All About Eyes

Eye Anatomy

Cornea:
Transparent front segment of the eye that covers iris, pupil, and anterior chamber, and provides most of an eye's optical power.

Pupil:
Variable-sized, circular opening in center of iris; it appears as a black circle and it regulates amount of light that enters the eye.

Iris:
Pigmented tissue lying behind cornea that (1) gives color to eye, and(2) controls amount of light entering eye by varying the size of the black pupillary opening (3) separates the anterior chamber from the posterior chamber.

Lens:
Natural lens of eye; transparent intraocular tissue that helps bring rays of light to focus on the retina.

Retina:
The "Movie Screen" of the eye. The part of the eye that converts images into electrical impulses sent along the optic nerve for transmission back to the brain. Consists of many named layers that include rods and cones.

Macula:
Small, specialized central area of the retina responsible for acute central vision.

Vitreous:
Transparent, colorless, gelatinous mass; fills rear two-thirds of the interior of the eyeball, between the lens and the retina.

Optic Nerve:
Largest sensory nerve of eye; carries impulses for sight from retina to brain.

Vision Conditions

Myopia (Nearsighted)
Myopia is the medical term for what most people call nearsightedness. Myopia is typically the result of the eye being to long or the curvature of the cornea being too steep. It is a condition where distant object are more blurry and you can see objects clearly only when they are closer. Myopia usually develops in early childhood, though it sometimes develops in early adulthood. In rare cases, myopia can lead to more serious conditions such as a retinal detachment.

Myopia is considered to be a genetic disorder. If your parents are nearsighted, you are at greater risk of also being nearsighted. Another risk factor is "near work" - work involving fine detail or focusing on close objects; the more near work you perform, the more likely you are to be nearsighted. People with uncorrected myopia often experience difficulty focusing far away They commonly are found squinting and experience differing levels of eyestrain.

Myopia is typically corrected with eyeglasses or contact lenses. Sometimes myopia continues to gradually worsen throughout life. Myopia can also be corrected by LASIK surgery and other refractive surgical procedures. We recommend you review more about Myopia at the American Optometric Association's website: http://www.aoa.org/x4688.xml.

Hyperopia
Hyperopia is more commonly known as farsightedness. Hyperopia is typically the result of the eyeball being too short or the curvature of the cornea being too flat. As the name suggests, people with farsightedness are able to focus on objects that are further away, but have difficulty focusing on objects which are very close. About a quarter of the population are afflicted with hyperopia. Hyperopia can lead to chronic glaucoma, a more serious condition, later in life.

A family history of hyperopia is a risk factor for developing hyperopia. If your parents are farsighted, you are at a greater risk of also being farsighted. Often babies are born with hyperopia, but they usually outgrow the condition as the eye develops.

People with uncorrected hyperopia often experience difficulty focusing up close, headaches, eyestrain and fatigue. Many eye screenings are ineffective in diagnosing hyperopia.

Hyperopia is typically corrected with eyeglasses or contact lenses. There are also refractive surgical procedures that can correct hyperopia. Read more about Hyperopia at AMA's website: http://www.aoa.org/x4696.xml.

Emmetropia
When an eye's optical power is perfectly matched to its length, the eye is said to be emmetropic. Emmetropia is the medical term for 20/20 vision needing no corrective lenses, contact lenses, or reading glasses. It occurs because the optical power of the eye can perfectly focus an image to the retina, giving them "perfect" vision.

Astigmatism
Astigmatism is typically the result of an irregular shape of the cornea or the lens-this causes the eye to focus an object on two different areas of the retina at the same time. For the cornea to bend light correctly, it should be dome-shaped, like a basketball. Astigmatic corneas are shaped more like a football. This causes a distorted view when looking at objects which are close-up and far away.

The cause of astigmatism is unknown. Astigmatism is often associated with myopia or hyperopia, and usually occurs from birth. In some cases astigmatism is caused as the result of an injury to the eye.

