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

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?

Astigmatism is a typical vision problem that occurs when the shape of the cornea is distorted due to injuries or other causes. With astigmatism, the lenses of the eye or the cornea curves. This irregular curve can change the way light refracts or passes through your retina. This causes hazy, fluffy, or twisted vision. Farsightedness and partial blindness are two different sorts of issues with the way light goes to your retina. Farsightedness is called hyperopia. Partial blindness is called astigmatism.

Types: There are two types of Astigmatisms. These are:

1. Corneal astigmatism
It happens when your cornea itself is distorted.

2. Lenticular astigmatism
Lenticular astigmatism happens when your lens is distorted.

Risks: Astigmatism can happen in youngsters and grown-ups. Your danger of creating astigmatism might be higher if you have any of the following:

1. A family history of astigmatism or other eye issues like dislocation of the cornea.
2. Scarring or diminishing of your cornea
3. Excessive partial blindness, which makes foggy vision at a separation
4. Excessive farsightedness, which makes hazy close-up vision
5. A past of eye surgeries, for example, cataract surgery (surgical expulsion of a blurred focal point)

Symptoms; The side effects of astigmatism include:

1. Hazy, Bended, Or Fluffy Vision At All Separations (Close-Up And Far Away)
2. Trouble seeing during evening
3. Lazy eye
4. Squinting
5. Irritation in the eye
6. Cerebral Pains

Diagnosis:

Visual Acuity Assessment Test

Patients are required to read letters from a graph at a particular distance to decide how well they can see the letters.

Refraction Test

A refraction test uses a machine called an optical refractor. The machine has various remedial glass lenses that are used to read an outline while looking through lenses on the optical refractor.

Treatment:

Keratometry

Keratometry is a route for your specialist to measure the bend of your cornea. They will do this by taking a look at your eye through a keratometer.


Corrective Lenses

Remedial eyeglasses and contact lenses prescribed by a specialist are the most well-known and least obtrusive solution for astigmatism.


Orthokeratology

Orthokeratology is a treatment that uses contact lenses to correct the deformation and flow of your cornea. You will wear inflexible contact lenses for certain time-periods. It is easier to wear them while you are sleeping and remove them during the day.


Surgery

Your specialist may suggest refractive surgery if your case is a serious one. This kind of surgery includes use of lasers or little blades to reshape your cornea. This will correct astigmatism permanently. The three basic surgeries for astigmatism are:

1. Laser in situ keratomileusis (LASIK)
2. Photorefractive keratectomy (PRK)
3. Spiral keratotomy (RK).

All these surgeries might carry some risks depending upon the symptoms of your problem. As innovation advances, it is very important for the patient to explore more options before choosing which refractive surgery is a good fit for him or her.

Types and Treatment for Astigmatism

Hypertension is a killer disease whose symptoms develop late when the damage is in advanced stages. Hypertensive Retinopathy is one such disease.

It damages the retina of eyes. Since retina is responsible for vision formation, Hypertensive Retinopathy can result in loss of vision. It is of grave concern that in most cases, Hypertensive Retinopathy is diagnosed later.

This is due to the fact that there are often no symptoms in the early stages of the disease. In some cases, where symptoms do manifest, patients may experience pain in the eyes, reduced vision, or headache.

What Happens in Hypertensive Retinopathy

People suffering from long term hypertension are susceptible to Hypertensive Retinopathy. Long-term hypertension affects the small and narrow blood vessels that join arteries to capillary blood vessels taking blood to different parts of the eye. These blood vessels become narrow with time if hypertension in the eyes continues unabated. This narrowing is more common in young adults compared to older people. Such unabated systemic hypertension also leads to leakage of fluid. This is why in some cases of Hypertensive Retinopathy, patients may experience exudation. Ultimately, Hypertensive Retinopathy may lead to damage to retinal blood vessels.

Risk Factors

Long standing hypertension is the number one risk factor for Hypertensive Retinopathy. People who are suffering from longer hypertension become most susceptible for this ailment.

However, studies have shown that hypertension for more than 5 years can even make people susceptible to this ailment.

