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Your Eyes and Vision: How the Eye Works
Our ability to "see" starts when light reflects off an object at which we are looking and enters the eye. As it enters the eye, the light is unfocused. The first step in seeing is to focus the light rays onto the retina, which is the light sensitive layer found inside the eye. Once the light is focused, it stimulates cells to send millions of electrochemical impulses along the optic nerve to the brain. The portion of the brain at the back of the head interprets the impulses, enabling us to see the object.
If my vision is less than optimum, what can I do?
A comprehensive eye examination will identify causes that may affect your ability to see well. We may be able to prescribe glasses, contact lenses or a vision therapy program that will help improve your vision.
If the reduced vision is due to an eye disease, the use of ocular medication or other treatment may be needed. If necessary, referral will be undertaken if an eye disease is found which warrants further investigation.
To keep your eyes healthy and white with clear, crisp vision it is important to schedule an annual exam. With advancements in technology, your annual eye exam is a portal to more than just vision. Today, we can help identify the onset of other ailments as well. Additionally, you can take an active role in the prevention of eye disease by learning more about proper nutrition and how it affects your eyes and vision.
What is 20/20 Vision?
You may be pleased to hear that you have 20/20 vision and think you have perfect vision. But do you?
Not necessarily. 20/20 only indicates how sharp or clear your vision is at a distance. Overall vision also includes peripheral awareness or side vision, eye coordination, depth perception, focusing ability and color vision.
20/20 describes normal visual clarity or sharpness measured at a distance of 20 feet from an object. If you have 20/20 vision, you can see clearly at 20 feet what should normally be seen at that distance. If you have 20/100 vision, it means that you must be as close as 20 feet to see what a person with normal vision can see at 100 feet.
Is 25/25 vision better than 20/20?
No. 25/25 means normal sharpness of vision, or visual acuity, at 25 feet just as 20/20 indicates normal vision at 20 feet.
Why do some people have less than 20/20?
The ability to see objects clearly is affected by many factors. Eye conditions like nearsightedness, farsightedness, astigmatism or eye diseases influence visual acuity. Most people with vision slightly below 20/20 function very well, whereas some people who have better than 20/20 vision feel that their vision is not satisfactory. Everybody's visual expectations are different and satisfactory vision is far more complex than just being able to see 20/20.
Light, Refraction and Its Importance.
Light entering the eye is first bent, or refracted, by the cornea -- the clear window on the outer front surface of the eyeball. The cornea provides most of the eye's optical power or light-bending ability.
After the light passes through the cornea, it is bent again—to a more finely adjusted focus—by the crystalline lens inside the eye. The lens focuses the light on the retina. This is achieved by the ciliary muscles in the eye changing the shape of the lens, bending or flattening it to focus the light rays on the retina.
This adjustment in the lens, known as accommodation, is necessary for bringing near and far objects into focus. The process of bending light to produce a focused image on the retina is called "refraction". Ideally, the light is "refracted," or redirected, in such a manner that the rays are focused into a precise image on the retina.
Most vision problems occur because of an error in how our eyes refract light. In nearsightedness (myopia), the light rays form an image in front of the retina. In farsightedness (hypermetropia), the rays focus behind the retina. In astigmatism, the curvature of the cornea is irregular, causing light rays to focus to more than one place so that a single clear image cannot be formed on the retina, resulting in blurred vision. As we age, we find reading or performing close-up activities more difficult. This condition is called presbyopia, and results from the crystalline lens being less flexible, and therefore less able to bend light.
Since changing the apparent refraction of the eye is relatively easy through the use of corrective spectacle or contact lenses, many of the conditions that contribute to unclear vision can be readily corrected.How do we make sense of light?
Even with the light focused on the retina, the process of seeing is not complete. For one thing, the image is inverted, or upside down. Light from the various "pieces" of the object being observed stimulate nerve endings -- photoreceptors or cells sensitive to light -- in the retina.
Rods and Cones
Two types of receptors—rods and cones—are present. Rods are mainly found in the peripheral retina and enable us to see in dim light and to detect peripheral motion. They are primarily responsible for night vision and visual orientation. Cones are principally found in the central retina and provide detailed vision for such tasks as reading or distinguishing distant objects. They also are necessary for color detection. These photoreceptors convert light to electrochemical impulses that are transmitted via the nerves to the brain.
