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Age related macular degeneration is a potentially visually devastating disease that affects your central vision. Your prognosis depends on the form and severity of the disease as well as your risk factors.
The macula of the eye refers to the small central area of the retina which is highly specialized to resolve detail. This tiny area is our 20/20 sweet spot which we need to see any small detail including reading a book or seeing detail on a person’s face.
Macular degeneration is a degenerative process which disturbs this delicate, highly specialized tissue. It is linked to smoking, genetics, diet, light exposure and poor health. Untreated macular degeneration is one of the leading causes of blindness in those over 65 years old.
As you age it is important to check your eyes for the presence of macular changes. There are vitamins, diet and lifestyle changes that you can make to change the course of macular degeneration.
Early macular degeneration is often asymptomatic and can only be detected through an eye examination. Early symptoms can include blurry, cloudy or distorted central vision. In advanced stages, central vision loss can be severe.
Once early macular degeneration is recognized, you should have your eyes examined every 6-12 months, depending on the severity. If you notice a sudden change to your central vision, it is very important that we see you right away.
While researchers have not yet discovered a cure for dry age-related macular degeneration, there are treatment options which prevent the disease from progressing to blindness. It’s important to have an open discussion with your eye doctor about the risks and limitations of the different treatments.
Wet macular degeneration is the more severe form of the disease. If this is detected during your examination you will be referred promptly to a retinal ophthalmologist. This is treated by the injection of a medication directly into the eye inhibit blood vessel growth
A cataract is clouding that develops in the lens at the front of the eye. It is usually related to aging, but can also affect you at a much younger age.
Cataract progression is influenced by aging, genetics, UV/blue light exposure, trauma and non-optimal blood sugar levels.
Cataracts are caused by a clouding in the crystalline lens of the eye which is located just behind the iris. A cataract generally causes a gradual decline in your vision causing your vision to become blurry and dim. However, some cataracts progress very rapidly as well.
Cataracts are fairly easy to detect using a slit lamp evaluation during your comprehensive eye exam.
When your cataracts are compromising your vision enough to significantly affect your day to day visual needs or are causing annoying glare and difficulty seeing at night, they are ready to come out.
When your cataracts are ready to be removed, we will refer you to a local ophthalmologist for a surgical consult.
Ophthalmologists perform cataract extraction when they are ready to be removed. Cataracts are treated by small incision surgery in which your lens is replaced by an artificial lens. Although cataract surgery is usually successful, it is important to remember than it is not without risk.
We will perform an eye examination about 6 weeks after your cataract surgery to determine your new prescription and ensure that there are no complications from the surgery.
Glaucoma is a disease that causes irreversible damage the optic nerve of the eye, resulting in vision loss. It is often asymptomatic in the early stages, and only a comprehensive eye exam can determine if you have or are at risk for developing glaucoma.
Early detection of glaucoma is key to having a successful outcome. Your optometrist will determine if you are at risk for glaucoma during your examination and may need to order additional specialized testing. Glaucoma is a complex disease, and baseline data is needed to monitor for progression over time.
At Summerland Optometry we have advanced technology to detect glaucoma at an early stage. To monitor our patients for glaucoma we measure their eye pressures, and their corneal thickness. We also obtain a detailed optic nerve scan (OCT), and test for peripheral vision loss (Visual field). OCT nerve scans and visual field testing are necessary for the diagnosis and management of glaucoma.
Diabetes is a very common condition in our society. Unfortunately, it can put you at increased risk for developing many eye conditions including diabetic retinopathy, diabetic macular edema, glaucoma, and cataracts.
If you are diabetic you know and understand how important it is to control your blood sugar levels to ensure they are stable. Because diabetes is a vascular disease, it is very important for diabetics to have annual exams.
In a comprehensive eye exam, we will look closely at your retinal blood vessels which reflect the state of your capillary circulation in your entire body. The retina is the only place in the body where capillaries can be easily viewed. With wide field retinal imaging (Optomap) and cross-sectional macular scans (OCT), we can pick up early vascular anomalies and alert your medical physicians of our findings. In fact, when we see a diabetic for routine examination, we always send a report to your family doctor of our ocular findings.
If your diabetes is not optimally controlled or you have had the disease for many years, we often see diabetic retinopathy in your eyes. Blood vessels can leak blood and fluid into the eye and even grow new abnormal vessels. Diabetic retinopathy can cause permanent vision loss and often treatments are required.
Macular edema occurs when fluid accumulates at the macula from leaky blood vessels. Your macula is the central part of your retina responsible for central vision; therefore, damage to this area can be devastating. Macular edema is visualized on our cross-sectional macular scan (OCT). Referrals are often required to retinal ophthalmologists for treatment.
BC medical covers a portion of your eye examination if you have underlying systemic disease, such as diabetes, or ocular disease including cataracts or glaucoma.
The sudden onset of flashes and floaters is a common reason why patients report for urgent evaluations. These ‘flashes and floaters’ can be a very normal part of your eyes’ aging process, but any new symptoms can indicate a problem and need to be assessed in a timely manner.
Flashes are odd perceptions of light usually in the side vision that seem to come out of nowhere.
Floaters are shadowy forms that seem to drift in the vision. They are best observed when looking at a light background that has no detail such as a light wall or in dense fog.
Flashes and floaters of acute onset are usually cause by an acute event called a vitreous detachment which is a normal age-related change.
