What is astigmatism and why is it so hard to spell?

To answer the first part, picture a basketball. Are you picturing it? Good. That’s the shape of a normal cornea.

If you’ve got astigmatism, your cornea is shaped more like a football. It’s a fetching look, to be sure, but it means that light bends unevenly as it enters the eye, causing blurriness. Basically, the more like a football your eye looks, the worse your vision is likely to be.

There are two types of astigmatism – regular and irregular. Regular astigmatism is by far the most common and is probably hereditary. Irregular astigmatism is much less common and can be caused by eye disease or injury.

Almost everybody has astigmatism to one degree or another, though most don’t require treatment. As for why it’s so hard to spell? We don’t know, but we’re guessing that astigmatism got its name during the great vowel shortage of 1878.

How can LASIK help?

You’re probably thinking, “Great, I’ve got a football instead of an eyeball, no amount of laser eye surgery can fix that.”

And you’re right! If you’ve got an actual football instead of an eyeball, you’ve got bigger problems than blurry vision. If, however, you’ve got an eyeball that’s merely shaped like a football, chances are good that LASIK can help.

LASIK works by using a highly focused laser to reshape the cornea. This allows the light entering the eye to do so without being distorted, improving your vision. Anesthetic eye drops are provided before the procedure to help manage pain, and for most patients the whole thing takes less than 10 minutes per eye. In a study, more than 93% of people with mild or moderate nearsightedness and astigmatism who underwent LASIK saw 20/20 or better six months after the procedure.

Am I a candidate?

There’s a common, dated misconception that astigmatism rules out LASIK as an option, but in reality, people with mild to moderate astigmatism can be candidates for the procedure. Of course, you have to be a candidate for LASIK in general in order to be a candidate for LASIK treatment of your astigmatism.

LASIK’s not for everyone

Although many patients with astigmatism in a clinical trial saw 20/20 or better six months after the procedure, your results with LASIK may vary. Some complications cited by the FDA include dry eyes; halos, glare and other visual disturbances; over-corrections and under-corrections.

Today is the first day of spring! While that sounds great at first after our cold and wet winter, those with eye allergies might not be as excited about it. Here are 8 tips for dealing with eye allergies from All About Vision.

1. Get an early start. See your eye doctor before allergy season begins to learn how to reduce your sensitivity to allergens.
2. Try to avoid or limit your exposure to the primary causes of your eye allergies. In the spring and summer, pollen from trees and grasses are the usual suspects. Ragweed pollen is the biggest culprit in late summer and fall. Mold, dust mites and pet dander are common indoor allergens during winter.
3. Protect your eyes from airborne allergens outdoors by wearing wraparound-style sunglasses.
4. Don’t rub your eyes if they itch! Eye rubbing releases more histamine and makes your allergy symptoms worse.
5. Use plenty of artificial tears to wash airborne allergens from your eyes. Ask your eye doctor which brands are best for you.
6. Cut down your contact lens wear or switch to daily disposable lenses to reduce the buildup of allergens on your lenses.
7. Shower before bedtime and gently clean your eyelids to remove any pollen that could cause irritation while you sleep.
8. Consider purchasing an air purifier for your home, and purchase an allergen-trapping filter for your heating/cooling system.

From the American Academy of Ophthalmology

A recent study from England has found that people who have had cataract surgery have better mental function in later life. The report joins a growing body of research that suggests that taking care of vision has benefits for older adults beyond just improving sight.

Researchers compared the rates of cognitive (thinking) decline before and after patients had cataract surgery. The researchers found the rate of cognitive decline was slowed by 50 percent following cataract surgery over 13 years of follow-up. The rate of decline among people who had cataract surgery was slower after the surgery compared with beforehand and became similar to the decline among those with no cataracts. 

