development of abnormal blood vessels) which, in turn, cause repeated vitreous hemorrhages and further loss of vision. Severe vision loss usually results from repeated vitreous hemorrhages, macular edema, macular holes, retinal detachment and the development of glaucoma. It appears that the treatment of choice for the neovascularization is peripheral scatter photocoagulation ("laser surgery") of the ischemic retina - a procedure similar to that used in diabetic eye disease. A vitrectomy is also performed on patients with Eales disease to remove blood and dead tissue from the vitreous, and has been proven successful.Interestingly, one set of investigators have found that about 25% of patient's with Eales disease having a hearing loss and many more suffer from balance problems. Another report notes that almost 50% of Eales patients have, had or have been exposed to tuberculosis. Unfortunately, very little is known about this complex disease.
Q. Where can I find information on nearsightedness? HERE. Nearsightedness is the common name for myopia. Myopia gradually develops over time as the person ages and has been shown to have a genetic and an environmental component. If your parents are nearsighted you're more likely to be nearsighted. If you do a lot of close work, like reading, you're also more likely to become nearsighted. Although there are a number of anatomical reasons why a person becomes nearsighted or myopic, the most common reason is that the eye becomes too oblong and as a result the eye focuses images in front of the retina and thus you see a blurred image. So-called minus lenses are used to correct myopia and the newest surgical procedure is Lasik surgery (Go to Past Featured Articles).
Q. My daughter had a stye in her eye. The stye has almost cleared now but the inflammation has spread inside her right eye. She is on steroids and antibiotics for the last two years. Is it safe to take steroids for such a long time? She is three years old. Our medical experts seriously question the use of topical steroids for such a long time and in such a young child. Although you should never just stop steroid use, we would advise that it is time for a second opinion, preferably from a pediatric ophthalmologist. Your child should be checked for glaucoma; a condition that can be caused by long term steroid use.
Q. I am a 24 year old female and was just told about a month ago that I have pseudo tumors on my eyes. I believe one doctor called it a papilladema. Can you tell me what this is and how it is treated? Regarding your question, there are a number of confusing ideas…papilledema refers to swelling of the optic nerves (actually the optic nerve heads) in each eye and the papilledema can be a sign of Pseudotumor cerebri. – The patient appears to have a brain tumor, in terms of symptoms such as swelling of the optic nerves, but there is no evidence found for the brain tumor. A doctor cannot make the diagnosis of Pseudotumor cerebri by the presence of papilledema alone. The patient would also, probably, need an MRI or CAT scan or/and a spinal tap to determine that a tumor is not present. If you have papilledema and some vision complaints, and if your doctor said you have pseudotumor cerebri WITHOUT additional testing, you should go to another doctor, an ophthalmologist, for a second opinion ASAP.
Q. What is a stigmatism? The correct spelling is astigmatism. An astigmatism occurs when the front of the eye, the cornea, is not perfectly shaped. The astigmatism results in a blurred image along only one axis; for example, along the horizontal axis. It might help to think of the visual world as being 360 degrees (top is 0, right is 90 degrees, left is 270 degrees, etc.). So an astigmatism involves just one axis or a line along a certain degree. An astigmatism does not usually cause problems with seeing unless it is large. If an infant has an astigmatism that is very large, he/she could develop a lazy eye due to the astigmatism - a condition called meridianal amblyopia.
Q. Our son has been diagnosed with RP [Retinitis Pigmentosa] and our eye doctor said that there is something experimental that may come up in the next few years for RP . I believe he said in Chicago. Something to do with retinal implants. Have you heard anything about this. If so what exactly are the details? There are several types of retinal implants under development in animal studies and in limited human clinical trials. One type of retinal implant involves the placement of stem cells, cells that can grow into different types of cells, into the retina. It is hoped that these cells grow and develop into new cells to replace the RP damage. Another type of retinal implant involves the placement of a device (a computer chip) that essentially replaces the function of the retina – the device gathers light and image information and converts it into nerve impulses that directly stimulate the optic nerve (ganglion cells) of the eye. These studies are in the very early stages of development. Both types of research are being undertaken at several sites in the US.
Q. Can you tell me something about diabetic retinopathy? Q. What is diabetic eye? Diabetic eye and diabetic retinopathy refer to the effects that diabetes has on the eye. Diabetes can have several adverse effects on the eye. For example, diabetes leads to the development of abnormal growth of blood vessels in the retina that can leak and cause an immediate loss of vision (See Simulations). If this occurs, the ophthalmologist my do "laser surgery" (pan retinal photocoagulation) to try and halt the development of more blood vessels and their leaking. Diabetes also leads to the formation of cataracts. If cataracts develop the ophthalmologist can do cataract surgery to remove the cloudy lens and replace it with an artificial intraocular lens. If a person has diabetes, it is absolutely essential that the person see an eye doctor on a regular basis.
Q. What is congenital hypertrophy of the retinal pigment epithelium? Is it dangerous? Congenital hypertrophy of the retinal pigment epithelium means that the condition is present at birth (congenital), involves hypertrophy (something that has been damaged and recovers or changes) and affects the retinal pigment epithelium - a layer of cells underneath the retina of the eye. Congenital hypertrophy of the retinal pigment epithelium does not usually cause much of a problem and is usually of a very localized, limited nature. Patients are usually not having vision problems and it is often found on routine eye exam. Patients can have some loss of visual acuity if the area of hypertrophy involves the macula of the eye - that part of the eye used for reading. Usually the hypertrophy is off to the side. Patients may have some problems being able to see with that part of the eye where the hypertrophy is located - known as a scotoma or blind spot. The condition is not dangerous, unless it is in both eyes in several spots. If so, the patient may have a condition called Gardner's syndrome - a dominant cancer syndrome that 50% of family members would have, but this is very rare and unlikely.
Q. What is the difference between an eye disease and an eye defect? The terms are sometimes used interchangeably, but in general an eye disease usually refers to an ongoing disease process which starts with a normal eye and then the eye becomes abnormal because of a genetic problem or acquired disease (virus, bacteria). An eye defect sometimes refers to an eye problem that the person is born with or has as a result of damage or accident. However, sometimes one can lead to another. For example, in closed angle glaucoma there is an anatomical defect in which the lens of the eye is too far forward in the eye and presses against the iris or colored part of the eye. This defect can lead to glaucoma or abnormal increased pressure in the eye and glaucoma is considered a disease.
Q. I have been wearing a patch on one eye for 10 years now due to uncorrectable double vision. Will this cause my stronger eye to over work and make my other eye weaken more? I am 39 and worried. No. At your age, wearing a patch over one eye to avoid diplopia (double vision) will not make the covered eye weaker or cause the seeing eye to overwork. Nevertheless, we would question the practice of wearing an eye patch to correct diplopia, particularly for such a long time. Have you ever seen an ophthalmologist about eye muscle surgery to correct the eye misalignment or, possibly, an optometrist or orthoptists for ways to work toward getting the eyes to achieve single vision?
Q. What does it mean if a person sees rings around lights when you drive at night? Seeing rings around lights at night usually means that there are some changes taking place with either the cornea or lens of the eye that creates light scatter. Anything that causes the cornea or lens to become even slightly cloudy will cause the person to see rings around lights. Typically, older people will often complain of rings around lights because of some changes taking place with the lens - typically the early beginnings of a cataract. This leads to problems with seeing lights at night and also leads to glare problems and photophobia.
Q. I was told that I had a Marcus Gunn pupil. What is it and what are the symptoms and are there any complications from having it? A Marcus Gunn pupil is a pupil that does not respond very well to light when the light is shined that eye. For example, when light is shined in one normal eye (only), both pupils will constrict or get smaller. If the light is then moved rapidly to the affected, Marcus Gunn, eye even though the light is shining in the affected eye BOTH pupils dilated or get larger. The patient usually does not know that he/she has a Marcus Gunn pupil. Some people are born with a Marcus Gunn pupil and other people may acquire one without any other problems. However, sometimes a Marcus Gunn pupil may be a sign of a serious eye problem or neurological problem, sometimes restricted to the optic nerve of the affected eye. Therefore, if the eye doctor detects a Marcus Gunn pupil AND you've never had one before, the doctor may perform additional testing to make sure that you don't have something that is causing the Marcus Gunn pupil. So, if you've been recently diagnosed with a Marcus Gunn pupil be sure to follow-up on all the testing that the doctor may want to perform - It may be VERY IMPORTANT.
Q. What is birdshot retinochoroidopathy? Birdshot retinochoroidopathy, also called birdshot retinochoroiditis, is an autoimmune disease in which the person's immune system appears to turn on itself and, specifically, the retina and choroid. It is a chronic inflammatory process. It usually occurs in middle-aged patients (35 - 70). When the eye doctor looks in the back of the eye he/she sees multiple whitish dots that appear like a shotgun blast, thus the name. Dye studies show that the disease involves a breakdown of the blood-eye barrier and involves inflammation of several parts of the eye including the retina, its blood vessels and the vitreous. Patients often complain of floaters (dots, lines with strings and cobwebs), blurred vision of both eyes, color vision problems and problems with dark-light or light-dark transitions. Later in the course of the disease, optic nerve atrophy, subretinal neovascularization (growth of abnormal blood vessels) and hemorrhages can develop and lead to further vision loss. Initially, prednisone and cyclosporine are used to control the inflammation, but long-term treatment is very difficult and it is usually best to be regularly seen by doctor that has experience in immunosuppressive agents, since several potential serious side effects from treatment can result.
Q. What is lattice degeneration? Lattice degeneration is a rather common disease in patients with myopia (nearsightedness). It is characterized by well defined elongated areas of retinal thinning of the peripheral retina (extreme side vision). Pigmentation is abnormal and there may be whitish-yellowish dots, ovals and lines that make-up the disease. Retinal tears and holes and excessive floaters are common. There may be a posterior vitreous detachment and eventual retinal detachment. Patients with myopia in the range of -6 to -10 diopters appear to have a particular susceptibility to the disease. If you have high myopia (greater than 5 diopters), you should have a regular, yearly, dilated eye exam to check for retinal holes, tears and detachments that are amenable to treatment.
Q. I have a rapid loss of the ability to focus. Any information? As we age, the lens of the eye gradually loses its ability to focus or accommodate - a condition known as presbyopia. It is common in patients over the age of 40 or so. Often the first sign is that close-up objects appear blurred and the patient often has to have reading material at arms length in order to see it. Sometimes the patient will comment that their arms "aren't long enough". At other times the patient will complain that after reading for a while that objects in the distance appear blurred and that the patient can't focus on distant objects. Usually at this point the eye doctor will prescribe bifocals - eye glasses that have a different strength of lens on the top and bottom for distance vision and near vision, accordingly.
Q. What is Fuch's disease? Fuchs' heterochromic iridocyclitis is an unusual disease and accounts for about 3 - 4% of patients with uveitis. Patients complain about floaters, problems with glare and blurred vision due to cataracts, although often patients have no specific complaints, at least initially. Sometimes patients are seen because of some color changes of the iris associated with the disease. In Fuchs' the iris partly becomes depigmented and appears white, such that parts of the iris look of normal color and other parts look almost white. Clinically, small deposits or so-called precipitates are seen in the back part of the cornea - almost looking like fine particles of sand. Unfortunately, a large percentage of patients develop glaucoma and almost all patients develop cataracts. There is no cure for Fuchs', although the complications of the disease are often treatable. If you have Fuchs' it is essential that you maintain regular eye exams, as the doctor will check you for the development of glaucoma, cataracts, and inflammation.
Q. My son has Coats Disease. The retina is detached and cannot be fixed by surgery. Do you have any information on eye replacement for a child and if there are any new research out there for me. My son is 2 ½ and is currently blind in his left eye. Coats disease usually affects one eye only and, unfortunately, little can be done about it. We cannot do eye transplants yet or in the distant future. Sometimes there is a need to remove the eye and an artificial eye can be put into the eye socket. The newer artificial eye can even move with the unaffected eye. Also go to COATS for more information. Q. I am a 17 year old male, and I am having trouble with my vision. I see floaters all the time, I see halos around all lights at night time, and during broad daylight I see dark flashes all the time. It is really disturbing and scary. Can you tell me what is wrong? You need to see an eye doctor ASAP. Unless you are real nearsighted (myopic) you should not be seeing floaters. Lots of floaters may be a sign of a retinal tear, detachment or/and bleeding in the eye. Are you diabetic? Sometimes a retinal hemorrhage as a result of diabetes will cause some of your symptoms. You may have a serious eye problem and need to see an eye doctor NOW.
Q. I am 52 years old. In the last 2 years I have experienced this problem. I get blind spots in both my eyes and also its like a broken glass in both eyes—like a jagged edge with colors in it. This happens in both eyes. It has happened twice now in the last month so now I am more concerned about what’s going on. I experience no pain. What are these symptoms of? If the vision problem happens in both eyes at the same time then it is probably a brain or cortical problem involving the visual areas of the brain. Your description is similar to that experienced by patients with migraines - even though you don't have the classic migraine headache. What about loss of balance, ringing in the ears or strange body sensations. You should consult with an eye doctor about the problem and for peace of mind.
Q. I sent the question about floaters, halos, and dark flashes. I was wondering if you could give me some more feedback on my problem. You asked if I was a diabetic and I'm not, but I do wear glasses (I can see close, but I can’t see far away, without glasses). So I think that means I'm nearsighted. I'm 17 years old and I have had glasses since I was about 7. So I don't think I have severe nearsightedness. Also, I don't have any other medical problems. Basically, my floaters are really bad, they are there constantly, and there are a lot of them. The shapes range from wavy lines, circles, and dark patches of the floaters, pretty much any shape imaginable. Also, the halos around lights are terrible too. I see them all the time in the night. But the worst thing is The dark flashes that I see out in broad daylight. They are there all the time, the dark flashes are all over my eyes. Just if your wondering I’m, 6 foot 5 and I've been growing a lot in the past 3 years, but all the problems in my eyes seem to be getting worse. We urge you to talk to your parents and tell them of your eye
problems. You need to see an eye doctor for a dilated exam NOW. Please see an eye doctor
today or at the earliest moment. DO NOT schedule a regular eye exam (it may take them
several weeks or months to see you). Tell the receptionist at the doctors office the
problems that you are experiencing and they should see you ASAP.
Q. Is nystagmus correctable with surgery? This is a complicated question. Nystagmus is not correctable with surgery; however, if you have nystagmus AND a null point then eye muscle surgery might enable you to not have nystagmus in primary gaze (when you look straight ahead). When a person is born with nystagmus sometimes if the person looks in a certain direction, for example to the right, the nystagmus will stop. The direction of gaze where the nystagmus stops is called the null point. Some patients do not have a null point and their eyes will beat when they look in any and all directions. If you have a null point, an ophthalmologist can sometimes perform eye muscle surgery in which the eye muscles are moved so that the null point is changed to the straight ahead position. So, you don't have nystagmus when you look straight ahead. However, such patients will still have nystagmus in the other gaze directions. This is an excellent question to ask your eye doctor.
Q. What are large pupils a sign of? Larger than normal pupils can be a sign of a number of things. Most common, larger than normal pupils are a sign of the ingestion of certain legal and illegal drugs. Large pupils can also be a sign that the person is excited. In patients, sometimes larger than normal pupils can be a sign of a retinal disease, although this is rare.
Q. Three days ago I started seeing a gray oval in my right eye, top right side. Today it is smaller and has moved closer to the center of my vision and is more of a flash of light and sometimes a light gray circular spark. The fact that the gray oval is only seen in your right eye suggests that it is located in the right eye. If you see it all the time then it probably is not just a floater. Your description suggests the presence of a small retinal/vitreous hemorrhage in your right eye. The spark may be a sign of a retinal tear or break. You need to seen an ophthalmologist ASAP.
Q. Our daughter has recently been diagnosed with a congenital cataract. She will be 8 in three weeks. Will having cataract surgery be advisable at this stage? Will regaining some of her eye sight in the limited time she has be beneficial? A cataract is simply a opacity of the lens and a congenital cataract is one present from birth. Congenital cataracts come in all shapes and sizes including small discrete dots and white plaque type opacities. Some congenital cataracts rarely interfere with vision and do not cause amblyopia or lazy eye. Others can interfere with vision and create deep amblyopia. There are a number of causes of congenital cataracts including gestational infections, the most common being rubella. Sometimes a congenital cataract is one symptom of a more complex disease or syndrome. As the lens grows as we age, depending on the precise location of the cataract, the cataract may start to affect more central vision. Because of their individual and complex nature, without examining your daughter it would not be possible to give a valid answer to your questions. However, given the thrust of your questions, it is apparent that your daughter has amblyopia due to the cataract. Sometimes the eye doctor will try occlusion therapy even at 8 to see if the patient will respond and gain improved vision in the amblyopic eye even with the cataract present. If your eye doctor thinks that the cataract is significantly affecting vision, he/she may advise that surgery is necessary, in which case you should proceed with surgery. Sometimes it is surprising how much vision can be saved or/and regained even at 8 years of age. Finally, a cataract, even in just one eye, can cause severe problems with glare as well as sensitivity to lights (photophobia) and, as a consequence, are further reasons why it may be necessary to have the cataract operation.
Q. Is there a way to correct eyes that are not level? I have to turn my head sideways to see straight. Yes. If a patient has an eye misalignment he/she will sometimes compensate with a head tilt. This achieves several things; single binocular vision and apparent eye alignment. In addition, sometimes a head tilt can lead to neck, shoulder and back pain and discomfort. You should see an ophthalmologist that does eye muscle surgery (for strabismus)for an opinion.
Q. While pregnant with my second child I began to see trails or tracers after moving objects...I have never used drugs, which I understand can cause a similar sensation. I recently had a complete dilated eye exam which revealed nothing. Should I see an eye doctor again or a neurologist? Probably neither. Trails or tracers is one of those symptoms that is nearly impossible to quantify or measure since only the patient can see them. Everybody can see tracers or trails after objects since they are actually a series of short lived afterimages of the object as it passes through one's visual field. The difference is that most people do not concentrate on them or get them much thought. When a patient complains of seeing tracers or trails, it is often the case that the patient has certain psychological issues that are unresolved, or that the patient has an obsessive-compulsive type tendency or personality. In turn, stress (e.g., having a child) can aggravate any underlying psychological issues and make symptoms worse.
Q. Are there any funds or assistance available to people who do not have vision insurance, but need surgery to correct their vision? Not through the research foundation but try the following:
Q. My small daughter has a lesion in her eye. What causes the lesion and what is the best treatment? A lesion is defined as "any pathological or traumatic discontinuity of tissue or loss of function of a part". Lesions come in all shapes and sizes and for hundreds of reasons - some serious and some benign. Sorry, but more information is needed to address your question further. Seeing a doctor is always a traumatic event and everybody forgets to ask important questions during the visit. Before seeing your eye doctor again, please be sure to write down all your questions for him/her to answer. Also, you can contact your doctor's office and get additional information such as "What is it?" "Is it serious?" and "What is the prognosis?".
Q. Have you ever heard of bumps under and along the eyelid filled with yellow wax-like substance? And what about floaters that are blocking my vision seriously (they are like having absolutely filthy glasses that someone has put some Vaseline on the viewing portion, making it extremely frustrating to see. Regarding the bumps along the lid margin, go to Stye. The presence of severe floaters may be a sign of serious eye disease so you should see an eye doctor ASAP. There is also a possibility that the styes and floaters are symptoms of a more generalized, systemic, disease so you really need to see an ophthalmologist.
Q. What is Eyeritis? Correct spelling is Iritis. See Iritis under Uveitis. Also go to Iritis, as it related to autoimmune disorders.
