Search Results

By Dr. Zach Skurski Board Certified Ophthalmologist, Cornea and Refractive Surgery Specialist Dry eyes, also known as dry eye syndrome (DES), is a broad term for a common eye condition affecting millions of people worldwide. It typically occurs when the eyes do not produce enough tears or when the tears evaporate too quickly. This can lead to a range of uncomfortable symptoms, including dry sensation, redness, itching, burning, blurred vision, and pain. While dry eyes can be a chronic and frustrating condition, there are numerous strategies and lifestyle changes you can employ to manage and alleviate its symptoms. In this article, we will explore the causes of dry eyes, the importance of early detection, and a variety of practical tips to help you manage and find relief. I'll also offer my perspective and recommendations for treatments that I use in my day to day ophthalmology and cornea practice. The essentials boil down to treating with consistent lubrication, heat, dietary change, and lifestyle adaptations. Contents Causes of Dry Eye Early Detection Tips for Treatment Causes of Dry Eye Before diving into strategies for managing dry eyes, it's essential to understand what causes this condition. Several factors can contribute to the development of dry eyes, including: Aging: One of the most common causes of dry eyes is the natural aging process. As we get older, our tear production tends to decrease, leading to a higher risk of dry eye symptoms. Environmental Factors: Environmental factors play a significant role in dry eye development. Exposure to smoke, wind, dry air, and air conditioning can all contribute to worsening symptoms. Additionally, prolonged screen time on digital devices can reduce the frequency of blinking, leading to quicker tear evaporation. Medical Conditions: Certain medical conditions can increase the likelihood of dry eyes. These include autoimmune diseases such as Sjögren's syndrome, diabetes, thyroid disorders, and rheumatoid arthritis. Medications: Some medications, including antihistamines, decongestants, and antidepressants, can have dry eye as a side effect. Contact Lenses: Wearing contact lenses for extended periods or not cleaning them properly can have a major contribution to dry eyes. Hormonal Changes: Hormonal changes in women, such as those experienced during pregnancy, menopause, or while using birth control pills, can affect tear production and increase the risk of developing symptoms. The Importance of Early Detection Recognizing the signs and symptoms of dry eyes early is crucial for effective management. If left untreated, dry eyes can lead to more severe complications in rare cases, such as corneal damage and vision impairment. Some common symptoms of dry eyes include: Persistent dryness, itching, or burning sensations in the eyes Redness and inflammation Excessive tearing (a reflex response to dryness) Blurred vision Light sensitivity Stringy mucus in or around the eyes Difficulty wearing contact lenses If you experience any of these symptoms regularly, it's essential to consult an eye care professional for a proper diagnosis and treatment plan. Early intervention can help prevent long-term complications and provide relief from discomfort. How to Manage Dry Eyes: My Practical Tips While dry eyes can be a chronic condition, there are several lifestyle changes and over the counter treatments that can help manage and alleviate its symptoms. Let's explore these in detail: 1. Artificial Tears: Over-the-counter artificial tear drops and lubricating eye gels can provide immediate relief from dry eye symptoms by supplementing your natural tear film. It's essential to choose preservative-free eye drops, especially if you find yourself applying drops more than four times a day, as preservatives can exacerbate dryness if used too frequently. Here are some examples of preservative free drops that I regularly prescribe for patients and use for myself: Refresh Plus: There are many variations on the Refresh brand and I find that Refresh Plus is the best for everyday use. TheraTears: Another common preservative free tear I frequently recommend for daily symptoms. For patients who regularly experience symptoms of dryness. I typically recommend starting one of these preservative free artificial tears as needed. If symptoms remain persistent this is usually increased to at least four times a day (breakfast, lunch, dinner, bedtime), even if there are no symptoms. I find that they lose efficiency after more than about 8 times a day. 2. Warm Compresses: Commonly the eyelid's oil glands are blocked like clogged toothpaste, instead of the healthy olive oil like secretions we need. Applying a warm compress to your closed eyes can help soften the blockages and open the oil glands (Meibomian glands), improving the quality of your