Lindsay wrote:
I am 22 years old and was in a car accident 8 months ago. I experienced severe trauma to my right eye which caused a vitreous detachment. I was referred to a specialist due to the fear I would develop a retinal detachment, but after 2 follow up appointments nothing indicated that this would occur and I needed no further appointments. Ever since my accident, my eyes have bothered me frequently. It is as if my eyes do not focus the same anymore. I do wear glasses and contacts, but following a checkup my prescription has not changed which leads me to believe that this is not the cause of my eye discomfort. I find it extremely difficult to read for a prolonged period of time, or watch TV for that matter. As I am a student, I spend a large portion of time on my computer doing research and writing papers, and it is increasingly difficult to get any work done because my eyes refuse to focus naturally and I need to squint and really concentrate in order to read or write. It is almost as if my right eye is slightly fuzzy or cloudy 100% of the time, and that if I could just rub my eye it would clear up, but it doesnt. It is almost like waking up first thing in the morning when your eyes a kind of fuzzy and unfocused, except that it never goes away. It is becoming really frustrating because it is so distracting, even during lectures I always wish I could just rinse my eye or rub it really hard and have it clear up but nothing makes the minor cloudiness go away. Is this normal for someone who has experienced a vitreous attachment? I have only had this problem post-accident, so I assume that it is somehow connected to it. Also, is there anything I can do about it? It is driving me nuts! Any information would be appreciated because I cannot get in to see my eye doctor until 5 months from now… I really just want to make sure it is nothing serious/ nothing that will get worse, and also wish to know if there is anything I can do about it. Thanks so much.

ANSWER

Hello Lindsay,

Sounds very frustrating… It is hard to diagnose because I have so many questions, however, first thing you have to do, is see your optometrist, and make sure you have the maximum correction for distance and also for near.  You may have developed a little near prescription due to eye muscle fatigue post accident.  Also get your optometrist to dilate your eyes and check the vit. detachment and make sure there is no traction on retina.  and then examine your fovea (central vision) and make sure that part is OK.  Your optometrist should also check if you maybe developed a little cataract in your right eye due to trauma.  and screen you for glaucoma due to trauma.  If all come out negative, and your new prescription does not make the blur go away, then unfortunately that’s all that can be done, and hopefully with time your brain will learn to suppress that little blurry in right eye, but might take time.

Good luck

<!– /* Font Definitions */ @font-face {font-family:”Cambria Math”; panose-1:2 4 5 3 5 4 6 3 2 4; mso-font-charset:0; mso-generic-font-family:roman; mso-font-pitch:variable; mso-font-signature:-1610611985 1107304683 0 0 415 0;} @font-face {font-family:Calibri; panose-1:2 15 5 2 2 2 4 3 2 4; mso-font-charset:0; mso-generic-font-family:swiss; mso-font-pitch:variable; mso-font-signature:-520092929 1073786111 9 0 415 0;} /* Style Definitions */ p.MsoNormal, li.MsoNormal, div.MsoNormal {mso-style-unhide:no; mso-style-qformat:yes; mso-style-parent:”"; margin:0cm; margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:12.0pt; font-family:”Times New Roman”,”serif”; mso-fareast-font-family:Calibri; mso-fareast-theme-font:minor-latin;} .MsoChpDefault {mso-style-type:export-only; mso-default-props:yes; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:Calibri; mso-fareast-theme-font:minor-latin; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:”Times New Roman”; mso-bidi-theme-font:minor-bidi; mso-fareast-language:EN-US;} .MsoPapDefault {mso-style-type:export-only; margin-bottom:10.0pt; line-height:115%;} @page Section1 {size:612.0pt 792.0pt; margin:72.0pt 72.0pt 72.0pt 72.0pt; mso-header-margin:36.0pt; mso-footer-margin:36.0pt; mso-paper-source:0;} div.Section1 {page:Section1;} –>

Michelle wrote:
My daughter is 8 years old and just had an eye exam.  I was told that she is farsighted and requires glasses.  Her prescription is +1.25 in one eye and +1.75 in the other.

