Common Vision Problems

All content is provided for education and information,  and is no substitute for the advice of your optometrist. All content provided by CNIB, please visit their website for further information.

AMD is a progressive eye disease that affects central vision. People who have AMD may no longer be able to read, drive or see the faces of their family members. For many people, the personal, social and economic costs of AMD can be extremely challenging. And with an aging population, the number of people with the disease is expected to double in the next 25 years.

Without treatment, AMD can advance to uncorrectable vision loss. But with proper management, regular eye exams and help from the members of your health care team, you can slow down or even stop the progression of vision loss, and learn some helpful tips that will help you fully participate in life, despite vision loss.

Diagnostic tests for AMD include:

– visual acuity tests
– dialted eye exams
– fluorescein angiograms
– optical coherence tomography (OCT)

Glaucoma is the second most common cause of vision loss in seniors in Canada. More than 250,000 Canadians have chronic open-angle glaucoma, the most common form of the disease.

Glaucoma involves damage to the optic nerve most often caused by high pressure inside the eye due to a build up of excess fluid. High eye pressure is not always a sign that you have glaucoma but may be an indication you are at risk of developing it.

Over time the disease develops into a loss of peripheral (side) vision. If glaucoma is untreated it could advance to later stages where central vision narrows to “tunnel” vision, or it may result in complete loss of vision. Early detection and treatment is essential to prevent severe vision loss or blindness.

Risk Factors

Elevated pressure in the eye
Family history
Age – after age 40 and after age 60
Ethnicity
Myopia
Diabetes

Eye floaters are those tiny spots, specks, flecks and “cobwebs” that drift aimlessly around in your field of vision. While annoying, ordinary eye floaters and spots are very common and usually aren’t cause for alarm.

Floaters and spots typically appear when tiny pieces of the eye’s gel-like vitreous break loose within the inner back portion of the eye.

detach_diagram-1

Retinal detachment is a serious problem that usually affects middle-aged or older people. If it isn’t treated immediately, it will lead to vision problems or even vision loss.

In most cases the retina detaches because of small tears or holes. These may occur as the retina thins with age. More often, they happen because the vitreous partially separates from the retina. The vitreous is firmly attached to the retina in a few places, and as we get older it separates and may tear the retina at those areas of attachment. In about half of the population, the vitreous has separated from the retina by age 50.

Nearsightedness, infection or injury such as a hard solid blow to the eye, can also make the vitreous separate. It is more common in people with a family history of retinal detachment. When there is a hole in the retina, fluid from the vitreous space may pass through the hole and flow between the retina and the back wall of the eye. This can separate the retina from the back of the eye and cause it to detach. The detached part of the retina will not work properly, and you will see a blurry or blind spot in your field of vision.

Less commonly, retinal detachment can also be caused by eye diseases, complications of diabetes, or tumours. In these cases there may be no tears or holes in the retina.

How is Retinal Detachment Diagnosed?

You may notice that spots or flashes of light have suddenly appeared in your vision. This can mean the vitreous is separating and possibly tearing the retina. Your vision may seem wavy or watery, or you may have a shadow in your side (peripheral) vision.

As the retina detaches further, central vision gets blurry. This can lead to serious vision loss unless it is fixed. Sometimes retinal detachment happens suddenly, leading to blindness in one eye. You may also quickly lose sight if your retina is torn and bleeding into the vitreous.

A detached retina is painless and cannot be seen from the outside of the eye. If you notice symptoms, you should your optometrist right away. If you are very nearsighted or have a family history of retinal detachment, you should have regular eye exams to detect changes and prevent retinal detachment.

More than 2.5 million Canadians have cataracts. They are painless, develop within the existing lenses in your eyes, and are usually detected during routine eye exams.

As you age, your lenses naturally harden and may also turn cloudy. A cloudy lens blocks light from reaching the retina and interferes with vision – the effect is similar to looking through a dirty car windshield. Cataracts may form in one or both eyes, at the same time or at different times.

Fortunately, cataracts can be removed and your vision can be restored. Surgery is usually recommended once a person feels their vision interferes with daily activities such as driving, reading or watching TV.

Cataract surgery is among the most highly perfected, safe and successful procedures in medicine – more than 95 per cent of patients have improved vision after surgery. It removes the cloudy lens and replaces it with an artificial one.