A vitreous detachment occurs when the jelly in the back cavity of the eye, the vitreous gel, shrinks and separates from the retina. The vitreal gel can sometimes pull on the retina, and this traction lead to flashes of light. The floaters are seen when you can view the back of the vitreous gel.
If you experience any new symptoms of flashes or floaters you should have your eyes checked promptly. The tractional effect on the retina can cause a retinal tear and this needs to be treated ASAP. A retinal tear keeps progressing until treated with laser or surgery and can lead to a retinal detachment in worst case scenarios.
At Summerland Optometry we are committed to offering our patients the most advanced diagnostic equipment and technology available to detect and treat eye disease. We believe that preventative eye care is an important part of total eye health.
Optos ultra-widefield retinal imaging produces a high-resolution digital image of the back of the eye including, the macula, the optic nerve and the periphery of the eye, in one panoramic image. This image is invaluable in the assessment of the health of the inside of your eye making the diagnosis and documentation of internal pathology very clear. This device captures more than 80% or 200 degrees of the retina in single image without the need for dilating drops. Patients love being able to actually see what we are looking at inside their eyes. This image is taken before your appointment with the doctor.
An optical coherence tomography scan (referred to as an OCT scan) is the latest advancement in imaging technology. It produces a high-resolution image of the layers of the retina or optic nerve which allows us to diagnose and treat conditions accurately. The instrument is essential for early diagnosis of glaucoma, macular degeneration and diabetic retinal disease. OCT images are critically important in the assessment of both wet and dry macular degeneration and in both the detection and treatment of glaucoma.
A visual field test measures the range and sensitivity of your peripheral or ‘side’ vision to assess whether you have any areas of vision loss or areas of reduced sensitivity. In this test, one eye is covered and you look straight ahead while spots of light as presented randomly off to the side. You have to press a button whenever you see the light. The test takes about 15-20 minutes for both eyes. If defects are present, it is the pattern of defects which are critical. This test is used to detect and monitor glaucoma as well as to check for possible neurological visual effects of intracranial disease such as strokes, aneurysms or tumours.
Corneal topography is an imaging technique for mapping the entire curvature of the cornea. This technology allows for precise specialty contact lens fitting and for diagnosing and monitoring irregular corneas, such as keratoconus. Since the cornea is normally responsible for ~70% of the eye’s refractive power, its topography is of critical importance in determining the quality of vision.
Myopia, or near-sightedness, occurs when the eyeball is too long or too powerful, resulting in blurred distance vision. Myopia progresses primarily due to elongation of the eyeball which occurs primarily between age 7 to 16. Myopia is on the rise for a variety of reasons including, but not limited to, genetics, increased near-work demands and decreased time spent outdoors.
It is estimated that 28% of the Canadian population is myopic and according to WHO, this figure is expected to grow to 58% by the year 2050. Myopia is also starting at earlier ages and progressing at a faster rate than seen historically.
Generally, once you become myopic, it tends to worsen over time. Higher levels of myopia are associated with significantly higher risks of sight-threatening eye disease such as glaucoma, retinal detachments and macular degeneration which can lead to choroidal neovascular membrane formation. This is primarily due to the associated stretching of the retinal tissue as the eye elongates. All these conditions lead to permanent vision loss.
Although glasses and standard contact lenses can correct a person’s vision, they do not treat the underlying cause of myopia or slow its progression.
There is so much research going into preventing myopia and we can now try to prevent its progression.
- Increase time spent outdoors. Children who spend more time outdoors, at least 90 minutes per day, are
less likely to develop myopia.
- Try to limit leisure screen time to 1 hour per day in school aged children.
- Hold devices and books further away from their eyes. Avoid bringing reading material too close and consider working on a desktop computer.
- Take regular breaks from reading and screens to reduce strain. Follow the 20-20-20 rule. Every 20 minutes take a 20 second break and look at something 20 feet away.
Myopia management is an area of eye care that uses various treatments to prevent or slow your child’s myopia progression. Depending upon your child’s specific needs, our doctors will recommend different management options.
Currently, there are four main methods used in clinical practice to help slow the progression of myopia including MiyoSmart glasses, soft multifocal contact lenses, ortho-K and atropine therapy.
A great new option for myopia control. They are special lenses that have areas of defocus built into the periphery of the lens, creating a myopic defocus on the retina. This has been clinically proven to reduce the progression of myopia by an average of 60%, which is huge!
We will often also prescribe lenses with a near focus built into the bottom of the lenses, if we feel this is more appropriate based on their examination.
Soft multifocal contact lenses provide comparable efficacy to the MiyoSmart lenses with regards to slowing the progression of myopia. The lens design has optical rings of distance power and near power to create the appropriate mid-peripheral defocus. This, in turn, minimizes the stimulus for myopia progression by focusing the light in front of the peripheral retina.
This is a very easy method if your child is interested in contact lenses.
Atropine is an anticholinergic agent. In the eye, atropine is known to induce pupil dilation by blocking contraction of the circular pupillary sphincter muscle. Research has shown that low-dose (0.01%) atropine can help slow myopia progression. The low dose minimizes side effects including increased pupil size or blurred near vision.
This method uses custom-designed gas permeable contact lenses that are worn at night that reshape the cornea to temporarily reduce refractive error. Our clinic does not currently do orthokeratology at this time.
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Summerland Optometry's head office.
13225 N Victoria Road
Tel: 250 494-9266.
13225 N Victoria Road
Tel: 250 494-9266