While a comprehensive eye examination by an eye care practitioner can determine for certain if you have a cataract forming, there are a number of signs and symptoms which may indicate a cataract. Among them are: blurred or hazy vision where colors may seem yellowed; the appearance of dark spots or shadows that seem to move when the eye moves; a tendency to become more nearsighted because of increasing density of the lens; double vision; a gradual loss of color vision; a stage where it is easier to see without glasses; the feeling of having a film over the eyes; and an increased sensitivity to glare especially at night.

Cataracts are most often found in persons over the age of 55, but they are also occasionally found in younger people, including newborns. A chemical change within the eye causes the lens to become cloudy. This change may be due to advancing age, heredity, an injury or disease. Excessive exposure to ultraviolet or infrared radiation present in sunlight or furnaces, cigarette smoking and/or the use of certain medications are also cataract risk factors. Cataracts usually develop in both eyes, sometimes at different rates. Currently, there is no proven method to prevent cataracts from forming.

Cataract surgery is considered when the individual can no longer function properly. This usually means difficulty with reading and driving. We are very fortunate that cataract surgery has been perfected over the years. Cataract surgery is performed as an outpatient procedure under local anesthesia.

Cataract surgery is a microsurgical procedure. The majority of surgeries are performed with phacoemulsification. This procedure removes the cataract by ultrasound. The cloudy lens (cataract) is then replaced by an artificial lens. A foldable intraocular lens is used the majority of the time. This allows the procedure to be performed through a very small incision. Usually, no stitch is required when surgery is complete. Most patients return to their normal activities the next day. Your individual physician will discuss further details with you. Rest assured that cataract surgery is a state-of-the art procedure performed by the doctors at Fox Cities Eye Clinic. If you are experiencing the symptoms described above please call our office to discuss your situation and schedule an appointment

DIABETES
Diabetes mellitus, a disease that prevents your body from making or using insulin to break down sugar in you bloodstream, can affect you eyes and your vision. Fluctuating or blurring of vision, occasional double vision, or floaters within the eyes may be symptoms related to diabetes. Diabetes can cause changes in nearsightedness and farsightedness and lead to premature presbyopia (the inability to focus on close objects). It can result in cataracts, glaucoma, a lack of eye-muscle coordination (strabismus) and decreased corneal sensitivity. The most serious eye problem associated with diabetes is diabetic retinopathy, which, if not controlled, can lead to blindness.

Diabetic retinopathy occurs when there is a weakening or swelling of the tiny blood vessels in the retina of your eye, resulting in blood leakage, the growth of new blood vessels and other changes. It is important to control your diabetes as much as possible to minimize the risk of developing retinopathy. Diabetes-related eye problems can be prevented by monitoring and maintaining your diabetes. Follow your physician’s instructions regarding diet, exercise and medication. See an ophthalmologist for a thorough eye examination when you are first diagnosed as a diabetic, at least annually, and more frequently as recommended.

In the early stages, diabetic retinopathy can be treated with laser therapy. A bright beam of light is focused on the retina, causing a burn which seals off leaking blood vessels. In other cases, surgery inside the eye may be necessary. Early detection of diabetic retinopathy is crucial.

In summary, diabetes mellitus is a leading cause of vision loss and blindness in the United States. However, with the use of lasers, vision loss can be prevented and, in some cases, reversed. The most important thing to realize about diabetic eye disease is that it is most treatable when detected early, before vision has been affected. Therefore, it is very important for all diabetics to have annual eye exams, even if they have good vision. Fox Cities Eye Clinic can provide these eye exams to prevent visual loss from diabetes.

GLAUCOMA
Glaucoma is a group of diseases that cause damage to the optic nerve, which can lead to permanent vision loss. Peripheral vision is typically lost first and can go unnoticed by a patient. In fact, most forms of glaucoma do not produce symptoms until severe vision loss has occurred. Once optic nerve damage and vision loss has developed, they are not reversible. That is why it is important to diagnose the disease early so it can be treated to prevent permanent vision loss.

There are many known risk factors for glaucoma, including aging, a family history of glaucoma, ethnicity, intraocular pressure, diabetes, and nearsightedness. Anyone who has these risk factors should have regular examinations by an ophthalmologist.

Of the risk factors for glaucoma, only one, intraocular pressure, is clinically treatable. What’s more, studies confirm that lowering intraocular pressure to a safe level can slow and even stop vision loss in glaucoma. There are a number of ways to lower intraocular pressure, including; administration of eye drops or pills to reduce the rate at which eye fluid is produced or to increase the outflow of fluid from the eye, laser treatment to open the drainage angle, and surgery to create a new passage for fluid drainage. Surgery is usually reserved for patients who have already tried eyedrops and laser treatments.

A comprehensive glaucoma evaluation can be performed at Fox Cities Eye Clinic by a fellowship trained glaucoma specialist. This would include four non-invasive, pain-free procedures; measurement of the intraocular pressure, assessment of the optic nerve; evaluation of the peripheral vision through visual field testing; and measurement of the thickness of the cornea (window to the eye). The appointment usually takes 1 1/2 - 2 hours.

Early detection and treatment of glaucoma can greatly reduce the chance of optic nerve damage and vision loss. This is why regular eye examinations are important.

