cataracts

What Are Cataracts?

A cataract is a cloudy area in the lens of the eye. There are three classifications of adult cataracts: immature, mature, and hypermature. A cataract is considered immature when there are some remaining clear areas in the lens. A mature cataract is completely opaque. A hypermature cataract has a leaky liquid surface that may cause inflammation of other eye structures.

What Causes Cataracts?

Cataracts usually develop with advancing age, although in rare cases, they can be congenital (present at birth). Adult cataracts may run in families. The condition can also be caused by medical problems such as diabetes, injury to the eye, medications (especially steroids), overexposure to sunlight, previous eye surgery, and other unknown factors. Congenital cataracts can be the result of genetic inheritance or can be caused by infections and disorders that can occur during pregnancy.

What are the Symptoms of Cataracts?

• Blurred Vision
• Loss of Color Intensity
• Poor Night Vision
• Double Vision in One Eye
• Frequent Change in Eyeglass Prescription
• Problems with Glare or Light Sensitivity
• Seeing Halos Around Lights

How are Cataracts Detected?

An examination conducted by an ophthalmologist can detect the presence of a cataract.

Who is Most at Risk?

Most people experience some lens clouding after the age of 60. About 50% of people aged 65-74 and about 70% of people over 75 have visually significant cataracts.

How are Cataracts Treated?

Many people with cataracts are able to attain adequate vision with glasses; however, cataracts can only be removed surgically. The surgery is recommended when a person cannot see well enough with glasses to perform normal activities. Cataract surgery is typically performed as an outpatient procedure under local or topical anesthesia. The natural lens is usually removed and replaced with a permanent intraocular lens implant. Over 1.4 million people have cataract surgery each year in the United States, and over 95% of those surgeries are performed without complications.

How can Cataracts Be Prevented?

Protecting your eyes from the sun's radiation with UV-filtering sunglasses may help slow the progression of cataracts. Controlling other eye diseases and quitting smoking if you are a smoker will also decrease your risk.

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This document is provided for informational purposes only. Please consult an eye care professional about symptoms that may require medical attention and may or may not be covered by your medical plan and/or routine vision plan.

detached retina

What is Detached Retina?

When the retina separates from the deeper layers of the eyeball that normally support and nourish it, the retina is said to be detached. Without this nourishment and support, the retina does not function properly, and this can cause a variety of visual symptoms.

What Causes a Detached Retina?

The most common type of retinal detachment starts when a tear or hole develops in the retina, and some of the gel-like substance that fills the inside of the eye (vitreous fluid) leaks through the opening. Eventually, the leaking vitreous fluid gets behind the retina, separating the retina from other layers of the eye. The retinal tear that triggers a retinal detachment is sometimes caused by trauma. More often, it is caused by a change in the gel-like consistency of the vitreous fluid that can occur as a part of aging.

What are the Symptoms of a Detached Retina?

Symptoms of a detached retina may include sudden appearance of dark, semi-transparent, floating shapes in the field of vision, brief, bright flashes of light that may be most noticeable when you move your eyes in the dark, loss of central vision, and loss of peripheral vision (the curtain effect). If any of these symptoms or noticeable changes in your vision occur, please contact your ophthalmologist, a physician who specializes in eye problems, immediately.

How is a Detached Retina Detected?

During a retinal examination, the doctor will check for retinal tears and areas of detachment by using a special hand-held ophthalmoscope (a lighted instrument for looking inside the eye) or a slit lamp. If necessary, your doctor will do more tests to determine the extent of your visual field loss.

Who is Most at Risk?

There are certain groups who have an unusually high risk of developing this problem; including, people who have had cataract surgery, severely nearsighted people, and people who have had blunt trauma to the eye or penetrating eye injuries.

How is a Detached Retina Treated?

If you have a detached retina that is causing symptoms, you should be treated by an ophthalmologist, a physician who specializes in eye problems, immediately. Several techniques are available to repair retinal tears and to eliminate the area of separation behind the detached retina. Some options include scleral buckling, cryotherapy, laser photo-coagulation, pneumopexy, and vitrectomy.

How can a Detached Retina Be Prevented?

Most retinal detachments are age related, and cannot be prevented. If you are middle-aged or older, you may be able to identify eye problems in their early stages by scheduling an eye examination with an ophthalmologist every one to two years.

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This document is provided for informational purposes only. Please consult an eye care professional about symptoms that may require medical attention and may or may not be covered by your medical plan and/or routine vision plan.

Sources: American Academy of Ophthalmology (AAO) - www.aao.org

diabetic retinopathy

What is Diabetic Retinopathy?

When long-term diabetes causes progressive damage to the eye's retina, this condition is referred to as Diabetic Retinopathy. It is the most common diabetic eye disease that occurs when blood vessels in the retina change. Sometimes these vessels swell and leak fluid or even close off completely. In other cases, abnormal new blood vessels grow on the surface of the retina. There are two stages of Diabetic Retinopathy: Nonproliferative diabetic retinopathy (NPDR) and Proliferative diabetic retinopathy (PDR). NPDR is an early stage of Diabetic Retinopathy in which damaged blood vessels in the retina begin to leak extra fluid and small amounts of blood into the eye. Sometimes, deposits of cholesterol or other fats from the blood may leak into the retina. Diabetic Retinopathy is the leading cause of blindness in working-age Americans.

What Causes Diabetic Retinopathy?

The disease occurs when blood-sugar levels are high for extended periods of time, it can cause damage to the capillaries (tiny blood vessels) that supply blood to the retina. Over time, these blood vessels begin to leak fluids and fats, causing edema (swelling). Eventually, these small blood vessels can close off (called ischemia). These problems are a sign of NPDR and can lead to vision problems if existing blood vessels leak fluid into the retina. PDR can lead to visual disruption if abnormal new blood vessels hemorrhage and leak fluid.

As diabetic eye problems are left untreated, PDR can develop. Blocked blood vessels from ischemia can lead to the growth of new abnormal blood vessels on the retina (called neovascularization) which can damage the retina by causing wrinkling or retinal detachment. Neovascularization can even lead to glaucoma, damage to the optic nerve that carries images from your eye to your brain.

What are the Symptoms of Diabetic Retinopathy?

• There Often are No Symptoms at First
• Decreased Visual Acuity
• Seeing Floating Spots, dots or cobweb-like dark strings floating in your vision(Floaters)
• Vision changes periodically from blurry to clear
• Blank or dark areas in your field of vision
• Colors appear washed out or different
• Vision loss
• Vision Change in Only One Eye
• Vision Changes Lasting More than a Few Days
• Decreased Visual Acuity
• Blurred Vision
• Vision Changes Not Associated with a Change in Blood Sugar

How is Diabetic Retinopathy Detected?

The only way to detect diabetic retinopathy and to monitor its progression is through a comprehensive eye exam

There are several parts to the exam:

• Visual acuity test
• Slit-lamp exam
• Dilated exam
• Fluorescein angiography
• Optical coherence tomography (OCT)
• Ultra Sound

Who is Most at Risk?

People with both Type 1 and Type 2 diabetes are at risk as well as women with gestational diabetes.

Several factors can influence the development and severity of diabetic retinopathy, including:

• Blood sugar levels
• Blood pressure
• Duration of diabetes
• Blood lipid levels (cholesterol and triglycerides)
• Ethnicity
• Pregnancy

How is Diabetic Retinopathy Treated?

Treatment of diabetes is also considered treatment for Diabetic Retinopathy. The best treatment for diabetic retinopathy is to prevent it. Strict control of blood sugar will significantly reduce the long-term risk of vision loss. Treatment usually won't cure diabetic retinopathy nor does it usually restore normal vision, but it may slow the progression of vision loss.

Retinopathy Laser surgery can be used to treat Diabetic retinopathy. It shrinks abnormal new vessels and reduces macular swelling.

How can Diabetic Retinopathy Be Prevented?

Management of diabetes is the best way to prevent vision loss. Yearly diabetic retinopathy screenings with a dilated eye exam is important to detection in the early stages. If pregnant, it is recommended to have regular eye exams throughout the pregnancy, because pregnancy can sometimes worsen diabetic retinopathy.

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This document is provided for informational purposes only. Please consult an eye care professional about symptoms that may require medical attention and may or may not be covered by your medical plan and/or routine vision plan.

Sources: American Academy of Ophthalmology (AAO) - www.aao.org, Kd: Diabetic Retinopathy 10-13

glaucoma

What is Glaucoma?

It is a condition in which increased fluid pressure inside the eye causes damage to the optic nerve, resulting in partial vision loss or blindness. There are four types of glaucoma: closed-angle (acute), open-angle (chronic), secondary, and congenital. Glaucoma is the third most common cause of blindness in the U.S.

What Causes Glaucoma?

Fluid pressure increases in the eye when the eye's fluid (called aqueous humor) does not drain properly. This pressure reduces the blood supply to the optic nerve and causes the death of nerve cells. As these cells die, blind spots develop. Without treatment, glaucoma can eventually lead to blindness. Closed-angle (acute) glaucoma occurs when the iris slips forward and closes off the exit of the aqueous humor. This type is more common amongst farsighted people. Open-angle (chronic) glaucoma is the most common type of glaucoma. It occurs when the fluid channels in the wall of the eye gradually narrow with time. Secondary glaucoma is caused by other diseases or drugs. Congenital glaucoma is present at birth and occurs as a result of a defect in the development of the eye's fluid channels.

