This is probably the most common medical condition seen by the optometrist and ophthalmologist. Simply put, dry eyes are when the body cannot keep up with the demand for tear production and unwanted symptoms of burning, blurry vision or even watery eyes results. Tears are quite complex and a deficit in any of the three components can cause problems. Reading and computer work exacerbate dry eye symptoms because when our eyes turn in to look at something up close (converge), we automatically blink less, allowing the tears to evaporate more. Treatment protocols vary with the type of dry eye. It can be as easy as supplementing tears with lubricating drops to as complex as creating an individualized therapy from the patient’s own blood serum. It sounds trivial, but dry eye is responsible for real and sometimes miserable symptoms that can even limit work hours.

Right behind the colored part of the eye, the iris, hidden from view, is the lens. It is a flexible, clear structure about the size and shape of an M&M that changes shape and allows the eye to focus up close. As we age, it gets firm, eventually resulting in the need for reading glasses. As this process continues the lens can become milky and irregular. This is called a cataract. Everyone eventually gets them, but advanced cataracts scatter the light so that it doesn’t focus properly on the retina, even with proper glasses. Cataracts are removed when one or more of a patient’s activities of daily living are compromised due to blurry vision. These can include difficulty reading or challenges driving, especially at night.

The retina is a thin layer that lines the back inside of the eye. It is what perceives light, dark and color. The area of the retina that corresponds to our sharp center vision is called the macula. In some people, the chemical process that happens to create vision results in an accumulation of bi-products called drusen. They sit on the deepest layer of the retina and in small numbers, can be of no consequence to vision. Patients with early macular degeneration can have 20/20 or better vision. This is frequently called dry macular degeneration.

In some patients, certainly the minority with macular degeneration, the drusen create small imperfections in the deepest layer of the retina allowing blood vessels from underneath to grow through. This can cause distortion, but more ominously, the body doesn’t recognize it as normal and will try to stop it with scarring. Unfortunately that process destroys the retina in that area and causes central vision loss. This can be stopped in many cases with early detection and proper treatment. This is referred to as wet macular degeneration.

In the United States, diabetic eye disease is the leading cause of blindness in patients under age 65. Patients who suffer from diabetes have too much sugar (glucose) in their blood. In and of it self that’s not much of a problem. It’s that glucose competes with oxygen on red blood cells. By giving up oxygen seats on the bus to carry glucose if you will, the blood is less efficient at delivering oxygen to the areas where it is needed. Areas with many small blood vessels (capillaries) like the extremities, kidneys and eyes are especially susceptible to not receiving enough oxygen. The body naturally tries to compensate, but as with macular degeneration, it doesn’t recognize what it has done as normal and tries to stop it by creating scar tissue. This can reek havoc on vision.

Fortunately early detection through regularly scheduled dilated eye examinations by your eye doctor, either optometrist or ophthalmologist, vision loss from diabetes is largely preventable.