Taking care of your eyes

August 30, 2017 GMT

Taking care of your eyes and preventing eye disorders was the topic of a conversation on the Talking Health radio interview on News Radio 1240 KQEN recently.

Dr. Andrea Gray, an ophthalmologist in Roseburg, talked with host Lisa Platt about eye health for all ages.

The following is an edited version of that conversation.

Lisa: Is there anything we can do to prevent eye disorders?

Andrea: There are a lot of things we can do to prevent eye disorders. Basically anything that is heart healthy also turns out to be good for our eyes as well. Wear sunglasses and hats outside to help protect eyes from sun damage. If you’re doing something that could potentially create a hazard for your eye, working in your shop, on your car or even mowing the lawn, wear protective glasses, and don’t wear contacts overnight.

Lisa: At what age should we get our eyes checked? When should we start this process?

Andrea: It’s a good idea to take your child in before they start kindergarten, so any vision issues can be identified and won’t influence their ability to learn.

From age 40 on, it’s good to have an exam every two years and then after age 60, yearly.

Lisa: Can you tell us about bifocals and trifocals, what does it all mean?

Andrea: Starting with the bifocal, that would be a multifocal lens, where the top of the lens is focused at a far away distance, and then the bottom D-shaped area is focused for up close reading. Sometimes we will make it intermediate distance to be focused on the computer, depending on what a person’s visual needs are.

There are also trifocals that have distance, intermediate, as well as near vision in them.

Probably the most practical and popular version is a progressive lens which is an infinity focal. The top part is focused far away, and then the farther down in that lens you get, the closer the focal gets.

Lisa: What are cataracts and how are they treated?

Andrea: Most people, if they live long enough, will get a cataract that is visually significant and needs to be removed. A cataract is a gradual clouding of the lens inside the eye. It’s on the same spectrum as that of presbyopia, or trouble seeing up close.

Proteins gradually change in the lens, making the lens a little less flexible and causing it to become more and more opaque. Once vision is at a point where we can’t get better than 20-40 with glasses, and it’s creating issues for the person, then it’s possible to have an eight minute surgery to remove the cataract.

Lisa: After the removal of the cataract, does our eyesight improve?

Andrea: It depends on what else is going on in that person’s eye. We can’t fix glaucoma’s field loss or macular degeneration vision loss with cataract surgery, but we can get rid of the cataract part of it.

Cataract surgery is an outpatient surgery and it takes us about eight minutes or so to do, so it’s quick. As far as surgeries in general, it’s one of our most successful, reliable lowest risk things to do. But it is a real surgery too so your eye surgeon will talk to you about the risks.

Lisa: How about recovery afterwards?

Andrea: The first day after the cataract is removed, most people will see better than they were prior to the surgery. Full recovery generally takes three to seven days. At the one month mark, things are often healed enough that a new prescription, if needed, can be issued to correct near vision.

Lisa: What is glaucoma and what are some of the symptoms of it?

Andrea: There are no symptoms until it’s far too late. Glaucoma is a disease where the pressure in the individual’s eye is too high for the optic nerve to handle. That means that some people will have normal pressures in their eye and still have damage. It’s permanent and progressive damage so you really want to know if you have this or not.

Glaucoma is diagnosed during an eye exam when the doctor will measure the pressure in the eye. If it’s higher than usual, that’s a red flag and the doctor will then also look at the optic nerve and see if the optical nerves are symmetrical, do they match, is there any hemorrhage or notches or thinning, is the dimple in the center normal size, and is the rim of the optic nerve nice and healthy.

If any of those things don’t look quite right then the next step would be a visual field to see what the function of that nerve is. Glaucoma can be very treatable with drops if found early.

Lisa: So checking for glaucoma is one of the primary reasons to see an eye doctor if you’re over a certain age?

Andrea: That would be the biggest reason to go in and have a routine eye exam. Glaucoma can cause blindness and it’s a permanent and progressive blindness. Once you have the vision blindness from it, you can’t get that vision back. I can generally stop it from progressing so the goal is to catch it early, before it does any damage.

Lisa: What is macular degeneration and how do you test for that?

Andrea: Macular degeneration is a degenerative disease of the central retina. When you move your eye to look at something, you’re moving the region called the macula. That’s where we have our highest concentration of photo receptors, where most of our color vision comes from.

Macular degeneration is a disease in which those cells don’t metabolize properly and material gets built up underneath the retina and sometimes causes thinning and atrophy of the central retina.

Lisa: Do you recommend eye drops for tired eyes?

Andrea: Artificial tears are always good for our eyes. They lubricate the eye and sometimes will even clear up vision a little bit if eye dryness is causing some fogginess. Lubricating drops are a great thing to have by your computer, too.

I do recommend avoiding anything that promises to get the red out because that has a medication that will constrict the blood vessels which is counterproductive and can cause long term inflammation.