People with astigmatism often experience blurred vision, headaches and eyestrain. Most people have a mild amount of astigmatism and it usually doesn't need to be corrected. Higher amounts of astigmatism can be corrected with eyeglasses, contact lenses, or refractive surgical procedures. Read more about Astigmatisms at http://www.aoa.org/x4698.xml.

Presbyopia
Presbyopia is a condition where the lens of the eye gradually looses it ability to flex and focus up close. It typically begins earlier, but is first noticed by patients as the approach their early to mid 40's.

Presbyopia is a natural part of the aging process. There is no cure, though researchers are constantly looking for one. Even if a someone has never had vision problems before, they can still develop presbyopia. It may seem to occur suddenly, but actually occurs over a long period of time.

People with presbyopia often experience blurred vision up close. They often have to hold objects further away to bring them into focus. Often they will say "my eyes are fine, but my arms aren't long enough". Other symptoms include eye strain, fatigue, and headaches from near work.

Many options are available to treat presbyopia including reading glasses, bifocals, trifocals, progressive lenses, contact lenses, monovision and more. Read More about Presbyopia at the American Optometric Association: http://www.aoa.org/x4697.xml.

Amblyopia (Lazy Eye)
Amblyopia, commonly called lazy eye, occurs when one eye does not see as well as the other because the eye and the brain are not working well together. The eye looks normal, but it is not functioning properly because the brain favors the other eye.

People with amblyopia are difficult to diagnose as they can often use the other eye to compensate. Sometimes you may notice them favoring one eye or bumping into objects on one side. Amblyopia typically develops before the age of 6. The best way to tell if your child has lazy eye is through a complete exam around six months and three years. Early diagnosis can prevent amblyopia from leading to more serious problems such as loss of the ability to see three dimensions or functional blindness in the amblyopic eye. Early diagnosis is the key with this condition.

Amblyopia is not correctable with eyeglasses or contact lenses alone. Often prism and eye patching are necessary. Typically some level of visual therapy is necessary to teach the eyes to work together. Treatment is not always effective. Early diagnosis and treatment will give the best chance to a full recovery. You can find out more about Amblyopia at the American Optometric Association (http://www.aoa.org/amblyopia.xml) and the National Eye Institute Amblyopia Resource Guide (http://www.nei.nih.gov/health/amblyopia/index.asp).

Strabismus (Crossed Eyes)
Strabismus, commonly called crossed eyes, is a condition where the muscles of the eye do not allow the eye to align properly and one or both eyes turn. The eye(s) may turn in, out, up, down, or a combination of these. This condition is more noticeable when the person is tired. Crossed eyes are often easier to see in photographs.

Patients with strabismus may experience blurred vision or double vision. There are times when the brain will "shut off" one eye to prevent double vision. This may cause the eye not to develop properly. Early diagnosis and treatment are necessary in these cases as they can prevent permanent decreases in vision.

Treatment for patients with strabismus may include glasses, prism, visual therapy and in some cases, surgery. This condition will not get better on its own, though it may get worse. Treatment for strabismus is not always fully effective. Early intervention gives the best the chance for a complete recovery. Read more about Strabismus at the American Optometric Association: http://www.aoa.org/strabismus.xml.

Computer Vision Syndrome

Computer vision syndrome (CVS) affects three out of four computer users. It is a series of symptoms related to extended periods of computer usage.

Your vision, your computer, and the environment where you use your computer are all factors which can lead to CVS. Though it is no cause for panic, measures can be taken to relieve symptoms of CVS.

People with Computer Vision Syndrome may experience a variety of symptoms. Headaches, eye strain, neck and back aches, sensitivity to light, blurred vision, double vision, dry or irritated eyes, and color distortion are all possible problems related to CVS. A person with CVS may experience any combination of these symptoms. There are many options for treatment of CVS, depending on the symptoms each person is experiencing. Often times having glasses specifically made for the computer can help relieve many symptoms. Dry eye treatment is often necessary-when on a computer, we blink our eye approximately 1/3 as often as we should. Many other options are available to assist in relieving symptoms, such as changes being made in the workstation, changing settings on the computer and more. A thorough evaluation and discussion is needed with your optometrist to determine what the best options are for you. Click Here to read more about CVS at Healthy Computing.