Does she really need them?  He told us that right now the reason she is able to see clearly is because she is young and the muscles around her eyes are very strong and therefore can compensate but as she ages they won’t be able to compensate as well.  His said that her eye muscles are very tight right now from over straining all the time.  I just don’t want to start with glasses unless we absolutely have to and will she always need them?

ANSWER

Michelle,
The glasses will make reading much more comfortable for your daughter, allowing her to comprehend better and do better in school.  She will grow in the next few years and as she gets taller, her eyes likely will get larger/longer, which should make her less far sighted.  If this happens, she will not need the glasses so much.

Dr. Joan Hansen, Optometrist for CAO

Sharon wrote:
I hope I am able to explain myself properly because I am at my wits end regarding the problems I have been having with my eyes.  I have worn glasses since I was 7 years old – am now 51.  Most recent rx - right eye -6.00/-050/095 – left eye -7.25/-050/085 (add -2.00 in both eyes).

A couple of years ago, I started to notice a problem I seemed to have with the right eye – it felt like the lens of my glasses was dirty, and I couldn’t see as well in certain light.   I had my eyes tested and was given a new prescription with stronger power in the right eye (increased ½ dioptre).  At this same time I got my first pair of progressive lenses.

However, I continue to experience the problem with my right eye.  It’s hard to explain – it’s not that I can’t see out of it - it is more like it is fighting with the left eye.  I have constant eyestrain and it is at its worst when I am watching TV or reading.  I am also hearing impaired so when I am trying to read the close captioning on the TV it is like the picture and words are somehow distorted by the light on the TV.  Things are not blurry but they are uncomfortable to look at it.

Since this began, I have had 4 eye tests from 2 different optometrists.  Both doctors agree on the rx and my eyes appear to be healthy although the one doctor did say the right eye had more vitreous detachment than the left eye (although I do not actually see floaters).  As well I have had countless adjustments to my glasses by opticians and I have seen a doctor to rule out any underlying health issues.  No one has been able to help.

Tonight I noticed something strange.  I was sitting on the couch trying to watch TV, despite the eye discomfort, and unconsciously playing with the remote.  I put it up between my eyes resting on my nose.  The visual discomfort disappeared immediately!   I tried it a few more times – every time I put a barrier between my eyes, the visual discomfort was relieved.

What can be happening?  This problem has caused me considerable duress as I am no longer able to do much of anything without constant eye strain and discomfort.

ANSWER

Hello Sharon,
I’m sorry to hear that you’re experiencing so much discomfort.  It’s very difficult to give you a diagnosis without examining your eyes.  Certainly the symptoms you’ve described are unusual.  I can suggest that you have your eyes evaluated by an optometrist who has a special interest in binocular vision issues.  Sometimes symptoms of eyestrain can be attributed to problems with the eyes functioning together (which may be why it feels better to separate them).  Again, I can’t say for sure what the problem is, but I think that due to the fact that you’re suffering so much, it warrants further investigation.
I wish you the best of luck.
Dr. Donati

Charlene wrote:
Each visit, my optometrist asks if I have problems seeing at night.  It seems like a somewhat vague question given it is naturally harder to see at night since it is dark.  How do I know the difference between expected reduction in sight due to low light and an actual issue with my night vision?

Mark wrote:
What are the common causes of poor eye sight at night?

