ophthalmopathy

Even if your eyes feel healthy, you could have a problem and not know it. That's why regular eye exams are so important. Refractive errors are the most common type of vision problem that makes it hard to see clearly. But some eye conditions or diseases don't have any symptoms and can lead to a permanent loss of vision.

Some common eye diseases and conditions include:

• Cataracts, which happens when the clear lens in the front of your eye becomes cloudy. Cataracts are common as you get older and can lead to vision loss.
• Optic nerve disorders, which includes glaucoma. Glaucoma usually happens when the fluid pressure inside your eyes slowly rises.
• Retinal disorders, which are problems with the nerve layer at the back of your eye.
• Macular degeneration, which is a disease that destroys your sharp, central vision.
• Diabetic eye problems, which can cause vision loss and blindness.
• Conjunctivitis, which is an infection also known as pink eye. It can cause pink or red itchy eyes. Some types of pink eye can spread very easily.

Some eye conditions and diseases do not always have symptoms. Early detection through a comprehensive dilated eye exam could help your eye care provider detect diseases in the early stages. Proper treatment could help slow or prevent vision loss.

Get regular eye exams and call your eye care professional right away if you notice any of these symptoms:

• A sudden change in vision
• Everything looks dim
• Flashes of light
• Eye pain
• Double vision
• Fluid coming from your eye
• Inflammation (swelling)

Getting older increases your risk of some eye diseases. Other things that may put you at a higher risk of some eye diseases can include if you:

• Are overweight or obese
• Have a family history of eye disease
• Are African American, Hispanic, or Native American
• Have certain health conditions such as Diabetic eye problems, or high blood pressure

Treatment may depend on the eye condition or disease but can include:

• A new prescription for eyeglasses or contacts
• Use of bright lights or magnifying lenses for reading and other activities
• Medicines
• Prescription eye drops or ointments
• Laser treatment
• Surgery

Depending on your eye condition or disease, treatment may slow vision loss but may not restore vision. Talk to your provider about what treatment is best for you.

Your best defense is to have regular checkups. Be sure to tell your provider if any eye diseases run in your family.

You can also help take care of your vision by making lifestyle changes to lower your risk of health conditions that can cause vision problems. This could include by:

• Protecting your eyes from the sun
• Wearing protective eyewear while using tools or playing certain sports
• Getting regular physical activity
• Staying at a healthy weight
• Quitting smoking (or not starting)
• Eating a healthy diet

NIH: National Eye Institute

Your eyes are an important part of your health. Most people rely on their eyes to see and make sense of the world around them. But some eye diseases can lead to vision loss, so it is important to identify and treat eye diseases as early as possible. You should get your eyes checked as often as your health care provider recommends it, or if you have any new vision problems. And just as it is important to keep your body healthy, you also need to keep your eyes healthy.

There are things you can do to help keep your eyes healthy and make sure you are seeing your best:

• Eat a healthy, balanced diet. Your diet should include plenty or fruits and vegetables, especially deep yellow and green leafy vegetables. Eating fish high in omega-3 fatty acids, such as salmon, tuna, and halibut can also help your eyes.
• Maintain a healthy weight. Being overweight or having obesity increases your risk of developing diabetes. Having diabetes puts you at higher risk of getting diabetic retinopathy or glaucoma.
• Get regular exercise. Exercise may help to prevent or control diabetes, high blood pressure, and high cholesterol. These diseases can lead to some eye or vision problems. So if you exercise regularly, you can lower your risk of getting these eye and vision problems.
• Wear sunglasses.Sun exposure can damage your eyes and raise your risk of cataracts and age-related macular degeneration. Protect your eyes by using sunglasses that block out 99 to 100% of both UV-A and UV-B radiation.
• Wear protective eye wear. To prevent eye injuries, you need eye protection when playing certain sports, working in jobs such as factory work and construction, and doing repairs or projects in your home.
• Avoid smoking. Smoking increases the risk of developing age-related eye diseases such as macular degeneration and cataracts and can damage the optic nerve.
• Know your family medical history. Some eye diseases are inherited, so it is important to find out whether anyone in your family has had them. This can help you determine if you are at higher risk of developing an eye disease.
• Know your other risk factors. As you get older, you are at higher risk of developing age-related eye diseases and conditions. It is important to know your risk factors because you may be able to lower your risk by changing some behaviors.
• If you wear contacts, take steps to prevent eye infections. Wash your hands well before you put in or take out your contact lenses. Also follow the instructions on how to properly clean them, and replace them when needed.
• Give your eyes a rest. If you spend a lot of time using a computer, you can forget to blink your eyes and your eyes can get tired. To reduce eyestrain, try the 20-20-20 rule: Every 20 minutes, look away about 20 feet in front of you for 20 seconds.