Comprehensive Exam

Dr Gray will use a wide variety of tests and procedures to examine your eyes. The purpose of these tests are to determine not only your ability to see, but also to evaluate the overall health of your eyes. Many of the tests performed during an eye exam are similar, but testing will vary depending on your individual needs.

Your exam may include Automated testing to give the doctor baseline information about your eyes. This includes autorefraction - a test to determine if you are nearsighted, farsighted or have astigmatism, lensometry - a test to read the current prescription in your glasses, and keratometry - a test to determine the curvature of your cornea.

Your vision will be measured by reading the eye chart or visual acuity.

Muscle function tests will be performed to check the movement of your eyes. This test will identify any muscle weakness or involuntary eye movement. We will check your binocular vision to ensure your eyes work together. Binocular vision or stereo vision is important for proper depth perception, eye muscle coordination and the ability to change focus from near to far objects.

Visual field testing may be performed to measure your peripheral vision, or the total area you are able to see. This test is used detect and monitor diseases of the eyes and neurological disorders.

A check of your eye pressure or intraocular pressure will be performed. High intra-ocular pressure may be a sign of glaucoma.

Color vision testing will allow us to ensure you perceive colors properly.

A total eye health assessment will be performed. This will allow the doctor to evaluate the overall health of your eyes. We will evaluate your pupil responses, cornea, lens, vitreous, retina, optic nerve, macula and more.

Typically an eye exam will take anywhere from a half hour to an hour depending on the number and complexity of tests required for your eyes.

Vision Therapy

Vision therapy is a type of physical therapy for the eyes and brain. In many cases, vision therapy is a highly effective non-surgical treatment for many common visual problems such as lazy eye, crossed eyes, double vision, convergence insufficiency and some reading and learning disabilities. The goal of Vision Therapy is NOT to strengthen eye muscles. Your eye muscles are already incredibly strong! Vision Therapy uses specialized medical equipment and is supervised by a doctor of optometry. (Vision Therapy is not to be confused with any self-directed program of eye exercises which is or has been marketed to the public.)

The first step in any Vision Therapy program is a comprehensive eye examination where your optometrist will determine if vision therapy is likely to improve your visual problems. If vision therapy is recommended a customized plan for therapy will be made for you.

Often vision therapy requires a variety medical devices including prescription lenses, therapeutic lenses, prisms, optical filters, eye patches or occluders, electronic targets with timing mechanisms, computer software, vestibular (balance) equipment and more. Therapy is conducted in our office once or twice per week in 30 to 60 minute sessions. These sessions are aimed to be interactive and fun while working to train your eyes. At times these sessions are supplemented with procedures done at home between office visits ("homework").

The goal of visual therapy is to help our patients develop or improve fundamental visual skills and abilities. We aim to enhance visual comfort and improve the efficiency of their eye function.

Diseases of the Eye

Conjunctivitis
Conjunctivitis, commonly called pink eye, is an inflammation of the conjunctiva, the thin, clear tissue that cover the white part of your eye.

Symptoms
Patients typically have an eye that appears read and irritated. It is often accompanied by a discharge (clear, yellow, or white), itching and a feeling like something is in your eye. Occasionally blurry vision may occur.

Causes
Pink eye may be caused by a viral infection, bacteria or allergic reaction. The viral and bacterial pink eye are highly contagious.

Prevention and Treatment
If you are experiencing any of these symptoms you should contact your eye doctor right away. To avoid spreading conjunctivitis wash your hands often and don't touch the infected area with your hands. You also don\'t want to share wash cloths or towels. Avoid using makeup which may become contaminated. Sometimes your eye doctor will need to prescribe antibiotic eye drops and ointments to treat the conjunctivitis.

