Glaucoma is a disease that damages your eye's optic nerve. It usually happens when fluid builds up in the front part of your eye. That extra fluid increases the pressure in your eye, damaging the optic nerve.Glaucoma is the second largest cause of eye blindness in the world.

There are several types of Glaucoma:
1. Open-angle Glaucoma
2. Normal-tension Glaucoma
3. Angle-closure Glaucoma
4. Congenital Glaucoma
5. Secondary Glaucoma
6. Glaucoma suspect

How will you know that you are suffering from Glaucoma?
Only half the people with glaucoma are aware that they are suffering from this condition. When Glaucoma develops, there are usually no early symptoms. This is why glaucoma can 'steal' sight gradually.

Symptoms:
1. In its early stages, open-angle Glaucoma has no obvious symptoms. As the disease progresses more blind spots develop in the peripheral (side) view.
2. An attack of angle-closure Glaucoma includes the following:
a. Severe pain in the eye or forehead
b. Redness of the eye
c. Decreased vision or blurred vision
d. Vision rainbows or halos
e. Headache
f. Nausea
g. Vomiting
If you get any of the symptoms rush to your doctor and take an eye exam as soon as possible.

Causes:
1. Eye injury
2. Inflammation of the eye
3. Dilating eye drops
4. Blocked or restricted drainage in your eye
5. Use of steroid-containing medications (pills, eye drops, sprays)
6. Poor or reduced blood flow to your optic nerve
7. High or elevated blood pressure

Who is at Risk for Glaucoma?
People with more risk of developing Glaucoma include people who:
1. Are over age 40
2. Have family members with glaucoma
3. Have high eye pressure
4. Are farsighted or nearsighted
5. Have had an eye injury
6. Have diabetes, migraines, high blood pressure, poor blood circulation or other health problems affecting the whole body.

Types, Causes and Symptoms of Glaucoma

People may suffer from visual impairment even though their eyes are perfectly normal. Such loss of vision may result from neurological impairment.

Vision is the combination of image formation and perception of various attributes of the image by the brain. When the brain is not able to perceive images or various attributes of images, the patient may suffer from neurological impairment of vision. Such impairment owes its origin to the nervous system.

Causes of Visual Impairment:

There are various areas in the brain that process some or the other attribute of the image that has formed on the retina. Occipital cortex, the area situated at the rear side of the brain is a very important site. It is responsible for processing visual stimuli and allowing people to make an idea about shape, distance, movement, color, etc. The severity of loss of vision depends on the extent and location of damage in the brain.

Neurological loss of vision may result from acquired brain injury, difficulties with visual perception, impairment in coordination of the eyes, etc. All these may stem from damage areas in the brain that are responsible for vision. There are many areas in the brain that are responsible for vision.

These areas can get damaged from various accidents like:

Stroke: If a person suffers a stroke, a part of his or her brain is likely to get damaged due to a haemorrhage or a blocked blood vessel.

Traumatic Brain Injury: A traumatic brain injury such as in a car accident or a violent fall can damage visual perception of the brain.

Infections: Infections such as meningitis attack the brain and may impair various areas of it.

Lack of Oxygen: People may suffer from lack of oxygen if they experience accidents like a near-drowning episode or a heart attack or something else, which has the effect of interrupting blood flow to the brain.

Diseases: Diseases such as brain tumors, multiple sclerosis etc. can precipitate neurological vision loss.

Symptoms of Visual Impairment:

Symptoms of neurological vision loss depend on the type of vision impairment and the location of damage in the brain. It may include:

Blurry vision: In Blurry vision, a person will not see things clearly or may see something in light but find it difficult to see them in dim light.

Double vision: In double vision, the patient sees a single object as two and cannot merge them as one.

Problems with depth perception of objects

Problem with bright light: In this type of problem, a person experiences difficulty seeing an object in a bright light. One may also feel pain or discomfort in the eye in bright light.

Difficulty with interpreting the object the person is looking at

Partial loss in the visual field: In this problem, half of the visual field in each eye is missing.

Treatment of Visual Impairment:

There is hardly any treatment for such vision loss since the rectification of visual acuity is of no help. Depending on the location and degree of neurological impairment, vision may improve over time. Some children with acquired brain injury or impairment in the coordination of the eyes and difficulties with visual perception also tend to improve with age.

