Myopia (or nearsightedness) is very common. One out of two people (50%) have it. With myopia, the eye is longer than normal from front to back, or the cornea (the clear window at the front of the eye) is too steeply curved. This makes things that are far away from you look blurry. Myopia is corrected with glasses, contact lenses or surgery in some cases. Having myopia can increase your chances of having some eye problems later, like cataract, glaucoma and retinal detachment.

Studies show myopia is becoming more common among children. While there is no proven direct link, research suggests that children who spend more time indoors doing near-focused activities (such as computer work, video games, and reading) have higher rates of myopia than those who spend more time outdoors.

Doctors are looking at ways to slow the progression of myopia in children. While myopia cannot be reversed, the goal of treatment is to keep it from getting worse. This can protect a child’s eye health in the future, despite still needing to wear glasses or contact lenses.

Low-dose atropine eye drops

You may be familiar with atropine eye drops. When given to children in small amounts for 2 to 3 years, atropine eye drops may slow the progression of myopia.

Peripheral defocus contact lenses

These special contact lenses are worn by children 6-12 years of age with myopia. This “multifocal” contact lens has different areas of focus.

Orthokeratology (Ortho-K)- Orthokeratology is a contact lens that a child wears overnight to correct blurry distance vision during the day. Also called Ortho-K, the lenses flatten your cornea while you sleep. The next day, light passing through the reshaped cornea falls precisely on the retina, making distant images appear clearer. 

LASIK /LASER SURGERY-

Steps You and Your Child Can Take that May Help Slow Myopia

Make sure your child spends more time outdoors. Limit screen time on computers or other digital devices. By balancing screen time with outdoor time, you may help limit your child’s myopia and protect their vision as they grow older.

Lazy eye (amblyopia) is reduced vision in one eye caused by abnormal visual development early in life. The weaker — or lazy — eye often wanders inward or outward.

Amblyopia generally develops from birth up to age 7 years. It is the leading cause of decreased vision among children. Rarely, lazy eye affects both eyes.

Early diagnosis and treatment can help prevent long-term problems with your child's vision. The eye with poorer vision can usually be corrected with glasses or contact lenses, or patching therapy.

Symptoms

Signs and symptoms of lazy eye include:

• An eye that wanders inward or outward

• Eyes that appear to not work together

• Poor depth perception

• Squinting or shutting an eye

• Head tilting

• Abnormal results of vision screening tests

Sometimes lazy eye is not evident without an eye exam.

When to see a doctor

See your child's doctor if you notice his or her eye wandering after the first few weeks of life. A vision check is especially important if there's a family history of crossed eyes, childhood cataracts or other eye conditions.

For all children, a complete eye exam is recommended between ages 3 and 5.

Treatment

It's important to start treatment for lazy eye as soon as possible in childhood, when the complicated connections between the eye and the brain are forming. The best results occur when treatment starts before age 7, although half of children between the ages of 7 and 17 respond to treatment.

Treatment options depend on the cause of lazy eye and on how much the condition is affecting your child's vision. Your doctor might recommend:

• Corrective eyewear. Glasses or contact lenses can correct problems such as nearsightedness, farsightedness or astigmatism that result in lazy eye.

• Eye patches. To stimulate the weaker eye, your child wears an eye patch over the eye with better vision for two to six or more hours a day. In rare cases, wearing an eye patch too long can cause amblyopia to develop in the patched eye. However it's usually reversible.

• Bangerter filter. This special filter is placed on the eyeglass lens of the stronger eye. The filter blurs the stronger eye and, like an eye patch, works to stimulate the weaker eye.

• Eyedrops. An eyedrop of a medication called atropine (Isopto Atropine) can temporarily blur vision in the stronger eye. Usually prescribed for use on weekends or daily, use of the drops encourages your child to use the weaker eye, and offers an alternative to a patch. Side effects include sensitivity to light and eye irritation.

• Surgery. Your child might need surgery if he or she has droopy eyelids or cataracts that cause deprivation amblyopia. If your child's eyes continue to cross or wander apart with the appropriate glasses, your doctor might recommend surgical repair to straighten the eyes, in addition to other lazy eye treatments.

Activity-based treatments — such as drawing, doing puzzles or playing computer games — are available. The effectiveness of adding these activities to other therapies hasn't been proved. Research into new treatments is ongoing.

For most children with lazy eye, proper treatment improves vision within weeks to months. Treatment might last from six months to two years.

