Pink Eye (Conjunctivitis)

This article was provided by AllAboutVision.com.  Follow the links below for more information on eye health and vision correction.

Technically, pink eye is the acute, contagious form of conjunctivitis – inflammation of the clear mucous membrane that lines the inner surface of the eyelids and overlies the white front surface of the eye, or sclera. Bacterial infection causes the contagious form of conjunctivitis.

However, the term “pink eye” is often used to refer to any or all types of conjunctivitis, not just its acute, contagious form.

Signs and symptoms of pink eye

The hallmark sign of pink eye is a pink or reddish appearance to the eye due to inflammation and dilation of conjunctival blood vessels. Depending on the type of conjunctivitis, other signs and symptoms may include a yellow or green mucous discharge, watery eyes, itchy eyes, sensitivity to light and pain. 

How can you tell what type of pink eye you have? The way your eyes feel will provide some clues:

• Viral conjunctivitis usually causes excessive eye watering and a light discharge.
   
• Bacterial conjunctivitis often causes a thick, sticky discharge, sometimes greenish.
   
• Allergic conjunctivitis affects both eyes and causes itching and redness in the eyes and sometimes the nose, as well as excessive tearing.
   
• Giant papillary conjunctivitis (GPC) usually affects both eyes and causes contact lens intolerance, itching, a heavy discharge, tearing and red bumps on the underside of the eyelids.

To pinpoint the cause and then choose an appropriate treatment, your eye doctor will ask some questions, examine your eyes and possibly collect a sample on a swab to send out for analysis.

What causes pink eye?

Though pink eye can affect people of any age, it is especially common among preschoolers and school children because of the amount of bacteria transferred among children.

Conjunctivitis may also be triggered by a virus, an allergic reaction (to dust, pollen, smoke, fumes or chemicals) or, in the case of giant papillary conjunctivitis, a foreign body on the eye, typically a contact lens. Bacterial and viral infections elsewhere in the body may also induce conjunctivitis.

Treatment of pink eye

Avoidance. Your first line of defense is to avoid the cause of conjunctivitis, such as contaminated hand towels. Both viral and bacterial conjunctivitis, which can be caused by airborne sources, spread easily to others.

To avoid allergic conjunctivitis, keep windows and doors closed on days when the airborne pollen count is high. Dust and vacuum frequently to eliminate potential allergens in the home.

Stay in well-ventilated areas if you’re exposed to smoke, chemicals or fumes. If you do experience exposure to these substances, cold compresses over your closed eyes can be very soothing.

If you’ve developed giant papillary conjunctivitis, odds are that you’re a contact lens wearer. You’ll need to stop wearing your contact lenses, at least for a little while. Your eye doctor may also recommend that you switch to a different type of contact lens, to reduce the chance of the conjunctivitis coming back.

Medication. Unless there’s some special reason to do so, eye doctors don’t normally prescribe medication for viral conjunctivitis, because it usually clears up on its own within a few days. Your eye doctor might prescribe an astringent to keep your eyes clean, to prevent a bacterial infection from starting. Another common prescription is for artificial tears, to relieve dryness and discomfort.

Antibiotic eyedrops or ointments will alleviate most forms of bacterial conjunctivitis, while antibiotic tablets are used for certain infections that originate elsewhere in the body.

Antihistamine allergy pills or eyedrops will help control allergic conjunctivitis symptoms. In addition, artificial tears provide comfort, but they also protect the eye’s surface from allergens and dilute the allergens that are present in the tear film.

For giant papillary conjunctivitis, your doctor may prescribe eyedrops to reduce inflammation and itching.

Usually conjunctivitis is a minor eye infection. But sometimes it can develop into a more serious condition. See your eye doctor for a diagnosis before using any eye drops in your medicine cabinet from previous infections or eye problems.

Prevention tips

Because young children often are in close contact in day care centers and school rooms, it can be difficult to avoid the spread of bacteria causing pink eye. However, these tips can help concerned parents, day care workers and teachers reduce the possibility of a pink eye outbreak in institutional environments:

• Adults in school and day care centers should wash their hands frequently and encourage children to do the same. Soap should always be available for hand washing.
   
• Personal items, including hand towels, should never be shared at school or at home.
   
• Encourage children to use tissues and cover their mouths and noses when they sneeze or cough.
   
• Discourage eye rubbing and touching, to avoid spread of bacteria and viruses.
   
• For about three to five days, children (and adults) diagnosed with pink eye should avoid crowded conditions where the infection could easily spread.
     
• Use antiseptic and/or antibacterial solutions to clean and wipe surfaces that children or adults come in contact with, such as common toys, table tops, drinking fountains, sink/faucet handles, etc.

Article ©2009 Access Media Group LLC.  All rights reserved.  Reproduction other than for one-time personal use is strictly prohibited.