Symptoms :

Sensitivity to bright light or experiencing glares and haloes around lights
Difficulty seeing details and poor central vision
An inability to distinguish colours
Difficulty seeing at night
Double vision
Risk Factors:
Age
Family History
Other health problems – complications such as diabetes
Smoking
Drinking alcohol
Excessive sun exposure
Medications
Eye injury (puncture, cut, intense heat or chemical burn to the eye)

What is Dry Eye?

Simply put, dry eye is the result of not being able to produce enough tears to keep the eye comfortable. Without a film of tears, spread over the eye by a blink, good vision is not possible.

The symptoms include stinging or burning eyes, scratchiness, stringy mucus around the eyes, irritation from smoke or wind, excess tearing or difficulty wearing contact lenses

A sty is a red, tender swelling near the edge of your eyelid. You can treat a sty by applying a clean, warm compress to your closed eye several times a day (use a small towel or face cloth dipped in clean hot water and wring it out, then apply it to your eye for about ten minutes). If your sty doesn’t go away in a few days, see your doctor, who will prescribe a topical antibiotic.

What is Retinitis Pigmentosa?

Retinitis pigmentosa (RP) refers to a group of diseases which tend to run in families and cause slow, but progressive loss of vision. The retina is the tissue which lines the inside of the eye and sends visual images to the brain. In RP, there is gradual destruction of some of the light sensing cells in the retina.

Diabetes occurs when the body can’t produce or properly use a hormone called insulin, which results in high levels of blood sugar (glucose) in the body, and can damage organs, blood vessels and nerves.

In type 1 diabetes, the body produces little or no insulin, and the condition can be controlled by insulin injections. Type 2 diabetes occurs when the body produces inadequate amounts of insulin or cannot respond appropriately to it. Type 2 diabetes may be controlled by diet, medication and sometimes exercise.

Diabetes can affect many parts of the body, and people with diabetes are at a high risk of developing vision problems, usually from a condition called diabetic retinopathy. It’s estimated that half a million Canadians have diabetic retinopathy.

Without treatment, the condition can lead to uncorrectable vision loss or even blindness, usually in both eyes. In fact, diabetes is the leading cause of blindness in Canadians under 50. But with regular comprehensive eye exams by an eye doctor, diabetic retinopathy can be detected and treated, often prolonging the ability to see and preventing further damage.

Vision Conditions

All content is provided for education and information, and is no substitute for the advice of your optometrist.

What is Amblyopia?

Amblyopia (‘lazy eye’) happens when the vision in one eye doesn’t develop properly in early childhood. You may not be able to notice it easily in your child, but if it isn’t treated it will become a permanent visual problem.

What Causes Amblyopia?

Babies are able to see when they are born, but they have to learn how to use their eyes. They have to learn how to focus, and then how to use both eyes together. Our vision continues to develop until we are about 9 to 12 years old. After that, our eyesight is complete and can’t be easily changed.

However, sometimes the vision in one eye doesn’t develop properly. This may be caused by misaligned eyes (called strabismus) or because one eye is out of focus compared with the other. When this happens, the brain ‘shuts off’ the eye that is out of focus, and the child depends only on the better eye to see.

An eye disease such as a cataract or anything else that stops a clear image from being focused inside the eye can cause amblyopia in children. They may also inherit conditions from their parents that lead to amblyopia.

How Is Amblyopia Diagnosed?

You may not be able to tell that your child has amblyopia. Many children with the condition look completely normal and see well with their good eye. If your child has an eye that turns in, out, or up, or if he or she closes one eye (especially in bright sunlight), these are warning signs.

What is Astigmatism?

In normal, undistorted vision, the cornea (the clear window in front of the eye) is smooth and equally curved in all directions. With astigmatism, the cornea is “warped”, meaning it curves more in one direction than the other distorting or blurring vision for objects at any distance.

Large amounts of astigmatism are usually inherited, present at birth and frequently remain unchanged throughout life. Small amounts of astigmatism can be acquired any time in life and are, in fact, very common. It often does not require correction.

Treatment

Correction is not difficult if the distortion proceeds across the cornea in a regular direction. Prescription glasses can often be ordered that neutralize or off set the distortion to the cornea.

What is Hyperopia?

Hyperopia, or far-sightedness, is the ability to clearly see objects at a distance but not those up close.