Other studies have associated visual impairment with lower cognitive ability in older adults. But until now, about it wasn’t known whether improving vision through cataract surgery would help slow changes in mental function. The new study included 2,068 adults who underwent cataract surgery and 3,636 adults with no cataracts. Researchers tested participants’ memory by asking them to recall 10 words, both immediately after the words were read aloud and then again after participants had been distracted by other tasks.

The researchers note that scientists still don’t know why vision problems affect cognitive decline. But they think that the isolation, embarrassment and lack of physical activity from vision problems may contribute to the problem.

“There is little doubt that cataract surgery is very likely to improve a person’s vision, which can allow people to stay active and independent,” said Thomas Steinemann, MD, professor of ophthalmology at Case Western University and an ophthalmologist at MetroHealth Medical Center in Cleveland. Dr. Steinemann wasn’t involved in the English study. “If you can’t do things for yourself because you can’t see well, it’s easy to fall into a depression and withdraw from activities. This could affect a person’s cognitive abilities.”

Another recent study found that people who are diagnosed or identified as having reduced mental function are less likely to receive cataract surgery than those with normal mental function.

Dr. Steinemann is part of another study being conducted at Case Western on cataract surgery and cognitive decline. The study includes patients who have had cataract surgery, those who agreed to wait to have the surgery and the caregivers of both groups. Preliminary data from the study suggests that improving vision isn’t the only benefit of cataract surgery, it also improves quality of life and delays or lessens cognitive decline in adults. The results also suggest that patients who had cataract surgery — and their caregivers — have less emotional distress compared with patients who did not have the surgery and their caregivers.

Other Benefits of Cataract Surgery

One study found that when older people have cataract surgery to improve their vision, they also lower their risk of falling and breaking a hip. Another study of 55- to 85-year-olds with and without cataracts found that those with cataracts were four times more likely to report difficulty with challenging driving situations. Drivers with cataracts were also 2.5 times more likely to have a history of at-fault crash involvement in the prior five years.

Correcting Vision Improves Quality of Life

Dr. Steinemann has seen that correcting vision problems, including cataracts, can make a big difference in a person’s quality of life.

“Sometimes family members say, ‘My mother doesn’t do much anymore – she doesn’t read, or drive, and she’s a little confused, so why bother doing surgery?'” he said. “I take issue with that. I’ve seen some pretty amazing changes in older patients who have their eye conditions treated. Cataract surgery is a safe outpatient procedure. It can enhance people’s lives and make them more engaged with the world.”

Sometimes something as simple as getting new eyeglasses can make a difference in an older person’s vision, Dr. Steinemann said. A new study published in JAMA Ophthalmology found that almost 40 percent of the adults age 78 and older in the study needed eyeglasses or an updated prescription. Many of those in the study had a hard time getting to the eye doctor.

“A majority of those in the study had worse than 20/40 vision, which is considered ‘driving vision,'” Dr. Steinemann said. “Even something as simple as getting your eyeglasses checked can really help a lot. It helps maintain your driving vision, allows you to see your pills and the food on your plate.”

Headed to the beach for spring break? Or maybe you’re going camping or hiking in the woods, or even just some time at the local ball field or park. No matter what the activity, there’s a good chance of getting some type of dirt or sand in your eyes. If that happens, be sure you know these steps from the American Ophthalmology Association for proper treatment.

Getting sand, dirt, dust or other small natural particles in your eye is usually not an emergency. Our eyes are very good at flushing out these kinds of particles with tears and blinking. Let your eyes try to take care of the particles naturally before doing anything else.

If you’ve gotten metal, glass or other man-made materials in your eye, that can be more serious. These kinds of objects can become embedded in the surface of the eye and cause ongoing irritation and more damage.

• DO NOT rub the eye.
• Blink several times and allow tears to flush out the particle.
• Lift the upper eyelid over the lashes of your lower lid to let the eyelashes try to brush the particle out.
• Use eyewash, saline solution or running tap water to flush the eye out.
• See a doctor or go to the emergency room as soon as possible If you can’t get the particles out of your eye or if it still feels like there’s something in your eye after you’ve gotten the material out.