What are the Symptoms of Glaucoma?

• Blurred Vision
• Headache
• Seeing Halos Around Lights
• Severe Eye Pain
• Nausea/Vomiting

How is Glaucoma Detected?

Regular eye examinations by your ophthalmologist are the best way to detect glaucoma. Your ophthalmologist will measure your intraocular pressure, inspect the drainage angle of your eye, evaluate whether there is any optic nerve damage, and test the peripheral vision of each eye.

Who is Most at Risk?

African-Americans over age 40, everyone over age 60 (especially Mexican-Americans), and people with a family history of glaucoma.

How is Glaucoma Treated?

Damage caused by glaucoma usually cannot be reversed. Eye drops, laser surgery, and operating room surgery can be used to help prevent further damage. Oral medication may also be prescribed.

How can Glaucoma Be Prevented?

There is no real prevention for glaucoma. Early detection, however, may prevent further vision loss and blindness. Anyone older than 35 should have an eye examination at least every 2 years.

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This document is provided for informational purposes only. Please consult an eye care professional about symptoms that may require medical attention and may or may not be covered by your medical plan and/or routine vision plan.

macular degeneration

What is Macular Degeneration?

It is a disorder that causes a deterioration of the macula (the central part of the eye's retina). The macula allows the eye to see fine details at the center of the field of vision. A functional macula is essential to activities such as reading and driving; however, macular degeneration does not lead to blindness. Macular degeneration has “Dry” and “Wet” forms. “Dry” (atrophic) MD is more common. It occurs when the tissues of the macula thin due to aging and results in gradual vision loss. “Wet” (exudative) MD is less common and results from the formation of abnormal blood vessels underneath the retina. These new blood vessels then leak fluid or blood which blurs central vision and may cause rapid severe vision loss.

What Causes Macular Degeneration?

The most common type of Macular Degeneration is Age-Related Macular Degeneration (AMD). Risk factors besides advanced age include family history, cigarette smoking, and being Caucasian. Macular Degeneration is the leading cause of severe vision loss in Caucasians over 65, and by age 75, almost 15% of people have this condition.

What are the Symptoms of Macular Degeneration?

• Blurred or Distorted Central Vision
• A Dark Area in the Center of Vision
• Straight Lines Look Distorted

How is Macular Degeneration Detected?

There are several tests your ophthalmologist can use to detect Macular Degeneration. Three methods commonly used are taking the Amsler grid test, viewing the macula with an ophthalmoscope, and taking photographs of the eye called fluorescein angiographs.

Who is Most at Risk?

Macular Degeneration becomes increasingly common among people over 50 as they age. Smokers, Caucasians, and people with a family history are especially at risk.

How is Macular Degeneration Treated?

Sometimes nutritional supplements such as zinc and antioxidant vitamins help slow the progression of the disease. Certain types of “Wet” MD can be treated with laser surgery or photodynamic therapy. Unfortunately, there is no cure for Macular Degeneration.

How can Macular Degeneration Be Prevented?

Studies have shown that the use of vitamins and good nutrition may reduce the risk of developing MD. Using cigarettes or other forms of tobacco should be avoided, especially among people with a family history of the disease.

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This document is provided for informational purposes only. Please consult an eye care professional about symptoms that may require medical attention and may or may not be covered by your medical plan and/or routine vision plan.

retinitis pigmentosa

What is Retinitis Pigmentosa?

Retinitis pigmentosa (RP) is the name given to a group of hereditary eye diseases that affect the retina. Retinitis pigmentosa causes the degeneration of photoreceptor cells in the retina. These are cells that capture and process light that helps us to see. As these cells degenerate and die, patients experience progressive vision loss.

What are the Symptoms of Retinitis Pigmentosa?

• Loss of or diminished night vision (the earliest & most frequent symptom)
• Normal visual acuity in early stages
• Donut shaped visual field loss progressing to severe constriction (loss of peripheral vision)
• Night blindness
• Decreased response to magnification
• Need for more light

How is Retinitis Pigmentosa Detected?

There are special tests that can be used to detect RP:

• Acuity Tests: measures the accuracy of your central vision.
• Color Testing: helps determine the status of your cone cells, the retinal cells that interpret color.
• Donut shaped visual field loss progressing to severe constriction (loss of peripheral vision)
• Color Testing: helps determine the status of your cone cells, the retinal cells that interpret color.
• Dark Adaptation Test: measures how well your eyes adjust to changes in lighting.
• ERG Test (electrophysiological test): records the electrical currents produced by the retina due to a light stimulus.

Who is Most at Risk?

Recent research findings suggest that in some forms of RP, those who have prolonged, unprotected exposure to sunlight may experience accelerated vision loss.

How is Retinitis Pigmentosa Treated?

As yet, there is no known cure for RP. However, intensive research is currently ongoing to discover the cause, prevention, and treatment of RP.

How can Retinitis Pigmentosa Be Prevented?

Reducing your exposure to sunlight is important for keeping the eye protected. However, since RP is an inherited disorder that runs in families, the disease is not preventable. If someone in your family is diagnosed with retinal degeneration, it is strongly advised that all members of the family contact an eye care professional.

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This document is provided for informational purposes only. Please consult an eye care professional about symptoms that may require medical attention and may or may not be covered by your medical plan and/or routine vision plan.

Sources: Foundation Fighting Blindness (FFB) - www.blindness.org

strabismus

What is Strabismus?

Strabismus, also known as crossed or turned eye, is the medical term used when the two eyes are not straight. It is a visual defect in which the eyes are misaligned and point in different directions. One eye may look straight ahead, while the other eye turns inward, outward, upward or downward. The eye turn may be constant, or it may come and go. The turned eye may straighten at times, and the straight eye may turn.

What Causes Strabismus?

The exact cause of strabismus is not fully understood. Most commonly, a tendency to have some type of strabismus is inherited. Occasionally, the condition is due to some muscle abnormality. To line up and focus both eyes on a single target, all of the muscles in each eye must be balanced and working together. In order for the eyes to move together, the muscles in both eyes must be coordinated. The brain controls these eye muscles. Very rarely, strabismus may be secondary to a serious abnormality inside the eye, such as a cataract or tumor.

What are the Symptoms of Strabismus?

• Turned or crossed eye
• Squinting
• Head tilting or turning
• Double vision (in some cases)

How is Strabismus Detected?

Strabismus can be detected during an eye exam. It is recommended that all children between 3 and 3 1/2 years of age have their vision checked by their pediatrician, family practitioner, or an individual trained in vision assessment of preschool children. If there is a family history of strabismus or amblyopia, or a family history of wearing thick glasses, an ophthalmologist should check vision even earlier than age 3.Notice the asymmetrical light reflection.

Who is Most at Risk?

Strabismus is a common condition among children. Strabismus is especially common among children with disorders that may affect the brain, such as Cerebral Palsy, Down Syndrome, Hydrocephalus, Brain Tumors, and Prematurity.

How is Strabismus Treated?

Treatment usually includes patching the eye that is always straight to bring the vision up to normal in the turned eye. Glasses may be used, particularly for eyes that are out of focus. Glasses and special drops (phospholine iodide) may also help straighten the eyes. The success of treatment may depend on how quickly treatment is begun. If treatment is unduly delayed, vision may not be restored. This type of legal blindness can be completely prevented. Do not delay if your child has strabismus. Seek professional advice from your family doctor.

How can Strabismus Be Prevented?

Any case of poor vision in one eye in a child may lead to strabismus. To detect poor vision in one eye or the other, parents should take children for regular eye examinations. The American Academy of Ophthalmology recommends regular eye exams from birth, then at 6 months, 3 years, and 5 years old. However, if you or your child notices problems with his or her vision, visit the eye doctor or pediatrician immediately.

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This document is provided for informational purposes only. Please consult an eye care professional about symptoms that may require medical attention and may or may not be covered by your medical plan and/or routine vision plan.

Sources: American Academy of Ophthalmology (AAO) - www.aao.org

vision conditions

Myopia

Myopia, also known as shortsightedness or nearsightedness, is a condition in which distant objects appear out of focus. Myopia occurs when the physical length of the eye is greater than the optical length, causing the visual image to focus in front of the retina instead of directly onto it. This condition cannot be prevented but can easily be corrected by eyeglasses, contact lenses, or a surgical procedure such as LASIK.

Hyperopia

Hyperopia, also known as farsightedness, is a condition in which nearby objects appear out of focus. Hyperopia occurs when the eyeball is too small or the eye's focusing power is too weak, causing the visual image to focus behind the retina instead of directly onto it. This condition cannot be prevented but can easily be corrected by eyeglasses, contact lenses, or a surgical procedure.

Presbyopia

Presbyopia is a condition in which the lens loses some of its focusing power over time, which diminishes a person's ability to see nearby objects. Presbyopia develops with increasing age, and usually begins to have a noticeable effect on vision around the age of 45. This condition cannot be prevented but can easily be corrected by eyeglasses, contact lenses, or a surgical procedure.

Astigmatism

Astigmatism is a condition in which the cornea of the eye is asymmetrically curved, causing vision to be out of focus. Astigmatism is very common, frequently occurs in conjunction with nearsightedness or farsightedness, and is usually present from birth. It can affect either close or far-range vision. This condition cannot be prevented but can usually be corrected by glasses or hard contact lenses (soft contact lenses do not work as well).

