An ocular migraine differs then from the usual migraine headache from which many people (mostly women) suffer, in that it does not have the throbbing pain and associated nausea, nor does it last for up to three days or even longer.

Conventional migraine sufferers do also suffer from ocular migraines in which case it’s given the descriptive name “aura”.

Causes

It’s pretty well certain that hereditary factors play a part in the occurrence of both ocular and conventional migraines, and surveys of twins has gone a long way in confirming the role of genetics.

Symptoms

After one or two initial disturbances a sufferer gets used to what is going to happen, and might even be waiting for it if particular circumstances usually precede it. These circumstances could be periods of stress or tiredness, even a desire for foods (chocolate springs to mind).

Symptoms experienced vary according to the person but mainly involve a blind spot that gradually gets larger, with jagged lines and flashes around it.

Occasionally other symptoms of feeling weak (not surprisingly), facial tingling and minor speech difficulty are experienced during a disturbance.

Treatment

Since an ocular migraine is harmless and sorts itself out in around half an hour, there seems to be no reason to physically treat a particular episode, other than taking time out for it to pass.

If one occurs when working at a computer, take a break and relax somewhere; and if driving then pull over and again relax. If the car is too hot, get out and sit if possible in some shade, and don’t resume driving until well past the recovery phase.

An ophthalmologist, after a full examination, might prescribe aspirin or a blood pressure reducing drug.

Prevention

The usual suspects that trigger migraine episodes – coffee, alcohol and the sweeteners used in cola type drinks – don’t seem to have the effects with respect to ocular migraine.

Some foods, or more importantly what’s in them, may be the source of triggers, so a good idea is to keep an accurate record in a diary of everything swallowed – solids, liquids, even taste tested – along with times and dates of the migraines.

It may well be that there is a delay in the body reacting to certain foods so the diary really helps in doing the detective work to catch the culprits – and if trying to lose a bit of weight is going to make you own up to why you might be failing!

Finally, although painless and of short duration, the frequency and severity of ocular migraine disturbances might warrant a visit to an optometrist or ophthalmologist, just in case there is something that needs checking out – better to be safe that sorry!

The two are relatively interchangeable, especially in the media, but the two terms do have different connotations.

A disease is something that destroys or damages a part of the body, whereas a disorder is something that does NOT necessarily do that. Disorder implies that something is “not in order” or different from what is considered normal and it’s often used when a condition has no known causes or cure.

So for example conjunctivitis is a disease that affects the eye, whereas myopia is a disorder in that sight is not considered to be standard or average.

Allergic Conjunctivitis

Symptoms of pink eye, watery eyes, as well as itchiness cause by a reaction to: 

• materials such as fur, fabric softener on clothes
• seasonal events from pollen and grass cutting as in hay fever.

Not contagious and can be treated effectively with antihistamines.

Astigmatism

A disorder of both the cornea and the lens of the eye, astigmatism affects some 25% of people, with light from objects not being correctly focussed on to the retina.

People with astigmatism, which is not easily detected, especially in younger children, may not see both distant nor near objects.

Bacterial Conjunctivitis

Symptoms are pink eye, watery eyes, itchiness and occasionally pus. It is highly contagious but readily treated with antibiotics.

It can easily be contracted from touching others infected, as well as surfaces and by sharing items such as face cloths and towels.

Blepharitis

Blepharitis is an inflammatory eyelid infection, often with dandruff like flaking, and can affect people of all ages. It can appear outside the eyelid or on the underside.

The main cause is infectious bacteria on the eyelids, also allergies and dust mites. There is no real cure, but management through disciplined eye cleanliness is effective.

Cataract

Cataracts are simply part of growing old!

It is the formation of a cloudy area in the eye lens, which slowly affects vision and requires more frequent visits to the optical dispenser for a new prescription, and any cataracts will be diagnosed during visits.

Although not very often needed, cataract surgery is very successful

Chalazion

A chalazion is similar to a stye in that it is a small red bump on the eye, but it’s not infectious.

Caused by the tear glands not working properly or becoming blocked, a chalazion will clear up with home treatment and only rarely needs minor surgery. If they become too regular then some sort of serious hygiene regime needs implementing.

Colour Blindness

A term that does not really describe the disorder – people aren’t blind in any way – they simple can’t distinguish between colours, especially reds and greens.