From the American Academy of Ophathalmology:

A new study suggests that mindfulness meditation may help lower eye pressure in glaucoma patients and improve quality of life by lowering stress hormones. Eye pressure—also called intraocular pressure or IOP—is a measurement of the fluid pressure inside the eye. Patients with glaucoma have numerous issues which may cause optic nerve damage, including increased eye pressure. This damage may permanently reduce vision. If glaucoma is not treated, it can lead to total blindness Glaucoma affects 65 million people worldwide, and it’s estimated that 10 percent of them are blind.

“This study suggests the possibility that complementary medical strategies like mindfulness meditation may play a role in helping patients cope with their disease and may actually improve outcomes,” the researchers report in the Journal of Glaucoma. The authors say meditation may be a useful complement to current glaucoma treatments such as eye drops, laser therapy or surgery.

The findings are intriguing, and provide support for similar results published in prior studies, according to J. Kevin McKinney, MD, an ophthalmologist and glaucoma specialist at Eye Health Northwest in Portland, Ore.

These earlier small studies suggested that psychological stress can increase eye pressure and that relaxation techniques might lower it. The newer study was a larger trial that divided participants by chance into separate groups that compared different treatments. But the study only lasted for 21 days, Dr. McKinney noted.

“I would want to see whether the same effect could be maintained over a longer period of time,” he said. The study did not assess whether mindfulness meditation had an effect on the progression of the patients’ glaucoma. “With our current level of understanding, I would not recommend using meditation as a substitute for current glaucoma treatment. But it might be a very useful addition.”

The new study included 90 patients with primary open-angle glaucoma, the most common form of the disease. One group of patients practiced mindfulness-based meditation, which involves being attentive to the present moment in a nonjudgmental way with an awareness of breathing. That group had a daily session for 21 days for 60 minutes under the supervision of a certified meditation teacher. The other group did not meditate. Both groups continued to take eye drops to lower their IOP.

Patients were monitored for IOP, quality of life and stress-related hormones and chemicals. At the end of three weeks, the meditators had significantly lowered IOP compared with those who did not meditate. The study found 75 percent of the patients who practiced meditation had a more-than 25 percent drop in eye pressure. Patients who participated in meditation also had a significant reduction in stress-related chemicals and reported a significantly improved quality of life after three weeks compared with those who did not meditate. There was no statistically significant change in IOP, quality of life or stress-related chemicals in the group that did not meditate.

It’s not known how stress is related to IOP, Dr. McKinney said. “It may be that hormones and chemicals that increase in the body when a person is stressed—called stress mediators—also work on receptors in the eye. When a person is stressed, these mediators may affect the eye in a way that increases IOP,” he said.

Dr. McKinney noted that many ophthalmologists think that stress reduction is useful for glaucoma management. “In my practice, I see that glaucoma patients who manage stress better tend to have better outcomes. But the idea that stress reduction lowers IOP hasn’t been validated in a study of this size before,” he said.

Dr. McKinney said based on the study’s findings, he will add meditation to the list of strategies he recommends to patients to reduce stress, including regular exercise, healthy sleep habits and other forms of mindfulness-based stress reduction.

“Techniques to reduce stress and increase mindfulness meditation would be welcome additions to an ophthalmologist’s tool kit. Afterall, the visual system is critical to a patient’s overall quality of life and we are constantly seeking new therapies to reduce the potentially devastating effects of uncontrolled and progressive glaucoma,” says Ravi D Goel, MD, an ophthalmologist and cataract surgeon in Cherry Hill, NJ.

Thank you for visiting the Maynor & Mitchell Eye Center website, and coming to our blog section! In this section, we’ll feature regular updates about all of the great things going on in our practice. as well as share helpful tips related to the latest in care for your eyes. We hope that you’ll use this as a resource for meeting your optical health care needs.