Cataract is clouding of clear natural lens present inside the eye, this is a major cause of decreased vision in elderly. Cataracts can occur in one or both eyes, usually developing very slowly. Things look blurry, hazy, less colourful and less sharp with cataract. 

Most cataracts are related to ageing, however many other factors can either increase the rate of formation or cause cataract formation. 

Causes of Cataract Formation-

Ageing: Most common cause. As the proteins present in the lens of the eye degenerates over the years ( just like any other organ) cataract is formed. If you are having Diabetes or hypertension, the rate of formation gets accelerated.

Radiation: Prolonged exposure to ultraviolet rays, especially UV-B rays, results in cataract in your eyes. Wearing sunglasses in the daytime helps in slowing down the process of cataract.

Genes: Many genetic disorders can result in congenital cataract ( cataracts present since birth) or early formation. Like in Lowe syndrome or Down's syndrome. 

Lifestyle Choices: Cigarette smoking, long hours of sun exposure regularly, antioxidant, poor diet etc. are responsible for the onset of cataract.

How To Detect Cataract?

Certain signs and symptoms suggest the existence of cataract in the eye. Depending on the type and level of cataract, problems in vision occurs. The main symptom is foggy cloudy vision as if seeing through a dirty glass window. 

Other Symptoms are- 

inability to see clearly in bright light (during the day) which becomes better in dim light ( evening and night) and vice versa. 
watery, tired eyes - mild pain in and around eyes. 
yellow tinge in vision 
Halos around light bulbs or bright light. 
If you are experiencing above symptoms and having problems in viewing things clearly, visit an ophthalmologist and get your eyes checked.

Foggy and Cloudy Vision - A Sign Of Cataract?

The most common vision problems are shortsightedness and farsightedness. Shortsightedness is when a person sees close objects clearly while distant objects appear blurry. It is more common than farsightedness and affects about 70% of the Asian population.

When there is a refractive issue, the prescription usually has a plus/minus with it and also a number. A  minus  symbol is used to represent shortsightedness; the greater the number of the glasses, the higher the shortsightedness. High myopia is a more severe form of shortsightedness where the power is -6.0 or higher.

Symptoms: 

As mentioned, the person will be able to see nearby objects but will have difficulty seeing far off objects.

Difficulty reading signs and boards
Squinting
Straining to reduce the strain on the eye
Tired and fatigue due to this eye strain, especially when in constant move like playing sports or travelling
How it happens?

Vision can be explained by a physical process where light passes through a lens and falls on the retina in the posterior portion of the eye where it forms an image. This is then sent to the brain where it is read and interpreted as a particular object. When the lens becomes elongated, the image that is formed is distorted in that it is formed in front of the retina and not on the retina. Though it gradually settles down with adulthood, in most cases, it progresses and requires corrective lenses. The corrective lenses ensure the image falls on the retina and visual perception is improved.

Treatment:

Corrective glasses are the most commonly used measure for nearsightedness. The lenses could be used either as spectacles or as contact lenses.
Laser surgery can also be used to correct the problem. A thin layer of the cornea is removed and the image formation is corrected.
Artificial intraocular lenses are also being used to treat this condition. They work like contact lenses and may need periodic replacement.
The most common technique, especially for high myopia is the use of surgery to correct the problem. This is a one-time correction and is a more durable solution than the earlier mentioned options.
Appropriate calculations are done to identify the lens to be used so that proper vision is restored.
Complications: 

Though not common, retinal detachment and variable postoperative refractive error can occur during the surgery.
It is very important to set realistic expectations with the patient in terms of what to expect before, during, and after surgery. If only one eye is going for repair, the chances of mismatch in vision could be present in the early stages. Being clear about what to expect will help in successful correction.

Myopia or Nearsightedness - How It Can Be Treated?

Visual impairment is a decreased ability to see to a degree that causes disabilities or problems, not fixable by usual means, such as glasses. Loss of vision may be acquired and develop suddenly. It may affect one or both your eyes.

What Causes Loss of Vision/Disability?

Loss of vision and disability can result from the following  

Clouding of normally transparent eye structures

Abnormalities in the retina

Abnormalities in the nerves carrying visual signals to the brain from the eyes

Changes in vision may also occur due to conditions like glaucoma, macular degeneration and diabetic retinopathy. 