More Information
American Optometric Association - http://www.aoa.org/conjunctivitis.xml
Kidshealth for Parents: http://kidshealth.org/parent/infections/common/conjunctivitis.html

Glaucoma
Glaucoma is a very common eye disorder affecting millions of Americans. It is typically caused by too much pressure on the inside of the eye. Fluid in your eyes helps to nourish and cleanse the inside of your eyes by constantly flowing in and out. When too much fluid is made or if the fluid is prevented from flowing out, the intraocular pressure builds and has the potential to damage the optic nerve. This leads to a gradual loss in peripheral vision.

Symptoms
Those suffering from open-angle glaucoma experience a type of tunnel vision; their field of vision gradually decreases from the outer edges of vision towards their central vision . It can eventually lead to blindness. The loss of vision is a slow progressing process and most patients with glaucoma will not notice any symptoms. Narrow-angle glaucoma, which is rare, carries symptoms of sharp pain in the eyes, blurred vision, dilated pupils, and even nausea or vomiting. It can cause blindness in a matter of days, and requires immediate medical attention.

Risk Factors
Heredity seems to be a risk factor. Also, you may be at greater risk if you are over 45, of African descent, near-sighted, or diabetic. Finally, if you have used steroids for a long period of time, or if you have suffered an eye injury in the past, you have a greater chance of developing glaucoma.

Prevention and Treatment
Early diagnosis and early treatment are the key with Glaucoma. Patients with glaucoma and patients who are at higher risk for glaucoma should have their eye pressure and their peripheral vision checked regularly. There is no way to prevent the glaucoma from occurring, but typically the use of medication eye drops is enough to stop the progression of the disease. In some cases surgery may be necessary.

More Information
Glaucoma Research Foundation: http://www.glaucoma.org

Dry Eye Syndrome
Dry Eyes effect almost 10 million Americans. Dry eye syndrome can be caused by a lack of tears or in some cases there are ample tears, but they have poor quality. Tears lubricate the outer layer of the eye, called the cornea. If there are not enough tears or if the tears are not composed of a proper balance of mucous, water, and oil, the eye becomes irritated.

Symptoms Dry eye syndrome leads to a number of symptoms, including itching, irritation, burning, excessive tearing, redness, blurred vision that improves with blinking, and discomfort after long periods of watching television, using a computer, or reading. Risk Factors There are many factors that can contribute to dry eye syndrome. These include dry, hot, or windy climates, high altitudes, air-conditioned rooms, and cigarette smoke. Contact lens wearers, people with drier skin, and the elderly are more likely to develop dry eye syndrome. You may also be more at risk if you take certain medications, have a thyroid condition, a vitamin-A deficiency, Parkinson's or Sjorgen's disease, or if you are a woman going through menopause.

Prevention and Treatment
There are many options for the treatment of Dry Eye Syndrome. In some cases, simply the use of lubricating eye drops is enough to improve the situation. In more severe cases, medication eye drops, oral supplements or even surgical correction are better options.

More Information
American Optometric Association: http://www.aoa.org/x4717.xml

Diabetic Eye Disease
Diabetic Eye Disease is a group of eye problems that can occur in patients with diabetes. Diabetes can effect many part of the eye, most notably the lens and the retina. Patients with diabetes are two times more likely to develop glaucoma. High levels of blood sugar and fluctuating blood sugar overtime will damage tiny blood vessels in your eye and make them leak. New vessels may form to replace the damaged vessels, but the new vessels tend to be weaker. This combination of poorly functioning blood vessels leads to starvation of the retina, which overtime causes vision loss.

Symptoms
Often there are no symptoms early on when a patient is experiencing diabetic eye disease, that is why it is so important that any person with diabetes has an eye exam a least every year. Some symptoms a patient might experience are...