Diagnosis

Diagnosis is done by Funduscopic Examination. The doctor would look at the eyes of the patient through an Ophthalmoscope which has different lenses. The Ophthalmoscope illuminates the retina and the doctor looks at the retina with different lenses. He can get a view of the retina, including blood vessels and optic nerve disks.

Findings of Diagnosis

For a person suffering from Hypertensive Retinopathy, this examination is likely to show:

Constriction of the arterioles.

Changes in the walls of retinal blood vessels.

Flame-shaped hemorrhages in the retina.

Yellow and hard exudates.

Spots in the shape of cotton wool.

Swelling of the optic disc.

Treatment

The primary treatment for Hypertensive Retinopathy is controlling blood pressure of the eyes. Some lifestyle changes like reducing the intake of salt, avoiding tobacco, etc., may bring down or control systemic hypertension in the eyes. In many cases, doctors may just recommend lifestyle modifications. Nevertheless, it completely depends on the extent of the damage and whether or not there is any fluid accumulation.

If the doctor feels that lifestyle modification is not enough, he may go for medicines that help the patients to control blood pressure effectively.

If the problem is in advanced stages and there is fluid accumulation behind the retina, the doctor may go for Intravitreal injection or Laser Therapy to control the edema.

Conclusion

Eyes are one of the most significant part of the body, this is why it is important for people to take care of it. In case of disease like Hypertensive Retinopathy, one must consult a doctor before opting any treatment or medicines.

Hypertensive Retinopathy - Everything About It!

Conjunctivitis is a medical condition that is marked by redness in the eyes owing to the inflammation of the conjunctiva, which is the membrane covering the white part of the eye. The condition is further characterized by the discharge of yellowish pus fluid from the corner of the eye. This condition, which is essentially an infection, can occur to people of all age brackets. 

Causes and Symptoms 

Conjunctivitis can be caused due to several reasons namely allergies, irritants, bacterial and viral infections, among others. Apart from the redness in the eye, some other apparent symptoms of conjunctivitis are: 

    Thin and watery discharge in viral conjunctivitis 
    Thick, mucous like discharge ranging from yellow to green in case of bacterial conjunctivitis
    Sticky eyelids
    Increased reactivity to light 
    Blurred or foggy vision
    Nasal discharges 

It is difficult to distinguish between viral, allergic and bacterial conjunctivitis. Different fields of medicine prescribe treatments according to the cause of the condition. Although subtle differences, such as thick and thin discharges can be observed, in Homeopathy the cause is not that important. 

Homeopathic medicines are natural and highly effective. The medications, which are prescribed in Homeopathy can more than manage the discharges, swelling, the sandy sensation and redness in the eyes. Homeopathic medicines are effective when the condition causes the eye to get dry, red, congested and swollen. Bathing the eyes with sterilized salt water is also a popular method of treating the infection. In addition to these, Homeopathic doctors also provide tips to curb the likelihood of further complications. Removing your contact lenses while treatment and cleaning your spectacles on a regular basis, if you wear any, are duly recommended.

Treating Conjunctivitis With Homeopathy

LASIK stands for Laser In-situ Keratomileusis. This is a common eye surgery that helps in correcting vision problems. During this procedure, the cornea of the eye is cut across by a medical expert to raise the tissues and reshape them to correct vision. LASIK is suitable for patients who have shortsightedness, long sightedness or who suffer from astigmatism.

Here are the 5 benefits that a LASIK surgery offers:

1. Improved vision

A study reveals that 95% of the people who underwent this surgery achieved uncorrected visual acuity of 20/40 and 85% of the people achieved 20/20 vision. This procedure ensures that a patient achieves enhanced vision.

2. Quick results and recovery

This surgery enables you to return to your normal schedule immediately the day after the surgery. You can have clear and improved vision within a day.

3. Long- lasting outcomes

A minimum timeframe of 3 months is required for the eyes to adjust, after which LASIK results are permanently noticeable in a patient. No follow up procedures are required unless something wrong went with the surgery. The patient will continue to have improved vision unless there is any normal loss due to illness or aging.

4. No need of glasses

You no longer require glasses as your vision turns to normal post-LASIK surgery.

5. Goodbye contact lenses

LASIK surgery will help eliminate the need for contacts. You will be able to avoid all the problems pertaining to wearing a contact lens, including lens solution.

5 Benefits of Lasik Surgery

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