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Am I a candidate for LASIK?

If you already rely on wearing glasses or contact lenses to be able to see clearly, you may be frustrated with the effect that they have on your life. Regular vision tests, finding glasses to suit your face shape, having to remember to take eyeglasses with you wherever you go, prescription sunglasses, fiddly contact lenses… the list of inconveniences associated with conventional ocular solutions is extensive. 
LASIK is a modern, minimally-invasive procedure that can substantially reduce or eliminate your need to use eyeglasses or contact lenses, allowing you to enjoy life without limitations or inconvenience. The popularity and success of LASIK laser eye surgery have helped to make it the number one elective surgery across the globe. 
 

Candidacy for LASIK

LASIK has an extremely high success rate. According to the American Society of Cataract and Refractive Surgery, 96% of patients achieve 20/20 vision or better. However, it’s high success rate doesn’t make LASIK automatically the right solution for everyone.

Candidacy for LASIK is assessed by our doctors on a case by case basis so that you be certain that whatever treatment is recommended for you, it will give you the very best opportunity to improve your vision. During your consultation, our doctors will perform a thorough examination of your eyes and vision, ask you about your general health and talk you through both the procedure and aftercare.

The general guidelines for LASIK candidacy state that patients must:
 

  • be at least 18 years of age

  • have had stable vision with no prescription changes for a minimum of 12 months

  • have a current prescription for eyeglasses or contact lenses that falls between specified parameters (Our doctors will be aware of what these parameters are)

  • have no significant medical or eye-related problems such as glaucoma, macular degeneration or diabetic retinopathy

  • have no history of corneal disease

  • not be pregnant or nursing at the time of the procedure


Refraction Test

A refraction test, also called a vision test, is usually performed as a part of a routine eye examination. The purpose of this test is to determine if a person has a refractive error which would then mean the patient would need glasses or contact lenses.
 

What Is The Normal Value for Refraction Test?

A value of 20/20 is normal (optimum) vision. This means that individuals who have 20/20 vision are able to read letters that are 3/8-inch (1 centimeter) tall from 20 feet (6 meters) away. The normal uncorrected vision (without glasses or contact lenses) refractive error is zero (plano). Individuals who don’t have 20/20 vision, have what is called a refractive error. A refractive error means that the light is not bending properly when it passes through the lens of the eye. The refraction test will tell the doctor what prescription lens should be used in order to have 20/20 vision.

For people over age 40 who have normal distance vision but difficulty with near vision, a refraction test with a small type size is used to determine normal near vision and the correct power of reading glasses.
 

How Is The Refraction Test Performed?

The test is performed by having the patient seated in a chair that has a special device (called a phoropter or refractor) attached to it. The patient looks through the device and focuses on an eye chart 20 feet (6 meters) away. The device contains lenses of different strengths that can be moved into the patient’s view. The test is performed one eye at a time. If the patient is wearing contact lenses, they should be removed before the test.

In case the final vision is less than 20/20 even with lenses, then there is probably another non-optical problem with the eye. The vision level achieved during the refraction test is called the best-corrected visual acuity (BCVA).
 

What Are The Causes of Abnormal Refraction Test Results?

  • Abnormal results may be due to:

  • Astigmatism (abnormally curved cornea causing blurred vision)

  • Hyperopia (farsightedness)

  • Myopia (nearsightedness)

  • Presbyopia (inability to focus on near objects that develop with age)
     

Other conditions under which the test may be performed:

  • Corneal ulcers and infections

  • Loss of sharp vision due to macular degeneration

  • Retinal detachment (separation of the light-sensitive membrane (retina) in the back of the eye from its supporting layers)

  • Retinal vessel occlusion (blockage in a small artery that carries blood to the retina)

  • Retinitis pigmentosa (an inherited disorder of the retina)
     

There is an art to refraction and the optometrist will always answer the patient’s questions and as well as discuss their findings. Based on the results of the refraction test, they can determine the amount of myopia, hyperopia or astigmatism.
 