Regardless of age or physical health, it is important for everyone to have regular eye examinations. A complete eye exam will determine not only your prescription for glasses or contacts, but also checks your eyes for common eye diseases, assesses how your eyes work together and evaluates your eyes as an indicator for your overall health.

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This document is provided for informational purposes only. Please consult an eye care professional about symptoms that may require medical attention and may or may not be covered by your medical plan and/or routine vision plan.

regular eye exams

Why Should You Get Your Eyes Examined?

An eye exam is one of the best ways to protect your vision because it can detect eye problems at their earliest stage - when they're most treatable. Regular eye exams give your eye doctor a chance to help you correct or adapt to vision changes. Even if you think your eyes are healthy, you still need an eye exam from time to time.

Here are some guidelines to follow for eye health:

Children 5 Years and Younger

Screening for eye disease should be conducted at:

• Newborn to 3 months
• 6 months to 1 year
• 3 years
• 5 years

Some factors may put your child at increased risk for eye disease. If any of these factors apply to your child, check with your eye doctor to see how often you should have a medical eye exam:

• Developmental Delay
• Premature birth
• Personal or family history of eye disease
• Previous serious eye injury
• Use of certain medications (check with you eye doctor)
• Some diseases that affect the whole body (such as diabetes or HIV infection)

School-Age Children and Adolescents

Have your child's vision checked before he or she enters first grade. If your child has no symptoms of vision problems and doesn't have a family history of vision problems, have your child's vision rechecked every two years. Talk to your child's eye doctor about what checkup schedule is best for your child.

Adults

If you don't wear glasses or contacts, have no symptoms of eye trouble, don't have a family history of eye disease and you don't have a chronic disease, such as diabetes, that puts you at risk of eye disease, have an eye exam at the following intervals:

• Ages 20 to 29: one examination
• Ages 30 to 39: two examinations
• Ages 40 to 65: examination every two to four years
• Ages 65 and over: examination every one to two years

If you do wear glasses or contacts, you'll need to have your eyes checked yearly. And if you notice any problems with your vision, schedule an appointment with your eye doctor as soon as possible. Blurred vision, for example, may suggest you need a prescription change. A sudden increase in the number of floaters (dark circles darting through your vision) could suggest vision-threatening changes to your retina.

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This document is provided for informational purposes only. Please consult an eye care professional about symptoms that may require medical attention and may or may not be covered by your medical plan and/or routine vision plan.

Sources: American Academy of Ophthalmology (AAO) - www.aao.org, The Mayo Clinic www.mayoclinic.com

common children’s conditions

Because your child can develop vision problems without showing obvious symptoms, it is important that infants be screened for common eye problems during their regular pediatric appointments. In addition, all children should have their vision tested by an eye doctor for the following common conditions beginning at around three years of age:

Strabismus (Crossed Eyes)

With strabismus, the eyes are not aligned. Strabismus is quite common and occurs in about 4% of children. One eye may gaze straight ahead while the other eye turns inward, upward, downward, or outward. When an eye turns inward, the child has "crossed" eyes (esotropia). There are two common causes for esotropia. Some children are born with crossed eyes (or develop it shortly after birth), and in this situation the muscles are too tight. Treatment commonly involves surgery on the eye muscles, generally performed prior to the age of 2. To learn more, click here Strabismus.

Amblyopia (Lazy Eye)

Lazy eye is reduced vision from lack of use in an otherwise normal eye. It usually happens only in one eye. Any condition that prevents a clear image can interfere with the development of vision and result in amblyopia. Amblyopia is common, affecting about 2% of children. Some causes of amblyopia include strabismus, droopy eyelids (ptosis), cataracts, or refractive errors. Because early treatment offers the best results, your pediatrician will refer you to an ophthalmologist. To learn more, click here Amblyopia.

Ptosis (Droopy Eyelids)

Ptosis refers to a situation in which the eyelids are not as open as they should be. This situation is caused by a weakness of a muscle that opens the upper eyelid. When ptosis is mild, it is just a cosmetic problem. However, ptosis can interfere with vision if it is severe enough to block the vision in the eye. In infancy, it is important that ptosis be eliminated so that vision will develop normally. Correction of ptosis usually requires surgery on the eyelid(s).

Color Deficiency (Color Blindness)

To interpret a world of color, there are three cone groupings in different regions of the visible spectrum that provide the brain with the information needed to see all colors. Instability in color recognition may be caused by visual media color changes, deficiencies or the absence of one or more cone groupings or from changes in the interpretation in the central nervous system. Approximately 8 percent of males and 0.4 percent of females have some degree of color deficiency. Congenital color blindness is the most common type. An X-linked recessive trait (only males affected, transmitted through female carriers to half of the sons, no father to son transmission), congenital color blindness is usually bilateral, symmetric and non-progressive. Patients may be tested binocularly. Acquired color blindness may be caused by poisoning, optic nerve or retinal disease. It may be unilateral, bilateral, asymmetric and progressive. Patients should be tested monocularly.

Refractive Errors

Nearsightedness (Myopia)

Children who are "nearsighted" see objects that are close to them clearly, but objects that are far away are unclear. Nearsightedness is very rare in infants and toddlers, but becomes more common in school-age children. Eyeglasses will help clear the vision but will not "cure" the problem. Despite using glasses, near-sightedness will generally increase in amount until the mid-teenage years so that periodic follow-up examinations by an ophthalmologist are indicated.s

Farsightedness (Hyperopia)

A hyperopic (farsighted) eye is too short. Instead of focusing on the retina, images focus beyond the retina, and vision is blurry. A small degree of farsightedness is normal in infants and children. It does not interfere with vision and requires no correction. It is only when the farsightedness becomes excessive, or causes the eyes to cross, that glasses are required.

Astigmatism

Astigmatism is the result of an eye that has an irregular corneal shape. Astigmatism may result in blurred vision. Children with astigmatism may need glasses if the amount of astigmatism is large. Learning disabilities are quite common in childhood years and have many causes. The eyes are often suspected but are almost never the cause of learning problems. Your pediatrician may refer you for an evaluation by an educational specialist to pinpoint the exact cause.

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This document is provided for informational purposes only. Please consult an eye care professional about symptoms that may require medical attention and may or may not be covered by your medical plan and/or routine vision plan.

Sources: American Academy of Ophthalmology (AAO) - www.aao.org

children’s eye exams

Why Should You Get Your Child's Eyes Examined?

Good vision is vital for physical and educational development in children. An eye exam is one of the best ways to protect your child's vision because it can detect eye problems at their earliest stage - when they're most treatable. The most common children's eye conditions include Strabismus and Amblyopia for which early detection is critical. Regular eye exams give your child's eye doctor a chance to help your child correct or adapt to vision changes.

Here are some guidelines to follow for your child's eye health:

Children 5 Years and Younger

Screening for eye disease should be conducted at:

• Newborn to 3 months
• 6 months to 1 year
• 3 years
• 5 years

School-Age Children and Adolescents

Have your child's vision checked before he or she enters first grade. If your child has no symptoms of vision problems and doesn't have a family history of vision problems, have your child's vision rechecked every two years.

Some factors may put your child at increased risk for eye disease. If any of these factors apply to your child, check with your eye doctor to see how often you should have a medical eye exam:

• Developmental Delay
• Premature birth
• Personal or family history of eye disease
• Previous serious eye injury
• Use of certain medications (check with you eye doctor)
• Some diseases that affect the whole body (such as diabetes or HIV infection)

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This document is provided for informational purposes only. Please consult an eye care professional about symptoms that may require medical attention and may or may not be covered by your medical plan and/or routine vision plan.

Sources: American Academy of Ophthalmology (AAO) - www.aao.org

eyewear prescriptions

How to Understand your Eyewear Prescription

After the examination, if necessary, your eye doctor will prescribe glasses or contact lenses to correct or improve your vision. The numbers on the prescription describe your eyesight measurement and eye condition. You will receive your eyeglass prescription at the end of your eye exam, and your contact lens prescription when your fitting is complete. Fitting contacts may involve more than one appointment.

Sample Doctor’s Prescription:

The numbers indicate the strength or power of the lenses prescribed, measured in units called diopters. If you have hyperopia (farsightedness), your sphere will be positive (+). If you have myopia (nearsightedness), your sphere will be negative (-).

The above prescription means the patient’s right eye has 1 ¼ diopters of myopia (nearsightedness) with 2 ½ diopters of astigmatism. The axis refers to the orientation of the cylindrical curvature of the lens. The axis can be anywhere from 1 to 180 degrees, with 90 being the vertical meridian. The left eye has ¾ diopters of myopia, 2 ¼ diopters of astigmatism, with an axis of 90.

Bifocal prescriptions are indicated with numbers such as the “+1.50 add” as seen on the sample prescription. This means that the patient will need 1 ½ diopters of power for reading added to the distance correction.

Definitions:

The following are some terms and definitions to help you understand your prescription:

R.E. / O.D. Right Eye L.E. / O.S. Left Eye

Refraction

Test to determine the amount of the ocular refractive error and the best corrective lenses to be prescribed.

Visual Acuity

The measure of visual power, expressed as a fraction that is usually determined by one's ability to read letters of various sizes at a standard distance from a test chart.

The normal sight is 20/20. The first number is the distance (20 feet) from the eye chart. The second number is the distance from which a normal eye sees a letter on the chart clearly. Someone with a visual acuity of 20/20 can see certain sized letters at a distance of 20 feet. Someone with a visual acuity of 20/40 only sees letters at 20 feet that a normal eye is able to see at 40 feet.

