Eye care tips for you and your family

• Cataracts: the hardening and clouding of the lens of the eye, occurring most commonly as a result of aging. Other causes are eye injuries, diabetes and some medications.

Cataracts are painless. Early signs are blurring and clouding of vision, double vision in one eye, and sensitivity to light and glare. Another sign may be acquiring glasses of increased prescription strength, but finding they don't help improve your vision. Surgery is the only effective remedy. An ophthalmologist will examine your eye and measure it for an artificial lens that will be implanted during surgery. More than 95 per cent of people say they have better vision after surgery.

The risk of a serious adverse effect after cataract surgery is one in a thousand or better, says Lloyd. The most common complication is swelling of the retina, called cystoid macular edema. This significantly prolongs recovery time, increasing it from a few days to a few weeks. The swelling can be treated with eyedrops.

• Age-related macular degeneration (AMD): the most common cause of severe vision loss. AMD is a disease of the macula, the central part of the retina, that results in blurry central vision and an inability to see fine details and colours. There are two types.

In dry AMD, the macula becomes distorted, coloured or thinned. Vision loss is gradual and almost unnoticeable (which makes it difficult to identify in the beginning) and leads, eventually, to severe vision loss. You can delay the onset of dry AMD by taking a special combination vitamin/mineral supplement, available from pharmacies.

Wet AMD is more severe; abnormal blood vessels develop and leak fluid into the retina. Severe vision loss can be sudden. Wet AMD can sometimes be detected in an exam before symptoms develop, but not always.

Lucentis (ranibizumab), a drug recently approved for use in Canada to treat wet AMD, is injected directly into the eye. It is often given monthly for a time, then the injections may be spaced at longer intervals. "It inhibits the leakage and formation of the abnormal blood vessels that are growing and bleeding. It is a breakthrough," says Lloyd, who notes that this is the first time we have a drug that can both halt the bleeding and improve the vision of some patients. Possible adverse effects include diarrhea, headache, nausea, flu-like symptoms, eye irritation and dry eye.

Laser surgery
Laser refractive surgery, such as LASIK, can be performed on adults of all ages who wish to correct hyperopia (farsightedness), myopia (nearsightedness) or astigmatism (a condition that prevents the eye from focusing correctly).

The procedure is fairly painless, can be performed without a hospital stay and is low risk. As with any surgery, however, there can be complications; in this case, painful dry eyes, blurred or double vision, or seeing a permanent glare and halos around objects. About 10 per cent of patients will need a second surgery.

Not everyone is a good candidate for the surgery, says Dr. John Lloyd, a staff ophthalmologist at Sunnybrook Health Sciences Centre in Toronto. A cornea may be too thin or too irregular or may require a strong corrective prescription.

Laser surgery also will not stop or correct the natural aging process of the eye, which can lead to presbyopia or cataracts.

Laser surgery is not recommended for those under age 20, because the condition of the eyes has yet to stabilize.

Page 4 of 5 – eye protection tips on the next page.