Cataract can be defined as the clouding of the natural lenses in the eyes. This is caused by the clumping of protein in the eye lens. Cataract is a common eye disorder and the leading cause of loss of vision in people who are past their fortieth birthday. Cataract can occur in one or both eyes. When diagnosed properly, cataract can be treated with surgery to prevent blindness.

Depending on where and how they develop, there are many types of cataract. The most common amongst these are:

1.        Subcapsular cataract

These occur at the back of the eye lens. Diabetic patients are very susceptible to this kind of cataract.

2.        Nuclear cataract

Yellowish-brown cataract that form in the center of the lens are called nuclear cataract. This is usually seen in cataract caused by ageing.

3.        Cortical cataract

Cataract in the lens cortex are known as cortical cataract. These are wedge shaped and whitish in color. Spokes protruding out of these opaque wedges can be seen moving towards the center of the eye.

4.        Congenital cataract

Though they are not common, babies can also have cataract. Cataract formed at birth or within the first year of a baby's birth are known as congenital cataract.

5.        Secondary cataract

Cataract is one of the known side effects of diabetes and glaucoma. Some steroids and medicines are also linked to cataract.

6.        Traumatic cataract

If your vision becomes cloudy years after an eye injury, it could be a traumatic cataract. It can take several years for this to happen.

7.        Radiation cataract

Exposure to radiation can also lead to cataract. This is seen sometimes in patients who have undergone radiation therapy to fight diseases like cancer.

Though the type of cataract might differ from person to person, the symptoms are usually the same. Some of the common symptoms of cataract are:

1. Blurred vision
2. Reduced night vision
3. Increased sensitivity to light and glare
4. Seeing halos around lights
5. Colors appearing faded
6. Double vision

A reading test is the first step towards diagnosing cataracts. This is followed by tests to measure the eye pressure. Your doctor will also need to dilate the pupil to check the condition of the optic nerves and retina.

Surgery is the safest way to remove a cataract. Surgery is usually recommended when cataract begin inhibiting your daily life such as preventing you from driving, interfering with reading etc.
 
In most cases, this can be done as an outpatient procedure. The earlier it is diagnosed, the easier it is to treat. Hence, if you notice any of the symptoms mentioned above, get your eyes checked at once. The surgery is a day-care surgery only, so a person can go home the same day.

Is Your Vision Clouded? It Could Be Cataracts

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?

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?

Do your eyes get tired easily? Do they look sore or sandy? If yes, then it s time to worry for your eyes now. There is every possibility that you might have developed a dry eye. It is a common disorder of the eyes that occurs due to aging. It causes discomfort as you end up feeling scratchy or gritty all the time. The eyes turn red and have a burning sensation and feel itchy. Things get worse when you tend to stress your eyes by spending extra hours in front of the computer or read texts. In fact, the discomfort increases as the blinking frequency of the eyes get reduced.

One may also develop blurred vision due to dry eyes. An individual feels as if there is some particle inside his or her eyes, but finds nothing. Though this condition doesn t lead to very dangerous consequences, it is always a wise decision to seek medical help. The medical term for this condition is keratoconjunctivitis sicca. Once you develop dry eye, there is always a tendency to get it back again. But, the good news is that it can be treated to get some relief.

Causes
Dry eye is caused due to problems related to tear formation. When we blink our eyes, a film is formed over it. This thin layer is called a tear film. Tear film is responsible for clarity in vision. In case, enough tear is not produced, one tends to suffer from dry eyes. It is mainly caused due to ageing. 
If you don't produce enough tears, if your tears aren't of the right quality or your tears aren't spread across the front of your eye properly then you may develop dry eye. The glands producing tear or the tear film get inactive with age. Sometimes, the tear film is also affected by certain medicines, contact lenses, diseases like rheumatoid arthritis and Sjogren's syndrome.

Treatment
Dry eyes caused due to ageing cannot be cured completely. You must see a doctor for treatment but there are no permanent cure remedies. However, there are ways to help you get some relief. Here are the ways:

Try to increase the natural tears: There are certain home-based remedies to get some relief from the problem. You can keep the temperature of your room lower to get rid of the symptoms of dry eyes. Higher temperature leads to the evaporation of the tears. You can keep a humidifier in your room that adds more moisture to the air inside the room. This prevents drying up of the eye due to evaporation of tears. It is also found that when one blinks less, tear formation is reduced. The blinking is reduced while working on computers and reading. One must be careful while doing such things and try and blink as many times as possible.
Use eye drops: One needs to use eye drops called  artificial tears.  They are an alternative to the natural tears. If usual drops are not effective, gel-based thicker drops or overnight ointments are prescribed.
Block tear ducts: Another way of tackling dry eyes is by reducing the drainage of tears. For this, the tear ducts are blocked by plastic pieces called punctual plugs. The process is termed as punctal occlusion.
Take food supplements: Certain oils and Omega 3 and 6 are known to be beneficial in treating dry eyes. Include these supplements in your diet to keep your eyes healthy.

Dry Eye Syndrome - 4 Ways to Treat It!

7 Easy ways to get relief from computer eye strain

Do you spend long hours in front of the computer? If you do, you may be experiencing eye strain on a regular basis. Eye strain is a common problem and is characterised by fatigue, decreased productivity, red eyes and eye twitching. You can get rid of eye strain by making use of any one of these simple tips. 

1. Ensure that your workplace has correct lighting
Often eye strain occurs as a result of improper lighting. This can be caused by exposure to bright sunlight coming in from the windows and doors or excessively dazzling indoor lights. You can avoid extra lights by keeping blinds or shades closed and by avoiding high-intensity bulbs or fluorescent lights. Alternatively, opting for incandescent or halogen lighting can be beneficial.

2. Minimise glare
You can install an anti-glare screen on the monitor of your computer to minimise glare. Keep the windows covered to reduce glare caused by outdoor sources.

3. Modify the display settings of your computer
You can modify the display settings of your computer in the following manner to reduce eye strain:
• Brightness-Set the brightness of the display to a level, which equals the brightness of your workplace.
• Text size and contrast-Modify the text size and contrast according to the comfort level of your eyes. For most people, black text colour on a white background ensures minimum eye strain and maximum convenience.
• Colour temperature- The spectrum of visible light, which a colour display usually emits is its colour temperature. Blue light is considered to cause more eye strain. So, you should decrease the colour temperature to minimize the amount of blue light emitted by your computer’s display.

4. Try some eye exercises
You can practise some easy eye exercises to prevent your eyes from getting tired. Try staring at a distant object for 10-15 seconds and then looking at any nearby object for another 10-15 seconds. Return your gaze to the first object. Repeat 10 times.

5. Opt for some computer eyewear while working
Try wearing a pair of computer glasses while working. They ensure that your eyes remain correctly focussed on the computer screen, while reducing strain to a minimum. Computer glasses also prove to be very effective in diminishing glare. 

6. Take short breaks at regular intervals
Apply the 20-20 rule to your work regime. After each 20 minutes of work on the computer, give your eyes a 20 second break by looking away from the screen towards any object located 20 feet away from you.

7. Go for a comprehensive eye exam
Make sure that you go for a comprehensive eye exam every year to reduce vision problems caused by computers. This will also help in detecting the root cause behind your problem, so that you can effectively employ curative or preventive measures to control eye strain.

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

7 Easy Ways to Get Relief from EveryDay Computer Eye Strain

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

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