Can Psychological Rehabilitation Help Manage Visual Impairment?

Vision loss and disability often interfere with one s functional ability in everyday tasks. Sometimes, the disability may be so devastating that it affects a person s mental health and behaviour. Psychological Rehabilitation is designed to help such visually impaired people deal with disability or impairment. 

Psychological rehabilitation involves a wide range of methods that aims to restore functioning after loss of vision, just as physiotherapy restores functioning after an injury or stroke. The program allows patients to continue living independently and maintain their quality of life despite vision loss. 

Complete or partial loss of vision can jeopardize one s career   you may not be able to continue with your job due to the disability.  Many people suffer psychological and physical challenges, which force them to escape the outside world. Psychological rehabilitation helps in the following ways  

Helps individual understand and accept the disability, and find ways to cope with it

Motivates them in to keep trying

Cope with the pain and depression

Overcome feelings of fear or despair

Prevents the person from sinking into a state of self-pity, which may hinder recovery

Rehabilitation Psychology adopts a holistic and expansive approach to treat visual impairment. 




Loss of Vision & Disability - How Can Psychological Rehabilitation Help?

A common headache can have a number of reasons behind it, such as defective vision, hetrophoria or convergence deficiency, etc. Now, the question arises as to how they can cause headache. Read on to know more...

Q. Why should defective vision cause headache?

To attain a perfect vision, eyes with defective vision have to make sustained extra efforts, which results in headache. Even if the refractive error is very small, it can be the cause of headache. More prolonged the working and smaller the print, higher the incidence of headache.

Q. Can this occur at all ages?

Yes, it can occur at all ages. However, with age, the resistance decreases and hence elderly people are more prone to get headache. More the use of computer, mobiles, TV or prolonged studies precipitates headache

Q What is Hetrophoria?

Normally, both eyes always remain parallel, but in some cases, eyes have slight tendency to develop minor squint, may be convergent or divergent. This is called Hetrophoria or Latent squint. Such patients have to take extra strain to keep the eyes straight

Q. What is convergence deficiency?

For reading, both eyes have to converge and if there is weakness of convergence, extra strain has to be put on the eyes, which cause headache.

Q. What is the ideal method of refraction in young patients, I,e below 40 years?

Ideal method is to dilate the pupil with Tropicasyl plus drops. This has the advantage that the doctor can see the retina and Optic Disc. This is important to exclude any involvement of brain as the cause of headache. It also relaxes accommodation and hence provides correct refraction. In cases of Hypermetropia, it is extremely essential to dilate the pupil.

Q. What is the role of Autorefractmeter (a computer) in refraction?

It is a very important instrument to provide correct refraction, but it cannot be totally relied upon. Some opticians rely on it and give wrong numbers.

Q. What is acceptance Test?

You have refracted the eyes with Autorefractmeter or Streak Retinoscope but exact power is what a patient accepts. This is very important.

Q. What is astigmatism?

There is a difference in refraction in different meridians and it is important that a cylinder number is prescribed in correct axis. This is a difficult task and needs lot of experience.

Q. Is it important to correct astigmatism?

To relieve headache and strain on the eyes, it is very important that exact cylinder is prescribed.

Q. What is the role of exact centring of Optical Lenses?

You may give correct number, but if the centre of the Optical lenses and cornea do not coincide, satisfactory results are not obtained. To dispense correct lenses is a big art and the Optician must be qualified and well experienced.

Q. Does the quality of lens affect the visual comfort?

Yes, it is important that quality of lenses should be good, preferable fibre lenses which are Ant reflect coated. Crizal coating with capability to block the UV rays are very popular.

Conclusion: Refractive errors are important cause of headache and needs proper examination of the eyes, preferably after dilating the pupil. Astigmatic error even if too small may be the cause of headache. Spectacle dispensing is an art and a patient must select proper optician. Spectacles if advised for constant use must be used constantly to get full relief.

Defective Vision - Can it be a Cause of Your Headache?

Night blindness is also called nyctalopia.It's a type of vision impairment. People with night blindness experience poor vision at night or in dimly lit environments. It is not a disease in itself, but rather a symptom of an underlying problem, usually a retina problem.