Q. Can you provide information on Parafoveal Telangiectasia in an otherwise healthy 64 year old female? Parafoveolar telangiectasia may be present from birth or acquired in later life. Parafoveolar telangiectasia can affect one or both eyes (more common). Given your gender and age, you probably have the type that affects both eyes and that is acquired. The cause of parafoveolar telangiectasia is not known. Initial symptoms include mild blurring and some loss of visual acuity. The loss of visual acuity slowly progresses.
Q. Blood in eye? Patients have blood in the eye either because of injury or disease. If the blood is in the front part of the eye, in front of and partially blocking the iris (colored part of the eye that makes the pupil), it is referred to as a hyphema. A hyphema requires immediate medical attention and if left untreated could lead to an onset of glaucoma and blindness in the eye. Blood in the back part of the eye, where the retina is, is usually caused by disease, such as diabetes, although trauma (e.g., shaken baby syndrome) can also cause retinal/vitreous bleeding. Whatever the cause, blood in the eye requires immediate medical attention. If there is blood inside the eye, depending on the situation, the eye doctor may wait for it to clear or may need to undertake surgery (vitrectomy) to remove the blood.
Q. Do you have any information on the eye disease called "Fugndris Flarvinoculations" [Fundus Flavimaculatus]? Fundus Flavimaculatus is also called Stargardt's disease. Go to Stargardt's Disease.
Q. For about the last six months I have noticed that my left eye is very blurry after I turn out the lights to go to bed. My right eye seems to pick up light, but my left eye seems completely dark. If I switch the lamp on, there’s no difference. I’ve always had 20/20 vision and I’m 34 years old. I read alot and wonder if I’ve strained my left eye. Straining an eye will not cause the symptom you describe. Poor night vision is sometimes a sign of serious eye disease. You need to see an eye doctor about the problem and he/she may want to perform a visual field test and an electroretinogram (ERG) to rule-out the possibility of a serious eye disease.
Q. Why do I have a little yellowness on the inner white part of my eye? Not sure. Could be several things including conjunctivitis, allergic reaction, jaundice or normal anatomy. In the very corner of the eye, near the nose, is a structure called the caruncle which is triangular and where tears accumulate. But the caruncle is not part of the sclera or white part of the eye.
Q. My mother has had blurry vision for a week now, with no other symptoms except thirst. She is waiting to see her doctor some time next week. Any ideas? Thrust is sometimes a symptom of diabetes. Diabetic patients may experience blurry vision associated with the early formation of a cataract or as a result of a retinal hemorrhage. Most probably, however, the blurry vision is not related to the thrust and all your mother has is the start of presbyopia - close things are hard to focus on.
Q. I have a droopy eyelid which has developed, the doctor has advised it is probably a lesion. Please advise best possible treatments and/or remedies? A droopy eyelid is called a ptosis. A ptosis can develop because of a lesion or damage to certain parts of the brain or due to damage to the nerves that innervate the eyelid(s). A ptosis can also be related to certain neurological diseases such as myasthenia gravis. You may need to have an exam and work-up by a neuro ophthalmologist to find the reason for the ptosis.
Q. What is a neurologist and what kind of tests do they run when you go to see them? A neurologist is a medical doctor that specializes in neurological problems, usually problems with the brain and central nervous system. They can "run" or order a large number of tests depending on the problem or disease at hand, including blood work, imaging of the body or/and brain (e.g., MRI, CAT scan. X-rays) and physical exam.
Q. If an adult has amblyopia are they able to see (have vision) out of the lazy eye? Or, do they have vision out of the good eye and blind in the other eye? Both and neither. A person with amblyopia, and it doesn't matter if it is a child or an adult, can have anywhere from near normal vision in the amblyopic eye to almost no vision in the amblyopic eye - it depends on the severity of the amblyopia. In general, the earlier the onset of the amblyopia there more severe the vision loss. For example, if a child is born with a cataract in one eye and the cataract is not detected until, say, age 8, then the child/adult would probably only have light perception in the amblyopic eye. If the child develops a cataract at, say, age 5 and the cataract is removed later and the child has appropriate therapy, the child may have normal or near normal vision in the amblyopic eye. To complicate matters, some amblyopes may have normal side vision in the amblyopic eye but almost no central vision in the amblyopic eye.
Q. Is there any way to cure Chalazion? A chalazion is solid lump (tumor) usually located away from the lid margin and is a chronic inflammation of the meibomian gland. Chalazions can involve all four lids and usually occur in adults and are usually associated with chronic blepharitis, seborrhea and acne. Often, a chalazion will disappear after a few months and some will disappear with the help of warm packs and topical antibiotics. Sometimes surgery (removal, incision and drainage) may be required.
Q. "Ceratocone (Keratoconus)?" What is involved in a corneal surgery? Keratoconus is an abnormally shaped cornea - often described as "cone" shaped or pointed outward. It is usually a progressive condition and leads to visual impairment and loss. Often contact lenses are tried in order to reshape the cornea. A cornea transplant is also utilized to cure the condition. In a cornea transplant, the patient's cornea is removed and a donor cornea, often received from a LIONS Eye Bank, is sutured onto the eye. Because the cornea is an immune privileged tissue, no immune suppressive drugs are needed.
Q. Is there any way to beat the Ishihara test? I am having trouble passing it. I need to pass it for a job and I'm slightly deficit. The Ishihara test is a color vision test that is composed of numerous pictures composed of different colored dots. The patient is required to detect a number or numbers embedded in each picture. Although there is no way to "beat" the test, except for memorizing all the correct answers, a person could improve their chances of passing the test by blurring the pictured that compose the test. An interesting aspect of the Ishihara test is that the sharp borders that make-up the individual dots of each picture actually can interfere with a person being able to see the larger number or numbers that are embedded in each picture. In scientist terms, the high spatial frequencies that make-up the sharp lines/contours "mask" the lower spatial frequencies that determine the number(s) to be identified by the test taker. Thus, if a patient can focus close-in while viewing each test picture and thus blur the picture, he/she may be able to improve their test score, particularly if the person doesn't quite pass the test. If the test taker is unable to voluntarily blur an object, than an alternative would be to buy a cheap pair of reading glasses, say with +3 diopter lenses, and to take the color test only with the glasses on. If you're myopic or nearsighted, you might improve your test score by taking your glasses off while taking the color test only. It is important to note that we do not condone people trying to cheat on any vision test. However, some of us believe that the Ishihara test itself is flawed, because of the masking issue.
Q. I am an adult whose left eye is higher than the right. Can this be fixed? It is unclear what you mean by one eye higher than the other. Sometimes a patient will have what appears to be one eye higher than the other by actually it is the eye lid that is higher or lower and not the eye itself. Nevertheless, you should consult with an ophthalmologist that specializes in plastic surgery for his/her opinion.
Q. At 51 years old my eyesight is expected to deteriorate, however it seems to be progressing far too rapidly. It definitely started at the time I started using a PC, at work and home (about 5 years ago). Does any have information that relates to VDU eye problems. Is a liquid display monitor safer? Can the refresh rates/radiation of the standard VDU effect or impair eyesight over a long period with excessive use? The juxtaposition of your age at the time of increased computer use and the standard age of the onset and worsening of presbyopia is probably the reason, in part, why you feel that the computer use has lead to a worsening of your eye sight. Presbyopia involves the loss of the ability of the lens of the eye to change shape and accommodate to near images. As a result, to achieve a clear image the person has to hold material further and further away as they age. In addition, as the lens of the eye decreases in its ability to focus, it becomes more difficult for the person to relax accommodation to distant objects after one is involved in near work for an extended period of time. As a consequence, after working on the computer for a while, distant objects appear blurred. Presbyopia can start as early as about 40 and last into the 50s so you're in the ball park. To complicate matters, it is also well known that close work can lead to the further progression of myopia or nearsightedness, although this is usually a problem in younger individuals. Eye fatigue is a problem with computer users and can be exacerbated by they type of computer monitor, viewing distance and glare. The faster the refreshment rate the better and users should avoid any monitors that have an interlaced scan pattern. Viewing distance is seldom mentioned as a problem, but the ideal viewing distance is about at arms length - or about one meter, which is the natural resting point of accommodation of the eye. Finally, glare is a real problem for computer users and antiglare screens or filters should be used and room lighting should be arranged to eliminate any glare on the monitor. Ergonomics is also a real problem for computer users and incorrect positioning of the operator to the computer screen and keyboard can cause numerous problems - shoulder, back or/and neck pain are common problems operators experience when they are not positioned correctly with the computer components. We are not aware of any information that a liquid display monitor is any better than a CRT type monitor in regards to safety or eye strain. Go to Computer Eye Problems for more information on computer use and the eye.
Q. I have been recently diagnosed with Sulzmann's (Salzmann's) Nodular Degeneration. What exactly is this and can you point me in the direction of further information? Salzmann's nodular degeneration is a noninflammatory degeneration of the outer parts of the cornea. The disease is characterized by nodules in the midperiphery of the cornea that appear bluish-white. These nodules sometimes are the result of contact lens wear (and possible previous inflammation), keratoconus and even after surgery on the cornea. Usually, the disease does not affect vision; however, if there are recurrent episodes vision may become blurred. Treatment includes removing the nodules by minor surgery.
Q. Why would the pupils of my eyes be yellow? The pupil of the eye is the dark center part or hole that is shaped by the iris and that allows light to enter the eye. If the pupil appears yellow it may be a sign of a cataract or tumor inside the eye; however, these would affect your vision. More likely, you mean the iris of the eye in which case it could be the result of certain oral medicines or a sign of Wilson's disease. Wilson's disease is usually diagnosed in patient's between the ages of 8 - 20 years. Wilson's is a type of liver disease and the yellow color is a sign of excessive copper in the liver and is similar to early cirrhosis. It is possible that you also have some other form of liver disease. Because Wilson's disease is treatable and treatment may slow down or stop the progression of the disease, you need to see a medical doctor (pediatrician, neurologist) ASAP. They'll probably want to run several liver tests and possibly take a liver biopsy to diagnose the problem. See a doctor today!
Q. What percentage of
Americans need glasses/contact lenses? In the early 70s it was estimated that approximately 25% of Americans between the ages of 12 and 54 needed optical correction for myopia or nearsightedness. In a more recent study (1994), it was estimated that 43% of Americans between the ages of 43 and 54 were myopic, but that the prevalence of myopia decreased to only 14% over the age of 75 year. [So it appears that if you're myopic you have a greater chance of dying before the age of 75! Just kidding] About 30 million Americans wear contact lenses. About 2 million Americans have had "laser surgery" to correct their refractive error. Statistics for hyperopia or farsightedness or any other condition that would require glasses have not been found but would represent a small percentage compared to myopia.
Q. Pupil dilation not happening in young child. Dilation means that the pupils of the eyes do not get bigger when the child is placed from a lighted room, for example, into a darker room. Because of several factors (e.g., smaller eyes and pupils) it can be difficult to tell that a child's eyes are dilating. More worrisome; if the child's pupils remain dilated in the dark and in the light then this could be a sign of a serious problem. Since all children should have a comprehensive eye exam by an eye doctor, why don't you see an eye doctor just for piece of mind and to make sure that everything is ok.
Q. I experienced a very serious episode of pain in the neck from radiculopathy and muscle strain which prevented me from sleeping, moving my neck, etc., for a couple of weeks. During the first four days of the acute pain in my neck, my right eye started to flash when I looked at bright windows and subsequently looked back into a room; or if I walked outside the door during the day, my right eye would sparkle or flash briefly as I walked back into the house. On the seventh day of the acute neck pain, I received an injection of steriods into the muscle in my neck. The next morning I suddenly noticed a significant decrease in visual acuity with a yellowish discoloration overlaying the blurred vision. I was diagnosed the next day with central serous retinopathy. I subsequently read it has been determined that steriods (which previosly had been used to treat central serous retinopathy) have been shown to complicate and worsen symptoms of central serous retinopathy. Have you ever seen a link between acute pain from radiculopathy in the neck and the development of central serous retinopathy, and is it true that the use of steriods during episodes of central serous retinopathy has a negative effect on the course of the disease? We could find no references showing a relation between radiculopathy and central serous retinopathy. However, there appears to be an association with steroids exacerbating the symptoms of central serous retinopathy (see references cited below). Whether steroid use can actually cause central serous retinopathy is not so clear. So, there appears to be no association, at least documented, between radiculopathy and central serous retinopathy. Apparently, you probably had central serous retinopathy (based on your earlier visual symptoms) when you had the steroid injection for the radiculopathy, which aggravated the eye condition.
Q. What is Walleye? Walleye is a layperson's term for exotropia - one or both eyes of the person appear to point outward. Conversely, cross-eyed or esotropia refers to a condition in which one or both eyes appear to turn inward toward the nose. Both conditions might be correctable, depending on the situation, with eye muscle surgery performed by an ophthalmologist.
Q. There is redness forming around the center of my eye, and eye drops don't help. I wear contacts. What is the problem? You may have contact lens induced keratopathy in which case you need to see your eye doctor for possible treatment. Stop wearing your contacts until you see your eye doctor. You may also have poor fitting contact lenses, in which case you should stop wearing your contacts and also see your eye doctor. If you ignore the problem and end up with a serious case of corneal infection, you could develop a permanent loss of vision. So, see your eye doctor.
Q. My mother is 80 years old and she is suffering from degenerative cornea in her left eye. The eye doctor said that a corneal transplant can give her vision. What should we do? Is a corneal transplant done on old people? Corneal disease can cause severe problems with glare and cause severe, disabling photophobia, not to mention pain and discomfort. You should follow your doctors suggestions. The age of the patient should not be an issue when it comes to the need for corrective surgery. Yes, corneal transplants are done on people of all ages. A women of 80 can expect to live another 7 years or there abouts. If you were your mother, would you want to be able to see in the last 5 -10 years of your life? Please discuss your concerns with your mother's doctor AND with your mother.
Q. What are oscillatory potentials? This is not recordable under lighting conditions in either eye. Can you tell me what it means? Oscillatory potentials are high frequency responses that are part of the b-wave of the electroretinogram (ERG). Oscillatory potentials are sensitive to circulatory problems of the retina and are often abnormal or absent in diabetic eye disease, or other diseases of the eye that involve the retina and its blood circulation.
Q. Can you direct me towards where I could look into getting a text to speech program? You are looking for what is called a screen reader. Regarding a text to speech program, go to www.gwmicro.com for information about their screen reader. Also, go to afb.org the web site for the American Federation for the Blind for further information about screen readers and for information about Access World – a publication that evaluates assistive technology, including screen readers. Please note that the Ohio LIONS Eye Research Foundation does not recommend or support any particular services or products and that this information is being provided to you simply as a response to your question. Thanks. Q. What is the name for a floating eye? Don't know what you mean. Could you give more detail as to exactly what the eye does? You may be referring to a "wandering" eye. In some patients with lazy eye, or reduced vision in one eye for a number of reasons, the one eye will wander or, in other words, not always be in alignment with the fellow, stronger eye. It looks like the one eye drifts-off of alignment and then returns.
Q. I have a field loss in the temporal area of 20%. Is this serious and could an airbag deployment be a causative factor? Yes. Any field loss is very serious and warrants a full work-up to determine the cause. Can a field loss be due to an airbag deployment? Probably yes. Blunt trauma can cause a field loss in several ways. If the deployed airbag hit the eye itself, it could cause a retinal detachment and, thus, a field loss; but this would be evident by the eye doctor. However, a field loss could also result if the deployed airbag caused optic nerve damage. The later would be more difficult to assess by regular eye exam alone. Nevertheless, follow your doctor's advice. If he/she wants to undertake additional tests, such as an MRI, CAT scan, retinal tests, etc., do it. Although a field loss could be due to an airbag deployment, numerous other things can also cause a field loss, including a brain tumor, retinal degeneration, optic nerve disease, glaucoma, etc. Q. What do OD and OS mean? OD stands for the latin o'culus dex'ter meaning right eye and OS stands for the latin o'culus sinis'ter meaning left eye. Q. Can you provide any information about an in-office procedure for a detached retina that sounds like "pneumatic retinoscopy"? You are referring to a procedure called "pneumatic retinopexy", a term coined by Drs. Hilton and Grizzard. In pneumatic retinopexy first the surgeon treats the outside of the eye, where the retinal break/detachment is located, with cryoapplications (freezing) or photocoagulation (laser "welding"). This is followed by an injection of expanding gas inside the eye and then the patient is positioned so that the gas bubble pushes on the retinal break/detachment to close it. It is a highly successful procedure in select patients. Q. What does "BILATERAL REHOLENTAL FIBVOPLASIN" mean? You are referring to "bilateral retrolental fibroplasia" (RFP). The newer term is referred to as "retinopathy of prematurity" (ROP). Bilateral means that both eyes are affected. ROP usually occurs in premature infants and has been associated with the use of oxygen. However, the exact role that oxygen plays in ROP is not known. In ROP, there is dilation of the blood vessels which develop abnormal growth, toruosity,swelling and possible retinal detachment in the more severe cases. Patients with ROP may have normal vision if the ROP is mild or may have no light perception if there is bilateral retinal detachments. Interestingly, in some patients with ROP, the ROP will actually disappear leaving the patient with noraml appearing eyes and normal vision.
