Detection and management of eye diseases

At Transcona Optical, our optometrists are trained in the most advanced optometric care to diagnose and treat a variety of eye diseases and conditions. Some of the most common conditions include:

AGE RELATED MACULAR DEGENeRATION (AMD)

The macula is the central most part of the retina which is the inner layer at the back of the eye responsible for detailed central vision. It is used for reading, driving, recognizing people’s faces and any detailed task. Macular degeneration is a condition that causes the center of your vision to blur while the side or peripheral vision remains unaffected. It is the leading cause of blindness in North America in adults aged 55+.

In the earliest stages, macular degeneration may be symptom free but can be detected during a comprehensive eye examination. However, one of the first symptoms of AMD is slightly blurred central vision when performing detailed tasks or a sense that there is dirt in the way. Over time, the blurred area may increase in size and interfere with reading and day to day tasks. Other symptoms of AMD include; straight lines appearing wavy or distorted and/or missing portions of central vision. AMD is not associated with pain.

There are two types of AMD: dry and wet. Dry AMD is more common and the milder form. This is associated with a gradual degeneration of the central retinal tissues and therefore gradual development of symptoms. The symptoms of wet AMD progress quickly because it is caused by sudden leaking, or bleeding from weak blood vessels under the macula. Wet AMD accounts for approximately 10% of cases, but the dry form can develop into the wet form over time. Many patients with vision loss due to AMD can benefit from low vision aids. Our optometrists can diagnose AMD, inform you if it is dry or wet and prescribe magnifying devices to enhance both distance and reading vision.

The risk factors for AMD include; increasing age, a family history of AMD, smoking, UV exposure, poor nutrition, lack of exercise, and conditions such as high blood pressure, diabetes and arteriosclerosis. Therefore, lifelong UV protection, good nutrition, ocular vitamin supplementation and a healthy lifestyle are believed to play a key role in preventing AMD. Regular eye examinations by one of our optometrists are also important in the early detection of AMD and guidance surrounding diagnosis and treatment. 

GLAUCOMA

Glaucoma is one of the leading causes of blindness in Canada. It is a group of eye diseases which result in a progressive degeneration of the optic nerve. This can lead to gradual irreversible vision loss and potential blindness if not detected and treated early. Usually the peripheral vision is affected first, followed by central vision during the later stages. If glaucoma is diagnosed at an early stage, treatment such as medication eye drops and/or laser surgery can usually control or prevent further vision loss.

The exact cause of this disease is unknown. It is generally associated with increased eye pressure, however the damage can also occur when the pressure is normal (Normal Tension Glaucoma). 

The most common form of glaucoma is primary open-angle glaucoma. In its early stages, there are no symptoms and it must be detected by your optometrist during a comprehensive eye exam. It develops painlessly and gradually and there are no warning signs. The patient often does not realize that they are gradually losing vision until the later stages of the disease. But by the time the vision is impaired, the damage is irreversible.

Changes because of glaucoma are often detected by monitoring for nerve and peripheral visual changes over time. Our optometrists will perform a procedure called tonometry during your comprehensive eye exam, which measures the internal eye pressure. They will also look into the eye to examine the health of the optic nerve and retina, and inspect your eye's drainage. Our specialized equipment allows us to measure your peripheral vision (Humphrey Visual Field Analyzer) and additional imaging machines including the Optomap, pachymeter and OCT allow us to evaluate the optic nerve and retinal layers to aid in the diagnosis and treatment of this disease. 

Angle-closure glaucoma or narrow angle glaucoma is another type of glaucoma which does not occur as often. It is considered a medical emergency that can cause sudden and painful vision loss. Symptoms include nausea, eye pain, red eyes, blurred vision and haloes around lights. 

Another type of glaucoma is secondary glaucoma which can occur as the result of an injury, infection, medical condition or tumor in or around the eye that causes the pressure to rise. 

Risk factors for glaucoma include;

  • Increasing age
  • Family history
  • Medical conditions such as diabetes and variations in blood pressure and heart disease
  • Physical injuries to the eye
  • Abnormalities in eye anatomy 
  • Eye conditions such as retinal detachment, eye tumors, and eye inflammations
  • Corticosteroid use 

Regular eye examinations with our optometrists are highly recommended to screen for, diagnose and treat glaucoma.

CATARACTS

The lens within the eye is initially clear and with age it becomes cloudy and opaque. This is then called a cataract. With time, a cataract will result in a noticeable loss in vision or clarity. Cataracts often occur as a function of age and vary in size and form. Cataracts can also be found in younger people and may be associated with certain medications, diseases or environmental factors. If a child is born with a cataract it is referred to as a congenital cataract.

