Astigmatism is a refractive condition in which the eye’s optical system is incapable of forming a point image for a point object (images are misconstrued).
The refractive error of the astigmatic eye stems from a different degree of refraction in different meridians; for example, the image may be clearly focused on the retina in the horizontal plane, but not in the vertical plane, or not on the retina in either plane.
It occurs when the front surface of the eye is uneven; an irregular shaped cornea or lens prevents light from focusing properly on the retina, the light sensitive surface at the back of the eye. As a result, vision becomes blurred at any distance.
Vision blurred or distorted whether the person is reading close up or looking further into the distance.
- Vision blurred at certain distances
- Tired or dry eyes
- Struggle to focus or read
- Headaches, especially when trying to focus
Astigmatism should be diagnosed by a qualified Optometrist and/or Ophthalmologist.
A full optometric examination should be done to assess the degree and extent of the problem.
Small children, who may not be able to answer the optometrist’s questions about what they can see, can be assessed using a test called retinoscopy that involves reflected light.
In most cases, astigmatism can be corrected by wearing properly fitted spectacles or contact lenses.
Milder astigmatism may not need treatment unless the person has a job that strains their eyes, for example, computer work.
In some cases, astigmatism can be corrected by laser surgery which reshapes the cornea.
Blepharitis is a common condition that causes inflammation of the eye lids and can affect people of all ages. It usually affects the rim of the eyelids of both eyes and usually is not serious but still irritating and uncomfortable. Eyelids may become crusty and scaly and eyes may feel gritty and very tired with increasing irritation when outdoors in sunshine or around any polluted or smoke filled environment.
Causes of Blepharitis can be associated with skin conditions such as rosacea and eye conditions like conjunctivitis.
- A gritty, burning or stinging sensation in the eyes
- Eyelids that appear crusty and scaly
- Itchy eyelids
- Red, swollen eyelids
- Flaking of the skin around the eyes
- Sensitivity to light
The Doctor may prescribe a combination of treatments depending on the type of Bepharitis: anterior or posterior.
- Clean the lid margin by dipping a clean cotton bud in normal saline and clean away any crusts present on the eyelashes. A mirror may be helpful. Refrain from cleaning the inside of the eyelids as this will result in them being sore. Repeat the process twice a day.
- Antibiotic drops: Apply as directed by pulling the lower lid off the eyeball and letting the drop fall into the pocket without touching the lid.
- Hot compresses: Dip a clean gauze in boiled water and hold it on your lids with your eyes closed, for 5 minutes twice a day. Ensure water temperature is not too hot prior to application.
- Lid massage: Roll your finger/cotton bud towards the margin 10 times each for the top and bottom lid, twice a day.
- Antibiotic ointment: Apply as directed, by squeezing 1 cm out of the tube onto your index finger and rubbing it onto the lid margin. It is very important that you follow the instructions in the order shown above.
Chalazion is a cyst on the eye lids and develops when a meibomian gland gets blocked and leads to swelling, and it can be of variable size. For the first few days the cyst is inflamed and you might see a small white head on the top of it which then tends to shrink, but might take months to disappear completely
The inflammation is caused by a sensitivity to a common bacteria found on your skin. When the openings of the small oil glands around your lashes become blocked by inflammation, a small tender swelling will occur on the upper or lower lid.
Some symptoms are:
- A small lump which develops on an eyelid.
- Mild pain or irritation
- Redness or swelling
Chalazion occurs due to blockage in one of the tiny meibomian glands of the upper and lower eyelids. The oil these glands produce helps to moisten the eyes. Inflammation or viruses affecting the meibomian glands are the underlying causes of chalazia.
Initially hot compresses with massaging of the area in addition to an antibiotic ointment are all that is required. If the cyst is very big to start with and doesn’t drain or if it tends to persist for months and is bothersome, it is best removed surgically.