Everyone needs to have their eyesight tested to check for vision and eye problems. Children usually have vision screening in school or at their health care provider's office during a checkup. Adults may also get vision screenings during their checkups. But many adults need more than a vision screening. They need a comprehensive dilated eye exam.

Getting comprehensive dilated eye exams is especially important because some eye diseases may not have warning signs. The exams are the only way to detect these diseases in their early stages, when they are easier to treat.

The exam includes several tests:

• A visual field test to measure your side (peripheral) vision. A loss of peripheral vision may be a sign of glaucoma.
• A visual acuity test, where you read an eye chart about 20 feet away, to check on how well you see at various distances
• Tonometry, which measures your eye's interior pressure. It helps to detect glaucoma.
• Dilation, which involves getting eye drops that dilate (widen) your pupils. This allows more light to enter the eye. Your eye care provider examines your eyes using a special magnifying lens. This provides a clear view of important tissues at the back of your eye, including the retina, macula, and optic nerve.

If you have a refractive error and are going to need glasses or contacts, then you will also have a refraction test. When you have this test, you look through a device that has lenses of different strengths to help your eye care professional figure out which lenses will give you the clearest vision.

At what age you should start getting these exams and how often you need them depends on many factors. They include your age, race, and overall health. For example, if you are African American, you are at higher risk of glaucoma and you need to start getting the exams earlier. If you have diabetes, you should get an exam every year. Check with your health care provider about if and when you need these exams.

Diabetes is a disease in which your blood glucose, or blood sugar, levels are too high. Glucose comes from foods you eat. The cells of your body need glucose for energy. A hormone called insulin helps the glucose get into your cells.

With type 1 diabetes, your body doesn't make insulin. With type 2 diabetes, your body doesn't make or use insulin well. Without enough insulin, glucose builds up in your blood and causes high blood glucose levels.

Over time, high blood glucose may damage the blood vessels and lenses in your eyes. This can lead to serious diabetic eye problems which can harm your vision and sometimes cause blindness. Some common diabetic eye problems include:

• Diabetic retinopathy, which is the leading cause of blindness in American adults. It affects blood vessels in the retina (the light-sensitive layer of tissue in the back of your eye). The blood vessels may swell and leak fluid into your eye. If it's not treated, it can cause serious problems such as vision loss and retinal detachment, where the retina is pulled away from its normal position at the back of your eye.
• Diabetic macular edema (DME), which happens when blood vessels in the retina leak fluid into the macula (the part of the retina needed for sharp, central vision). This usually develops in people who already have other signs of diabetic retinopathy.
• Glaucoma, a group of eye diseases that can damage the optic nerve (the bundle of nerves that connects the eye to the brain). Glaucoma from diabetes happens when the blood vessels in the front of your eye are damaged, and new blood vessels grow near the iris (the colored part of your eye). The blood vessels block the space where fluid drains from your eye. This causes fluid to build up and pressure to increase inside your eye.
• Cataract, which is the leading cause of blindness worldwide. It happens when the clear lens in the front of your eye becomes cloudy. Cataracts are common as people age. But people with diabetes are more likely to develop cataracts younger and faster than people without diabetes. Researchers think that high glucose levels cause deposits to build up in the lenses of your eyes.

Anyone with diabetes can develop diabetic eye disease. But your risk of developing it is higher if you have diabetes and:

• Have had diabetes for a long time
• Don't have good control over your high blood glucose or high blood pressure
• Are pregnant
• Have high blood cholesterol
• Smoke tobacco

In the early stages, diabetic eye problems usually don't have any symptoms. That's why regular dilated eye exams are so important, even if you think your eyes are healthy.