Cataract symtoms include:

  • Blurry or hazy vision (this may or may not be able to be corrected by changing the glasses prescription)
  • The feeling of a film over the eyes that does not go away with blinking
  • A change in distance and/or near vision
  • Sensitivity to glare (especially at night)
  • Haloes around lights
  • Colours appear faded
  • Double vision or multiple images seen with one eye
  • Difficulties driving at night

A comprehensive eye examination by our optometrists can determine if you have a cataract developing. Cataracts may develop slowly over a period of years or rapidly over a few months. However, some cataracts never progress to the point that they need to be removed. In the early stages of a cataract, our optometrists may prescribe new lenses for your glasses to give you the sharpest and maximum vision. When the cataract begins to interfere with your daily activities and a change in glasses can no longer help vision, we can arrange a consultation with a cataract surgeon/ophthalmologist. We also provide the post-operative care after the cataract surgery.

While age-related changes to the eyes are the primary cause of cataracts, there are things you can do to minimize your risk. To reduce your risk:

  • Wear sunglasses with the highest level of UV protection
  • Stop smoking
  • Protect your eyes from injury and disease
  • Maintain your general health (diabetes and hypertension increase your risk for developing cataracts)

DIABETIC RETINOPATHY 

Diabetes can have a negative impact on eyes. The most serious eye problem associated with diabetes is diabetic retinopathy. Diabetic retinopathy results in blood leakage in the retina and the growth of new blood vessels. If the advanced diabetic retinopathy is left untreated, blindness can result.

Our optometrists can detect early signs of diabetes during our comprehensive eye examinations and in the early stages, diabetic retinopathy is monitored regularly through these exams. When appropriate, a referral to an ophthalmologist for treatment or surgery may be necessary on an urgent or semi urgent basis. Early detection of diabetic retinopathy is crucial because the treatment is more likely to be successful at an early stage. It is important to control your blood sugar as much as possible to minimize your risk of developing retinopathy.

Diabetes and its complications can affect many parts of the eye. Diabetes can cause;

  • Nearsightedness, farsightedness and premature presbyopia (the inability to focus on close objects)
  • Cataracts
  • Glaucoma
  • Paralysis of the nerves that control the eye muscles or pupil (which can lead to double vision)
  • Fluctuating or blurring of vision

We advise a comprehensive eye exam when you are first diagnosed with diabetes, at least annually thereafter and more frequently if recommended.

 

Dry Eye

Our eyes produce tears naturally to maintain the health and clarity of vision. Dry eye occurs when our eyes do not produce enough tears or produce tears that do not have the proper chemical composition.

The common signs and symptoms of dry eye include;

  • Burning eyes
  • Stinging, gritty, scratchy and uncomfortable eyes
  • Fluctuating vision
  • A feeling of something foreign within the eye
  • Excessive tearing 
  • Red eyes

Dry eye symptoms can result from normal aging, hormonal changes, certain environmental conditions, blinking problems or from medications such as antihistamines,  antidepressants or oral contraceptives. Dry eye can also be associated with health problems, such as arthritis.

During the eye examination, our optometrists will ask questions to uncover your risk factors and causes for dry eye. Additional dry eye testing can be done in conjunction with your comprehensive eye exam. The use of a high-powered microscope known as a slit lamp and special dyes, will allow our optometrists to evaluate the quality, the amount and the distribution of tears to detect signs of dry eyes.

Although dry eye is usually chronic, we can help improve your comfort and maintain your eye health through use of artificial tears or medicated drops. New prescription medications are now available to help you produce more tears and reduce or eliminate dry eye symptoms.

red eye or EYE INFECTIONS

There are many reasons that a eye can become red. Some causes which require treatment include bacterial infections, allergic reactions, viral infections, uveitis or iritis, angle closure glaucoma, dry eye, corneal ulcers, contact lens related infections and blepharitis. 

The medical term for “pink eye” is conjunctivitis, and it can be caused by bacterial or viral infections, allergens or exposure to chemicals. This is an inflammation or an infection of the conjunctiva which is the thin layer of tissue that lines the inner surface of the eyelid and the white of the eye.

Symptoms of conjunctivitis include:

  • A gritty feeling in one or both eyes
  • Itching or burning in one or both eyes
  • Pain
  • Excessive tearing
  • Discharge from one or both eyes
  • Swollen eyelids
  • Pink or red color in the whites of one or both eyes
  • Increased sensitivity to light

Treatment for conjunctivitis depends on its cause and ranges from antibiotics for bacteria infections to home care and relief measures for viral infections. The goal of treatment are to increase comfort, reduce or lessen the course of the symptoms, and prevent the spread of the infection. In general, good hygiene is the best way to avoid or prevent the spread of conjunctivitis. 

 

ADAPTED FROM THE CANADIAN ASSOCIATION OF OPTOMETRISTS' WEBSITE