It’s inherited and there’s not much that can be done about it – except for educating the general public about how to use colour in everything from school books to the internet to make it easier for those with “Defective Colour Vision”.

Conjunctivitis

Is a general term to describe a family of diseases with symptoms of pink eye, watery and itchy eyes.

The diseases can be infectious as in the bacterial or viral types or reactive as in the case of an allergic type.

Dry Eyes

Just about everyone gets dry eyes now and again, but persistent dry eyes may be a symptom of something more.

Environment is a main cause, with people staring at computers for too long without blinking; the eye needs to blink every 3 seconds. Air-conditioning, especially noticeable in aircraft is another culprit.

Prevention by following an eye exercise regime is best, but over the counter eye drops provide a remedy.

Eye Strain

You know you are suffering from eye strain when your eyes are dry and itchy.

And you know why you are – too much time staring at a computer screen without blinking enough to lubricate the eyes.  Try the 20-20-20 exercise of every 20 minutes looking away for 20 seconds at something 20 feet (6 metres).

Eye strain could of course be due to eye focus problems, so book an eye examination.

Floaters

Floaters is a very descriptive term for the condition where small shadows or wisps may be seen gradually floating across the line of vision, especially when looking at a light background – but they do not exist!

The gel in the eyeball may in time become watery and small pieces of gel cast a shadow on the retina, so an image is sent to the brain.

Floaters are not anything to be concerned about, most people have them. Do become concerned however if multiple floaters suddenly happen, then seek medical attention.

Giant Papillary Conjunctivitis

A reactive type of conjunctivitis that is not infectious. It describes particularly the inflammation that results from a foreign body in the eye. In recent years with the advent of disposable contact lenses, any inflammation caused by their use – being a foreign body – is now called GPB to the extent that it is now almost the sole meaning

Hyperopia

This is the medical name for being farsighted or having farsightedness.

That of course is not a disorder – but not being able to see near things clearly and distinctly is. Children often have hyperopia, sometimes only detected when they can see a distant screen but can’t see the detail in a picture book.

Prescribed eyeglasses, contact lenses or laser surgery are treatment options.

Iritis

Iritis is an inflammation of the iris, the coloured part of the eye, and is one of the uveitis family, and is denoted as “anterior uveitis”.

There is no cure at the moment, but episodes of inflammation can be dealt with quite satisfactorily and further complications avoided using eye drops.

Itchy Eyes

Symptoms that are found in many eye disorders such eye strain from too much computer work, and with diseases such as conjunctivitis.

Keratoconus

This is an unusual (1 in 1000 people) degenerative disorder where the curved surface of the cornea changes to more of a cone shape. Since the cornea accounts for two thirds of the focussing power of the eye, vision is obviously affected.

Mainly genetic it’s thought, spectacles are the first line of treatment, but rigid gas permeable contact lenses are now being used to effect.

Myopia

Common expressions for having Myopia are being “nearsighted” or “short-sighted”.

It can be detected in children when they can read well but can’t distinguish distant objects. A good idea is to check a child’s ability to see road signs at a distance.

Treatment is usually eyeglasses, since prescriptions change sometimes.

Ocular Migraine

Unlike a migraine headache, an ocular migraine is painless and last up to thirty minutes. The symptoms are flashes of light and blurred or slight lack of vision.

The migraine connection in the name probably comes from the fact that conventional migraine sufferers also suffer from ocular migraines, in which case however the term “aura” is used.

Pink Eye

A general term used for a conjunctivitis, the main symptom of which is a blood red or so called “pink” eye.

Pink eye can be contagious, as with bacterial or viral conjunctivitis, or allergy related, and is usually accompanied by itchy and watery eyes, even a nasty discharge.

Presbyopia

Presbyopia is a disorder that creeps up on “old” people at forty or fifty when the lens of the eye undergoes changes and cannot be focussed to see small things in detail. Reading and especially computer work become increasingly difficult.

An eye examination by an optometrist and a visit to the optical dispenser will soon have the problem solved.

Pterygium

Pronounced “terr-idg-ee-um” with the p silent as in psychology, a pterygium is a growth that extends over the cornea of the eye, usually from the inner nose-side to the eye centre. 

The cause is well known and gives rise to the alternate common name “surfer’s eye”. Treatment is straightforward but prevention is easier – use good quality sunglasses with protective sides.

