Eye Floaters, Flashers, and Spots

Eye doctors often get asked about small specs that appear to float through someone’s field of vision. Even very young people may notice on occasion a spot that appears when they look at a light, plain surface. The good news is that there is no reason to be alarmed!

Eye floaters are simply how we see differences in the gel or liquid in the back of our eyes. Typically these spots appear as specks, circles, or stringy webs that drift through our field of vision. The reason that we see them is that the human brain works with the eyes to interpret light that enters through the front of the eye. In between the light entering the front of the eye and the structures inside the eye that create visual images there is a gel-like substance called vitreous or vitreous humor.

Vitreous is generally a thicker gel in young people and begins to change as we age. Through our youth, the gel generally remains consistent. With age, vitreous dissolves and starts to turn into a thinner liquid. Because some of the gel does not thin and remains in a gel state, you may be able to see small discrepancies in the consistency of the material. These are floaters.

Floaters like this are not anything to worry about, but other types of visual anomalies have different causes and may be something more serious. If you see an occasional floater, there’s no need to see the doctor. If you suddenly see lots of floaters, or if you are seeing flashes of light, contact your eye doctor right away. Sudden appearance of many floaters could mean that the vitreous is beginning to separate from your retina. This is a type of detachment and can lead to damage to the delicate retina which may cause permanent loss of vision.

Always keep in mind that any sudden changes to your vision could be serious and should be addressed with a medical professional right away.

What Does it Mean to be Legally Blind?

People often ask about the distinction between being blind and being “legally blind.” Because “blindness” can mean several different things, legally blind is the threshold at which someone is considered visually impaired for legal purposes such as for insurance purposes, receiving certain benefits, or being accepted into various programs.

Blind people are “legally blind,” but some people who can see with strong prescription eyewear say that they are legally blind without their eyewear. This means that, without eyewear, they would not be able to see well enough to see certain things, drive, and so on. Visual acuity less than 20/200 is considered legally blind, but to actually fit the definition, the person must not be able to attain 20/200 vision even with prescription eyewear. Many people who would be legally blind without eyewear can function well in everyday life with appropriate glasses or contact lenses.

The reason that some people use this term is because there are so many different kinds of “blindness.” People wrongly believe that all blind people just see darkness, or literally nothing at all. In fact, blindness can include seeing some colors or light, or having greater visual acuity in some parts of their field of vision while others are blurry or absent.

DId you know: the largest letter on the chart (an E on most Snellen charts) corresponds to 20/200 vision. If someone cannot distinguish that letter with their prescribed eyewear, they are considered legally blind.

Visual acuity of 20/20 is considered “perfect vision” because no aids are required to see better, and the average person with good eyesight can see clearly what doctors have determined is 20/20 vision. Some people (especially young people with good eyes) are able to see letters smaller than the general “20/20” size.

If you have any questions about your own visual acuity, or if it has been a while since you’ve seen an eye doctor to determine your vision ability, get in touch. We’re happy to assess your vision with a number of painless tests and discuss any concerns you may have. You can speak to the doctor about how well you’re seeing now, and what options are available to help you get your best possible vision!

What is Perfect Vision?

It’s generally assumed that “20/20” is perfect vision, but what does this mean?

Visual acuity is the term used to describe the sharpness of your vision. When doctors do a visual acuity test, they have you view something (usually the Snellen eye chart of letters) from a standard distance and tell them what you see.

One of the lines on the typical eye chart has letters that are a size which has been deemed “20/20 visual acuity,” meaning that at 20 feet, most people can accurately read those characters. This is the standard, so at 20 feet, you read them as well as someone at 20 feet should be able to. It is possible for some people to read smaller letters that fall on lines below. This would be 20/15 or 20/10 visual acuity, meaning at 20 feet, you read letters that most people can only read at 10 or 15 feet. Great!

For people who have less visual acuity, they may be 20/40 or 20/60. The largest letter on the chart (an E on most Snellen charts) corresponds to 20/200 vision. If someone cannot distinguish that letter without assistance, they are considered legally blind.

Did you know the 20-foot measurement isn’t used everywhere? In some countries they use 6 meters as the standard viewing distance.

Visual acuity of 20/20 is considered “perfect vision” because no aids are required to see better, but people can have better than 20/20 vision. Many young people are able to see letters smaller than the general “20/20” size. Even people who know that they see 20/20 or better, but feel that other aspects of their vision are lacking have options for improvement.

