Amblyopia is commonly known as'lazy eye. It is a vision development disorder, which affects eyes and the brain during infancy and childhood. It signifies that the eye does not achieve a normal visual acuity even with refractive correction in form of glasses or contact lens. During normal visual development, the eye and brain learns to'see' and develop binocularity, that is the ability to perceive depth (stereoacuity). This occurs in the first 8 to 10 years of life. 

Each eye transmits a clear and identical image from retina to the brain, which fuses the two images into a single image with 3 dimensions (adding depth). When the image is formed on the retina of two eyes is too dissimilar, the brain cannot fuse the two images and suppresses the more blurred image. As a result, the worse eye does not learn to'see' and becomes'lazy. This condition is seen in 1-4% of population.

The common causes for dissimilar images or amblyopia are:
1. Misalignment of the eyes or squint: it is the primary reason for amblyopia is misalignment of the eyes. In case, both your eyes are not aimed in the same direction, the image captured by each eye is different, resulting in diplopia. The brain will see from the dominant eye and suppress image from the other eye. Over a prolonged period of time, the eye dissociates from the visual cortex of the brain.

2. Refractive amblyopia:
A. Unequal refractive error in both eye. When the eye power of both eyes differ by more than 1.5d of spherical equivalent, which results in dissimilar images between the two eyes. As a result, the visual development in restricted in the worse eye.
B. High refractive error or astigmatism in both eyes, since there is a blurred image in both eyes, the normal vision development does not occur in either eyes resulting in bilateral lazy eyes.

3. Cloudiness in visual system or visual deprivation amblyopia: any kind of obstruction or cloudiness in the normal visual axis of the eye tissues can lead to amblyopia. Disorder of any kind, which blocks a clear image from being focused blocks the formation of a clear image on your retina. Commonly due to congenital or developmental cataracts or corneal opacities or prolonged closure of one eye in early childhood (drooping of one eyelid, eyelid swelling, patching of one eye).

Treatment for amblyopia
For treatment of amblyopia, a child must be compelled to utilize his affected, weaker eye. This can be done by correction of causative factor such as, treating refractive error with glasses, surgical correction of misalignment of eyes followed by patching and vision therapy, cataract surgery.

Patching or occlusion of the good eye
This is done to force the brain to pay attention to visual input from the worse eye. This allows nerve connections between affected eye and brain to develop due to, which the eye'learns to see. Eye drops such as atropine are also used for blurring the vision of the good eye. Some form of vision therapy may also be required to train both eyes to see together and develop some degree of depth perception.

To be effective, treatment should be implement as early as possible, within the period of normal visual development best within first 8 years of life. Some visual gain has been seen in selected patients up to age of 14 to 18 years. This also highlights the importance of a comprehensive eye examination as a routine in young children.

About Amblyopia or Lazy Eye

Eye Strain is an umbrella term that denotes a number of symptoms that relate to the extended use of eyes as well as discomfort that may come from excessive smartphone and computer use. This condition may or may not lead to significant eye damage and is usually characterised by blurry vision, headaches and a feeling of dryness in the eye as you blink less which creates less tears. This may happen due to the extended use of the eye when you are following objects on a screen or staring at a screen for too long. So, is eye strain the cause of your headaches? 

Find out more in this article.

Causes: Eye Strain or Asthenopia is caused by concentrating on visually intense tasks like reading from texts that have a fine print, the use of computers and other screens for prolonged periods, and trying to focus on objects in the dark. This can lead to distress of the muscles in this area which can also cause eye strain leading to a variety of symptoms including double imagery and even headaches and mild migraine like conditions.

Eye Muscle Imbalance: When there is eye strain which leads to headaches, it can also give rise to eye muscle imbalance which makes it difficult to concentrate with both eyes at the same time. In such cases, one may need bifocal glasses so as to fix the issue and prevent such debilitating headaches to remain on a persistent basis.

Diagnosis: Digital eye fatigue and ocular eye strain leading to headaches can be diagnosed by a doctor with the help of regular eye examinations. In any case, one should have the eyes checked at least once a year. This is especially important if your job involves sitting in front of the computer screen for prolonged hours.

Symptoms: There are a variety of symptoms of these headaches that are caused by eye strain. Apart from blurry vision which does not allow the patient to see properly and clearly without glasses, it can also cause headaches with symptoms like nausea and sensitivity to light. Retinal or eye migraines do not necessarily have to come with headaches, but the pressure can be painful enough.