Q. I was reading a report (black ink on white paper) outside in the bright light of the mid afternoon sun - for about 10 minutes. When I came inside and looked at the report, it appeared to be written with green ink, rather than black. As the seconds passed, there were times when the color seemed to flit between black and green, and then after a couple of minutes, the print was entirely black again. I would like to understand the mechanism behind this phenomenom. Another version of this I have heard about is a friend’s father who, when he is looking at something on a computer screen (black on white), sees various lines in black and others in red. Do either of these instances suggest a trip to the opthalmologist? Probably not. The phenomenon that you experienced is most likely an afterimage effect. Afterimages of colors are complimentary (e.g., blue - yellow, green - red) and also depends on the color of the background . Although you and your friend thought that you were reading something black on white, most likely the black ink contained a significant amount of the complimentary color to the afterimage; in your case the ink probably contained a large amount of red pigment. In addition, afterimages will also fad and reoccur for a while when, for example, the patient blinks or looks away from the background for a moment. Finally, afterimages are best seen when the "adapting" stimulus is real bright; for example, something seen in bright sunlight. Also, computer monitors are well known to contain a green phosphor, even though the screen appears white, and thus the afterimage would appear red. Q. Hi. I have retinitis pigmentosa, and it maybe an usher's syndrome, cause I was born with a hearing loss. I'm 27 years old. I'm going to Emory medical for more testing (ERG and a field test). Would you know if this could affect my brain if all of this causing by some nerve problems if you know respond please, I will ask Emory tomorrow as well, I just wanted to see if I get both answers to match. Thank you for your time. Retinitis Pigmentosa (RP) is a retinal degeneration that affects 1 in 4000 people. The photoreceptors in the retina die - off and, as a consequence, the signals from the eye to the brain become "distorted" and the patient experiences reduced vision during the night and day. Sometimes the optic nerve, the major nerve from the eye to the brain, will look pale, suggesting some involvement of the optic nerve (probably the ganglion cells in the retina). In general, however, the nerves in the brain are not affected in RP. Usher's syndrome is the leading cause of deaf-blindness in the United States. Patients with Usher's syndrome are born with a sensori-neural hearing loss of varying degree and later develop RP. Interestingly, patients with Usher's syndrome also have abnormal looking sperm. Again, neither RP nor Usher's syndrome affect the brain, per se. Although both affect the signals from the eyes to the visual centers of brain . Q. Went to eye doctor today and was told my son's (optic) nerve was pale. Doctor could not explain why this was. Need to go to neurologist. What could it be? What are the number of things that I need to look for? Pale optic nerve(s), referred to as optic nerve pallor, can be a sign of a serious neurological or/and ophthalmological condition. A host of things can cause a pale optic nerve. It is real important that you/your son keep all appointments will all the doctors. Don't be surprised it your son has a lot of tests done to try to find out why he has a pale optic nerve. Some of the tests might include imaging tests of the brain (CAT scan, MRI), electrophysiological tests such as the visual evoked response (VER, VEP), and certain blood tests. If your son is young, he may have been born with the condition, or it could be a sign of a progressive, worsening condition so keep your doctor appointments. Q. My one year old son has one eye where the pupil is slanted instead of round. Why and what is that? You may be describing several things,some of which can be serious. In aniridia, there may be a near complete absence of a pupil and is sometimes associated with nystagmus, sensitivity to light, glaucoma and reduced vision. Iris coloboma is a developmental defect in the pupil and may include a sector of the iris being missing, hole(s) or a notch in the iris. Iris dyscoria is an abnormal shaped pupil and iris corectopia is a pupil in an abnormal position. Some pupil abnormalities may be a sign of other complex conditions or associated with certain syndromes. You need to take your son to an ophthalmologist ASAP, since the condition could be very serious and vision threatening. Q. I have blurred vision in one eye which has occurred recently (two weeks). This has happened before and faded away. It usually takes a few weeks. The sensation is that my cornea has a spot or scratch in the middle. Is this something that I should be concerned with? Yes. You describe not a scratch on the cornea but a possible problem with the macula - the central vision part of the eye. If you are older, say past the age of 55 or so, you may be describing the early stages of age-related macular degeneration, as well as other possible conditions. To be on the safe side see an eye doctor for a dilated exam, where they will look in the back of your eyes and examine the retina for possible problems. Q. What causes one eye to have double vision? Double vision in one eye (while the other eye is closed) is usually a sign of a dislocated lens (natural or artificial lens), a defect in the media of the eye or a problem with the macula - the central vision part of the eye. If you recently developed monocular diplopia, see an eye doctor for evaluation and possible treatment, if applicable. Q. What is Axenfeld anomaly? Axenfeld's anomaly is an abnormal development of the front part of the eye, including the cornea and iris. In Axenfeld's anomaly, there are strands of iris, that are not supposed to be there, that cross from the iris to the cornea. Sometimes there is also glucoma that develops because of the disruption of the flow of fluid in the eye, due to the abnormal shaped iris, this later condition is referred to as "Axenfeld's syndrome." Q. At six months of age my son was diagnosed with Dwayne's (Duane's) syndrome. When he looks to the left, his left eye remains stationary and the right eye turns in toward the nose, giving him the appearance of being crossed eyed. The doctor has told us that there is nothing that can be done for this. Do you have any information? You give a great discription of Duane's syndrome and your doctor is probably right. As long as your son has straight eyes when looking straight ahead and does not have too much of a head tilt, then no surgical correction is indicated. If, however, he has a significant head tilt or/and his eyes are not straight in front gaze, then he could have eye muscle surgery to try to straighten the eyes in front (primary) gaze. In general, if the condition is minor leave it alone. In addition, the success of eye muscle surgery is not guarenteed and could actually make the condition worse. Q. My wife has a recurring problem called Tigesons (Thygeson's). She has recurring scratches on her cornea. Her doctor is treating her with steroids. What is the disease and can she pass it on to the kids or me? Thygeson's superficial punctate keratitis is a recurring inflammation of the cornea (keratitis) consisting of discrete spots (punctate) of inflammation. These are not scratches, per se. Symptoms include tearing, sensitivity to light, pain, and a feeling like there is a foreign body in the eye. The cause of Thygeson's is unknown and it is unlikely that the kids or you will be affected. Patients usually have Thygeson's for 2 to 3 years, and patients are usually in the 20s or 30s. The disease comes and goes and patient's can have spontaneous recurrences or it could go away completely. Treatment usually includes the use of artificial tears, ointments and certain types of soft contact lenses. Steroids have been shown to be effective at resolving the keratitis, but not a cure per se. This disease is different from chronic follicular conjunctivitis of Thygeson, which can be highly contagious and vision threatening. Q. I know that flashing lights can be a sign of a retinal detachment. What I am experiencing is a bright spot whenever I shift my focus quickly. So, if I'm at a stop light and look left and right real fast, I see a bright spot in the upper left quadrant of my field of vision. It is rather annoying, but not painful, and I don't see it when my eyes are steady. Should I be concerned about this?Is this the type of light one sees with a retina detachment? Yes and No. You should be concerned and should see a neuro ophthalmologist (you may have to be referred to one by your eye doctor) about the problem. He/she will probably do a visual field test to quantify the problem and may want to do additional testing to find the cause of the "scotoma". The problem is probably not with the retina or eye, but rather, with the brain. It is not what people typically see with a retinal detachment. Also go to small triangular bright spot in side vision. Q. I spilled iodine down my arm. It stained all of it. Since then, my eyelids have been crusty and itchy. Could this be the reason? Probably not. Crusty and itchy eye lids are signs of blepharitis. Q. I have a quite abnormal problem, I think. After physical activity like basketball, running, lifting weights, etc., my eyes become red and irritated within 15 minutes. The left eye will begin to swell and the white part of the eye becomes extremely red/pink. It will get so bad that the redness will actually overlap the lens part of the eye....I have seen several optometrists , 2 physicians and some ophthalmologists. They all said that this is unique, and have resorted to only giving me eye drops... If there is anything that could help with the problem I would extremely appreciate it. A search of the medical literature and several discussions with our ophthalmologists suggest that you may be experiencing an exercise induced pigmentary dispersion phenomenon. This is an eye disease that is difficult to diagnose and is often missed on routine eye exam. It also usually occurs in older individuals and not teenagers. In pigmentary dispersion, cells in the anterior part of the eye are "stirred-up" by exercise and cause a blockage of the drainage part of the eye (trabecular meshwork). This, in turn, causes pressure in the eye to increase leading to transient glaucoma and red, painful eyes and could affect your vision such that you think that the redness is blocking the pupil of the eye. You need to see an ophthalmologist and have a good eye exam that includes iris transillumination. You should also have your eye pressure checked and be examined immediately after exercise. If this hypothysis turns-out to be true, you'll need minor "laser surgery" to correct the problem of exercise induced glaucoma caused by the pigment dispersion. If this is true, if the condition is not corrected you could have a sudden attack AND possibly loss vision. So, it is very important for you to see an ophthalmologist ASAP. At a minimum, call the eye doctors that have examined you and have them check their records to see if they performed iris transillumination during your exam and that your concern is with exercise induced pigmentary dispersion glaucoma. Q. What causes protruding eyes? Protruding eyes can be caused by a number of diseases, some very serious. Probably the most common reason is thyroid eye disease, in which the eyes appear to buldge-out. If the condition worsens, in some patieints with thyroid eye disease the eyes may become misaligned and even stop moving. If your eyes were normal appearing and now appear to protrude-out, see an eye doctor ASAP. Q. I have just been told that I have a condition called pseudomyopia in my left eye... Do you have any information that could enlighten me on the condition. I am only 18, and told that I will grow out of it in 10 to 15 years. In so-called pseudomyopia, a patient who is slightly hyperopic (slighty farsighted) can appear to be slightly myopic (nearsighted) on examination. This benign condition is usually identified on cyclopegic evaluation (i.e., with the pupils are dilated and accommodation is fixed with eye drops) and usually is seen in young adults and older children. It is sometimes associated with an accommodative spasm, in whichthe eyes focus too close in when the patient tries to lok at near objects. Pseudomyopia really nothing to worry about. Q. I am unable to move my eye. What causes this? If you all of a sudden or over a short period of time are unable to move an eye, you need to see an ophthalmologist ASAP. Several very serious conditions can cause a persaon to not be able to move an eye, the most common reason is probably thyroid eye disease. Tumors behind the eye as well as other diseases that cause the tissue around the eye to swell can also cause a patient to lose the ability to move an eye. See an ophthalmologist or neurologist ASAP. Q. Why am I seeing squiggly lines? Seeing squiggly lines may be an early sign of age-related macular degeneration (ARMD). ARMD usually occurs in caucasians older than about 45. See Dictionary and Simulations for additional information. If you see squigggly lines or see straight lines that appear distorted, wavey, or there are missing parts of visual objects, you need to see an ophthalmologist ASAP for evaluation and treatment, if applicable. Q. I recently came from India. For the past week I have been getting a pain in my eye. Now there is swelling in my eye lid toward the nose. What is it and is there any treatment? Whenever there is pain, you should see an eye doctor. Go to Swollen upper eye lid for more information. Q. Vitamin A and Isotretinoin and floaters? I took isotretinoin (13 cis-retinoic acid) for acne and it gave me floaters... Isotretinoin, commonly called Accutane can cause a number of vision problems including poor vision at night, corneal opacities and "visual disturbances", possibly including floaters. Women who are pregnant or who may become pregnant SHOULD NEVER use Accutane because it can cause birth defects. Accutane can also cause a condition called pseudotumor cerebri - the symptoms include headache, nausea, vomiting and visual disturbances. If you have these symptoms and are taking Accutane, you should stop the drug immediately and see an ophthalmologist. Also go to Vitamin A and Floaters. Q. One eye focuses at a different point than the other. When the eyes are aligned but focus at different points in space, the condition is referred to as anisometropia ( a difference in refractive error between the eyes). For example, one eye may be nearsighted and the other eye may be farsighted. This is rather a common condition and, in children, if left untreated (with glasses) anisometropia can lead to amblyopia (lazy eye). Q. Eye all red inside, eye hemorrhaging. Several eye diseases can cause the eye to hemorrhage inside including diabetic eye disease and age-related macular degeneration. A patient that experiences bleeding inside the eye needs to see an ophthalmologist ASAP for treatment, which may include certain types of "laser surgery". Q. Blisters/ulcers on eye. What is the cause? Ulcers on the cornea can be caused by a numbers of factors and the signs usually include localized Haas and swelling of the cornea, swelling of the eye lid(s), sensitivity to light, pain, tearing and involuntary "twitching" of the eye. Often trauma, sometimes due to the over wearing of contacts, can cause serious and vision threatening corneal ulcers. Herpes simplex and other infectious diseases such as tuberculosis and syphilis can also cause corneal blisters/ulcers (referred to as interstitial keratitis). All these conditions require prompt and immediate medical attention, so if you have a corneal blister/ulcer see a doctor ASAP. Q. Droopy eyelid. A droopy eye lid is referred to as a "ptosis". Go to ptosis for more information. Q. My granddaughter has an eye that turns-in badly and they are talking about eye surgery for her, can you give more details about this type of surgery? When the eyes turn-in the condition is called esotropia. A young infant whose eye(s) has turned-in since birth or thereabouts is referred to as congenital esotropia. The standard treatment of esotropia is corrective eye muscle surgery, unless the patient has a type of esotropia called accommodative esotropia which can be corrected with glasses. When an eye turns-in, it usually means that there is a problem with one or both eye muscles that control left and right gaze. When an eye moves toward the side of the head, for example the right eye, the eye muscle near the side of the head (lateral rectus muscle) contracts and the eye muscle near the nose (medial rectus muscle) relaxes and stretches. In eye muscle surgery to correct esotropia, the eye doctor will put the patient asleep and then make a small incision in one or both eyes to gain access to one or more of the eye muscles. Depending on the circumstances, the eye doctor may cut the medial rectus muscle, move and reattach the muscle further back in the eye. Sometimes the surgeon will cut-out a small piece of the lateral rectus muscle to make the muscle shorter. In either case, the goal is to surgically move the eye(s) via muscle shortening or by repositioning the eye muscles such that the eyes end-up straight. In general, there is about a 70% chance that the surgery will be successful. Some patients require a second and sometimes a third surgery to straighten the eyes. In general, the earlier the eye muscle surgery the better, for eye alignment and the development of normal binocular vision. Also, there is a chance for a patient with esotropia to develop amblyopia (lazy-eye). Ideally, eye muscle surgery should be performed when there is no evidence of amblyopia; otherwise, the success of the eye muscle surgery will be less. Q. Sudden loss of sight in one eye. A sudden loss of sight in one eye can be caused by a number of things, most of which are very serious. Transient ischemia attacks(TIA), hemorrhage inside an eye due to diabetic eye disease or age-related macular degeneration, retinal detachment and transient glaucoma among others can cause a sudden loss of vision in one eye. If you have a sudden loss of vision in one eye, even if the vision returns after a short while, you should see an eye doctor ASAP for evaluation and treatment, if applicable. Q. Can your eye sight really be affected by watching your television too close? Yes. Watching television , or for that matter watching anything, too close can cause a number of eye problems. Nearsightedness can be worsened and eye strain (dry and red eyes, double vision, blurred vision, eye discomfort) can become a problem by viewing objects, including the television, too close or/and for too long of a time. Q. Have you heard of someone slowly loosing sight in one eye and then its supposed to come back in maybe a couple of weeks? I'm not sure what they call this? The word here is MAYBE. Sometimes patients with optic neuritis will experience a loss of vision in one eye and SOMETIMES vision will return to "normal" in a few weeks or months. The cause of the optic neuritis must be investigated. Sometimes patients with nonorganic vision loss (usually a vision loss due to psychological problems) may experience vision in one eye that comes-and-goes. We suggest that you talk to your doctor for further information about the condition. Q. My eyes feel pressured and irritated. I feel like I have to blink constantly. I've been to the eye doctor three times and one doctor told me my eyes were very dry and the other told me that my eyes were fine. However, my eyes certainly don't feel fine. Any suggestions? You may have dry eye disease. A common symptom of dry eye disease is that it waxes and wanes such that at one time the eyes may appear normal and at another time the eyes will appear more typical of patients with dry eye disease. As a consequence, both eye doctors may be right. Dry eye disease is a chronic problem, particularly for the elderly (over the age of 40). One of the first things to do is to make sure that the dry eyes are not due to environmental conditions, such as air circulation or low humidity in the home or work place. Also, certain medicines will cause the eyes to become very dry and irritated. See other questions about dry eye disease and stay-tuned for a featured article, shortly, about dry eye disease. Q. My doctor performed cataract surgery on my left eye and cannot correct it with glasses. He says that I have dot map fingerprint dystrophy???? Map-dot-fingerprint dystrophy gets it name from the visible description of the condition which includes very small cysts or "dots", irregular ridges of material ("fingerprints") and localized opaque areas or "maps" on or actually inside the cornea. The cornea is composed of a series of layers of cells including the epithelium (very front of the corneal) and a "basement membrane" that holds the epithelium to another deeper layer called "Bowman's layer". The problem in map-dot-fingerprint dystrophy is that waste material accumulates between the basement membrane and epithelium such that the epithelium cannot attach to Bowman's membrane. This, in turn, causes the further development and accumulation of debris. This material accumulates until it actually breaks through the epithelium or front part of the cornea causing a very irritated eye, swelling, pain and distortion. Because there is a distortion of the refractive parts of the eye (i.e., cornea), patients sometime complain of glare problems at night with oncoming headlights, reduced visual acuity and ghost images. Trauma, including cataract surgery, can exacerbate the problem. Some believe that map-dot-fingerprint dystrophy is a hereditary problem that 50% of family members have or can develop to varying degree. Treatment sometimes includes the use of lubricants and ointments, patching, and the use of certain types of soft contact lenses. The eye doctor may also need to scrape-off, very carefully, the debris to try to promote healing. Unfortunately, map-dot-fingerprint dystrophy is a chronic, incurable condition that waxes-and-wanes over time. Q. I just found out that I am left eye dominate. First, is there a cure? Second, if not what can I do to strengthen my right eye? I have recently taken up archery... There are a number of different kinds of eye dominance and, unfortunately, they all seem to measure of reflect different things. One type of eye dominance is sighting dominance, as in your case sighting a target with a bow and arrow. Eye dominance is nothing that can be "cured" since it is not a disease, per se. Much like hand dominance, some people are right eye dominant and some are left eye dominant. There is nothing that can strengthen the right eye, except possibly extensive practice . We suggest that you talk to other archery enthusiasts and find-out what others have done with a similar problem. Q. Kruckenburg. What is it? You are probably referring to Krukenberg (spindle), which occurs in pigment dispersion syndrome and pigmentary glaucoma. In Krukenberg spindle, there is a vertical accumulation of pigment inside the eye, on the central and inner side of the cornea (corneal endothelium). Q. Why does one have dark circles under the eyes? This condition is not related to sleep, I've always had them and now my son has them. What can I do? You can probably do nothing for your dark circles, but it might be worthwhile to consult with an ophthalmologist who specializes in cosmetic surgery. Go to dark circles for more information. Q. How do I find the spelling of a rare eye disease? First, ask your eye doctor. Otherwise, submit a comment to this site and spell the rare eye disease the best you can and ALSO describe the condition or disease the best you can. We'll do our best to inform you of the correct spelling and give a brief explanation of the condition or disease. Q. Is there anything to be done to reverse the atrophy of the optic nerve which prompted the loss of sight in one eye? Nothing will reverse optic atrophy. If the condition/disease that caused the optic atrophy is identified and corrected, if possible, then the optic atrophy and associated vision loss may not worsen. Whenever a patient is identified with optic atrophy, it is very important that the cause of the atrophy be identified. Often, extensive laboratory tests and imaging tests (MRI, CT scan) are used to help identify the reason for the optic atrophy and associated loss of vision. Unfortunately, particularly in infants and young children, the cause of the optic atrophy is sometimes never identified. Q. What causes double vision in older adults? Is the double vision in one eye? If yes, go to monocular diplopia. If the double vision is present only when both eyes are open, then this suggests that the eyes are not pointing in the same direction. There are a number of reasons why an elderly adult may develop double vision or diplopia, some causes of double vision may be very serious. There may be problems with one or more of the eye muscles. Or there may have been a tendency for the eyes to be misaligned all along but that age has caused the eyes to no longer be aligned. Certain