Your toddler may show every sign of good eyesight including the ability to see objects in the distance, however that doesn’t necessarily mean that he or she doesn’t have a vision problem.

Amblyopia is one common eye condition that is often hidden behind the appearance of good eyesight.  

Also known as “lazy eye” it usually occurs when the brain begins to ignore the signals sent by one eye, often because that eye is weaker and doesn’t focus properly. Sometimes it can occur in both eyes, in which case it’s called bilateral amblyopia. This eye condition is especially common in preemies, and tends to run in families as well, so it’s important to provide your eye doctor with a complete medical and family history.

There are several factors that can cause amblyopia to develop. These include:

• astigmatism, 
• high nearsightedness or farsightedness, 
• uneven eye development as an infant,
• congenital cataract (clouding of the lens of the eye),
• strabismus (where the eyes are misaligned or “cross-eyed”)

However in many cases of amblyopia there may be no obvious visible structural differences in the eye. In addition to the fact that the eyes may look normal, vision often appears fine as the brain is able to compensate for the weaker eye by favoring the stronger one. Because of this, many children live with their eye condition for years before it is diagnosed. Unfortunately, as a person ages, the brain loses some of its plasticity (how easy it is to train the brain to develop new skills), making it much harder – if not impossible – to treat amblyopia in older children and adults. That’s why it’s so important for infants and young children to have a thorough eye exam.

Are There Any Signs of Amblyopia?

If you notice your child appears cross-eyed, that would be an indication that it’s time for a comprehensive eye exam to screen for strabismus and amblyopia development.

Preschoolers with amblyopia sometimes show signs of unusual posture when playing, such as head tilting, clumsiness or viewing things abnormally close.

However, often there are no signs or symptoms. The child typically does not complain, as he or she does not know what normal vision should look like. Sometimes the condition is picked up once children begin reading if have difficulty focusing on the close text. The school nurse may suggest an eye exam to confirm or rule out amblyopia following a standard vision test on each eye, though it might be possible to pass a vision screening test and still have amblyopia. Only an eye doctor can make a definitive diagnosis of the eye condition.

So How Do You Know If or When To Book a Pediatric Eye Exam?

Comprehensive eye and vision exams should be performed on children at an early age. That way, hidden eye conditions would be diagnosed while they’re still more easily treatable. An eye exam is recommended at 6 months of age and then again at 3 years old and before entering first grade. The eye doctor may need to use eye drops to dilate the pupils to confirm a child’s true refractive error and diagnose an eye condition such as amblyopia.

Treatment for Amblyopia

Glasses alone will not completely correct vision with amblyopia in most cases, because the brain has learned to process images from the weak eye or eyes as blurred images, and ignore them. There are several non-surgical treatment options for amblyopia. While your child may never achieve 20/20 vision as an outcome of the treatment and may need some prescription glasses or contact lenses, there are options that can significantly improve visual acuity.

Patch or Drops

In order to improve vision, one needs to retrain the brain to receive a clear image from the weak eye or eyes. In the case of unilateral amblyopia (one eye is weaker than the other), this usually involves treating the normal eye with a patch or drops to force the brain to depend on the weak eye. This re-establishes the eye-brain connection with the weaker one and strengthens vision in that eye. If a child has bilateral amblyopia, treatment involves a regimen of constantly wearing glasses and/or contact lenses with continual observation over time. 

Your eye doctor will prescribe the number of waking hours that patching is needed based on the visual acuity in your child’s weak eye; however, the periods of time that you chose to enforce wearing the patch may be flexible. During patching the child typically does a fun activity requiring hand eye coordination to stimulate visual development (such as a favorite video game, puzzle, maze etc) as passive activity is not as effective. 

The earlier treatment starts, the better the chances are of stopping or reversing the negative patterns formed in the brain that harm vision. Amblyopia treatment with patches or drops may be minimally effective in improving vision as late as the early teen years (up to age 14) but better results are seen in younger patients.

Vision Therapy

Many optometrists recommend vision therapy to train the eyes using exercises that strengthen the eye-brain connection. While success rates tend to be better in children, optometrists have also seen improvements using this occupational therapy type program to treat amblyopia in adults. 

The key to improvement through any non-surgical treatment for amblyopia is compliance. Vision therapy exercises must be practiced on a regular basis. Children that are using glasses or contact lenses for treatment, must wear them consistently. Your eye doctor will recommend the schedule of the patching, drops, or vision therapy eye exercise and the best course of treatment.

Amblyopia: Take-home Message

Even if your child is not showing any signs of vision problems, and especially if they are, it is important to have an eye examination with an eye doctor as soon as possible, and on a regular basis. While the eyes are still young and developing, diagnosis and treatment of eye conditions such as amblyopia are greatly improved.