Treatment: To begin with, the best form of treatment for headaches born from eye strain includes prevention which can be done by getting plenty of rest and sleep even as we limit the hours spent in front of the screen. One can also lower the resolution of the screen and make it more ambient. Also, the screen should be placed at a considerable distance from the eyes. The doctor can also prescribe glasses and eye drops for better eye lubrication.

Headache - Can Eyestrain Be the Reason Behind it?

A red eye is one of the first and most common symptoms of conjunctivitis. Conjunctivitis is the inflammation of the tissue that lies over the white part of the eye and lines the inner side of the eyelid. It is usually the result of a viral infection and can easily spread from one person to another. Conjunctivitis can also be a symptom of STDs like Gonorrhea or Chlamydia. In newborns, conjunctivitis can be vision threatening, while in grownups it is not considered a serious health risk. The symptoms of conjunctivitis differ according to the cause of the infection. 

Some common symptoms of conjunctivitis are:
1. Green or white discharge from the eye
2. Redness of the white part of the eye
3. Inflammation of the eyelid
4. Waking up to crusted yellow discharge
5. Itchiness and burning in the eyes
6. Increased sensitivity to light
7. Blurred vision

An eye examination and testing a sample of the fluid secreted by the eye can be used to diagnose conjunctivitis.  It can easily be treated at home and does not require hospitalization. Antibiotics are often given in the form of eye drops and ointments to treat conjunctivitis. These usually need to be applied 3 to 4 times a day for a period of 5 to 6 days. Wash your eyes before putting the eye drops. Once applied, close your eyes and roll the eyeball around to distribute the medicine and keep it from overflowing out of the eye. Wash your hands immediately after applying the eye drops.

Viral conjunctivitis is highly contagious. If you are suffering from it, you should take a few days off work and restrict your social interactions. Wash your hands frequently as you may unconsciously rub your eyes. This is especially important with regards to meals and finger foods. Also, avoid sharing towels, pillowcases, etc. to minimize the transmission of the disease from one person to another.  

Avoid using makeup while being treated for conjunctivitis. With conjunctivitis, the eye is more sensitive to irritants and thus, a speck of makeup can worsen the situation. Also avoid contacts. If you wear contacts regularly, dispose the current set and start using a fresh set after your doctor gives you a clean chit. 
Artificial tears or non prescription eye drops can also be used to relieve the itchiness and burning in the infected eye. If only one eye had been affected by conjunctivitis, do not use the same eye drop bottle for both eyes.

Managing the Acute Red Eye

If you have got diabetes, then it is quite natural that you will soon face acute eye troubles. This is the reason diabetic patients are always suggested to keep their blood sugar levels controlled so that eye troubles can be easily avoided. Thorough medical check-up is required in order to detect conditions of the eyes. Some of the commonest eye troubles occurring due to diabetes are cataract, glaucoma, blurry vision, diabetic retinopathy and others. 

List of eye diseases caused by diabetes

1. Diabetic retinopathy: when the retina's smallest blood vessels get severely damaged due to increased blood sugar, then this kind of eye condition occurs. Early detection of this eye condition can save your eyes, but if it is too late, then nothing can be done, and it might even lead to blindness.

2. Cataract: fogging or clouding condition can bring this kind of condition and this can only be corrected by wearing proper corrective lenses. However, if you fail to control diabetes, then in spite of wearing glasses, your eye condition might get deteriorated day-by-day. Glared or blurred vision is the most common symptom in this regard. 

3. Glaucoma: when the eye fluid is not drained properly, then this kind of eye trouble occurs. In fact, eye pressure increases to a great extent as a result of which delicate eye nerves can get severely damaged. The blood vessels of the eyes can get clogged causing greater interruption in vision. Medicines can make aqueous humor to get drained in a proper manner, and thus you should go for a proper eye check-up so that you can acquire the requisite medicines. Some popular symptoms of glaucoma are headaches, eye aches, blurred vision, watery eyes, vision loss and others. 

4. Diabetic macular edema: this eye disease mainly occurs in the advanced stage of diabetic retinopathy. Macula is nothing, but the most delicate part of retina and when it gets swollen, then you might face this eye trouble. Only medications can help you to get rid of the same and thus immediate medical help is needed. 

5. Blurry vision: though this is quite a small and temporary eye issue for diabetic patients, but this condition might turn into a serious one if you neglect to correct the same in the very beginning. You might even face blindness due to negligence of this trouble. Also, fluctuating sugar-levels should be stabilized so that this kind of trouble can be easily tackled.

Eye Problems Caused by Diabetes

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?

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