Sphere

How nearsighted (-) or farsighted (+) you are.

Cylinder

The type of curvature of the spectacle lens to help patients with astigmatism.

Astigmatism

An irregularity in the curvature of the eye. It is usually due to the cornea being curved more in one direction than another.

Axis

The orientation of the placement of the cylinder for astigmatism correction. The axis can be anywhere from 1 to 180 degrees.

Myopia (Nearsightedness)

A refractive error in which parallel rays come to a focus in front of the retina, enabling a person to see distinctly only at near distances.

Hyperopia (Farsightedness)

A refractive error in which parallel rays come to a focus behind the retina, enabling a person to see better at far distances.

Presbyopia

The gradual loss of the ability to focus at close objects with advancing age. This makes reading difficult. Onset usually occurs between 40 and 45.

Lens Types:

The following are some typical types of lenses:

Single Vision

Corrective lenses with only one focal length (power).

Bifocal

Lenses containing upper and lower segments, each with a different power.

Trifocal

Corrective lenses with three focal lengths.

Progressive

An eyeglass lens that incorporates corrections for distance vision through midrange, to near vision (usually in the lower part of the lens), with smooth transitions and no bifocal demarcation line.

Contacts

Lenses that fit directly on the cornea of the eye.

Talk to your eye doctor if you have questions or concerns about your prescription so that you fully understand the results and implications of the examination.

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This document is provided for informational purposes only. Please consult an eye care professional about symptoms that may require medical attention and may or may not be covered by your medical plan and/or routine vision plan.

Sources: American Academy of Ophthalmology (AAO) - www.aao.org

vision facts for children with diabetes

Diabetes and Your Child's Eyes

Diabetes mellitus (mel-i-tuhs) is a disorder caused by a decreased production of insulin or by the body’s inability to use insulin. Insulin is produced by the pancreas and is necessary for the body’s control of blood sugar. Fluctuations in blood sugar can be harmful to the body, including the eyes.

Type 1 diabetes (insulin-dependent or juvenile diabetes) can occur at any age, but most commonly is diagnosed from infancy to the late 30s. In this type of diabetes, a person's pancreas produces little or no insulin.

Children with diabetes are at risk of developing eye disease that can affect their vision. Diabetic eye disease refers to a group of eye problems that affects those with diabetes.

Diabetic eye disease may include:

• Diabetic retinopathy (ret-in-AHP-uh-thee) A potentially blinding condition in which the blood vessels inside the retina become damaged from the high blood sugar levels associated with diabetes. This leads to the leakage of fluids into the retina and the obstruction of blood flow. Both may cause vision loss.

  Diabetic retinopathy is the most common and most serious eye-related complication of diabetes. It is a progressive disease that destroys small blood vessels in the retina, eventually causing vision problems. In its most advanced form (known as “proliferative retinopathy”) it can cause blindness. Nearly all people with juvenile (type 1) diabetes show some symptoms of diabetic retinopathy usually after about 20 years of living with diabetes; approximately 20 to 30 percent of them developed the advanced form. Those with type 2 diabetes are also at increased risk.

• Cataract (kat-uh-rakt) A clouding of the normally clear lens of the eye. It can be compared to a window that is frosted or yellowed.

  Cataract may occur at a younger age in diabetic patients.

• Glaucoma (glaw-KOH-muh) A disease of the optic nerve — the part of the eye that carries the images we see to the brain. The optic nerve is made up of many nerve fibers, like an electric cable containing numerous wires. When damage to the optic nerve fibers occurs, blind spots develop. These blind spots usually go undetected until the optic nerve is significantly damaged. If the entire nerve is destroyed, blindness results.

  The chances of developing glaucoma are doubled in diabetic patients.

Warning Signs

Since diabetes can be harmful to the eyes, parents should be aware of the following signs and symptoms of the disease:

• Blurred vision
• Extreme hunger accompanied by weight loss
• Excessive thirst
• Frequent urination
• Fatigue
• Loss of feeling or tingles in the extremities (hands and feet)

Other symptoms may include:

• Frequent infections of the bladder, skin, or gums
• Dry mouth
• Slow healing of cuts and scrapes
• Excessive or unusual infections

If you suspect your child might have diabetes, please contact your family doctor as soon as possible.

Taking Care of Your Child’s Sight

Diabetic eye disease can usually be controlled and permanent vision loss can be prevented through a combination of early detection, treatment, and good control of diabetes.

If your child is diagnosed with diabetes, schedule a complete eye examination with your eye doctor as soon as possible and at least once a year thereafter. Your eye doctor will recommend more frequent eye examinations if indicated by the presence of abnormalities.

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This document is provided for informational purposes only. Please consult an eye care professional about symptoms that may require medical attention and may or may not be covered by your medical plan and/or routine vision plan.

Sources: American Academy of Ophthalmology (AAO) - www.aao.org, Juvenile Diabetes Research Foundation International – www.jdf.org / www.jdrf.org

after-cataract, secondary cataract

Remnants of an opaque lens remaining in the eye, or opacities forming, after extracapsular cataract removal.

age-related macular degeneration (amd)

Group of conditions that include deterioration of the macula, resulting in loss of sharp central vision. Two general types: "dry," which is more common, and "wet," in which abnormal new blood vessels grow under the retina and leak fluid and blood (neovascularization), further disturbing macular function. Most common cause of decreased vision after age 60.

amblyopia

Also known as "lazy eye". Decreased vision in one or both eyes without detectable anatomic damage in the eye or visual pathways. Usually uncorrectable by eyeglasses or contact lenses. Amblyopia can be prevented through early diagnosis and treatment.

angle, anterior chamber angle

Junction of the front surface of the iris and back surface of the cornea, where aqueous fluid filters out of the eye.

anisometropia

A condition in which the eyes have unequal refractive power.

anterior chamber

Fluid-filled space inside the eye between the iris and the innermost corneal surface (endothelium).

aphakia

Absence of the eye's crystalline lens, such as after cataract extraction.

asthenopia

Vague eye discomfort arising from use of the eyes; may consist of eyestrain, headache, and/or browache. May be related to uncorrected refractive error or poor fusional amplitudes.

astigmatism

Optical defect in which refractive power is not uniform in all directions (meridians). Light rays entering the eye are bent unequally by different meridians, which prevent formation of a sharp image focus on the retina. Slight uncorrected astigmatism may not cause symptoms, but a large amount may result in significant blurring and headache.

background retinopathy

See Diabetic Retinopathy.

blepharitis

Inflammation of the eyelids, usually with redness, swelling, and itching.

blind spot

Sightless area within the visual field of a normal eye. Caused by absence of light sensitive photoreceptors where the optic nerve enters the eye.

cataract

Opacity or cloudiness of the crystalline lens, which may prevent a clear image from forming on the retina. Surgical removal of the lens may be necessary if visual loss becomes significant, with lost optical power replaced with an intraocular lens, contact lens, or aphakic spectacles. May be congenital or caused by trauma, disease, or age.

central retinal artery

First branch of the ophthalmic artery; supplies nutrition to the inner two-thirds of the retina.

central retinal vein

Blood vessel that collects retinal venous blood drainage; exits the eye through the optic nerve.

central vision

An eye's best vision; used for reading and discriminating fine detail and color. Results from stimulation of the fovea and the macular area.

choroid

Vascular (major blood vessel) layer of the eye lying between the retina and the sclera. Provides nourishment to outer layers of the retina.

color blindness

Reduced ability to discriminate between colors, especially shades of red and green. Usually hereditary.

cone

Light-sensitive retinal receptor cell that provides sharp visual acuity and color discrimination.

conjunctiva

Transparent mucous membrane covering the outer surface of the eyeball except the cornea, and lining the inner surface of the eyelids.

conjunctivitis

Also known as "pink eye". Inflammation of the conjunctiva. Characterized by discharge, grittiness, redness and swelling. Usually viral in origin, but may be bacterial or allergic; may be contagious.

convergence

Inward movement of both eyes toward each other, usually in an effort to maintain single binocular vision as an object approaches.

cornea

Transparent front part of the eye that covers the iris, pupil, and anterior chamber and provides most of an eye's optical power.

crossed-eyes

See Esotropia.

crystalline lens

The eye's natural lens. Transparent, biconvex intraocular tissue that helps brings rays of light to a focus on the retina.

diabetic retinophathy

Spectrum of retinal changes accompanying long-standing diabetes mellitus. Early stage is background retinopathy or nonproliferative (NPDR). May advance to proliferative retinopathy (PDR), which includes the growth of abnormal new blood vessels (neovascularization) and fibrous tissue.

diplopia

Double vision.

drusen

Tiny, white hyaline deposits on Bruch's membrane (of the retinal pigment epithelium). Common after age 60; sometimes an early sign of macular degeneration.

dry eye syndrome

Corneal and conjunctival dryness due to deficient tear production, predominantly in menopausal and post-menopausal women. Can cause foreign body sensation, burning eyes, filamentary keratitis, and erosion of conjunctival and corneal epithelium.

ectropion

Outward turning of the upper or lower eyelid so that the lid margin does not rest against the eyeball, but falls or is pulled away. Can create corneal exposure with excessive drying, tearing, and irritation. Usually from aging.

emmetropia

Refractive state of having no refractive error when accommodation is at rest. Images of distant objects are focused sharply on the retina without the need for either accommodation or corrective lenses.

