Prevention & Recovery

Your complete eye-care guide

By: Astrid van den Broek

Author: Canadian Living

Prevention & Recovery

Your complete eye-care guide

By: Astrid van den Broek
This story was originally titled "Vision Care Guide" in the November 2010 issue. Subscribe to Canadian Living today and never miss an issue!

Kristen Hamilton thought she needed better glasses. After her second child was born, the Greely, Ont., mom felt as if her glasses actually made it more difficult for her to see at night. And then came the headaches. Kristen went to see her ophthalmologist to get her eyes checked out. "He did tests and said, 'No wonder you are having problems [with your glasses] – your sight has improved significantly.' He told me that hormones can really affect your eyes during pregnancy, and I no longer needed glasses; my vision was almost perfect," says Kristen. "That was six years ago, and I haven't picked up a pair of glasses since I left his office."

Pregnancy is one of the many life changes and stages that can affect your sight and the overall health of your eyes. You can add family history, lifestyle factors (such as stress), diet, UV exposure, medication and even race to the list as well. But by making changes to improve your lifestyle, scheduling regular preventive checkups and prioritizing eye health, you and your family can have healthy peepers into your old age.

Young children
Newborns have their eyes checked after birth to rule out any eye conditions, such as a congenital cataract. But when should we start booking our babes for regular eye exams? "If your child isn't exhibiting any abnormality or there isn't a family history of eye problems, checkups usually begin around age two or three," says Dr. Rajiv Bindlish, an ophthalmologist in Oakville, Ont. "A family doctor or optometrist can do a screening to see if your child has any signs of amblyopia [lazy eye] or strabismus [when an eye turns inward or outward, sometimes called a cross-eye]. If this is the case, your family doctor can refer your child to an ophthalmologist or optometrist." While these conditions are not extremely common – one to five per cent of children have amblyopia and about five per cent have strabismus – if they're not detected early on, they can lead to serious visual consequences. If nothing unusual is found during the screening, most children can have their eyes checked every one to two years after that visit.

While it's a good idea to let your doctor know that Grandpa has glaucoma because it's part of your child's family history, at this stage doctors are more interested in whether anyone in the family had a lazy eye or cross-eye, or even if an older sibling or cousin began wearing glasses at a young age. Watch your child play or read, and let your doctor know what you've observed. "Look for whether her eyes turn in or out, whether she rubs her eyes a lot, or if she's sitting close to the TV or holding books close – things like that," says Dr. Carol Doman, an optometrist in Bedford, N.S.

Strabismus sometimes needs corrective surgery, while amblyopia might require a simple patching of the stronger eye to force the lazy eye to work harder. "Either way, you want to catch it at an early age, hopefully before your child starts school," says Doman.

Page 1 of 4 – Learn when to check your older child and teenager's vision on page 2.
Older kids and teens
By now you might have a budding A-Rod on your hands asking for contacts or laser surgery so his glasses won't mess up his ball game. Laser eye surgery isn't recommended until people are in their 20s (when vision prescriptions become stable), but contacts might be an option. Together you can determine whether he's responsible enough to care for contacts – including cleaning them, not wearing them too long and throwing them out on time, all measures that, if not followed properly, can lead to inflammation and sometimes permanent scarring.

If your child or teen isn't ready for this responsibility, Doman suggests daily disposable contacts. "I recommend these usually for kids – age 10 or older – because you wear them once and then throw them away each day," she says. Disposables, which are available to just about anyone needing vision help, come with a variety of timelines – from daily to biweekly to monthly.

At home, you might worry more about screen time and eye strain. Remember to take into account all the screens (TVs, hand-held video games, laptops) your kids are using, and watch for telltale signs of overuse, such as headaches or double vision. "There is something called computer vision syndrome, and that encompasses eye strain and dry eyes," says Doman. (Normally we blink about 12 times a minute, an act that helps keep our eyeballs lubricated. When we're looking at a screen, it's less than half that often.) Encourage your child to step away from the screen every 20 minutes. The Canadian Paediatric Society recommends no more than two hours a day of screen time for children.

Your 20s and 30s
Healthy living for optimal eye health includes not smoking, eating a diet packed with antioxidant-rich fruits and veggies (such as oranges and carrots), exercising regularly and protecting your eyes from sunlight with UV protective glasses.

Let your doctor know about relevant family history, such as glaucoma, macular degeneration, cataracts, diabetes and even your parents' ethnic backgrounds. A 2010 study supported by the National Eye Institute in the United States showed that Latinos have higher rates of visual impairment, blindness, diabetic eye disease and cataracts than Caucasians. African-Canadians "tend to [have] glaucoma at a younger age," says Bindlish, "and Caucasians have slightly higher incidents of macular degeneration, [occurring] more in their 50s and 60s."