disease of the orbits and of the brain can also cause diplopia. Because double vision may be a sign of a serious disease, see an eye doctor ASAP about the problem. Q. I have been wearing Red (vermilion) sunglasses for 15 years now. I heard that the red causes a stimulating effect in the mind and body (some how) and would agree. What I think I feel and what is real, however may be another story. I am sure there has to be studies on this. I am looking for articles which might shed some light on this subject. Can it be true and can you help me find some? We could not find any studies related to your observations. This would fall under "alternative medicine", which typically has no scientific basis. From an anatomical perspective, red glasses would screen-out the blue and green wavelengths that typically stimulate the rod photoreceptors that are used for night vision. So, as it gets dark outside you could probably see a little better after wearing red filters than if you had not been wearing red filters. But to have a stimulating effect on the body and mind? There is no scientific basis. If any reader comes across such a study, please send us the reference and we'll check it out. Q. I have a problem, somebody told me that I blink a lot and I became self conscious about it and now I find myself blinking like a maniac. I am blinking like every two seconds and I can’t stop because my eye will burn and I have to blink. Is there anything I can do to try and stop blinking so much? Excessive blinking is one sign of dry eye disease as well as a sign of irritants in the eyes. Also, do you notice the excessive blinking during certain times of the day or under certain work conditions? If so, environmental irritants (cold, wind, blowing air) can be causing the excessive blinking. Also, contact lens wearers often blink a lot to maintain moisture of the lenses (the contact lens is an irritant). See an eye doctor and describe your problem to him/her for evaluation and treatment, if applicable. I have orbital cellulitis. How did I get it and what can be done about it? Orbital cellulitis is an inflammation of the tissues on the orbit (eye socket) and typical symptoms include the eye(s) appearing to stick-out, limitation of the ability to move the eye(s), inflammation of the eye lids and some swelling of the eye itself (chemosis). Patients complain of sometimes double vision, pain and discomfort. Orbital cellulitis can be cause by several factors including direct damage to the eye or/and orbit from a would, whole body bacterial infection, spread of an infection from the eye lids or sinuses or lacrimal glands to thew orbit, for example. At least in children, the most common cause of orbital cellulitis is from a paranasal sinusitis (sinus infection). Complications from orbital cellulitis or from what caused the orbital cellulitis may be significant and could include the spread of the infection into the brain. Prompt and immediate medical treatment is necessary. Most of the time, hospitalization and treatment of the whole body with antibiotics is necessary. Q. Can blepharitis cause permanent eye problems and what are some of the causes of the problem? Blepharitis is an inflammation of the eye lid margins with crusting and scaling (sometimes oily scales) and causing the patient to have irritation, red lids, burning and itching of the eye lids and area. This may be a chronic, ongoing condition, more or less permanent, or may come and go. Blepharitis is often associated with conjunctivitis and superficial keratitis. Go to blepharitis and conjunctivitis for more information. Q. What is a nevus of the retina? A nevus is a benign tumor that develops from abnormal melanocytes - a certain type of cell that produces melanin which, in turn, produces pigmentation of skin and certain eye structures. Typically, a patient will have a nevus (or nevi - more than one nevus) involving the choroid - a layer of cells in the back of the eye that produces most of the pigmentation in the back of the eye "behind" the retina. A nevus typically is dark gray (because of excessive melanin) and is star-shaped. The cause of a nevus or nevi is not known, and patients are usually not aware they they even have a nevus (asymptomatic). However, some patients can develop loss of visual field and some loss of visual acuity, as well as macular detachment and growth of abnormal blood vessels in the back of the eye due to a nevus in the affected eye. Patient's with nevi should be closely monitored yearly or even sooner, particularly with photodocumentation of the size and extent of the nevi. Because of the similarity between a nevus and more serious disease (melanoma), the eye doctor may watch you closely to make sure that it is indeed a nevis and also to watch out for the complications of a nevus (e.g., macular detachment, neovascularization). Q. How can you tell if you have tunnel vision? If you have tunnel vision is it inevitable that it will get worse? As the name implies, tunnel vision means that you only have central vision: if a visual object is presented off to the side you won't see it. Patients with tunnel vision describe it as looking through a tube (like a toilet paper tube) that blocks-out all objects on the side of your vision. The standard test for tunnel vision is a visual field test, in which the patient maintains fixation on a point and is required to push a button when the patient sees a small light presented in the patient's visual field. Patients with tunnel vision only report seeing the small flash of light when it is presented near the person's central vision (that part of vision or part of the eye you read with). If the small flash of light is presented off to one side, a patient with tunnel vision will not report seeing the light. If the tunnel vision is real bad and only allows the patient to see with about 10% of their visual field, the patient could actually be considered legally blind (a visual field of 20 degrees of visual angle or less). In some retinal diseases like RP (retinitis pigmentosa), the patient will first have tunnel vision at night or under very dim light levels. As the RP progresses, the patient may develop tunnel vision during the day. Whether the tunnel vision progresses depends on the reason for the tunnel vision. A host of retinal diseases, optic nerve diseases and brain problems (e.g., tumors) can lead to tunnel vision. If, for example, the tunnel vision is due to a retinal disease like RP, then the tunnel vision will get worse and start to affect central vision later in the course of the disease. Sometimes, however, tunnel vision is due to stationary, nonprogressive visual problem such as optic nerve hypoplasia (small nerves). In optic nerve hypoplasia, the optic nerve fibers from the patient's peripheral visual field are abnormal or absent at birth while the patient's optic nerve fibers from the central vision part of the eye are not affected. In this case, the patient with a visual field loss may have a stationary tunnel vision, due to the optic nerve hypoplasia, that will not get worse over time. Q. What is Adie eye? Go to Adie's pupil. Q. I need any information available about a torn retina. The retina is a very thin membrane inside of the eye that contains a number of different cells, including the photoreceptors, necessary for vision. A number of conditions as well as trauma to the eye(s) can lead to the development of tears, holes, wrinkles and even detachment of the retina. For example, in patients that are very nearsighted (high myopia), the eye becomes elongated and the retina stretches and becomes very thin. In high myopes, the retina becomes so thin that it sometimes develops tears because of the forces that the vitreous places on the retina, requiring surgery to fix the problem. In general, any tear, hole or detachment of the retina is a serious condition. Symptoms of a retinal tear often include seeing flashes of light and the sudden onset of a lot of floaters - small dark objects inside the eye that can take-on a number of appearances. A retinal tear can cause fluid/gel to accumulate under the retina and can lead to a retinal detachment. For more information, go to retinal detachment and floaters. Q. I see flashing lights only when I move my eyes far from the left-to-the-right, back and forth. What can cause this? A patient with a posterior vitreous detachment will sometimes report that they see flashing lights only when they move their eyes. It is easier to see the flashing lights in the dark. In normal eyes, the vitreous is a gel that fills the eye ball. In various conditions, including aging, the vitreous gel will liquefy and collapse, causing the vitreous to detach from the back of the eye; thus, a posterior vitreous detachment. Because a posterior vitreous detachment can lead to a retinal tear and a retinal tear can lead to a retinal detachment, you should see an eye doctor for evaluation and treatment, if applicable. Q. What are the signs of diabetic eye disease? Q. What are the symptoms of diabetic retinopathy? The two main body parts that are affected by diabetes are the kidneys and the eyes. In diabetic retinopathy, the retinal blood vessels increase in permeability, allowing the swelling of the retina and closure of small blood vessels. This, in turn, leads to a reduced level of oxygen in localized areas of the retina which, in turn, leads to the development of abnormal blood vessels. These abnormal blood vessels leak/hemorrhage resulting in the loss of vision in the areas of the hemorrhage (see Simulations for diabetic eye disease). Other vision problems that develop in diabetic patients, particularly in those patients will poorly maintained blood pressure and poor glycemic control, include the development of swelling of the macula (central vision), numerous flare-shaped hemorrhages, and so-called cotton-wool spots. Finally, diabetics with end-staged renal disease will develop cataracts. Q. What does a white ring around the iris of the eye mean? It means that you need to see an eye doctor ASAP. It is unclear what the white ring may signify or what it could be a symptom of; however, any change in iris warrants a trip to the eye doctor. Because changes in the iris, either its shape or color, may also alter the filtering properties of the eye and lead to glaucoma, it is essential that any patient that experiences a change in the iris (or pupil) should see an eye doctor for a through examination. Q. I had a problem with my left eye that lasted about 15 minutes. I saw an arc shape with points on it. The arc was white and the points were different colors...any info would be appreciated. It is unclear what the problem could have been. One possibility is that you experienced a retinal tear - the most common type of retinal tear is the horseshoe tear that would take-on the appearance of an arc. As the visual system adapted to the constant image of the tear, the tear would quickly disappear, but could reappear it the visual scene changed. Since a retinal tear can lead to a retinal detachment, you should see an eye doctor for evaluation and treatment, if applicable. Q. My boyfriend (24 y.o.) has had a condition for approximately four years and it has gone undiagnosed thus far. (FYI he had a disorder when he was youndger and took steroids for an extended length of time.) Approximately once a month, his eye swells up. He feels the swelling begin and within a couple of hours his lower eyelid and upper eyelid swell up so much that they close over his eye. This is very painful for him - especially to touch. He has been a casualty numerous times and had his sinuses X-rayed and his tear ducts unblocked so many times, but each time the doctors find nothing. Finally today he went to an eye specialist who told him he has a condition called blepharochalasis. We have researched this condition and think he was wrong - the definitions say it is sagging of the eye lid which obscures vision. This is not the case. When he is not suffering from the swelling, his eye looks totally normal. Any idea what this might be?? or if not where to look for further info? We agree with your specialist and with additional information about blepharochasis you may also agree. Blepharochalasis is described as recurrent episodes of severe swelling of the eye lids (one or both eyes can be affected), redness (gorging of the blood vessels in the lids), accompanied by discomfort/pain. SOMETIMES, the lid edema will result in ptosis - drooping of the upper eye lid. The ptosis becomes more pronounced and permanent as the person ages and has repeated attacks. It is a rare condition that often starts with young people, like your boy friend. Over time, and repeated attacks, the eye lids become thinner, more wrinkles develop and the eye lid skin becomes discolored. Surgery may be indicated in advanced cases to repair the ptosis, reconstruct other parts of the eye lids and surrounding tissues/glands. The cause is unknown, although in some very rare cases blepharochalasis of the upper lids has been associated with leprocy. Q. what is papilladema (papilledema)? Papilledema, also called chocked disk, is a swelling (edema) of the optic nerve disk - that part of the optic nerve that the eye doctor can see when looking in the back of the eye. The optic nerve runs from the eye to the early visual centers of the brain. Papilledema is usually caused by an increase in intracranial pressure (pressure inside the head/brain), obstruction of the central retinal vein or malignant hypertension. The presence of papilledema is never a good sign and often requires extensive testing to determine the exact cause. Sometimes the cause of the papilledema is never found. Also go to pseudo tumor for more information. Q. Can a flashlight pointed straight in to the eye cause permanent damage? A regular flashlight as found in most stores is not of sufficient "strength" to cause a permanent eye problem. Also, so-called spotlights, like that found in police cars, are not of sufficient energy to cause damage, unless it is with very close viewing for an extended time. Light damage to the eye is most often caused by looking at the sun (solar retinopathy) and by welding torches (so-called welder burn retinopathy). Q. Thank you so much for your information on Blepharochalasis. I wonder if there is any treatment for Blepharochalasis? and how long might he suffer from it? Because the cause of blepharochalasis is unknown, there is no known treatment or cure for the disease. At present, it appears to be a life-long problem. The damage caused by the disease, such as ptosis, is treatable. However, with the advent of new therapies based on better knowledge of the immune system and genetics, there is hope that in the future the disease with be treatable/cureable. Q. I believe I have a conjunctival cyst.(A small transparent growth on the white of the eye which looks as if it has fluid in it) Is there a treatment for this ? Probably, you need to see an ophthalmologist, a doctor that can perform surgery. However, it is likely that you have scleritis or episcleritis. Go to those links on this page for more information. Q. As a child I had several corrective eye surgeries and wore patches and corrective lenses for most of my childhood. Recently a doctor told me that I had no depth perception. What causes this and does it affect things like driving or raquet sports? Most probably you have or had a lazy eye (amblyopia). Lazy eye causes a loss (actually a reduction) of vision in one eye and disrupts depth perception. But this is a special type of depth perception - one that capitalizes on the slightly different images received from the two eyes (called binocular disparity). For example, you'll never be able to see those Magic Eye 3D images, or really see the depth in 3D movies. However, although the depth perception deficit that you have is permanent, it is a very minor problem. This type of depth perception loss may prevent you from putting in a golf game very well or from seeing subtle changes in a golf course green. Also, it may limit some of your career possibilities. While it should not affect your driving it probably does affect your raquet ball game, since it will cause you to be less certain about the exact location of the ball in 3D space. Q. I am 51 and have been diagnosed with cataracts. I have extreme myopia (minus 25 in the left eye and a minus 19 in the right). The cataracts seem to be progressing rather rapidly. I have seen a retinal specialist and he reports that both retinas are perfect and there is no latticing or signs of disease. I know I need to have something done because I am having trouble getting a contact lens which will correct the left eye adequately. My concern is retinal detachment. What would you advise given the information provided? The surgeon is suggesting putting a lens in that has little or no power. I just don’t understand how vision will be improved so greatly since I have never had good vision. Any info from you would be greatly appreciated. There is a significant possibility of a retinal detachment in any patient with high myopia and the chance of a retinal detachment will be increased by the cataract surgery. But, if the cataracts get too bad your choices are limited. If the surgeon puts in an intraocular len with little power, then you'll need very thick glasses and/or contacts to return your vision to where it was before surgery. You may also need regular contacts as well as glasses in order to see well. Q. What can you use in your eye when a little blister like comes up inside the bottom lash? You can use an eye doctor. DO NOT MESS with the "blister". Go to your eye doctor for an evaluation and the APPROPRIATE treatment. Please note that the appropriate treatment depends on exactly what the problem is and you won't know that until you see an eye doctor. Q. I have recently been diagnosed as having Fuch’s dystrophy. I am a male 67 years of age. I have been informed that I am a candidate for a corneal transplant. I understand that a complication in corneal transplants arises when the stitches used to secure the new cornea are not precisely alike. If the stitches are not alike, astigmatism develops and the uneven stitches have to be removed. Is there any research group working on improved methods of corneal transplants. I control a charitable foundation and would like to make a contribution to such a research group. Would you kindly put me in touch. Many thanks in advance. Yes. Applied research into the exact topic that you discuss is being carried-out at the Ohio State University by Dr. Cindy Roberts in the Department of Ophthalmology (Ph: 614-293-70399). The research is being funded by the Ohio LIONS Eye Research Foundation. Not only is Dr. Roberts doing the research into corneal topography and corneal transplants, but in collaboration with corneal surgeons they're using the new techniques to perform the corneal surgery and to prevent the very issue that you raise. In a nut shell, the research/surgical team removes and replaces the cornea in advanced cases of keratoconus, for example, and when the new cornea is sutured into place Dr. Roberts does a corneal topography scan of the corneal surface to detect any irregular/abnormal areas during the surgery. If so, the surgeon is advised to adjust the sutures in question - another scan is performed, etc., until everything looks fine. Doing the corneal topography scans in the operating room while the surgery is being performed reduces the potential for complications afterwards. Please note: e-mail inquiries via the present web site are anonymous; we have no way to reply directly to your e-mail request since we do not record the address of the e-mail sender. For more information about Fuch's dystrophy go to Fuch's. Q. I have a blind spot in my right eye, for a year or so it was real bad for about 3 months and then I guess I got used to it and it didn't slow me done much I was tested for just about everything you can think of m.s and other things but after all the test result came back everything was negative.It has been a year or so since I was tested and the problem is getting worse, the doctor is positive that I have m.s or something along those lines but said it is to early to diagnosis the disease. I am 30 yrs old and need to know what to do next. If you had a brain scan (CT or MRI) and it can out normal and you had a Visual Evoked Response/Potential and it also can out normal then the possibility of MS (multiple sclerosis) is small, but still possible. Since the scotoma is only in the right eye then the problem is at the retinal level or early along the optic nerve (before the optic chiasm) in the right eye. Given your age it is unlikely to be a circulatory/blood supply problem in the eye or optic nerve. You may need to have an ERG (electroretinogram) and an EOG (electro-oculogram) to rule-out a retinal disease. Also, if the scotoma comes and goes, it could be related to an ocular migraine. Q. What causes black and white spots in eyes. I am pregnant? It is unclear from your description what the problem could be. Please provide additional information. For example, are the spots on the front part of the eye or something that you perceive in your vision? Q. My eyes have felt pressured and irritated for the past two months. I have to blink hard all the time. I am a 23 year old male. I recently went to the eye doctor and he immediately supposed that dry eyes were the problem. He did a tear test on me though and he said that my tears were normal. However, he did not have any answer for why my eyes still feel irritated or dry all the time. Any help? The tear test is not very reliable or valid, but it is about the only thing available to assess dry eyes. Given your age, please consider environmental factors for the dry eyes. Also, contact lens wearers often complain about dry eyes, so if you wear contacts consider an alternative. Seasonal effects also come into play this time of year (i.e., alergies). Q. Operation laser stigmatism myoia. We assume that your interested in information about laser surgery for correcting an astigmatism with myopia. Go to Past Featured Articles for information about LASIK laser surgery. Q. What does imagry mean? It depends somewhat on the context in which the word is used. In general, in terms of ophthalmology and vision science it means a mental representation of a visual object. For example, a dream would include a visual image of a scene or visual imagry. Q. Sore eyes, inflamed lids. I don't know it I have an infection or an allergy? Sounds like an allergy or an allergic reaction. See an eye doctor for evaluation and treatment. Go to Swollen Eyes for more information. Q. What causes redness around the eyes? If you mean that the white part of the eyes is red, then it may be caused by a number of factors, most likely an irritant, allergies or dry eye disease. Q. Why do I get black spots and black lines on my eyes? Q. Blurry spots in one eye. Go to information about floaters. Q. I am having a terrible time with my eyes swelling, especially the corners next to the nose. I have changed make-up several times, I have allergy tests and don't have any particular allergies. The swelling occurs when I go to sleep and wake-up in the morning. The swelling goes down somewhat during the day...Help please it is very bad looking. It sounds like you're having an allergic reaction. Unfortunately, allergy testing is very limited and it can test only for very common irritants. Do you have cats? Do you use hair spray or anything else that could be rubbed-off of your body and onto the pillow while you sleep? Is your bedroom dusty (dust mites)? What detergents do you use wash your pillow cases? Try isolating the irritant by sleeping in another room or some place else for a few days and see if that helps. Sorry, but you'll have to act like a detective to figure this one out. We assume that you've already been to one or more eye doctors for evaluation. If not, seeing an eye doctor should be on the top of the list of things to consider. Go to Swollen Eyes for more information. Q. WHAT INFORMATION CAN YOU TELL ME ABOUT THE DIFFERENT TREATMENTS FOR ANGLOID (Angioid) STREAKS. I CAN'T FIND ANY INFORMATION ANYWHERE AND I NEED ANSWERS. Exact spelling really helps. Angioid Streaks are reddish-darkish, curved lines or streaks the lay between the peripheral retina and choroid vasculature and branch-out in all directions, usually in both eyes. While about 50% of patients with angioid streaks have the pathology only, about 50% of patents that have angioid streaks have an associated disease such as pseudoxanthoma (affects the eyes, skin, heart and GI tract), Paget's disease(a connective tissue disorder) or hemoglobinopathy(abnormal red blood cells, for example, in sickle cell disease). Angioid streaks often lead to a loss of vision in one or both eyes, usually due to macular degeneration or choroidal neovascularization (development of abnormal blood vessels that subsequently hemorrhage). Also, patients with angioid streaks can develop a retinal detachment as a consequence of rather minor trauma to the eye or face area. As a consequence, patients with angioid streaks should not play contact sports and also should wear safety (polycarbonate) glasses. Unfortunately, treatment is rather limited and confined to the effects of the disease or associated