It's important for your child to be monitored for recurrence of lazy eye — which can happen in up to 25 percent of children with the condition. If lazy eye recurs, treatment will need to start again.

At a glance: Diabetic Retinopathy

• Early Symptoms: None

• Later Symptoms: Blurry vision, floating spots in your vision, blindness

• Diagnosis: Dilated eye exam

• Treatment: Injections, laser treatment, surgery  

Diabetic retinopathy is an eye condition that can cause vision loss and blindness in people who have diabetes. It affects blood vessels in the retina (the light-sensitive layer of tissue in the back of your eye).

If you have diabetes, it’s important to get a comprehensive dilated eye exam at least once a year. Diabetic retinopathy may not have any symptoms at first — but finding it early can help you take steps to protect your vision. 

What are the symptoms of diabetic retinopathy?

The early stages of diabetic retinopathy usually don’t have any symptoms. Some people notice changes in their vision, like trouble reading or seeing faraway objects. These changes may come and go. 

In later stages of the disease, blood vessels in the retina start to bleed into the vitreous (gel-like fluid that fills your eye). If this happens, you may see dark, floating spots or streaks that look like cobwebs. Sometimes, the spots clear up on their own — but it’s important to get treatment right away. Without treatment, scars can form in the back of the eye. Blood vessels may also start to bleed again, or the bleeding may get worse.

Other types of diabetic eye disease

Diabetic retinopathy is the most common cause of vision loss for people with diabetes. But diabetes can also make you more likely to develop several other eye conditions: 

• Cataracts. Having diabetes makes you 2 to 5 times more likely to develop cataracts. It also makes you more likely to get them at a younger age. 

• Open-angle glaucoma. Having diabetes nearly doubles your risk of developing a type of glaucoma called open-angle glaucoma

What other problems can diabetic retinopathy cause?

Diabetic retinopathy can lead to other serious eye conditions: 

• Diabetic macular edema (DME). Over time, about 1 in 15 people with diabetes will develop DME. DME happens when blood vessels in the retina leak fluid into the macula (a part of the retina needed for sharp, central vision). This causes blurry vision.

• Neovascular glaucoma. Diabetic retinopathy can cause abnormal blood vessels to grow out of the retina and block fluid from draining out of the eye. This causes a type of glaucoma (a group of eye diseases that can cause vision loss and blindness).

• Retinal detachment. Diabetic retinopathy can cause scars to form in the back of your eye. When the scars pull your retina away from the back of your eye, it’s called tractional retinal detachment.

Am I at risk for diabetic retinopathy?

Anyone with any kind of diabetes can get diabetic retinopathy — including people with type 1, type 2, and gestational diabetes (a type of diabetes that can develop during pregnancy).   

Your risk increases the longer you have diabetes. Over time, more than half of people with diabetes will develop diabetic retinopathy. The good news is that you can lower your risk of developing diabetic retinopathy by controlling your diabetes.  

Women with diabetes who become pregnant — or women who develop gestational diabetes — are at high risk for getting diabetic retinopathy. If you have diabetes and are pregnant, have a comprehensive dilated eye exam as soon as possible. Ask your doctor if you’ll need additional eye exams during your pregnancy. 

What causes diabetic retinopathy?

Diabetic retinopathy is caused by high blood sugar due to diabetes. Over time, having too much sugar in your blood can damage your retina — the part of your eye that detects light and sends signals to your brain through a nerve in the back of your eye (optic nerve).  

Diabetes damages blood vessels all over the body. The damage to your eyes starts when sugar blocks the tiny blood vessels that go to your retina, causing them to leak fluid or bleed. To make up for these blocked blood vessels, your eyes then grow new blood vessels that don’t work well. These new blood vessels can leak or bleed easily. 

How will my eye doctor check for diabetic retinopathy?

Eye doctors can check for diabetic retinopathy as part of a dilated eye exam. The exam is simple and painless — your doctor will give you some eye drops to dilate (widen) your pupil and then check your eyes for diabetic retinopathy and other eye problems.

If you have diabetes, it’s very important to get regular eye exams. If you do develop diabetic retinopathy, early treatment can stop the damage and prevent blindness.  

If your eye doctor thinks you may have severe diabetic retinopathy or DME, they may do a test called a fluorescein angiogram. This test lets the doctor see pictures of the blood vessels in your retina. 

