Usually, mild to moderate astigmatism can be corrected with eyeglasses or contact lenses.
While it used to be the case that contact lenses for astigmatism could only be rigid contact lenses (RGPs, also called GP lenses), this is no longer true. Now, soft lenses called toric contact lenses can correct astigmatism. But while soft toric lenses may be appropriate for some, if you have severe astigmatism, rigid contacts or glasses may be a better option. Your eye doctor will discuss your lens options with you.
For some people with astigmatism, surgery may be an option to correct vision, including LASIK. Your ophthalmologist can discuss the various types of refractive surgery procedures you may consider for astigmatism correction.
Farsightedness: Hyperopia Treatment
Eyeglasses or contact lenses are the most common methods of correcting hyperopia symptoms. They work by refocusing light rays on the retina, compensating for the shape of your eye. They can also help protect your eyes from harmful ultraviolet (UV) light rays. A special lens coating that screens out UV light is available.
In other cases, people may choose to correct hyperopia with LASIK or another similar form of refractive surgery. These surgical procedures are used to correct or improve your vision by reshaping the cornea, or front surface of your eye, effectively adjusting your eye’s focusing ability.
There is not adequate scientific evidence to suggest that eye exercises, vitamins or pills can prevent or cure hyperopia.
There is no best method for correcting hyperopia. The most appropriate correction for you depends on your eyes and your lifestyle. You should discuss your lifestyle with your eye doctor to decide which correction may be most effective for you.
Nearsightedness: Myopia Treatment
There is no best method for correcting myopia. The most appropriate correction for you depends on your eyes and your lifestyle. You should discuss your lifestyle with your ophthalmologist to decide which correction may be most effective for you.
Eyeglasses or contact lenses are the most common methods of correcting myopia symptoms. They work by refocusing light rays on the retina, compensating for the shape of your eye. Eyeglasses can also help protect your eyes from harmful ultraviolet (UV) light rays. A special lens coating that screens out UV light is available.
In many cases, people may choose to correct myopia with LASIK or another similar form of refractive surgery. These surgical procedures are used to correct or improve your vision by reshaping the cornea, or front surface of your eye, effectively adjusting your eye’s focusing ability.
You may have heard of a process called orthokeratology to treat myopia. It uses a series of hard contact lenses to gradually flatten the cornea and reduce the refractive error. Improvement of sight from orthokeratology is temporary. After use of the lenses is discontinued, the cornea goes back to its original shape, and myopia returns. There is no scientific evidence to suggest that eye exercises, vitamins or pills can prevent or cure myopia.
There is no best method for correcting presbyopia. The most appropriate correction for you depends on your eyes and your lifestyle. You should discuss your lifestyle with your ophthalmologist to decide which correction may be most effective for you.
Reading glasses are a very common and easy way to correct presbyopia symptoms and are typically worn just during close work such as reading, sewing, etc. These “readers” are easily purchased at drug stores and other retail stores. You can also choose higher-quality versions prescribed by your eye doctor. If you decide to pick out a pair of reading glasses from the store, it is important that you select the weakest pair that will allow you to read newspaper-size print without difficulty.
If you wear contact lenses, your eye doctor can prescribe reading glasses that can be worn with your regular contacts to help you adjust to detailed, close-up work.
Eyeglasses with bifocal or progressive lenses are another common method of correcting presbyopia. Bifocal lenses have two different points of focus. The upper part of the eyeglass lens is set for distance vision, while the lower portion of the lens has a prescription set for seeing close work. Progressive lenses are similar to bifocal lenses, but they offer a more gradual visual transition between the two prescriptions, with no visible line between them.
Another option for correcting presbyopic vision is multifocal contact lenses. Just as bifocal lenses have two levels of corrective power, multifocal contact lenses create multiple levels of corrective power.
Another way to correct presbyopia with contact lenses is monovision, in which one eye has a contact set for distance, and the other has a contact set for near vision. The brain learns to adapt to using one eye or the other for different tasks.
Because the eye’s lens continually changes with age, you will need to have your prescription increased over time as well. Your eye doctor can prescribe a stronger prescription as needed to help you with up-close vision.
LASIK can be used to create monovision, in which one eye is corrected for near vision while the other eye is set for distance vision. Another LASIK procedure — which is undergoing clinical trials in the U.S. — is presbyLASIK. This procedure uses an excimer laser to sculpt multifocal zones directly on the cornea, enabling vision at multiple distances.
Also, there is a procedure known as refractive lens exchange. This refractive surgery technique replaces your eye’s rigid natural lens with an artificial lens that corrects presbyopia symptoms, providing multifocal vision.
Blepharitis is often a chronic, or ongoing, condition, but it can be controlled with the following treatments. Your ophthalmologist will help you identify which treatments are most appropriate.
Wet a clean washcloth with warm water, wring it out, and place it over your closed eyelids for at least one minute. Repeat two or three times, rewetting the washcloth as it cools. This will loosen scales and debris around your eyelashes. It also helps break down oil from nearby oil glands. This prevents the development of a chalazion (pronounced kuh-LAY-zee-un) — an enlarged lump caused by clogged oil secretions in the eyelid.
Using a clean washcloth, cotton swab or commercial lint-free pad soaked in warm water, gently scrub the base of your eyelashes for about 15 seconds per eyelid.
