To our MDC College Colleagues,

Welcome back! 

The Medical Center Campus will continue our Healthy College Newsletter this
year with our first issue focusing on vision care.

Protecting your sight is essential! Please review the important information and
Internet links in our first Healthy College Newsletter of 2007-08.

We welcome your comments and questions on each of our Newsletters.
In the meantime, please protect your vision!

Thank you.

Kathie

Why Vision Care?
Common Vision Problems
Signs and symptoms of
common vision problems
Opticianry Program/Vision Care Clinic
Vision Screening for children
Useful Resources

Common Vision Problems


Cataracts

A cataract is a clouding of the lens in the eye. The lens is a clear part of the eye that helps to focus images on the retina. The lens consists mostly of water and protein. When the protein clumps up, it clouds the lens and reduces the light that reaches the retina. The color of the lens changes from clear to a yellowish/brownish color. Gradually, the tinting of the lens increases, and this adds a brownish tint to your vision.

Risk factors for cataracts are age, diabetes, smoking, alcohol use, and prolonged exposure to ultraviolet light.

Glaucoma

Glaucoma is a group of diseases that can damage the eye's optic nerve (which connects the retina to the brain) and results in vision loss and blindness. In the front of the eye is a space called the anterior chamber. A clear fluid flows continuously in and out of the chamber and nourishes nearby tissues. The fluid leaves the chamber at something called the open angle. When the fluid reaches this angle, it flows through a spongy meshwork and then leaves the eye. Sometimes, when the fluid reaches the angle, it passes too slowly through the meshwork drain. As the fluid builds up, the pressure inside the eye rises to a level that may damage the optic nerve. This damage then results in vision loss. (There are also less common forms of glaucoma that develop without increased eye pressure). Some people have increased eye pressure without nerve damage. This means that they are at risk for the disease.

Although anyone can develop glaucoma, risk factors include African Americans over age 40, Mexican Americans over age 60, and people with a family history of glaucoma.

Macular Degeneration

Age-related Macular Degeneration (AMD) is a disease that blurs the sharp, central vision you need for "straight-ahead" activities such as reading, sewing, and driving. AMD affects the macula, the part of the eye that allows you to see fine detail, but causes no pain. This disease may lead to a loss of vision in both eyes. AMD is a leading cause of vision loss in Americans 60 years of age and older. AMD occurs in two forms: wet and dry, with dry being the most common. In dry AMD, the light-sensitive cells in the macula slowly break down, gradually blurring central vision in the affected eye.Wet AMD occurs when abnormal blood vessels behind the retina start to grow under the macula. These new blood vessels tend to be very fragile and often leak blood and fluid. The blood and fluid raise the macula from its normal place at the back of the eye. Damage to the macula occurs rapidly. With wet AMD, loss of central vision can occur quickly. Wet AMD is considered to be advanced AMD and is more severe than the dry form.

Risk factors for AMD include aging, smoking, obesity, Caucasians, family history, and women.

Signs and Symptoms of Common Vision Problems

The signs and symptoms of Cataracts are diminishing or blurring vision (which is often described as a "fog"), seeing double, seeing a halo around lights, seeing brown spots in the visual field, and, surprisingly, being able to see clearly without your normal reading glasses (referred to as "second sight").

The signs and symptoms of Glaucoma vary depending on the type of glaucoma:

If you have chronic glaucoma (primary open-angle glaucoma), which is often referred to as "the silent thief of sight," you may have no warning signs that anything is wrong. By the time you notice it, permanent damage has already occurred.

If you have narrow-angle glaucoma (also called acute angle-closure glaucoma or acute closed-angle glaucoma), you may have sudden symptoms such as eye pain, headaches, haloes around lights, dilated pupils, vision loss, red eyes, nausea and vomiting. These signs may last for a few hours and then return again for another round. With each attack, you permanently lose part of your vision. Narrow-angle glaucoma is a medical emergency.

If the high pressure within the eye is not reduced within hours, it can permanently damage vision, and anyone who experiences this vision loss should immediately contact an ophthalmologist or go to a hospital emergency room.

If you have normal-tension glaucoma (also termed normal-pressure glaucoma, low-tension glaucoma or low-pressure glaucoma), you may not have any signs or symptoms.

If you have chronic narrow-angle glaucoma, you will not have any symptoms until vision loss occurs.

If you have congenital glaucoma (found in young children), it may be hard to spot because the children are too young to understand. One may notice the child may have a cloudy, white, hazy, enlarged or protruding eye.

If you have pigmentary glaucoma (which often exhibits no symptoms at all), you may notice some pain and blurry vision after exercise. If you experience vision loss following an eye injury, this could indicate secondary glaucoma.

The signs and symptoms of Age-Related Macular Degeneration are slow (or rarely, sudden) and painless and include seeing shadowy areas in your central vision or experiencing unusually fuzzy, blurry, or distorted vision. This usually becomes more apparent when viewing a chart of black lines arranged in a graph pattern.