Puffy Eyes

Too much work in front of the computer, staying up too late and even staying in bed too long – all these things contribute to getting “puffy eyes”, which is swelling around the eyes, mainly the lower lids.

Puffy eyes van be symptomatic of quite a few inflammations and irritations, particularly conjunctivitis infections.

Retinal Detachment

A sudden occurrence of multiple floaters (imaginary dark specks or streaks that are not really there) could be a signal of retinal detachment, where the light sensitive layer at the back of the eye breaks away from the outer wall.

If medical attention is sought quickly it’s possible that the situation can be remedied with 85% success rate, but make sure there is not too much delay.

Strabismus

A disorder where the eyes do not line up correctly to point directly at something since the six muscles pulling the lenses into shape do not work together as a team. Also called “cross eyed”, the disorder often disappears in young children. It can be corrected by surgery.

Stye

Is a large blemish or sore spot on the eyelid where the lashes are – it turns red and extends along the eyelid, begins by bacteria infecting a small cut or skin damage.

Lack of eye cleanliness and hygiene, as well as lack of sleep and poor nutrition are considered to be causes. Although a stye looks like a spot on the face, do NOT burst or prick to drain it but if required leave that to an eye professional. Meanwhile use warm compresses and it will usually disappear.

Twitching Eye

Eye twitching is quite common and can usually be linked to one or more causes:

• Too much coffee, colas and alcohol – easily fixed.
• Tiredness from lack of sleep – easily fixed.
• Stress – not easily fixed!  It might be an idea to learn how better to deal with it than try and remove it.

Uveitis

Uveitis is an inflammation of the iris of the eye.

There are actually three types, with one – anterior uveitis – making up 90% of cases – and to complicate matters this type is given its own name Iritis, with optical professionals switching between the two names.

Causes are not known but treatment with corticosteroids seems to do the trick, provided it is diagnosed early without becoming chronic.

Viral Conjunctivitis

Symptoms are pink eye, watery eyes, itchiness and occasionally pus. It is highly contagious but because it is a viral infection it cannot be treated with antibiotics.

Watery Eyes

Watery eyes are symptoms that are found in many eye disorders such as eye strain from too much computer work, and with diseases such as conjunctivitis.

There are quite a few disorders and diseases regarding which watery eyes are a precursor such as blepharitis, ingrown eyelashes and blocked tear ducts to name a few.

The earliest form of Spectacles or Glasses were probably made by the Venetian glass blowers in the 14th century, who made optical lenses from glass and fitted them into horn rim frames.

It was only when the lenses were connected to arms hanging over the ears that the term “spectacles” came into being. The word spectacles seems to have crept in somewhere in the 18th Century, probably adapted from the latin words spectare – to observe, or specere – to look at. 

Whilst spectacles may be the historically correct terminology used to describe a pair of lenses resting on your nose, people invariably use “glasses” in everyday conversation – even the optical professionals.

The optometrist carrying out an eye test would say: “How long have you had your glasses?” whilst when organising manufacture and delivery dates might say: “When would you want to pick up your new glasses?”

But whilst the whole optical profession seems loathe using the somewhat old fashioned term “spectacles”, they have instead adopted the everyday vernacular of “specs”, to the extent of using it in business and shop names.

Developments in Eyewear

Whatever you call them – glasses, spectacles or specs – eyewear has come a long way from the rudimentary pair of glass lenses first invented.  Now they are resistant to scratching, covered in a non-reflective coating so that others can see a wearer’s eyes (and a wearer see their own eyes in a mirror), ultra lightweight and durable.

Advances in lens technology has meant that bifocal lines are out, and progressive multi-focal is in, so that  a wearer can move imperceptibly from close reading through to computer screen  activity and on to distance vision.

Innovations in manufacture mainly though automated processes of both lenses and support frames has meant that costs have been reduced to the extent that even allowing for inflation a pair of quality “specs” are great value considering how they can improve your most important sense – your vision.

And for the fashion and image conscious, the use of new materials for frames used by up and coming designers from the fashion clothing and accessory fields has given the eyewear customer a varied and up to the minute look. It’s no longer necessary to accept that just because glasses are needed to be worn that the wearer need not be in fashion.

Spectacles Still Beating the Opposition

The opposition being contact lenses and laser eye surgery. 

