Signs and symptoms of retinal detachment

If you suddenly notice spots, floaters and flashes of light, you may be experiencing a retinal detachment. Your vision might become blurry, or you might have poor vision. Another symptom is seeing a shadow or a curtain coming down from the top of the eye or across from the side. These symptoms can occur gradually as the retina pulls away from the supportive tissue, or they may occur suddenly if the retina detaches immediately.

There is no pain associated with retinal detachment. If you experience any of the above symptoms, consult your eye doctor right away. Immediate treatment increases your odds of regaining lost vision.

What causes retinal detachments?

An injury to the eye or face can cause a detached retina, as can very high levels of nearsightedness. Extremely nearsighted people have longer eyeballs with thinner retinas that may be more prone to detaching.

On rare occasions, retinal detachment may occur after LASIK surgery in highly nearsighted individuals. In a study of more than 1,500 LASIK patients, just four suffered retinal detachment; their pre-LASIK prescriptions ranged from -8.00 D to -27.50 D.

Cataract surgery, tumors, eye disease and systemic diseases such as diabetes and sickle cell disease may also cause retinal detachments. New blood vessels growing under the retina – which can happen in diseases such as diabetic retinopathy – may separate the retina from its underlying support tissue as well.

Treatment for retinal tears and detachments

Surgery is the only effective treatment for a torn or detached retina. The procedure or combination of procedures your doctor uses depends on the severity and location of the problem.

Laser surgery. Also called photocoagulation, laser surgery is generally used for retinal breaks and tears that have not yet become retinal detachments. The surgeon directs a laser beam into your eye through the pupil to “spot weld” the damaged retina to its underlying tissue. Photocoagulation requires no surgical incision and causes less irritation to the eye than other treatments.

Cryopexy. In this treatment, the surgeon applies a freezing probe to the outer surface of the eye over the area of defective retina. The scarring that occurs from the freezing reattaches the retina to its support tissue.

Pneumatic retinopexy. This surgery is generally used to treat a retinal detachment in the upper half of the retina. The surgeon injects an expandable gas bubble inside the eye, positioning the bubble over the torn and detached retina. As the gas bubble expands, it pushes the detached retina against its support tissue. The surgeon then may use laser photocoagulation or cryopexy to firmly reattach the retina to the underlying tissue. Over time, your body absorbs the gas bubble. Until that occurs, certain precautions are necessary.

In a variation of pneumatic retinopexy, the surgeon may inject silicone oil rather than expandable gas into the eye to press the detached retina against its support tissue. In this procedure, the silicone oil must be removed from the eye after the retina is reattached.

Scleral buckling. This is the most common surgery used to treat a retinal detachment. In this procedure, the surgeon places a soft silicone band around the eye, which indents the outside of the eye toward the detached retina. The band is sutured against the tough outer white coating of the eye (the sclera). The surgeon then drains any fluid between the retina and its support tissue, and reattaches the retina with laser photocoagulation or cryopexy.

In about 90% of cases, detached retinas are successfully reattached with a single surgery. However, this does not mean your vision will return to normal. Patients who have the best visual outcomes from retinal detachment surgery are those who seek attention immediately upon noticing symptoms and have detachments that do not involve the central retina (the macula).

For more detached retina information, visit All About Vision®.

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RP affects approximately 1 out of every 4,000 Americans.

Signs and symptoms of retinitis pigmentosa

The first symptoms of retinitis pigmentosa usually occur in early childhood, when both eyes typically are affected. However, some cases of RP may not become apparent until affected individuals are in their 30s or older.

“Night blindness” is the primary symptom of the disease in its early stages. During later stages of retinitis pigmentosa, tunnel vision can develop, with only a small area of central vision remaining.

In one study of RP patients who were at least 45 years old, 52% had 20/40 or better central vision in at least one eye, 25% had 20/200 or worse vision and 0.5% had no light perception (total blindness).

What causes RP?

Not much is known about what causes retinitis pigmentosa, except that the disease is inherited. It is now believed that RP can be caused by molecular defects in 100 different genes, causing significant variations in the disease from person to person.

Even if your mother and father don’t have retinitis pigmentosa, you can still have the eye disease when at least one parent carries an altered gene associated with the trait. In fact, about 1% of the population can be considered carriers of recessive genetic tendencies for retinitis pigmentosa that, in certain circumstances, can be passed on to a child who then develops the disease.