entropion

Inward turning of upper or lower eyelid so that the lid margin rests against and rubs the eyeball.

esophoria

A tendency of one eye to turn inward.

esotropia

Also known as "crossed eyes". Eye misalignment in which one eye deviates inward (toward nose) while the other fixates normally.

exophoria

A tendency of one eye to turn outward.

exotropia

Also known as "wall-eyes". Eye misalignment in which one eye deviates outward (away from nose) while the other fixates normally.

extraocular muscles

Six muscles that move the eyeball (lateral rectus, medial rectus, superior oblique, inferior oblique, superior rectus, inferior rectus).

eyelids

Structures covering the front of the eye, which protect it, limit the amount of light entering the pupil, and distribute tear film over the exposed corneal surface.

farsightedness

See Hyperopia.

floaters

Particles that float in the vitreous and cast shadows on the retina; seen as spots, cobwebs, spiders, etc. Occurs normally with aging or with vitreous detachment, retinal tears, or inflammation.

fovea

Central pit in the macula that produces sharpest vision. Contains a high concentration of cones and no retinal blood vessels.

fundus

Interior posterior surface of the eyeball; includes retina, optic disk, macula, posterior pole. Can be seen with an ophthalmoscope.

glaucoma

A group of diseases that can damage the eye's optic nerve and result in vision loss and blindness. Although glaucoma usually occurs when the normal fluid pressure inside the eyes slowly rises, but it may also occur with eyes that have "normal" pressure. Treatment is aimed at halting loss of vision with prescription medications, laser treatment, or surgery.

heterophoria

The tendency of one eye to deviate from one direction to another due to an imbalance.

hyperopia

Also known as "farsightedness". Focusing defect in which an eye is underpowered. Thus light rays coming from a distant object strike the retina before coming to sharp focus, blurring vision. Corrected with additional optical power, which may be supplied by a plus lens (spectacle or contact) or by excessive use of the eye's own focusing ability (accommodation).

hyphema

Blood in the anterior chamber, such as following blunt trauma to the eyeball.

iris

Pigmented tissue lying behind the cornea that gives color to the eye (e.g., blue eyes) and controls amount of light entering the eye by varying the size of the pupillary opening.

keratoconus

Degenerative corneal disease affecting vision. Characterized by generalized thinning and cone-shaped protrusion of the central cornea, usually in both eyes. Hereditary.

l.e. / left eye

See O.S.

lacrimal gland

Almond-shaped structure that produces tears. Located at the upper outer region of the orbit, above the eyeball.

lazy eye

See Amblyopia.

legal blindness

Best-corrected visual acuity of 20/200 or less, or reduction in visual field to 20" or less, in the better seeing eye.

low vision

Term usually used to indicate vision of less than 20/200.

macula

Small central area of the retina surrounding the fovea; area of acute central vision.

macular degeneration

See "Age-Related Macular Degeneration".

myopia

Also known as "nearsightedness". Focusing defect in which the eye is overpowered. Light rays coming from a distant object are brought to focus in front of the retina. Requires a minus lens correction to "weaken" the eye optically and permit clear distance vision.

nearsightedness

See Myopia.

neovascularization

Abnormal formation of new blood vessels, usually in or under the retina or on the iris surface. May develop in diabetic retinopathy, blockage of the central retinal vein, or macular degeneration.

nystagmus

Involuntary, rhythmic side-to-side or up and down (oscillating) eye movements.

o.D. / right eye

Oculus Dexter (Latin)

o.S. / Left Eye

Oculus Sinister (Latin)

o.U. / Oculi Uterque (Latin)

Both eyes

optic disc, optic nerve head

Ocular end of the optic nerve. Denotes the exit of retinal nerve fibers from the eye and entrance of blood vessels to the eye.

optic nerve

Largest sensory nerve of the eye; carries impulses for sight from the retina to the brain.

peripheral vision

Side vision; vision elicited by stimuli falling on retinal areas distant from the macula.

photophibia

Abnormal sensitivity to, and discomfort from, light. May be associated with excessive tearing. Often due to inflammation of the iris or cornea.

pinguecula

Yellowish-brown subconjunctival elevation composed of degenerated elastic tissue; may occur on either side of the cornea. Benign.

pink eye

See Conjunctivitis.

presbyopia

The gradual loss of the ability to focus at close objects with advancing age. This makes reading difficult. Onset usually occurs between the ages of 40 and 45 years of age.

proliterative retinopathy

See Diabetic Retinopathy.

ptosis

Drooping of upper eyelid. May be congenital or caused by paralysis or weakness of the 3rd cranial nerve or sympathetic nerves, or by excessive weight of the upper lids.

pupil

Variable-sized black circular opening in the center of the iris that regulates the amount of light that enters the eye.

r.E. / Right Eye

See O.D.

refractive error

Imperfect refractive powers of the eyes as in astigmatism, myopia, or hyperopia.

retina

Light sensitive nerve tissue in the eye that converts images from the eye's optical system into electrical impulses that are sent along the optic nerve to the brain. Forms a thin membranous lining of the rear two-thirds of the globe.

retinal detachment

Separation of the retina from the underlying pigment epithelium. Disrupts visual cell structure and thus markedly disturbs vision. Almost always caused by a retinal tear; often requires immediate surgical repair.

rod

Light-sensitive, specialized retinal receptor cell that works at low light levels (night vision). A normal retina contains 150 million rods.

schlemm's canal

Circular channel deep in corneoscleral junction (limbus) that carries aqueous fluid from the anterior chamber of the eye to the bloodstream.

sclera

Opaque, fibrous, protective outer layer of the eye ("white of the eye") that is directly continuous with the cornea in front and with the sheath covering optic nerve behind.

scotoma

A blind area in the visual field.

strabismus

Also known as "crossed'eyes". Eye misalignment caused by extraocular muscle imbalance: one fovea is not directed at the same object as the other.

sty, stye

An infection of one of the sebaceous glands of the eyelid.

subnormal or low vision

Term usually used to indicate vision of less than 20/200.

trabecular meshwork

Mesh-like structure inside the eye at the iris-scleral junction of the anterior chamber angle. Filters aqueous fluid and controls its flow into the canal of Schlemm, prior to its leaving the anterior chamber.

uvea, uveal tract

Pigmented layers of the eye (iris, ciliary body, choroid) that contain most of the intraocular blood vessels.

vision

Sense by which light and color are apprehended; sight.

vitreous

Also known as vitreous humor. Transparent, colorless gelatinous mass that fills the rear two-thirds of the eyeball, between the lens and the retina.

vitreous detachment

Separation of vitreous gel from retinal surface. Usually innocuous, but can cause retinal tears, which may lead to retinal detachment. Frequently occurs with aging as the vitreous liquifies, or in some disease states, e.g. diabetes and high myopia.

zonules

Anatomy. Radially arranged fibers that suspend the lens from the ciliary body and hold it in position.

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This document is provided for informational purposes only. Please consult an eye care professional about symptoms that may require medical attention and may or may not be covered by your medical plan and/or routine vision plan.

Sources:
American Academy of Ophthalmology (AAO) – www.aao.org
EyeCare America - www.eyecareamerica.org
AAPOS – www.aapos.org
National Academy of Opticianry – www.nao.org
Excerpted from Dictionary of Eye Terminology, copyright 1984-2012
By Barbara Cassin and Melvin L. Rubin, MD. Reprinted with permission.

accomodation

Increase in optical power by the eye in order to maintain a clear image (focus) as objects are moved closer. Occurs through a process of ciliary muscle contraction and zonular relaxation that causes the elastic-like lens to "round up" and increase its optical power. Natural loss of accommodation with increasing age is called presbyopia.

amsler grid

Test card; grid (black lines on white background or white lines on black background) used for detecting central visual field distortions or defects, such as in macular degeneration.

comprehensive eye examination

A complete evaluation of the visual system that may be performed in one or more sessions.

cycloplegic refraction

Assessment of an eye's refractive error after lens accommodation has been paralyzed with cycloplegic eye drops (to eliminate variability in optical power caused by a contracting lens).

dilated pupil

Enlarged pupil, resulting from contraction of the dilator muscle or relaxation of the iris sphincter. Occurs normally in dim illumination, or may be produced by certain drugs (mydriatics, cycloplegics) or result from blunt trauma.

eye m.D.

See Ophthalmologist.

field of vision

The entire area that is seen without shifting one's gaze.

gonioscopy

Examination of the anterior chamber angle through a goniolens (special type of contact lens).

intraocular pressure

Fluid pressure inside the eye or the assessment of pressure inside the eye with a tonometer. Also called tension.

keratometry

Obtaining corneal curvature measurements with a keratometer.

mydriatic

A drug that dilates the pupil.

ophthalmologist (M.D.)