What can I do to prevent diabetic retinopathy?

Managing your diabetes is the best way to lower your risk of diabetic retinopathy. That means keeping your blood sugar levels in a healthy range. You can do this by getting regular physical activity, eating healthy, and carefully following your doctor’s instructions for your insulin or other diabetes medicines.  

To make sure your diabetes treatment plan is working, you’ll need a special lab test called an A1C test. This test shows your average blood sugar level over the past 3 months. You can work with your doctor to set a personal A1C goal. Meeting your A1C goal can help prevent or manage diabetic retinopathy.

Having high blood pressure or high cholesterol along with diabetes increases your risk for diabetic retinopathy. So controlling your blood pressure and cholesterol can also help lower your risk for vision loss.

What’s the treatment for diabetic retinopathy and DME?

In the early stages of diabetic retinopathy, your eye doctor will probably just keep track of how your eyes are doing. Some people with diabetic retinopathy may need a comprehensive dilated eye exam as often as every 2 to 4 months.  

In later stages, it’s important to start treatment right away — especially if you have changes in your vision. While it won’t undo any damage to your vision, treatment can stop your vision from getting worse. It’s also important to take steps to control your diabetes, blood pressure, and cholesterol. 

Injections. Medicines called anti-VEGF drugs can slow down or reverse diabetic retinopathy. Other medicines, called corticosteroids, can also help.

Laser treatment. To reduce swelling in your retina, eye doctors can use lasers to make the blood vessels shrink and stop leaking.

Eye surgery. If your retina is bleeding a lot or you have a lot of scars in your eye, your eye doctor may recommend a type of surgery called a vitrectomy.

What is the latest research on diabetic retinopathy and DME?

Scientists are studying better ways to find, treat, and prevent vision loss in people with diabetes. One NIH-funded research team is studying whether a cholesterol medicine called fenofibrate can stop diabetic retinopathy from getting worse.

What is a cataract? When the normally clear lens within your eye becomes cloudy and opaque, it is called a cataract. Cataracts vary from extremely small areas to large opaque areas that cause a noticeable blurring of vision. Cataracts develop without pain or redness.

 Who gets cataracts? Cataracts are a function of aging and are most often found in people over the age of 60, although they are also occasionally found in younger people, including newborns. If a child is born with a cataract, it is referred to as a congenital cataract.
What causes cataracts?  aging changes that cause the lenses to become cloudy, may be heredity, an injury or a disease. Excessive exposure to ultraviolet radiation (present in sunlight), cigarette smoke, diabetes, maternal infection, or the use of steroids are also risk factors for the development of cataracts. Cataracts usually develop in both eyes.

Can cataracts be prevented? Currently, there is no proven method to prevent cataracts from forming. Wearing sunglasses is a tremendous benefit as they protect your lens from harmful UV rays, which can speed up cataract formation. A diet rich in antioxidants (such as Vitamins A, C, E, Zinc Selenium & Magnesium) can also be beneficial.
What are the signs/symptoms of cataracts?  blurred or hazy vision that cannot be corrected by changing the glasses, or the feeling of having a film over the eyes that does not go away with blinking. A temporary change in distance and/or near glasses may also occur. An increased sensitivity to glare, especially at night. Cataracts develop without pain or redness.
How are cataracts diagnosed? A comprehensive eye examination by an optometrist.

How are cataracts treated? In the early stages of a cataract, prescribe new lenses for your glasses. The treatment for a cataract that is interfering with vision, is surgery. When the cataracts start to interfere with your daily activities and glasses cannot improve this vision, ophthalmologist (eye surgeon) recommend the surgical removal of the cataracts. 

When will I need to have cataracts removed?  When a change in glasses can no longer provide functional vision, and the cataract is starting to interfere with your daily activities, consultation with a cataract surgeon.
What is cataract surgery? Cataract surgery is a safe and effective procedure to remove the cloudy crystalline lens from the eye and replace it with a clear implant. During cataract surgery, the cloudy lens in the eye is removed and a clear plastic artificial lens is inserted in its place. Sometimes the lens implant can give sufficient distance vision that you may not need glasses for driving or watching TV.  Recently, multifocal artificial lens implants have been used in cataract surgery to reduce the need for reading glasses after the operation.

What happens after cataract surgery? 

