Matter floating inside the eye moves into the line of sight and appears as specks floating in front of our eyes.

Overview

Floaters (also called “spots”) are tiny clumps of gel or other semi-transparent matter that drift freely inside the vitreous, the jelly-like fluid that fills the inside of your eyes. In most cases, they are more bothersome than harmful – appearing as specks of varying shapes and sizes, or as strands, crystals, cobwebs or as fuzzy clouds that float about and may dart away when you attempt to look at them directly.

Floaters result from several causes: In childhood and early adulthood, most are pieces of blood vessels that were left suspended in the vitreous during fetal development, or small flecks of protein trapped during the formation of your eye. They may also result from specks of pigment on the muscle fibers attached to the iris, or particles caught in the tear layer in front of the eye.

More often, however, they result from the natural aging process, as the vitreous fluid deteriorates and crystal-like clumps form, a process that usually begins in your mid 40s. You may notice them more readily when looking at something bright, such as the sky or a white wall.

Floaters can affect anyone and are usually harmless, but tend to be more noticeable and frequent in people who are nearsighted, have undergone cataract surgery, or have injured or inflammed the eye. If you notice a sudden increase in floaters, see your eyecare provider, because they could indicate a more serious problem such as diabetic retinopathy, retinal hemorrhaging or the first signs of a detached retina.

Flashes, which appear as lightning streaks, shooting stars, fleeting white pinpoints or blasts of light, are false bursts of light produced by optic nerves of the retina. Most adults experience flashes after age 50, as the vitreous thickens as part of the normal aging process and begins to alternately pull away from and rub against the light-sensitive retina. They also appear in those prone to migraine headaches, sometimes right before the onset of a migraine, and can also result from head trauma or by blood vessel spasms in the brain. As with floaters, flashes should be checked by an eyecare provider to ensure they’re not the early sign of a more serious problem.

Symptoms

If you have floaters or flashes, you may notice:

• Spots, strands or shadowy shapes that appears to float or move
• Flashes of light that appear as streaks of jagged lines
• A migraine or headache may follow

Prevention

There is no way to prevent floaters or flashes, but if they occur suddenly or frequently, see your eyecare provider.

Treatment

Floaters and flashes are usually harmless and fade over time. When everyday floaters are bothering you, try looking up and down and from side-to-side. This stirs the vitreous fluid in your eyes, moving floaters away from your line of vision. Flashes caused by the vitreous separating from the retina are a normal part of aging and should subside in a few weeks or months.

There is no safe, reliable treatment to control or eliminate floaters or flashes. If you notice a sudden or dramatic increase in floaters or flashes that last more than 20 minutes, seek immediate medical attention, as this may indicate that you have retinal damage and left untreated, permanent vision loss may result. Surgery may repair damage if caught early.

In the rare case that vision is almost entirely clouded by floaters and floaters, a vitrectomy may be performed. In this procedure, the vitreous is replaced by clear saline solution to improve vision clarity. This is not usually recommended due to the high risk of total blindness associated with the procedure.

A farsighted eye is too “short,” causing light to converge behind the retina and blurring near vision.

Overview

Farsightedness, medically known as hyperopia (hi-pur-OH-pea-uh), refers to vision that is good at a distance but may be poor at close range. Farsightedness occurs when the eyeball is shorter than normal, as measured from front to back, or when the cornea has too little curvature. This reduces the distance between the cornea and retina, causing light to converge behind the retina, rather than on it.

Since we’re usually born with eyes that are too short, the majority of newborns are farsighted. As we grow, the “normal” eye gets longer and by 1 year, close vision is generally clear. Even when it doesn’t, farsightedness – also known as hypermetropia and long-sightedness – may go unnoticed until middle age – when the ciliary muscles controlling the lens begin to weaken and can no longer compensate for the limitation in near vision. This is why farsightedness, which is usually congenital, often isn’t apparent until the development of presbyopia.

Disease such as retinopathy, eye tumors and lens dislocation can also contribute to farsightedness, which is easily treated with corrective lenses and can also be managed with refractive laser surgery.

Symptoms

People who are farsighted typically have good distance vision, but may find it difficult to do close visual tasks, such as reading. Besides blurred vision or difficulty focusing during close activities such as reading or sewing, other symptoms include:

• Aching, burning, red or tearing eyes
• Eye fatigue
• Headaches or “brow” aches (occurring on the top of the eye), which can result from overworked ciliary muscles
• Poor hand-eye coordination
• Severely farsighted children may appear cross-eyed – a condition called accommodative esotropia that usually develops around age 3 and may be constant or intermittent.