It’s not that the other vision solutions are not up to the mark – it’s just that spectacles have adapted to continue to have features that appeal to users – people still like to wear spectacles (or glasses if you prefer), and nowadays have more than one pair of the same prescription even to suit a mood or workplace or an outfit.

If you are the unfortunate person who has a stye, the people you meet and make eye contact with will unashamedly firstly inspect your blemished eye before pronouncing “What’s wrong with your eye?”

It would be nice to be able to reply that you’ve had some grit or dust get into your eye, but instead you have to own up to having a highly contagious eye infection caused by bacteria on the skin.

Whilst generally caused by staphylococcal bacteria that lays dormant ready to start infection near damaged or cut skin near the eye, a stye can erupt when a duct that leads from the oil producing glands becomes blocked and a type of pimple develops.

Styes can be external on the eyelid where the lashes grow or internal, underneath the eyelid but still eventually becoming visible and definitely unattractive.

Causes

Lack of hygiene especially with respect to face and eye cleanliness is a common cause of a stye, so no wonder you would become embarrassed at having one.

Other factors reputed to affect the propensity to develop styes are lack of sleep and poor nutrition – these two being seen as common factors in many eye disorders. Rubbing the eyes can easily turn a mild infection in to a more serious one leading to more than one stye, and in both eyes.

Being bacteria based, it’s important not to infect others, so sharing towels or face cloths is definitely out; and here you might think that no-one would do such a thing, but it’s a common occurrence at bath time if a few children are involved.

Symptoms

• Swelling of the eye and a  painful sensation when blinking
• Itching as if grit or dust were in the eye
• The formation of a pimple type small lump on the upper or lower eyelid
• Increased redness that slowly extends along the eyelid
• Watery eyes and maybe sensitivity to light and glare

• A head appearing on the infectious bump.

Treatment

Now you might have burst or pricked a pimple on your face or body before and lived to tell the tale, but do NOT attempt to do the same with a stye!

A simple inspection by your optometrist or ophthalmologist will determine whether or not you have a stye or the beginnings of something more serious.

If it is indeed a stye that you have, then all that may be recommended is that you apply a warm cloth for a few minutes on a regular basis. Sometimes a course of antibiotics may be prescribed especially if the stye has been around for a while or re-infection keeps occurring. Medication may be topical – ointment applied physically to the eyelid – or oral. Oral antibiotics are far more effective as they get to the source of the problem. Topical ointments might help in protecting other oil glands but they are relatively ineffective in treating the existing stye.

If all else fails, some minor surgery to lance the stye might be the way to go.

Preventing Styes

• Cleanliness is the key, so washing hands regularly and use of clean dry towels or hand driers.
• Keep fingers out of the eyes. If you do need to rub the eye areas then use a quality tissue.
• Cleaning eyelids with cotton buds and a mild dilution of baby shampoo is effective.
• Pay attention to nutrition – especially taking regular fish oil. Fish oil is very effective in all things about eyes.
• Women who wear makeup should remove makeup before bed and probably clear out old makeup – why not get a whole new kit?

Could the Stye be Something More Serious?

The stye could be the start of a chalazion, when a tear duct becomes blocked and swelling develops. It is not in fact serious but might take more effort to treat, and it’s not infectious so you need not feel embarrassed!

A difference between a stye and a chalazion is that usually a stye grows outwards from the eye whereas a chalazion grows inwards.

The lens of the eye helps focus the outside world on to an image on the retina at the rear of the eye, and if the lens focuses to a point before the surface of the retina, a blurred image is all that is seen if an object is far away, but distinctly if close up. One important consideration is that eyes can be healthy even though myopic.

Up to a third of people struggle with myopia, and one of the first instances of them becoming aware of this is when other people with them in a car can read approaching road signs well before them.

Objects and especially books that need close scrutiny are no problem to someone with myopia. If you have myopia the chances are you got it from one or both of your parents.

Symptoms

Myopia affects children in early school years up to teenage years, and an indication of its occurrence can be a child squinting to change blurred distant objects into clear ones.

It used to be said “Children with myopia can’t see the blackboard but can read a book” – now the modern version of that phrase is “Children with myopia can’t see an image from a data projector but can certainly see a laptop screen”.

Nearsightedness gets progressively more serious as a child grows, with new prescriptions for eyewear being required regularly until at the age of twenty or so some stability is attained.