A physician and surgeon who is qualified and specially trained to diagnose and treat all eye and visual system problems, as well as diagnose general diseases of the body. An Ophthalmologist prescribes lenses to improve visual acuity.

ophthalmoscope

Device for viewing the interior of the eye or the retina.

optician

An independent professional who designs, verifies and dispenses lenses, frame and other fabricated optical devices upon the prescription of an Ophthalmologist or an Optometrist.

optometrist

Doctor of optometry (OD) specializing in vision problems, treating vision conditions with spectacles, contact lenses, low vision aids and vision therapy. May prescribe some medications.

perimetry

Method of charting extent of a stationary eye's field of vision with test objects of various sizes and light intensities. Aids in detection of damage to sensory visual pathways.

refraction

Test to determine an eye's refractive error and the best corrective lenses to be prescribed.

retinoscope

Device for measuring an eye's refractive error with no response required from the patient. Light is projected into the eye, and the movements of the light reflection from the eye are neutralized (eliminated) with lenses.

slit lamp

Microscope used for examining the eye; allows cornea, lens and otherwise clear fluids and membranes to be seen in layer-by-layer detail.

snellen chart

Test chart used for assessing visual acuity. Contains rows of letters, numbers, or symbols in standardized graded sizes, with a designated distance at which each row should be legible to a normal eye. Usually tested at 20 ft.

tonometry

Measurement of intraocular pressure.

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This document is provided for informational purposes only. Please consult an eye care professional about symptoms that may require medical attention and may or may not be covered by your medical plan and/or routine vision plan.

Sources:
American Academy of Ophthalmology (AAO) – www.aao.org
EyeCare America - www.eyecareamerica.org
AAPOS – www.aapos.org
National Academy of Opticianry – www.nao.org
Excerpted from Dictionary of Eye Terminology, copyright 1984-2012
By Barbara Cassin and Melvin L. Rubin, MD. Reprinted with permission.

20/20

See Visual Acuity, Normal visual acuity. Upper number is the standard distance (20 feet) between an eye being tested and the eye chart; lower number indicates that a tested eye can see the same small standard-sized letters or symbols as a normal eye at 20 feet.

aphakic lenses

Prosthetic lenses that are designed for patients that have had their crystalline lens removed (aphakia), such as after cataract extraction.

aspherical lenses

Not spherical; used to reduce marginal aberration; such conic sections as parabolic, hyperbolic, or ellipsoidal; a lens surface having an infinite number of curves with different radii.

axis

The orientation of the placement of the cylindrical area of the lens. The axis can be anywhere from 1 to 180 degrees.

base curve

Applied to a toric surface, the B.C. is the flattest curve on that surface of the lens. In general, the B.C. is the cataloging curve or curve common to a group of lenses; the weakest curve on the front of a lens.

bifocal lenses

With two focal lengths; an area for distance vision and an area for near vision.

binocular vision

Blending of the separate images seen by each eye into one composite image.

coating - UV Protection

Blocks ultraviolet rays which are harmful for the crystalline lens, retina, and other parts of the eye and is available on all types of lenses.

coating - anti-Reflective

Coating that can reduce glare and reflections. Can be useful for people with strong prescriptions and people who drive at night.

coating - mirrored

Mirror finishes are thin layers of various metallic coatings on an ordinary lens.

coating - scratch

Protects lens against scratches and is recommended for anyone with plastic lenses.

contact lenses

Thin, clear disks of plastic that float on the tear film that coats the cornea, the curved front surface of the eye. This lens is used to correct refractive errors including irregularly shaped cornea.

cylinder

The type of curvature of the spectacle lens to help patients with astigmatism.

diopter

Unit to designate the refractive power of a lens.

eyewear

Lenses, frame and/or contact lenses.

focal length

The distance from the back vertex of a lens to its focal point, strictly called the back vortex focal length.

frame

The structural part(s) that provide support to the lenses.

iOL (Intraocular lens)

Synthetic lens that may be surgically implanted to replace the eye's natural lens.

lens or lenses

Transparent refracting medium usually made of plastic.

lenticular lenses

A strong lens which has a central area usually 30 to 40 mm ground to the prescription. The margin has a shallow curve to reduce weight and/or thickness.

patching

Covering an amblyopic patient's preferred eye, to improve vision in the other eye.

photochromic

Photochromic are lenses that darken and lighten and change color, in accordance with the amount of ultraviolet light to which they are exposed.

plano lenses

Value of no power or zero; such as non-prescription sunglasses or non-prescription sunglasses or colored contact lenses.

polarized lenses

Lenses that incorporate a filter that reduces reflected glare, such as, sunlight that bounces off smooth surfaces like pavement or water. They can be particularly useful for driving and fishing.

polycarbonate

A material that is significantly more impact-resistant than other plastic. Polycarbonate lenses are lightweight, scratch-resistant, thin and can be designed to meet most eyeglass design or prescription.

prism

A wedge-shaped piece of glass or plastic that refracts rays of light. Eye glasses with prisms can correct mild double vision associated with adult strabismus.

progressive lenses

Eyeglass lens that incorporates corrections for distance vision through midrange, to near vision (usually in lower part of lens), with smooth transitions and no bifocal demarcation line. A single pair of glasses enables the user to see at various distances.

reading add / reading addition

The amount of plus (+) power in the segment of a bifocal lens.

rx

Lens prescription to include the sphere value, cylinder value, axis and any prism present.

single vision lenses

Corrective lenses with only one focal length.

sphere

Indicates how nearsighted (-) or farsighted (+) you are.

subnormal or low vision aids

Devices that are either worn, hand-held, or free-standing that manipulate images to improve vision. It may or may not be used with regular corrective eyewear.

tint

Color added to lenses for either cosmetic or sun sensitivity reasons.

trifocal lenses

A lens with three focusing points: distance, intermediate and reading.

visual acuity

See 20/20, The measure of visual power, expressed as a fraction (e.g. 20/20) that is usually determined by one's ability to read letters of various sizes at a standard distance from a test chart.

visual field

Full extent of the area visible to an eye that is fixating straight ahead.

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This document is provided for informational purposes only. Please consult an eye care professional about symptoms that may require medical attention and may or may not be covered by your medical plan and/or routine vision plan.

Sources:
American Academy of Ophthalmology (AAO) – www.aao.org
EyeCare America - www.eyecareamerica.org
AAPOS – www.aapos.org
National Academy of Opticianry – www.nao.org
Excerpted from Dictionary of Eye Terminology, copyright 1984-2012
By Barbara Cassin and Melvin L. Rubin, MD. Reprinted with permission.

benefit brochure

A booklet or pamphlet or outline describing specific vision plan benefits.

employer group

A group that has chosen, in lieu of insurance, to reserve funds for payment for covered services incurred by its employees.

health care service plan or specialized health care service plan

An organization that undertakes to arrange for the provision of health care services to subscribers or enrollees, in return for a prepaid or periodic charge. Vision Plans that provide specialized care to their members are called "Specialized Health Care Service Plans".

health maintenance organization (HMO)

An organization engaged in providing managed care and assuming the risk for health related benefits.

insurance carrier

An organization engaged in providing and assuming the risk of various benefits.

non-Elective (Medically necessary) contact lenses

Prescribed to patients who meet specific medical criteria for contact lenses. Medically necessary contact lenses are provided for any of the following criteria: if the examination indicates a prescription change when required following cataract surgery; or for certain conditions of Myopia, Hyperopia, or Astigmatism; or when contact lenses are the only means to correct visual acuity to 20/40 for certain conditions of Keratoconus, or 20/60 for certain conditions of Anisometropia. A report from the provider and approval from Medical Eye Services is required.

non-Particpating provider

An Ophthalmologist, Optometrist or Opticians who is not a contracted vision plan provider.

participating provider

A contracted Ophthalmologist, Optician, or Optometrist who accepts benefit allowances as payment-in-full for covered services.

preferred provider organization (PPO)

An organization of contracted providers who agree to provide designated services and accept assignment of benefits for those services.

third party administrator (TPA)

An organization that administers and processes claims for an Insurance Carrier, Health Maintenance Organization, or Employer Group.

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This document is provided for informational purposes only. Please consult an eye care professional about symptoms that may require medical attention and may or may not be covered by your medical plan and/or routine vision plan.

Sources:
American Academy of Ophthalmology (AAO) – www.aao.org
EyeCare America - www.eyecareamerica.org
AAPOS – www.aapos.org
National Academy of Opticianry – www.nao.org
Excerpted from Dictionary of Eye Terminology, copyright 1984-2012
By Barbara Cassin and Melvin L. Rubin, MD. Reprinted with permission.

20/20

See Visual Acuity, Normal visual acuity. Upper number is the standard distance (20 feet) between an eye being tested and the eye chart; lower number indicates that a tested eye can see the same small standard-sized letters or symbols as a normal eye at 20 feet.

accomodation

Increase in optical power by the eye in order to maintain a clear image (focus) as objects are moved closer. Occurs through a process of ciliary muscle contraction and zonular relaxation that causes the elastic-like lens to "round up" and increase its optical power. Natural loss of accommodation with increasing age is called presbyopia.

after-cataract, secondary cataract

Remnants of an opaque lens remaining in the eye, or opacities forming, after extracapsular cataract removal.

age-related macular degeneration (amd)

Group of conditions that include deterioration of the macula, resulting in loss of sharp central vision. Two general types: "dry," which is more common, and "wet," in which abnormal new blood vessels grow under the retina and leak fluid and blood (neovascularization), further disturbing macular function. Most common cause of decreased vision after age 60.

amblyopia

Also known as "lazy eye". Decreased vision in one or both eyes without detectable anatomic damage in the eye or visual pathways. Usually uncorrectable by eyeglasses or contact lenses. Amblyopia can be prevented through early diagnosis and treatment.

amsler grid

Test card; grid (black lines on white background or white lines on black background) used for detecting central visual field distortions or defects, such as in macular degeneration.

angle, anterior chamber angle

Junction of the front surface of the iris and back surface of the cornea, where aqueous fluid filters out of the eye.