Children’s Vision FAQs

This article was provided by AllAboutVision.com.  Follow the links below for more information on eye health and vision correction.

Q: How often should children have their eyes examined?

A: According to the American Optometric Association (AOA), infants should have their first comprehensive eye exam at 6 months of age. After that, kids should have routine eye exams at age 3 and again at age 5 or 6 (just before they enter kindergarten or the first grade).

For school-aged children, the AOA recommends an eye exam every two years if no vision correction is needed. Children who need eyeglasses or contact lenses should be examined annually.

Q: My 5-year-old daughter just had a vision screening at school and she passed. Does she still need an eye exam?

A: Yes. School vision screenings are designed to detect gross vision problems. But kids can pass a screening at school and still have vision problems that can affect their learning and school performance. A comprehensive eye exam by an optometrist can detect vision problems a school screening may miss.  Also, a comprehensive eye exam includes an evaluation of your child’s eye health, which is not part of a school vision screening.  

Q: What is vision therapy?

A: Vision therapy (also called vision training) is an individualized program of eye exercises and other methods to correct vision problems other than nearsightedness, farsightedness and astigmatism. Problems treated with vision therapy include amblyopia (‘lazy eye”), eye movement and alignment problems, focusing problems, and certain visual-perceptual disorders. Vision therapy is usually performed in an optometrist’s office, but most treatment plans also include daily vision exercises to be performed at home.

Q: Can vision therapy cure learning disabilities?

A: No, vision therapy cannot correct learning disabilities. However, children with learning disabilities often have vision problems as well. Vision therapy can correct underlying vision problems that may be contributing to a child’s learning problems. 

Q: Our active 1-year-old boy needs glasses to correct his farsightedness and the tendency for his eyes to cross. But he pulls them off the second they go on. We’ve tried an elastic band, holding his arms, tape… He just struggles and cries. How do we get him to wear his glasses?

A: In most cases, it just takes awhile for a toddler to get used to the sensation of wearing glasses. So persistence is the key. Also, you may want to put his glasses on as soon as he wakes up – this will usually help him adapt to the glasses easier.

But it’s also a good idea to recheck the prescription and make sure his glasses were made correctly and are fitting properly. Today, there are many styles of frames for young children, including some that come with an integrated elastic band to help keep them comfortably on the child’s head. Bring your son and the eyewear to our office. Even if you didn’t purchase the glasses from us, we will be happy to give you our opinion about why your son is having a tough time wearing them and what you can do about it.

Q: Our 3-year-old daughter was just diagnosed with strabismus and amblyopia. What are the percentages of a cure at this age?

A: With proper treatment, the odds are very good. Many researchers believe the visual system can still develop better visual acuity up to about age 8 to 10. If your daughter’s eye turn (strabismus) is constant, it’s likely surgery will be necessary to straighten her eyes in order for her therapy for amblyopia (or “lazy eye”) to be successful. Strabismus surgery may be needed even if her eyes alternate in their misalignment. See a pediatric ophthalmologist who specializes in strabismus surgery for more information.

 Q: My daughter (age 10) is farsighted and has been wearing glasses since age two. We think she may have problems with depth perception. How can she be tested for this, and if there is a problem, can it be treated?

A: We can perform a very simple stereopsis test to determine if your daughter has normal depth perception. In this test, she wears “3-D glasses” and looks at a number of objects in a special book or on a chart across the room. If she has reduced stereopsis, a program of vision therapy may help improve her depth perception.

Q: We have an 11-year-old son who first became nearsighted when he was 7. Every year, his eyes get worse. Is there anything that can be done to prevent this?

A: Rigid gas permeable (GP) contact lenses may help. Research shows that, in many cases, fitting myopic youngsters with GP lenses may slow the progression of their nearsightedness. There’s also a special fitting technique with GP contacts called orthokeratology (or “ortho-k”) that can even reverse certain amounts of myopia. There is also research that suggests bifocals and/or reading glasses may slow down the progression of myopia in some children.

Q: My 7-year-old son’s teacher thinks he has “convergence insufficiency.” What is this, and what can I do about it?

A: Convergence insufficiency (CI) is a common learning-related vision problem where a person’s eyes don’t stay comfortably aligned when they are reading or doing close work. For reading and other close-up tasks, our eyes need to be pointed slightly inward (converged). A person with convergence insufficiency has a tough time doing this, which leads to eyestrain, headaches, fatigue, blurred vision and reading problems. Usually, a program of vision therapy can effectively treat CI and reduce or eliminate these problems. Sometimes, special reading glasses can also help.

Q: My son is 5 years old and has 20/40 vision in both eyes. Should I be concerned, or could this improve with time?

