Common Vision Disorders

Visual and Eye Conditions

 

There are a host of visual and eye conditions that may occur at any time during our lives. As you age, your best natural defenses against vision loss are a healthy diet and wise lifestyle choices.

 

Nonetheless, vision problems, eye diseases and various age-related eye conditions can and do occur. A highly trained team of ophthalmologists, optometrists, opticians and eye technicians is your best vision loss prevention strategy to diagnose and treat eye disease early in order to prevent or slow its progression.

 

Half the U.S. population has congenital eye defects known as refractive errors ranging from nearsightedness to farsightedness and astigmatism, and all of us will develop presbyopia (loss of near vision) as we age into our 40’s and 50’s. Your Virginia Beach Eye Center ophthalmologist will screen your eyes for these and many other eye diseases during your annual eye exam. For more information or to schedule an appointment, contact us.
Normal Eye
In the normal eye without refractive errors (a condition called emmetropia), light from a distant object is focused by the cornea (front part of eye where a contact lens sits) and the lens (just behind the pupil and iris-“colored” part of eye) into a sharp image on the middle (macula) of the retina. The retina responds to light like the film in a camera or the light sensing (CCD) portion of a digital camera, to change the light energy into a neural impulse which is sent to the brain through the optic nerve to be processed into our perception of vision.

 

When the light is not focused onto the retina properly because of abnormalities in the shape or size of the eye, we call these disorders ametropias or simply refractive errors.
Nearsightedness (Myopia)

 

In a nearsighted person, the eye is either slightly longer than usual from front to back, or the cornea is too steeply curved, causing light rays to focus in front of the retina rather than directly on its surface. The eye literally has too much power. This results in clear near vision and blurry distance vision. Nearsightedness affects about a third of the population and is more prevalent now than even 30 years ago. It tends to run in families and is usually diagnosed when you are young. Rarely, nearsightedness may progress throughout life, a condition known as pathologic myopia.

 

If your glasses or contact lens prescription begins with a minus(–) sign, you have myopia. For most people, nearsightedness stabilizes in the late teens or early twenties. Early in life, myopic vision may be corrected with glasses or contact lenses. Once the eye stabilizes, refractive surgery vision correction procedures can change the shape of the cornea to reduce or eliminate the need for glasses or contacts.

 

If you are considering refractive surgery to correct your myopia, the doctors at Virginia Beach Eye Center may recommend one of the following procedures, depending on your particular eye condition:

 

Refractive eye surgery to correct nearsightedness is one of the most highly successful procedures in all of medicine, with very low risk and excellent patient satisfaction rates. Most patients are able to reduce or eliminate their dependence on glasses or contact lenses.

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Farsightedness (Hyperopia)
The eye of a farsighted person is either shorter than normal or the cornea is too flat in relationship to the length of the eye. This causes light to attempt to focus behind the retina (it really can’t focus there, because the back of the eye is in the way—but that’s where it would focus). The eye does not have enough power to focus the light on the retina. The visual disturbance in farsightedness is very dependent on the amount and the age of the patient. This is because the human lens has a great ability to focus (increase in power) early in life, but loses this ability throughout life. At a young age and mild hyperopia, there is usually no need for correction since the lens can focus enough to compensate. However with age and higher amounts of hyperopia, the patient first starts losing the ability to see up close, but eventually also notices decrease in distance vision requiring vision correction with glasses, contact lenses or refractive surgery at all distances.   Hyperopia affects about a quarter of the population. Almost all children are born with hyperopia and many “outgrow” it as their eyeball lengthens with normal growth. If your glasses or contact lens prescription begins with plus (+) sign, you are farsighted. Early-on, hyperopia is treated with contacts or glasses. As vision stabilizes in your early 20’s, refractive surgical vision correction procedures usually result in excellent vision reducing or eliminating the need for glasses or contact lenses.   Your doctor at Virginia Beach Eye Center will determine which of several options in refractive surgery is best for you after a comprehensive eye exam.

 

The likely procedures for hyperopia include:

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Astigmatism
Astigmatism means “lack of point focus” and, in the eye, it occurs when the cornea is asymmetrical, shaped more like a football instead of a basketball. With astigmatism, light rays are focused at two points, rather than one, resulting in blurry vision, eyestrain, shadows on letters (“ghost image”), squinting and double vision.   Astigmatism is hereditary, a result of your genetic make-up, and occurs as your eye forms and grows to it’s final adult shape. Astigmatism may accompany farsightedness or nearsightedness, or occur by itself (so called “mixed” astigmatism).   It can be corrected with glasses or contacts. For those patients choosing refractive surgery, it is usually corrected at the same time as the NuSite™, Z-LASIK  , Visian ICL or Refractive Lens Exchange (RLE)  procedures. With cataract surgery and significant astigmatism, most patients are offered either Limbal Relaxing Incisions (LRI) or in some cases an astigmatism correcting intraocular lens implant (Toric IOL).   Your doctor at Virginia Beach Eye Center will recommend the procedure that is appropriate for the best outcome for your eyes.

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Presbyopia
Presbyopia literally means “old vision” and is a natural aging process of the human crystalline lens. When a person is young, the lens is very soft and flexible so it can change shape. It is also relatively thin, allowing it to move back and forth in the eye in response to the contraction of a ring shaped muscle behind the outside part of the iris called the ciliary muscle. When this muscle contracts in response to viewing a near object (such as reading), the lens changes shape and moves forward slightly, increasing it’s focusing power allowing the light from the object to focus clearly on the retina. This process of focusing on near objects is also called “accommodation”.

 

Everyone in the world loses their focusing ability gradually over time, it is a continuous process throughout life.   For most people, presbyopia becomes manifest somewhere around age 40, when you notice that you can’t see as well at near, your “arms are too short”, or in the case of nearsighted patients, you have to take off your glasses or take out your contacts to read. Patients who see well at distance without glasses often can just buy “over-the-counter” readers (aka “cheaters”).

 

Patients who are already in glasses for distance, often switch to bifocals or progressive addition lenses (Varilux / PAL’s / “lineless” bifocals). Some nearsighted patients with good comfortable reading vision without glasses, will simply remove their glasses to read and just wear them for distance. Patients who wear contact lenses will often try either monovision (one contact for distance, one for near) and, if they can’t tolerate that effect, will try multifocal contact lenses.   Some patients over 40 who opt for refractive surgery will want good uncorrected vision both for distance and up close. For them, their are two choices. Monovision with NuSite™,  Z-LASIK or Refractive Lens Exchange (RLE), or Refractive Lens Exchange with the Crystalens AO™ accommodating lens implant, or Tecnis™ multifocal lens implant.  Cataract surgery patients who wish to be glasses free for distance and near can also opt for monovision, Crystalens AO™ or the Tecnis™ multifocal intraocular lens implant. View Video