Millions of impulses travel along the nerve fibers of the optic nerve at the back of the eye, eventually arriving at the visual cortex of the brain, located at the back of the head. Here, the electrochemical impulses are unscrambled and interpreted. The image is re-inverted so that we see the object the right way up. This "sensory" part of seeing is much more complex than the refractive part—and therefore is much more difficult to influence accurately.
Vision plays a critical role in the daily lives of people of all ages, and is especially important as children grow and develop.
What Are Eye Allergies?
An eye allergy is the eye's overreaction to a substance that it thinks will harm it. Dust, for example, is harmless to most people, but to allergy sufferers it is a brutal assault that the eye tries to flush out with tears and mucus.
Seasonal allergic conjunctivitis (SAC) is perhaps the most common type of eye allergy and often a result of exposure to pollen, dust, mold, cat or dog hair and other environmental factors.
Signs and symptoms of SAC usually occur in late spring and summer, and their severity will vary from day to day, often fluctuating with pollen counts. During seasons of low pollen counts or relative lack of sunshine, the incidence and severity of SAC is significantly reduced if caused by seasonal pollen.
What Are the Symptoms of Eye Allergies?
Eye allergy symptoms may include itching, redness, eyelid swelling and tearing. Nasal congestion occurs in some sufferers as well.
Who Do Eye Allergies Affect?
Eye allergies can affect almost anyone at anytime. Those impacted by seasonal allergies can be more affected in the late spring and summer when the pollen counts are high. Those who suffer allergies from pet dander will most likely experience eye allergy symptoms when exposed to cat or dog hair.
How to Avoid Eye Allergies
Avoidance of the allergen(s) is the best way to treat eye allergies. Try to identify the thing that causes the allergic reaction and avoid it. Symptoms should improve dramatically.
Dust mites, fecal particles and mold are the most frequent causes of chronic or recurrent allergic conjunctivitis. And because dust mites are often found in beds and linens, they can be controlled by using impermeable mattress and pillow covers and by changing bedding weekly and washing it in a hot water cycle.
During high pollen seasons, patients should limit their time outdoors in high-exposure activities.
For domestic pet sensitivity, the most effective measure is to eliminate the source by removing the pet from indoors, as carpets, upholstery, and clothing are all havens for animal allergens.
Allergy sufferers should also try and avoid non-specific irritants such as smoking, air pollution, and strong odors or perfumes.
How Are Eye Allergies Treated?
If avoiding the allergen is not possible, physicians often prescribe antihistamines, corticosteroids and combination drugs to treat symptoms. Pharmacological treatments have become the most widespread form of treatment for eye allergy, as they are widely available, simple to use, and offer the greatest relief in the shortest time.
Alcon manufactures and sells a prescription eye drop called Patanol® or Opatanol® ophthalmic solution, depending on your country of residence, to treat every day eye allergy symptoms.
Kids & Vision
Vision Skills for School
Your school-age child's eyes are constantly in use in the classroom and at play. When his or her vision is not functioning properly, learning and participation in recreational activities can suffer.
Good vision involves many different skills working together to enable your child not only to see clearly but also to understand what he or she sees.
Those skills include:
Near Vision: Ability to see clearly and comfortably at 13-16 inches, the distance at which school deskwork should be performed.
Distance Vision: Ability to see clearly and comfortably at 10 feet or more.
Binocular Coordination: Ability to use the two eyes together.
Eye Movement Skills: Ability to aim the eyes accurately, and move them smoothly across a page and quickly and accurately from one object to another.
Peripheral Awareness: Ability to be aware of things to the side while looking straight ahead.
Eye/Hand Coordination: Ability to use the eyes and hands together. If any of these or other vision skills is lacking or not functioning properly, your child's eyes have to work harder. This can lead to blurred vision, headaches, fatigue and other eyestrain symptoms.
Why Vision Examinations are Important: Don't assume your child has good vision because he or she passed a school vision screening. A 20/20 score means only that your child can see at 20 feet what he or she should be able to see at that distance. It does not measure any of the other vision skills needed for learning.
Vision screenings are important but they should not be substituted for a thorough vision examination.
Things You Can Do
There are things you can do to help ensure that your child's vision is ready for school each year and to relieve the visual stress of schoolwork. Be alert for symptoms that may indicate your child has a vision problem. Note if your child frequently:
- Loses his or her place while reading.