In RP, the light-sensitive cells in the retina gradually die. Usually, cells called rods are primarily affected. These cells are needed for night vision and peripheral vision. However, other cells called cones can also be affected. Cone cells are responsible for our central vision and color vision.

Retinitis Pigmentosa tests and treatment

Visual field testing likely will be done to determine the extent of peripheral vision loss. Other eye exams may be conducted to determine whether you have lost night vision or color vision.

No treatments currently are available for retinitis pigmentosa, although some practitioners believe that vitamin A supplements may delay vision loss.

Illuminated magnifiers and other low vision devices can be helpful to help RP patients get the most out of their remaining vision. Occupational therapy and psychological counseling are also recommended to help the person with RP deal with their vision loss.

Researchers are looking into ways to treat RP in the future, such as retinal implants and drug treatments.

For more information on retinitis pigmentosa and low vision, visit All About Vision®.

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However, the term “pink eye” is often used to refer to any or all types of conjunctivitis, not just its acute, contagious form.

Signs and symptoms of pink eye

The hallmark sign of pink eye is a pink or reddish appearance to the eye due to inflammation and dilation of conjunctival blood vessels. Depending on the type of conjunctivitis, other signs and symptoms may include a yellow or green mucous discharge, watery eyes, itchy eyes, sensitivity to light and pain.

How can you tell what type of pink eye you have? The way your eyes feel will provide some clues:

• Viral conjunctivitis usually causes excessive eye watering and a light discharge.
  
• Bacterial conjunctivitis often causes a thick, sticky discharge, sometimes greenish.
  
• Allergic conjunctivitis affects both eyes and causes itching and redness in the eyes and sometimes the nose, as well as excessive tearing.
  
• Giant papillary conjunctivitis (GPC) usually affects both eyes and causes contact lens intolerance, itching, a heavy discharge, tearing and red bumps on the underside of the eyelids.

To pinpoint the cause and then choose an appropriate treatment, your eye doctor will ask some questions, examine your eyes and possibly collect a sample on a swab to send out for analysis.

What causes pink eye?

Though pink eye can affect people of any age, it is especially common among preschoolers and school children because of the amount of bacteria transferred among children.

Conjunctivitis may also be triggered by a virus, an allergic reaction (to dust, pollen, smoke, fumes or chemicals) or, in the case of giant papillary conjunctivitis, a foreign body on the eye, typically a contact lens. Bacterial and viral infections elsewhere in the body may also induce conjunctivitis.

Treatment of pink eye

Avoidance. Your first line of defense is to avoid the cause of conjunctivitis, such as contaminated hand towels. Both viral and bacterial conjunctivitis, which can be caused by airborne sources, spread easily to others.

To avoid allergic conjunctivitis, keep windows and doors closed on days when the airborne pollen count is high. Dust and vacuum frequently to eliminate potential allergens in the home.

Stay in well-ventilated areas if you’re exposed to smoke, chemicals or fumes. If you do experience exposure to these substances, cold compresses over your closed eyes can be very soothing.

If you’ve developed giant papillary conjunctivitis, odds are that you’re a contact lens wearer. You’ll need to stop wearing your contact lenses, at least for a little while. Your eye doctor may also recommend that you switch to a different type of contact lens, to reduce the chance of the conjunctivitis coming back.

Medication. Unless there’s some special reason to do so, eye doctors don’t normally prescribe medication for viral conjunctivitis, because it usually clears up on its own within a few days. Your eye doctor might prescribe an astringent to keep your eyes clean, to prevent a bacterial infection from starting. Another common prescription is for artificial tears, to relieve dryness and discomfort.

Antibiotic eyedrops or ointments will alleviate most forms of bacterial conjunctivitis, while antibiotic tablets are used for certain infections that originate elsewhere in the body.

Antihistamine allergy pills or eyedrops will help control allergic conjunctivitis symptoms. In addition, artificial tears provide comfort, but they also protect the eye’s surface from allergens and dilute the allergens that are present in the tear film.

For giant papillary conjunctivitis, your doctor may prescribe eyedrops to reduce inflammation and itching.

