Food for Health
Food for Health
Improve Vision
Wellness Goals

Improve Vision

Explore the available health information, treatment context, and integrative evidence for Improve Vision.

Background
  • Any condition affecting the eye is classified as an eye disorder. Eye disorders can affect any part of the eye, including the eyelids, eyelashes, iris, pupil, lens, and the sclera (the "white" of the eye). Nerves, muscles, and blood vessels that surround the eye can also be affected by eye disorders.
  • Eye disorders may include any of the following: vision problems, including astigmatism (vision difficulties due to a football-shaped cornea), diabetic retinopathy, myopia (nearsightedness), or hyperopia (farsightedness); conjunctivitis (inflammation of the conjunctiva); uveitis (inflammation of the uvea); keratitis (inflammation of the cornea); xerophthalmia (dry eye); glaucoma (an increase in intraocular pressure); age-related macular degeneration; and cataract (an opacity that develops in the crystalline lens of the eye). Some of these conditions, such as astigmatism myopia, glaucoma, macular degeneration, cataracts, and retinitis pigmentosa, have been linked to genetic abnormalities. Treatment and prognosis varies, depending on the specific condition.
  • Please see individual Natural Standard condition monographs on glaucoma, cataracts, retinopathy, and macular degeneration for more information on these eye disorders.
Signs and Symptoms
  • Vision problems: Symptoms of vision problems include vision loss, altered eye movements, eye pain, visual field loss, bulging eyes, double vision, and headaches. Eye symptoms may involve changes in vision, changes in the appearance of the eye, or an abnormal sensation in the eye. Eye symptoms typically develop as a result of a problem in the eye but occasionally indicate a problem elsewhere in the body.
  • Conjunctivitis: The most common signs and symptoms of conjunctivitis include redness in one or both eyes and itchiness in one or both eyes. Other common symptoms include blurred vision and sensitivity to light, a gritty feeling in one or both eyes, a discharge in one or both eyes that forms a crust during the night; and tearing.
  • Uveitis: Symptoms include light sensitivity, blurring of vision, pain, and redness of the eye. Uveitis may come on suddenly with redness and pain, or it may be slow in onset with little pain or redness, but with gradual blurring of vision.
  • Xerophthalmia (dry eye): Symptoms of dry eye range form mild irritation and foreign body sensation to severe discomfort with sensitivity to light.
  • Keratitis: Keratitis usually makes the eyes very painful and watery, bloodshot, and sensitive to light. The condition is often accompanied by blurred or hazy vision. If the herpes simplex virus is the cause, the individual will notice a small white spot on the cornea.
  • Corneal abrasion: A corneal abrasion should be suspected if the individual has sustained an injury to the eye. Some of the symptoms experienced may include: a sensation of a foreign body in the eye (this feeling sometimes develops a few hours later rather than immediately after the apparent injury); tearing of the eyes; blurred vision or distortion of vision; eye pain when exposed to a bright light; and spasm of the muscles surrounding the eye causing the individual to squint.
  • Retinitis pigmentosa: Each individual with retinitis pigmentosa may experience symptoms differently, depending upon the severity and progression of the condition. Some individuals with retinitis pigmentosa experience a slow, very progressive loss of vision, while others lose their visual ability much more quickly and severely. Other common symptoms may include: difficulty seeing in poor light (such as at dusk or in a dimly lit area) or in the dark; a diminished visual field, either central vision (a condition called macular dystrophy) or peripheral vision (sometimes referred to as tunnel vision); difficulty reading print (with a loss of central vision); difficulty deciphering detailed images (with a loss of central vision); difficulty with stumbling or tripping over objects not seen; clumsiness (with a loss of peripheral vision); and glare. The symptoms of retinitis pigmentosa may resemble other eye diseases, such as glaucoma.
Diagnosis
  • A person who experiences eye symptoms should be checked by a doctor. However, some eye diseases cause few or no symptoms in their early stages, so the eyes should be checked regularly (every 1-2 years or more frequently if there is an eye condition). Healthcare professionals that deal with eye disorders include: opticians - they dispense glasses and do not diagnose eye problems and optometrists - they perform eye exams and may diagnose eye problems. Optometrists may prescribe glasses and contact lenses. In some states, they prescribe eye drops to treat diseases. Ophthalmologists are medical doctors who diagnose and treat diseases that affect the eyes. Ophthalmologists may also provide routine vision care services, such as prescribing glasses and contact lenses.