School Vision Screening for children

Importance of vision screening:

“80% of what is learned is learned through vision.”
Any strain or stress created by a child’s vision diverts energy from the learning process to the effort the child makes to improve his vision. This can result in poor grades, reading problems, behavior problems and an attention deficit problem.

Fact: According to the Health Department of the City of New York, 80% of Kindergarten students who fail a vision screening never see an eye doctor. Conclusion: A vision screening is only as good as the follow-up care received.

Fact: According to the National Institute of Health, only two out of three children with vision problems are detected by the best vision screening.
Conclusion: The vision screening method used should be the best possible, or every student should have a comprehensive eye exam.

The Snellen chart test is commonly used in schools for vision screening. A Snellen eye chart is presented to the child at 20 feet. Vision is recorded by indicating the smallest letters seen and placing the number of the smallest letters seen under the distance at which the test is made, in the form of a fraction. The size of the letter is printed on the chart. One eye is covered. The child is asked to read the letters seen on the lowest line of letters he can read on the chart.

This technique is not 100% accurate in diagnosing all vision problems. Here are some signs and symptoms you can look for:

What to look for in a child with Myopia:

• Poor visual acuity
• Squinting when looking at a distance
• Sitting close to the TV
• Holding reading material very close to the face
• Holding the head up and back to force the eyelids to partially cover the pupil
  
  What to look for in a child with high Hyperopia:
  
• Depending on age and the amount of hyperopia, poor visual acuity
• Chronic red eye due to the constant accommodative effort
• Chronic tearing
• Burning
• Frontal headache located just above the brow
• Squinting
• Holding the head up and back

What to look for in a child with a high Exophoria:

• Difficulty in maintaining fixation of both eyes while reading
• The feeling of eye strain when doing a lot of close work
• Frequent episodes of diplopia when tired or emotionally upset
• Frequent headaches

What to look for in a child with a high Esophoria:

• Holds reading material too close
• Frequent headaches
• Usually a high achiever or “type A” personality

  What to look for in a child with a Hyperphoria:

• Frequent episodes of vertical diplopia
• Suppression of vision in the non-dominant eye
• Severe migraine type headaches
• Often a compensating head tilt

What to look for in a child with a Tropia:

• May be accommodative or due to paralysis or paresis of the extra-ocular muscles
• Lack of depth perception
• Suppression in the non-dominant eye
• Concern in cosmetics due to the appearance of the eyes
• Amblyopia (Inability to achieve 20/20 vision due to an unknown cause)

Useful Resources

Miami Dade College’s Libraries have a number of resources on vision care. In addition to the print and web sources recommended below, MDC’s Libraries maintain subscriptions to several online health databases that provide full text Medical Dictionaries, Medical Encyclopedias, and articles from reputable medical journals.
These databases can be accessed by connecting to the Libraries’ Homepage at http://www.mdc.edu/libraries/, clicking on “Find Articles” and entering your Borrower ID and PIN # from your MDCard.

The Macular Degeneration Sourcebook:
A Guide for Patients and Families
Bert Glaser and Lester A. Picker
http://www.linccweb.org/catalog?lib_code=flcc1600&index=BN&query=1886039534

Mayo Clinic on Vision and Eye Health
Helmut Beuttner, ed.
http://www.linccweb.org/catalog?lib_code=flcc1600&index=BN&query=1893005208

Recommended Websites

American Optometric Association:
provides information on eye conditions & concerns and a directory to locate an optometrist near you.
http://www.aoa.org/

All About Vision: provides comprehensive information on vision care.
Topics range from computer vision to sunglasses to vision problems & diseases. This site also provides a directory to locate an optometrist or LASIK surgeon near you.
http://www.allaboutvision.com/

Medlineplus: http://medlineplus.gov/ : includes a medical dictionary and medical encyclopedia. This site also provides multimedia tutorials on cataracts (Spanish version – cataratas); macular degeneration (Spanish version – degeneracion macular); glaucoma (Spanish version – glaucoma); and LASIK surgery (Spanish version – LASIK).

Information for this newsletter was taken from the following sources:

All About Vision. Eye problems and diseases. Retrieved June 2006 from http://www.allaboutvision.com/conditions/

MedlinePlus Medical Encyclopedia.
Vision problems. Retrieved June 2006 from http://www.nlm.nih.gov/medlineplus/ency/article/003029.htm

National Eye Institute. Diseases and disorders. Retrieved June 2006 from http://www.nei.nih.gov/health/

St. Luke’s Cataract & Laser Institute. Eye conditions: Glaucoma. Retrieved June 2006 from http://www.stlukeseye.com/Conditions/Glaucoma.asp

Weill Cornell Medical College. Signs and symptoms of potential eye problems. Retrieved June 2006 from http://www.med.cornell.edu

Wills Eye Hospital. Signs & symptoms. Retrieved June 2006 from http://www.willseye.org/patients/topics/symptoms/#adults

Wrong Diagnosis. Symptom: Eye symptoms. Retrieved June 2006 from http://www.wrongdiagnosis.com/sym/eye_symptoms.htm