Some people who can pass a visual acuity test sufficiently may still have what we refer to as “high-order aberrations.” Low-order aberrations are familiar to most people as nearsightedness, farsightedness, and astigmatism, but high-order aberrations are less well-known. The eye doctor may find that you have coma, spherical aberration, or trefoil. These can produce symptoms including bad night vision, double vision, starbursts or halos, glare, or blurring.

Options exist for people with high-order aberrations who would like sharper vision. Gas permeable (GP) contact lenses are rigid lenses that may improve your vision better than glasses or soft contacts can. There are also laser vision correction surgeries that can address some eye irregularities leading to various types of eyesight problems.

Of course, if you want to know your visual acuity, a comprehensive eye exam is the best way to assess your vision. You can speak to the doctor about how well you’re seeing now, and what options are available to help you get 20/20 vision!

Diabetic Retinopathy

Diabetic retinopathy is a condition where diabetes causes damage to the retina. It is the leading cause of blindness among American adults. Sadly, many instances of vision loss from diabetic retinopathy could have been prevented with appropriate treatment and regular eye exams. Once damage has occurred, it is not possible to regain lost vision.

Light-sensitive tissue comprises the retina that lines the back of the eye. With diabetic retinopathy, changes to blood vessels in the rear of the eye cause bleeding or leaking fluid, which starts to distort vision. The changes in blood flow happen because diabetes (especially uncontrolled diabetes) can create chronically high blood sugar. This damages very small blood vessels in the retina and eventually leads to retinopathy.

There are four stages to this type of retinopathy:

1. Mild nonproliferative retinopathy is when small areas of the blood vessels sweet and balloon. These are called microaneurysms and may begin to leak fluid into the retina.
2. Moderate nonproliferative retinopathy happens as the disease progresses. Blood vessels that supply the retina with blood and essential nutrients may swell and distort. When this happens, they may also lose their ability to transport blood. This may contribute to diabetic macular edema (DME).
3. Severe nonproliferative retinopathy is when several blood vessels are blocked, depriving blood supply to parts of the retina. These problem areas secrete materials that tell the body to grow new blood vessels in the retina.
4. Proliferative diabetic retinopathy (PDR) is the advanced stage of diabetic retinopathy. Growth factors secreted by the retina cause too many new blood vessels to form. They grow inside the retina and into surrounding areas, but are fragile and likely to leak and bleed. Scar tissue can shift and cause retinal detachment. If the retina pulls away from underlying tissue, permanent vision loss may occur.

If you have diabetes, it is very important to control blood sugar to guard against developing symptoms. Make sure that you are working closely with a qualified doctor to manage your care and have regular follow-ups.

The same is true for eye care with diabetes. Diabetic eye disease is a group of several eye conditions that are commonly caused by diabetes. These conditions include diabetic retinopathy, diabetic macular edema, cataracts, and glaucoma. If caught in time, treated, and managed as part of a diabetes care plan, many people can maintain their vision or slow the progression of trouble seeing.

Kids and Computer Vision Syndrome

Most of us remember being told not to sit too close to the TV because it would ruin our vision. Well, that may have been an exaggeration of the actual dangers of sitting too near a tube television, but new risks are at play when it comes to electronic screens and the eyes of our children.

Old tube televisions and things like handheld games relied on much different electronics and lights to power their screens in the early years. It wasn’t until much more recently that we have moved to bright, LED and plasma screens that use a lot of blue light to show unimaginably crisp images. Whereas sitting pretty close to one of those screens twenty years ago probably wasn’t a good idea, it’s likely that prolonged and extreme use of screens nowadays is more problematic.

We know that using a computer can improve school readiness and academic achievement. Children learn digital tools quickly, and have relatively little trouble using them for educational games, math, reading, and more. These things aid cognitive development when used appropriately, and will not harm your child’s vision.

The risks associated with using a digital screen come from prolonged use, improper ergonomics, and developmental problems caused by getting too much screen time instead of getting social interaction and physical activity.

Children’s eyes are more sensitive to bright light because they lack certain tints that we develop as we get older. As we age, our eyes take on a slightly yellowish tint that helps filter bright blue light. The sun is the largest source of bright blue light, but digital devices also rely on this kind of light to produce clear videos and graphics. This means that children who use a bright screen up close are naturally less protected than older people, and their eyes are more susceptible to damage. Over time, our risk for macular degeneration increases along with years of exposure to “high-energy visible light.”

