PATIENT SERVICES

Common Eye Conditions of the Aging Eye
Cataracts
Presbyopia
Macular Degeneration
Diabetic Retinopathy, Retinal Tears, Detached Retinas
Retinal Tears & Detached Retinas
Spots, Floaters, Flashes, Vitreous Detachment
Dry Eye
Glaucoma

Cataracts
Cataracts are one of the most common disorders of the eye and are a natural part of the aging process. They usually begin developing in people around mid-life, and approximately 70% of those age 60 and older have some degree of this disorder. Untreated cataracts are the most common cause of blindness in humans.
Many people still think a cataract is a hazy film that covers the eye. Actually, a cataract is a clouding of the eye's natural or crystalline lens located just behind the pupil. This clouding of the lens keeps light from passing through the eye, or diffuses the light in such a way that vision becomes fuzzy or hazy. The name cataract is the Greek word for waterfall and was first used in early medical times because the blurred vision was likened to viewing the world from behind a waterfall.
Because a cataract cannot be reversed, the object of modern cataract surgery is to remove the hazy lens and replace it with a plastic prescription lens that is permanently implanted in the eye.

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Presbyopia
Presbyopia is an aging eye disorder that eventually affects nearly everyone over the age of 40. As we age, the eye's natural crystalline lens, located just behind the pupil, loses some of its elasticity and can no longer focus on nearby objects. It is the most common reason why doctors prescribe bifocals, trifocals or reading glasses.
Presbyopia is irreversible and, although much research is being devoted to the development of specialized intraocular lenses that would compensate for the condition, the only proven treatment is eyeglasses or specialized contact lenses. The replacement of cloudy lenses during cataract surgery will not eliminate presbyopia. The artificial lens used to replace the eye's natural lens has minimal elastic qualities, so the patient will probably still need some type of eyeglasses following cataract surgery.

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Macular Degeneration
This serious eye disorder is the most common cause of irreversible central vision loss among seniors. The macula is an area about the size of a pencil eraser that is located near the center of the retina and allows us to see the fine details of objects. No other portion of the retina has the capability, thus it is the macula that is responsible for detailed, straight-ahead vision such as needed for reading, using a computer or driving a car. The remainder of the retina takes care of peripheral vision and most of nighttime vision.
As some people age, the macula can develop changes that lead to a loss of function and scarring, a condition known as macular degeneration or ARMD. There are two forms of ARMD, the dry form and the wet form. The dry form is simply a case of the macular wearing out and thinning with age. Vision loss tends to be gradual over years. Unfortunately, there is no medical or surgical treatment at this time. The wet form occurs when blood vessels under the retina begin to degenerate. This can cause serious and sometimes rapid vision loss. Lasers have been used with some success in the treatment of the wet form of macular degeneration, but vision that has been lost cannot be restored.
As with most eye problems, early detection usually results in more successful treatment of macular degeneration. There is a home eye test for ARMD called the Amsler Grid Chart. You will find a copy that you can print out and use at home on this web site. Just click here.

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Diabetic Retinopathy, Retinal Tears, Detached Retinas
More than 18 million Americans suffer from diabetes and nearly 50% of them will be affected by a disorder called diabetic retinopathy. Because the risk of developing this condition increases the longer a person has diabetes, age in an important factor in this disorder. Many cases of blindness could be avoided if patients with diabetes received regular eye examinations.
Diabetes can attack the eyes in several ways, but it principally affects the retina, the light-sensitive membrane at the back of the eye that captures images and transmits them to the brain via the optic nerve. Diabetes causes small blood vessels in the retina to weaken and leak, and can also cause the growth of new blood vessels that leak more easily. Both conditions cause scarring of the retina.
Fortunately, timely treatment with a laser can decrease the leakage from the damaged vessels and stop new, weaker blood vessels from growing. Laser treatment given in a timely manner can stop the deterioration, but it cannot restore visual losses, so early detection is essential.