Pink eye or Conjunctivitis is a common condition which causes the surface of your eye to go red and, often, sticky or watery and your eye becomes sore. There are two types of conjunctivitis:
- Viral conjunctivitistends to cause a watery red eye and can last for two to three weeks even with the correct treatment. Generally, viral conjunctivitis does not affect vision but in some cases vision may become blurry or see glare when looking at lights. This is due to an inflammatory reaction causing small white dots on the cornea, the transparent window at the front of the eye. These usually fade with time, but it can take a few weeks or even months.
- Bacterial conjunctivitisis more likely to cause a red eye with a sticky yellow discharge.
Conjunctivitis can be caused by infection from bacteria, viruses or other organisms as well as through allergy or inflammation.
- Itchy eyes or watery eyes
- Redness over the white of the eye which can be mild to very severe
- Pus like discharge from the eye
- Eyes are usually sticky and crusty in the morning or after sleep
- Mild lid swelling
- Mild discomfort or irritation but no pain
There is no antiviral medication for viral conjunctivitis and it does not respond to antibiotic drops as it is not caused by bacteria. The best treatment for viral conjunctivitis is to use artificial tears and simple painkillers, with regular lid cleaning and cold compresses. Conjunctivitis disappears when the body becomes immune to the virus and fights the germs off similar to a cold or ‘flu. Less often, steroid drops are prescribed for severe cases of viral conjunctivitis or when the cornea is affected.
In cases with bacterial conjunctivitis, Antibiotic drops can be helpful and are usually prescribed for 7 days or two-week course.
It is important to refrain from using contact lenses during any type of conjunctivitis.
Corneal abrasions are little scratches on the cornea of the eye. They are usually caused as a result from trauma (injury) to the surface of the eye. Common causes include poking of the eye, quick movements close to the eye, and getting dust in the eye, especially if the eye is then rubbed. Injuries can also be caused by contact lens insertion and removal.
Tree branches or plants, paper, makeup brushes, pets, sudden move close to the eye, dust or debris, sports equipment are common causes of corneal abrasion.
- Gritty feeling
- Sensitivity to the light
Treatment for corneal abrasion generally includes a thorough examination of your eye and lids, to check for any trapped foreign body or grit and ensure there is no serious eye injury, followed by drops or ointment and, sometimes, an eye patch. If you are given an eye patch, you will need to keep it on for 12 to 24 hours; if this becomes uncomfortable, you may take it off and wear sunglasses as a replacement.
You should also note the following:
- You may take ordinary pain killers, such as paracetamol, to help with the pain
- Avoid rubbing or touching your eye
- If you wear contact lenses, don’t use them until your eye is completely healed; you need to see your contact lens practitioner after finishing treatment for your abrasion before you wear your contact lenses again
If you are asked to use drops or ointments, please follow these steps:
- Lie down, or lean your head back, and look up
- Use a clean finger to gently pull down your lower eyelid to create a pocket
- If you are using eye drops, gently squeeze them into the pocket you have created, not directly onto your eye
- If you are using ointment, apply a small strip into the pocket
- Blink to spread the medication over your eye
Dry Eye Disease is a condition in which the eye does not produce tears properly, or when the tears are not of the correct consistency and evaporate too rapidly. If left untreated, this condition can lead to inflammation and pain, ulcers, scarring of the cornea, and some loss of vision.
Dry Eye disease can affect the quality of life of the sufferer; dry eye can make it more difficult to perform some everyday activities, such as using a computer or reading for an extended period of time, and it can also reduce tolerance to dry environments, such as an airplane cabin. There are many factors involved in DED, which is a chronic and progressive disease that produces a range of symptoms and can potentially lead to damaging the eyes.
DED does not present a specific set of symptoms and can affect different people with different symptoms and different levels of severity, but there may be no symptoms present in the early stages of the disease.