tears. These oils protect your tears to prevent early evaporation that leads to drying out. Use a clean, warm, damp washcloth or commercial eye mask, and gently place it over your closed eyes for about 10 minutes minutes. Repeat this process initially 1-2 times a day. I also recommend using a finger to massage the edge of the eyelids to help open up the glands. There are many home remedies for the warm compress, including hot washcloth or towel, hardboiled egg, or uncooked rice microwaved a few seconds in a sock to name a few I've come across. Be careful that the heat is not too hot that it could cause a burn to the skin. For regular daily use, I've found that commercial eye masks that can be heated tend to be easier to manage. These can also serve as sleep masks, which I frequently recommend for night time and morning dry eye symptoms. Here are a few examples of simple heat masks: Myhalos Microwave Heat Mask Avenova Heat Mask 3. Omega-3 Fatty Acids: Omega-3s are found in foods like salmon, flaxseeds, and walnuts, can help reduce inflammation and may work to enhance the effectiveness of warm compresses. Omega-3 can help soften the oil secretions in the eye lids and make it easier to open and express these glands with the use use of warm compresses. In my practice I typically recommend dietary supplementation with 3,000mg (3 grams) of fish oil daily. If you find you can't tolerate fish oil, try a dietary adjustment to include salmon, nuts, avocados, and extra virgin olive oil. I often recommend one tablespoon of extra virgin olive oil a day. 3. Blink Regularly: If you're like me and spend long hours staring at screens, make a conscious effort to blink more frequently. Blinking helps distribute tears evenly across your eyes and reduces the risk of tear evaporation. When we focus intently on screens or reading our blink rate goes down and this dries the eyes out. You can also use the "20-20-20 rule": every 20 minutes, take a 20-second break, and focus on an object at least 20 feet away. 4. Humidifiers: If you live in a dry climate or frequently use air conditioning or heating, consider using a humidifier in your home or office. Adding moisture to the air can help prevent excessive tear evaporation. The dry air is also why flying on planes can really irritate the eyes. 5. Stay Hydrated: Drinking plenty of water is essential for overall health and can help maintain adequate tear production. Dehydration can worsen dry eye symptoms, so make a habit of staying well-hydrated. 6. Protective Eyewear: When exposed to windy or dusty environments, wearing wraparound sunglasses or protective eyewear can shield your eyes from irritants and reduce tear evaporation. Blue light reducing glasses are also controversial option in managing dry eye symptoms due to screen use. There is mixed scientific data but so far it seem there is little proven benefit for the use of these glasses. That being said, there is little downside to wearing them and I personally will use them from time to time, especially for longer computer session in the evening. There are a lot of affordable and stylish options on Amazon. You can find the pair I wear here. 7. Avoid Smoke and Allergens: If you smoke, I urge you to quit, as smoking can worsen dry eye symptoms, not to mention the extreme benefits of quitting. Additionally, minimizing exposure to allergens like pollen and pet dander can help reduce eye irritation. Over the counter allergy eye drops may help with allergies but these types of medications (antihistamines) can also seriously dry out eyes. If you live in an area where air quality is affected by forest fires, city pollution, or just bad seasonal pollen, consider an air purifier to filter out any irritants. Here you can find the one that I use. 8. Limit Contact Lens Wear: If you wear contact lenses, try limiting their use, especially in dry or windy conditions. Consider switching to glasses temporarily to give your eyes a break after 10 or more hours of wear. However, in some cases, like I personally experienced before laser vision correction, contacts can act as a protective barrier and dry eye symptoms may be worse without them while wearing glasses. 9. Prescription Medications: In some cases, your eye care professional may prescribe medications like cyclosporine (Restasis, Cequa) or lifitegrast (Xiidra) to help manage chronic dry eye symptoms. These medications are typically used twice a day on a long term basis and work to reduce inflammation and promote tear production. These are frequently prescribed in the U.S., however in my experience there is often modest, if any notable benefit by patients. These medications have also not been approved in Europe due to questions about their efficacy. 