By GARY ASANO, O.D, FAAO
Astigmatism? … and I’ll go blind someday soon?
Relax! These terms practically can’t be related! And they are even different parts of the eye!
Now for a red eye, there are some we can see in the mirror and panic us. They are the bright red areas on the white part of the eye that are pretty large, that we suddenly notice, or someone else does. Those have a long name, subconjunctival hemorrhage, which describes where it is, and the redness is so bright because the blood is trapped there. And for a short, simple, almost always harmless reason.
There should never be any pain … just a minor sensation of some heaviness. But if there is, or you are very sensitive to any light, go and see your eye doctor as soon as possible because that means inflammation.
A small blood vessel can develop a leakage in the layer just underneath the top one (conjunctiva), therefore the “sub,” and gradually goes away over 7-10 days. The majority of the time it’s not a real problem, unless it starts occurring monthly or more, which could mean anemia or some other systemic blood system problem.
Guaranteed there is no eyedrop that gets rid of it since any “anti-red” one will stop drainage. Gravity does, although one can use a cold compress on the closed eyelid for a few minutes at least several times the first two days to greatly shorten the time span. And then you can take a selfie!
Other reasons for a red eye are an infection, inflammation … or even an eyelash growing into the white part of the eye and poking it. Called trichiasis, it can cause tearing, or feel like something is in the eye. Epilation tweezers for eyelashes can work, but how can we see our own eyelashes unless they’re large and essentially waving at us?
So go to an eye doctor since they have the microscope to look at the eye and eyelids to see and easily remove the eyelash.
Let’s discuss the others that sound more scary next time, so you can fall asleep tonight.
Now astigmatism sounds like a dreaded word, right? Patients would tell me, “Oh no, I have astigmatism!!” I tell them that 99% (it’s true!) of patients have some, and I have it in one eye, and it’s not fatal at all.
It’s merely that the outside seeing surface of the eye (remember the cornea?) in front of the pupil is not the same curvature horizontally and vertically. So when light comes in, there are two points of focus created on the back of the eye … so we see a straight line slanted or elongated. The only way an inflamed red eye can cause it is if the reason for the red eye isn’t professionally managed and treated, creating a warped surface.
And yes, there are more extreme forms of a less-common type of astigmatism that become much worse, so next time we’ll have more to discuss.
Because astigmatism is present in almost everyone, and is rarely equal between the two eyes, over-the-counter reading glasses are not advisable at all. They are for people who have exactly the same focus point in both eyes, which happens in much less than 1% of people. So wearing these “convenient” readers makes our eyes focus at different distances, meaning one eye is always out of focus … not a good thing for concentrating any longer than 15 seconds.
On the subject of both eyes, for numerous people, even with glasses, the two eyes initially, when looking at an object, will aim too far (exophoria) or too close (esophoria), or even one eye sees higher than the other (hyperphoria). Small amounts of this are usually not a problem, but just think if always have to compensate for a six-inch aiming disparity!
There are quite a number of prescribed eye exercises, called vision therapy, to lessen the obvious eye strain, or even double vision, and that’s a specialized field in itself. None of the so-called general eye exercises on the Internet are designed to help specifically, and may even worsen the condition, since there is no diagnosis to begin with.
In these conditions the eyes and we ourselves fatigue readily, cause headaches, short attention spans or can even cause just one eye to be used … so less depth perception! With specific vision therapy, the positioning error decreases and the compensating ability increases. Yes, at some point in time, these may need to be done again for a “refresher course,” just like any physical therapy.
In talking about reading, you may have noticed that GE has a line of different color temperature bulbs, called “Relax,” “Refresh” and “Recharge.” Remember when there was just “cool white” and “warm white” fluorescent bulbs? Technology realized that when we’re outdoors, the sun has a different “color temperature” at different times of the day.
And in our residence, there is an individual preference for the bluish-white LED lights like “Recharge,” or the warm color called “Relax.” The “Refresh” is in between and does represent mid-morning and mid-afternoon when outdoors.
There are individual choices and there are conditions of the eye that can cause one type to be too glaring, especially with white walls. And there is also at Home Depot a type with a switch in the base of the bulb to choose which color temperature you want, and when!
Now being that I just had cataract surgery, I would like to add onto the eyedrops advice I just gave. Make sure when putting the drop in one eye, to not close the other one … since the nerve system for the eyelids works in tandem. And closing the other eye will cause the one you’re trying to get the drop in to shut down too! To say the least, I’m finding that I’m not perfect in putting in the drops either!
The typical thinking about glaucoma that it’s due to the drainage channel between the iris and the cornea being insufficient, so the pressure increases. But there is also a low-pressure type, which we will talk about in the next article, and it’s very definitely not rare. We will discuss other factors like the blood vessels near the optic nerve.
A cataract involves the natural lens that focuses and grows throughout life, adding on layers. So when the interior of the lens starts getting yellowish and expanding, it will start blocking that channel and raising the eye pressure. It could even cause it to close completely, causing, you guessed it, “closed angle glaucoma”!
So get a proper, complete eye examination. We can’t see ourselves what is happening. As for other intriguing instances, stay tuned for the next chapter … and I promise it won’t be so long in coming!
Gary Asano, OD has been a proactive leader and lectured to a wide swath of low vision rehabilitation for over four decades. Though honored with three national awards, his most rewarding moments are of seeing the innate interest of interns of the two Colleges of Optometry in Southern California. Opinions expressed in this column are not necessarily those of The Rafu Shimpo.