Exceed your vision Microsurgery & Laser Centre
  • FAQs
    FAQs
eye checking

GENERAL

You will be light sensitive but if you are legal to drive you may. However, if you think you will be more comfortable please bring a driver.
Your visit will last approximately 45-minutes to 1 ½ hours .
You should wait 1-5 minutes between each drop.
After the second day post operative you may.
Depending on positioning requirements and the limitation of activity.
No more that 10-pounds of lifting and no bending over.
Take the drop once you remember. If it is almost time to take the next dose, skip the one you missed and continue with the schedule.
This is dependent on the prescription needed.
No. Drops are to be instilled during waking hours only.
Medication should be discussed with your medical doctor and the surgical center.
You should bring photo ID, and a driver if you prefer.
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RETINA

ANTI-VEGF

Anti-VEGF treatment is a way to slow vision loss in people with conditions like wet form of AMD (Age related Macular Degeneration), CNVM (Choroidal Neo Vascular Membrane), Severe Diabetic Retinopathy, Macular Edema (swelling), Vascular Blocks, Neovascular Glaucoma (NVG), Vitreous Hemorrhage, etc. These retinal diseases, which were earlier considered incurable, or had very poor results with existing treatments are now being tackled with good results with these anti-VEGF agents.
A certain chemical in your body is critical in causing abnormal blood vessels to grow under the retina. That chemical is called vascular endothelial growth factor, or VEGF. Recently, scientists have developed several new drugs (anti-VEGF) that can block the trouble-causing VEGF. Blocking VEGF reduces the growth of abnormal blood vessels, slows their leakage, and helps to slow vision loss.
The anti-VEGF drug must be injected into your eye with a very fine needle. Your ophthalmologist will clean your eye to prevent infection and will administer an anaesthetic to your eye to reduce pain. Usually, patients receive multiple anti-VEGF injections over the course of many months. As with any medical procedure, there is a small risk of complications following anti-VEGF treatment. Any complications that might occur usually result from the injection itself, which in rare circumstances can injure the eye's lens or retina or lead to an infection. For most people, though, the benefit of the treatment outweighs the small risk of injection injury.
Your ophthalmologist will determine if the treatment is appropriate for you. In some cases, your ophthalmologist may recommend combining anti-VEGF treatment with other therapies. For instance, some patients also receive photodynamic laser therapy. With this treatment, a special drug is injected into the veins in your arm, where it flows to your macula. Your ophthalmologist uses a special laser to activate this drug in order to close abnormal blood vessels in the macula. The treatment that's right for you will depend on the specific condition of your retina. As of now, there are three injections available with us for treatment. These are Lucentis, Avastin and Macugen. These injections are given inside the eye. The procedure is a very small one, but is performed inside the operation theatre to maintain the strict asepsis. The patient is discharged within 10-15 minutes of the procedure, and can resume his/her normal activities immediately.

DEGENERATIVE MYOPIA

(I am very shortsighted (-9.5D) and just heard about "degenerative myopia". I wonder how many high degree myopia people will have "degenerative myopia" ?)

2% of the population has this. You are nearsighted. Any person with a high degree of myopia has a higher risk of retinal detachment. It is not likely that you have this but an ophthalmologist (not an optometrist) should be consulted if you feel you may have it.

How can I tell if I have it or not? I'm 13 and my vision has been getting worse every year for just about the past 7 years. I believe there was one year when my vision actually got better, but I dunno. Last I checked, my vision was -9 and -7 in my right and left eye, and I know it's gotten worse this year. Do I have degenerative myopia?

What you are describing is referred to as "progressive" myopia. Progressive myopia is a genetically inherited condition. The classical presentation of progressive myopia tends to follow this time line -- Most first notice a shift into myopia causing a blurring of distance around second to third grade (7 to 8 years of age). The individual then consistently and continually increases in nearsightedness until about the age 17 to 19 at which time most then become somewhat stable in their degree of nearsightedness for many years until other vision issues such as cataract may cause changes.

Could I? What are the symptoms? How can I tell?