disease. Sometimes "laser surgery"(laser photocoagulation) is performed to treat the choroidal neovascularization, but reoccurrence can occur. Please note that because angioid streaks are often misdiagnosed, you should consider a visit to a retinal specialist to confirm the diagnosis and get a second opinion. Q. What is the treatment for retro bulbous neuritis (retrobulbar neuritis)? Retrobulbar neuritis is an inflammation behind the eye of the optic nerve. It is essentially an optic (nerve) neuritis which does not show-up in the eye itself. Treatment depends on the cause of the optic neuritis. However, in the majority cases the optic neuritis is associated with multiple sclerosis (MS). The treatment for optic neuritis is limited. Q. I have a problem with a watery right eye. I have no lumps or anything to speak of in that eye and the optician has already tested for a blocked tear duct, which proved negative. This manifests itself most noticably, with streaming tears, when I ride a motorcycle (full face helmet). Any ideas what the problem could be ? Wind can act as an eye irritant, so it is possible that the watery eye is a normal response to wind in your eye. Also go to Watery Eyes for more information. Q. Could you tell me how the Lions got involved with "Knights of the Blind" When and how. Would like to include in our Newsletter. In 1925 at the International LIONS club meeting heald at Ceder Point OH, Helen Keller gave the keynote address. In her address she challenged the LIONS to become the Knights for the Blind. LIONS members throughout the world accepted her challenge and have, ever since, worked to help the blind and also help prevent blindness through advocacy work and through research. Toward these goals, in the early 1950s the Ohio LIONS Eye Research Foundation was established. Research centers throughout Ohio have been funded by the Ohio LIONS Eye Research Foundation since 1952. Q. Is there such a thing as arthritis of the eye? Yes and no. In juvenile rheumatoid arthritis, anywhere from 10 - 50% of patients can develop a potentially blinding eye disease called iridocyclitis. Iridocyclitis involves redness of the eye(s), pain, sensitivity to light and decreased visual acuity. If not detected or treated early enough (and sometimes despite agressive treatment) the eye disease can lead to an abnormal shaped pupil, cataract, glaucoma and a general degeneration of the eye ball and blindness. It is essential that a child with JRA have an eye exam, specifically a slit lamp exam, by an eye doctor three to four times per year to look for the very early signs of the eye disease. Also, if the patient ever complains of an eye hurting, or seems sensitive to light, the patient should been seen by an eye doctor ASAP for evaluation and treatment. Q. My son has a lazy eye. What mineral/herb can he take instead of using glasses? None. A lazy eye is an eye with reduced vision, typically because of crossed eyes (esotropia) or a difference in refractive error between the eyes (anisometropia) or because of a problem with how the eyes turn-in as the child fixates on close objects (accommodative esotropia). So sometimes a child will need glasses to prevent an eye from turning in or to correct an refractive error, but this is not the same as a lazy eye. The standard treatment for a lazy eye is patching the stronger eye and forcing the child to use the lazy eye. Glasses will help the eyes keep straight or correct a refractive error, depending on the circumstances. Under NO CIRCUMSTANCES should you give a child any herbs or any minerals. Consult with an eye doctor. Q. I am a 16yr high school student with amblyopia. I am wondering if the use of L-dopa would work on me since I am older? Some studies on older children and adults with amblyopia have shown that L-dopa can improve vision in the lazy eye. However, the improvements in vision and, specifically, visual acuity has been on the order of about one line on the visual acuity chart. So, the improvement in visual acuity from taking L-dopa has been small. Q. What are the eye complications of having myasthenia gravis? Myasthenia gravis is a disease of the muscles, specifically a disease of the junction between the nerve and muscle fibers that utilize acetylcoline, a neural transmitter. The eyes are usually the first to be affected by the disease and, specifically the eye lids and eye muscles. The primary symptoms of myasthenia gravis include a drooping eye lid (ptosis) and double vision (diplopia). Double vision is caused by misaligned eyes because the eye muscles are affected. Also, since the eye muscles are affected, the patient my have difficulty in looking rapidly at different objects in the environment. Symptoms usually get worse with fatigue, or even after a "long day". The patient may appear normal during the morning hours and develop more and more, worse and worse symptoms as the day progresses. Sometimes associated with the ptosis is a retraction of the other eye lid, which makes the patient look "bug-eyed". Q. Would like information on Oscillopsia. A patient with oscillopsia experiences the visual world as constantly moving or jiggling whenever he/she moves the eyes or/and head. The symptoms may vary depending on the circumstances, and things like riding a bike or driving a car over a rough road can aggravate the condition. Oscillopsia is caused by a loss of ocular stabilization by the vestibular system typically through disease or injury. For more information and demonstration of oscillopia go to Jumping eye. Q. I have been to an optomologist twice in the last month for my eyes. My eye lids are really dry, almost crusty, where they meet my eyelashes. The Doctor told me that it was similar to scalp dandruff, but on the eye. He prescribed two different medications and neither seemed to work. They are both still itchy and sore. I have been told that boric acid would probably help them. Any thoughts on that? Or what this may possibly be? Any advice is greatly appreciated. Absolutely NOT! Do not put anything in your eyes that is not prescribed by your doctor. You probably have blepharitis. Go to Chronic Blepharitis for more information. Q. What is a cresent (crescent) scotoma? A scotoma is an area of reduced vision in one or both eyes. A scotoma can take-on almost any appearance, and the shape sometimes reflects the disease or cause of the scotoma (see Simulations). In your case, the scotoma is shaped like a crescent - something like a crescent of the moon. It is likely off to the side - in your peripheral visual field. A crescent scotoma is sometimes seen in retinal diseases. As a rule-of-thumb, if you see the scotoma only in one eye then the cause of the scotoma or disease process is within the affected eye (retina) or along the early part of the optic nerve (before the optic chiasm) in the affected eye. If the scotoma is present in both eyes and looks very similar in each eye, then it is likely that the cause or disease process is in the brain at the optic chiasm or further back along the visual pathways. [Note: the optic chiasm is where the optic nerves from the two eyes cross and, more or less, join together. Thus, anything that happens to the visual system that occurs at or after the optic chiasm almost always affects both eyes to more or less the same extent. Conversely, anything that happens along the visual pathways before the optic chiasm most likely affects one eye.] However, as the disease process progresses, like in a retinal degeneration that affects both eyes, eventually both eyes will become affected, even though the disease process is at the retinal or eye level on the visual system. Q. My consultant said I have a freckle on the back of my eye, and has taken a photo of it.What is it , and should I be concerned as I have not heard of this before I have had my eyes tested lots of times and this has never shown up. An eye doctor will sometimes tell a patient that they have a "freckle" on the back of their eye when referring to an area of (changed) pigmentation. Much like the skin, the back of the eye should have a particular color. And, much like the skin, the back of the eye can change color, sometimes reflecting a disease process. You probably have a choroidal nevus or change in pigmentation at the level of the choroid (a layer of cells under the retina layer and that gives the back of the eye most of its color). This is usually a benign condition. Your doctor did the right thing in photograping it - this is an excellent way to watch it and determine that it is nothing to worry about. On follow-up, just make sure that you return to the same doctor so he/she can compare photos of the freckle over time. See follow-up question and response. Q. My sister-in-law, who lives in the UK, developed Coats’ disease approximately 15 years ago. After unsuccessful laser treatment at Moorfield’s Eye Hospital she eventually lost the sight in the affected eye. Unfortunately she lost the sight in her other eye at an early age and is now registered as totally blind. On questioning her it would appear that she does not know the reason why she lost the sight in one eye at an early age (some 45 years ago). Apparently she had a cast in her eye (not the one with coats’) and gradually lost the sight in it. Over the last 12 years she has also developed a cataract on this eye. My question is whether it is worth taking her to a specialist here in the USA to see if anything can be done to regain some sight in the eye unaffected by Coats’ disease. There is nothing special about eye care in the USA vs UK. Your sister-in-law should find-out from her current eye doctors what happened to the other eye. It should be noted that while most of the time (about 90%) Coat's disease affects only one eye, in about 10% of patients the disease affects both eyes. In addition, Coat's disease often causes vision problems before the age of 10 years, which would match the age when your sister-in-law lost vision in the one eye. Thus, without additional information it is likely that your sister-in-law may have Coat's disease in both eyes. Unfortunately, the prognosis is not good simply because she is registered as "totally blind". Total blindness usually refers to a patient with no light perception (NLP), so even removing the cataract would not help. However, if she is registered as "legally blind", then there may be hope for her, particularly if she does have some vision such as for lights and possibly large objects. [Please note that there may be some language or terminology differences between the USA and UK.] If she does have some vision, a bright flash VER (visual evoked response) is sometimes used to assess vision through a cataract and to determine the visual prognosis in the event that the cataract is removed. Q. A week ago, my husband began to experience some strange symptoms. First, when he moves his head, instead of getting a clear, scanning image, he gets a series of frames, as if he were viewing the world as a rapidly moving series of slides instead of a smooth image like you might see in a movie. Second, he feels pressure behind his eyes, which he thinks could be from a sinus infection. He gets frequent sinus infections and has allergies. Third, he has been experiencing a little bit of vertigo, although not serious enough to make him dizzy and cause him to lean against a wall, or anything. It seems kind of mild. He went to his GP (we are with an HMO and must go to a GP before we can see a specialist). The GP looked in his eyes and said his retinas were not detached and that he did not see symptoms of MS. He said my husband’s problems could be caused by an inner ear virus that would clear up in "a week or two," and told him to come back then if it did not. This worried me as I am concerned that we might be sitting on a serious eye problem that needs to be taken care of right away. The doctor did not check him for a sinus infection or look in his ears. Can you tell me what might cause this strange frame-like vision? It’s like one of those flipbooks with pictures that animate when you turn the pages quickly. My husband is 31 years old. He does use eye drops as his eyes often get red, possibly from working for long hours every day in front of the computer. Sometimes he uses Ocuhist because of his allergies. Can you help? We agree with your doctor that it is probably some type of inner ear infection with possible involvement of the vestibular system. Follow-up with the GP if it doesn't get any better. Although possible, it is unlikely to be related to MS. Go to Oscillopsia for more information about a similar subject regarding misperceiving the world as jerking or jumping as you describe. Q. My 14 year old daughters eye sight changes every 6 months her vision is now -7.00 sphere and -1.25 cylinder axis 19 she is very worried that she will one day be blind. What if anything can be said or done to her the doctor said she will probably be in her twenties before her eyes stabilize and she does have an astigmatism that also gets worse each time. She will not go blind because of a refractive error or because of a need for thick glasses. However, because she is considered a "high myope" she should be seen yearly for a dilated eye exam. She is more likely then others to have some complications of high myopia such as a retinal tear or/and detachment which are treatable. Floaters are also common in high myopes. While most myopes stabilize, in terms of the progression of their refractive error, in the late teens or early twenties, about 15 - 20 % continue to progress. Close work (e.g., reading, computer work) may aggravate the condition and lead to faster progression of the myopia. There is also a strong hereditary component to the myopia. We would not advise her to have laser surgery (e.g., LASIK) to correct the refractive error at this time simply because she will probably progress further and again have the need for corrective lenses. Q. My child has strabismus. Is surgery necessary? My child is 5 years old. It depends on the cause and type of the strabismus. Most kids that develop strabismus at about 5 years of age have accomodative esotropia - a strabismus where the eyes appear to turn-in toward the nose and the child appears crossed-eyed. Accomodative esotropia is due to a mismatch between the eyes ability to turn-in together and the accomdative process of the eyes to focus-in on near objects. Basically, when the eyes try to focus on a near object the eyes overcompensate and turn-in too far. Accomodative esotropia is usualy correctable with glasses and does not require surgery. A child with any type of strabismus should be checked for a lazy eye. If one eye appears to point outward, the strabismus is called exotropia and the layperson name for the condition is wall-eyed. This type of strabismus does usually require surgery, but then again it depends on the circumstances and the extent of turning-out. If an eye simply appears to "drift" in any direction, it is likely that the child has reduced vision in one eye. In any and all cases, a child with misaligned eyes should see an eye doctor ASAP, in order to rule-out a serious eye or neurological problem and to check for amblyopia (lazy eye). Q. Is there a data base on health histories of uveitis patients, prior to uveitis onset? If your asking if there are studies about uveitis patients and their prior medical histories (their health before the onset of uveitis) then you would probably have to search individual studies on uveitis and see if prior medical histories are given. Off hand we do not know of any detailed studies on this specific topic. We will search the literature on uveitis and report back here at a later date if something comes up. Q. I have noticed a spot on my left eye.It moves when I move the eye . It has been there for a month now. What could it be? It is most likely a floater. Go to Floater for more information. Q. I am a 19 year old male. I have a lazy left eye, which was discovered at around 10 years of age. The Optician said that it was too late to be corrected with an eye patch. The sight in my left eye isn’t that good, but recently I have noticed a shiny/white blur kind of thing in front of it. A few days ago, when I woke up, the eyelids of both my eyes were "stuck" together. When I opened them they were both bloodshot. Since then they have been VERY crusty in the mornings. I think this is Blepharitis. I am more worried about the white blur in my left eye. I also have two yellow/brown rings around my pupils even though I don’t smoke,drink alcohol or coffee,or do drugs.Can you help? Yes, you probably have blepharitis which causes crusty eyes. The blurry spot is probably a floater. The yellow brown rings are probably normal variation in iris color. Go to an eye doctor for your vision complaints, for treatment if applicable and for peace of mind. Q. I have iritis in both eyes and having treatment. How can I stop it from happening again and how did I get it in the first place? Go to Iritis and Uveitis for more information. These are good questions that, unfortunately have no easy, or difficult for that matter, answers. Q. Further to the question about the freckle behind the eye. How likely is a choroidal nevus to become dangerous or cause blindness? Other sites on the net seem to suggest that it is quite likely to become malignant. A nevus, by definition, is a benign tumor due to abnormal/atypical melanocytes. Melanocytes are mature melanin producing cells and it is the melanin that gives skin as well as the back of the eye most of its color or actually pigmentation. As a consequence, nevi are usually slate gray, reflecting the increased amount of melanin. Choroidal nevi are fairly common in the general population; depending on the patient population tested, primarily in terms of age, a good estimate is 5% of the population. In general, patients with choroidal nevi are asymptomatic (i.e., do not experience any visual complaints). Sometimes, but rarely, choroidal nevi can lead to the build-up of fluid underneath the retina leading to a "serous" retinal detachment that is treatable. In about 20% of patients, in the area of the nevi there may be some loss of visual field but this is usually limited. Overall, the vision loss due to nevi or their secondary complications is small. In terms of a choroidal nevus becoming malignant, in one study it was estimated that 1 patient in 500 will become malignant, and that was over a 10 year period. However, the biggest concern is that a large nevus may actually turn-out to be a small melanoma (cancer). Although the two can usually be differentiated based on size, thickness, visual symptoms, whether there is serous retinal detachment and whether there is an orange pigment present. Bottom line, this is precisely why your eye doctor will take photographs of the nevus and follow it with periodic exams and photos. If there are no or little concern, eye exams can be spaced a year apart. If there are some questions or concerns then the patient may be seen every six months and require additional testing (e.g., visual fields, fluorescein angiography). Type 2 diabetes and eye problems? A person with type 2 diabetes (adult onset diabetes) can develop the same eye problems as a person with type 1 diabetes (childhood onset diabetes). These include cataracts, diabetic retinopathy, hemorrhages, retinal detachment and sudden loss of vision. In general though, type two diabetic patients are usually better controlled and have milder symptoms and complications. A big factor is that patients with type 1 diabetes have diabetes for a longer time, run into more serious complications and have more difficult to control glucose levels. All of this leads to worse vision complications and loss than compared to patients with type 2 diabetes. Whatever type of diabetes you have, regular eye exams by an eye doctor are essential. What is cellophane retinopathy? Is it a serious condition and is there a treatment? Cellophane retinopathy (maculopathy) is a term applied to a wrinkling of the retina due to epiretinal membranes. Epiretinal membranes are caused by a number of factors and are composed of an accumulation of cells and collagen on the retina. Depending on the thickness, location and other factors, patients with epiretinal membranes can be asymptomatic or have a significant vision loss in the range of legal blindness (20/200 or worse visual acuity, in about 5% of patients). If the epiretinal membrane does not involve the macula (reading part of the eye) the patient may not have any symptoms. If the epiretinal membrane involves the macula and causes traction on the retina and is thicker and causes other problems, then significant vision loss could result. Most patients with epiretinal membranes will have or will develop a posterior vitreous detachment and increased number of floaters. In general, epiretinal membranes are slowly progressive and cause mild visual symptoms. If symptoms or vision loss is severe, surgery (vitrectomy) can be undertaken and result in a significant improvement of vision in the majority of patients. If the epiretinal membranes cause no or mild symptoms, it is best just to leave them alone. Q. What are halos in the eyes? You are referring to halos that people see around lights. For example, looking at oncoming automobile headlights at night will cause some people to see halos around the lights. Halos are usually the result of light scatter caused by changes/disease of the front part of the eye including the cornea and lens. People with cataracts or people that have had laser surgery for correcting a refractive error (e.g., LASIK) sometimes see halos around lights. Q. Itchy eyes. Our eight year old son has for a year now had a problem with his eyes being constantly irritated, itchy, having to rub them. We have seen a couple of specialists in allergies and they have found no sign of any specific allergy problem...Nothing seems to explain the itchiness in his eyes...It seems to present [everywhere] and year round. Looking for suggestions and help. Given that you've seen several specialists in allergies and they found no allergy problem then lets assume that there is no allergy problem, per se. Since he seems to have an eye problem, has he seen an ophthalmologist? If not, then this should be your next stop. A number of eye diseases will cause dry, itchy, irritated eyes. Just some of these include blepharitis, pink eye, infections and problems with of the tear generation and drainage parts of the eyes. Q. I HAVE RECENTLY (LAST COUPLE OF MONTHS) EXPERIENCED OCCASIONAL BLURRED VISION. IT ONLY LASTS FOR A SHORT TIME, BUT IT SORTA SCARES ME. IT COMES WITH NO WARNING BUT OFTEN WHEN I CHANGE MY LIGHTING. IT IS AS IF I AM SEEING WHITE SPOTS. IT IS HARD TO FOCUS AND MY PUPILS GET VERY SMALL. IT IS USUALLY IN JUST ONE EYE. I DO HAVE SINUS AND ALLERGY PROBLEMS AND I FIGURE IT IS RELATED TO THIS. WHAT DO YOU THINK? I ALSO HAVE A LOT OF STRESS RIGHT NOW, GETTING MARRIED, NEW JOB, AND MOVING. COULD STRESS ALSO BE A FACTOR? It is not clear what the problem may be. Sinus and allergy problems are probably unrelated. Stress, and you're under a lot of it, can precipitate and aggravate any underlying physical and psychological issues in a person. We would suggest that you see an eye doctor for a complete dilated eye exam, just to be on the safe side and to put your mind to rest. You don't need any more stress in your life so let's eliminate any potential eye problems. Q. I am seeing different colored blobs, not necessarily lights or flashes, it just looks like spots I guess you would call it. Sometimes they’re orange, sometimes yellow and sometimes blue. Anyone have suggestions? One of the most common complaints as well as questions asked on this web site are related to floaters. However, every patient describes floaters as dark, gray or like a shadow; never as having any color. One possibility is that you're experiencing a visual "afterimage". If a person looks at a certain color for a period of time or if the colored object is very bright when the person looks away or looks at a white wall, for example, they'll see a complimentary color. For example, if you look at a blue object and then look at a white wall you could momentarily see an image of the object in the complimentary color, in this case the object would take-on a yellowish color . Q. My sister has a blood spot on her eye, right next to the pupil. What is this? She did’t poke or hurt herself, it just developed overnight. If it is on the white part of the eye it is probably a subconjunctival hemorrhage. Go to subconjunctival hemorrhage for more information. Also see Pink Eye. If the blood is actually in the front of the iris or colored part of the eye and appears to be a puddle of blood sitting in the front of the iris and pupil, then you have a hyphema which warrants immediate medical attention - See an eye doctor ASAP. Q. In the last few months my eyesight has been deteriorating. What I am now seeing are elongated parallel wavy lines with lots of circles in between. This is in both eyes. Neither G.P nor neurologist know what is happening. I am 20 years old. Please help. Since you're seeing the lines and bubbles in both eyes, (we assume that you see them in both eyes at the same time and that they also look very similar in each eye) then the problem must be located in the visual parts of