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Retinal Tears & Detached Retinas
Retinal damage can also occur for reasons other than diabetic retinopathy. A tear or hole in the retina can develop either spontaneously or be caused by a blow to the eye. A tear in the retina can result in retinal detachment, a serious problem that can lead to permanent vision loss. Although this condition can occur at any age, it is a more frequent disorder of the aging eye. Fortunately, most retinal tears and detachments can be surgically repaired; however, only partial recovery of vision may be possible if the condition has been present for a long period of time.

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Spots, Floaters, Flashes, Vitreous Detachment
Many people occasionally experience the sensation of spots floating in their field of vision. These spots usually come and go in short order, but the spots can become more frequent with age. Floaters are most noticeable in bright light or when looking at distant objects. When the spots appear to become strung together with a web-like thread, they are called floaters.
Flashes and floaters are usually harmless symptoms of an age-related change in the vitreous humor, the gel that fills the inside of the eye behind the lens. This gel starts to shrink as middle age approaches forming clumps or strands inside the eye. The shrinking may cause it to detach from the retina, and this pulling can cause small amounts of bleeding that appears as floaters or flashes of light.
Flashes are bright points of light - usually in the form of an oval, circle or arc - that literally flash into your field of vision when your eyelids are closed. Flashes last only a fraction of a second and usually occur in one eye at a time. Although flashes and floaters are normally harmless, if the floaters increase in number or the flashing becomes continuous, an immediate visit to an ophthalmologist is recommended because these can be symptoms of a retinal detachment or other problem resulting from the shift of the vitreous.

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Dry Eye
The term dry eye describes a common disorder that occurs when the eye produces too few tears or produces tears that are lacking the proper chemical composition to lubricate and protect the eye from dust and other irritants. Spread by blinking (about every six seconds), tears keep the surface of the eye optically clear and smooth and also protect the eye from infection.
The most common symptoms of dry eye are a "gritty" feeling, itchiness, burning, stinging, redness and sensitivity to light. Ironically, one of the symptoms of dry eye can be excessive watering of the eyes. The watering is a natural reflex caused by irritation to the eye because the composition of the tears is wrong. These tears are mostly water and evaporate quickly, providing little protection for the eye.
Dry eye can develop under many circumstances but is often the result of the natural aging process. Those who wear contact lenses may also have a problem because the lenses normally float on the eye's tear film. If the tear film is deficient, the lenses can rub against the surface of the eye causing redness and irritation.
Dry eye cannot be cured, but discomfort can be lessened and treatment prescribed so eyes remain healthy and vision is not affected. Artificial tears in the form of eye drops are the most common treatment. A humidified environment also helps in dry eye treatment by adding moisture to the air and helping prevent the evaporation of tears.
Left untreated, dry eye is not only uncomfortable and irritating, it can cause changes in the ocular surface such as cornea scarring and infection. People with dry eyes, or who suspect they have the problem, should seek medical attention.

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Glaucoma
Glaucoma is one of the most common causes of preventable vision loss. It is actually a group of diseases that cause an increase in pressure inside the eye, which can damage the optic nerve and the retina. This damage can result in serious vision loss and even blindness if not detected and treated early.
There are two basic types of glaucoma: open angle glaucoma and narrow angle glaucoma. Open angle glaucoma, sometimes called chronic glaucoma, is the most common type, affecting 70 to 80% of those who suffer from the disorder. Open angle glaucoma is the leading cause of blindness among adults in the United States and is particularly dangerous because it can progress gradually and unnoticed for years. The only way to detect the disease before it becomes a serious problem is with regular eye examinations, including a simple, painless pressure test. The disease usually affects both eyes.
Narrow angle glaucoma is not as common and is usually very painful because of the sudden increase in pressure inside the eye. In some cases, there can be warning attacks such as blurred vision and the appearance of colored halos around lights, or severe pain and redness. The symptoms of an acute attack are much more severe and can be totally disabling. They include severe pain, often accompanied by nausea and vomiting, and should always be treated as a medical emergency. If the symptoms occur, call your eye doctor at once, or go to the emergency room if you are unable to contact your physician. Vision may be preserved or serious damage may be avoided by prompt treatment. If caught at an early stage and properly treated, narrow angle glaucoma can be controlled.

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