You should also watch for sudden changes in your vision that could be signs of an emergency. Call your eye care professional right away if you notice any of these symptoms:

• Many new spots or dark wavy strings floating in your vision (floaters)
• Flashes of light
• A dark shadow over part of your vision, like a curtain
• Vision loss
• Eye pain or redness

Talk with your eye care professional if you have these symptoms, even if they come and go:

• Spots or dark wavy strings floating in your vision
• Blurry or wavy vision
• Vision that changes a lot
• Trouble seeing colors

Eye care professionals do dilated eye exams to diagnose eye problems. A dilated eye exam uses eye drops to open your pupils wide so your eye care professional can look for signs of eye problems and treat them before they harm your vision. They will also test your vision and measure the pressure in your eyes.

Treatment for diabetic eye problems depends on the problem and how serious it is. Some of the treatments include:

• Lasers to stop blood vessels from leaking
• Injections (shots) in the eye to stop new, leaky blood vessels from growing
• Surgery to remove blood and scar tissue or replace a cloudy lens
• Eye drops to lower fluid pressure in the eye

But these treatments aren't cures. Eye problems can come back. That's why your best defense against serious vision loss is to take control of your diabetes and get regular eye exams. It's also important to keep your blood pressure and cholesterol in a healthy range.

NIH: National Institute of Diabetes and Digestive and Kidney Diseases

Vision impairment is the loss of vision. It includes blindness, which means that you have lost all or most of your sight. It also includes low vision, which means you have some vision, but the vision loss makes it hard to do everyday activities. You may have trouble reading, shopping, cooking, writing, and watching TV. Low vision can't be fixed with glasses, contact lenses, medicine, or surgery.

Aging doesn't cause vision loss on its own. But many diseases that are more common in older adults can cause it. The leading causes of low vision and blindness in the United States are age-related eye diseases such as macular degeneration, cataracts, and glaucoma. Other eye disorders, eye injuries, and birth defects can also cause vision loss.

Vision impairment is diagnosed with a dilated eye exam. Early warning signs of a vision problem can include not being able to see well enough to:

• Do everyday tasks like reading and driving
• Recognize people's faces
• Tell the difference between colors
• See the television or computer screen clearly

You can have these symptoms even though you are wearing glasses or contacts.

There are several types of low vision. Which type you have depends on the condition that caused your low vision.

Common types of low vision include:

• Central vision loss (not being able to see things in the center of your vision)
• Peripheral (side) vision loss (not being able to see things out of the corners of your eyes)
• Night blindness (not being able to see in low light)
• Blurry or hazy vision

Low vision is permanent. Glasses, medicine, and surgery can't cure low vision. But sometimes they can improve your vision, help you do everyday activities more easily, or keep your remaining vision.

Your treatment options will depend on the condition that caused your low vision. Ask your eye doctor which treatments might help you. They may recommend vision aids or vision rehabilitation, which might make everyday activities easier.

Vision rehabilitation teaches you how to live with your vision loss. It may include:

• Showing you how to use a magnifying device or screen readers for reading
• Helping you set up your home so you can move around more easily
• Employment and job training
• Assistive devices, like lighting and reading stands

Your provider may suggest other resources, such as transportation and household services, to help you cope with your vision loss.

The sooner vision loss or eye disease is found and treated, the greater your chances of keeping your remaining vision. Whatever the cause, lost vision cannot be restored. But it can be managed. A loss of vision means you may have to reorganize your life and learn new ways of doing things. Your provider may make suggestions to help make life easier. These may include:

If you have some vision:

• Visual aids such as magnifiers
• Telescopic glasses or monoculars for seeing distance
• Large print books
• Clocks with larger numbers
• Brighter lights
• Anti-glare sunglasses or glare shields

If you have no vision (blindness):

• Devices like text-reading software and braille books

You can help take care of your vision by:

• Having regular comprehensive eye exams by an eye care professional
• Wearing sunglasses and protective eyewear to protect your eyes
• Making lifestyle changes to lower your risk of health conditions that can cause vision problems:
  • Getting regular physical activity
  • Staying at a healthy weight
  • Quitting smoking (or not starting)
  • Eating a healthy diet

NIH: National Eye Institute

Hyperthyroidism, or overactive thyroid, happens when your thyroid gland makes more thyroid hormones than your body needs.