ANSWER

Dear Mark and Charlene:
Since your questions are so similar, I will answer them together.
Many of my patients have complaints about night vision, but to accurately quantify the degree of difficulty a person with otherwise healthy eyes might be having is very difficult. There are certain diseases of the retina such as retinitis pigmentosa that usually have a profound effect on night vision. Most of these conditions are inherited, and most have obvious clinical signs inside the eye which helps to make the diagnosis.
However, many people with healthy eyes do complain of some difficulty with their night vision. As Charlene has pointed out, it is naturally harder to see at night because it is dark. I do not want to make this answer burdensomely scientific, but a little background information on the anatomy and physiology of the eye may be helpful here.
In our retinas, we have two different sets of visual receptors, rods and cones. Rods are designed to work in very low levels of illumination and become the primary receptors once our eyes have been “dark adapted”. Complete dark adaptation usually takes about 15 minutes or so. Rods do not give us very acute vision and they do not perceive colour. You may have noticed, for instance, that when you get up in the night to go to the bathroom and you do not turn on any lights, that you are moving through a grayish, somewhat blurred world. In this circumstance, you are navigating by the vision provided by your rod receptors. As soon as you flick on the lights, your cones become active, you perceive colour, and your eyes have much better resolution – better visual acuity. Cones work best in relatively bright light conditions, such as may be experienced when outside or in a brightly lit room. When travelling around at night, whether driving by the light provided by the lights of your vehicle, or by the light provided by any artificial street lighting, the level of brightness is much less than it is in daylight conditions. In this light level, your cones do not function as well, and your vision will be less clear than it is in the daytime.
There are several other factors, many age related, that also tend to diminish our ability to see at night. For instance, younger people in their teens and twenties, are more susceptible to a condition known as “night myopia” which causes them to actually become more nearsighted in low light levels. This is a result of a larger pupil diameter in dim light, a relatively active focusing mechanism and the common aberrations of the crystalline lens inside the eye.  In some cases, patients require a slightly stronger prescription for night driving.
Additionally, as we get older, the crystalline lens inside our eye becomes less clear and it tends to cause more scattering of light inside the eye. When these changes become more significant, we refer to the changes as cataracts, and as needed, surgery is performed to remove the cloudy lens and replace it with a clear artificial implant. The vitreous humor inside the eye, also becomes less clear as we mature and we often develop “floaters” – bits of debris. These are often perceived as dark particles when viewed against a light background in daylight conditions, but they also cause additional light scattering inside the eye at night, reducing our ability to see will in low light levels. As well, when our glasses get older, they tend to become somewhat scratched, and this adds to the amount of light reflection and scatter, making vision in low light more difficult. The best defence against this problem is to have a good anti-reflection coating applied to your prescription lenses, and to take good care not to scratch the coating so the beneficial properties are maintained.
Smokers also tend to have more difficulties with night vision as their circulation systems often do not provide a sufficient flow of blood to the back of the eye to keep the retina functioning normally.
For the reasons cited above, it is normal to experience some decrease in night vision as we get older. This decrease is difficult to quantify outside of a laboratory setting. If you feel that you are not seeing well enough to drive safely at night, you probably are not, and should avoid driving at night. If the underlying cause is cataract development or compromised lens surfaces on your eyeglasses, it may be possible to improve your situation. Check with your optometrist to see if your particular problem can be helped.
Hope this is helpful.

Dr. Smit

Jennifer wrote:
I do not currently wear eye glasses nor have I ever worn them (I’m 39). Recently I went to a local optometrist for an eye test, basically to check for glaucoma because it runs in my family. I was told I didn’t have glaucoma. In fact, the optometrist told me there is nothing currently wrong with my vision. While I was there, however, he wrote me a prescription for computer glasses because I mentioned I work in front of a computer for up to 8 hours a day.  His reason for the prescription is that my eyes will eventually deteriorate and wearing glasses while looking at a computer will help to slow down this deterioration. I put a deposit of $50 on the glasses which they call PL Readers. The total cost is $266. I do not have any insurance plan that covers this.

Now that I’m at home, I’m wondering if I’ve made a mistake in ordering these. The deposit is nonrefundable so I’m going to lose it if I don’t purchase them. However, I don’t understand the concept of wearing glasses to prevent deterioration that hasn’t happened yet. I have heard of computer vision syndrome but I honestly haven’t noticed any symptoms of it eg. dry eyes, headaches, etc. I feel like this was just a way to get me to buy expensive glasses. Can you tell me if it makes sense to wear computer glasses now to prevent deterioration later?