the brain. Unfortunately it is not clear what the problem might be given the limited amount of information. Are these things that you see always present or do they come and go? If they come and go, are they associated with anything like a headache afterwards (possible migraine with visual fortification phenomenon)? Since they are visually related, you really need to see an ophthalmologist for further evaluation. Q. Bumps in eyeball. Bumps on the white part of the eye ball can be caused by a number of things including episcleritis., scleritis, scar tissue, as well as signs of other types of eye disease and some neurological problems. See an eye doctor for evaluation and treatment, if applicable. Q. What is myopia and it's symptoms? Myopia is also called nearsightedness - you can see close objects and can't see distant objects. Objects up close are seen in all their detail and distant objects appear blurry. Nearsightedness can be easily corrected with glasses. If you are about 40 years old or older, and objects are only clear and in focus when you hold them further (and further) away, then you have a condition called presbyopia. See the dictionary on this web site for further information about myopia, presbyopia and hyperopia (can only see things clear that are far away). Q. The vision in my father’s left eye top half is black. He can see out of the bottom half. This started about 6 months ago in both eyes and within a couple of days the right eye had cleared up. Any suggestions on what this might be? We assume that your father has seen an ophthalmologist or/and a neurologist (medical doctors) about this condition. If not, your father should seen one ASAP [NOW]. In older adults, sudden loss of vision in one or both eyes is sometimes related to some type of circulatory (blood supply) problem in the brain or optic nerve(s) or the eye(s). Your father may have has a stroke, in which the blood supply to his brain and/or eyes was interrupted. Strokes occur when the blood vessels are suddenly clogged (by clotted blood, calcium fragments or other material) thus preventing the blood and needed oxygen from reaching the brain and/or eyes. Sometimes the embolus (the thing that clogged-up the blood vessel) will clear and blood supply will be restored. The embolus appears to have cleared, at least in the right eye. By now, the damage and loss of vision in the left eye is probably permanent. Of great concern, if he has not received treatment for the original cause of the loss of vision, he is at great risk of having another stroke so HE REALLY NEEDS TO SEE A MEDICAL DOCTOR TODAY. Q. My eyelids get real tired. I have to make an effort to keep them open. It is not out of sleepiness. Can you help? Probably not. Need more information. Are your eyelids fine in the morning and then as the day progresses they get harder to keep open? Also, is it both eyelids or really one eye lid? Have you ever had any damage/injury to the upper face area? If your eyelids are fine in the morning and as the day progresses they are harded to keep open, particularly if it is only one eye, then you may have the early signs of myasthenia gravis. If you answer no to the first question, then a number of things can cause the eye lids to be difficult to keep open including nerve damage (either through disease or injury) that controls the eyelids . See an eye doctor for evaluation and treatment. Q. We discovered that my mom’s natural eye lens has slipped due to which reason we dont know (she is a thyroid patient & was on the border line for high blood presure)...she was’nt hurt in the eye or anything of the sort...what i need to know how safe is the surgery in order to replace the natural ?? what will be the cost of the surgery??? The removal of the natural lens and replacement with an intraocular lens is now performed several hundred thousand times a year in the US alone and is a generally safe outpatient surgical procedure. It is the same surgical procedure as when a person with a cataract has a cataract operation with the placement of a intraocular lens. However, as with all surgical procedures there are risks involved including infection, retinal detachment, misplaced/mislocated lens, as well as post surgical complications. The eye surgeon will go over all the risks of the operation with you/your mother before the operation. We don't deal with costs of things; however, this type of surgery is usually covered by insurance. Q. Where can I get Financal help or Assistance. I have RP Disease paired with Cataracts and no insurance, but i also work. Any suggestions will be greatly Appreciated. Although the Ohio LIONS Eye Research Foundation does not provide individuals with financial help or assistance, individual LIONS clubs in each city do sometimes provide individuals in their area with assistance for particular reasons. So one possibility is to contact your local LIONS club (usually ask around and find out who a member is and when the club meets). Go to the local BSVI (Bureau of Services for the Visually Impaired) for help on the job, if applicable. Contact the Department of Health in your state to see what they can provide for help with the surgery to remove/replace the cataracts. Also look into applying for Medicaid/Medicare for assistance with your health related needs. Q. When looking at white objects it is all yellow or just part of it will be bright yellow. What could cause this problem? Seeing yellow is referred to as xanthopsia. Xanthopsia is caused by a number of things including certain drugs and chemicals such as barbiturates, bromides, DDT, digitalis, Hydro Diuril (Hydrochlorthiazide), methyl salicylate, Metrazol, phenacetin, picric acid, santonin streptomycin and sulfathiazole. Other drugs and chemical reactions also can surely cause a patient's vision to appear yellow when looking at white objects. A warning is that digitalis and digitoxin poisoning can cause xanthopsia. You should make a list of all the medications that you are taking or have taken before the development of the xanthopsia and go over the list with your doctor or/and pharmacist to determine which drug or drug interactions may have a side effect of xanthropsia. If they have no success in finding out why you see yellow you should also see an ophthalmologist for further evaluation. Q. Can phototherapeutic keratectomy [PTK] be used to treat Fuch's dystrophy and is there any research study on the application of PTK to Fuch's dystrophy? No. Because Fuch's dystrophy involves a problem with the corneal edothelium and basement membrane, PTK would not help in Fuch's. PTK, almost identical to PRK (photorefractive keratectomy) but without the concern for changing refractive error, is limited to the epithelium - the front most part of the cornea. As to your second question, Waring et al (1997, J. Refractive Surgery May - June Issue, p308-310) published a case report on PTK and Fuch's dystrophy and stated "A 63 year old female with Fuch's ...was inappropriately treated with [PTK], leading to a central focal circular corneal scar and decreased visual acuity that required penetrating keratoplasty" (cornea transplant). Q. I wear contacts, and lately my contact cut my eye. Now my eye is becoming very red and sensitive to light. What is that? When you say that your contact "cut your eye", we assume that you mean that your cornea was scratched. A scratched cornea or corneal abrassion is very painful and also leads to sensitivity to light (photophobia). Since your eye is very red, you may now also have an infection of the cornea, and some of these infections can be very serious. You need to see an eye doctor ASAP for treatment and should not wear your contacts again until you're examined by the doctor. Q. Yesterday my husband started complaining of seeing a dark spot & pain/pressure in his eye - I think he needs to see a doctor, but he doesn't think its serious. What are some of the problems this could be indicative of? Your husband's symptoms could be a sign of a serious eye disease including, but not limited to, glaucoma, retinal detachment or hole, diabetic eye disease and age-related macular degeneration among others. If caught early, many of these eye diseases are treatable. If he waits too long and has one of these problems he could become legally blind for the rest of his life. If it turns out to be something more minor, then both of you can have peace of mind for the price of a simple eye exam. Have him see an eye doctor today. Q. Seeing flashing lights at corner of eyes. We assume that you mean that you see flashing lights off to the side in your peripheral vision. Flashing lights can be a sign of several retinal problems so you do need to see an eye doctor about the problem. Flashing lights are a symptom of a retinal tear or detachment, vitreous tags, posterior vitreous detachment, among others. See other questions about flashing lights for more information. Q. Isochromatic? Means one color or same color. Q. Are there any articles on work lighting or office lighting? It would seem that OSHA (osha.gov) would have information on this topic, but a search of their site lead nowhere. We did find an interesting, although rather technical article at http://www.nrc.ca/irc/light/lq_project/publications/LQ1.html. This article/site gave some interesting background on the topic of work and office lighting - a topic much more complicated then it would seem at first glance. Q. My eye itches and burns and its a little swollen and i feel a lump in my upper lid closest to my nose. A lump on the upper eye lid toward the nose may indicate a lacrimal gland inflammation and disease. As a result, secretion of the gland is decreased and your eyes become dry, itchy and burn (called keratoconjunctivitis sicca). See an eye doctor for evaluation and treatment. Q. My eyes is diagnosed with Anisometripia plus Vertical Muscular Imbalance, so what is the effect on the person’s ability to live, learn and digest information if either or both of the disease are not discovered? ie: education wise? Probably none. Anisometropia is simply a difference in refractive error between the two eyes, such that one eye may be a little more nearsighted than the other eye. If you are under the age of 10 years or so, anisometropia can cause a lazy eye. So, in children it is very important to correct the anisometropia and to check for lazy eye (amblyopia). Anisometropia is easily corrected with glasses. A vertical muscle imbalance is also probably a minor problem that, if not too large, can be corrected with some prism in the glasses or needs no correction at all. Together, in an adult, anisometropia and a small vertical muscle deviation are minor problems that should not affect knowledge acquisition and education. Q. Please, I have a question regarding to myopia which I have not seen in Q/A section. My son has a myopia since the age of 10 year. Now he is 18 years. His power is constant for the last five year at -3.5 but his vision never comes to 6/6. It is always 6/9. Doctor say nothing to worry. I would like the probable cause for it. Good question but with a difficult answer. As you are aware, normal visual acuity is said to be 6/6 or 20/20 (Snellen). In reality however, most patients will have better than 6/6 (20/20) and a few will have, as in your son's case, 6/9 (20/30) or worse visual acuity. In general we get concerned when a patient cannot be corrected to 6/6 (20/20). Sometimes the patient may have a mild case of amblyopia (lazy eye) in BOTH eyes, or a mild case of optic nerve hypoplasia (small optic nerves) that causes the patient to have mildly reduced vision. Sometimes the reason for the mild loss of visual acuity is never known. As long as the patient has no other complaints then there is nothing else to be done or concerned about. However, if vision starts to decline (say to 6/12 (20/40)) or worse then there is a real problem. So as long as your son maintains 6/9 (20/30) visual acuity it will have to be just something that he, and you, will have to live with. The fact that your son is myopic (- 3.5) and has a stable refractive error probably has nothing to do with his reduced visual acuity. Q. What is a nevus? A nevus is any lesion or abnormal tissue, either excessive or a deficiency of, that is congenital (i.e., born with). A nevus is a stable condition. A nevus can involve any body part or component. Regarding the eye, the most common nevus is probably a conjunctival nevus (on the white part of the eye) which is a benign, small elevated bump that can range in color from a pale to dark brown. A large nevus on the skin is referred to as a mole. Q. I’d like to know if you or anyone else has any information regarding acute episodic events where a patient’s vision has the following presentation: 1. It starts as a small wavering non-focusing field that overlays the true image. A small peripheral blotch. 2. After a few seconds, the image starts to grow as a circular wavering field where the center of the image gains focus as the circle grows. It’s almost like a smoke ring and the patient is stepping through the ring. 3. Patient noted that closing either eye does not effect the image malformation. It just seems to be in the vision field. 4. Typically, the acute episode occurs after a direct exposure to an extremely bright light but not always. 5. Patient’s eyes were check for Glaucoma with negative results. 6. The average occurrence lasts several minutes with the patient feels a slight headache and nausea because of the object’s motion. 7. There were 5 acute attack about a month apart and then 3 attacks with about six months apart. With no additional attacks since. Patient has suffered no addition attacks for one year. Noted that there has been a slight loss of vision over the last two to three years but was noted as normal for age group. Was evaluated by Ophthalmologist one year ago with nothing else stated nor a referral. Patient History / Physical: Caucasian, Male, 45 yrs. old, 5 ft 11 inches tall, 230 lbs, Slightly Elevated BP, No major surgery or illness, Patient had normal adolescent illnesses (Measles, Mumps, Glandular Fever, and Pneumonia).
Q. My daughter has one puffy eye her doctor says is from the sinuses draining through her eye. but when i looked up sinusitis, that was not listed as a problem. She has been referred to an ENT specialist in the meantime. Do you have any information on this condition? Based on your description, it is not possible to determine the problem. Given that a doctor has actually examined your daughter, we'll agree with him/her. In chronic sinusitis, the symptoms are wide ranging and may include postnasal drip or discharge, headache, pain and sensitivity when touching the area of inflammation, sneezing attacks, mouth breathing, and the patient may easily fatigue, have mental concentration problems and may not even want to eat. Also go to blocked tear duct and Swollen eyes for related topics. Q. What causes the color of the eye to gather in spots in the iris it is red? If your iris has red spots it is unlikely that it is pigment. More likely the red spots are small blood vessels or/and small hemorrhages. You really need to see an ophthalmologist ASAP because red spots on the iris could be a sign of serious eye or/and neurological disease. For example, iris blood vessels (iris neovascularization) and/or iris hemorrhages can be a sign of uncontrolled diabetes (e.g., if you don't even know that you're diabetic). Other diseases that could cause such changes in the iris include long standing anterior uveitis, occlusion of the blood vessels to the eye, acute iritis, acute glaucoma, hyperemia with red iris nodules, among others. Because of the way the iris just covers the lens of the eye and the drainage of the eye, a common worry when changes take place with the iris, such as a change in color, always warrants a trip to the eye doctor because of the worry about sudden onset glaucoma. So you need to see an ophthalmologist now. Q. I am searching for information on Devic's Syndrome. I need some lay material regarding it. HELP. Devic's disease or syndrome is a disease that causes the demyelination of the optic nerves, those nerves that go from the eyes to the vision centers of the brain, and demyelination of the spinal cord. The nerves have a fatty "insulation' surrounding them that allows them to carry nerve impulses. When a disease process starts to destroy the myelin (demyelination) the nerves start to "short circuit" and reduces their ability to conduct nerve impulses. Many doctors believe that Devic's disease is a special form of Multiple Sclerosis (MS). Devic's disease usually starts suddenly, without warning, and usually starts with the eyes with pain followed by loss of vision in one or both eyes. When the spinal cord becomes involved, there may also be a sudden onset of back pain, fever and loss of some ability to walk. The legs may feel weak, difficult to control and floppy. There may also be swelling of the spinal cord and loss of bladder control. While vision usually returns to near normal levels, there may be persistent problems with mobility and bladder control. The disease waxes and wanes over time and is slowly progressive. Q. My mother is a diabetic and has had both lens replacement as well as laser for Diabetic Retinopathy. The doctor now wants to do more laser. Will this help? Is there anything else that can be done to stop further eye loss or better still, improve her vision? Yes, continued "laser surgery" is needed and required to help control the proliferation of abnormal blood vessels and to control bleeding and further loss of sight. Unfortunately, treatment for diabetic retinopathy is far from ideal but treatment options are very limited. If applicable, the patient does have some control over the situation. In general, patients do better if they lose weight and keep within general weight guideline for their gender and height, don't smoke, eat right, exercise, maintain good glucose (sugar) levels, and take their medicine(s) religiously. Also, it is extremely important to follow the doctor orders and have regular dilated eye exams. Q. What causes lightening flashes of light in the outside corner of the eyes? Noticed at night in the dark. Go to Flashing Lights in the corner of the eyes. Q. Floaters. Questions about floaters, specks in front of the eyes, strings, blobs, etc., are the most sought after questions/concerns with visitors of this web site. For information about floaters, go to FLOATERS. Also see Vitamin A and Floaters. And Test Your Eyes for Floaters. Q. What is lattice degeneration? My daughter who is 11 has been know to have this in her Left eye since her eyes were first dilated 3 years ago what should we do? You should continue to see your eye doctor on a regular basis. Lattice degeneration is usually detected in patients within the second decade of life, so your eye doctor was/is on top of things to have detected it at 8 years of age. In general, it is not something to get overly concerned about AS LONG AS YOUR DAUGHTER HAS REGULAR EYE EXAMS. These are needed because about 2% of patients will develop retinal tears which can lead to retinal detachment, and retinal detachments require surgery to repair. Also, about 25% of pateints with lattice degeneration develop retinal holes which may or may not require treatment. On average, about 8% or more of patients have lattice degeneration, so it is a fairly common finding. Also, about 55% of patients have it only in one eye. Go to Lattice degeneration for more information. Q. I was told that I have reinarts disease but can't find any information on it. Is this a real condition, how long does it last? Sorry, but we could not identify the disease or syndrome with either a spelling or similar sounding name as "reinarts". This is probably why you can't find any information on it. If you describe the condition it might help us find-out what it is. The closest that we could even think of is Reiter's syndrome or disease. Reiter's is a syndrome with three main components; urethritis (inflammation of the lining of the ureter - tube from the kidney to the bladder), conjunctivitis and arthritis (all the itises), with the most dominant feature being arthritis. The cause of Reiter's syndrome is unknown, but most probably involves something to do with the immune system not working properly. The syndrome affects more young adult males than females, is self limiting but with reoccurrence. It is sometimes associated with venereal or postvenereal disease, particularly with Clamydia or Ureaplasma urealyticum. Q. Bumps on the eye? A number of diseases can cause "bump(s)" on the eye, particularly on the white part of the eye (sclera). Some of these include scleritis, episcleritis, pterygium, allergic reactions, conjunctivitis, nevus and tumors(rare). Any bumps on the eye warrants a trip to the eye doctor for evaluation and treatment, if necessary. Q. How much does an average surgery for esotropia cost? We do not deal with the costs of surgical procedures. However, in addition to the surgeon's operating costs, there would also be costs associated with the surgical room, anesthesia, recovery room and misc costs. Esotropia surgery is now usually done on an outpatient basis; that is, in and out of the hospital the same day. Q. What is rod cone dystrophy? A rod cone dystrophy is a retinal degeneration the affects both the day light part of the eye (cones) and the night vision part of the eye (rods). In a rod cone dystrophy, first the rods (night vision and side vision) are affected and later in the course of the disease the cones (day vision) start to be affected. The most common rod cone dystrophy is retinitis pigmentosa (RP). Go to cone rod dystrophy/degeneration for more general information about a related topic. Q. Hi, I have this problem where my eyes are constantly bloodshot. I don’t have particularly dry eys. They are the worst when I wake up and before I go to bed. I use over the counter eye drops which only mildly help for a few hours. What could be causing this? I have had this problem for quite sometime. There is nothing foreign (i.e. not conjuctivitus) in my eyes and it is equally bad in both eyes. Please help! Very few dry eye disorders cause a daily variation that you describe that is also associated with bloodshot eyes, except meibomitis and meibomian gland dysfunction. Patients with meibomitis often complain of burning, bloodshot eyes in the morning. This is because there is decreased tear secretion at night and inflammatory processes serve to create eye irruption on awaking. As the disease progresses, there is increased tear evaporation during the day which causes the symptoms to again appear in the evening hours. Thus the morning and evening problems with the eyes. And, as in your case, lubricating eye drops only provide temporary relief. Because you've had this problem for some time, there may be continuing damage to the meibomian gland. See an eye doctor, preferably one that specializes in dry eye disorders for evaluation and treatment, if applicable. Go to Meibomian gland for more info. Q. Where can I donate eye glasses? The LIONS collect used eye glasses for use in third world countries. Many local libraries have donation boxes for used eye glasses. Some eye glass/optician shops and Eye Clinics and Ophthalmology or Optometry departments also collect used eye glasses. If you know someone that is a LIONS member, he/she would probably be happy to take the glasses. Q. My father has just been in a car crash and as a result is blind at present. The doctors seem to think he has a pale optic nerve. What is this and is this treatable. Pale optic nerve(s) after a car crash could be a sign of optic atrophy - or abnormal changes to the optic nerves due to trauma. In layperson terms, optic atrophy means that the optic nerves, those nerves that run from the eyes to the visual parts of the brain, are degenerating or dying. If your father has optic atrophy, treatment options are very limited and the prognosis for significant return of vision is poor. Optic atrophy or pale optic nerves is never a good sign and, in general, is not a treatable condition particularly given that it was the result of trauma. If your father regains some vision it may take place in the next year (a year after the accident). Usually after trauma it can take about one year for whatever vision recovery there will be to take place. If the doctors are not sure about the pale nerves, hopefully they'll refer your father to an ophthalmologist for further evaluation. Q. My father has a lesion or small knot on the white part of his eye. His optician has sent him to a specialist. What could this be? Go to Bumps on Eye for information. Q. I do not think this falls into the "floaters" category. A few weeks ago, while 38 weeks pregnant, I all of a sudden lost a section of my vision in my left eye. It was like a "blank" in the visual field that would move with my eye. For instance, if I were looking at an object in the "right" way, he would disappear. Very scary...So I called my midwife who said she heard of this phenomenon several years ago, and it was not pregnancy related. She said I should rest and my vision should return to normal in a few hours. It did. It has not recurred. The "blank" spot was not like anything in the "holes" simulation, but was more of a rectangle in shape. Do you have any info on