What Causes Night Blindness?
A number of eye conditions can cause night blindness, including:
1. Nearsightedness or blurred vision when looking at faraway objects.
2. Cataracts or clouding of the eye's lens.
3. Retinitis pigmentosa, which occurs when dark pigment collects in your retina and creates tunnel vision.
4. Vitamin A Deficiency
5. Zinc Deficiency
6. Dry Eyes
7. Diabetes

Are the Symptoms of Night Blindness?
The sole symptom of night blindness is difficulty seeing in the dark. You're more likely to experience night blindness when your eyes transition from a bright environment to an area of low light, such as when you leave a sunny sidewalk to enter a dimly lit restaurant. You're likely to experience poor vision when driving due to the intermittent brightness of headlights and streetlights on the road.

How can I Prevent Night Blindness?
You can't prevent night blindness that's the result of birth defects or genetic conditions, such as Usher syndrome. You can, however, properly monitor your blood sugar level and eat a balanced diet to make night blindness less likely. 

Orange colored foods are excellent sources of vitamin A, including:
1. Cantaloupes
2. Sweet potatoes
3. Carrots
4. Pumpkins
5. Butternut squash
6. Mangoes

What are the Treatment Options for Night Blindness?
The treatment will depend on its causes.
1. Nutrient deficiency (Vitamin A and Zinc) is the easiest to treat. 
2. If the cause is cataract, you can go for cataract surgery to remove the clouded lens and replace it with artificial intraocular lens. Vision is usually dramatically improved after surgery. 
3. For dry eye syndrome, lubricate your eyes with artificial tear drops as they provide instant relief. Just make sure that they are without preservatives. 
4. Diabetic retinopathy can be prevented with tight control over blood sugar, active lifestyle and good dietary habits.
5. As for retinitis pigmentosa, unfortunately there are no treatments available. Thankfully, new research is showing that vitamin A might have a slowing effect on the progression of this eye disease.

Night Blindness: Causes and Symptoms

Blurred vision is most often a sign that you need corrective spectacles for near sightedness, far sightedness or astigmatism but it could also be a sign of a bigger problem including eye diseases or neurological problems. Blurred vision involves the loss of sharpness of vision and objects appearing hazy and out of focus. It can affect one eye or both eyes simultaneously.

Whatever be your age, it is a good idea to consult a doctor as you begin to experience a blurred vision. To measure the extent of your vision problem, a doctor will do a comprehensive eye examination including spatial contrast sensitivity and a standard eye chart test. Some of the factors that trigger blurred vision are:

1. Myopia or nearsightedness
2. Hypermetropia or farsightedness
3. Astigmatism caused by an irregularly shaped cornea
4. Presbyopia - the diminished ability to focus on objects due to the hardening of the lens in the eye
5. Dry eyes or the lack of lubrication on the surface of the eyes
6. Hormonal changes during pregnancy
7. Migraine headaches
8. Temporary floaters in the eye formed by the liquefying of the gel in the eyes
9. After effects of lasik surgery
10. Eye drops or medication
11. Overuse of contact lenses
12. Diabetes

Blurred vision can also be a symptom of a serious condition such as cataract, glaucoma, macular degeneration, diabetic retinopathy and cardiovascular diseases.

Treatment for blurred vision depends on the factors triggering it. Wearing corrective glasses can cure blurred vision caused by myopia, hypermetropia and astigmatism. These conditions can also be treated by lasik surgery. For blurred vision related to diabetes, check your blood sugar and get it into its optimal range.

Exercises for the eye muscles can also help sharpen vision and lower the rate of eye muscle degeneration. Some of these exercises are:

1. Alternately focus on an object close to you and another far from you for ten seconds each.
2. Blink your eyes and hold for two seconds
3. Roll your eyes clockwise and anticlockwise. Repeat 15-20 times.
4. Rub your palms together to generate heat and place over your eyes to relax them.

A healthy diet with plenty of vitamin a can help keep your eyes healthy and prevent blurring of vision. Wearing sunglasses can also protect your eyes from harmful uv radiation and lower their rate of wear and tear. Lastly avoid reading in moving vehicles and holding a book too close to your face.

Is Your Vision Blurry? What Should You Do?

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