  • An individual with eye or vision problems describes the location and duration of the symptoms, and then the doctor examines the eye, the area around it, and possibly other parts of the body, depending on the suspected cause. An eye examination usually includes refraction, a visual field testing, ophthalmoscopy, a slit lamp examination, and tonometry. A doctor may take a sample of eye secretions from the conjunctiva for laboratory analysis to determine which form of infection the individual has and how best to treat it. A doctor will ask about any eye pain or discomfort.
  • Visual acuity test: Acuity refers to the sharpness of vision or how clearly the individual sees an object. In this test, the eye doctor checks to see how well the individual reads letters from across the room. The eyes are tested one at a time, while the other eye is covered. Using a chart (called a Snellen eye chart) with progressively smaller letters from top to bottom, an eye doctor determines if the individual has 20/20 vision or less acute vision.
  • Slit-lamp examination: A slit-lamp allows the eye doctor to see the structures at the front of the eye under magnification. The microscope is called a slit lamp because it uses an intense line of light (or a slit) to illuminate the cornea, iris, lens, and the space between the iris and cornea. The slit allows the doctor to view these structures in small sections, which makes it easier to detect any small abnormalities.
  • Retinal examination: In a retinal examination, an eye doctor puts dilating drops in the eyes to open the pupils wide and provide a bigger window to the back of the eyes. Using a slit lamp or a special device called an ophthalmoscope, the doctor can examine the lens for signs of a cataract, glaucoma, or damage to the retina. Dilating drops usually keep the pupils open for a few hours before their effect gradually wears off. Until then, the individual will probably have difficulty focusing on close objects, while distance vision is generally less affected. With the pupils open this wide, individuals may want sunglasses for their trip home, especially if it is a bright day. Also, it may be safer to let someone else do the driving.
  • Genetic testing: Genetic testing is available for some genetic eye disorders. For example, genetic testing is available for several genetic mutations associated with retinitis pigmentosa, including: RLBP1, RP1, RHO, RDS, PRPF8, PRPF3, CRB1, ABCA4, and RPE65.
Treatment
  • Vision problems :
  • Eyeglasses or contact lenses are the treatment for vision disturbances, such as astigmatism, hyperopia, and myopia.
  • Lenses with bifocal or progressive addition lenses (PALs) are the most common correction for presbyopia. Bifocal means two points of focus: one section corrects for distant vision and the other section corrects for near vision. There are multifocal contact lenses available also for individuals with presbyopia.
  • Progressive addition lenses are similar to bifocal lenses, but they offer a more gradual visual transition between the two prescriptions, with no visible lines between them.
  • Reading glasses are another choice. Unlike bifocals and PALs, which most people wear all day, reading glasses are typically worn just during close work. If the individual wears contact lenses, an eye doctor can prescribe reading glasses that can be worn while the contacts are in. Reading glasses may be purchased over-the-counter (OTC) at a retail store or higher-quality versions are also available by prescription from an eye doctor.
  • Because the human lens continues to change as an individual grows older, the presbyopic prescription will increase over time as well.
  • Surgery: Surgical options to treat vision problems are available. LASIK, which stands for laser-assisted in situ keratomileusis, is one of the most popular modern treatments for a number of refractive errors, including myopia, hyperopia, and astigmatism. LASIK has a number of benefits; aside from the short amount of time required for the procedure itself, the LASIK procedure allows for rapid healing with minimal discomfort. Laser vision correction takes only about 15 minutes to complete. Most individuals see well enough to drive within 24 hours of their LASIK treatment.
  • Although LASIK is an option for most individuals with vision problems, there are certain groups of people who are not good candidates for the surgery, including: those under the age of 21 as most individual's eyes are still developing when they are younger, and it is important that the prescription has stabilized before performing LASIK surgery to correct the vision; those with autoimmune conditions such as lupus, Sjogren's syndrome, and rheumatoid arthritis; those with scarred corneas or a history of herpes infection in the eye; and women who are pregnant or breastfeeding. Often, prescriptions will fluctuate dramatically during and after pregnancy. Women should wait until after they are done nursing before undergoing LASIK.