I have -9.00 diopters in my right eye and -7.00 in my left. I'm not even an adult yet and my vision seems to keep getting worse even if I don't use it much.

"Degenerative myopia" is a form of myopia where the retinal health is affected. It is different from juvenile myopia progression, in which teens get increasingly nearsighted. The only way to know if you have degenerative myopia is to have a dilated eye examination and have an eye doctor (optometrist or ophthalmologist) make that diagnosis for you. Your retina either has a degenerated appearance or it does not. There is no way to tell by just the spectacle Rx (whether you are -9.00 or not) or whether you are becoming increasingly nearsighted or not.

I see floaters and such. Do I have degenerative myopia?

Floaters are pretty normal, unfortunately. If your vision is suddenly grey, like you're looking through a curtain, call your ophthalmologist immediately.

What kind of profession is most suitable for people who suffer from high degrees of myopia (nearsightedness) or what kind of work they should perform in order not to hurt their eyes?

Well this optometrist gets to -14.25 in the worst meridian of my worst eye. It's given me some insight (sorry) and empathy with at least my high myope patients.

It's a question better tackled from the other end. High myopes are marginally more prone to retinal detachment, so occupations exposed to vibration or shocks are to be avoided: pneumatic drills, driving heavy machinery... High diver, professional football player.

Some occupations require good vision without glasses or contact lenses... principally branches of the military and the fire service, but heavy goods vehicle driving is also legally barred from high myopes on grounds of a minimum vision without glasses requirement in most countries.

RETINAL DETACHMENT

The retina is the layer of neurosensory tissue that lines the back, inside wall of the eye. If you imagine that your eye is like a camera, then the retina is the film. When rays of light enter the eye and are focused on the retina by the cornea and lens, the retina reacts. The light receptive nerve cells that comprise the retina generate a nerve impulse whenever they are exposed to light. The retina then sends these nerve impulses along the optic nerve to the brain which interprets them as a picture. It's rather like the film in the camera being developed so that pictures can be viewed. However, just like a picture cannot be developed if the camera has defective film, vision is not possible in an eye with a defective retina.

The back cavity of the inner eye is filled with clear jelly called vitreous . When the vitreous jelly undergoes the natural aging process it deteriorates and becomes liquid. As the eyeball moves, small pockets of liquid vitreous can move around as well inside the vitreous cavity. This movement causes the vitreous to pull on the retina, causing flashing (photopsia).

Normally the jelly is only loosely adherent to the retina and easily peels away from the retina during vitreous degeneration (syneresis). This event is called a posterior vitreous detachment (PVD) and again is a normal event occurring in most people sometime between 50 and 70 years of age.

However, occasionally, the vitreous jelly is so adherent to the retina and pulls so hard on it that it creates a tear. If this tear is along a blood vessel of the retina this may cause bleeding into the vitreous (called a vitreous hemorrhage) which could lead to a shower of floaters which cloud the vision. Acute retinal tears with or without flashes and floaters pose a risk because fluid can enter through the tear under the retina and lift the retina off, causing a retinal detachment, much like damp wallpaper peeling from the wall. Since PVDs are usually the initiating event of most retinal detachments, this is why PVDs are such a concern.

Retinal tears may be sealed with lasers or cryotherapy (a freezing treatment), or both, to prevent retinal detachment. These treatments are usually painless and seal the retina to the wall of the eye. Both of these procedures create a scar to seal the retina to the back of the eye. This prevents fluid from traveling through the tear and under the retina, and is thought to be helpful in preventing a retinal detachment.

A retinal tear is considered so serious because the vitreous liquid may leak through the tear, and pool under the retina. Gradually, the build up of liquid separates the retina from the wall of the eye, a condition called a Rhegmatogenous Retinal Detachment ( a retinal detachment associated with a hole or break in the retina). Retinal Detachments are a separation of the retinal tissue from the inside wall of the eye. Similar to wallpaper coming lose from a wall, the retinal tissue may develop folds or come completely away from its proper position along the interior of the eye resulting in loss of vision.