Cataract surgery is a very safe and effective procedure to remove the cloudy crystalline lens from the eye and replace it with a clear implant. However, there are risks and limitations that need to be discussed with an optometrist.  The old cloudy lens is removed and an intraocular lens implant (IOL) is inserted in your eye at the time of surgery, which serves as a new lens. Before surgery, your optometrist may recommend lens implant options with new "specialized" intraocular lenses designed to minimize your need for glasses following the surgery.   Sometimes the lens implant can give you good enough distance vision that you may not require glasses. Your near vision will still be blurred, so you may need glasses to read. Your optometrist will prescribe new lenses for your glasses about four to six weeks after surgery to maximize your distance and near vision. 

Types of Intraocular Lens Materials

Biomaterials.

Polymethylmethacrylate (PMMA)

Once the standard for excellence, these lenses are not as pliable and conducive to micro procedures as newer materials. Occasionally, however, some patients require a material with less flex, in which case your surgeon may recommend a PMMA lens.

Silicone

Also a popular choice that is giving way to advanced acrylics better suited to microincisions. Still, certain biomaterial advantages make silicone lenses the ideal choice for some patients. Your Edina Eye surgeon will explain why you may or may not be a candidate for a silicone IOL.

Hydrophobic Acrylic

Today’s most popular choice in part because it’s easy to fold and ideally suited for microsurgery. Most Edina Eye lens implants are performed with these advanced acrylics and we cannot speak highly enough of their qualities and success rate. There are different types available, and your surgeon will help you understand which qualities you need and which lens material best suits your needs.

Types of Intraocular Lenses

Your surgeon will help you choose the ideal lens for you.

This is an exciting time for people requiring an intraocular lens implant, as your choices are now safer and more effective than ever. Your Edina Eye surgeon is an expert on all available lenses and how their individual benefits pertain to each patient’s needs.

Monofocal Lens Implants

These lenses have been around longest and are still the most common IOLs. Though the quality of materials and designs continue to improve, the function of the lens remains constant. A monofocal IOL has equal power in all regions and a single zone of clear focus, producing excellent vision from a determined distance.

Most patients choose lenses that focus at a far-away point. This gives them excellent distance vision, but also requires they wear glasses for near-vision needs like reading. A smaller number of patients choose lenses that focus at a nearby point. This gives them excellent near vision, but means they need to wear glasses to see distant objects.

Some patients choose distance vision for one lens and near vision for the other (called monovision) and rely on the brain’s natural tendency to compensate, often producing excellent vision near and far. Your surgeon will discuss this option and explain the key role your dominant eye plays in the decision.

Multifocal Lens Implants

These special lenses continue to evolve with designs that offer a variety of regions with different power and several zones of clear vision within a single lens, allowing patients to see a continuous range of vision from long, intermediate and near distances. Results vary depending on each person’s eyes and IOL choice, but the vast majority of patients with multifocal lens implants achieve excellent levels of clarity and a general improvement over a broad range of vision. Rings and halos can occur, and your surgeon will discuss these concerns with you to make sure you understand all aspects of your options.

After implantation, many patients can read fine print and see well from a distance, a dramatic improvement unachievable not too many years ago. This includes people with presbyobia. A majority of patients with multifocal IOLs never wear eyeglasses or contact lenses again. One issue patients need to consider is how much of the cost will be covered by Medicare and private insurance. Policies vary, but at this point in time, much of the cost is often the responsibility of the patient.

Accommodating Lens Implants

These revolutionary IOLs flex like a human lens to achieve the continuous range of vision a person would have naturally. The lens accommodates itself to the shape of the eye, literally changing its shape and allowing itself to focus on both far and near objects. After implantation, patients typically function well without glasses for distance and intermediate viewing and often do not even require glasses for casual reading. Glasses are typically needed for fine print and micro tasks. Here, also, Medicare and private insurance restrictions apply.

Toric Lens Implants

The only lens type that can correct astigmatism, toric IOLs have different powers in different areas of the lens that align with the patient’s vision correction requirements. This alignment demands the lens be positioned in a precise configuration, placing greater emphasis on your surgeon’s expertise and surgical skill.

Correcting astigmatism often required making microincisions to alter the cornea’s shape, but advanced toric designs have eliminated much of this need. Some severe astigmatisms still require a combination of incisions and implants, but typically toric lenses are implanted and function as flawlessly as other implants. They also typically reduce the power of your glasses at all distances and can minimize your need to wear glasses for distance vision. Again, Medicare and private insurance restrictions apply.