ANSWER

Hi Jennifer,
Presbyopia is an age related condition.  Similar to grey hair and wrinkles, presbyopia is caused by the natural course of ageing.  The consequence of presbyopia is a progressive diminish of our near focus (Books and computers) with age.  Usually starts between ages of 40-50.  You can’t escape presbyopia, even if you’ve never had a vision problem before nor, can you slow its progression by wearing computer glasses early.

Symptoms of presbyopia would be holding books, magazines, newspapers, menus and other reading materials at arm’s length in order to focus properly, and/or when performing near work, such as embroidery or handwriting, you may develop headaches, eye strain or feel fatigued.  This is usually the time to start wearing near or computer glasses in order to perform at near longer without symptoms.

Dr. Sally Aldayeh, OD

Michael wrote:
I didn’t know what category to place this under, but over the summer of 2009 I began to have vision problems, I would suddenly have blurry vision, I would squint my eyes, at first this only happened when I would get stressed or upset, or so I thought, I would be fine one min and then look at my cell phone for 2 seconds and look away and things were blurry. Come sept-nov 2009 it would happen randomly at any given time. My eyes would feel sore like my eye balls were swollen; I felt it every time I blinked. and now march 2010 my eyes just hurt, between summer and now my vision has changed dramatically and generally I have great vision all my life I have never had any problems. Somebody told me that if this gets worse than by next summer I could lose my sight all together and possibly be blind, has anyone heard of this before? this is really random, and sounds dumb but I’m really scared cause even I can’t see how rapidly I’m losing my sight, I went to my optometrist and he did full eye scans front and back and then quickly told me he saw nothing wrong but I know in my heart something is wrong, I wake up in the morning, I can’t see, periodically I can’t see, at night I suddenly can’t see, my eyes hurt to blink, it’s all so random, and above all, since I went to see him in Feb., my vision has reduced dramatically.

I’ve never heard let alone see this anywhere with anyone, I sit at the computer all day long but I’ve been this way since I was 14 and have never had any problems, I know it could be a reason but no I don’t think it would cause something like this. Please any feedback would be great. My vision is getting worse each day and I can’t even see across the room anymore. And all this over a period of months.

ANSWER

Michael,
You don’t say how old you are, so this is more difficult to answer. Sometimes prolonged close work (reading) can cause some of these symptoms especially if you are hyperopic (far sighted). I would suggest that you again see an optometrist and describe your symptoms and changes to them. They should then do an exam where they measure your focusing ability more closely, as well as instilling drops to better measure how far sighted you really are. It is possible that you need glasses for close work.

Dr. Joan Hansen, Optometrist for CAO

Becky wrote:
I am 32 years old and have been wearing glasses/contacts since I was a teenager.  I had my regular eye check-up less than a year ago and noticed a big change in my vision about a couple of months ago. I was noticing it around the Christmas season and thought it might be due to stress.  It however, did not improve when the stress was gone.  Things seem to be a lot more blurry and I find myself squinting a great deal. I went to my eye doctor just after I noticed this change thinking I’d have a major change in prescription.  He said that there was no change in my prescription and that it was probably due to dry eyes.  He suggested I start using eye drops regularly.  I didn’t feel that my eyes were dry but have been using eye drops and it’s not working.  I’m really frustrated because my eyes have obviously changed but the eye doctor doesn’t see a change, what could be causing this.  Recently I have also been to my regular doctor to see if any health concerns would be doing this and they found nothing.