Your thyroid is a small, butterfly-shaped gland in the front of your neck. It makes hormones that control the way the body uses energy. These hormones affect nearly every organ in your body and control many of your body's most important functions. For example, they affect your breathing, heart rate, weight, digestion, and moods. If not treated, hyperthyroidism can cause serious problems with your heart, bones, muscles, menstrual cycle, and fertility. But there are treatments that can help.

Hyperthyroidism has several causes. They include:

• Graves' disease, an autoimmune disorder in which your immune system attacks your thyroid and causes it to make too much hormone. This is the most common cause.
• Thyroid nodules, which are growths on your thyroid. They are usually benign (not cancer). But they may become overactive and make too much thyroid hormone. Thyroid nodules are more common in older adults.
• Thyroiditis, inflammation of the thyroid. It causes stored thyroid hormone to leak out of your thyroid gland.
• Too much iodine. Iodine is found in some medicines, cough syrups, seaweed and seaweed-based supplements. Taking too much of them can cause your thyroid to make too much thyroid hormone.
• Too much thyroid medicine. This can happen if people who take thyroid hormone medicine for hypothyroidism (underactive thyroid) take too much of it.

You are at higher risk for hyperthyroidism if you:

• Are a woman
• Are older than age 60
• Have been pregnant or had a baby within the past 6 months
• Have had thyroid surgery or a thyroid problem, such as goiter
• Have a family history of thyroid disease
• Have pernicious anemia, in which the body cannot make enough healthy red blood cells because it does not have enough vitamin B12
• Have type 1 diabetes or primary adrenal insufficiency, a hormonal disorder
• Get too much iodine, from eating large amounts of foods containing iodine or using iodine-containing medicines or supplements

The symptoms of hyperthyroidism can vary from person to person and may include:

• Nervousness or irritability
• Fatigue
• Muscle weakness
• Trouble tolerating heat
• Trouble sleeping
• Tremor, usually in your hands
• Rapid and irregular heartbeat
• Frequent bowel movements or diarrhea
• Weight loss
• Mood swings
• Goiter, an enlarged thyroid that may cause your neck to look swollen. Sometimes it can cause trouble with breathing or swallowing.

Adults over age 60 may have different symptoms than younger adults. For example, they may lose their appetite or withdraw from other people. Sometimes this can be mistaken for depression or dementia.

If hyperthyroidism isn't treated, it can cause some serious health problems, including:

• An irregular heartbeat that can lead to blood clots, stroke, heart failure, and other heart problems
• An eye disease called Graves' ophthalmopathy. It can cause double vision, light sensitivity, and eye pain. In rare cases, it can lead to vision loss.
• Thinning bones and osteoporosis
• Fertility problems in women
• Complications in pregnancy, such as premature birth, low birth weight, high blood pressure in pregnancy, and miscarriage

Your health care provider may use many tools to make a diagnosis:

• A medical history, including asking about symptoms
• A physical exam
• Thyroid tests, such as
  • TSH, T3, T4, and thyroid antibody blood tests
  • Imaging tests, such as a thyroid scan, ultrasound, or radioactive iodine uptake test. A radioactive iodine uptake test measures how much radioactive iodine your thyroid takes up from your blood after you swallow a small amount of it.