• - "Floaters" - small specks that pass across your field of vision, made up of cells floating in the transparent gel of your eyeball
• - Difficulty reading or seeing things close-up
• - Sudden loss of vision
• - Flashes
• - Blurred or darkened vision

Risk Factors and Treatment
If you have diabetes, make sure you regularly see your family doctor and work to control your blood sugar level. This will reduce your risk of getting diabetic retinopathy. If you are experiencing some of the symptoms listed above, you should call your eye doctor right away. Many treatment options are available.

More Information
National Eye Institute: Facts About Diabetic Retinopathy (http://www.nei.nih.gov/health/diabetic/retinopathy.asp)

Macular Degeneration
Macular degeneration is the leading cause of blindness is Americans over the age of 65. It is a disease which affects the small, central area of the retina responsible for precise central vision, known as the macula. The macula allows us to see the fine detail of whatever is directly in front of us. Macular degeneration occurs when the macula begins to deteriorate; this leads to loss of central vision.

"Wet" vs. "Dry"
Macular degeneration has two forms: dry (not involving the formation of new blood vessels) and wet (includes the formation of new blood vessels). Most often, macular degeneration is accompanied by formation of yellow deposits called "drusen" under the macula. Wet macular degeneration accounts for about 10 percent of case - this type is typically associated with more severe vision loss.

Risk Factors
A number of uncontrollable factors contribute to macular degeneration, including genetics, age, sex, eye color, farsightedness, and race. Risk factors you can control include smoking, high blood pressure, obesity, exposure to harmful sunlight, and diet.

Symptoms
It is difficult to detect dry macular degeneration in early stages and the onset is typically gradual. The most common symptoms, when detected, include a spot of blurry vision, dark vision, or fuzzy and distorted vision. Often macular degeneration is detected by your eye doctor before symptoms even begin to occur.

Prevention and Treatment
While there is no cure for macular degeneration many treatment options are available to slow the progression of the disease. Many patients are put on nutritional supplements by their doctor. Prescription medications and laser treatments are also available and should be discussed with your eye doctor.

More Information
Macular Degeneration: http://www.allaboutvision.com/conditions/amd.htm
Macular Degeneration Foundation, Inc. http://www.eyesight.org/Table_of_Contents/table_of_contents.html

Cataracts
Cataracts are a cloudiness that occurs in the lens of the eye. The lens is made mostly of water and protein arranged to let light through. Sometimes the protein clumps, blocking light and making the lens appear cloudy. A clear lens is necessary for crisp vision, as this lens get cloudy-vision will begin to blur.

Symptoms
A person with cataracts may encounter faded colors, problems with light (such as glare, halos, or headlights that seem too bright), poor night vision, double vision, or multiple vision.

Prevention and Treatment
Your eye doctor can detect the presence of cataracts through a thorough eye exam, including a visual acuity test and dilation of the pupils. Treatment is available to prevent cataracts and decrease symptoms. Once a cataract progresses to a level where it interferes with your daily activities, it can be surgically removed. This is a decision you should discuss with your eye doctor.

More Information
National Eye Institute: Facts About Cataracts (http://www.nei.nih.gov/health/cataract/cataract_facts.asp)

Retinal Detachment
The retina is the part of the eye which collects light and transmits the light messages to the optic nerve and brain; it lines the inner back wall of the eye. When the retina separates from the back wall, it is known as retinal detachment. It is a serious condition which can cause permanent damage and vision loss if not treated quickly.

Symptoms
Patients with a retinal detachment may experience a variety of symptoms. "Floaters," which look like small particles or fine threads or bugs in your vision; Flashes of light may be noticed; a curtain or cobweb type shadow in your vision. Some patients experience "wavy" vision or blurred vision. Anyone who experiences new floaters or a change in their floaters, flashing lights, a curtain or cobweb type shadow in their vision or a total loss of vision should see an eye doctor as soon as possible.