Treatment

Treatment in the case of children or young adults is to ascertain by means of a thorough eye examination that it is only myopia that’s present – then it’s a case of thinking about glasses or “specs”. 

Contact lenses may be a considered option, but usually an optometrist will wait until the patient is older and lens prescriptions have stabilised, unless of course a sportsman or sportswoman is being treated, when contact lenses can be THE preferred option.

Younger sportspeople will happily wear glasses during normal activities and change to contact lenses only when playing sport – this has the advantage of reducing the possibility of adverse reactions and obviates the need to be disciplined in the hygiene required, especially when first starting out.

Laser surgery, whilst very effective and safe, is not contemplated by many people initially and they prefer to adopt a wait and see approach, also giving them more time to think about the cost.

Early Detection Essential

It’s important that myopia in a child is detected early as otherwise education is the big loser, along with self esteem. The modern looks of eyewear and their relatively low cost means that children no longer have to suffer the stigma that seemed to exist years ago with wearing glasses at school.

What About Prevention?

Myopia can’t be prevented, even by reducing the amount of television or computer time spent by children. Treatments by way of glasses or contact lenses only assist in aiding the wearer to deal with “being short-sighted”.

Affecting only one person in a thousand, the disorder can often be diagnosed in the teen years and reaches its maximum severity at around twenty or thirty. The ability to read and drive is often compromised if both eyes are influenced, but prescription glasses remedy the situation, and it’s good to know that prognosis does NOT include blindness. Continued management enables a sufferer to lead a normal life.

Symptoms

Early signs are nearsightedness, blurred vision and sensitivity to light and glare, particularly car headlights whilst driving. It’s difficult for an inexperienced optometrist to detect the early signs, developing slowly as it does, although too frequent changes in prescriptions for glasses could be an indicator. Another clue is that frequently one eye is much worse than the other, with a time lag extending as much as five years.

Once the disorder becomes advanced of course, diagnosis becomes easier, and there are specific items of equipment like the computerised corneal topographer available for an accurate diagnosis and its assessment of its severity.

Causes

Causes thought to bring onset of the condition include genetic influences, environmental conditions and cell mutations, but no-one is really sure.

Too much eye rubbing to alleviate symptoms from allergic reactions might be a factor, especially if the allergies are frequent as in hay fever, asthma and so on.

As far as hereditary influences go, there does seem to be some link to family member occurrences, with twins often showing the same incidences, indicating that the incidence of keratoconus is not entirely random. Studies seem to suggest that if an individual is diagnosed with keratoconus, the probability that another family member has the condition is around 8%.  In other words 92% of people with keratoconus do not know of any other family member that exhibits the condition.

Treatment

For a while an optometrist is able to prescribe suitable spectacles or soft contact lenses to assist vision, with the frequency of prescriptions possibly requiring frequent change.

Thereafter the patient may be able to benefit from wearing rigid gas permeable contact lenses which fit better over the cornea shape that is developing; however these can be more difficult to accept in terms of comfort. An expert optometrist that specialises in keratoconus is always the best eye professional to see to manage keratoconus. Their success rate in rigid contact lens fitting is as high as 95%.

The importance of seeing a contact lens specialist cannot be overstated for keratoconus, as ill fitting lenses can cause keratoconus to get worse and force the need for an invasive surgical procedure called corneal transplant.

What the Future Holds

Today optometrists and ophthalmologists are both more aware of the incidence of keratoconus and its detection and effective treatment.

A non-invasive procedure involving strengthening the cornea to stop it bulging can be carried out by first introducing eye drops containing the B2 vitamin to the eye and then using a complementary ultra violet A light source  for thirty minutes to activate chemicals that have the effect of strengthening the cornea.

Should the disorder progress too far for conventional optical remedies, corneal transplant surgery is an option, with a very high percentage success rate, albeit often requiring continued use of contact lenses.

An alternative to transplant surgery has been developed which involves implanting semi-circular rings to flatten the bulging curve of the cornea. These are called Intacs or Kera Rings. The procedure only requires day surgery and results in improved vision in up to 90% of those patients for whom the procedure is suitable. Intacs or Kera Rings must be used very carefully, as incorrectly chosen patients will be very disappointed with the results.

Recently another procedure called Keraflex seems to show promise. To date (2011) no procedures have been performed in Australia.