Several long-held beliefs were confirmed in a literature review by ophthalmologists and gerontologists from the United Kingdom.  While the cause and origination between cataracts and dementia are not the same, there are clear links between neurodegenerative disorders and visual impairment.

A multidisciplinary approach to treating cataracts with neurodegenerative disease has been identified as a result of the study.  The authors state that, because there is an overlap between dementia and visual symptoms, diagnosis of both disorders may be more difficult when the two disorders occur simultaneously.

Ophthalmology Management, Research Digest,  February 2011 p 18.

Cynthia Matossian, MD

Eye Floaters: An Overview

An “eye floater” is actually a “slang” term to describe tiny strings of internal matter “floating” within the eyeball. These appear in the visual field as hard-to-see web-like strands, wavy lines or strings.

Eye floaters are naturally-occurring within the eyeball. As we age, the gel inside the eyeball shrinks over time and tears away. These tiny, string-like strands appear in your field of vision as eye floaters.

In general, an eye floater is a mild nuisance more than anything else, a natural side effect of aging. However, significant amounts of eye floaters may indicate an injury to the eye, an infection or inflammation of the eye, even a partial or complete retinal detachment.

Persons who are extremely nearsighted have diabetes, or have had cataract surgery are also more likely to report eye floaters.

Eye Floater Symptoms:

Eye floaters appear as gauzy, web-like lines and shapes that seem to “float” across the field of vision. Move your eyeball, and an eye floater moves with it, often continuing to glide slightly when you stop your eyeball.

Eye floaters can be slightly annoying, especially when looking at bright fields of color. It’s important to remember that floaters actually occur inside the eyeball, though they may appear (visually) to be on the surface of the eye.

A sudden appearance of many eye floaters can signify a more serious underlying condition, such as an infection or inflammation. And if floaters appear suddenly along with light sensitivity, light flashes, or a loss in peripheral vision, you may have damage to your retina that requires immediate medical attention.

Eye Floater Treatment:

The most common eye floaters treatment is no treatment at all—people tend to adjust to their presence in the visual field and learn to virtually ignore them.

In some instances of serious clusters of floaters, surgery may be necessary though this is very rarely necessary.

Clayton Grinage, COE

Eye twitching, eyelid tics and spasms are pretty common.  Usually only the bottom lid of one eye is involved, but the top eyelid also can twitch.  Most eye twitches come and go, although they can last for weeks or even months.

Called myokymia in doctor lingo, these rippling muscle contractions in an eyelid can be triggered by:

• Stress
• Tiredness
• Eye strain
• Caffeine
• Alcohol
• Dry eyes
• Nutritional imbalances
• Allergies

Almost all sudden-onset eyelid twitching is benign, meaning the condition is not serious or a sign of a medical problem.  However, this kind of eye twitching also can be hard to treat.  The only option for making the twitching stop may be to figure out the cause and deal with it.

More serious forms of eyelid twitching are caused by neurological conditions such as blepharospasm or hemifacial spasm.  These conditions are much less common and should be diagnosed and treated by an eye doctor.

Clayton Grinage, COE

According to the January issue of Archives of Ophthalmology, approximately 6.5 percent of Americans age 40 and older have age related macular degeneration, AMD, a lower rate than was reported 15 years ago.

“Despite new medical and surgical interventions AMD remains an important cause of loss of vision in the United States,” the author wrote as background information in the article. 

A total of 7,081 individuals 40 or older were selected to participate and had photographs taken of both eyes.  The overall prevalence of AMD among adults age 40 and older was an estimated 6.5 percent, which represented a decrease from the 9.4 percent report reported in the 1988 to 1994   Third National Health and Nutritional Examination Survey (NHANESIII). 

“These estimates are consistent with a decreasing incidence of AMD reported in another population-based study and have important public health implications,” the authors concluded.  “The decreasing prevalence of AMD may reflect recent change in the frequency of smoking and other exposures such as diet, physical activity and blood pressure associated with AMD.  It remains to be seen whether public health programs designed to increase awareness of the relationships of these exposures to AMD in patients at risk and their physicians and eye care providers will continue to result in further decline of the prevalence of AMD in the population.”

Review News Volume XVIII, No.2, February 2011 pg. 6

Cynthia Matossian, MD

Think big.  Think curved.  Too much light around the frame edges can defeat the best sunglasses.  Curved lenses reduce the risk of a foreign body blowing into your eye.

Polarized lenses do the best job of reducing glare.  Anti-glare coatings are less effective and are harder to keep clean.

UV blocking capability provides added safety and offers some protection for macular degeneration and early cataract patients.

Tinting is highly personal and often reflects a fashion statement.  Neutral Gray gives the most realistic color rendition.  Blue Blocking tints add contrast.  Yellow adds transparency thru water.

The amount of tint depends on your individual sensitivity and your personal need to reduce the amount of light.  Do not let someone tell you how dark the tint should be.  Let them show you the various degree of tinting out of doors on a sunny day.

Michael E. Starrels MD