anisometropia

A condition in which the eyes have unequal refractive power.

anterior chamber

Fluid-filled space inside the eye between the iris and the innermost corneal surface (endothelium).

aphakia

Absence of the eye's crystalline lens, such as after cataract extraction.

aphakic lenses

Prosthetic lenses that are designed for patients that have had their crystalline lens removed (aphakia), such as after cataract extraction.

aspherical lenses

Not spherical; used to reduce marginal aberration; such conic sections as parabolic, hyperbolic, or ellipsoidal; a lens surface having an infinite number of curves with different radii.

asthenopia

Vague eye discomfort arising from use of the eyes; may consist of eyestrain, headache, and/or browache. May be related to uncorrected refractive error or poor fusional amplitudes.

astigmatism

Optical defect in which refractive power is not uniform in all directions (meridians). Light rays entering the eye are bent unequally by different meridians, which prevent formation of a sharp image focus on the retina. Slight uncorrected astigmatism may not cause symptoms, but a large amount may result in significant blurring and headache.

axis

The orientation of the placement of the cylindrical area of the lens. The axis can be anywhere from 1 to 180 degrees.

background retinopathy

See Diabetic Retinopathy.

base curve

Applied to a toric surface, the B.C. is the flattest curve on that surface of the lens. In general, the B.C. is the cataloging curve or curve common to a group of lenses; the weakest curve on the front of a lens.

benefit brochure

A booklet or pamphlet or outline describing specific vision plan benefits.

bifocal lenses

With two focal lengths; an area for distance vision and an area for near vision.

binocular vision

Blending of the separate images seen by each eye into one composite image.

blepharitis

Inflammation of the eyelids, usually with redness, swelling, and itching.

blind spot

Sightless area within the visual field of a normal eye. Caused by absence of light sensitive photoreceptors where the optic nerve enters the eye.

cataract

Opacity or cloudiness of the crystalline lens, which may prevent a clear image from forming on the retina. Surgical removal of the lens may be necessary if visual loss becomes significant, with lost optical power replaced with an intraocular lens, contact lens, or aphakic spectacles. May be congenital or caused by trauma, disease, or age.

central retinal artery

First branch of the ophthalmic artery; supplies nutrition to the inner two-thirds of the retina.

central retinal vein

Blood vessel that collects retinal venous blood drainage; exits the eye through the optic nerve.

central vision

An eye's best vision; used for reading and discriminating fine detail and color. Results from stimulation of the fovea and the macular area.

choroid

Vascular (major blood vessel) layer of the eye lying between the retina and the sclera. Provides nourishment to outer layers of the retina.

coating - UV Protection

Blocks ultraviolet rays which are harmful for the crystalline lens, retina, and other parts of the eye and is available on all types of lenses.

coating - anti-Reflective

Coating that can reduce glare and reflections. Can be useful for people with strong prescriptions and people who drive at night.

coating - mirrored

Mirror finishes are thin layers of various metallic coatings on an ordinary lens.

coating - scratch

Protects lens against scratches and is recommended for anyone with plastic lenses.

color blindness

Reduced ability to discriminate between colors, especially shades of red and green. Usually hereditary.

comprehensive eye examination

A complete evaluation of the visual system that may be performed in one or more sessions.

cone

Light-sensitive retinal receptor cell that provides sharp visual acuity and color discrimination.

conjunctiva

Transparent mucous membrane covering the outer surface of the eyeball except the cornea, and lining the inner surface of the eyelids.

conjunctivitis

Also known as "pink eye". Inflammation of the conjunctiva. Characterized by discharge, grittiness, redness and swelling. Usually viral in origin, but may be bacterial or allergic; may be contagious.

contact lenses

Thin, clear disks of plastic that float on the tear film that coats the cornea, the curved front surface of the eye. This lens is used to correct refractive errors including irregularly shaped cornea.

convergence

Inward movement of both eyes toward each other, usually in an effort to maintain single binocular vision as an object approaches.

cornea

Transparent front part of the eye that covers the iris, pupil, and anterior chamber and provides most of an eye's optical power.

crossed-eyes

See Esotropia.

crystalline lens

The eye's natural lens. Transparent, biconvex intraocular tissue that helps brings rays of light to a focus on the retina.

cycloplegic refraction

Assessment of an eye's refractive error after lens accommodation has been paralyzed with cycloplegic eye drops (to eliminate variability in optical power caused by a contracting lens).

cylinder

The type of curvature of the spectacle lens to help patients with astigmatism.

diabetic retinophathy

Spectrum of retinal changes accompanying long-standing diabetes mellitus. Early stage is background retinopathy or nonproliferative (NPDR). May advance to proliferative retinopathy (PDR), which includes the growth of abnormal new blood vessels (neovascularization) and fibrous tissue.

dilated pupil

Enlarged pupil, resulting from contraction of the dilator muscle or relaxation of the iris sphincter. Occurs normally in dim illumination, or may be produced by certain drugs (mydriatics, cycloplegics) or result from blunt trauma.

diopter

Unit to designate the refractive power of a lens.

diplopia

Double vision.

drusen

Tiny, white hyaline deposits on Bruch's membrane (of the retinal pigment epithelium). Common after age 60; sometimes an early sign of macular degeneration.

dry eye syndrome

Corneal and conjunctival dryness due to deficient tear production, predominantly in menopausal and post-menopausal women. Can cause foreign body sensation, burning eyes, filamentary keratitis, and erosion of conjunctival and corneal epithelium.

ectropion

Outward turning of the upper or lower eyelid so that the lid margin does not rest against the eyeball, but falls or is pulled away. Can create corneal exposure with excessive drying, tearing, and irritation. Usually from aging.

emmetropia

Refractive state of having no refractive error when accommodation is at rest. Images of distant objects are focused sharply on the retina without the need for either accommodation or corrective lenses.

employer group

A group that has chosen, in lieu of insurance, to reserve funds for payment for covered services incurred by its employees.

entropion

Inward turning of upper or lower eyelid so that the lid margin rests against and rubs the eyeball.

esophoria

A tendency of one eye to turn inward.

esotropia

Also known as "crossed eyes". Eye misalignment in which one eye deviates inward (toward nose) while the other fixates normally.

exophoria

A tendency of one eye to turn outward.

exotropia

Also known as "wall-eyes". Eye misalignment in which one eye deviates outward (away from nose) while the other fixates normally.

extraocular muscles

Six muscles that move the eyeball (lateral rectus, medial rectus, superior oblique, inferior oblique, superior rectus, inferior rectus).

eye m.D.

See Ophthalmologist.

eyelids

Structures covering the front of the eye, which protect it, limit the amount of light entering the pupil, and distribute tear film over the exposed corneal surface.

eyewear

Lenses, frame and/or contact lenses.

farsightedness

See Hyperopia.

field of vision

The entire area that is seen without shifting one's gaze.

floaters

Particles that float in the vitreous and cast shadows on the retina; seen as spots, cobwebs, spiders, etc. Occurs normally with aging or with vitreous detachment, retinal tears, or inflammation.

focal length

The distance from the back vertex of a lens to its focal point, strictly called the back vortex focal length.

fovea

Central pit in the macula that produces sharpest vision. Contains a high concentration of cones and no retinal blood vessels.

frame

The structural part(s) that provide support to the lenses.

fundus

Interior posterior surface of the eyeball; includes retina, optic disk, macula, posterior pole. Can be seen with an ophthalmoscope.

glaucoma

A group of diseases that can damage the eye's optic nerve and result in vision loss and blindness. Although glaucoma usually occurs when the normal fluid pressure inside the eyes slowly rises, but it may also occur with eyes that have "normal" pressure. Treatment is aimed at halting loss of vision with prescription medications, laser treatment, or surgery.

gonioscopy

Examination of the anterior chamber angle through a goniolens (special type of contact lens).

health care service plan or specialized health care service plan

An organization that undertakes to arrange for the provision of health care services to subscribers or enrollees, in return for a prepaid or periodic charge. Vision Plans that provide specialized care to their members are called "Specialized Health Care Service Plans".

health maintenance organization (HMO)

An organization engaged in providing managed care and assuming the risk for health related benefits.

heterophoria

The tendency of one eye to deviate from one direction to another due to an imbalance.

hyperopia

Also known as "farsightedness". Focusing defect in which an eye is underpowered. Thus light rays coming from a distant object strike the retina before coming to sharp focus, blurring vision. Corrected with additional optical power, which may be supplied by a plus lens (spectacle or contact) or by excessive use of the eye's own focusing ability (accommodation).

hyphema

Blood in the anterior chamber, such as following blunt trauma to the eyeball.

iOL (Intraocular lens)

Synthetic lens that may be surgically implanted to replace the eye's natural lens.

insurance carrier

An organization engaged in providing and assuming the risk of various benefits.

intraocular pressure

Fluid pressure inside the eye or the assessment of pressure inside the eye with a tonometer. Also called tension.

iris

Pigmented tissue lying behind the cornea that gives color to the eye (e.g., blue eyes) and controls amount of light entering the eye by varying the size of the pupillary opening.

keratoconus

Degenerative corneal disease affecting vision. Characterized by generalized thinning and cone-shaped protrusion of the central cornea, usually in both eyes. Hereditary.

keratometry

Obtaining corneal curvature measurements with a keratometer.

l.e. / left eye

See O.S.

lacrimal gland

Almond-shaped structure that produces tears. Located at the upper outer region of the orbit, above the eyeball.