Risk Factors
Eye injuries, tumors, and cataract surgery can cause retinal detachment. Near-sighted individuals and the elderly are at greater risk for spontaneous detachment. Also, diabetic retinopathy, a condition associated with diabetes, can cause bleeding which leads to retinal detachment.

Prevention and Treatment
The best chance for recovery comes with immediate care from your eye doctor. A variety of treatment options are available typically involving surgery.

More Information
All About Vision: http://www.allaboutvision.com/conditions/retinadetach.htm

LASIK

LASIK, Laser-Assisted In Situ Keratomileusis, surgery is intended to help patients reduce their dependence on glasses or contact lenses. The first step with LASIK surgery is to determine if you are a candidate for surgery. If you are not a candidate for LASIK surgery, there are other refractive procedures available that may be able to help you decrease your dependence on glasses or contact lenses. Some of these options are PRK, Photorefractive Keratectomy, Phakic IOLs, and more. To determine which procedure would be best for you, come in and speak with Dr Gray about it today.

The LASIK Procedure- a step by step guide to the procedure:

• 1. Anesthetic (numbing) drops are applied to the eye.
• 2. A protective flap is created in the cornea and gently lifted by the surgeon, revealing the inner corneal tissue. Today's technology allows our surgeons to be incredibly precise using lasers to create this flap.
• 3. Computer-controlled pulses of cool laser light are applied to the inside of your cornea. The inner cornea is reshaped with the laser to correct for your contact lens or glasses prescription.
• 4. The surgeon gently replaces the flap and aligns it to its original position. This flap tissue heals naturally and securely.
• 5. Some patients may feel slight irritation for a few hours, but most are quite comfortable after a nap and rest.

Eyes over age 40

Presbyopia
Presbyopia is a condition where the lens of the eye gradually looses it ability to flex and focus up close. It typically begins earlier, but is first noticed by patients as the approach their early to mid 40's. Even if a person has never had a visual problem before, they can still develop presbyopia.

Presbyopia is a natural part of the aging process. There is no cure, though researchers are constantly looking for one. Even if a someone has never had vision problems before, they can still develop presbyopia. It may seem to occur suddenly, but actually occurs over a long period of time.

People with presbyopia often experience blurred vision up close. They often have to hold objects further away to bring them into focus. Often they will say "my eyes are fine, but my arms aren't long enough". Other symptoms include eye strain, fatigue, and headaches from near work.

Many options are available to treat presbyopia including reading glasses, bifocals, trifocals, progressive lenses, contact lenses, monovision and more.

Options to Treat Presbyopia

Bifocals
For many people, different lenses are needed for seeing at different distances. Bifocal lenses allow the wearer to look through two areas of the lens. One area focuses on distant objects. The other is used for reading. If you are focusing on distant objects, you look through the top half of the lenses. To read a book, magazine, or newspaper, you look through the "reading" area. One thing that is difficult about using bifocals is dealing with the line between the two vision areas. Fortunately, recent technologies have developed a new type of lens, called the no-line, or progressive lens.

Computer Glasses
To reduce eye strain and fatigue, we carry specialized computer lenses. These lenses are perfect people who spend the majority of their day working on a computer. And since three out of four computer users will suffer from Computer Vision Syndrome, computer lenses are a great way to keep your eyesight healthy.

Reading Glasses
One of the first areas of your life where presbyopia becomes prominent is in your ability to read. There are a variety of reading glass styles available, with sleek designs that allow you to carry them anywhere.

No-Line Bifocals
For many presbyopes, bifocal lenses are a necessity. But, it can be difficult to adjust to the harsh line that is found in bifocal lenses. Fortunately, there are lenses available with no-line; these are called progressive lenses. No more lines! Just a gradual change in focusing power which allows you to comfortably focus on any distance. Just like bifocals, distant objects are viewed through the top portion of the lenses, and near objects are viewed through the bottom portion of the lenses. The benefit now is, no one knows it but you!