Prevention

Farsightedness is largely believed to be inherited, with little evidence that enviromental factors cause its development. However, to avoid accentuating symptoms, your eyecare practitioner may recommend that you keep work areas well-lit and glare-free and give your eyes a break during close visual work by focusing on distant objects every 30 minutes or so.

Occasionally, conditions such as diabetes, lens dislocations and eye tumors can cause farsightedness. So if you experience any symptoms, see your eye doctor for a complete examination. Children should get a complete eye exam by age 3 and those with severe hyperopia need to be monitored to avoid the development of crossed eyes (strabismus) or lazy eye (amblyopia).

Treatment

If you are mildly farsighted, your eyecare practitioner may not recommend corrective treatment at all, since your ciliary muscles may be compensating by adjusting the shape of your lens to bring close vision into focus. However, if you are moderately or severely hyperopic or presbyopic, you have several treatment options:

• Corrective Lenses
  • Eyeglasses with convex lenses, which are thicker in the center and thinner on the edges, to bend light to converge further forward in the eye to reach the retina.
  • Contact lenses offer several options, such as soft lenses and rigid gas-permeable (RGP) lenses, which conform to the shape of the lens

• Laser surgery is effective for many people with farsightedness, but the long-term effects of these relatively new procedures are still being studied. Laser surgery, which still may result in the need for reading glasses, is generally not recommended for those under age 18 and carries risk of side effects such as increased sensitivity to glare, seeing halos around lights, poor vision, dry eye and others. Options include:
  • LASIK (laser in situ keratomileusis) is a procedure in which a surgeon slices a flap into the cornea and a laser removes some tissue from beneath the sliced area to reshape the cornea.
  • Photorefractive keratotomy (PRK) uses a laser beam to remove tissue from the outer surface of the cornea, reshaping it to improve its focus.

Dry eye can result from an imbalance in the components of tears.

Overview

Dry eye syndrome refers to a breakdown in the quantity or quality of tears to moisten, cleanse and protect the eyes. This is significant because with each blink, tears protect the surface of the eye, washing away dust and microorganisms. When this protective coating dries up, the eyes may feel “gritty” or burn, are more easily scratched and vulnerable to infection, and can be more sensitive to light. In extreme cases, vision can be blurred.

Dry eye syndrome is among the most common eye problems, and often results from the aging process, affecting nearly three in four people older than age 65. It is also more common among computer users, those with allergies to dust or pollen, contact lens wears, those with arthritis or certain immune disorders and those who work outdoors. Women are typically affected more often than men, as dry eye syndrome is triggered by hormonal changes such as post-menopause and during pregnancy or breast-feeding.

It also results from taking certain medications, including antidepressants, birth control pills, cold medications that act as antihistamines and decongestants, antihypertensives, antidiarrheals, acne medications and diuretics such as blood-pressure drugs. Dry eye is also a common but temporary side effect of LASIK, resulting from a disruption of the nerves of the cornea.

Dry eye occurs when there is a malfunction in one of more tear glands, or an imbalance in one or more of the three layers of tears:

• Oily layer, a thin outer tear layer produced in the meibomian and Zeis glands. These tiny glands line the edge of the eyelid and serve three purposes: To slow the evaporation of the watery middle layer; to increase surface tension so tears don’t overflow the eyelid; and to lubricate the eye during blinking.

• Watery layer, the middle layer of the tear that comes from lacrimal gland, which lies beneath a bone near the nose, and the glands of Krause and Wolfring, which are on the inner surface of the eyelids. This layer works to supply oxygen to the eye’s surface; to fight infection with natural antibiotics, such as lactoferrin and lysosomes; to act as a filling that smoothes the eye’s surface; and to wash away debris such as dead cells and dust.

• Mucous layer , the innermost layer of the tear that originates in the goblet cells, Henle’s crypts, and Glands of Manz. These glands are located in the conjunctiva, on the surface of the eye and inner eyelids. This thin layer helps tears glide evenly across the eye’s surface. Without it, the other layers of tears would form into tiny droplets instead of a smooth, even coating.