Retinal tears and detachments generally offer the following painless symptoms:

  • New Floaters: The presence of some floaters is common because the vitreous is not completely transparent or uniform in consistency. However, a sudden increase in the number and size of floaters perceived in your vision is a warning sign that a retinal tear could be in progress.
  • Flashes: The sudden appearance of flashes in vision may indicate that the vitreous material is pulling away from or tugging on the retina, which could be the first stage of a retinal tear or detachment.
  • Shadow or curtain over vision: The onset of a growing, dark shadow or the appearance of a curtain being pulled over a portion of the vision in one eye is an indication of a retinal detachment. These symptoms usually occur in the peripheral (side) vision. The growing shadow results from the increasing area of retinal tissue being pulled away from the back wall of the eye and no longer able to react to light.
  • Decreased vision: Another common symptom of a retinal tear or detachment is a sudden decrease in vision.

Many people experience flashes or floaters and these are not necessarily a cause for alarm. However if they are severe and seem to be getting worse, and/or you are losing vision then you should see an ophthalmologist immediately. An eye examination with dilated pupils will allow the determination of the source of your symptoms, as well as a recommendation for the appropriate treatment. Prompt treatment can often minimize the damage to your eye.

  1. Retinal Surgery

    The detachment of the retina from the back wall of the eye causes it to be removed from its blood supply and therefore its source of nutrition. An untreated detachment will cause the retina to degenerate and lose its ability to function, permanently in some cases. Retinal surgery though offers hope and the chances of successfully restoring vision are dramatically improved when intervention occurs as soon as possible following the onset of symptoms.

    Very small detachments of the retina can be surrounded by laser treatment, just like retinal tears, to help limit their spread. Large retinal detachments, however, need to be repaired surgically. The two major surgical treatments for retinal detachment are scleral buckling - where a sponge or length of silicon plastic is placed on the outside of the eye and sewn in place (the scleral buckle is very small and not visible after surgery), pushing the sclera toward the tear in the retina - and pneumatic retinopexy, a less severe treatment where the surgeon injects a gas bubble inside the vitreous cavity. The bubble pushes the retina against the wall of the eye, allowing the tear to seal against the eye wall.

  2. Vitreous Surgery

    If the retinal detachment is too severe for scleral buckling or pneumatic retinopexy, surgery to reattach the retina may be necessary. Under general anesthesia, the surgeon removes the vitreous entirely, replacing it with air or a fluid compatible with the eye. Over time, the fluid (or air) is absorbed, and replaced with the eye's own fluid. Lack of vitreous does not affect the patient's vision.

    The success of these surgical techniques depends upon several factors including the size and location of the damaged area of the retina, the length of time that elapses between the onset of the tear or detachment and the surgery to repair the damage, and whether or not other complicating factors are present. Many persons who have undergone retinal reattachment surgery regain all of their previous vision, while some regain only functional vision. Even in these latter instances, the treatment is usually effective in preventing further damage to the retina and more vision loss.

    All of these surgical techniques are done microscopically. We want to reassure you that your surgeon does not take your eye out of its socket to operate on it. This is simply impossible.

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CATARACT

Contrary to popular belief, a cataract is not a "film" over the eye. Rather it is a gradual opacification of the lens that causes the lens to become so clouded that light is either distorted or cannot reach the back of the eye (the retina) Retina: The transmitter located at the back of your eye that sends the images to your brain.
About half of the population has a cataract by age 60, and nearly everyone over 75 has at least one. But in rare cases it is earlier. Also infants can have congenital cataracts. These may be related to the mother having German measles, chickenpox, or another infectious disease during pregnancy, but sometimes they are inherited.
A cataract usually starts very small and practically unnoticeable but grows gradually larger and cloudier. Your doctor is probably waiting until the cataract interferes significantly with your vision and your lifestyle. You need to continue to visit your eye doctor regularly so the cataract's progress is monitored. If your cataract is interfering with your vision to the point where it is unsafe to drive, or doing everyday tasks is difficult, then it's time to discuss surgery with your doctor.
All surgery involves some risk, so yes, it is serious. However, cataract surgery is the most commonly performed type of surgery. Many cataract surgeons have several thousand procedures under their belt. Choosing a surgeon with this much experience will reduce the risk of something going wrong.
A small incision is made into the eye. The surgeon will either remove the lens as is, or use ultrasound (Phacoemulsification), commonly but incorrectly termed "laser" to break it up, and then remove it. The back membrane of the lens (called the posterior capsule) is left in place. Usually, a replacement lens (called an intraocular lens, or IOL) is inserted.