this? Thanks! It is unclear what the problem could be. The most common cause of temporary field loss is due to migraines. Other conditions that can lead to temporary field loss include transient ischemic attack (TIA). To be on the safe side, you should see an ophthalmologist, perferably a neuro ophthalmologist (an eye doctor that specializes in the eyes and in neurological problems) for evaluation. Q. Could someone please give me some information "lymphatic anjectasia" (the spelling must be incorect, as I can’t find it anywhere. It is bubblewrap like blisters on the surface of the eye. Thank you. The correct spelling of the condition is lymphangiectasias. Lymphangiectasias causes localized swelling of the lymphatic vessels - tortuous dilatations of conjunctival lymphatics that wax and wane over time. These do look sometimes like "bubbles" as you describe Q. I am 58 -years ,for the last one and a half years,i have developed inocular-degeneration..it is more in left eye and is also developing in right eye as well,as a result of this there is dimness of vision and the vision also gets blurred in day light. As such there is no pain or any visible sympton.i am using eye site glasses for the last 30-years. Given your age, you may have age related macular degeneration (ARM), the leading cause of significant vision loss in people over the age of 60. There are several types of ARM and some of these types are treatable. Also, there has been new developments in the treatment of patients with ARM that can reduce the probability of vision loss in the future. We hope that you're under the care of an ophthalomlogist who can perform the necessary treatment, if applicable. If not, you need to see an ophthalmologist ASAP - your future sight may depend upon it! Q. What is Pingueculoe? The correct spelling is pinguecula - a yellowish colored spot on the white part of the eye near the cornea and usually on the side of the eye near the nose. These are commonly seen in the elderly, who have had lots of exposure to the sun (exposure to UV light), wind and warmer climates. Many believe that a pinguecula is an early version of a pterygium. Q. My husband, age 67 and a Type II diabetic, went to the eye doctor on 7/11 complaining of dry eyes, particularly in one eye. He had a complete eye exam and the doctor found no evidence of disease and recommended soothing eye drops which my husband is taking. On 7/14, he suddenly developed a floater in one eye, having never had them before. In addition, both eyes are bothering him more than ever—they are extremely dry and red. Could there be a connection with the exam or with the eye drops? How long do floaters typically last? It is very bothersome to him and our doctor has said he could have it "forever". Thank you in advance for your response. Sounds like your doctor is on top of things. A real problem in patients over the age of 50 is dry eye disease (see Featured Article). The symptoms and your description match the disease. Also, your doctor is more or less right about floaters, although they come and go, once you have them they just keep coming and coming (although technically it isn't the same floater you see forever). Your husband's symptoms are probably not related to the exam or use of eye drops, although one should be careful in the use of lubricating eye drops - too much of a good thing (used extensively over a long period of time) can cause problems in of itself. If your husband continues to have problems and particularly if he all of a sudden sees a LOT of floaters, please see your eye doctor again for further evaluation. Q. I recently asked a question regarding my father who was blinded in a car crash. it was originally stated that his optic nerve had died, but further tests have shown that his left eye is responding to light, even he still states it is completely dark. is there any hope of his eyesight returning or is this just a false hope? It is always a positive sign that the pupil(s) dilate to light. Whether your father's sight returns or whether he may have some residual vision is unknown. As noted earlier, it may take several months, up to a year, recovery before you and he know how much vision there is remaining. Q. What is the procedure for glaucoma? The surgical procedure for glaucoma depends on the type of glaucoma. Basically, there are three types of glaucoma; primary open-angle glaucoma, primary closed-angle glaucoma and normal pressure glaucoma (a variant of primary open-angle glaucoma). In primary open-angle glaucoma, surgery may include laser trabecular surgery in which a laser (argon) is used to repeatedly "stimulate" the trabecular meshwork (located near the outer part of the iris) which, in turn, causes increased flow of aqueous fluid out of the eye and thus decreased pressure in the eye. Nobody really knows HOW laser trabecular surgery really works. In general, repeated laser trabecular surgery is less and less effective when repeated on the same eye. In open-angle glaucoma surgery may also include so-called "filtering surgery" - where the surgeon may perform one of a number of different surgical procedures (trabeculectomy, trephination, thermal sclerostomy, posterior or anterior lip sclerectomy) with the goal of increasing aqueous flow out of the eye. In very advanced cases the surgeon may even place a tube in the eye to facilitate drainage. Typically certain medicines are also used to control either the glaucoma or improve the chances of the surgery. In closed-angle glaucoma, the surgery is usually laser iridotomy - where a laser is used to "burn" holes through the iris (colored part of the eye that forms the pupil). These holes help aqueous fluid to pass from the inner part of the eye to the front part of the eye where it can drain out of the eye and thus reduce pressure inside the eye. All surgeries may have complications, so your eye doctor will go over the possible complications with you before the surgery. The surgeon is also the one to ask about the chances of a successful surgery and what medicines you may have to take following the surgery as well as the number of follow-up exams. Q. Is there a treatment for adults with amblyopia that failed correction at a young age? In general the answer is no. However, if you have a certain type of amblyopia, called anisometropia or refractive amblyopia, you could benefit from wearing your corrective eye glasses. Also, recent research has shown the L-dopa (levodopa) can improve your visual acuity in the amblyopic eye by about one line on the eye chart (see recent breakthroughs for more info on L-dopa). Finally, ALL amblyopic adults should wear protective glasses with polycarbonate lenses to protect the remaining good eye. Q. I have stargardt's...I don't fully understand that with today's technology we can't create/make a new replacement to fix this problem. What's stopping us? A number of things are preventing us from curing and/or developing (eye) replacements for Stargardt's disease. Some of the roadblocks include lack of funding for basic and applied research into the problem, lack of knowledge of the disease as well as so-called animal rights groups that think, wrongly, that the use of animals (mostly rats and mice) in research is not important for medical discoveries. However, with developments based on the human genome project and with advances in scientific knowledge including knowledge gained from animal research, a cure is predicted in 10 - 20 years. Most likely the cure will be based on gene therapy whereby the defective gene(s) that cause Stargardt's disease will be replaced with correctly working genes. Q. I am scheduled for an MRI next week to find out why my optic nerves are swollen (papilladema). What are the scenarios and treatments for what might be discovered? It will be a week before I have the MRI, is this too long to wait? There is no way all the possibilities of what might be found on the MRI can be discussed. Likewise for the treatments. There is also a good possibility that they'll find nothing. Waiting a week seems actually fast given that some MRI facilities, depending on location, are booked for several weeks in advance. Q. My father has had multiple procedures related to the treatment of ARMD. The latest was the photo laser dye treatment and since that procedure has developed subretinal fibrosis; a term widely used but not described. Please explain what this is and what can be done. Fibrosis refers to the formation of fibrous tissue, usually as a result of inflammation or as a result of a loss of tissue and subsequent replacement of that tissue with fibrous tissue. Subretinal fibrosis thus means that the fibrous tissue is developing underneath the retina, possibly related to the ARMD or the treatment(s). In general nothing can be done about subretinal fibrosis. As the ARMD progresses, there is more and more damage or/and inflammation to the retina and to the other layers of cells in the back of the eye, and the fibrosis is the body's response to this damage or inflammation. Q. I am legally blind and I was wondering if there is any possible way I could get a drivers license? I want to know all of the options I could consider. In several states, including Ohio, a legally blind person MIGHT be able to obtain a drivers license if they can pass a lengthy vision evaluation and complete a very detailed and comprehensive driving test with a bioptic telescopic device. The program costs several thousand dollars and there is no guarantees that you will actually get a drivers license. Call 614-292-1104 to reach the Low Vision Rehabilitation Services section of the College of Optometry for more information about the low vision drivers program. Q. In the Web page, the first image is not the image of normal view, it is the same image as "Ring or Donut Scotoma" image. I like this page and I would be pleasing you updated the page with images of more eye diseases. Thank you. Thanks for the input and correction. We have added more to Simulations and we'll continue to do so as time permits. Q. I have an 11 month old son and the optician said that he has black pigments in the back of his eye on the retina. What is this? Pigmentary changes in the back of the eyes, or retina, can be a host of different things, some not serious and some very serious. You son needs to be seen by a pediatric eye doctor ASAP. Once you have a diagnosis, we can help you with additional information. Q. I had each eye seeing the same object seperately, what causes that? If your eyes are not pointing in the same direction, you will experience double vision or diplopia. Some patients can do this voluntarily and in some patients diplopia is caused by something that causes the eyes not to point in the same direction (eye muscle weekness, damage to the nerves that run to the eye muscles, for example). Q. One of my girlfriends has ever since her pregnancy been suffering of something called subretinal neofaxulanisation. A severe eye condition which started during her second trimester. Her baby is now almost 3 months old and the desease / fungus (???) is starting to effect her other eye. The specialists can't tell her much about the cause or possible cure. She has now undergone surgery two times, sees 20 - 40 % and has no idea what to expect next. She's 32 years old. Are there any other people out there who might be suffering form the same thing and know more about it? Thanks in advance for your time. Your friend probably has subretinal neovascularization, probably as a result of diabetes. The diabetes and associated proliferative retinopathy was probably aggravated by her pregnancy which, in turn, caused the further neovascularization and possible subsequent retinal hemorrhages. [Although diabetes can develop during pregnancy, gestational diabetes does not lead to diabetic retinopathy and subretinal neovascularization] Subretinal neovascularization refers to the development of abnormal blood vessels underneath the retina. These blood vessels tend to leak and where they leak vision is lost (See Simulations of diabetic retinopathy). Laser scatter photocoagulation ("laser surgery") is the treatment of choice for retinal problems associated with diabetic retinopathy. It sounds like your friend is receiving appropriate care; unfortunately, the condition is a serious one with guarded prognosis.
August 2000 Q. I have recently had two separate incidents where it suddenly appeared as though I was looking either through water or through a prism. The first occasion the prism effect was only in the outer area of my field of vision. The second occurrence the prism effect was in the center of my field of vision. I was recently told I have high blood pressure and put on Tenormin. The prescription was made without any further exam, just my blood pressure reading at the time I went in for a sore throat and cough. I am a 49 yr old female in relatively good health, but I do suffer from allergies and asthma. At first glance, your visual experiences are similar to those experienced by migraine suffers. See Migraine in the Q and A Archives section for more information. However, your visual symptoms could be related to high blood pressure. You should be examined by an eye doctor to rule-out any eye problem, per se. Q. I want to thank you that you paid attention to my previous e-mail and you fixed the wrong image in the simulations web page and you had published more simulations about others pathologies. I think that this page can help people to understand visual impairments viewing. Nice work Thank you. We'll add more simulations as time permits. Q. What is "PIC"? Click on PIC in the Q and A Archives for information. Or, do a Find (under Edit) for PIC in the Q and A Archives. Q. Thank you for answering my two previous questions regarding my father who was involved in the car crash. Since the last question he is now seeing light in his left eye, but only for periods of upto a hour then it goes dark again. Could you give me some indication of his condition and is his chances getting better of recovering some vision. It is impossible to give an impression of his condition or his chances of gaining/recovering vision. His doctors are in the position to answer these types of questions. In general, the regaining of any sight is always a good sign and, of course, the more he regains the better the prognosis. But the recovery process will be a long one and sometimes takes a year for most vision recovery to take place. Q. I heard about braces for the eyes. It is when you wear contacts while you sleep and during the day you take them off and you can see without them. Have you heard about this? I think they cost about $2,000 for both eyes. The use of contact lenses to reshape the cornea of the eye has been tried for a long time with only modest success. The effect is short lasting and used only on patients with mild refractive errors. Why a patient would want to wear contacts at night so they don't have to wear them during the day is not clear. However, there are serious problems with wearing contacts at night, particularly if the patient also wears them all day long. Serious corneal infections can occur with any extended wear contacts. Q. Hi. This doesn't have anything to do about a disease but please don't pass this off as nothing. I am seriously considering a career as an eye doctor and I was wondering how many years of schooling it takes to be an eye doctor. And what classes and how much money? There are two types of eye doctors; optometrist and ophthalmologist. To become an optometrist requires a four year bachelors degree and three or four years of optometry school. Sometimes an optometrist will also do a one or two year specialty fellowship (e.g., glaucoma) or research fellowship after completing the OD degree. An ophthalmologist is a MD (medical doctor) or DO (osteopath) with a specialty in ophthalmology. The ophthalmologist needs a four year bachelors degree and four years of medical or osteopathic school, usually followed by a one year internship and then followed by a three or four year residency in ophthalmology. Following the completion of the ophthalmology program, the ophthalmologist may take one to three years in a specialty (e.g., pediatrics). Although things are changing to blur the distinction between an optometrist and an ophthalmologist, one of the big differences is that an optometrist cannot perform surgery. The types of classes one takes to become an optometrist or an ophthalmologist is beyond the scope of this web site - suffice it to say there are a great deal of courses related to anatomy, physiology, chemistry, optics, and disease. Costs? A lot! Eyes that water excessively either have a problem with excessive tear production or a problem with proper tear drainage. Both warrant a trip to the eye doctor for evaluation and treatment, if applicable. In general, patients that only complain of weeping eyes usually have a problem with epiphora - tear drainage. Warning: some serious eye diseases do have as a symptom watery or weeping eyes (e.g., glaucoma), so please see an eye doctor. Q. Was there another disease concerning the eyes named after a man other than Graves (disease)? Yes. A wild guess would be about 200 diseases. Q. A What is bletharitis (Blepharitis)? Blepharitis is a common condition that can be controlled but not cured. Blepharitis is caused by several things including Staphylococcal infection and Seborrhea (excessive secretion of lipid from glands). Blepharitis may also be associated with dandruff, eczema, allergy, drugs and Acne rosacea. Signs of Blepharitis include scales on the lashes, red swollen lids, burning and itchy eyes and discharge (e.g., serum-like or mucus like) from the eyes. Staphylococcal blepharitis typically is an acute inflammation and occurs mostly in females. It is also associated with Dry eye. Seborrhea blepharitis is reflected by oily,greasy scales around the lashes and there may be excessive secretions or the glands may become plugged. Treatment often includes the following:
Will you be able to wear contacts again? That is a good question for your eye doctor. Blepharitis waxes and wanes over the years and if you're able to control the outbreaks by following the above recommendations you may be able to wear contacts again. Unfortunately, since blepharitis is associated with dry eye in some cases, be careful - blepharitis can lead to complications including corneal ulcers and conjunctivitis. See an eye doctor for diagnosis and possible treatment. Good luck Q. How do I address the public on eye donations? The most important thing is to have EVERYONE sign the Anatomical Gift card as part of the driver's license renewal form AND to carry the anatomical gift card with them at all times. Ideally, donors should check the box "any needed organs or parts." As an alternative, if you just want to donate the eyes, make the box "The following part(s) _______" and write-in "eyes." The people in charge of procuring body parts will do the rest. Q. Bulging Eye. A bulging eye is a sign of a potentially serious eye or neurological problem (the most common problem is Graves disease, thyroid eye disease). You should see an ophthalmologist ASAP for evaluation and treatment, if applicable. Q. What is it when you see stars when you close your eyes at night? Its time to go see an eye doctor. Seeing stars or bright specks of light or flashes of light are all indications of a possible retinal or vitreous problem. Some of these problems include retinal tears, detachments, vitreous detachment (posterior vitreous detachment), among others. Less likely but also possible are disease of the optic nerve. See an eye doctor for evaluation and peace of mind. Q. I see a blurry bit in both eyes and when I do I get a real bad headache. Go to Q and A Archives and do a Find (under Edite) for Migraine or/and fortification phenomenon. Just to be on the safe side, you also should see an eye doctor or an internist for evaluation and treatment, if applicable. Q. Macular Hole. A macular hole is a lesion in the fovea - that part of the macula or central part of the retina used for reading. To the eye doctor a macular hole looks like a hole or depressed circular or oval area that typically is reddish in appearance. To the patient a macular hole looks like a dark area or scotoma in which the patient can't see through (see simulations). Prior to a full-blown macular hole, a "pre-macular hole lesion" may be present and these have been referred to by various names including macular cyst, involutional macular thinning or impending macular hole. Depending on the severity, size and location of the macular hole, the patient may have from about 20/50 to 20/400 visual acuity in the affected eye. Some macular holes, about 10%, partially resolve or improve, but the majority are permanent as is the loss of vision. Usually only one eye is affected and women are affected much more than men. Trauma to the eye accounts for about 15% of macular holes, while the rest are typically associated with aging (50 and older). Because a macular hole is difficult to diagnose, some tests that the eye doctor may order include a fluorescein angiogram and a biomicroscopy with a contact lens. A retinal detachment may result from a macular hole and surgery may be needed. Ophthalmologists have tried a number of treatments for macular holes with varying degrees of success. A patient with a macular hole must see the eye doctor on a regular basis. Q. I seen dark spots in my field of vision.. These spots are of various shapes and sizes and move back and forth as I look around a room. I have been told they are called floaters. I have seen them for years and have become accustom to them. They become very clear on bright days or against white backgrounds. They appear to be nerve endings or even cells. can you tell me more about them? Go to Simulations for a view of floaters. Also, go to Q and A Archives, follow the directions for doing a search with your browser for floater or floaters. Q. Our son is 5 yrs old with amblyopia. Dxd at 4 and 1/2 yr old at routine eye check--20/200 in affected eye(secondary to esotropia with minus 5 diopters). After 9 mos patching, mostly 8-10 hours daily, max improvement is 20/60, but now also has more strabismus. Would l-dopa and eye exercises help to get more improvement? These are both good questions and your eye doctor is the best person to answer these questions. Why not ask him or her? In general, L-dopa will improve vision in the amblyopic eye by 1 - 2 lines. At present, we recommend L-dopa plus occlusion therapy AFTER all other attempts/treatments have run their course. After you son's vision has improved to some stable point, his eye alignment must be addressed/treated with surgery, glasses, or/and orthoptics, depending on the situation. Your eye doctor may also consider penalization therapy, whereby eye drops are placed in the stronger, dominant eye to blur the image and help the amblyopic eye gain vision. Unfortunately, treatment for amblyopia is a long one. If you live in Ohio, there is a new program for amblyopic children and their families. The program is called the Ohio Amblyope Registry, and more information about amblyopia can be found at their web site; ohioamblyoperegistry.com. Q. Every time I turn my head, in either direction, I see what looks like a flash of light in the far right hand corner of my right eye. what could have happened? Flashing lights can be a sign of several retinal problems so you do need to see an eye doctor about the problem. Flashing lights are a symptom of a retinal tear or detachment, vitreous tags, posterior vitreous detachment, among others. See other questions in the Q and A Archives about flashing lights for more information. Q. Twitching eye. Lid twitching of one eye or the corner of an eye, as well as facial tics, is a common complaint in patients and seems to be exacerbated by mental or physical stressful situations, lack of sleep and possibly by stimulates such as caffeine/coffee. The literature is sparse on this topic, however, as it appears to be a benign and fleeting problem. Only rarely does eye twitching reflect a more serious neurological problem. If the eye twitching is more like a facial spasm such that the eyes close, you may have blepharospasm. Blepharospasm is an involuntary contraction of the muscles around the eyes. It is a progressive disorder that sometimes starts with one eye but almost always involves both eyes as the disorder progresses. Interestingly, the spasms do not occur during sleep and are exacerbated by stress and fatigue. The cause of blepharospasm is not known and treatments are limited. If the eye twitching is possibly a blepharospasm, see an Ophthalmologist since there are some surgical treatments that may be considered. Sometimes, but rarely, facial spasms may be a sign of a more serious condition and need to be evaluated by a Neuro-Ophthalmologist. Go to the Q and A Archives and use your browser to do a Find (under Edit) for twitching for more information on a twitching eye. Q. Hi I am 16, and over the past year or two I have developed purple bags underneath my eyes. I don't do drugs or drink a lot, I get the proper amount of sleep and vitamins and drink a lot of water. I was just wondering does this have anything to do with my actual eye and if you have any ideas on what's causing this please tell me??? thank you!