The treatments for hyperthyroidism include medicines, radioiodine therapy, and thyroid surgery:

• Medicines for hyperthyroidism include
  • Antithyroid medicines, which cause your thyroid to make less thyroid hormone. You probably need to take the medicines for 1 to 2 years. In some cases, you might need to take the medicines for several years. This is the simplest treatment, but it is often not a permanent cure.
  • Beta blocker medicines, which can reduce symptoms such as tremors, rapid heartbeat, and nervousness. They work quickly and can help you feel better until other treatments take effect.
• Radioiodine therapy is a common and effective treatment for hyperthyroidism. It involves taking radioactive iodine by mouth as a capsule or liquid. This slowly destroys the cells of the thyroid gland that produce thyroid hormone. It does not affect other body tissues. Almost everyone who has radioactive iodine treatment later develops hypothyroidism. This is because the thyroid hormone-producing cells have been destroyed. But hypothyroidism is easier to treat and causes fewer long-term health problems than hyperthyroidism.
• Surgery to remove part or most of the thyroid gland is done in rare cases. It might be an option for people with large goiters or pregnant women who cannot take antithyroid medicines. If you have all of your thyroid removed, you will need to take thyroid medicines for the rest of your life. Some people who have part of their thyroid removed also need to take medicines.

If you have hyperthyroidism, it's important not to get too much iodine. Talk to your health care provider about which foods, supplements, and medicines you need to avoid.

NIH: National Institute of Diabetes and Digestive and Kidney Diseases

The retina is a layer of tissue in the back of your eye that senses light and sends images to your brain. In the center of this nerve tissue is the macula. It provides the sharp, central vision needed for reading, driving and seeing fine detail.

Retinal disorders affect this vital tissue. They can affect your vision, and some can be serious enough to cause blindness. Examples are:

• Macular degeneration - a disease that destroys your sharp, central vision
• Diabetic eye disease
• Retinal detachment - a medical emergency, when the retina is pulled away from the back of the eye
• Retinoblastoma - cancer of the retina. It is most common in young children.
• Macular pucker - scar tissue on the macula
• Macular hole - a small break in the macula that usually happens to people over 60
• Floaters - cobwebs or specks in your field of vision

NIH: National Eye Institute

Your cornea is the outermost layer of your eye. It is clear and shaped like a dome. The cornea helps to shield the rest of the eye from germs, dust, and other harmful matter. It also helps your eye to focus. If you wear contact lenses, they float on top of your corneas.

Problems with the cornea include:

• Refractive errors
• Allergies
• Infections
• Injuries
• Dystrophies - conditions in which parts of the cornea lose clarity due to a buildup of cloudy material

Treatments of corneal disorders include medicines, corneal transplantation, and corneal laser surgery.

NIH: National Eye Institute

If you have diabetes, your blood glucose, or blood sugar, levels are too high. Glucose comes from the foods you eat. A hormone called insulin helps the glucose get into your cells to give them energy.

With type 1 diabetes, your body does not make insulin. With type 2 diabetes, your body does not make or use insulin well. Without enough insulin, the glucose stays in your blood.

Over time, having too much glucose in your blood can cause complications, including:

• Eye disease, due to changes in fluid levels, swelling in the tissues, and damage to the blood vessels in the eyes.
• Foot problems, caused by damage to the nerves and reduced blood flow to your feet.
• Gum disease and other dental problems, because a high amount of glucose in your saliva helps harmful bacteria grow in your mouth. The bacteria combine with food to form a soft, sticky film called plaque. Plaque also comes from eating foods that contain sugars or starches. Some types of plaque cause gum disease and bad breath. Other types cause tooth decay and cavities.
• Heart disease and stroke, caused by damage to your blood vessels and the nerves that control your heart and blood vessels.
• Kidney disease, due to damage to the blood vessels in your kidneys. Many people with diabetes develop high blood pressure. That can also damage your kidneys.
• Nerve problems (diabetic neuropathy), caused by damage to the nerves and the small blood vessels that nourish your nerves with oxygen and nutrients.
• Sexual and bladder problems, caused by damage to the nerves and reduced blood flow in the genitals and bladder.
• Skin conditions, some of which are caused by changes in the small blood vessels and reduced circulation. People with diabetes are also more likely to have infections, including skin infections.

If you have diabetes, you need to watch out for blood glucose levels that are too high (hyperglycemia) or too low for you (hypoglycemia). These can happen quickly and can become dangerous. Some of the causes include having another illness or infection and certain medicines. They can also happen if you don't get the right amount of diabetes medicines. To try to prevent these problems, make sure to take your diabetes medicines correctly, follow your diabetic diet, and check your blood glucose regularly.