For proper eyesight, the cornea (the clear window in front of the eye) and the lens (behind the pupil) must properly focus or “refract” light onto the retina (at the back of the eye). If the length or shape of the eye is not ideal, the light may get focused too early or too late leaving a blurred image on the retina.

Keratoconus is a progressive disease affecting the front window of the eye and the cornea, and it results in poor vision that cannot be corrected fully with glasses. Keratoconus usually begins in the late teenage years. However, it can start in the 20s or early 30s. Keratoconus causes the cornea at the front of the eye to become thin and bow outwards. It is this irregular distortion of the cornea that makes vision correction with glasses less than optimal.

Myopia, or near-sightedness, is the ability to clearly see objects up close but not those at a distance.

For proper eyesight, the cornea (the clear window in front of the eye) and the lens (behind the pupil) must properly focus or “refract” light onto the retina (at the back of the eye). If the length or shape of the eye is not ideal, the light may get focused too early or too late leaving a blurred image on the retina.

As people age, they often begin to have difficulty focusing their eyes for reading or close work. This is called presbyopia and is the normal aging of the eyes. It usually affects people over the age of forty as the eye starts to lose some of its flexibility.

Treatment

This condition is easily corrected with eye glasses of increasing strength as a person ages. Bifocal of trifocal lenses may be prescribed to some people with presbyopia who also have other refractive problems such as myopia (near-sightedness), hyperopia (far-sightedness) or astigmatism (distorted vision due to a irregularly shaped cornea).

What is Strabismus?​​

Strabismus is the medical term for misalignment of the eyes two eyes that are not straight. It occurs in at least 5% of the population. There are three common types:

Esotropia, or ‘crossed eye
One eye is turned inward, toward the nose. A child may be born with this condition, or it may develop a few months after birth or around age two to three.

Exotropia, often called ‘wall-eye’ in the past
One eye is turned outward, away from the nose. A child is rarely born with this condition. More often, it develops later.

Vertical strabismus
The eyes are out of alignment vertically.

Strabismus can cause a couple of different vision problems:

Defective binocular vision: The eyes need to be straight for the brain to combine the images seen by the two eyes into a single picture. This gives us 3-D vision, which allows us to judge depth. Any turn of the eye can interrupt 3-D vision. As well, if an eye turns in, it can reduce the total field of vision.
Vision loss in the turned eye: When a child’s eye is turned, he or she may end up with only partial sight in the turned eye. This condition is called amblyopia, or ‘lazy eye.’ This can also happen if the eyes are unequally focused.
What Causes Strabismus?

Strabismus can run in families. Sometimes the condition is due to the eyes being out of focus; in this case, eyeglasses are part of the treatment. Sometimes there is a problem with the eye muscles or nerves. Strabismus can also be caused by a serious problem inside the eye, such as a tumour or a cataract, which leads to poor vision.

How is Strabismus Diagnosed?

A child can be checked at any age to see whether his or her eyes are properly aligned. If you are not sure whether your child’s eyes are straight, ask your family doctor or a qualified eye care professional, who may refer you to an ophthalmologist.

Vision Screening in Children

All newborns should have their eyes checked in the hospital for visual problems, such as cataracts or lack of visual response. All children should have their vision checked by age three and a half to four and a half to detect common treatable problems such as strabismus, amblyopia or the need for glasses.

Is My Child Especially At Risk?

If any member of your immediate family has had strabismus or amblyopia, it is more likely that your child will have it. In this case, even if your child’s eyes seem straight, he or she should be examined by a qualified eye care professional by age one and again by age three. Premature birth, neurological diseases, and a family history of severe eye diseases are also reasons to have your child’s eyes examined early.

How is Strabismus Treated?

The goal of treatment is for your child to have good vision in each eye, as well as good binocular (3-D) vision. If your child’s strabismus has caused amblyopia, treatment will aim at bringing the vision up to normal in the ‘lazy’ eye first. Glasses may help for eyes that are out of focus, especially when one is much worse than the other. They may also help straighten the eyes. Surgery on the eye muscles may be necessary, especially when glasses are not enough to straighten the eyes.

The results of treatment can be excellent. How much your child’s vision improves depends on how early in life and how quickly treatment was started. This is especially true for amblyopia and for strabismus that develops in a child who was born with straight eyes. If treatment is delayed too long, it may not be possible to completely restore your child’s vision. This kind of vision problem can be effectively prevented, so it is important to seek professional advice as soon as possible.

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