What to Expect During an Eye Exam

The parts of a comprehensive eye examination vary according to the patient's age, date of last exam, and other factors. Not all parts of the eye exam may be needed or performed, but the first part of the eye exam will include documenting medical history. Here are some eye and vision tests that are likely to be encountered during a comprehensive eye exam:
 

Visual Acuity Tests

Visual acuity tests measure the sharpness of vision and are usually performed using a projected eye chart to measure the distance visual acuity and a hand-held small acuity chart to measure the near vision (for reading).
 

Color Blindness Test

A screening test that checks the color vision is often performed early in a comprehensive eye exam to rule out color blindness.
 

Cover test to check eye alignment.

A test used to assess strabismus or a more subtle binocular vision problem that could cause eye strain or amblyopia (lazy eye).
 

Ocular Motility (Eye Movements) Testing

Ocular motility testing is performed to determine how well eyes can follow a moving object and/or quickly move between and accurately fixate on two separate targets.
 

Stereopsis (Depth Perception) Test

This is used to test perception of depth and 3-dimensional structure obtained on the basis of visual information deriving from two eyes by individuals with normally developed binocular vision.
 

Retinoscopy

This test is used to estimate which lens powers will best correct distance vision. Based on the way the light reflects from the eye, the doctor is able to obtain an approximation of the eyeglass prescription. This test is useful for children and patients who are unable to accurately answer the doctor's questions.
 

Manual refraction with a phoropter.

This is the test used to determine the exact eyeglass prescription.


Macular Degeneration

Macular degeneration, commonly referred to as age-related macular degeneration (AMD), is the single largest cause of sight loss in the developed world and affects more than 10 million Americans. It usually affects people over the age of 60, but has been known to affect those who are younger. It is a painless condition that usually affects both eyes with the loss being experienced in the central vision. It does not affect the peripheral vision, meaning that it does not cause total blindness.
 

What is the macula?

The macula is the most sensitive part of the retina and is responsible for our central vision and what allows us to see fine details with clarity.
 

Varieties of AMD

 

Wet AMD

Wet AMD is one variety of the condition in which abnormal blood vessels grow into the macula, leaking blood or fluid which then causes scarring and a rapid loss of central vision. Wet AMD can develop suddenly and rapid referral to a specialist is essential as it can be treated if caught quickly.
 

Dry AMD

Dry AMD is the most common variety of age-related macular degeneration and is a gradual deterioration of the retina as the cells die off over time and are not regenerated. Up to 15% of people with dry AMD go on to develop wet AMD, and so any sudden changes in your vision should be followed up with your optometrist as soon as possible.


Pink Eye

When you were a kid, did you experience your eyes become reddish and all of a sudden, someone close to you was also suffering from it? Your eyes, as well as those who contracted it, got itchy and swollen, right? Then it must have been that you were suffering from pink eye.

Pink eye is well known as conjunctivitis and it is the infection or inflammation of the conjunctiva or the transparent membrane that serves as a covering for the white part of the eye called the sclera that lines the eyelid. In addition to inflammation, there is usually tearing in the eyes that emits a sticky discharge which develops into a crust while one is sleeping, making it difficult for the patient to open their eyes in the morning.

One thing about the pink eye, which could affect one or both eyes, is that it is highly contagious. While it is more common in children, adults can also victims of this eye condition. Here are the 3 major causes of pink eye:
 

  • Bacteria

Streptococci and staphylococci are bacteria types that are most responsible for pink eye. However, chlamydia and gonococci can also cause pink eye. It is accompanied by serious eye pain, itching, swelling, redness, and discharge. The spread of bacterial pink eye is usually as a result of using personal items of infected parties, such as makeup or makeup tools that have been infected with bacteria or putting dirty hands in the eyes. If not treated, it can last for more than 10 days, but if treated, it should resolve in less than 3 days.