lazy eye

See Amblyopia.

legal blindness

Best-corrected visual acuity of 20/200 or less, or reduction in visual field to 20" or less, in the better seeing eye.

lens or lenses

Transparent refracting medium usually made of plastic.

lenticular lenses

A strong lens which has a central area usually 30 to 40 mm ground to the prescription. The margin has a shallow curve to reduce weight and/or thickness.

low vision

Term usually used to indicate vision of less than 20/200.

macula

Small central area of the retina surrounding the fovea; area of acute central vision.

macular degeneration

See "Age-Related Macular Degeneration".

mydriatic

A drug that dilates the pupil.

myopia

Also known as "nearsightedness". Focusing defect in which the eye is overpowered. Light rays coming from a distant object are brought to focus in front of the retina. Requires a minus lens correction to "weaken" the eye optically and permit clear distance vision.

nearsightedness

See Myopia.

neovascularization

Abnormal formation of new blood vessels, usually in or under the retina or on the iris surface. May develop in diabetic retinopathy, blockage of the central retinal vein, or macular degeneration.

non-Elective (Medically necessary) contact lenses

Prescribed to patients who meet specific medical criteria for contact lenses. Medically necessary contact lenses are provided for any of the following criteria: if the examination indicates a prescription change when required following cataract surgery; or for certain conditions of Myopia, Hyperopia, or Astigmatism; or when contact lenses are the only means to correct visual acuity to 20/40 for certain conditions of Keratoconus, or 20/60 for certain conditions of Anisometropia. A report from the provider and approval from Medical Eye Services is required.

non-Particpating provider

An Ophthalmologist, Optometrist or Opticians who is not a contracted vision plan provider.

nystagmus

Involuntary, rhythmic side-to-side or up and down (oscillating) eye movements.

o.D. / right eye

Oculus Dexter (Latin)

o.S. / Left Eye

Oculus Sinister (Latin)

o.U. / Oculi Uterque (Latin)

Both eyes

ophthalmologist (M.D.)

A physician and surgeon who is qualified and specially trained to diagnose and treat all eye and visual system problems, as well as diagnose general diseases of the body. An Ophthalmologist prescribes lenses to improve visual acuity.

ophthalmoscope

Device for viewing the interior of the eye or the retina.

optic disc, optic nerve head

Ocular end of the optic nerve. Denotes the exit of retinal nerve fibers from the eye and entrance of blood vessels to the eye.

optic nerve

Largest sensory nerve of the eye; carries impulses for sight from the retina to the brain.

optician

An independent professional who designs, verifies and dispenses lenses, frame and other fabricated optical devices upon the prescription of an Ophthalmologist or an Optometrist.

optometrist

Doctor of optometry (OD) specializing in vision problems, treating vision conditions with spectacles, contact lenses, low vision aids and vision therapy. May prescribe some medications.

participating provider

A contracted Ophthalmologist, Optician, or Optometrist who accepts benefit allowances as payment-in-full for covered services.

patching

Covering an amblyopic patient's preferred eye, to improve vision in the other eye.

perimetry

Method of charting extent of a stationary eye's field of vision with test objects of various sizes and light intensities. Aids in detection of damage to sensory visual pathways.

peripheral vision

Side vision; vision elicited by stimuli falling on retinal areas distant from the macula.

photochromic

Photochromic are lenses that darken and lighten and change color, in accordance with the amount of ultraviolet light to which they are exposed.

photophibia

Abnormal sensitivity to, and discomfort from, light. May be associated with excessive tearing. Often due to inflammation of the iris or cornea.

pinguecula

Yellowish-brown subconjunctival elevation composed of degenerated elastic tissue; may occur on either side of the cornea. Benign.

pink eye

See Conjunctivitis.

plano lenses

Value of no power or zero; such as non-prescription sunglasses or non-prescription sunglasses or colored contact lenses.

polarized lenses

Lenses that incorporate a filter that reduces reflected glare, such as, sunlight that bounces off smooth surfaces like pavement or water. They can be particularly useful for driving and fishing.

polycarbonate

A material that is significantly more impact-resistant than other plastic. Polycarbonate lenses are lightweight, scratch-resistant, thin and can be designed to meet most eyeglass design or prescription.

preferred provider organization (PPO)

An organization of contracted providers who agree to provide designated services and accept assignment of benefits for those services.

presbyopia

The gradual loss of the ability to focus at close objects with advancing age. This makes reading difficult. Onset usually occurs between the ages of 40 and 45 years of age.

prism

A wedge-shaped piece of glass or plastic that refracts rays of light. Eye glasses with prisms can correct mild double vision associated with adult strabismus.

progressive lenses

Eyeglass lens that incorporates corrections for distance vision through midrange, to near vision (usually in lower part of lens), with smooth transitions and no bifocal demarcation line. A single pair of glasses enables the user to see at various distances.

proliterative retinopathy

See Diabetic Retinopathy.

ptosis

Drooping of upper eyelid. May be congenital or caused by paralysis or weakness of the 3rd cranial nerve or sympathetic nerves, or by excessive weight of the upper lids.

pupil

Variable-sized black circular opening in the center of the iris that regulates the amount of light that enters the eye.

r.E. / Right Eye

See O.D.

reading add / reading addition

The amount of plus (+) power in the segment of a bifocal lens.

refraction

Test to determine an eye's refractive error and the best corrective lenses to be prescribed.

refractive error

Imperfect refractive powers of the eyes as in astigmatism, myopia, or hyperopia.

retina

Light sensitive nerve tissue in the eye that converts images from the eye's optical system into electrical impulses that are sent along the optic nerve to the brain. Forms a thin membranous lining of the rear two-thirds of the globe.

retinal detachment

Separation of the retina from the underlying pigment epithelium. Disrupts visual cell structure and thus markedly disturbs vision. Almost always caused by a retinal tear; often requires immediate surgical repair.

retinoscope

Device for measuring an eye's refractive error with no response required from the patient. Light is projected into the eye, and the movements of the light reflection from the eye are neutralized (eliminated) with lenses.

rod

Light-sensitive, specialized retinal receptor cell that works at low light levels (night vision). A normal retina contains 150 million rods.

rx

Lens prescription to include the sphere value, cylinder value, axis and any prism present.

schlemm's canal

Circular channel deep in corneoscleral junction (limbus) that carries aqueous fluid from the anterior chamber of the eye to the bloodstream.

sclera

Opaque, fibrous, protective outer layer of the eye ("white of the eye") that is directly continuous with the cornea in front and with the sheath covering optic nerve behind.

scotoma

A blind area in the visual field.

single vision lenses

Corrective lenses with only one focal length.

slit lamp

Microscope used for examining the eye; allows cornea, lens and otherwise clear fluids and membranes to be seen in layer-by-layer detail.

snellen chart

Test chart used for assessing visual acuity. Contains rows of letters, numbers, or symbols in standardized graded sizes, with a designated distance at which each row should be legible to a normal eye. Usually tested at 20 ft.

sphere

Indicates how nearsighted (-) or farsighted (+) you are.

strabismus

Also known as "crossed'eyes". Eye misalignment caused by extraocular muscle imbalance: one fovea is not directed at the same object as the other.

sty, stye

An infection of one of the sebaceous glands of the eyelid.

subnormal or low vision

Term usually used to indicate vision of less than 20/200.

subnormal or low vision aids

Devices that are either worn, hand-held, or free-standing that manipulate images to improve vision. It may or may not be used with regular corrective eyewear.

third party administrator (TPA)

An organization that administers and processes claims for an Insurance Carrier, Health Maintenance Organization, or Employer Group.

tint

Color added to lenses for either cosmetic or sun sensitivity reasons.

tonometry

Measurement of intraocular pressure.

trabecular meshwork

Mesh-like structure inside the eye at the iris-scleral junction of the anterior chamber angle. Filters aqueous fluid and controls its flow into the canal of Schlemm, prior to its leaving the anterior chamber.

trifocal lenses

A lens with three focusing points: distance, intermediate and reading.

uvea, uveal tract

Pigmented layers of the eye (iris, ciliary body, choroid) that contain most of the intraocular blood vessels.

vision

Sense by which light and color are apprehended; sight.

visual acuity

See 20/20, The measure of visual power, expressed as a fraction (e.g. 20/20) that is usually determined by one's ability to read letters of various sizes at a standard distance from a test chart.

visual field

Full extent of the area visible to an eye that is fixating straight ahead.

vitreous

Also known as vitreous humor. Transparent, colorless gelatinous mass that fills the rear two-thirds of the eyeball, between the lens and the retina.

vitreous detachment

Separation of vitreous gel from retinal surface. Usually innocuous, but can cause retinal tears, which may lead to retinal detachment. Frequently occurs with aging as the vitreous liquifies, or in some disease states, e.g. diabetes and high myopia.

zonules

Anatomy. Radially arranged fibers that suspend the lens from the ciliary body and hold it in position.

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This document is provided for informational purposes only. Please consult an eye care professional about symptoms that may require medical attention and may or may not be covered by your medical plan and/or routine vision plan.

Sources:
American Academy of Ophthalmology (AAO) – www.aao.org
EyeCare America - www.eyecareamerica.org
AAPOS – www.aapos.org
National Academy of Opticianry – www.nao.org
Excerpted from Dictionary of Eye Terminology, copyright 1984-2012
By Barbara Cassin and Melvin L. Rubin, MD. Reprinted with permission.