10. Punctal Plugs: For moderate to severe cases of dry eyes, your eye care professional may recommend punctal plugs. These tiny plugs block the tear ducts, preventing tears from draining away too quickly and keeping your eyes moist. They come in dissolvable and non-dissolvable forms. 11. Eyelid Hygiene: Keeping your eyelids clean and free from debris can help prevent blockages in the oil glands that contribute to dry eyes. If you have a lot of crusting around your eye lashes, this is often more suggestive of a related ocular surface disease, blepharitis. Keeping the lashes clear will help reduce inflammation and irritation. This classically has been recommended as using Johnson's Baby Shampoo to gently scrub the eyelashes. Conclusion Managing dry eyes is a multifaceted process that involves both lifestyle adjustments and potential medical treatments. By beginning to understand the causes of dry eyes and recognizing the importance of early detection, you can take proactive steps to alleviate discomfort and prevent complications. Whether you're using artificial tears, practicing good eyelid hygiene, or making dietary changes, the goal is to maintain the health and comfort of your eyes. Remember to consult with a doctor for a full examination and a treatment plan tailored to your specific needs. With the right approach, you can enjoy relief from dry eye symptoms and maintain optimal eye health. Additional Resources for Dry Eye Syndrome Research to Prevent Blindness: Dry Eye The Dry Eye Foundation NIH National Eye Institute: Dry Eye American Academy of Ophthalmology: Prevention

By Dr. Zach Skurski Board Certified Ophthalmologist, Cornea and Refractive Surgery Specialist Across the world, 2.2 billion people have vision impairment and in at least 1 billion of these people, the condition could have been prevented or treated. Cataract and refractive error are the leading causes of vision impairment and blindness globally. In the US, over 1 million people over 40 years old are blind, while 2.4 million are visually impaired. According to the NIH, this is expected dramatically rise with the aging Baby Boomer population,. Leading Causes of Blindness Blindness is a profound and life-altering condition that affects millions of people worldwide. In the United States alone, vision impairment is a significant public health concern and impacts the lives of many individuals and their families. While advancements in medicine have made it possible to prevent or treat several causes of blindness, there are still leading causes that continue to challenge healthcare providers and researchers. In this article, we'll take a look at the top seven leading causes of blindness in the United States, exploring their causes, risk factors, prevention, and available treatments. Contents Diabetes Age-Related Macular Degeneration (AMD) Glaucoma Cataract Refractive Error 1. Diabetic Retinopathy With the growing health trends and rise in diabetes, diabetic retinopathy is a common and leading cause of vision impairment. Diabetic retinopathy is a complication of diabetes that affects the blood vessels in the retina. Diabetes essentially makes small blood vessels become leaky an ineffective, which affects the eyes early in the disease. It is one of the leading causes of blindness among working-age adults in the United States. Causes: Prolonged high blood sugar levels in people with diabetes can damage the blood vessels in the retina, leading to diabetic retinopathy. Poorly managed diabetes and long-duration diabetes are significant risk factors. Prevention: The most effective way to prevent diabetic retinopathy is by managing blood sugar levels through a healthy lifestyle, regular medical check-ups, and following the prescribed treatment plan for diabetes. Treatment: Treatment options for diabetic retinopathy include laser therapy, injections of medications into the eye, and surgery in advanced cases. Early detection and intervention are crucial to preserving vision. 2. Age-Related Macular Degeneration (AMD) Age-related macular degeneration, often abbreviated as AMD or ARMD, is the leading cause of blindness in older adults in the United States. As the named, this condition primarily affects the macula, the part of the retina (inner nerve lining of the eye) responsible for sharp central vision. AMD comes in two forms: dry (atrophy or thinning) AMD and wet (neovascular, fluid collection) AMD. Causes: The exact cause of AMD is not fully understood, but genetics and age are the primary risk factors. Smoking, high blood pressure, and a diet lacking in antioxidants may also contribute to its development. Prevention: Regular eye exams, a healthy diet rich in vitamins and minerals (especially antioxidants), not smoking, and managing conditions like hypertension can reduce the risk of AMD. Eye vitamins in a form known as AREDS 2 (Age Related Eye Disease Study 2), have been shown to slow, and potentially stop the