Your ophthalmologist may prescribe an antibiotic ointment. Using a clean fingertip or cotton swab, gently apply a small amount at the base of the eyelashes before bedtime.
Artificial tears or steroid eyedrops may also be prescribed temporarily to relieve dry eye or inflammation. A new antibiotic drop that also helps improve the oil secretions of the meibomian glands may be prescribed by your Eye M.D.
Research suggests that a lack of certain nutrients may contribute to meibomian gland blepharitis. An imbalance of omega fatty acids have been found to cause abnormal secretions of the oil glands that help lubricate your eyes. Ask your ophthalmologist about a proper diet and nutritional supplements to help treat this imbalance.
Because blepharitis can be an ongoing problem, you should regularly clean your skin and eyelids to keep blepharitis from returning. In addition to carefully cleansing your eyelashes, you can also wash your hair, scalp, and eyebrows with antibacterial shampoo to help control blepharitis.
Dry Eye Treatment
Eyedrops called artificial tears are similar to your own tears. They lubricate the eyes and help maintain moisture. Artificial tears are available without a prescription. There are many brands on the market, so you may want to try several to find the one you like best.
Preservative-free eyedrops are available for people who are sensitive to the preservatives in artificial tears. If you need to use artificial tears more than six times a day, preservative-free brands may be better for you.
You can use the preservative-free artificial tears as often as necessary — once or twice a day or as often as several times an hour.
Conserving your tears
Conserving your eyes’ own tears is another approach to keeping the eyes moist. Tears drain out of the eye through a small channel into the nose (which is why your nose runs when you cry). Your ophthalmologist may close these channels either temporarily or permanently. This method conserves your own tears and makes artificial tears last longer.
A temporary method of closing the channels may involve the use of punctal plugs. The plugs are inserted into the punctum (tear duct) and work much like a dam by blocking your eye’s drainage system. Your Eye M.D. may also choose to permanently close your tear ducts by using heat to seal the puncta closed.
Tears evaporate like any other liquid. You can take steps to prevent evaporation. In winter, when indoor heating is in use, a humidifier or a pan of water on the radiator adds moisture to dry air. Wraparound glasses may reduce the drying effect of the wind.
A person with dry eye should avoid anything that may cause dryness, such as an overly warm room, hair dryers or wind. Smoking is especially bothersome.
Some people may find dry-eye relief by supplementing their diet with omega-3 fatty acids, which are found naturally in foods like oily fish (salmon, sardines, anchovies) and flax seeds. Ask your Eye M.D. if you should take supplements of omega-3 fatty acids and, if so, in what form and dosage.
If other methods do not give you adequate dry eye relief, your ophthalmologist may suggest that you use a prescription medication. One such medication, cyclosporine, works by stimulating tear production. Steroid eye drops may also be used, but are generally not recommended for long-term treatment. Other treatment options may include ointments, gels and inserts.
Dry eye due to lack of vitamin A in the diet is rare in the United States but is more common in poorer countries, especially among children. Ointments containing vitamin A can help dry eye if it is caused by unusual conditions such as Stevens-Johnson syndrome or pemphigoid. Vitamin A supplements do not seem to help people with ordinary dry eye.
If you are bothered by dry eye, talk with your Eye M.D. for ways to find relief.
Pinguecula and Pterygium (Surfer’s Eye) Diagnosis and Treatment
An ophthalmologist can diagnose pterygia and pingueculae through an examination using a slit-lamp (pictured at left). This device allows your ophthalmologist to closely examine the eye’s cornea, iris, lens and the space between the iris and cornea. The doctor is able to closely examine the eye in small sections, making it easier to see abnormalities.
Pterygia and pingueculae generally don’t require treatment until symptoms are severe enough. When pingueculae or pterygium become red and irritated, lubricating eye drops or ointments or possibly a mild steroid eye drop may be used to help reduce inflammation.
If these growths become large enough to threaten sight or cause persistent discomfort, they can be removed surgically by an ophthalmologist in an outpatient procedure. They are also sometimes removed for cosmetic reasons.
For milder pterygia, a topical anesthetic can be used before surgery to numb the eye’s surface. Your eyelids will be kept open while the pterygium is surgically removed. After the procedure, which usually lasts no longer than half an hour depending on the type of surgery done to remove the pterygium, you likely will need to wear an eye patch for protection for a day or two. You should be able to return to work or normal activities the next day. Note that pterygium removal can cause astigmatism or worsen the condition in people who already have this refractive error.
After removal of the pterygium, steroid eye drops may be used for several weeks to decrease swelling and prevent regrowth.
Despite proper surgical removal, pterygium may return. In fact, the recurrence rate is between 30 and 40 percent and is more likely among people under age 40 with significant UV exposure. To prevent regrowth after surgery, your ophthalmologist may suture or glue a piece of surface eye tissue onto the affected area. This method, called autologous conjunctival autografting, has a low recurrence rate. Medications that prevent tissue growth are sometimes used to help prevent recurrences of pinguecula or pterygium. One example of this is a medication called Mitomycin C
The best way to avoid recurrence of pinguecula or pterygium after treatment is to limit exposure to the environmental factors that contribute to their growth.
- Adequately protect your eyes from excessive UV light with proper, wraparound sunglasses.
- Protect your eyes in dry, dusty conditions with proper eyewear.
- Apply artificial tears to your eyes in dry conditions.