January is Glaucoma Awareness Month

Make your resolution for healthy vision this year by knowing the risks and signs of glaucoma.

As the leading cause of blindness worldwide, glaucoma has earned the nickname “The Sneak Thief of Sight”. This is because often there are either no symptoms or a sudden onset of serious symptoms that can quickly lead to vision loss if not treated.

Glaucoma-related vision loss is usually caused by optic nerve damage due to elevated pressure within the eye (intraocular pressure). The damage cannot be reversed however there is treatment for glaucoma, particularly when it is caught early before nerve damage has occurred.

While anyone can develop glaucoma (children are sometimes even born with it) there are risk factors that increase the chances of developing the disease. These include:

• Age over 60 (over 40 for African Americans)
• Family history of the disease
• High eye or blood pressure
• African American, Japanese, or Hispanic descent
• Previous eye injury or surgery
• Diabetes
• History of corticosteroid treatment
• Severe myopia (nearsightedness) or hyperopia (farsightedness)

Known measures to help prevent glaucoma or reduce the risks include maintaining a healthy diet and weight, regular exercise, refraining from smoking and protecting your eyes from UV exposure. Controlling blood pressure is also beneficial.

Types of Glaucoma

There are two main types of glaucoma, open-angle and angle-closure, with open-angle being the most common and accounting for approximately 70-90% of cases. Open-angle refers to chronic cases of the disease that progress slowly over time, and are usually caused by high intraocular pressure. Angle-closure glaucoma can be chronic or acute and is often caused by an inherited condition or the result of an injury to the eye.

While each of these types of glaucoma has subtypes the major differences between them have to do with the way the disease affects the eye and the symptoms. While open-angle often has no early symptoms yet may eventually cause loss of peripheral vision, angle-closure glaucoma is often characterized by more obvious signs such as blurred vision, pain, headaches, tunnel vision, halos that appear around lights and even nausea and dizziness. These symptoms can be a medical emergency and must be treated immediately.

Detecting Glaucoma

Since there are often no symptoms as glaucoma develops, regular glaucoma screenings are key to early diagnosis and treatment. Such screenings should include an exam of the optic nerve, measuring the inner eye pressure and visual field screenings. Some cases of glaucoma occur with normal or even low eye pressure (low tension glaucoma) and therefore people should not rely on any vision screenings where all they do is an “airpuff” test.

Newer technologies such as OCT, can painlessly scan the optic nerve and determine if there is glaucomatous damage even earlier than visual field tests or other exams might show.

Treatment for Glaucoma

While vision that is lost from glaucoma’s damage to the optic nerve can’t be restored, the eye can be repaired (and intraocular pressure returned to normal) to prevent further damage and loss. Treatments include eye drops and surgery, depending on the type of glaucoma, the cause and the severity of the disease.

If you have been diagnosed with glaucoma and prescribed eye drops, it is important to keep using the eye drops as directed even if the drops irritate your eyes or you do not notice improvement in vision. The eye drops prevent eye pressure spikes that can damage the optic nerve. Since the vision loss from glaucoma is not reversible, if you have concerns with the eye drops, ask your eye doctor to try out a different brand instead.

Childhood eye injuries, such as a ball hit or puncture, particularly one which altered the internal structures of the eye or allowed fluid to flow out of the eye can cause problems later in life. Glaucoma that results from such long-forgotten injuries may not be detected until years after the injury, so it is important to have routine eye checkups if you have ever sustained an eye injury.

The best way to protect your eyes and vision from this devastating disease, especially if you have heightened risk factors, is to ensure you have regular comprehensive eye exams to look for signs of glaucoma inside the eye. Since symptoms often don’t appear until damage is done, the best course of action is preventative.

If you have any of the risk factors listed above, when you come in for your yearly comprehensive eye exam, speak to your eye doctor about glaucoma and what you can do to prevent it.

Red, itchy, watery eyes and swollen eyelids (along with sneezing, congestion or a runny nose)… these symptoms are a clear indication that allergy season has arrived. These allergic symptoms are caused by a reaction to allergens, which are substances in the environment that are usually harmless. If, however, you are one of the unlucky that is predisposed to allergies, these substances can illicit a serious and sometimes even debilitating allergic response. 

As opposed to food, medicine, or insect allergies which don’t often affect the eyes, eye allergies are a common symptom of airborne allergens including mold, pollen (from trees and flowers), dust and pet dander. The summer fall and spring are often the worst times for a high pollen count and many individuals suffer during these seasons. 

An allergic eye reaction occurs when your eye releases histamines in an effort to protect itself from a perceived threat (an allergen such as dust, pollen, animal dander, mold spores, eye drops or airborne chemicals). The release of the histamines causes the symptoms of redness, itchiness, burning and tearing. This response is also sometimes known as allergic conjunctivitis. 