progression of intermediate macular degeneration into advanced stages. Patients are frequently provided with Amsler grid's by their ophthalmologist to screen for any changes or new symptoms as illustrated in the image above. Treatment: Treatment options for AMD vary depending on the form. While there is no cure for dry AMD, certain dietary supplements (AREDS 2) and lifestyle changes may slow its progression. Wet AMD can be treated with anti-VEGF (vascular endothelial growth factor) injections, photodynamic therapy, or laser therapy, which can help manage symptoms and prevent further vision loss. 3. Glaucoma Glaucoma is a group of eye conditions characterized most frequently by increased intraocular pressure (IOP) that is believed to stress and damage the optic nerve, causing slow and gradual vision loss. It is often referred to as the "silent thief of sight" because it can progress without noticeable symptoms until significant vision loss occurs. Causes: Elevated IOP is a major risk factor for glaucoma, but the exact cause is not fully understood. Some patients develop glaucoma with normal eye pressure (normal tension glaucoma). Family history, age, and certain medical conditions like diabetes may also increase the risk. Prevention: Early detection through regular eye exams is crucial for preventing vision loss due to glaucoma. Managing underlying health conditions and maintaining a healthy lifestyle can also help reduce the risk. Treatment: Treatment for glaucoma typically involves lowering IOP through medications (eye drops), laser therapy, or surgery. The choice of treatment depends on the severity of the condition and the individual's response to therapy. 4. Cataracts Cataracts are a common age-related eye condition that affects the clarity of the eye's natural lens, leading to vision impairment. Causes: Cataracts often develop as a natural result of aging, but they can also be caused or accelerated by factors such as smoking, excessive UV exposure, and certain medications. Prevention: While cataracts cannot be prevented entirely, wearing sunglasses, quitting smoking, and managing underlying health conditions can help reduce the risk. Treatment: Cataracts can be surgically removed and replaced with an artificial lens (intraocular lens or IOL). This is one of the most common surgeries that I perform, and is the most commonly performed surgery in the US. This outpatient procedure is highly successful in restoring vision. Unfortunately cataract surgery is often not widely available in underserved areas of the world, making this a major cause of treatable blindness. 5. Refractive Error Refractive error is a common vision problem that occurs when the eye is unable to focus light properly onto the retina, resulting in blurred or distorted vision. They are the leading cause of vision impairment in the world. There are several types of refractive errors, including myopia (nearsightedness), hyperopia (farsightedness), astigmatism, and presbyopia. Causes: Refractive errors are typically caused by the shape and size of the eye, which affect how light is bent (refracted) as it enters the eye. Common causes include: Myopia: The eye is too long or the cornea is too curved. Hyperopia: The eye is too short or the cornea is too flat. Astigmatism: The cornea or lens has an irregular shape. Presbyopia: Age-related loss of the eye's ability to focus on close objects. Prevention: Preventing refractive errors is not always possible, as some are genetic or age-related. However, there are measures to reduce the risk include regular eye exams to correct any error early with glasses, contact, or refractive surgery, and reducing eye strain by practicing good eye ergonomics (20-20-20 rule to break from screens). Treatment: Refractive errors can be corrected most commonly with eye glasses, either for reading or distance vision. Bifocals can help to treat both distances. Contact lenses are another common correction, worn directly on the eye. Refractive surgery (my specialty) is also an option, with procedures like LASIK, SMILE, and PRK to reshape the surface of the eye to focus better Conclusion Blindness is a significant and life-altering condition, and understanding its leading causes is essential for prevention and early intervention. Regular eye exams, a healthy lifestyle, and managing underlying health conditions are key strategies in preserving vision and preventing blindness. Advances in medical science and ongoing research offer hope for improved treatments and prevention strategies in the future, giving individuals at risk of vision loss reason to remain optimistic about their eye health. Ultimately, increasing awareness about the leading causes of blindness in the United States and globally can empower us to take proactive steps in safeguarding their vision. Stay healthy my friends.