When children use a digital device for long periods of time, they do not “flex” their eyes by focusing on distant objects, as well as looking in the near and intermediate fields. This causes eyestrain. Additionally, sitting for too long and making repetitive movements with hands (like clicking a mouse or controller) or sitting in a position with bad posture or an unsupported upper body can lead to problems like carpal tunnel, muscle soreness, and poor physical development. Everyone knows that kids need time to burn off energy, build gross motor skills, and strengthen their muscles and bones through exercise and play. When they get too much time sitting down while indoors, other important activities like outdoor play, conversation, spacial reasoning, and other skills suffer.

To reduce your child’s risk of computer vision syndrome:

• Limit their time on computers and devices
• Prompt them to take breaks regularly (this is a good habit for many activities)
• Make sure they are sitting in a comfortable, supported position
• Opt for anti-glare protection on their eyewear to reduce eyestrain
• Teach them to view digital screens at arm’s length and not too close

Eating Well for Eye Health

Everyone wants to know how eating can affect the ways our bodies function. Maybe it’s because we want even more reasons to eat healthy, or because more of us want natural ways to lower our risk for diseases and deficiencies, but the good news is that you can easily eat right for your vision!

Antioxidants
Many foods contain antioxidants. Antioxidants literally remove oxidizing agents in living organisms. These oxidizing agents may be potentially damaging to our various systems, so many people believe that foods rich in antioxidants could help lower our risk for certain illnesses.

There are many delicious foods that can help promote overall health and may be part of a plan to lower your risk for eye disease.

Vitamin C (ascorbic acid) helps with building and maintaining connective tissues in the human body. It also helps maintain collagen found in the cornea. By promoting healthy skin, bones, and circulation, you retina may be aided by vitamin C. People who have healthy levels of vitamin C in their diet are also at a lower risk of forming a cataract and vision loss from macular degeneration.

Red peppers are especially high in vitamin C, as are green peppers, strawberries, broccoli, and some citrus fruits.

Flavonoids
Many of the foods that contain vitamin C also contain flavonoids. Unlike vitamins, these substances are not necessarily required for life and crucial functions of the body, but they are generally linked with health benefits as part of an overall healthy diet.

Anthocyanins are a type of pigment and antioxidant that are considered good for your eyes because they may reduce risk of cataracts or macular degeneration. These substances are found in many berries like blueberries, cranberries, raspberries, and blackberries. You can also get anthocyanins from grapes, red cabbage, and red apples.

Fatty Acids
Many people falsely believe all fat is bad, but there are lots of healthy fats that we need in our diets. Our brains demand various kinds of fats to function properly, and healthy fats help our circulation, digestion, and even things like our outward appearance. Diets with proper omega-3 fatty acids are also very good for your eyes, and are especially important for eye development in children.

You can get these essential nutrients from foods like flaxseed, walnuts, fish, soy, and veggies like brussel sprouts and cauliflower.

Though we can’t be totally sure how much these foods help lower our risk for illnesses, there’s no doubt that a balanced diet and healthful lifestyle are important for a strong body and healthy eyes!

April Showers Bring May (and More) Allergies

Spring has arrived! The birds are chirping, the days are getting longer, and suddenly you’re experiencing itchy and watery eyes. Seasonal allergies affect an estimated 50 million people in the United States, making the spring season a little (or a lot) less pleasant for many Americans. Up to 30 percent of adults and up to 40 percent of children report having problems with seasonal allergies. That’s no small amount of people with itchy eyes and runny noses!

Spring is what comes to mind when most people think of seasonal allergies, but allergies are not limited to April, May, and June alone. Seasonal allergies can be a disruption almost any time of year, depending on what causes your allergies and where you live. Learning how to cope with seasonal allergies and treat the symptoms can improve your daily life and make nice weather more enjoyable.

How do you combat seasonal allergies? There are some tips you can use to fight seasonal allergies. First, know what triggers them. You’re not going to frolick in a field of goldenrod if you know that it causes an allergic reaction. Ask your physician if he or she can help you narrow down what is causing your discomfort.

The most common seasonal allergens are grass, pollen, and mold. For an allergy sufferer, avoiding these allergens is the first approach to minimize symptoms. It can be difficult to avoid them, however, because they are very common in most parts of the country. Unless you’re able to move somewhere without allergens (or maybe you can live in a bubble), you’ll have to consider some additional options.

Make sure to protect your eyes. Sunglasses can help keep pollen and allergens from entering the eye to an extent, but they also minimize strain on your eyes that can be worsened during allergy season. Protection can also come in the form of wearing a protective mask while doing things like gardening or yard work.