YAG lasers are used in a later procedure to create a clear opening in the lens-containing membrane, if the membrane becomes cloudy in the months following the original cataract removal.

Also, "laser-assisted" cataract surgery does exist in a few centers. The technology is in its developmental stage and has not yet attained the popularity of non-laser cataract surgery techniques currently performed by the vast majority of cataract surgeons.

Nowadays, cataract patients who have intraocular lenses (IOLs) implanted during surgery may need reading glasses for close vision, but that's about it.

In fact, with the newer multifocal and accommodating IOLs, even reading glasses are unnecessary.

It varies from one doctor to the next; it also depends on the procedure that is prescribed and the type of artificial lens (intraocular lens) used as a replacement.

As with any surgery, pain, infection, swelling and bleeding are possible, but very rare patients have serious problems or cataract surgery complications.

Retinal detachment also occurs in a few people. Be on the lookout for excessive pain, vision loss, or nausea, and report these symptoms to your eye surgeon immediately.

Cataracts typically cause no symptoms until they have grown large enough to interfere significantly with the passage of light through the lens. Once symptoms of cataracts develop, they may include:
  • cloudy or blurry vision
  • double vision (diplopia)
  • a sense that colors appear faded
  • seeing halos around lights
  • an increased sensitivity to glare and
  • a distortion of vision that makes objects appear as if you're looking at them through a veil.

Age-related cataracts develop very slowly and painlessly. In fact, you may not even realize that your vision is changing until you find yourself going to the eye doctor seeking a change in your eyeglass or contact lens prescription.

Many things can cause a cataract to form, the most common being the natural aging process. As the lens of your eye ages, it gradually thickens and yellows, eventually becoming so cloudy that you are said to have a "cataract." Other diseases, like diabetes Diabetes: A disease in which the body does not produce enough, or properly use, the hormone insulin, Glaucoma: An eye disease that develops when too much pressure inside the eye damages the optic nerve due to the slow drainage of eye fluid through the eye's trabecular meshwork. Without treatment, Glaucoma can cause permanent blindness within just a few years. Symptoms include halos around lights, tunnel vision and vision loss. Glaucoma is most often treated with medications designed to reduce intraocular pressure. Some of these can increase the chances of developing cataracts. Eye injuries and chronic use of corticosteroids Corticosteroids: A class of steroid hormones used to treat a variety of conditions. Chronic use may lead to the formation of posterior subcapsular cataracts.

In many cases, cataracts are age-related, appearing first when a person is in his or her 40s or 50s, but not affecting vision until after age 60. In other cases, cataracts may be related to eye trauma, long-term diabetes, corticosteroid medications or radiation treatments. In infants, cataracts may be congenital (present since birth), occurring as a result of an infection that happened during pregnancy, especially toxoplasmosis, cytomegalovirus, syphilis, rubella or herpes simplex. In infants and young children, cataracts may also be one symptom of a metabolic disease affecting the body's processing of carbohydrates, amino acids, calcium or copper.

Cataracts are the world's leading cause of blindness, accounting for approximately 42 percent of all cases of blindness in all nations. In the United States, most cataracts are age-related, affecting more than half of all Americans older than 65 to some degree. Although the exact cause of age-related cataracts is still being investigated, some scientists suspect that this disorder is linked to chemical changes affecting a class of eye proteins called alpha-crystallins. Current research suggests that alpha-crystallins act as chemical "chaperones," which prevent the abnormal clumping of other types of proteins into cataracts. Inactivation of alpha-crystallins due to age-related exposure to oxidizing agents or ultraviolet light, or to very high levels of blood sugar (in diabetics), may make it possible for cataracts to form.

