Eyes and Vision

Can I do anything to reduce the risk of glaucoma?

DEAR DOCTOR K: My mother has open-angle glaucoma. This increases my risk for glaucoma. Can I do anything to reduce that risk?

DEAR READER: You're right to think that your risk is increased. Because your mother has the condition, your chance of getting it is at least double that of most people you know. That doesn't mean you definitely will get glaucoma; it just means you inherit a risk, and therefore need to be particularly careful.

How can we protect our eyes from the sun?

DEAR DOCTOR K: Does spending time in the sun pose a threat to our eyes? What can we do to protect ourselves?

DEAR READER: Yes, it does. And to a large extent, the damage may already be done. I spoke to Dr. Louis Pasquale, an ophthalmologist at Harvard-affiliated Massachusetts Eye and Ear Infirmary. He noted that spending a lot of time in the sun without sunglasses when you're young may put you at risk for developing eye problems when you're older. The damage would probably be done in your 20s and 30s.

Can you describe the complications of cataract surgery?

DEAR DOCTOR K: I am having cataract surgery in a few weeks. Can you describe the possible complications?

DEAR READER: A cataract is a clouding of the normally clear lens of the eye. As the condition worsens, you may experience blurred or dim vision, increased glare, double vision, nearsightedness and worsening night vision. Surgery is the only effective cure. During cataract surgery, the doctor removes the clouded lens and replaces it with a clear artificial lens. (I've put an illustration of the procedure at the end of this post.)

Are dark circles and under eye bags caused by lack of sleep?

DEAR DOCTOR K: I have dark circles and bags under my eyes. Does this mean I'm not getting enough sleep?

DEAR READER: Lack of sleep probably has nothing to do with the dark circles and bags under your eyes. In fact, getting too much sleep is more likely than too little to cause this appearance. That's because when you're sitting or standing up, gravity tends to pull excess fluid in your body downward toward and into your belly and legs.

What can I do to continue driving safely at night?

DEAR DOCTOR K: I am in my 60s. Over the last few years, my night vision has gotten worse, and I'm finding it increasingly difficult to drive at night. What can I do to continue driving safely after dark?

DEAR READER: Night vision does start to decline as we get older, usually after age 50. Perhaps you've noticed more difficulty seeing in dim light, or maybe you're more bothered by the glare from headlights. Problems with night vision are the result of several changes to the eye that occur with aging. The first change involves the iris and pupil. As we age, the iris muscle weakens and becomes less responsive.

How do you put in eye drops?

DEAR DOCTOR K: I have dry eye syndrome. My doctor prescribed artificial tears, but I can't manage to get the drops into my eyes. Any advice?

DEAR READER: Dry eye syndrome occurs when your body doesn't produce enough tears. Tears moisten, protect and cleanse our eyes. Without enough tears, your eyes may burn, itch, or feel like there is something gritty in them. Dry eye syndrome can also increase your sensitivity to light and cause excessive tears. Dry eye syndrome is often effectively treated with artificial tears. Available over the counter, they mimic the composition of natural tears. Of course, they work only if you can get them into your eyes. Like you, many people need to learn how to do it.

Can you tell me more about blepharitis?

DEAR DOCTOR K: I had some itching and burning in my eye. My ophthalmologist said I have blepharitis. Can you tell me more about this condition?

DEAR READER: Blepharitis is an inflammation of the edges of the eyelids and eyelash hair follicles. It is a common and sometimes long-lasting condition. The good news is that it will not permanently damage your eyesight. Blepharitis can be triggered by bacterial infections, though it is not contagious. You can also develop blepharitis if your eyelid glands make too much oil. People with skin conditions such as rosacea, seborrhea, oily skin, dandruff or dry eyes are more likely to get this condition.

Why is it harder for our eyes to focus on close objects as we get older?

DEAR DOCTOR K: Why does it become harder for our eyes to focus on close objects as we get older?

DEAR READER: The eye is like a camera: It has a lens that continuously focuses to sharpen the picture. As light rays enter the eye, the flexible lens alters its shape, allowing the eye to focus on objects at varying distances. The lens focuses light rays on the retina, the light-sensitive layer at the rear of the eye. As we age, the lens of the eye becomes increasingly inflexible. As a result, light rays focus behind the retina, rather than on it. This is called presbyopia. (Below, I've put an illustration of how the lens focuses light rays in a normal eye and in a presbyopic eye.)

What is endophthalmitis?

DEAR DOCTOR K: A few weeks after my cataract surgery, my eye began to hurt and my eyelid became swollen. My doctor said I have "endophthalmitis." What is this? Is it related to my cataract surgery?

DEAR READER: Endophthalmitis is inflammation inside the eye that is usually triggered by an infection. In the United States, most cases are caused by bacterial infections that develop after eye surgery. Endophthalmitis is a serious problem that can lead to permanent loss of vision.

My eyes are affected the most by allergies, what can I do for relief?

DEAR DOCTOR K: I have allergies, and my eyes are affected the most. They're puffy, red and itchy. What can I do?

DEAR READER: Pollens, animal dander, dust mites and mold: The same allergens that cause sneezing and an itchy nose and throat can trigger allergy symptoms that affect your eyes, too. If your eyes are red and itchy, you may also have tearing, mucous discharge and swelling of your conjunctiva (the inside of your eyelid). This constellation of symptoms is known as allergic conjunctivitis. It can be uncomfortable, but it is not a threat to vision.