NIH: National Institute of Diabetes and Digestive and Kidney Diseases

Down syndrome is a condition in which a person has an extra chromosome or an extra piece of a chromosome. This extra copy changes how a baby's body and brain develop. It can cause both mental and physical challenges during their lifetime. Even though people with Down syndrome might act and look similar, each person has different abilities.

Chromosomes are tiny "packages" in your cells that contain your genes. Genes carry information, called DNA, that controls what you look like and how your body works. People with Down syndrome have an extra copy of chromosome 21. In some cases, they may have an extra copy of part of the chromosome. Having an extra copy of a chromosome is called trisomy. So sometimes Down syndrome is also called trisomy 21.

Down syndrome is usually not inherited. It happens by chance, as an error when cells are dividing during early development of the fetus. It is not known for sure why Down syndrome occurs or how many different factors play a role.

One factor that increases the risk of having a baby with Down syndrome is the age of the mother. Women ages 35 and older are more likely to have a baby with Down syndrome.

The symptoms of Down syndrome are different in each person. And people with Down syndrome may have different problems at different times of their lives. They usually have mild to moderate intellectual disabilities. Their development is often delayed. For example, they may start talking later than other children.

Some of the common physical signs of Down syndrome include:

• A flat face
• Eyes that slant up
• A short neck
• Small hands and feet
• Poor muscle tone
• Loose joints

Many people with Down syndrome have the common physical signs and have healthy lives. But some people with Down syndrome might have one or more birth defects or other health problems. Some of the more common ones include:

• Hearing loss
• Sleep apnea (a disorder that causes you to repeatedly stop breathing during sleep)
• Ear infections
• Eye diseases
• Congenital heart defects (heart defects that are present at birth)
• Digestive problems
• Problems with the upper part of the spine
• Obesity

Health care providers can check for Down syndrome during pregnancy or after a child is born.

There are two basic types of tests that help find Down syndrome during pregnancy:

• Prenatal screening tests can show whether your unborn baby has a higher or lower chance of having Down syndrome. If a screening test shows that your baby could have Down syndrome, you'll need another test to find out for sure.
• Prenatal diagnostic tests can diagnose or rule out Down syndrome by checking the chromosomes in a sample of cells.

These tests have a small risk of causing a miscarriage, so they're often done after a screening test shows that an unborn baby could have Down syndrome.

After a baby is born, the provider may make an initial diagnosis of Down syndrome based on the physical signs of the syndrome. The provider can use a karyotype genetic test to confirm the diagnosis. The test can check for extra chromosomes in a sample of the baby's blood.

There is no single, standard treatment for Down syndrome. Treatments are based on each person's physical and intellectual needs, strengths, and limitations.

Services early in life focus on helping children with Down syndrome develop to their full potential. These services include speech, occupational, and physical therapies. They are typically offered through early intervention programs in each state. Children with Down syndrome may also need extra help or attention in school, although many children are included in regular classes.

Since people with Down syndrome can have birth defects and other health problems, they will need regular medical care. They may need to have certain extra health screenings to check for problems that happen more often in people with Down syndrome.

Centers for Disease Control and Prevention

Herpes is an infection that is caused by a herpes simplex virus (HSV). Oral herpes causes cold sores around the mouth or face. Genital herpes affects the genitals, buttocks or anal area. Genital herpes is a sexually transmitted infection (STI). It affects the genitals, buttocks or anal area. Other herpes infections can affect the eyes, skin, or other parts of the body. The virus can be dangerous in newborn babies or in people with weak immune systems.

There are two types of HSV:

• HSV type 1 most commonly causes cold sores. It can also cause genital herpes.
• HSV type 2 is the usual cause of genital herpes, but it also can infect the mouth.

HSV spreads through direct contact. Some people have no symptoms. Others get sores near the area where the virus has entered the body. They turn into blisters, become itchy and painful, and then heal.

Most people have outbreaks several times a year. Over time, you get them less often. Medicines to help your body fight the virus can help lessen symptoms and decrease outbreaks.