Dark circles under the eyes or darker appearing skin under the eyes can be due to a number of factors. The lack of adequate sleep will cause the eyes to appear swollen or puffy and darker than normal. In women, hormonal changes can cause the skin under the eyes to darken. As part of the aging process, small wrinkles under the eyes will also cause the appearance of dark skin under the eyes. Finally, the skin under the eyes will appear dark because of shadow. What can you do about it? See an Ophthalmologist that specializes in cosmetic surgery or reconstruction surgery for an opinion. Although surgery is not typically an option, the Ophthalmologist will diagnose the problem. If the skin is indeed darker than normal certain bleaching agents can be used to lighten the skin. If the eyes appear darker because of wrinkling of the skin, certain laser surgery can be used to remove the wrinkles. Certain cosmetics, even for men, can be used to cover-up the darker appearing skin. Finally, be sure to get enough sleep and take regular rest breaks every hour when using the computer. Go to the Q and A Archives and do a Find (under Edit) for dark circles for more info on bags and dark circles under the eyes. Q. What is posterior vitreous detachment? Go to the Q and A archives and do a Find (under Edit on your browser) for posterior vitreous detachment for info on this topic. Q. What is a growth on the white area of the eye? The spot may be several things. A number of diseases can cause "bump(s)" on the eye, particularly on the white part of the eye (sclera). Some of these include scleritis, episcleritis, pterygium, allergic reactions, conjunctivitis, nevus and tumors(rare). Any bumps on the eye warrants a trip to the eye doctor for evaluation and treatment, if necessary. A dermoid cyst is a noncancerous tumor about the size of a pea that is usually present since birth. A dermoid typically looks yellowish-white (tan would be in the ball park) and is usually on the white part of the eye - sclera. Dermoids do tend to increase in size during puberty. Removal of a dermoid is usually done in the first 5 or so years of life. Another possibility is that the spot is a nevis - a collection of darker pigment on the sclera. However, a nevis is usually darker in appearance than that which you describe, although a nevis can be caused by a thinning of the sclera which allows the darker choroid to show through. Depending on your complexion, the choroid can be tan to darker tan. A nevis, however, does not increase in size. A pterygium, after the Greek word meaning "wing", is a triangle shaped spot on the conjunctiva (thin membrane that covers the exposed area of the sclera) and it usually, but not always, occurs on the side of the eye near the nose. Pterygiums often occur in people who work outside in dusty, windy climates. Sometimes they can increase in size and affect the cornea and vision. If so, it can be surgically removed under local anesthesia. If not affecting vision it is best to just leave it alone. Episcleritis. is an inflammation of the episclera - the outer most layers of the sclera, or white part of the eye. In addition to redness and discomfort there is sometimes a nodule present in the area of redness. Episcleritis is sometimes associated with rheumatoid arthritis, ulcerative colitis and gout, but most of the time the cause is unknown. Wearing contacts will aggravate the condition and make the eye more red and painful. The reason the eye is red is because of the swelling of the blood vessels and this is why certain eye drops will constrict the blood vessels and the eye will appear white, at least while the eye drops are still working. Scleritis, or inflammation of the sclera (white part of the eye) is a condition that mostly affects women and is fairly rare. It can affect the front of the eye, making the eye look red and it can be very painful. It can also be restricted to the back part of the eye, so the eye appears white but it is still very painful. In about half of the cases it is related to other diseases including rheumatoid arthritis, ankylosing spondylitis, acute herpes, and connective tissue disease. The other half of the time the cause is unknown. Scleritis can also be associated with uveitis, cataracts and glaucoma. If you have the scleritis that affects the front of the eye steroid eye drops are prescribed for treatment. If you have the scleritis that affects the back of the eye, oral medicines are prescribed, including ibuprofen. Whatever the bump is, you should be seen by an eye doctor for evaluation and treatment, if applicable. Q. My daughter is having a Cat Scan because she has pale optic nerves and has been suffering from migraines. What would they be looking for in a CAt scan? A CT scan is a technique for examining intracranial (within the head) structures. A CT scan is great for looking at brain tissue vs cerebrospinal filled spaces (ventricles), as such, a CT scan is often used to search for or evaluate ventricular size or/and displacement, subdural accumulation of fluid and mass lesions. A CT scan is often used to look for brain swelling, contusions, hemorrhages,solid tumors and vascular tumors, calcifications, vascular malformations, and brain abscess. Q. What is a prism? A prism refracts or bends light. A prism is usually placed in corrective lenses or glasses to correct for small eye misalignments. Q. How is a sty caused? Go to Q and A Archives and do a Find (under Edit on your browser) for Stye or/and sty for an answer. Q. Is there any way to correct my vision after they were burnt with oxygen when I was a baby? You probably have Retinopathy of Prematurity (ROP) or what was in earlier years (1950s) called Retrolental Fibroplasia. Go to Q and A Archives and do a Find (under Edit) for Retinopathy of Prematurity. Because ROP is a developmental problem with the retina, there is no treatment for adults with ROP. Q. I have a broken blood vessel in my right eye. The lid hurts. Should I be worried? Whenever there is pain associated with an eye condition, you should see an eye doctor for evaluation and treatment, if applicable. Q. WHAT DOES IT MEAN WHEN VERY OCCASSIONALLY I SEE LIKE FLICKERING IN BOTH EYES, KINDA LIKE A KALIADSCOPE U R LOOKING AT THAN IT PASSE. THANKS VERY MUCH The most common cause of the phenomenon you describe is migraines (so-called fortification phenomenon). Go to the Q and A Archives and do a Find (under Edit) for migraine for more information. However, other ischemic (reduced blood flow or reduced oxygen delivery) to the brain can also cause the phenomenon that you describe, so you should see an eye doctor just to be on the safe side. Q. I am a 14 year old girl and i have a cyst on the bottom of my left eye. I have had this problem for at least 6 months and i have had the cyst drained 2 times which was extremely painful for me. The cyst keeps coming back again and again. I would appreciate it if you have any advice if you would give it to me. Please. I do not want to have my eye drained again. If the cyst is a sty, go to the Q and A Archives and do a Find (under Edit) for sty or/and stye for more information. However, you should talk with your eye doctor about other possible forms of treatment, if applicable. Q. I have a baby boy who is now 1 year and 3 months old. On 10th July 2000 he had his MMR immunization without any high fever after that. How ever a day or two after the injection, I realised his eye closed shut on the left once he woke up from sleep in a morning. The eyes only widely open after 2 hours and so but swollen.The next day I saw another eyes on the right shows the same problem but not too serious like the left eye. The next day the swollen becoming very big at the left eye and I touched the eye lid and it was soft. My son seems did not feel any pain. I look into his eye ball but there is no reddish or simptoms that the eye was being infected. I brought him to see a local doctor and he prescribed fucithalmic, and I applied to my son's eyes two times daily. For the first two days the swollen subsided but then it swollen again even though I applied the eye-drops. 4 days ago I make appointment to see a pedetrician, and he suspected my son is having a kidney problem. However he prescribed another eye-drops called sofradex containing framycetin sulphate, gramicidin , and dexamethasone. He asked me to collect the urine if the situation do not improve. I apply the eye-drops and the swollen shrink drastically but my son crying everytime I put the eyedrops which I suspect due to the pain. Still the eyeball is white-blue and looks normal to me. No reddish or infection-like to the eye. However the swollen grows again two or three hours after I put the eyedrops, but the swollen is not too big like before. Tomorrow I will bring the urine for urine test. To describe further, the stomach of my baby is bigger than usual now, but I do not see a problem as he has a good appetite. Lastly, my house is clean and wellkept. It is unlikely that the MMR (measles-mumps-rubella) immunization caused the lid swelling, although it is always possible, although unlikely, that the MMR caused an allergic or hypersensitivity reaction resulting in kidney damage or disease. Facial swelling is one of the signs of kidney disease. However, the most common cause of lid swelling is due to an allergic reaction to something in the environment or ingested. Since the swelling appears in the morning, check/change anything and everything that contacts the baby's body while he/she is sleeping (blankets, pillows, clothing) as well as any soaps and shampoos and see if this has any effect on the lid swelling. Also, check/change what the infant is eating and drinking. [Important note: NEVER GIVE YOUR CHILD ANY HERDS, TONICS, LOTIONS, ETC!] One of the more serious diseases that we worry about in infants and young children that has lid swelling as a symptom is orbital cellulitis, most often associated or caused by paranasal sinusitis. Be sure to keep a close watch on your child for any other symptoms such as the eyes appearing to bulge-out or lack of ability of the child to move his/her eyes. Also watch closely for any other "unusual" behaviors. Be sure to keep all your doctor appoints, it sounds like your child is receiving appropriate care. Good luck and let us know what happens. Q. What can cause redness in eyes and vision disturbance? Numerous things, the most common are the "itises" including iritis and conjunctivitis and uveitis. Go to the Q and A Archives and do a Find (under Edit) to receive info on these diseases. Because there is visual disturbance, you need to see an eye doctor ASAP for evaluation and treatment, if applicable. Don't delay, the longer you wait the worse it could become. Q. My boyfriend has recently gone semi-blind in his left eye started 5 days ago he couldn't see out of it and now all vision out of the eye is blurry and is unable to see clearly. The doctors have said it may be eyeitis and linked to the arthiritis in his legs. Could you please help and tell me what you think it could be? Iritis can cause vision loss/disturbances and is sometimes associated with arthritis. If so, your boyfriend needs prompt medical attention. For example, in juvenile rheumatoid arthritis, anywhere from 10 - 50% of patients can develop a potentially blinding eye disease called iridocyclitis. Iridocyclitis involves redness of the eye(s), pain, sensitivity to light and decreased visual acuity. If not detected or treated early enough (and sometimes despite aggressive treatment) the eye disease can lead to an abnormal shaped pupil, cataract, glaucoma and a general degeneration of the eye ball and blindness. It is essential that a child/teenager with JRA have an eye exam, specifically a slit lamp exam, by an eye doctor three to four times per year to look for the very early signs of the eye disease. Also, if the patient ever complains of an eye hurting, or seems sensitive to light, the patient should been seen by an eye doctor ASAP for evaluation and treatment. Q. My daughter is 4 months old. I've noticed that her eyes are not properly aligned, i.e. her eye-balls are non-aligned slightly. Could this be a serious problem or will it get rectified on its own, as my daughter gets a little older. Usually by three months of age an infant will maintain straight eye alignment. However, between about 3 months and 6 months of age the infant may occasionally and momentarily have misaligned eyes. If your daughter is 4 months old and has constantly misaligned eyes, you should take her to an eye doctor for evaluation. Some children with large, wide bridges of the nose will sometimes appear to have crossed eyes (pseudostrabismus), as in Asian-Americans. Misaligned eyes may be due to several reasons; for example, simply eye muscle alignment problems, a sign of amblyopia (lazy eye), and sometimes because of more serious problems with one or more eyes or the brain. Since almost everyone (American Academy of Pediatrics, American Ophthalmological Association, American Optometric Association) recommend that an infant have an eye exam at about 6 months of age, take your daughter to an eye doctor for evaluation and peace of mind. Q. Would like to discuss a problem and I await a decent response. During a treatment, due to absence of oxygen to the brain at some point of time the cells related to the vision were affected and now the patient has an improper vision. Is there a solution available to treat and let the patient lead a normal life. We have tried all the possible treatment (in allopathic, homeopathic). Your response would be a great help to us. It is not possible for us to figure-out what the problem is. If the patient is a child, lack of oxygen to the brain can cause brain damage and affect the visual parts of the brain. Many of these patients have cortical visual impairment or cortical blindness. Early intervention services including early infant visual stimulation is suggested for these patients. If the patient is an older child or an adult that has had a stroke, for example, treatment options for vision recovery are limited. Usually it can take up to a year for vision and visual function to recover (as much as it will). Q. This is a follow-up to a question that I asked recently and is posted on your site in the Q&A archives as "Bloodshot eyes in the morning and evening". I went to the eye doctor and was thoroughly checked over. She could not find the cause of my constantly bloodshot eyes. She said that I did not suffer from dry eye syndrome and the surface of the eyes looks fine. I was wondering if there were any surgeries (i.e. laser surgery, etc..) that could remedy the redness or any other treatments that would work on a long-term or permanent basis. Like I said earlier, I have no other symptoms and it is a basically a HUGE annoyance..... We're glad that you went to the eye doctor and that she count not find any serious problems with your eyes. Unfortunately, this doesn't help you because you still have bloodshot eyes. There are no surgeries, per se, that will fix bloodshot eyes and we DO NOT recommend that you use over the counter eye drops since excessive use of such eye drops can cause problems in of itself. A possible clue to your problem may be that you only have bloodshot eyes in the morning and in the evening and not during the middle of the day. Patients with meibomitis or with advanced meibomian gland dysfunction do complain of a chronic sandy-gritty burning sensation of the eyes with red eyes in the morning and the evening. The meibomian gland provides a lipid (greasy film) for the eye to control tear evaporation. Decreased lipid release, as in the case of meibomian gland dysfunction, thus causes increased tear evaporation and red, irritated eyes. Go to the Q and A Archives and do a Find (under Edit) for meibomian gland for further information. Q. How to minimize risk to eye sight.
Q. Why does my eye hurt? Why is it puffy and watery? I feel pressure. We don't have a clue. Because your eye hurts, you need to see an eye doctor for evaluation and treatment, if applicable. Q. I have two very small white growths in the corner of my eye on the inner most section of the lid close to the beginning of my nose. Do you know what these growths are from and what I can do? The small white growths on the corner of the eye lids near the nose can be a number of things. Most likely are blocked or infected tear ducts and/or allergic reaction. What can you do? - You can go to the eye doctor for evaluation and treatment. For information on macular degeneration, go to the Q and A Archives and do a Find under Edit) for macular degeneration. Also, go to Simulations of vision loss. Q. I am 31 years old, for 6 months I have been seeing in my right eye a light gray/lavender spot. It is in the upper right hand side on my eye and looks like an oval that flashes when I blink. It is always in the same spot and I can see it with my eyes closed. I went to the eye doctor and he said that I have very healthy eyes. That this maybe from a migraine, which I do suffer from. Can you give me more information? I don't beleive that this is from migraines ands I need to know who I should see next or if this is something that will go away. Are you sure that the spot (scotoma) is only in the right eye? If yes, then the problem is in the eye itself (e.g., localized retinal detachment) or something to do with the optic nerve in that eye. If it is in one eye only then it most likely is not something in the brain, per se. Did the eye doctor perform a visual field test to quantify the spot? If no, a visual field test ON BOTH EYES should be performed. We agree with you that this scotoma is not related to migraines. We suggest that you see a neuro-ophthalmologist or possibly a retinal specialist for further evaluation. Let us know what they find, if anything. Q. When I look to one side, the conjunctiva appears to wrinkle up in the outer corner rather than side past my eye lid. The problem is worse in the morning and improves as the day goes on. What causes this? What can I do to improve the situation? Your description seems a bit unusual, but you may be actually suffering from, among other things, conjunctivitis, episcleritis or scleritis or possibly an allergic reaction. What can you do about it? - You can see an eye doctor for evaluation and treatment, if applicable. Since the problem is worse in the morning, make an eye doctor appointment in the morning so he/she can have a better appreciation of the problem. Go to the Q and A Archives and do a Find (under Edit) for floaters for an answer. Also go to Simulations. In general, floaters are caused by both normal aging processes in the eye and disease. Q. My two year old boy looks at the sun. He does it through the car windows when we are driving somewhere and he looks at the reflection of the sun in the neighbors windows. What are the risks of this behavior. If he has normal vision and does what you describe, probably none. Of course, no one should look directly at the sun; as this will cause burn spots on the retina and could lead to legal blindness. However, if he is looking at a reflection off clear glass, then the light energy (both visible and nonvisible) from the sun is greatly reduced and put on top of that the fact that he is looking through a car glass window, which would further reduce energy reaching his eyes, strongly suggests that it would not cause damage. Q. Why do I sometimes wake up in morning and blind, briefly, in right eye only? I see flashes, lightning, and darkness gradually returning to normal but dimmer sight. Also my right iris is very white during this time but the normal blue returns later, also. It is unclear why you are experiencing temporary blindness in one eye in the morning. Nevertheless, you need to see a doctor ASAP for evaluation. Go today! Q. I have read all your Q&A's on dark flashes but am not sure my symptoms are the same. For many years, whenever I turn my head sharply to the right or left, I see lots of black rods with flashes on the ends. They dart around and I feel a little faint until I relax my head position. Should I be concerned? Yes. Some patients with limited blood flow through the various arteries located in the neck will experience a change in vision and/or lightheadedness when they turn their head to the left or right, as you describe. You should go see an internist doctor for evaluation. Q. One pupil is larger than the other one. One pupil larger than the other is called anisocoria. Go to the Q and A Archives and do a Find (under Edit) for anisocoria for an answer to your question. Q. Which part of eye is taken out for transplant after death? After death, the whole eye is removed. The cornea (very front of the eye) is used for transplantation. Other parts of the eye may be used for research. Q. What is a yellowish colour appears on the white of the eye? A number of conditions can cause the white (sclera) part of the eye to change color to yellow including jaundice (possible liver disease), leptospirosis infection (an infection spread to man by opossum, skunk, raccoon for example and causing jaundice), brucellosis (an infection caused by cattle, sheep and goats, for example that infects humans), as well as chemical compounds such as picric acid or/and nitro and aromatic amido compounds and lipid deposits. If your eyes appear yellow you need to see a doctor ASAP. Q. Something strange happens to my nephews eye...symptoms start with on the top corner of the lid appears a rock hard like marble thing and then swells up so much that his eye mostly shuts and then turns into what looks like a black and blue bruise but he's had no injury at all, I think its some sort of infection but not sure. Have you heard of anything like this before? Your nephew needs to see an eye doctor. He may have a cyst or an inflammatory occlusion of the lacrimal gland, sometimes due to a foreign body, infection, chemical injury, burns or tumors. He also may have blepharochalasis. Go to the Q and A Archives and do a Find (under Edit) to learn more about blepharochalasis. Q. My son has a growth on his eye, its red and the doctor said it will need surgery or it will cover the cornea. What is it called? Q. I have a growth in my eye and I'm considering remove it. It is called Pfenygium. Do you have any information on this. It is like a clear tissue that starts groing on top on the cornea. Please reply soon. I'm doing some research on it before I have it remove. It is probably a pterygium. Go to the Q and A Archives and do a Find (under Edit) for pterygium for more information. Q. Swollen eyes. Go to the Q and A Archives and do a Find (under Edit) for swollen eyes for information. Q. Good day. My name is Mohamed and I use my computer for too long and when I finish I watch TV...about 7 hours a day..now when I am in the house my vision is normal but when I go out to the sun I start seeing like black spots and whenever I move my eye they move too...this is constantly happening to me...there is no professional eye doctor here in Africa where I am...can u give me an idea of what I am experiencing?thankyou Possibly. It sounds like you are experiencing floaters. Floaters become much more visible when you're outside and looking at the clear blue sky, for example. Go the the Q and A Archives and do a find (click Edit then Find) within your browser for floaters. Also go to Simulations and click on Floaters for examples of what they look like. Floaters are common as we age and in patients with nearsightedness. A lot of floaters may be a sign of a retinal or inner eye problem. If you are in Ghana, we have a contact that may be of help to you. If so, supply your e-mail address and we'll forward his e-mail address to you. Good luck. Q. My grandmother started having really bad problems with her eyes. She says her eyes always have moucous (mucous) around them, and it sometimes is almost like a leagon (lesion), can you help, because the doctors have no idea, and are just wasting her money on many costly eye drops and various medications. Please help!!!! We're sorry that you're not pleased with your mother's eye doctors; unfortunately, we are in no position to second guess her eye doctors. Some chronic eye conditions that occur when we age include dry eye disease as well as Blepharitis (see current 8/16/00 |
