EYESIGHT PROBLEM
More than 4.2 million Americans aged 40 years and older are either legally blind (having best-corrected visual acuity of 6/60 or worse (=20/200) in the better-seeing eye) or are with low vision (having best-corrected visual acuity less than 6/12 (<20/40) in the better-seeing eye, excluding those who were categorized as being blind).
The leading causes of blindness and low vision in the United States are primarily age-related eye diseases such as age-related macular degeneration, cataract, diabetic retinopathy, and glaucoma.
Other common eye disorders include amblyopia and strabismus.
A. Active Errors
Refractive errors are the most frequent eye problems in the United States. Refractive errors include myopia (near-sightedness), hyperopia (farsightedness), astigmatism (distorted vision at all distances), and presbyopia that occurs between age 40–50 years (loss of the ability to focus up close, inability to read letters of the phone book, need to hold newspaper farther away to see clearly) can be corrected by eyeglasses, contact lenses, or in some cases surgery. The National Eye Institute states that proper refractive correction could improve vision among 150 million Americans.
B. Age-Related Macular Degeneration
Macular degeneration, often called age-related macular degeneration (AMD), is an eye disorder associated with aging and results in damaging sharp and central vision. Central vision is needed for seeing objects clearly and for common daily tasks such as reading and driving. AMD affects the macula, the central part of the retina that allows the eye to see fine details. There are two forms of AMD—wet and dry.
Wet AMD is when abnormal blood vessels behind the retina start to grow under the macula, ultimately leading to blood and fluid leakage. Bleeding, leaking, and scarring from these blood vessels cause damage and lead to rapid central vision loss. An early symptom of wet AMD is that straight lines appear wavy.
C. Diabetic Retinopathy
Diabetic retinopathy (DR) is a common complication of diabetes. It is the leading cause of blindness in American adults. It is characterized by progressive damage to the blood vessels of the retina, the light-sensitive tissue at the back of the eye that is necessary for good vision. DR progresses through four stages, mild nonproliferative retinopathy (microaneurysms), moderate nonproliferative retinopathy (blockage in some retinal vessels), severe nonproliferative retinopathy (more vessels are blocked leading to the deprived retina from blood supply leading to growing new blood vessels), and proliferative retinopathy (most advanced stage). Diabetic retinopathy usually affects both eyes.
D. Glaucoma
A glaucoma is a group of diseases that can damage the eye’s optic nerve and result in vision loss and blindness. Glaucoma occurs when the normal fluid pressure inside the eyes slowly rises. However, recent findings now show that glaucoma can occur with normal eye pressure. With early treatment, you can often protect your eyes against serious vision loss.
There are two major categories “open-angle” and “closed-angle” glaucoma. Open-angle is a chronic condition that progresses slowly over a long period of time without the person noticing vision loss until the disease is very advanced, that is why it is called “sneak thief of sight.” Angle-closure can appear suddenly and is painful. Visual loss can progress quickly; however, the pain and discomfort lead patients to seek medical attention before permanent damage occurs.
E. Amblyopia
Amblyopia, also referred to as “lazy eye,” is the most common cause of vision impairment in children. Amblyopia is the medical term used when the vision in one of the eyes is reduced because the eye and the brain are not working together properly. The eye itself looks normal, but it is not being used normally because the brain is favoring the other eye. Conditions leading to amblyopia include strabismus, an imbalance in the positioning of the two eyes; more nearsighted, farsighted, or astigmatic in one eye than the other eye, and rarely other eye conditions such as cataract.
Unless it is successfully treated in early childhood amblyopia usually persists into adulthood, and is the most common cause of permanent one-eye vision impairment among children and young and middle-aged adults. An estimated 2%–3% of the population suffer from amblyopia
F. Strabismus
Strabismus involves an imbalance in the positioning of the two eyes. Strabismus can cause the eyes to cross in (esotropia) or turn out (exotropia). Strabismus is caused by a lack of coordination between the eyes. As a result, the eyes look in different directions and do not focus simultaneously on a single point. In most cases of strabismus in children, the cause is unknown. In more than half of these cases, the problem is present at or shortly after birth (congenital strabismus). When the two eyes fail to focus on the same image, there is reduced or absent depth perception and the brain may learn to ignore the input from one eye, causing permanent vision loss in that eye (one type of amblyopia)
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DR JOSEPH
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