ANSWER

Becky,
I am pleased that you have returned to your eye Doctor, and also that you have seen your Medical Doctor and found out that all is fine health wise.  I would suggest that you call your eye Doctor again and explain the continuing concern. The Eye Doctor likely will need to see you again to recheck your Contact lenses and your glasses.  Have you started to use your eyes in a different way recently - are you reading more?  - did you change Contact lens solution?  Did you switch right and left contacts?  There are so many possibilities, that you need to see the doctor to sort them out

Dr. Joan Hansen, Optometrist for CAO

Amie wrote:
I noticed my 2.5 year old daughter doing a lot of exaggerated blinking lately, so I took her in for an eye exam. I was told that she needs glasses. Her prescription is +5.75 in one eye and +6.25 in the other with slight stignatisms in both eyes. I was told that the prescription written is lower then she actually needs to give her eyes room to adjust as she grows. I’ve been doing a lot of research on farsightedness and I was wondering if a child with her type of vision problems needs to have glasses. If she doesn’t get them is there more of a chance that she will outgrow some of the farsightedness? Her eyes are straight and she seems to be able to see everything close up and far away. Any insight you can give me into this would be great thanks!

ANSWER

Dear Amie,

This is a very good question. Thanks for asking it.

Your optometrist is perfectly right to say that at +5.75 and +6.25 your child needs glasses. Farsightedness creates an image that is focused back from the retina. Eyes have to adjust their “power” to refocus that image at the appropriate point on the retina. This is done with the effort of the crystalline lens. Over +4.00, many studies have proved that the effort to compensate farsightedness is too demanding for the visual system.  At near, you have to add +2.50 to the visual demand at far. That means that your daughter has to compensate +7.25 and +8.75 at near! She can, but she is already rapidly developing visual fatigue… OR she compensates by not looking for a long time at near or doing many things at the same time. Some parents think their children are hyperactive but in fact they are just hyperopes… She also develops a tendency to look at near at a closer distance than normal. This is linked to the fact that for every dioptre the child has to compensate the eyes turn inward by 6 degrees. For a natural demand of +2.50 to +4.00, a regular reading distance is maintained. At +7.00 or +8.00 your daughter is focusing and seeing well at near only if she is at less than 12 cm! Very close. Further than that, she would see double since the eyes crossed at this distance.

In the long term, it is not possible, with such a problem uncorrected to learn to read efficiently and to maintain near work for more than 1-2 minutes. Many children drop out of school simply because their visual system cannot handle the demand.

Even if the child seems to see well, high hyperopia is known to be amblyogenic, meaning that without the appropriate correction the eyes will never develop to their optimal level. We can translate that by the fact that, without correction, these eyes will remain at 80-85% of their capacity and that further on the binocular vision and the 3D vision will be also reduced. This is sad  because that can cause reading difficulties, headaches while doing computer work and this reduced capacity can also make the difference in career choices: a policeman, a firefighter or an aircraft pilot have to have 100% percent vision with full 3D vision.

Under +4.00, habitually we do not correct and we observe how the eyes are developing between 2 and 8 years old. This is the critical period when eyes have to be appropriately stimulated in order to fully develop their capacities. This period of development is known as the emmetropization phenomenon. This means that whatever the visual problem is from birth, the eyes tend to compensate for it in order to get perfect unaided vision at 8 years old. When you are under +4.00 this phenomenon should not be altered and to prescribe glasses could interfere with “nature”. This is another story over +4.00, which is the case of your daughter. Considering that the eyes don’t have the possibility to fully develop their potential, emmetropization is cancelled. This is also true for myopia over 5.00D and astigmatism over 1.50. Yes, just 1.50 because astigmatism is way more disturbing for the visual system than spherical refractive errors such as farsightedness and myopia.

The way to prescribe glasses has to take in account the age of the children. This is true that, for hyperopes (farsightedness) we have to lessen the amount of the full correction by the normal visual demand at near. For a younger child, like your girl, a +2.00 reduction is OK. Older than that, this reduction will be +1.25.

To get the right script, it is necessary to perform a cycloplegic refraction. This means that the optometrist or the ophthalmologist will put some drops on the eye of the patient. This aims to alleviate any compensation of the refractive error by the natural lens of the eye, the crystalline lens. Once done, this test allows us to assess the “real” amount of hyperopia on which to base the prescription.