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CORNEA

Corneal Grafting

  • Optical: To restore vision by replacing the opaque or physically distorted (astigmatism) corneal tissue with clear, non distorted healthy tissue from a donor. These are typically Keratoconus patients and corneas scarred following trauma or infections
  • Reconstructive: to restore the corneal anatomy in patients with extreme thinning and perforations
  • Therapeutic: To remove inflamed corneal tissue which is not responding to medical therapy
  • Cosmetic: To improve the appearance of white opaque corneal scars
Corneas are sourced from local and/or overseas ‘eye banks'. The donor tissue is rigorously inspected for suitability and safety i.e. HIV free and free of pre-existing corneal disease or past corneal surgery. The corneal tissue is transported in a chilled growth medium containing antibiotics.

Corneal tissue "fails" i.e. loss of transparency with consequent drop in vision due to endothelial cell counts dropping below a critical level. Most cases are due to rejection and repeated ophthalmic procedures (as with repeated transplants). Fortunately, corneal rejection is uncommon and if it occurs can be treated medically in most circumstances.

Most corneal transplants ‘last' well beyond 10 years! Corneal transplant patients require bi-annual ophthalmic checkups to ensure optimal eye health.

This varies enormously from patient to patient and which transplant technique was employed to execute the procedure.

In general, using the new Femto laser technique, patients achieve navigational vision without contacts or glasses within 2 to 3 weeks. At 6 to 7 months post surgery, when some or all of the sutures are removed, most patients have 6/12 or better vision with glasses or contacts.

The older technique (PK using a trephine) has a much longer recovery period. A similar outcome is achieved in 18 months on average.

Laser vision correction can be performed after corneal transplantation – to achieve glasses or contact lenses independence. The timing of this depends on the cornea's stability.

This is variable but in general resuming normal activities like gym, golfing etc is much sooner after the new Femto laser corneal transplant technique. Within 1 month most normal activities can be safely resumed.

The older trephine (hand held blade system) is still widely used. However, the incisions are weak and consequently sutures remain in situ for at least a year post op. Post operative astigmatism is usually very high requiring hard contact lenses to correct vision.

However, the newer Femto dalk technique uses a precise laser to remove only the abnormal corneal tissue whilst conserving the patient's own endothelial cells (less risk of rejection). Furthermore, with early removal of sutures (due to much stronger wounds after laser) result in earlier visual rehabilitation within 7 months as opposed to the 18 months with the older techniques.

No, your eye colour stays exactly the same. The transplant involves only the transparent clear cornea and not the pigmented iris!
This depends entirely on which technique is used. Medical Aids will generally cover the older method in full and will contribute towards the cost of a procedure done with a Femto laser but don't cover the entire cost. Please contact your medical aid advisor for details in your contract pertaining to transplantation. There is usually no/little cover for the laser utilization in the new technique. You will need to ‘top up' this cost. Costs for transplant differ between the older techniques (cheaper) and the new laser technique (more expensive)
Typically, donor families wish to remain anonymous but the donor Eye bank can be approached to pass on recipient's thoughts if appropriate.
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Keratoconus

Researchers estimate that Keratoconus affects 1 in 2000 people. The disease affects men and women alike and there are no known differences between races. Although the cause of the disease is unknown, research has suggested that genetics, allergies and other environmental factors may contribute to the onset of the disease.
Initially, a person with early stage Keratoconus will notice a subtle change in their vision. As the disease progresses, one's vision will fluctuate and frequent changes to one's glasses or contact lenses often occur. This happens as a result of a thinning taking place within the cornea and bulging caused by one's normal eye pressure pushing on the weakened front surface of the eye. As the disease continues to advance, the light rays entering the eye become significantly distorted, called irregular astigmatism. The outer portion of the eye begins to bulge, creating what often looks like a cone shape.
Yes, in approximately 90% of Keratoconus cases the disease will manifest itself in both eyes. The rate of progression and the timing of the onset of the disease is typically different for each eye.
The onset of Keratoconus can occur anywhere between the ages of 8 to 40. In the majority of the cases, it becomes apparent during the teen years and slowly worsens before stabilizing somewhat in the 30's or 40's.
Typically, an eyecare professional will treat early stage Keratoconus with contact lenses or glasses addressing the early vision correction needs of the patient. In later stages, rigid gas permeable contact lenses are often recommended. These lenses are used to improve one's vision and to brace the bulge in the cornea. In advanced cases, where the patient can no longer achieve adequate functional vision with contact lenses, corneal transplant surgery may be necessary.
No, historically very few if any persons suffer from total blindness from Keratoconus alone. But in severe cases, one's vision can be significantly impaired and normal everyday activities may be difficult.