  • First, the individual's prescription is entered into a computer that controls the laser. After the eye is prepared and numbed with anesthetic drops, the surgeon creates a flap in the cornea using an extraordinarily precise instrument called a microkeratome. The individual may feel some pressure during this portion of the procedure. The laser is then positioned over the eye, where it will emit small, controlled bursts of energy. Depending on the desired outcome of the surgery, small amounts of corneal tissue will be removed in order to change the focus of the eye. For the duration of the laser's operation, the surgeon will closely monitor the eye through a surgical microscope to make sure the desired prescription has been achieved. Next, the flap is returned to its original position. The flap will self-adhere and does not typically require sutures. The major advantages of corneal flap creation are that healing is faster and that discomfort is greatly reduced.
  • It is recommended by healthcare professionals to go directly home and sleep (or at least keep the eyes closed) for about four hours. The eyelids will help the corneal flap to continue the bonding process. After this time period, it is essential that the individual keep their eyes lubricated with the drops provided the surgeon and follow all of the postoperative instructions.
  • Photoreactive keratectomy (PRK): Photoreactive keratectomy (PRK) is similar to LASIK in that a laser is used to reshape the cornea to change the way that it focuses. However, in PRK, no flap is created in the cornea. Instead, a thin layer of epithelial, or surface, cells is removed to expose the corneal tissue underneath. PRK is effective for patients with myopia and astigmatism. PRK is an alternative for those who are not suitable candidates for LASIK, including those whose corneas are too thin to accommodate a flap.
  • Because there is no corneal flap to protect the treated area, patients who undergo PRK can expect to experience more discomfort and a slightly longer recovery period than those who undergo LASIK. Surgeons will likely place a bandage contact lens on the affected eye to protect it during the first few days after surgery. Once the healing period is over, however, PRK patients should enjoy the same amount of success and satisfaction as with other procedures.
  • Conjunctivitis :
  • A doctor may prescribe antibiotic eyedrops, such as Neosporin®, if the infection is bacterial. The infection should clear within several days of starting treatment. Antibiotic eye ointment, in place of eyedrops, is sometimes prescribed for treating bacterial conjunctivitis in children. An ointment is often easier to administer to an infant or young child than are eyedrops. It is important to use the medication as prescribed to prevent recurrence of the infection.
  • Viral conjunctivitis cannot be treated with antibiotic eyedrops or ointment. Like a common cold, individuals can use an over-the-counter (OTC) remedy, such as naphazoline (Vasoclear®, Naphcon®) to relieve some symptoms. Individuals may notice a worsening of symptoms in the first three to five days. Signs and symptoms should gradually clear on their own. It may take up to two to three weeks from the time of infection for the virus to go away.
  • If the irritation is allergic conjunctivitis, a doctor may prescribe one of many different types of eyedrops. These may include antihistamines, decongestants, mast cell stabilizers, steroids, and anti-inflammatory drops.
  • Xerophthalmia (Dry eye) :
  • In treating dry eye, the first thing to do is to remove or reduce the cause. Reducing contact lens wear time and taking breaks from intense visual work are just two such examples. The use of over-the-counter (OTC) artificial teardrops is the primary treatment for dry eye. If the individual has chronic dry eye, it is important to use the drops even when the eyes feel fine, to keep them lubricated. If the eyes dry out while sleeping, there are thicker lubricants, such as ointments, which can be used at night.
  • Temporary punctal occlusion: A temporary punctal occlusion is a procedure that closes the ducts that drain tears out of the eye. A plug that will dissolve quickly is inserted into the tear drain of the lower eyelid. This is a temporary procedure, done to determine whether permanent plugs can provide an adequate supply of tears.
  • Permanent punctal occlusion: Permanent punctal occlusion is used if temporary plugging of the tear drains works well. Permanent punctal occlusion involves the use of silicone plugs placed in the tear ducts. The plugs will hold tears around the eyes as long as they are in place. They can be removed. Rarely, the plugs may come out spontaneously or migrate down the tear drain. Many individuals find that the plugs improve comfort and reduce the need for artificial tears.