Bifocal Contacts
If you need bifocals but can't stand wearing glasses, bifocal contact lenses are an option for you. Now you can have all of the benefits of bifocal lenses in the convenience of contact lenses. Just like bifocal glasses, bifocal contacts will allow you to see objects both far away and up close at the same time. Talk with your doctor about bifocal contacts today.

Monovision Correction
For some of our emerging presybopes we offer another option called monovision. We set up monovision using your contact lenses (this can also be done with refractive surgery). With monovision we fitting your dominant eye for distance vision and your non-dominant eye for near vision. Contacts are available in disposable, extended wear, and even daily disposable lenses to fit your lifestyle. Monovision correction is not a perfect system, it has some compromises to it with depth perception and fine detail. Most patients require 2-4 weeks to make the adjustment to monovision. Ask your eye doctor if monovision is right for you.

Children's Vision

Children with uncorrected vision conditions or eye health problems face many barriers in life, academically, socially, and athletically. High-quality eye care can break down these barriers and help enable your children to reach their highest potential! As a parent, make sure you are giving your children the eye care they need. Visit the Children's Vision Information network for more info: http://www.childrensvision.com/development.htm.

Infant's Vision

Newborns have all the eye structures necessary to see, but they haven't learned to use them yet. Infants' vision begins to develop at birth. Babies spend much of their early weeks and months of life learning how to see- developing such skills as focusing, teaming their eye movements, recognizing depth, developing eye-hand coordination, and making spatial judgments. As the child grows, more complex skills, such as visual perception and visual motor integration, develop to meet the child's growing need to understand and interpret his world.

During the first four months of life, your baby should begin to follow moving objects with the eyes and reach for things, first by chance and later more accurately, as hand-eye coordination and depth perception begin to develop.

At about age six months, you should take your baby to your doctor of optometry for his or her first thorough eye examination. Things that the optometrist will test for include excessive or unequal amounts of nearsightedness, farsightedness, or astigmatism and eye movement ability as well as eye health problems. These problems are not common, but it is important to identify children who have them at this stage. Vision development and eye health problems can be more easily corrected if treatment is begun early.

Pre-School Vision

During the infant and toddler years, your child has been developing many vision skills and has been learning how to see. In the preschool years, this process continues, as your child develops visually guided eye-hand-body coordination, fine motor skills and the visual motor skills necessary to learn to read. As a parent, you should watch for signs that may indicate a vision development problem, including a short attention span for the child's age; difficulty with eye-hand-body coordination in ball play and bike riding; avoidance of coloring and puzzles and other detailed activities. By age three, your child should have a thorough optometric eye examination to make sure your preschooler's vision is developing properly and there is no evidence of eye disease. If needed, your doctor can prescribe treatment including glasses and/or vision therapy to correct a vision development problem.

Here are several tips to make your child's optometric examination a positive experience:

• 1. Make an appointment early in the day. Allow about one hour.
• 2. Talk about the examination in advance and encourage your child's questions.
• 3. Explain the examination in your child's terms, comparing the E chart to a puzzle and the instruments to tiny flashlights and a kaleidoscope.

Unless recommended otherwise, your child's next eye examination should be at age five. By comparing test results of the two examinations, your optometrist can tell how well your child's vision is developing for the next major step...into the school years.

School-Age Vision
A good education for your child means good schools, good teachers and good vision. Your child's eyes are constantly in use in the classroom and at play. So when his or her vision is not functioning properly, learning and participation in recreational activities will suffer. The basic vision skills needed for school use are:

• Near Vision: The ability to see clearly and comfortably at 10-13 inches
• Distance Vision: The ability to see clearly and comfortably beyond arm's reach
• Binocular Coordination: The ability to use both eyes together.
• Eye movement skills: The ability to aim the eyes accurately, move them smoothly across a page and shift them quickly and accurately from one object to another.
• Focusing skills: The ability to keep both eyes accurately focused at the proper distance to see clearly and the change focus quickly.
• Peripheral awareness: The ability to be aware of things located to the side while looking straight ahead.
• Eye/hand coordination: The ability to use the eyes and hands together.