  • Allergies

Pink eye caused by allergies is followed by serious itching and tearing of the eyes. Pain is minimal, but it typically comes with quite a bit of discomfort. Most of the time, pink eye is accompanied by sneezing or coughing. Allergens that trigger pink eyes include grass, dust, pollen, mold, and ragweed. Allergy based pink eye is not usually contagious.
 

  • Viruses

Viruses such as the adenoviruses and herpes virus are the most common causes of pink eye. When a virus is the cause, there is usually a lot of teary discharge accompanied by nasal congestion, puffy eyelids, runny nose, and sharp pain. It is usually contracted from cough and sneeze droplets from an infected individual. It can take as long as 2 weeks to treat depending on the seriousness of the infection.

General Symptoms of Pink Eye:

  • Itchy eyes

  • Redness of the sclera

  • Pain

  • Watery discharge

  • Swollen eyelids

  • Hazy or blurry vision

  • Oversensitivity to light


Low Vision

Low vision is a term for conditions that result in reduced sight and cannot entirely be corrected with eyeglasses, contact lenses, medicines or surgery. Several eye diseases or conditions can cause low vision and here we will discuss the four most common causes of low vision and their risk factors.
 

Macular Degeneration

Macular degeneration is a disorder that affects the retina, which is the light-sensitive tissue lining the inside of the eye. Within the retina, the area responsible for sharp central vision (called the macula) deteriorates, causing blurred vision. This can cause a blind spot in the central area of vision, which leads to low vision.

There are two types of macular degeneration – non-exudative (dry form) and exudative (wet form). The dry form usually progresses slowly, while the wet form causes more rapid and severe vision loss due to abnormal blood vessels developing under the macula and leak fluid and blood. The biggest risk factor for macular degeneration is age. Other risk factors include genetics, race, smoking, and high blood pressure.
 

Diabetic Retinopathy

Diabetic retinopathy is a diabetes complication that affects the eyes. High blood sugar levels cause damage to blood vessels in the retina. These blood vessels can swell and leak (called macular edema). Sometimes they close, stopping blood from passing through (called macular ischemia). At first, diabetic retinopathy may cause no symptoms or only mild vision problems. However, over time, it can severely damage the retina, leading to low vision. Anyone who has diabetes can develop diabetic retinopathy. The risk increases for those who have had diabetes longer, as well as those with poor control of blood sugar levels, high blood pressure or cholesterol as well as those who smoke.
 

Cataracts

A cataract is a clouding of the lens in the eye that affects vision. This clouding can block the light from reaching the retina at the back of the eye, resulting in a general loss of vision. In some cases, a cataract can be surgically removed. Cataract surgery has a high success rate in otherwise healthy eyes but it is not always possible for people who also have other eye diseases. While the risk of cataract increases as you get older, other risk factors include diabetes, smoking, alcohol use, and prolonged exposure to ultraviolet sunlight.
 

Glaucoma

Glaucoma is a disease that damages your eye’s optic nerve. Most commonly, this occurs when fluid builds up in the front part of your eye which increases the pressure in your eye, damaging the optic nerve. There are four types of glaucoma: open-angle, normal tension, angle-closure, and secondary.


Eye Emergencies

Eye emergencies cover a range of incidents and conditions such as; trauma, cuts, scratches, foreign objects in the eye, burns, chemical exposure, photic retinopathy, and blunt injuries to the eye or eyelid. Since the eye is easily damaged, serious complications can occur from an eye injury thus, any of these conditions without proper treatment can lead to a partial loss of vision or even permanent blindness. Likewise, certain eye infections, other medical conditions, such as blood clots or glaucoma, and eye problems such as a painful red eye or vision loss that are not due to injury also need urgent medical attention.
 

Depending on the type of injury, any of the following symptoms may be present:

  • Bleeding or other discharge from or around the eye

  • Bruising

  • Decreased vision

  • Double vision

  • Loss of vision, total or partial, in one eye or both

  • Pupils of unequal size

  • Eye pain

  • New or severe headaches

  • Itchy eyes

  • Redness or bloodshot appearance

  • A sensation of something in the eye

  • Sensitivity to light

  • Stinging or burning in the eye

  • One eye is not moving like the other

  • One eye is sticking out or bulging

  • Nausea or headache occurring with eye pain (this may be a symptom of glaucoma or stroke).