My name is Dr. Zach Skurski, and I'm an Ophthalmologist and subspecialist in cornea, external disease, and refractive surgery. I started this site to develop a trusted resource for all things related to eye health and eye care. Vision 101 is your gateway to a world of knowledge and expertise in the field of ophthalmology. My mission at Vision 101 is to provide you with accessible, informative, and up-to-date educational articles on common and important eye care concerns and topics. Whether you're curious about cataracts, seeking relief from dry eye, exploring solutions for macular degeneration, or considering the possibilities of LASIK and laser vision correction, I hope my comprehensive articles will empower you with the knowledge you need to make informed decisions about your eye health. My journey in eyecare and surgery began at the Walter Reed Military Medical Center (aka the President's Hospital), in Bethesda, MD, where I went through the rigors of internship and residency as a medical officer in the US Army. With those four years of residency as a foundation, I was selected to further hone my skills and expertise through fellowship at the renowned Johns Hopkins University School of Medicine, Wilmer Eye Institute in Baltimore, MD. There I was fortunate to train with the best in ocular surgery and medicine to perform corneal transplants and other advanced eye surgeries. Now, with years of experience and a deep understanding of the complexities of eye health and challenges for patients, I've taken an interest in sharing my knowledge and insights with you through Vision 101. At Vision 101, I aim to share my dedication to promoting eye health, preventing eye disease, and enhancing your overall quality of life through insightful eye care education. I invite you to explore the articles and embark on a journey towards better vision and eye health. Your vision matters, and Vision 101 is here to guide you every step of the way. Thanks for reading! -Dr. Zach Skurski

Cataracts are the bread and butter of my ophthalmology practice. With time and age, the natural lens in the eye grows cloudy, affecting the clarity of light focusing in the eye and eventually will become severe enough that vision may no longer correct well with glasses or contact lenses. This is when I start to discuss cataract surgery with my patients, especially if the symptoms start to affect driving or other hobbies and activities. A common and hugely successful procedure, cataract surgery removes the clouded natural lens (the cataract) with ultrasound and replaces it with an artificial lens implant to improve your vision. There are many other considerations with the procedure that we'll explore below. Table of Contents What are cataracts? Causes Symptoms When to Get Treatment Treatment Options What to Expect with Surgery Recovery from Cataract Surgery Prevention Understanding Cataracts Cataracts are a common eye condition that affects millions of people worldwide. In fact, cataracts are the leading cause of curable blindness in the world! While they are often associated with aging, cataracts can occur at any age and can significantly impact your vision. In this comprehensive guide, I'll explain what cataracts are, the causes, symptoms, and when it's best to seek treatment, as well as some details about surgery. What Are Cataracts? Cataracts are a clouding of the eye's natural lens, which is located inside the eye, behind the iris and the pupil. This lens is responsible for focusing light onto the retina, enabling us to see clearly. When cataracts develop, they prevent light from passing through the lens properly, causing blurred or cloudy vision. Types of Cataracts There are several types of cataracts, each with its own unique characteristics: Age-Related Cataracts: The most common type, these cataracts develop as a natural part of aging and usually progress slowly over time. Essentially everyone will get cataracts if they live long enough. Congenital Cataracts: These are present at birth or develop in childhood. They can be caused by genetic factors, infection during pregnancy, or other medical conditions. Traumatic Cataracts: These cataracts occur due to an eye injury and can develop immediately or years after the injury. Secondary Cataracts: These may develop as a result of other eye conditions or medical treatments, such as diabetes, certain medications, radiation therapy for cancer treatment, or previous eye surgery. Causes of Cataracts While the exact cause of cataracts is not always clear, several risk factors and contributors have been identified: Aging: The natural aging process is a primary risk factor for cataract development. UV Radiation: Excessive exposure to ultraviolet (UV) radiation from the sun can increase the risk of cataracts. Smoking and Alcohol: These lifestyle factors have been associated with an increased risk of cataracts. Medical Conditions: Conditions like diabetes and hypertension can increase the likelihood of developing cataracts. Medications: Some medications, such as corticosteroids and certain antibiotics, can contribute to cataract formation. Eye Injuries: Trauma to the eye can lead to the development of traumatic cataracts. Symptoms of Cataracts Cataracts typically progress slowly, and the symptoms may not be noticeable at first. However, as the cataract grows, you may experience the following symptoms: Blurry or Cloudy Vision: Objects may appear hazy or less sharp. Glare: Increased sensitivity to light, especially from headlights and driving at night. Difficulty Seeing at Night: Night vision can be particularly challenging due to glare and halos around lights. Frequent Changes in Eyeglass Prescription: You may find that your prescription needs to be adjusted more often. Double Vision: Seeing a double image in one eye can be a sign of cataracts. Fading Colors: Colors may appear less vibrant or yellowed. Difficulty Reading: You may need more light to read comfortably. Difficulty with Depth Perception: Tasks like judging steps or stairs may become challenging. It's important to note that not all cataracts progress to the point where they severely impact vision. Some remain mild and may not require immediate