If you must go outside to work or exercise, try to do it early in the morning or later in the evening. These are times when pollen counts are typically lower than during the middle hours of the day. Also, check pollen counts. Many weather apps and sites offer pollen counts as a way to inform allergy sufferers of the worst days for allergies, and other days when it might not be so bad.

Talk to your doctor about an over-the-counter remedy. Not a lot of people report mowing the lawn as their favorite thing to do, but gardening can be very satisfying, and a fun way to get dirty, make your yard more beautiful, or even save money by growing your own food. Seasonal allergies make rustling around in the weeds nearly impossible, however. No one wants to spend their time in nature rubbing their eyes! Your physician can give you advice on medical treatments for allergies and medication that may be available to help you keep your routine and pursue your hobbies without too much disruption.

On days when the pollen count is high, sufferers may choose to stay inside. Itchy eyes can be painful, making it difficult to accomplish everyday tasks like working on a computer screen, watching TV, or even just focusing on small details for a prolonged period of time. With many people working behind a computer for their job, just imagine the productivity that could be gained if eye-related allergies were eliminated! Thankfully, you can help keep indoor air quality clear so you can live comfortably and get your work done indoors. Simply try an air purifier. They help to reduce allergens from the air, and keep those pesky particles out of your nose and eyes. Also, make sure the air filters on your heating and cooling units are changed or cleaned regularly. Special filters exist for allergy sufferers, and they can help improve indoor air quality when changed regularly.

In addition to cleaning the air, wash the dog, your hair, and your clothes. Pollen and other allergens can easily stick to clothes, pets, and even you. A regular wash will prevent allergens from sticking around this allergy season.

The best way to combat the change in seasons is to avoid the allergen as much as possible, refrain from itching your eyes, and use artificial tears to wash away airborne allergens when necessary. Talk to your physician and eye care professional if seasonal allergies are getting in your way.

Preventing Computer Vision Syndrome

It’s the end of the week and you’ve only got a few hours left before the weekend. As you try to finish the last of your tasks, you find yourself unable to focus—not just mentally, but physically. You have trouble seeing the screen in front of you. Maybe your vision is blurry or your eyes start to burn. These are symptoms of computer vision syndrome.

Computer vision syndrome is simply the name given to a group of symptoms and problems associated with overuse of computers and strained eyes from excessive computer use. It’s becoming a more common problem as more people work in offices behind computers, and rely on tablets or smartphones instead of paper. These devices have helped make us more productive with faster communication and easier recordkeeping, but the reliance on electronic screens in front of our faces can also be a problem for our eyes.

There are many things you can do to prevent or relieve the symptoms of computer vision syndrome. If you wear glasses, make sure your prescription is up to date. If you do not wear glasses (or if you wear contact lenses that you’re sure are an appropriate prescription for you) yet still experience discomfort while on a computer, computer glasses may be what you’re looking for.

Computer glasses are different than traditional eyeglasses or reading glasses. Due to such a short distance between your eyes and the computer screen, distance eyeglasses and reading eyeglasses may not be as effective for your eyes. They’re not necessarily meant for focusing for longer periods on the intermediate zone of vision. Made specially for viewing a computer screen, computer glasses help you focus on this very zone where your monitor sits, making daily use much more comfortable.

Without a proper prescription or an aid like computer glasses, those experiencing blurred vision may end up leaning forward in order to see. This can negatively affect posture and cause even more strain on your body. In addition to eye health, it’s very important to have a healthy workspace and comfortable posture.

Because computer glasses have a modified lens, they give you the most comfortable view of your computer screen. For maximum viewing quality, the lenses should include anti-reflective coating. Tinted computer lenses are also recommended in order to block out blue light that is emitted from computer screens.

With a decrease in eyestrain, and no more blurred vision or headaches, it’s obvious how much computer glasses can help make you feel better and more productive. Ask your eye care professional if you’re interested in learning more about computer glasses and how they can help prevent computer vision syndrome.

Healthy Vision is More than 20/20

Taking care of your eyes includes more than going to a yearly exam and wearing an up-to-date prescription. Although both are certainly important, there are many more things you can (and should) do to make sure you’re preventing eye problems and protecting your vision.

Diet and nutrition play an important role in the long-term health of your eyes. Certain vitamins and minerals have proven necessary for good vision while also protecting against eye diseases. A diet high in dark leafy greens such as spinach, kale, and collard greens provides us with lutein, bioflavonoids, and beta-carotene. Omega-3 fatty acids are great for those who suffer from dry eyes. Omega-3s can be found in fish, fish oil supplements, flaxseed, and walnuts. Vitamin A, C, D, E and zinc can be consumed through foods such as eggs, sweet peppers, milk, almonds, and beef. Consumption of these foods high in vitamins may reduce the risk of macular degeneration, cataracts, blindness, and dry eyes, among others.