The most common type of eye allergies are perennial and seasonal allergic conjunctivitis. Perennial eye allergies are a response to household allergens that exist all year round such as pet dander, mold, or dust mites. Seasonal allergies usually result from pollen from plants, grass and trees that are found in the air and depend on the season and the types of pollens in the environment.  Seasonal allergic conjunctivitis is often more severe than perennial and can cause puffy eyelids and itching which can make symptoms worse. 

The best way to reduce discomfort and prevent an allergic reaction is to stay away from allergens as much as possible. Here are some tips on how to reduce exposure:

• Minimize outdoor exposure during pollen season: 
• Stay inside when pollen counts are particularly high or during a windy day.
• Keep windows closed and use air conditioner with a clean filter.
• Wear sunglasses outside to keep irritants from entering the eyes. 
• Reduce indoor allergens:
• Wash bedding frequently in hot water and use mite-proof covers on pillows, blankets and mattresses. 
• Prevent household mold by reducing humidity and keeping areas that are subject to humidity or dampness (such as bathrooms, kitchens or basements) clean. Use a dehumidifier when necessary and clean any mold you see with bleach. 
• To reduce dust, clean floors and surfaces with a damp rag or mop rather than sweeping or dry dusting. 
• Wash your hands and clothes after coming into contact with animals.
• DO NOT rub your eyes as this can worsen symptoms, greatly aggravating swelling and itchiness, and can sometimes even cause an infection. 

If you have severe allergies, avoid contact lens wear or reduce wear time when allergies flare up, as contact lenses can worsen symptoms and do not fit as they normally would when the eyes are swollen. This is why having back up glasses is so important. Changing to one day single use disposable contacts can also sometimes reduce allergy symptoms.   

There are some steps you can take to alleviate symptoms of eye allergies. Over-the-counter solutions include artificial tears, decongestant eye drops (which shouldn’t be used for longer than a week) or oral antihistamines (which can sometimes worsen symptoms). If no eye drops are available, cool compresses (avoid heat) will also help to reduce the itch.  If these treatments don’t work, you can get a prescription for stronger eye drops (antihistamine or short term steroid drops to reduce symptoms), oral antihistamines or possibly immunotherapy (such as allergy shots).

If you are experiencing symptoms of allergic conjunctivitis, don’t just assume they are allergies. See your eye doctor to determine the cause to ensure that it is not a more serious eye condition. 

Most people wouldn’t consider contact lenses dangerous. In fact, they are a great alternative to glasses, offering convenience and great vision for those who wear them. However, when not obtained and used according to an eye doctor’s instructions, the consequences can be devastating.  

Contact Lenses Need to Fit

Like shoes, one size of contact lens does not fit all. Even daily disposable contact lenses need a proper lens fitting, as lens materials and curvatures vary from one brand to the next. Often patients that complain of contact lenses that feel dry within a couple hours of applying them are actually wearing contact lenses that are not an ideal fit. Many factors can affect a lens fit, including growth, allergies, medications, hormone changes, and others.   Sensitivities to eye drops and cleaning solutions may also affect comfortable contact lens wear.  

The Dangers of Contact Lens Use

We all know how uncomfortable it is when there is a foreign object in our eye. The tearing and watering that occurs as the eye’s natural attempt to remove foreign matter displays the eye’s sensitivity compared to other parts of the body.  Any time a foreign object comes into contact with the eye (even your finger), there is a risk to the eye – and that risk includes contact lenses.  Improper hygiene and useage of contact lenses can scratch the surface or bring bacteria into the eye which can lead to serious infections and permanent damage to the eye and vision.

According to a recent report from the Centers for Disease Control and Prevention, almost 20% of patients that reported infections of the cornea related to contact lenses had a corneal scar, a decrease in visual acuity or needed a corneal transplant as a result of the infection.  Further, 25% of infections involved poor contact lens hygiene, which means they likely could have been prevented.

Dangerous Behaviors that Put Contact Lens Users At Risk

Here are some of the most dangerous contact lens habits that should be avoided to eliminate your risk of eye damage or a potentially blinding eye infection.

• Failing to wash your hands with soap and dry them before applying or removing lenses.
• Rinsing contacts or your lens case with tap water, sterile water or other substances.
• Re-using solution or topping off the solution in your lens case rather than emptying it, cleaning it and refilling it.
• Failing to remove lenses before swimming or entering a hot tub.
• Leaving in contact lenses too long or sleeping in contacts that are not meant to sleep in.
• Failing to follow the wearing schedule prescribed by your eye doctor.
• Using the same lens case for too long (it should be cleaned regularly and replaced around every three months).
• Wearing lenses that are not obtained with a prescription through an eye doctor or legally authorized contact lens distributor.
• Ironically, as you can see, water is one of the biggest dangers for contact lens wearers at it can harbor dangerous bacteria under the lens or in a contaminated lens case.  These dangers can be easily avoided by following your eye doctor’s instructions in handling and wearing your contact lenses.