Conclusion:

This is a type of vision loss where glasses, contact lenses, surgeries, or eye drops are not going to help. Such vision loss is usually permanent. Children with similar symptoms need to be presented with pictures, bright light, etc., which may help to form an idea about the object.

Visual Impairment Related To Nervous System!

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

Tip for eye care

This is the worst time of the year, for your eyes. Pollution from firecrackers, smog due to weather change and generally ever increasing vehicular pollution adds up to be the worst for your eye health. 

Protect your eyesight and take care of your eyes by following these simple daily eye care tips.

1. Eat Well: Protect your eyes from within. Eat for good vision. Eat foods that have various nutrients such as omega 3 fatty acids, zinc and lutein, vitamins A, C and E to keep eye problems at bay. Green leafy vegetables, salmon and other oily fishes, eggs and nuts, orange and citrus fruits are great for eyesight.

2. Quit Smoking: For better eye-care leave smoking. This simple activity can make you likelier to get optic nerve damage, macular degeneration and cataracts.

3. Have eye-care routine: Most of us don’t have an eye care routine, which is essential for keeping them fit. So, develop a good eye-care routine. In this routine, practice eye exercises, focusing eyes on a point far away to promote muscle development. Clean eyes everyday with fresh, clean water to reduce eye mites and other problems.

4. Wear Sunglasses: Wearing sunglasses on a regular basis will protect eyes from UV rays and ensure protection. This will help in reducing the chances of getting cataracts and developing macular degeneration.

5. Use Safety Wear: It is important that you regularly wear safety wear problems. For instance, for sports, wear eye protection products, sports goggles or protective face masks.

6. Look away from computer: A lot of us use computers too much for work and recreation. Now is the time to look away from it. Staring at the computer for long can cause eyestrain and blurry vision, trouble focusing at a distance and result in dry eyes as well as neck and shoulder pain with headaches. So, take regular breaks from that computer.

If you would like to consult with me privately, please click on 'Consult'.

Doctor's Advice On How To Keep Your Eyes Safe This Diwali

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?

Glaucoma is a leading cause of blindness in people across the globe. It damages the optic nerve that carries sensory images from the retina to the brain. A faulty eye pressure is responsible for damaging the very delicate optic nerve fiber causing small blind spots in the retina. Unfortunately, for most patients this disease only gets diagnosed when the number of blind spots is on the higher side.

Types of Glaucoma

Open angle: This is a type of Glaucoma which results from the blockage of the drainage angle of the eye resulting into an increased eye pressure.
Angle closure: This is the kind of Glaucoma which results from the narrowing down of the drainage angle leading to complete blockage.
Target segment of Glaucoma

Family history: Inheritance surely plays a role in case of Glaucoma too. If Glaucoma runs through families of an individual, there are higher chances of getting this disease. Although there is no hard and fast rule about it, the risks of inheriting this disease are on the higher side.
Eye injury: If there is any history of previous eye injuries, the probability of the onset of Glaucoma cannot be turned down. Specially, if the injury is related to optic nerve, there are very high risks involved.
Bilateral Oophorectomy: Dual Ovary removal before the age of 40 results in deficiency of estrogen resulting in Glaucoma. Although most surgeons warn their patients of the possible risk of these procedures, many surgeries such as these have resulted in patients losing eyesight in the form of Glaucoma.
Patient with Diabetes: In case of acute diabetes, retina gets damaged and the eye starts producing new blood vessels on the iris resulting into an increased eye pressure. This condition often leads to Glaucoma due to blockage of fluid flow in the eye.
Eye Conditions: Myopia, multiple surgeries to the eye, blunt trauma etc. can lead to Glaucoma. A patient who has undergone any kind of eye surgeries suffers from inflammation. However, major inflammation is often found twisting blood flow in the eye resulting into Glaucoma.
If a patient is 40 or above: After a person reaches 40 years of age, a lot of diseases start cropping in to the body. Studies show that Glaucoma has a higher frequency in people who is more than the age of 40 or above.
High eye pressure: A patient with an eye pressure of above 21 mm HG is also at a very high risk of getting glaucoma. For a normal person the IOP lies between 10 to 21 mm HG.
Blood flow related disease: Diseases such as acute migraine, hypertension and low blood pressure which involves blood flow related problem often aggravate to glaucoma.
Ethnic Background: Statistics show that people from Afro American, Hispanics, Asian and Caribbean background have greater chances of being affected by Glaucoma.

Glaucoma - Are You at Risk?

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