Full-body physical exams are also important. Physicals check for diabetes and high blood pressure. These conditions can lead to diabetic retinopathy, macular degeneration, glaucoma, and ocular hypertension if left untreated.

Shielding your eyes from the sun is important, but many people believe it is just the tint of sunglasses that offers protection. In actuality it’s the UV-blocking abilities of sunglasses that guard your eyes from damage. Make sure that your eyewear is dark enough to keep you from squinting into the sun when you’re outdoors, but also check that your glasses have a UV coating. Some sunglasses have an inexpensive UV coating that rubs off over time, so your best bet is to purchase a reputable brand that offers a durable coating or is manufactured into the lens itself and will block 99–100% of UVA and UVB rays.

The number of people in the United States who smoke has been declining for several years, and now just 18% of people in the US smoke. Unfortunately, smoking still accounts for 480,000 deaths each year, and smoking increases several risk factors for poor eye health. Smoking doubles your chance of developing cataracts, a clouding of the eye that is the leading cause of blindness. Also, age-related macular degeneration (AMD) causes blind spots and impairs vision, and smokers have a three-fold increase in their risk of developing AMD. So quitting smoking is crucial for your overall health, but also to protect your eyesight.

Most people know that they should be getting twenty minutes of exercise three times a week, but eye health is yet another reason that you should get moving. Regular exercise is linked to retina health. Plus, sufficient exercise along with a balanced diet can help prevent other medical conditions that put your eyes at risk.

Aside from these things, being aware of your family’s health history is another big factor in eye health. Your physician and eye care professionals can help you check for symptoms that may be signs of known health problems common to your family, and can suggest prevention tips as well as early intervention if you discover there is a problem.

If you notice any changes in your vision—things like haziness, cloudiness, double vision, difficulty seeing at night—see your doctor right away. A healthy lifestyle, regular checkups, knowing your risk factors, and basic protective measures will help you keep your eyesight clear for as long as possible.

Children and Computer Vision Syndrome

People are always touting the benefits and the risks of social media, videogames, television, and other screen activities. It’s common to hear about someone giving up social media for a period of time just to see if they are able to kick what they consider an ‘addiction.’ New Year’s resolutions are often to read more and spend less time at a computer or on a smartphone. These may seem like grown-up problems, but adults and teens aren’t the only demographics spending a large part of their daily routine behind a screen. Children barely old enough to move a mouse are using computers and devices for recreation and learning every day.

In 2009, kids in grades 7–12 reported spending an average of more than 90 minutes a day just sending or receiving texts on cell phones. In 2011, 50% of children under eight-years-old reported having access to a mobile device like a smartphone or tablet. Children under two watch 53 minutes a day of television.

Should all screen time and computer usage be cause for concern? Not quite. Consider this: studies have found that children who use a computer at school and at home perform better on tests of school readiness, visual motor skills, gross motor, and cognitive development. This positive effect seems to diminish if you look at children’s screen time beyond physician-recommended daily limits, however. Excessive screen time does not help children learn, and overuse has been shown to put children at risk for vision problems.

Children aged 8–18 reported in 2009 that they spent more than seven hours a day devoted to “entertainment media” including computers and videogames. That makes screen time a full-time job! Pediatric eye doctors are warning parents that this sort of heavy screen time is putting children at risk for early nearsightedness, among other possible issues.

According to the National Eye Institute, over the past 30 years the prevalence of nearsightedness has increased from 25 percent to over 41 percent. This is an increase of more than 66 percent. No one can be certain if this increase is caused by screen time, but many professionals are concerned that there may be a connection.

The longer children are exposed to a computer screen, the greater their risk is for developing computer vision syndrome. Computer vision syndrome is the term used to describe problems associated with focusing on an electronic display for excessive, uninterrupted amounts of time. The risk is increased because children’s eyes are not as well-developed as adults. It’s easier for children to experience these problems because they often lose track of time, are assigned lots of homework to do on the computer, or may not realize that they should be taking frequent breaks. Additionally, children are notorious for sitting very close to screens even if they have perfect vision—a position that strains the eyes and the rest of the body.

Parents should pay careful attention to how long a child spends with electronics. Set limits and help them develop good habits for how to use their devices. Talk to your eye care professional to discuss your child’s media habits and determine if you should change how they interact with electronics for optimal eye health.

Martin Eyecare