A black eye is usually caused by direct trauma to the eye or face, causing a bruise resulting from bleeding under the skin. The skin around the eye turns black and blue, gradually becoming purple, green, and yellow over several days. Swelling of the eyelid and tissues around the eye may also occur. The abnormal color usually disappears within 2 weeks.

A blow to the eye can potentially damage the inside of the eye. Trauma is also a common cause of hyphemia, which is blood inside the front of the eye and is often due to a direct hit to the eye from a ball. Besides, certain types of skull fractures can cause bruising around the eyes, even without direct injury to the eye.

A chemical injury to the eye can be caused by a work-related accident, common household products such as cleaning solutions, garden chemicals, solvents, or other types of chemicals. Fumes and aerosols can also cause chemical burns. With acid burns, the haze on the cornea often clears and there is a good chance of recovery. However, alkaline substances such as lime, lye, drain cleaners, and sodium hydroxide found in refrigeration equipment may cause permanent damage to the cornea. It is important to flush out the eye with large amounts of clean water or salt water (saline).


Cataracts

If you’ve been diagnosed with cataracts, you may wonder if cataract surgery is right around the corner. Not to worry. There are many preventive steps you can take to slow the progression of cataracts and preserve your vision. That doesn’t mean you won’t eventually need surgery, but you can at least delay the need for quite a while.
 

Protect Your Eyes from the Sun

The National Eye Institute recommends protecting your eyes from the sun's harmful ultraviolet (UV) and high-energy visible (HEV) rays by always wearing good quality sunglasses while outdoors. Look for sunglasses that block 100 percent of UV rays and absorb most HEV rays with large lenses or a close-fitting wraparound style. Remember that the peak hours for sun exposure are between 10 am and 3 pm or 11 am and 4 pm during daylight savings time and that the sun’s rays are strong enough to pass through clouds, so you need your sunglasses every day.
 

Avoid Steroid Eye Drops

Steroid eye drops are routinely prescribed to treat dry eyes or an arthritic flare-up in the eyes. Unfortunately, they can also speed up the progression of cataracts. Talk to your Optometrist about how you can manage both conditions without inadvertently making your cataracts worse – and hastening the need for surgery.
 

Check Your Medications

There are over 300 commonly prescribed medications with side effects that may impact cataract progression. Since your primary care physician may not have access to your eye doctor’s medical records, be sure to ask your doctor if your current medications will affect your cataracts. If you must stay on the medication, it’s even more important to avoid sunlight during peak hours and to wear sunglasses.


Glaucoma Testing

You might be surprised at how many tests eye doctors use to diagnose glaucoma. A proper diagnosis requires careful evaluation of many aspects of your eye’s health – from eye pressure to cornea thickness to the health of your optic nerve. This article describes how your eye doctor assesses your risk and all the tests needed to properly diagnose glaucoma.
 

Risk Factor Assessment

Your eye doctor will begin by assessing your risk level for developing glaucoma. This will help determine the frequency and extent of testing needed. Through a family history and medical questionnaire, the eye doctor is looking for the following risk factors:
 

  • Over the age of 60

  • Ethnic background such as African or black Caribbean descent, Hispanic, or Asian

  • Family history of glaucoma, such as a sibling or parent with glaucoma

  • History of eye conditions, injuries or surgeries

  • Prolonged corticosteroid use (eye drops, pills, inhalers or creams)

  • Chronic conditions that affect blood flow, such as migraines, diabetes, low blood
    pressure or hypertension

  • Current or former smoker
     

If you’ve already had a comprehensive eye exam, your eye doctor will also consider these risk factors:
 

  • Eye pressure higher than normal (above 21 mm Hg)

  • Thin corneas (less than 0.5 millimeters)
     

Your type of eyesight is also important. People with farsightedness are at a higher risk for narrow-angle glaucoma, a more serious type that can advance quickly. While nearsightedness is associated with open-angle glaucoma, which progresses slowly without any symptoms.
 