Due to the onset and progression of Keratoconus, the weakened cornea loses; its natural dome-like shape. As a result, the light rays entering the eye are no longer focused properly, impairing one's ability to see images clearly.

Intacs are specially designed inserts, made of medical plastic, which are surgically placed under the surface of the cornea. Due to their unique patented design, Intacs are able to remodel the architecture of the cornea re-establishing a more natural dome-like shape and improving one's vision.

Of those who suffer from Keratoconus, approximately 20% will undergo a corneal transplant. The success rate is high although the grafts only last for about 10 years, therefore a young person may have to undergo several corneal transplants. The recovery time for the patient varies and can take more than a year. Contact lenses or glasses are typically required after surgery to achieve acceptable vision.

A corneal transplant is an invasive surgical procedure, requiring the removal of a section of your cornea and having it replaced with donor tissue. Although successful, it is a delicate procedure with typically a long recovery period.

The Intacs procedure does not require removal of corneal tissue, but rather works on the principle of reshaping your own cornea from within utilizing special designed corneal inserts that provide structure to a weakened cornea. The recovery period is typically short, with visual improvement noticed almost immediately.

In the few cases in which a corneal transplant was performed after an Intacs procedure, there were no complications reported.

Cross-linking is a medical procedure that combines the use of ultra-violet light and riboflavin eye drops.
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Lasik

There is a slight chance that treatment could result in an unintended under-response or over-response that may require the continued use of glasses or contact lenses after surgery has been performed.
Although infrequent, infection or inflammation is possible during the healing of the cornea. This may result in permanently decreased vision.
Some patients experience haze (or corneal cloudiness). PRK and LASEK procedures have higher risks of haze than LASIK. Haze is difficult to treat and may result in loss of best-corrected visual acuity, including permanent loss of visual sharpness or clarity.
Vision at night could not seem as sharp as during the day. Some patients may experience night-glare, as a "starburst," a "halo effect," or haze around lights in the night time. Some degree of night glare can be expected in many patients. It usually is tolerable and resolves in time, but on occasion could be permanent.
There may be an increased sensitivity to light or glare in some patients.
Blurriness is common in the healing process. While blurriness generally clears in several days, it may take longer to clear, and could remain permanently.
There is a risk of loss of best corrected visual acuity. For most patients, visual acuity will have stabilized in about 3 to 6 months, although full recovery, especially for PRK, may take 4 to 12 months.
If you are over 40 years of age and have laser vision correction to correct both eyes for distance vision, you will likely need reading glasses in order to see objects approximately 3 feet and closer, either now, or sometime in the next several years.
You may experience dryness of the eyes and this dryness may cause severe irritation, discomfort, and blurring of vision for several weeks, or longer, and could rarely be permanent.
The cornea could become weakened from the thinning of laser vision correction, and begin to bulge. This is known as ectasia. There is no way to completely eliminate the risks of ectasia with LASIK, PRK or LASEK. Patients having LASIK are at higher risks for ectasia than patients having PRK or LASEK. The doctor may recommend PRK as a way to lower the risk of ectasia, but there is no guarantee that the condition will not develop. Ectasia can result in vision loss.
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GLAUCOMA

Glaucoma is a neurodegenerative disease including a number of related conditions that cause damage to the optic nerve, which transmits information from the eye to the brain. It usually (but not always) is associated with high intraocular pressure (IOP). Glaucoma occurs when the pressure inside the eye is high enough to pinch off the circulation of the optic nerve in the back of your eye. The optic nerve is like a telephone cable. When the cable is damaged you start to lose the connections between the eye and brain. This leads to gradual blindness if not treated in time.