- Avoids close work.
- Holds reading material closer than normal.
- Tends to rub his or her eyes.
- Has headaches.
- Turns or tilts their head to use one eye only.
- Makes reversals when reading or writing.
- Uses a finger to maintain their place while reading.
- Omits or confuses small words when reading.
- Performs below potential.
- Closes one eye while reading.
Make sure your child's homework area is evenly lighted and free from glare. Furniture should be the right size for proper posture. During periods of close concentration, have your child take periodic breaks. Rest breaks are also recommended when your child is using a computer or playing video games.
To make TV viewing easier on your child's eyes:
- Be sure the room has overall soft lighting.
- Place the set to avoid glare and reflections.
- Watch from a distance at least five times the width of the screen.
Be sure your child's hours away from school include time for exercise and creative play. Both can help keep his or her vision skills functioning properly.
Teach Your Child Eye Protection Through These Safety Rules:
- Keep away from the targets of darts, bows-and-arrows, air guns and missile-throwing toys.
- Don't shine laser pointers into anyone's eyes. Teach them laser pointers are not toys.
- Don't run with or throw sharp objects.
- Wear safety goggles when using chemistry sets, power tools and household and yard chemicals. (Note: Be certain your child is mature enough to handle these items safely, and provide proper supervision.)
Prevention & Nutrition
Good nutrition is very important to healthy eyes. Just like the rest of your body, your eyes require the right amount of nutrients to work their best, especially as you get older.
More and more research points to the importance of proper nutrition in the treatment and prevention of age-related eye diseases (AREDS). Several research studies have focused on the role of carotenoids in eye nutrition.
Carotenoids are an essential nutrient group derived from fruits and vegetables, especially dark green leafy vegetables. Carotenoids include vitamins A, C and E, which help promote and maintain healthy vision.
Results from the age-related eye disease study show that zinc, copper and other antioxidants are also essential in maintaining healthy vision. Our bodies don't manufacture these nutrients on their own, so we must get them through our diet.
Vitamin supplements are another way to provide our bodies with these nutrients.
Most changes in vision occur in the early and later years of life. Although some people may discover they have nearsightedness—or difficulty seeing at a distance -- as late as their mid-20s, vision typically stabilizes during the late teen years. From then until around age 40, vision typically changes little, if at all.
Presbyopia - Age-related Loss of Close-Up Vision
At about 40 years of age, seeing to read or do close work such as sewing may become difficult. This is known as "presbyopia." Presbyopia, a name that comes from the Greek words for "old eye," occurs because the crystalline lens, an essential component of the eye's refractive, or light-bending structure, loses flexibility as it grows thicker with age. This lack of flexibility affects the ability to focus on close objects.
Generally, by around age 45, reading glasses may be required for nearby tasks. If near- or farsightedness is also present, a number of vision correction options will be evaluated to best meet your needs.
Spots and Floaters
People of every age may at times see spots and floaters, which appear to look like specks of material, cobwebs, thread-like strands or showers of brilliant crystals. During the middle years of life, they may become more frequent.
These are optical defects that occur, as the vitreous, the jelly-like body in the main globe of the eye, becomes less jelly-like and more liquid as time goes by. This change is not always uniform, and so the mixture of jelly-like and liquid materials can affect the passage of light to the retina.
The result is seen as 'floaters.' Although spots and floaters are typically not of concern, they should be evaluated promptly. If you suddenly experience a large number of floaters, don't delay in making an appointment. A sudden change may signify that something is wrong.
For adults, it is important to schedule regular eye examinations in order to detect and treat any occurrence of glaucoma in its earliest stages. Most types of glaucoma occur without the presence of any symptoms and can only be detected during a routine eye examination. Glaucoma occurs when fluid pressure inside the eye rises, cutting off the blood supply in the very small arteries carrying food and oxygen to the retina and causing loss of side vision or blindness if left untreated.
It is a condition that can be arrested or slowed down but not reversed, so early detection is essential. Treatment often involves special eye drops or medicine, but, in some cases, surgery may be required. If detected early, chances that vision can be maintained are usually very good.
Retinal disorders have a greater chance of developing in older adults, due to the aging process. These often impair central vision. Advances in eye and health care have made treatments more successful, with chances of maintaining good vision now better than ever. Conditions once considered sight threatening may now be successfully treated if diagnosed early.