Cosmetic/Decorative Contact Lenses

With Halloween on the way it’s important to stress that you should ONLY purchase contact lenses from an eye doctor or legally authorized contact lens seller with a prescription. Even if you are purchasing  purely decorative contact lenses with no vision correction, you need a doctor to measure your eye to ensure they fit properly.  Contact lenses are a medical device and it is illegal to sell them without proper authorization. Therefore you should never purchase them from a costume or party store – they are unregulated and could cause serious harm to your eyes and vision.

If you notice any unusual redness, discharge, crusting, light sensitivity or pain, immediately remove your contact lenses and go see your eye doctor as soon as possible. Some serious eye infections can cause permanent vision damage or loss even within a day or two.

While you should not approach contact lens use as a dangerous activity, it is important to understand the importance of proper hygiene and use.  As long as you obtain contact lenses safely and follow the instructions of your eye doctor, contact lenses are a safe, convenient and effective option for vision correction.

90%! That’s the number of sports eye injuries that studies show can be prevented using proper eye protection.  Yet most sports leagues don’t require protective eyewear as part of their uniform or safety requirements.  This leaves it up to athletes, parents and coaches to ensure that proper measures are taken to keep eyes safe during athletic play.

Protective sports eyewear can come in a number of forms depending on the sport, and includes sports glasses or goggles, eye shields and eye guards.  Regular prescription eyeglasses or sunglasses do not protect the eyes and can sometimes cause greater injury if impact is made and lenses or frames are shattered or broken. If you do wear prescription eyewear, there are a number of options including wearing contact lenses with safety eyewear, purchasing prescription safety eyewear or wearing safety goggles over your regular prescription glasses.   

What Makes Safety Eyewear Safer?

Protective eyewear is made of impact resistant lenses from materials such as polycarbonate or trivex, which are much stronger than other types of plastic used to make typical eyewear lenses.  Polycarbonate has a long history of safety eyewear use in adults and children and Trivex is a newer optical material that is lighter than polycarbonate and offers better optical quality.  Both materials have built in ultraviolet protection to protect your eyes from damage from the sun.

Sports frames are also made from strong, impact-resistant materials such as strong plastics or polycarbonates.  They tend to cover larger areas than traditional glasses to protect more of the area around the eye and block dust, sunlight and other elements from entering from the sides or top of the frame. Sports glasses and goggles usually incorporate impact resistant padding to create a cushion between the frame and the face or nose for increased comfort, impact absorption and to prevent slipping.

Some goggles do not fit well under helmets, such as those used in football and lacrosse, so it is wise for athletes to bring in their helmets when shopping for sports eyewear to ensure they fit under the helmet properly.

Although athletes often shy away from wearing sports eyewear due to concerns of reduced performance, in reality they often can improve performance with new innovations in sportswear that offer improved peripheral vision.

Common Sports Eye Injuries

Eye injuries commonly occur in baseball, basketball, racquetball, tennis, badminton, and other sports.  Here are some of the common types of injuries.

• Scratched eye or corneal abrasion – This is when damage occurs to the external surface of the eye and commonly occur from being poked, scratched or rubbed when there is a foreign body present on the surface such as sand or dust.  Corneal abrasions can be very painful, cause redness and sensitivity, particularly to light. Scratched eyes should be treated immediately by a doctor because bacteria can enter through the eye causing serious infections, that can even lead to blindness.
• Blunt trauma/swelling – is when an object, such as a ball or an elbow impact the eye causing swelling or bleeding such as a black eye (in which the eyelids bruise and swell) or a subconjunctival hemorrhage (bleeding from a blood vessel between the white of the eye and the clear conjunctiva). Black eyes may not appear serious but they should be checked out by a doctor to make sure there is no internal damage.
• Traumatic iritis – an inflammation that occurs following an eye injury such as a blunt trauma that affects the color part of the eye that surrounds the pupil. The inflammation should be treated to ensure there is no permanent vision loss.  
• Penetrating injury – injuries that occur when a foreign object enters the eye, causing the eye to rupture, can cause severe damage, swelling and bleeding.  These should be considered a medical emergency and treated immediately.

As you can see, most of these injuries can be prevented simply by wearing proper protection over the eye.  Your vision is essential for playing the sports you love, so don’t put it as risk by failing to protect your eyes properly. With the increasing selection of frames and lenses for safety and sports eyewear at affordable pricing, an active lifestyle can also be safe.