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Please select from the following ophthalmic conditions to better understand your diagnosis

Amblyopia - Lazy Eye

In some children, sight doesn't continue to develop properly in one eye even though that eye is structurally normal. The condition is called amblyopia (amblee-oh-pee-uh), or "lazy eye," because the eye seems to have lost the desire to see.

Amblyopia causes no discomfort, so the child will not be aware of the decreased vision since the other eye sees normally. Amblyopia is often discovered at a vision screening examination at the pediatrician's office or when the child starts school.

What Causes Lazy Eye?

Each eye sends a slightly different visual image to the brain. Normally, the images are similar enough to allow them to be combined into a single image by the brain. If the two images are too different from one another, the brain cannot combine them, and the result is double vision. Young children are able to avoid double vision by suppressing (actively ignoring) the image from one eye. Eventually, the eye that suppresses images loses its ability to see clearly.

Why Are There Two Different Images?

The most common conditions that can cause the eyes to send different visual images to the brain are strabismus (misaligned eyes: one eye looks straight ahead while the other turns in, out, up, or down) and anisometropia (ann-eye-so-mehtroh-pee-uh), which means that the two eyes have very different optical powers (for example, one may be normal and the other very farsighted or have extreme astigmatism).

Even if you can tell that your child has one of these conditions along with poor vision, you still have no way, on your own, of knowing whether one eye is lazy.

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Astigmatism

Astigmatism is an optical defect that interferes with the eye's ability to focus sharply, so it can result in unclear vision. It occurs because the shape of the cornea (the clear focusing surface that overlies the colored iris) is not perfectly round like a marble, but more oval like a spoon. Almost everyone is born with some astigmatism, though the amount may be so small that it isn't important.

Heredity is the most common cause of astigmatism. It does not come from reading or using your eyes "too much" or reading in dim light.

What It's Like to Have Astigmatism?

Astigmatic images are never sharp and crisp, either close up or in the distance. If you have a large amount of astigmatism, your vision may be very blurred. Straight lines running in one direction may be more blurred than lines running in another; for example, only the vertical edges of a window may appear out-of-focus. As you try to overcome the blur and see more clearly, you might get a headache from continually contracting the muscles around your eyes and furrowing your brows (actions that may be so automatic that you aren't aware of them).

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Cataract

What is a cataract?

A cataract is a clouding of the normally clear lens of the eye. It can be compared to a window that is frosted or "fogged" with steam.

There are many misconceptions about cataract. It is

  • Not a film over the eye
  • Not caused by overusing the eyes
  • Not a cancer
  • Not spread from one eye to the other
  • Not a cause of irreversible blindness

Common symptoms of cataract include

  • A painless blurring of vision
  • Glare, or light sensitivity
  • Frequent eyeglass prescription changes
  • Double vision in one eye
  • Needing brighter light to read
  • Poor night vision
  • Fading or yellowing of colors

The amount and pattern of cloudiness within the lens can vary. If the cloudiness is not near the center of the lens, you may not be aware that a cataract is present.

Normal sight

A cataract may cause hazy or blurred vision.

What causes cataract

The most common type of cataract is related to aging of the eye. Other causes of cataract include:

  • Family History
  • Glare, or light sensitivity
  • Medical problems, such as diabetes
  • Injury to the eye
  • Medications, such as steroids
  • Long-term, unprotected exposure to sunlight
  • Previous eye injury

How is cataract treated?

Surgery is the only way your ophthalmologist can remove the cataract. However, if symptoms from a cataract are mild, a change of glasses may be all that is needed for you to function more comfortably.

There are no medications, dietary supplements, exercises or optical devices that have been shown to prevent or cure cataracts.

Protection from excessive sunlight may help prevent or slow the progression of cataracts. Sunglasses that screen out ultraviolet (UV) light rays or regular eyeglasses with a clear, anti-UV coating offer this protection.

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Corneal Transplants

What conditions may require corneal transplants?

  • Corneal failure after other eye surgery, such as cataract surgery
  • Keratoconus, a steep curving of the cornea
  • Hereditary corneal failure, such as Fuchs' dystrophy
  • Scarring after infections, especially after herpes
  • Rejection after first corneal transplant
  • Scarring after injury

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Diabetic Retinopathy

Diabetes can affect sight

If you have diabetes mellitus, your body does not use and store sugar properly. Diabetes can cause high blood-sugar levels, excessive thirst and urination. It can also cause changes in the body's blood vessels, the veins and arteries that carry blood throughout your body.

Because diabetes affects your body in these ways, it can affect vision by causing cataracts, glaucoma and, most importantly, damage to blood vessels inside the eye.

What is diabetic retinopathy?

Diabetic retinopathy is a complication of diabetes that is caused by changes in the blood vessels of the eye. The retina is a nerve layer at the back of the eye that senses light and helps to send images to your brain.

When blood vessels in the retina are damaged, they may leak fluid or blood, and grow fragile, brush-like branches and scar tissue. This can blur or distort the images that the retina sends to the brain.

Diabetic retinopathy is the leading cause of new blindness among adults in the United States. People with untreated diabetes are said to be 25 times more at risk for blindness than the general population.

Diabetes damages blood vessels in the retina, and can cause then to leak or grow abnormally.

The longer a person has diabetes, the more the risk of developing diabetic retinopathy increases. About 80% of the people who have had diabetes for at least 15 years have some blood vessel damage to their retina. People with Type 1, or juvenile, diabetes are more likely to develop diabetic retinopathy at a younger age.

If you have diabetes, it's important to know that today, with improved methods of diagnosis and treatment, only a small percentage of people who develop retinopathy have serious vision problems.