- Stinging or burning of the eye
- A sandy or gritty feeling as if something is in the eye
- Episodes of excess tears following very dry eye periods
- A stringy discharge from the eye
- Pain and redness of the eye
- Episodes of blurred vision
- Heavy eyelids
- Inability to cry when emotionally stressed
- Discomfort when wearing contact lenses
- Decreased tolerance of reading, working on the computer; or any activity that requires sustained visual attention
The precise causes of dry eye are difficult to identify and can include a wide range of possible contributing factors including hormonal changes, ageing, environmental factors (hot dry climate, or lots of reading, computer work when people tend to blink less), certain medications, laser eye surgery, contact lenses, and medical conditions, from allergic conjunctivitis to rheumatoid arthritis.
Dry Eye Disease is a chronic condition and so treatment aims to control the disease – there is no cure but treatment can help patients enjoy a better quality of life.
- Eye drops for dry eyes
- Oral medication treatment
- Good eye hygiene
- Dietary supplements
- Minor surgical procedures
- Tear duct plugs
- Intense Pulsed Light Sessions
Eye infections can invade the eyeball or the area around it – they are generally microorganisms that can be harmful, including viruses, bacteria and fungi.
Causes and Types of Eye Infections
- Conjunctivitis is a common infection usually caused by bacteria or virus; it’s very contagious and often affects children in schools or other places where it is easily passed from child to child. It gives the eye a pink tinge, which is why it is also known as ‘pink eye’.
There are other types of infections caused by viruses (viral keratitis), such as ocular herpes caused by the herpes simplex virus.
- Fungal eye infections (fungal keratitis) can be caused by a penetrating injury allowing the fungus to invade the area. People who wear contact lenses are vulnerable to infections caused by parasites (acanthamoeba keratitis) which can be serious and even threaten sight. Contact lens users generally need to take special precautions and ensure lenses are well cared for and cleaned properly.
- The trachoma infection is very common in some areas of the developing world where it may also be one of the main causes of blindness. It can be spread by flies and one of the main problems with this is reinfection and so proper hygiene and access to treatment is essential.
- Endophthalmitis is a bacterial infection that affects the inside of the eye (because of an injury or very rarely after eye surgery) and can cause blindness without immediate powerful antibiotic treatment. There is also a type of mould that can cause the problem, although this is rare. Mould that penetrates the eye’s interior also can cause endophthalmitis, though rarely.
A stye of chalazion is an infection that affects the inside of the eyelids.
- Dacryocystitis is an infection of the tear ducts that inflames and blocks the system that drains tears from the eyes
- Orbital cellulitis may attack the soft tissue around the eyelids and this infection is a serious emergency and needs treatment to stop it spreading.
With early diagnosis and treatment, most of the common bacterial infections will resolve themselves with the use of prescribed medications such as antibiotics – eye drops, ointments and compresses.
Most viral infections disappear with little effort but if they are severe, antiviral drops may be needed to reduce inflammation.
A bloodshot ‘red eye’ may be worrying but is rarely serious or causes pain. Symptoms often disappear within a few days, without treatment. But if it does not improve within a few days, there may be a more serious problem.
You will need to see an eye specialist for a diagnosis and red eye treatment, if you have:
- Painful red eye
- other symptoms including reduced vision, sensitivity to light, or a severe headache and sickness
- recently had any injury to the eye – especially a blow with a sharp object
With a painless red eye, the most likely causes are conjunctivitis or a burst blood vessel, which don’t usually affect the vision.
- Iritis: inflammation of the iris (coloured part of the eye) – symptoms include red eye but there may be other symptoms such as sensitivity to light, blurred vision, or a headache. Red eye treatment with steroid medication reduces the inflammation. Iritis rarely leads to any severe problems but see an eye specialist.
- Acute glaucoma: If your red eye is severe and painful, with nausea and seeing halos around lights, and your vision is blurred or cloudy, this may be acute glaucoma – a serious condition with a sudden increase in eye pressure and you must see an eye specialist immediately.
- Corneal ulcer (ulcer on the cornea) An ulcer on the cornea (the clear outer layer at the front of the eyeball) can cause the eye to become red and sensitive to light, with discomfort in your eye. Bacterial corneal ulcers are usually seen in people who wear contact lenses. Your ophthalmologist will advise on red eye treatment.