Glaucoma is the second leading cause of blindness and the first leading cause of preventable blindness. Risk factors for Glaucoma include:

  • Diabetes
  • High degree of nearsightedness
  • Family history of Glaucoma
  • African-American descent
  • High blood pressure
  • Elevated ocular pressure
  • High degree of farsightedness
  • Previous eye injury
  • Prolonged steroid use

In recognition of the importance of early detection and management of Glaucoma, Medicare and most private insurers offer coverage for annual Glaucoma screenings. For patients that have been diagnosed with Glaucoma, they should schedule an eye exam every 3 to 4 months, since there is no way to determine whether Glaucoma is under control based on the way they feel.

The average pressure for most people is 10-21.
Unfortunately, yes. Many people with a susceptibility to Glaucoma do have optic nerve damage with much lower pressures. This is called Low Tension or Low Pressure Glaucoma
Ocular hypertension is another term for high eye pressure. In ocular hypertension, IOP is higher than normal but does not cause optic nerve damage and vision loss. Ocular hypertension is a risk factor for Glaucoma and should be monitored closely.
Yes, a family history of Glaucoma increases your risk of developing Glaucoma by two to ten times depending on the closeness of the relationship. If you have Glaucoma, all of your blood relatives need to be informed and they need regular eye exams to watch for it. Age is also a risk factor. After age 40 the risk starts to rise each year.

The "puff test" that most people are familiar with is a screening test that measures IOP. But the gold standard for measuring eye pressure is applanation tonometry. In this Glaucoma test, an eye drop is used to numb the surface of your eye and a small probe rests gently on your cornea to measure IOP. Also, the corneal thickness needs to be measured as the applanation reading depends on it.

Your doctor may also want to check for optic nerve damage by dilating your eyes and check for vision loss with a visual field test.

Though it's unclear whether Glaucoma can be prevented, you might be able to reduce your risk for the disease by maintaining a healthy lifestyle.

I would advise to avoid smoking and excessive alcohol, eat a healthy diet, keep your weight down, exercise, take nutritional products and be sure to see your eye specialist on a regular basis.

There are usually no symptoms to suggest that you're developing Glaucoma until vision loss occurs, which is why it's so important to have regular eye exams. Your eye doctor can detect and treat high IOP before it progresses to optic nerve damage and vision loss.
In some types of Glaucoma you may have headaches. But by and large NO! Glaucoma is called the "sneak thief of sight because it starts by affecting your side vision in very subtle ways that you cannot detect.
Primary open-angle Glaucoma (POAG), normal-tension, narrow-angle (PACG), closed-angle, congenital, pigmentary and secondary. PACG is more common is Asians and East- Asians.
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SQUINT

Myopia (poor distance vision) and other vision problems often develop gradually. Young children rarely complain about poor vision, and may be completely unaware that they don't see well. For all of these reasons, you will want to make sure that your pediatrician or family doctor checks your children's vision before their fourth birthday. The American Academy of Ophthalmology recommends a child's vision should then be re-tested every two years.

Signs of vision problems that you may detect at home include squinting, crossed or wandering eyes, turning and tilting the head while watching television, or lack of interest in reading. If your family has a history of poor vision or crossed eyes, your child may be at increased risk for a similar eye problem. These children need to be tested at a very young age.

The school screening program or your family doctor will use a special chart with pictures or symbols. These charts help to assess vision in preschool-age children even if they do not know the alphabet. Toddlers and infants can also be evaluated for vision and eye health by using behavioral tests such as observing how your child looks at special objects, or how they move their eyes.
If vision problems are detected, you should have a more complete exam with an Eye specialist. A general ophthalmologist will be able to determine if your child needs glasses to correct his or her vision, or if a more serious problem exists. From there, you may be referred to a pediatric ophthalmologist for further treatment.

Children and infants can successfully and comfortably wear glasses. In fact, if they recognize that they see better, they may insist on wearing them. Children who are too young to talk show their obvious preference for wearing glasses by growing fussy or crying when the glasses are taken away!