Vision loss is largely preventable

  • Corneal failure after other eye surgery, such as cataract surgery
  • Keratoconus, a steep curving of the cornea
  • Hereditary corneal failure, such as Fuchs' dystrophy
  • Scarring after infections, especially after herpes
  • Rejection after first corneal transplant
  • Scarring after injury

If you have questions or would like further information, contact our office for an appointment with Dr. Lehr, Retinal Specialist.

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Hyperopia (Farsightedness)

A condition in which light rays are focused behind the retina resulting in blurry images at near. The laser concentrates on the central cornea to flatten it therefore placing light rays directly on the retina.

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Macular Degeneration

What is macular degeneration?

Macular degeneration is damage or breakdown of the macula of the eye. The macula is a small area in the back of the eye that allows us to see fine details clearly. When the macula doesn't function correctly, we experience blurriness or darkness in the center of our vision. Macular degeneration affects both distance and close vision, and can make some activities - like threading a needle or reading - impossible.

Although macular degeneration reduces vision in the central part of the retina, it does not affect the eye's side, or peripheral, vision. For example, you could see the outline of a clock but not be able to tell what time it is.

Macular degeneration alone does not result in total blindness. People continue to have some useful vision and are able to take care of themselves.

What causes macular degeneration?

Many older people develop macular degeneration as part of the body's natural aging process.

The two most common types of age-related macular degeneration are "dry" (atrophic ) and "wet" (exudative):

"Dry" macular degeneration (atrophic)
Most people have "dry" macular degeneration. It is caused by aging and thinning of the tissues of the macula. Vision loss is usually gradual.

"Wet" macular degeneration (exudative)
"Wet" macular degeneration accounts for about 10% of all cases. It results when abnormal blood vessels form at the back of the eye. These new blood vessels leak fluid or blood and blur central vision. Vision loss may be rapid and severe.

How is macular degeneration treated?

Despite ongoing medical research, there is no cure yet for "dry" macular degeneration. Some doctors believe that nutritional supplements may slow macular degeneration, although this has not yet been proven. Treatment of this condition focuses on helping a person find ways to cope with visual impairment.

In its early stages "wet" macular degeneration can be treated with laser surgery, a brief and usually painless outpatient procedure. Laser surgery uses a highly focused beam of light to seal the leaking blood vessels that damage the macula. Although a small, permanently dark "blind spot" is left at the point of laser contact, the procedure can preserve more sight overall.

Despite advanced medical treatment, people with macular degeneration still experience some vision loss.

Your ophthalmologist can prescribe optical devices or refer you to a low-vision specialist or center. A wide range of support services and rehabilitation programs are also available to help people with macular degeneration maintain a satisfying lifestyle.

Because side vision is usually not affected, a Person's remaining sight can be very useful. Often, people can continue with many of their favorite activities by using low-vision optical devices such as magnifying devices, closed-circuit television, large-print reading materials, and talking or computerized devices.

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Myopia (Nearsightedness)

A condition in which light rays are focused in front of the retina resulting in blurry images at distance. The laser concentrates on the peripheral cornea to help steepen the cornea therefore focusing incoming light directly on the retina.

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Presbyopia

Presbyopia (pres-bee-oh-pee-uh) is a loss in focusing ability that comes with getting older, and everyone must put up with it eventually. (The word is from the Greek and means "old sight.") Most people are between the ages of 40 and 50 when they first become aware that they are losing the ability to see objects or reading matter close to their eyes. The print in the telephone book becomes "too small" to read. They have to hold the newspaper farther from their eyes to see it clearly . At the same time, their focus for distant objects remains normal.

Presbyopia is certainly a nuisance, but it is not dangerous. It is a normal, inevitable part of reaching middle age, and it is no more abnormal than gray hair. Try to think of it as "growing up."

What Causes Presbyopia?

In young people, the lens within the eye is soft and flexible. Its shape can change readily-which changes its optical power-to enable the eye to accommodate (change focus) quickly and automatically between close-up and faraway objects. With increasing age, the lens gradually loses its flexibility, which results in a decreased ability to focus at close range. At the same time, there is a progressive decline in the strength of the focusing muscle within the eye, and this adds to the difficulty in seeing close-up objects clearly.

Optical Correction

Whenever the time comes that your eyes can no longer generate enough extra optical power to focus up close, you will need optical help. As focusing ability continues to decline, you will probably need to have the lenses changed every few years. Then, sometime between the ages of 65 and 70, just about all the near focusing power will be gone. From then on, your prescription for reading will stay pretty much the same.

People sometimes notice that their presbyopia gets "worse" after they start wearing reading glasses, and they believe that the glasses are responsible. The fact is, presbyopia will "worsen" whether you wear glasses or not, and putting off the use of corrective lenses will not slow down the presbyopia.

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Tecnis Lens

Over the years, as our vision declines, objects in lower light conditions, such as a gray truck in the fog or a small child in a light-colored jacket at dusk, become much more difficult to see. Cataracts make this problem even worse. Using innovative lens surface technology, the TECNIS™ intraocular lens (or IOL) gives you safer, sharper vision. This proven technology improves your functional vision in all light conditions. Whether climbing stairs, dining by candlelight or even driving at night, TECNIS™ is the first and only lens implant proven to increase functional vision and may help you drive more safely in low light situations. www.tecniiol.com

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Crystalens

The crystalens in the first intraocular lens, or IOL, for cataracts that also provides accommodation. How? All other IOL’s are fixed and stationary within the eye. Their particular design prevents them from accommodating, or moving to focus. The crystalens is unique because it actually accommodates to reconnect you continuously and effortlessly to everything in your day, no matter the distance. www.crystalens.com

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For additional information or if you don’t see your diagnosis, try www.webmd.com.