It is not rare to find +2.00 to +3.00 higher values compared to the test done without cycloplegia.

For instance, if with that test your daughter is +6.00 at far, I would start the prescription at +4.00 and see how the eyes will develop. IMPORTANT: These glasses have to be worn ON A FULL TIME BASIS. ALWAYS.

With time, this prescription will be updated according to the evolution of the eyes.

In the long term, most of the hyperopes, well corrected with appropriate glasses, will be back on the emmetropization pathway. This means that the system will adjust to lessen the amount of hyperopia over the years. Most of the hyperopes cease to wear glasses by the age of 12-15 but again this is unique to each patient. Genetics play a big role here.

Some patients will remain hyperopes, no matter if they wear glasses or not at a younger age. Again, glasses will not do anything but good for the development of your children. This is a misconception that eyes can be made stronger by leaving them without correction. The visual system is not built that way.

Consequently, my recommendation are the following:
1) Re-consult your optometrist if the first exam was not performed with drops.
2) Follow his recommendation — it seems that you are in very good hands considering the recommendations he gave to you.
3) Your daughter should wear her glasses on a full time basis. Her future in school depends on the way you deal with her hyperopia NOW.
4) Make regular follow-ups until the age of 8 to confirm the full development of the eyes.
5) Make annual follow-ups thereafter.
6) Contact lenses can be considered by the age of 8 for most of the children. There are a lot of benefits and self-esteem of the children is boosted as a consequence. Many studies were done in the last years that prove this.

Thanks for sharing that with us. Hoping that this will help,

Dr. Langis Michaud, OD, MSc, FAAO (Dipl)
Associate Professor
Université de Montréal

Lila wrote:
I went to the optometrist last week and the lady asked me questions about my health, etc… Which I didn’t find strange until she asked 3 times if anyone has Diabities in my family to which I responded no.  She then said that at my next annual mention that I had my eyes checked and that the optometrist mentionned that I should be checked for diabities.  I asked her if she thought I should call my Dr and she said well, that’s up to you to decide.  I have asked a few people about her comment and they have all said to call my dr.  What do you think?

ANSWER

Hi Lila,
During the course of your annual eye examination, your optometrist is not only checking your glasses prescription, but checking the health of your eyes as well.  Optometrists often find signs of systemic health concerns such as diabetes, high blood pressure, high cholesterol, even brain issues and cancer!
If your optometrist suggested that you be screened for diabetes, she may be concerned that she saw some early signs of the disease.  I recommend seeing your family doctor, and call your optometrist and ask that a letter outlining her concerns be sent to your doctor so that he/she and your optometrist are on the same page.
Best of luck to you,
Dr. Donati

Tina wrote:
Hello,

I started wearing glasses for reading/computer work about 12 years ago, but I could go without glasses the rest of the time. I’ve always had a really weak prescription, but with astigmatism. Then a year ago, I started getting headaches and my Dr. explained that I might need to wear my glasses all the time. So I started doing that, but cannot ever go without my glasses without getting headaches/blurred vision.

Then tonight, suddenly, I had blurry vision with my glasses on and better vision with them off. About 20 minutes later, I find I need them for the computer in a lit room, but not in a dark room, and that I need them to read the spines of books about 12 feet away, but not for my television (which I always need).

Is it possible that I only need them for reading again? It may be important to note that I have fibromyalgia and have always expected given that the disease attacks the muscles, that it might be related.

I’ll make an appointment with my optometrist, but any insight would be appreciated.

Thank you!

ANSWER

Dear Tina
You do need to see your optometrist. Rapid fluctuations in vision such as you are describing are not normal and are most commonly associated with systemic health conditions. Your fibromyalgia might certainly be a factor, but the possible existence of other conditions such as diabetes needs to be investigated.
Best of luck
Dr. Smit