A: Usually, 5-year-olds can see 20/25 or better. But keep in mind that visual acuity testing is a subjective matter – during the test, your child is being asked to read smaller and smaller letters on a wall chart. Sometimes, kids give up at a certain line on the chart when they can actually read smaller letters. Other times, they may say they can’t read smaller letters because they want glasses. (Yes, this happens!) Also, if your son had his vision tested at a school screening (where there can be plenty of distractions), it’s a good idea to schedule a comprehensive eye exam to rule out nearsightedness, astigmatism or an eye health problem that may be keeping him from having better visual acuity.

 Q: My daughter has been diagnosed with refractive amblyopia due to severe farsightedness in one eye. She just got her glasses and the lens for her bad eye is much thicker than the other lens. She complains that the glasses make her dizzy and she refuses to wear them. Can anything be done about this?

A: In situations like this, where one eye needs a much stronger correction than the other, contact lenses are a better option. With glasses, the unequal lens powers cause an unequal magnification effect, so the two eyes form images in the brain that are different in size. This can cause nausea, dizziness because the brain may not be able to blend the two separate images into a single, three-dimensional one. And, of course, the glasses will be unattractive because one lens will be much thicker than the other.

Even if your child is quite young, she can probably handle contact lens wear. Contact lenses don’t cause the differences in image magnification that glasses do. Continuous wear lenses (worn day and night for up to 30 days, then discarded) or one-day disposable contact lenses may be good options.

Keep in mind that amblyopia is a condition where one eye doesn’t see as well as the other, even with the best possible correction lens in place. Simply wearing the contacts may not improve the vision in her weak eye. Usually a program of vision therapy will also be needed.

Article ©2009 Access Media Group LLC.  All rights reserved.  Reproduction other than for one-time personal use is strictly prohibited.

Amblyopia (Lazy Eye)

This article was provided by AllAboutVision.com.  Follow the links below for more information on eye health and vision correction.

Amblyopia, also known as “lazy eye,” is the lack of normal visual development in an eye, despite the eye being healthy. If left untreated, it can cause legal blindness in the affected eye. About 2% to 3% of the population is amblyopic.

Amblyopia signs and symptoms

Amblyopia generally starts at birth or during early childhood. Its symptoms often are noted by parents, caregivers or health-care professionals. If a child squints or completely closes one eye to see, he or she may have amblyopia. Other signs include overall poor visual acuity, eyestrain and headaches.

What causes amblyopia?

The most common cause of amblyopia is strabismus (intermittent or constant misalignment of the eyes).  Another common cause is a significant difference in the refractive errors (nearsightedness, farsightedness and/or astigmatism) in the two eyes. It’s important to correct amblyopia as early as possible, before the brain ignores vision in the affected eye.

Treatment of amblyopia

Amblyopic children can be treated with vision therapy (which often includes patching one eye), atropine eye drops, the correct prescription for nearsightedness or farsightedness or surgery.

Vision therapy exercises the eyes and helps both eyes work as a team. Vision therapy for someone with amblyopia forces the brain to use the amblyopic eye, thus restoring vision.

Sometimes the eye doctor or vision therapist will place a patch over the stronger eye to force the weaker eye to be used more. Patching may be required for several hours each day or even all day long, and may continue for weeks or months. If you have a lot of trouble with your child taking the patch off, you might consider a prosthetic contact lens that is specially designed to block vision in one eye but is colored to closely match the other eye.

In some children, atropine eye drops have been used to treat amblyopia instead of patching. One drop is placed in your child’s good eye each day (your eye doctor will instruct you). Atropine blurs vision in the good eye, which forces your child to use the eye with amblyopia more, to strengthen it. One advantage of this method of treatment is that it doesn’t require your constant vigilance to make sure your child wears an eye patch.

If your child has become amblyopic due to a strong uncorrected refractive error or a large difference between the refractive errors of their eyes, amblyopia can sometimes simply be treated by wearing eyeglasses or contact lenses full-time. In some cases, patching may be recommended along with the new glasses or contact lenses.

In cases when the amblyopia is caused by a large eye turn, strabismus surgery is usually required to straighten the eyes. The surgery corrects the muscle problem that causes strabismus so the eyes can focus together and see properly.

Amblyopia will not go away on its own, and untreated amblyopia can lead to permanent visual problems and poor depth perception. If your child has amblyopia and the stronger eye develops disease or is injured later in life, the result will be poor vision through the amblyopic eye. To prevent this and to give your child the best vision possible, amblyopia should be treated early on.

If amblyopia is detected and aggressively treated before the age of 8 or 9, in many cases the weak eye will be able to develop 20/20 vision.

Article ©2009 Access Media Group LLC.  All rights reserved.  Reproduction other than for one-time personal use is strictly prohibited.