Your child is more likely to wear the glasses if they are comfortable and fit well. If your child needs glasses, you should have the prescription filled at an optical shop that carries children's frames and impact resistant lenses.

Glasses are now considered a fashion accessory. Have fun selecting them; your child's first impression will be a lasting one!

The answer depends on the sport. In 1997, over 44,000 eye injuries occurred in sports related activities. A large percentage of these were in young athletes. Protective eyewear may decrease these injuries by 90%.

In sports such as basketball, racquetball, tennis and soccer, goggles should be worn to protect the eyes from the ball or from other players' elbows, knees or feet. If your child wears glasses, you may purchase protective goggles with the prescription already built in.

In low risk sports, such as track and field, street wear frames with polycarbonate or plastic (CR-39) lenses should be adequate. A sports head strap that secures the frames also increases safety by helping to keep the glasses from falling off.

People who are nearsighted, or myopic, have difficulty seeing in the distance without glasses. Children with myopia may squint to see distant objects, or complain of being unable to see the board. Infrequently, they may complain of headaches. Headaches are actually more often a sign of other eye problems.

There is no set age for the onset of myopia. Parents who never needed glasses may have a child who starts to wear them in 1st or 2nd grade. Parents who had glasses in grade school may have a son or daughter who does not need them until later if ever. If children exhibit signs of poor vision, such as squinting, closing one eye or wandering eyes, or if a school screening test has detected a problem, you should arrange an exam with an Eye Doctor.

Amblyopia, also known as "lazy eye" is poor vision due to lack of normal development of sight. It is a very common condition, affecting 2-3 of every 100 people. Normally, children's eyes continue to develop from birth until age 9 or 10.

Amblyopia is caused by conditions that interfere with that normal development. There are three major causes of amblyopia:

  1. Unequal focus. In the healthy eye, equal focusing problems can be corrected with glasses. If there is unequal focus because one eye is more nearsighted, farsighted, or has astigmatism, amblyopia may occur. In these cases, the out of focus or blurry eye "turns off" and becomes amblyopic. The brain ignores that blurry eye, and it develops poor vision. This type of amblyopia is very difficult to detect, because the eyes look normal.
  2. Strabismus or misaligned eyes can cause amblyopia when the brain ignores the crossed eye to avoid seeing double. The straight eye usually retains normal vision. Some children may have a large amount of crossing, which is easy to detect. Others have a very tiny amount, which can be difficult to see at home, but can still cause amblyopia.
  3. Cloudiness of the normally clear parts of the eye can prevent a sharp image from reaching the inside of the eye. One example of this is a cataract, or cloudiness of the lens of the eye. Although far less common in children than in the elderly, cataracts can occur in young children.

Amblyopia is diagnosed by finding a difference in the vision of the two eyes. A vision screening exam will help detect this, though further diagnosis and treatment will need to take place with an ophthalmologist. An Eye Doctor will help determine which of the three causes of amblyopia are occurring in your child. Sometimes, more than one can exist at the same time. During that visit, the entire eye will be carefully examined to check for other causes of poor vision.

Treatment of amblyopia involves using the weak eye. Covering or patching the stronger eye accomplishes this by making the weaker eye work alone. Glasses may also be prescribed to correct the unequal focus, or to attempt to straighten misaligned (strabismic) eyes. Patching often needs to be done while wearing glasses full time in order to completely treat amblyopia. If surgery is required for straightening the misaligned eyes, patching or glasses may continue afterward. Surgery, if necessary, may correct the strabismus, but only patching or using the weak eye can correct amblyopia. All forms of treatment need to be started as soon as possible. Amblyopia in particular can become permanent if not treated at an early age.

While the colloquialism "lazy eye" is frequently used to refer to amblyopia, the term is inaccurate because there is no laziness of the eye involved in the condition. For a variety of reasons the brain fails to make the normal neural connections necessary for sight.
Common causes are a misalignment of the eyes, uncorrected refractive error (short-sightedness, far-sightedness or astigmatism), or an obstruction in the line of vision e.g. a cataract.
Usually only one eye is affected. Detecting the condition in early childhood increases the chance of successful treatment.
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