Usually conjunctivitis is a minor eye infection. But sometimes it can develop into a more serious condition. See your eye doctor for a diagnosis before using any eye drops in your medicine cabinet from previous infections or eye problems.

Prevention tips

Because young children often are in close contact in day care centers and school rooms, it can be difficult to avoid the spread of bacteria causing pink eye. However, these tips can help concerned parents, day care workers and teachers reduce the possibility of a pink eye outbreak in institutional environments:

• Adults in school and day care centers should wash their hands frequently and encourage children to do the same. Soap should always be available for hand washing.
  
• Personal items, including hand towels, should never be shared at school or at home.
  
• Encourage children to use tissues and cover their mouths and noses when they sneeze or cough.
  
• Discourage eye rubbing and touching, to avoid spread of bacteria and viruses.
  
• For about three to five days, children (and adults) diagnosed with pink eye should avoid crowded conditions where the infection
  could easily spread.
  
• Use antiseptic and/or antibacterial solutions to clean and wipe surfaces that children or adults come in contact with, such as common toys, table tops, drinking fountains, sink/faucet handles, etc.

For more information on pink eye or types of conjunctivitis, visit All About Vision®.

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Currently an estimated 90 million people in the United States either have presbyopia or will develop it by 2014. This is generating a huge demand for eyewear, contact lenses and surgery that can help older Americans deal with their failing near vision.

Presbyopia signs and symptoms

With the onset of presbyopia, you’ll find you need to hold books, magazines, newspapers, menus and other reading materials farther away in order to see the print clearly. Headaches and eyestrain when reading or performing other near work after age 40 are other symptoms of presbyopia.

What causes presbyopia?

Presbyopia is an age-related loss of flexibility of the lens inside the eye. This is different from astigmatism, nearsightedness and farsightedness, which are related to the shape of the eyeball and occur early in life. When the lens becomes hardened and less elastic, the eye has a harder time focusing up close.

Presbyopia treatment: Eyewear

Eyeglasses with bifocal or progressive addition lenses (PALs) are the most common correction for presbyopia.

“Bifocal” means two points of focus: the main part of the eyeglass lens contains a prescription for nearsightedness, farsightedness and/or astigmatism, while the lower portion of the lens holds the stronger near prescription for close work. Progressive addition lenses are multifocal lenses that offer a gradual transition between a number of lens powers for different viewing distances, with no visible lines in the lens.

Reading glasses are another choice. Unlike bifocals and PALs, which most people wear all day, reading glasses are typically worn just during close work. If you wear contact lenses, your eye doctor can prescribe reading glasses to wear over your contacts for near vision tasks. You may also purchase non-prescription “readers” over-the-counter at a retail store for the same purpose.

Multifocal contact lenses, available in gas permeable (GP) or soft lens materials, also are available for presbyopes.

Another type of contact lens correction for presbyopia is monovision, in which one eye wears a distance prescription, and the other wears a prescription for near vision. The brain learns to favor one eye or the other for different tasks.

Because changes in the lens of your eye continue as you grow older, your presbyopic prescription will increase over time. Your eyecare practitioner will prescribe a stronger correction for near work as you need it.

Presbyopia treatment: Surgery

Surgical options for the correction of presbyopia also exist. If you also have nearsightedness, farsightedness or astigmatism, monovision LASIK eye surgery can correct these problems and decrease your dependence on reading glasses as well. It’s also expected that a multifocal LASIK treatment option for presbyopia will soon be available in the United States.

If you only need glasses for reading and close work, conductive keratoplasty (CK) may be a good option. This surgical technique is less invasive than LASIK and can be performed on one eye for a monovision correction.

Another surgical treatment for presbyopia is refractive lens exchange (RLE), where your eye’s hardened lens is removed and replaced with a special type of intraocular lens (IOL) to restore your distance vision and near vision lost to presbyopia. This procedure is similar to cataract surgery, and is more invasive than CK or LASIK.

Because the field of vision correction surgery is changing rapidly, ask your eye doctor for the latest information about surgery for presbyopia if you are interested in this treatment option.

For more information on presbyopia and bifocals, visit All About Vision®.

Article ©2008 Access Media Group LLC. All rights reserved. Reproduction other than for one-time personal use is strictly prohibited