Some people with dry eye experience “reflex tearing.” After experiencing the discomfort of extremely dry eyes, a substantial amount of tearing suddenly occurs. For example, if you stare for a long period without blinking, your eyes will dry out and reflex tearing will kick in, causing a significant amount of tears to pour out. These tears contain unbalanced proportions of the different layers of tears.

Symptoms

Dry eye can cause any of the following:

• Burning or itching eyes
• A feeling of grittiness, as if there was sand in your eyes
• Difficulty in wearing contact lenses comfortably
• In some cases, you may experience increased sensitivity to light or excessive tearing
• In extreme cases, vision may appear blurred

Prevention

There are several ways to prevent the natural occurrence of dry eye to interrupt the quality of your life:

• If you use a computer regularly, take a 10-minute break every hour or so to give your eyes a rest.
• Use a humidifier when you are indoors, since dry heat and lack of humidity can be aggravating. This is especially important if you use a hair dryer or are exposed to chemical vapors, smoke, air conditioning or similar environmental conditions.
• Avoid wearing contact lenses when you experience symptoms. If you must wear contacts, be sure to lubricate eyes more frequently with artificial tear products.
• Wear protective eyewear when outdoor during windy days or around dust, pollen or other irritants.

Treatment

If you suspect that you have dry eye, see your eye doctor. Proper care will not only increase your comfort, it will protect your eyes. Your eyecare specialist can use simple tests to determine if your tears are drying up too quickly, and/or if your glands under your eyelids are not producing enough tears. If you have dry eye, your eye doctor can suggest many treatment options:

• Replace the natural tears with artificial tears. In most cases, the solution for dry eye is artificial tears. These are different from drops that remove redness and can be purchased over-the-counter. Moisturizing ointment may be prescribed, and certain homeopathic eyedrops may help the body increase tear secretion.

There are many types of artificial tears. If they are too thin, they will drain away or dry out too quickly. If too thick, they will blur vision. Some will have restrictions on the frequency of use. Read the labels carefully and try a few brands to determine which best suits your needs. Artificial tears usually solve the problem of mild to moderate dry eye. If they do not ease your symptoms, additional treatment may be necessary.

• Plug the eye’s drain. Your eyecare practitioner may suggest plugging the punctum, or drain opening, on your lower eyelids. Blinking creates a vacuum that sucks tears into these drains, from where they travel through nasolacrimal ducts to the throat. These tiny silicone punctual plugs are inserted manually to block drainage, and are recommended for moderate to severe dry eye.
• Seal the eye’s drain. Thermal cauterization will seal the punctum, blocking tear drainage permanently. In this procedure, using local anesthetic, the eye doctor inserts a hot wire into the punctum. The heat seals the drain. Scarring may occur, and the procedure is not reversible. A laser can be used to seal the punctum with less scarring, but there is a 20 percent change that the drain will reopen on its own.

Before considering medical approaches such as sealing and plugging the puncta, there are several “do-it-yourself” treatment methods you can try:

• Increase blinking. You may not be blinking enough, especially when working at a computer or reading for long periods of time. Try to blink more often, and take frequent breaks from using computers to avoid fatiguing your eyes.
• Massage your eyelids. A simple eyelid massage will stimulate the tear glands. Just place a warm washcloth over closed eyes and gently massage the upper eyelid against the brow bone for 5 to 10 seconds. Then massage the lower eyelid against the lower bone.
• Monitor your diet. Natural diuretics can dry your eyes (as well as the rest of your body). You may benefit from reducing or eliminating your intake of coffee, tea, cola, alcohol and chocolate. It’s also advised to drink at least 8 glasses of water each day to ensure proper hydration.
• Adjust your medications. Your healthcare provider may be able to lower the dosages or switching medications that can contribute to dry eye. These drugs include antidepressants, birth control pills, antihistamines, decongestants, antihypertensives, antidiarrheals, acne medications and diuretics such as blood-pressure drugs.
• Control your environment. Simple changes in your home or office may eliminate your dry eye symptoms, such as using a humidifier, installing incandescent lighting instead of fluorescent, turning down the thermostat, and avoiding smoke and allergens.
• Change your contact lens care regimen. When not disinfected or wetted properly, contact lenses can wick tears away from the eye. Be sure to follow all care instructions closely. Try switching brands of lens care products. Preservative-free products are usually gentler on your eyes.