Why eye exams are important

Refractive error

Myopia-AKA "near sighted"

This is a normal refractive condition in which the eyes are able to focus up close but are not able to see clearly far away. Myopia normally progresses through childhood and teen years while the eyes are growing. It is common for the strength of the lens to increase every year during this period, so it is important for children to have yearly eye exams. Sometime in the mid twenties the prescription usually stabilizes as the eyes stop growing. With high myopic prescriptions it is important to have the eyes dilated every two years to monitor for thinning of the peripheral retina. Myopic prescriptions are written with a negative sign.

Hyperopia- AKA "far sighted"

This is a normal refractive condition in which the eyes are more easily able to focus at distance than up close. For many people with hyperopia the visual system is able to completely focus through any prescription needed, however in the late thirties it may become necessary to correct this error. Because hyperopia often does not create blurry vision, children may not want or feel the need to wear the correction. Without h their correction, headaches often develop as well as poor reading skills, it is therefore important for these children to wear the correction even if they resist. Hyperopic prescriptions are written with a positive sign.

Astigmatism-

Often described as a "football eye", this normal refractive condition causes blurry vision at all distances, particularly at night. A spherical (non-astigmatism) eye will have one focal point; as with the sun through a magnifying glass has one bright point. An astigmatic eye however, has two of these focal points. The two images overlap in a way that does not create double vision, but creates blur. With the appropriate correction the two images are brought into alignment to one clear image. An astigmatic correction is written with an axis, which is the positioning of the two corrections.

Presbyopia ("the need for bifocals")-

This condition is often incorrectly associated with old age, but this is not true. This is a normal physiologic change in every human during their late 30’s or early 40’s. This occurs as the lens inside the eye, which normally focuses up close for us, starts losing its focusing ability by becoming more rigid. The more rigid the lens gets the less it is able to change shape and allow us to focus up close, so a reading power must be used. The standard correction for this is a bifocal, but there are many alternatives, progressive lenses (no-lnes) are more cosmetically appealing as well as more functional, because they provide an increased range of clear vision such as at a computer screen. Another good choice of corrections is multi-focal contacts lenses. These lenses provide clear vision at all distances without the need to rely on "cheaters".

Binocular Problems

Binocular visions problems are most often congenital problems because of this they can be detected and treated early in life. These binocular vision problems manifest themselves as; blurry vision, double vision, headaches, falling asleep while reading and poor attention and grades. While all of these problems are difficult for a person to deal with the latter can be most damaging. Many children with binocular vision problems develop poor attention because of their visual discomfort. These children are then misdiagnosed as having behavioral problems and often start on medication to help calm them down and focus. If these children’s vision problems can be detected and treated by a professional, attention may improve without the help of a medication.

There are 4 main treatments for binocular vision problems. The first is wearing the appropriate spectacle prescription. This alone may solve any binocular anomalies. The second is with the use of prism. Prism is a special prescription that is put into glasses to change the orientation of the image through the spectacles to alleviate any double vision or visual discomfort. The third is the use of visual therapy (VT). Vision Therapy is very similar to the physical therapy of the body. During VT, exercises are given to a patient to increase their control of their visual system. The last treatment is surgery to permanently shift the eyes to the appropriate positions.

Multiple treatment options are often used together to provide the best outcome. For example, a patient is given a prism to shift the images they see to eliminate double vision and also started on a vision therapy program. As the patient gains better control of their visual system the prism is taken out of the spectacles and the patient now has a comfortable visual system.