If any of these or other vision skills is lacking or does not function properly, your child will have to work harder. This can lead to frustration, headaches, fatigue and other eyestrain problems. As a parent, be alert for symptoms that may indicate your child has a vision or visual processing problem. Be sure to tell your optometrist if your child frequently:

Loses their place while reading Avoids close work Holds reading material closer than normal Tends to rub their eyes Has headaches Turns or tilts head to use one eye only Makes frequent reversals when reading or writing Uses finger to maintain place when reading Omits or confuses small words when reading Consistently performs below potential

Since vision changes can occur without you or your child noticing them, your child should visit the optometrist at least every two years, or more frequently, if specific problems or risk factors exist. If needed, the doctor can prescribe treatment including eyeglasses, contact lenses or vision therapy.

Remember, a school vision screening or pediatrician's screening is not a substitute for a thorough eye examination.

Protective Eyewear
Please don't overlook the importance of safety eyewear when playing sports. Prevent Blindness America reports that hospital emergency rooms treat 40,000 eye injuries every year that are sports-related. To help prevent sports eye injuries, athletes should use protective athletic eyewear - this is whether or not prescription eyewear is needed. One choice is a sports frame with prescription or non-prescription polycarbonate lenses.

Children and Sunglasses

Sunglasses are essential for protecting eyes from sun damage, they also improve vision. Sunglasses are important for people of all ages. Many experts believe our eyes get 80 percent of their total lifetime exposure to the sun's UV rays by age 18. And since excessive lifetime exposure to UV radiation has been linked to the development of cataracts and other eye problems, it's never too early for kids to begin wearing good quality sunglasses outdoors.

Children and Contact Lenses
It is very important for children who wear contact lenses (and their parents) to remember that contacts are prescribed medical devices. There are some risks involved in lens wear, including infections, allergic reactions, eye dryness, redness or irritation. If contact lenses are not cared for properly they can lead to permanent vision loss. It is extremely important that the lenses be properly cleaned and worn according to the instruction of the optometrist.

Thanks to technological, medical and cosmetic advances in contact lenses, more parents are switching their children's glasses with contacts. Children often want contacts for many of the same reasons adults do, including appearance, comfort and improved vision. Children may benefit from contact lens wear more often than we think.

Children's vision is constantly developing, and contacts give a more "real" or less distorted view of the world. Contact lenses can balance the image from both eyes, and correct any irregularities or astigmatism of the eye. Some studies have also shown that progression of nearsightedness can be lessened by contact lens use. Contacts are an excellent option for the budding athlete as well.

Contact lenses are designed to fit each individual, no matter what age, so fitting your child should be no more difficult than fitting an adult. Your eye care provider can help you make an informed decision as to whether contacts are right for your child.

It is important to know whether your child is suited for contact lenses. Indications may include medical or cosmetic reasons, whereas eye health, cost, allergies, and parental responsibilities may indicate that contacts are perhaps not best for your child. However, by staying with the prescribed care regimen and having good follow-up and communication with your eye care provider, most complications are rare. You know your child and what they are capable of- please let us know if you would like your child to try contact lenses today.

InfantSEE

Through the InfantSEE program, Dr. Gray will provide a one-time, comprehensive eye and vision assessment to infants between 6 and 12 months of age, offering early detection of potential eye and vision problems at no cost regardless of income.

• Vision eye problems can occur without any noticeable symptoms.
• 1 in 10 children is at risk of developing eye and vision problems by the time they reach 18.
• Up to 5 percent of America's preschoolers-nearly 4 million children, or up to one in every 20 nationwide-have impaired vision.
• Many of these children have a problem that can be prevented or easily corrected if it is caught early.
• A vision screening by your pediatrician is not a substitute for a complete eye health and vision evaluation.

Click here to visit InfantSEE Online for more information.