Standard Glaucoma Tests

During a comprehensive eye exam, your eye doctor will always check for glaucoma, regardless of the risk level. This provides a baseline for comparison as you age. There are two tests: tonometry and ophthalmoscopy.
 


Common Eye Disorders Explained

People will often experience some type of eye disorder during the course of their lives. While the majority of these are minor and don’t require treatment, even minor problems can have significant adverse impacts on your vision, and you should seek the guidance of a licensed medical professional.

We’ve compiled some of the most common eye disorders, their causes, and treatments below. This guide is meant to be educational and not all of the disorders listed below require medical attention, but if you are concerned, you should contact your medical provider immediately.
 

Eyestrain

Eyestrain is a prevalent eye disorder. Most people have experienced this at one time or another. This optical issue can be caused by placing excessive strain on the eyes. It often occurs when reading, viewing a screen or driving for too long. The eyes may begin to feel tired, or a mild burning sensation can occur. Simple rest is often enough to correct this issue. However, if you continue to feel discomfort for a few days, its time to visit your doctor.
 

Eye Redness

Eye redness can often be a minor issue that is caused by the inflammation or irritation of blood vessels near the eye’s surface. This can be caused by an irritant, lack of sleep, or allergies. If the redness in your eyes is linked to some type of traumatic injury, you should see a doctor. Typical treatments for this condition are eye drops to help lubricate the eye, resting your eyes, or taking medication to treat your allergies. Eye redness can also be a warning sign for conjunctivitis, pink eye, or sun damage. These conditions should receive medical treatment from a licensed professional.
 

Night Blindness

Some people find that they have difficulty navigating in darker areas like movie theaters, dark rooms, or driving at night. Several possibilities could lead to night blindness. Some may have been born with this condition, or it could be the result of a degenerative retina. These issues cannot be resolved by a medical professional. However, night blindness can also be caused by nearsightedness, vitamin A deficiency, cataracts, or keratoconus. All of these issues can be corrected by a doctor.
 

Strabismus (Crossed Eyes)

Crossed eyes are not a condition that you can fix by yourself. This issue is seen in the eyes not properly lining up with each other. However, an optometrist may be able to help correct this issue, so it’s worth scheduling an appointment.

 

Nystagmus (Shaky Eyes)

Nystagmus is the constant shaking of the eyes of which the patient has no ability to control it. Medical professionals have several options for treatment at their disposal. Sometimes vision therapy is enough to strengthen the muscles and correct the issue. If this doesn’t work, surgery can also correct the problem. Your doctor can discuss your best options with you.
 

Colorblindness

Red and green color blindness is the most common form of colorblindness, although other types may affect your ability to see different color combinations. Color blindness is caused because the eyes lack the appropriate “cones” that help to interpret and differentiate these colors. This makes certain colors appear identical to colorblind individuals. Very severe forms of colorblindness only allow individuals to see shades of gray, but this is very rare.

While there is no current treatment for the correction of color blindness, special contact lenses or eyeglasses can be prescribed to help.
 

Uveitis

This condition is the inflammation of the uvea. There are several potential causes of uveitis that can be very serious, but uveitis is an umbrella phrase that covers all causes that create inflammation of the middle layer of the eye.

Some of these causes can be compromises of the immune system, like AIDS, rheumatoid arthritis, or ulcerative colitis. If you have light sensitivity, blurred vision, eye pain, and eye redness that lasts more than a few days you should see your eye care professional.
 

Knowing When to Get Help

Your eyes are a sensitive and critical organ for your health and small injuries or damage to your eyes can have lasting effects. For this reason, if you sense that something is wrong with your eyes, it’s always a good idea to visit your eye care professional. Additionally, make sure to get your regular annual eye exams which can help detect any issues that your eyes may be having and assure that you get the appropriate care more quickly.


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