And then there's pregnancy. Like many things with pregnancy, your eyesight may or may not be affected. Sometimes myopia, or nearsightedness, can progress, and then return to premyopic levels after birth. Keep in mind, though, that while your eyesight may change while you are pregnant or nursing, it may also revert to its original status after your child is born. "When a woman is pregnant, we often won't do any laser corrective surgery or change a prescription," says Bindlish.

During those 40 weeks, let your health-care provider know of any significant symptom changes (sudden headaches, blurriness, pain in the eye area). And if you haven't already stopped smoking, consider this: The more a pregnant woman smokes, the higher the chance of her child developing strabismus, according to a 2010 study of 1,300 babies with strabismus in Denmark.

Page 2 of 4 – Discover the early symptoms of cataracts, as well as treatment options available on page 3.
Your 40s and 50s
We see you there, holding your menu at arm's length. "People commonly notice that reading starts getting difficult [when they're] in this age group. It's called presbyopia; you're holding books farther away," says Dr. Darana Yuen, an ophthalmologist and glaucoma specialist in Toronto. Reading glasses or bifocals (glasses with two lenses inside to help you view things both up close and from afar) might be in order. It's something to address at your biannual checkup.

Is laser surgery an option? "You could have it to fix your distance vision, but reading up close may become an issue again by your mid-40s," says Doman. Instead, consider contact lenses. You can try multifocal or bifocal contact lenses, which allow you to see both at a distance and up close.

You may also notice some clouding in your eyesight, which could indicate a cataract (although cataracts are mostly found in people over 55, they can develop as early as 30). While wearing UV-blocking sunglasses does help (UV rays fuel cataracts), you may need cataract surgery down the road. "It involves an incision that's very small and the procedure takes only 10 to 30 minutes," says Yuen. Yuen also notes that Type 2 diabetes can have a big impact on your eyes, leading to fluctuation in vision quality and the development of cataracts, glaucoma and even retinal detachment. Though there may be no vision-related symptoms of diabetes early on, in the advanced stage, permanent and irreversible loss of sight can occur.

Your 60s – and beyond
This is when most people have surgery for cataracts. Glaucoma – dubbed the silent thief because it has virtually no symptoms and is one of the leading causes of blindness in Canada – may become an issue at this age; it is caused by damage to the optic nerve, which leads to vision loss. "Advancing age is a major risk factor, along with family history [of the disease]," says Yuen.

Page 3 of 4 – Should you see an ophthalmologist or optometrist? Find out on page 4.
Your eye specialist can test you for glaucoma with an intraocular pressure test. Yuen adds that research is examining the effect that postural changes have on the intraocular pressure in your eyes, which is good news for people who are susceptible to the condition.

"We're also looking at a wireless contact lens sensor to measure eye pressure," says Yuen. These contacts, which have small sensors embedded into the lenses, are worn by the patient throughout a day and can detect pressure changes throughout the day, rather than just during the test in the physician's office. "It's like a monitor for your heart, so we can tell what the pressure has been like during the day." Drops are most often prescribed to relieve eye pressure, but glaucoma surgery is also an option to talk about with your doctor.

Macular degeneration, which triggers blurring in the centre of your vision while leaving your peripheral vision intact, is another eye problem largely associated with aging. There are two types of degeneration: dry, which is the most common, and wet, which is caused by leaky blood vessels in the back of the eye.

"A new treatment for wet macular degeneration is an injection, Lucentis," says Doman. "It's a prescription medication injected into the eye that can stop the progress of the degeneration and somewhat improve vision."

Studies are also examining the role of lifestyle in age-related macular degeneration. One study, from the National Eye Institute, suggests that regulating your levels of "good" cholesterol (HDL) can affect macular degeneration.

Ultimately, eye specialists say that sharing information is one of the best ways to arm yourself against eye conditions that may develop as you age. "It's important to be screened and be aware of your family history," says Bindlish. "If you bring to your doctor's attention that glaucoma or diabetes runs in your family, your doctor will look more carefully for subtle signs that might be an early tip-off to a disease."

Ophthalmologist versus optometrist: What's the difference?
While the two professions are often confused, an ophthalmologist is a licensed physician who has completed medical school and can perform surgery and other eye-related medical needs. An optometrist, however, is trained in eye care and can examine vision, and diagnose and prescribe eyeglasses, lenses and other treatments. Optometrists are not medical doctors.

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Prevention & Recovery

Your complete eye-care guide