MACULAR DEGENERATION
Macular degeneration is most often related to aging. There are some unusual types of macular degeneration which start very early in life, however most patients with macular degeneration begin to notice problems with eyesight sometime around the age 50. Macular degeneration tends to be hereditary and therefore may run in the family. When any family member is affected, special attention should be paid to the eye care of other blood relatives. Their eyes, especially the retinas, should be examined annually.

Macular degeneration usually starts with the appearance of spots in the retina. These spots are called drusen. Drusen are like age spots and do not usually change vision very much themselves. Most patients with drusen never have a serious loss of vision and only a few develop severe macular degeneration. When macular degeneration does lead to a loss of vision, that loss usually starts in just one eye and only later may affect the other eye. In some patients, it never affects the second eye. The patient may not even notice it because they can still see detail with the healthy eye. It is important to identify changes in eyesight as early as possible because the chance that treatment will help is greatest in the early stages. That is why everyone should test their eyesight in each eye, every day.

If macular degeneration has affected the vision of only one macula, you will still be able to see detail, (to read, drive, or thread a needle) with the other, healthy macula. It is only when the macular degeneration severely affects both eyes that it will become very difficult and perhaps even impossible to do the kind of work requiring close and focused eyesight.

But even if the ability to see detail has been lost from each eye, a person with macular degeneration rarely losses peripheral vision. So even a person who can no longer see detail with either eye will be able to get along fairly well. It is very rare for people with macular degeneration to loose both macular (detail) and peripheral (side) vision. Macular degeneration only very rarely causes total blindness. Almost all patients will see well enough to take care of themselves and continue those activities which do not require detailed vision.

Patients with macular degeneration in each eye usually learn to make use of the areas just outside the macula to see detail better. This ability to look slightly off center improves with time, although eyesight will never be as fine as it was before the macula was damaged. It is important that patients be aware of what they are seeing with each eye. If a patient can detect a problem with vision at the earliest possible moment, the chance of saving eyesight is greater. Once the macula has been severely damaged, treatment is no longer possible.

DRY or ATROPHIC MACULAR DEGENERATION
Drusen can lead to any one of three types of macular degeneration: the dry form, the wet form, or pigment epithelial detachment (PED). The dry form occurs in approximately 85 to 90% of patients with macular degeneration. The wet form, which can be more severe, occurs in only about 10% of patients. PED occurs in less than 5% of patients. In the dry form, the macula thins and stops working. This is referred to as atrophy or atrophic macular degeneration. Although there is no medical or surgical treatment for this form of macular degeneration, eyesight may be helped somewhat with the use of special low vision lenses: magnifying lenses for close-up and telescopic lenses for distance. With counseling, patients can learn to use some of their peripheral vision to help them see more clearly, and to cope more effectively with the practical tasks of every day life. Because the dry form of macular degeneration can change into the wet form, it is important for patients with the dry form to monitor their vision with Amsler paper and report any new changes to their eye doctor.

Although the dry form of macular degeneration can cause a large loss of detail vision, the damage done is generally not as great as the damage that can be caused by the wet form.

WET MACULAR DEGENERATION
(Subretinal Neovascularization – SRNV
In the wet type of macular degeneration, abnormal blood vessels grow under the retina and lift the retina up, very much like the roots of a tree growing under a sidewalk. These abnormal blood vessels are called subretinal neovascularization, or SRNV. The abnormal blood vessels (SRNV) located under the retina bleed, leak fluid, and lift up the retina. When this happens, vision is reduced.

An eye with the wet type of macular degeneration will loose its ability to see detail unless laser treatment is done promptly, even though this treatment does not guarantee that vision won’t be lost. It is clear that the longer the blood vessels continue to leak, bleed, and grow, the more detail vision will be lost. In addition, is subretinal neovascularization occurs in one eye, there is about a one in ten chance per year that is will occur in the other eye. The earlier that SRNV can be discovered, the more likely that vision can be saved.

PIGMENT EPITHELIAL DETACHMENT (PED)
The third form of macular degeneration is called pigment epithelial detachment (PED). In this form of macular degeneration a blister can form in the macula, causing blurring or distortion of vision. Laser treatment is not usually recommended unless the abnormal vessels (SRNV) are also present. If you have a PED, you will want to have your eyes examined regularly to see that the condition does not worsen.

FLASHES & FLOATERS
Everyone sees a few flashes of light, stars, or streaks that aren’t really there from time to time. Usually you see them in one eye at a time. Flashes are often caused by the vitreous (the gel filling the inside of your eye) pulling on the retina (the membrane that lines the inside of your eye). If you are nearsighted you are more likely to see flashes, and sometimes flashes are signs of other eye problems that need care.

Floaters look like dark specks, clouds, threads, or spider webs moving through your vision. Most people see them once in a while. Floaters may be pieces of gel or other material floating inside your eye and are usually harmless. The older you get, the more likely you’ll notice floaters. Floaters can also be caused by eye injury or surgery. If, however, floaters appear suddenly or greatly increase in number, they may be a sign of an eye problem that needs care.

Most often, seeing a few flashes and floaters is normal. Also, some people may notice them for a while after surgery. Most flashes and floaters require not treatment. However, sometimes they can be signs of a serious eye problem and you should consult with your eye doctor to find out if you should have an exam.