Suggestions for Better Sight
Be aware of your visual limitations and compensate for them.
You may need more light for reading and other close tasks. Move the lamp closer to you and/or use a larger watt bulb. It is a fact that a 60 year old needs three times as much light as a 20 year old to see near work as easily.
- Side vision and reaction time may reduce with age. Keep this in mind while driving or walking near traffic.
- Limit night driving to well-lighted roads; keep headlights and windshields clean; and be visually aware of traffic.
- Be sure to keep glasses clean.
Be sure to wear distance spectacles if they are prescribed for you. While you may feel that your distance vision is as good as it was when you were younger, very often this is not the case.
Although natural vision changes can't be prevented, they need not mean giving up activities such as driving your car. By practicing good health habits and having regular eye examinations, you should be able to continue an active, productive and independent life.
TV, Screentime & Vision
Eye care experts generally agree: Watching television will not harm your eyes or vision if the TV room is lit properly and if you follow a few viewing tips. In fact, there is usually less strain involved in TV viewing than in doing close work such as sewing or reading. But TV watching for long stretches of time can leave your eyes fatigued.
What are the Best Conditions for TV Viewing?
A normally lit room, suitable for general activities, is best. Excessively bright lighting tends to reduce contrast on the screen and "wash out" the picture. No lights should be placed where glare or reflections will be seen in or near the television screen. Strongly colored lighting should not be used and surroundings should be neutral in color.
Is it All Right to Watch Television in a Dark Room?
This situation is not ideal. When the room is totally dark, the contrast between the television screen and the surrounding area is too great for comfortable and efficient vision. When the room is softly illuminated, undesirable high contrast is kept to a minimum.
Is it Better to Adjust the Television Set to Room Lighting or Room Lighting to the Set?
Adapt the set's brightness and contrast to room lighting -- not room lighting to the set -- after the room lights have been turned on.
Is it OK to Wear Sunglasses while Watching Television?
Generally, no. Sunglasses may shut out too much light for good vision. If worn when not needed, they tend to make it difficult for the viewer to adapt promptly to normal light levels. If you are bothered by brightness, consult with an eye care practitioner about the possible need for lenses more appropriate to TV viewing.
Possible Difficulties with TV Viewing
Children sometimes sit close to the set. Does this hurt their eyes?
While close-up viewing is certainly not recommended, it is generally not harmful. It is best to watch television from a distance of at least five times the width of the picture. Picture details will appear sharper and better defined and the television lines and defects will be less apparent. If your child persists in watching television from a short distance, have his or her vision checked. Nearsighted (myopic) children like to sit close to the screen.
What does it mean if the eyes water or if there is other visual discomfort while watching television?
It could indicate a problem that needs professional attention. Some viewers, especially those over 50 years old, may find relief with special glasses for television viewing. Discomfort could also indicate that the drainage passages which drain tears from the eyes into the nose are partially blocked and require examination.
What about color television for viewers with color vision deficiencies?
Color deficiency (i.e. color blindness) is generally not a barrier to enjoying color television. However, viewers with color deficiencies may disagree with others as to the "proper" color adjustment.
A color TV picture properly adjusted for most people may appear too green to a protanomalous (weak red) observer, or too red to a deuteranomalous (weak green) viewer. When the set is adjusted to "correct" its color, the resulting picture is usually unsatisfactorily tinted for other viewers.
Viewers who are severely color deficient, the so-called "red blind" or "green blind," will see little or no difference in widely different color mixtures, and will not be bothered by most color adjustments.
TV Viewing Tips:
- Make sure your television set is properly installed and the antenna properly adjusted.
- Place the set to avoid glare and reflections from lamps, windows and other bright sources.
- Adjust brightness and contrast controls to individual and/or viewer's taste and comfort.
- Have the set at approximately eye level. Avoid having to look up or down at the picture.
- Avoid staring at the screen for lengthy periods. Briefly look away from the picture, around the room or out the window.
- Wear lenses prescribed for vision correction, if advised to do so by your eye care practitioner.
- View from a distance at least five times the width of the television screen.
Easily Order Your Contacts Online
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In order to permit us to best respect your time, we encourage appointments. However, we also recognize your busy schedule may not always permit this, and we make every effort to accommodate patients on a walk-in basis.
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