  • Restasis: Restasis® is a prescription eye drop used for the treatment of chronic dry eye. It helps the eyes increase their own tear production.
  • Other medications: Other medications, including ophthalmic anti-inflammatory eye drops and eye ointments (steroids and non-steroids), may also be beneficial in some cases.
  • Surgery: If needed, the ducts that drain tears into the nose can be permanently closed to allow more tears to remain around the eye. This is done with a local anesthetic on an outpatient basis. There are no limitations in activity after having this surgery.
  • Uveitis :
  • Treatment of uveitis depends in large part on what's causing the condition. Often, a doctor prescribes anti-inflammatory medications, such as ophthalmic corticosteroids or non-steroidal antiinflammatory drugs. A doctor also could give the corticosteroids by pill or by injection into the eye. If uveitis is caused by an infection, antibiotics, antiviral medications, or some other medicine may be given with or without corticosteroids to bring the infection under control. If uveitis is caused by an underlying condition, treatment will focus on treating that specific condition.
  • The part of the eye affected by uveitis, either the front (anterior) or back (posterior) of the uvea, may determine the duration of the condition. With proper treatment, anterior uveitis can clear up in a matter of days to weeks. Posterior uveitis, on the other hand, may last several months or years and could permanently alter vision.
  • If the uveitis responds poorly to corticosteroids or becomes severe enough to threaten vision, the individual may need to try a different kind of medication, such as an immunosuppressive or cytotoxic agent.
  • Vitrectomy, surgery to remove the jelly-like material in the eye (vitreous), may sometimes be necessary for diagnosis and treatment of uveitis.
  • Keratitis :
  • Minor corneal infections such as keratitis are commonly treated with anti-bacterial or anti-fungal eye drops. If the problem is more severe, a person may receive more intensive prescription antibiotic treatment to eliminate the infection and may need to take steroid eye drops to reduce inflammation. With residual corneal scarring or thinning, corneal transplantation may be necessary to restore vision. Early treatment may help reduce the risk of complications. Frequent visits to an eye care professional may be necessary for several months to eliminate the problem.
  • Retinitis pigmentosa :
  • Effective treatments for retinitis pigmentosa are currently unknown. Retinal microchip implants have been investigated for treating blindness associated with retinitis pigmentosa. In early research, Artificial Silicon Retina (ASR) microchips in patients with retinitis pigmentosa have shown promising improvements in visual function. The ASR microchips measure 2mm in diameter and one-thousandth of an inch thick and contain approximately 5,000 microscopic solar cells that convert light into electrical impulses. These cells are intended to replace photoreceptors in the retina, which are damaged in patients with retinitis pigmentosa. Study results are variable and additional research is needed to better understand the role of retinal microchip implants in patients with retinitis pigmentosa.
References
  1. American Academy of Family Physicians. . Accessed March 26, 2009.
  2. American Academy of Ophthalmology. . Accessed March 26, 2009.
  3. Gutteridge IF, Hall AJ. Acute anterior uveitis in primary care. Clin Exp Optom. 2007;90(2):70-82. View Abstract
  4. National Eye Institute. . Accessed March 26, 2009.
  5. Natural Standard: The Authority on Integrative Medicine. . Copyright © 2009. Accessed March 26, 2009.
  6. Owsley C, McGwin G. Measuring the personal burden of eye disease and vision impairment. Ophthalmic Epidemiol. 2007;14(4):188-91. View Abstract
  7. Patel PB, Diaz MC, Bennett JE, et al. Clinical features of bacterial conjunctivitis in children. Acad Emerg Med. 2007;14(1):1-5. View Abstract
  8. Swamy BN, Chilov M, McClellan K, et al. Topical non-steroidal anti-inflammatory drugs in allergic conjunctivitis: meta-analysis of randomized trial data. Ophthalmic Epidemiol. 2007;14(5):311-9. View Abstract
  9. University of Illinois Eye and Ear Infirmary. . Accessed March 26, 2009.