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Myopia (near-sighted) is a refractive error that causes blurred distance vision. It results from the eye being longer than average and as a result light focuses in front of the retina providing an unclear image. Myopia may present at any age although typically before the age of 20. Since the blur comes from the length of the eye the prescription can increase with growth and often changes after the initial presentation.

Hyperopia (far-sighted) is a refractive error that causes blurred near vision. It develops when an eye is shorter than average and the light focuses behind the retina.

Occurs when the cornea has more curvature than average. When the cornea is shaped like a football instead of round it causes light to split and focus in two places. To correct the vision, a lens with two powers 90 degree apart is required. Astigmatism can present by itself or in combination with myopia or hyperopia. Uncorrected astigmatism can cause blur, headaches and eyestrain.

Presbyopia is a condition that affects everyone and presents in our early to mid-40s. The lens inside our eye that focuses for near vision becomes hard over time and can no longer automatically focus us for reading. Effectively the near prescription and the distance prescription have now become two different things. To correct presbyopia a lens is needed on the outside of our eye to compensate. The lens inside the eye continues to harden with age and whether we correct with reading spectacles or not, the condition progresses. Usually the reading spectacles increase in power every couple of years until mid-50s where the changes level off. If a patient has no refractive error they typically use reading glasses that they take on and off as needed. If there is already a refractive error present at the time presbyopia presents bifocals or progressive lenses are typically prescribed to ensure near and far clear vision. Although many myopic patients can take their distance spectacles off to read clearly since they are near sighted and have an up close advantage.

Strabismus is an eye turn. The eye can turn in or out and usually presents in childhood. High refractive errors, muscle weakness and ocular disease are causes of strabismus. Most often the strabismus is caused by a high refractive error in young children. However in the case of every strabismus ocular disease must be ruled out. It is important to see an optometrist as soon as an eye turn shows up even if it only occurs when the child is tired. Strabismus untreated causes amblyopia (lazy eye) which is the leading cause of reduced vision in children and is completely preventable. Very rarely strabismus can present in adulthood and usually is the result of trauma, loss of vision or cardiovascular disorders.

Amblyopia is a lazy eye. That is an eye that has poor vision regardless of any spectacle therapy. It is a problem with the development of the vision. The eye’s job is to focus light on the retina, the optic nerve then transmits that information from the eye to the occipital lobe in the back of the brain. If the eye is out of focus the pathway to the brain does not develop properly and the child is unable to process to the level of 20/20 vision. There is a critical period that this can be corrected, after the age of 8 it becomes very difficult to prevent a lazy eye because the brain is hard wired at that point. Amblyopia can be caused by any condition that causes one eye to be out of focus, that includes high refractive error, congenital cataract, ptosis (lid droop) and strabismus. Treatment involves removing the source of blur such as prescribing spectacles, cataract surgery or lid surgery. Often the strong eye will be patched to help development of the weaker eye. Due to the limited time we have to correct a lazy eye it is important to diagnose and treat early. If the amblyopia is not corrected early or watched closely depth perception can be reduced and certain careers may be limited. Annual eye exams will monitor for strabismus and amblyopia and prevent any reduced vision.