A scratch to the cornea or particle in the eye can also cause a painful red eye. The best option is to go to an accident and emergency department.
Hypermetropia is a common refractive condition of the eye in which vision is better for distant objects than for near objects. It can be called far-sightedness or hypermetropia.
It results from the eyeball being smaller than average, causing images to be focused behind the retina. In hypermetropia, the light is focused too far back in the eye, behind the retina, which causes things to look blurred close-up.
Many very young children have mild hypermetropia that gets better by itself as they grow older.
- Blurred vision
- Asthenopia (eye strain)
- Accommodative dysfunction
- Binocular dysfunction
- Amblyopia and
Hypermetropia is a results of the eyeball being smaller than average, causing images to be focused behind the retina.
Eyeglasses and contact lenses are the treatment of choice for most people with far sightedness but refractive surgery can also cure some cases of hyperopia.
Usually, itchy eyes are the result of an allergy although there are other possible causes, depending on the symptoms.
Itchy eyes are generally caused by an allergy – such as pollen, dust or animal dander. That triggers a reaction in the body and the release of histamines in the tissues around the eyes, which results in itching, red eyes and swollen eyes.
Eye allergies can be seasonal or perennial.
All sorts of products and their ingredients may give you itchy eyes and these include solutions you use for your contact lenses, some kinds of eye makeup and skins creams, lotions and soaps; even eye drops for dry eyes can cause the itching.
You may have other symptoms along with the itching, such as burning eyes and these could be caused by a gland dysfunction or dry eye syndrome, rather than any allergies.
Blepharitis is a condition that makes your eyelids red and swollen; it’s usually caused by bacteria but microscopic mites are another possible cause.
- Irritated red eyes.
- Tearing in the eyes.
- Swollen eyelids.
- Soreness, burning, or pain.
Artificial tears and eye drops to stop any allergy can be used to treat itchy eyes. Sometimes, relief from the symptoms of itchy eyes can only be relieved by using oral medicines or even prescription eye drops.
The cures for itchy eyes can include drops for allergies or even artificial tears, antibiotics or other medications.
The most important basic advice to anyone with itchy eyes is not to rub them because it just makes them worse and even itchier. You could even create more problems by scratching the cornea or causing an eye infection through bacteria on your fingers.
Presbyopia is a condition which makes it difficult to focus on close objects. With age, by the mid-forties, people experience blurred vision at close points, such as reading, sewing or working on a computer.
Presbyopia it is not a disease as it is a results of the natural ageing process of the eye and it cannot be prevented .
- Eyestrain or headaches after reading or doing close work.
- Difficulty reading small print.
- Needing to hold reading material farther away to make the letters clearer and easy to read
Presbyopia is caused by a hardening of the lens of the eye, which occurs with aging. As the lens becomes less flexible, it can no longer change shape to focus on close-up images. As a result, these images appear blurry.
Correction of presbyopia is commonly done through eyeglasses with bifocal or progressive addition lenses.
A variety of surgical solutions is also available to reduce or fully correct the need for spectacles for patients of any age.
Myopia is a common refractive condition commonly referred to as near or short sightedness. People with Myopia can see near objects clearly but distant objects are blurry. Myopia occurs when the cornea and lens focus the light in front of the retina instead of exactly on it, usually because the eye is a little larger than it should be.
Several factors probably combine to cause myopia. There is a tendency for myopia to run in families, however, environmental factors play a big role too. Myopia usually appears around puberty, but can appear at any age from early childhood.
A widely held misconception is that myopia corrects itself with age. Although patients with low-level myopia can read without glasses throughout life, their distance vision remains poor.
- Difficulty seeing distant objects clearly
- Squinting frequently
- Holding books or other objects very close to the face
Myopia is usually treated with eyeglasses or contact lenses which compensate for the elongated shape of the eye allowing the light to focus properly on the retina. Refractive surgery (such as LASIK, PRK among others) is another very successful option that eliminates dependency on glasses or contact lenses.