treatment and can be monitored over time. Cataracts often cause glare and difficulty seeing at night and while driving. When to Seek Treatment Determining when to seek treatment for cataracts can be a crucial decision for your eye health and overall well-being and quality of life. In general, regular eye exams will help to diagnose and monitor cataracts from an early stage. Here are some guidelines to help you know when it's time to consult with an eye care professional: 1. Vision Interference: If your cataracts significantly interfere with your daily activities, such as driving, reading, or watching television, it's time to seek treatment. When your vision affects your quality of life, it's essential to address the issue. This is a major point of discussion that I have with my patients to assess the risk of surgery vs. the potential benefit on quality of life. 2. Visual Acuity: A comprehensive eye exam, conducted by an ophthalmologist or optometrist, can assess your visual acuity and the extent of cataract development. If your visual acuity falls below a certain level, often legal driving standard as a baseline, your eye care professional may recommend cataract surgery. 3. Impact on Safety: If you experience difficulty seeing at night due to glare and halos around lights, it can pose safety risks while driving or walking. This is a clear indication that treatment is necessary. 4. Reduced Independence: Cataracts can make you dependent on others for daily tasks. If you find yourself relying on assistance for activities you once did independently, it's time to discuss treatment options. 5. Impact on Work: If your job requires good vision, such as reading fine print or operating heavy machinery, cataracts that affect your performance may warrant treatment. 6. Dissatisfaction with Visual Aids: If you rely on glasses or contact lenses to compensate for cataracts but still struggle with vision issues, treatment may provide a more satisfactory solution. 7. Other Eye Health Concerns: If you have other eye conditions, such as glaucoma or macular degeneration, addressing cataracts promptly can help your ophthalmologist monitor these conditions better. 8. Personal Choice: Ultimately, the decision to seek treatment for cataracts is a personal one. I have plenty of patients who are satisfied with their vision and quality of life, despite cataracts, so there's no rush for surgery. If you feel that your vision is no longer meeting your needs or expectations, it's worth discussing your options with an eye care professional. Treatment Options You Should Know for Cataracts As a cataract surgeon myself, I can speak directly to what treatment options you need to know and my approach to guiding patients through surgery. Typically if vision is no longer correctable with glasses to a level that is safe to drive, surgery is often recommended. For reference, this is about 20/40 vision best corrected in glasses. I also consider surgery when a patient describes the symptoms of glare or decreased vision as interfering with his or her ability to function as well as they desire. Here's an overview of the treatment options: 1. Cataract Surgery: There is no way to remove cataracts except for surgery. Thankfully, this is a cure and once removed, a cataract cannot return! Surgery involves the removal of the clouded lens using ultrasound through a small incision and replacing the lens with an artificial intraocular lens (IOL) in a procedure that is often just 10-20 minutes. This is an outpatient procedure and is highly effective in restoring clear vision, often with minimal recovery. More on this later. 2. Prescription Eyewear: Upgrading your prescription eyeglasses or contact lenses can help improve your vision temporarily. However, this is not a permanent solution for advanced cataracts. 3. Lifestyle Modifications: In the early stages of cataracts, you can make certain lifestyle changes to cope with the condition. These may include using brighter lighting, magnifying lenses, or anti-glare sunglasses. It's important to discuss your treatment options thoroughly with your eye doctor to determine the most suitable approach for your individual needs and lifestyle. Cataract Surgery: What to Expect Cataract surgery is the most common surgery performed in the United States, and also one of the safest! Here's quick overview of what you can expect before, during, and after cataract surgery: 1. Preoperative Evaluation: Before surgery, your ophthalmologist will conduct a comprehensive eye exam to measure your eye's shape and size, determine the appropriate IOL power, and assess any other eye conditions. There will also be a discussion about the lens implants available and goals for your vision. 2. Anesthesia: Cataract surgery is typically performed under local anesthesia (eye drops or gel), which numbs the eye and surrounding tissues. You will likely be awake during the procedure but will often receive a sedative to help you relax. Most commonly this is done through IV sedation to ensure your comfort during the procedure. This may also depend on the OR setting you have surgery, differing between a hospital, surgery center, or office based surgery. 3. Surgical Procedure: During the surgery, a small incision is made in the cornea, the clear front of the eye. The cloudy natural lens is then broken into small pieces using ultrasound and then removed. Lasers are occasionally used to assist in this process to assist in creating incisions and softening the lens, though typically at an additional cost to the patient. An IOL is then inserted to replace the natural lens to correct vision. 4. Recovery: After the surgery, you'll spend a short time in a recovery area to ensure there are no immediate complications. You will be given instructions on post-operative care, including the use of eye drops to prevent infection and reduce inflammation. The eye will be dilated from the procedure, and there is always some inflammation and swelling, so vision will be blurred or foggy immediately after. This starts to clear within the first several days of surgery. Most commonly there is minimal discomfort in the eye after surgery. 5. Improved Vision: Many people experience improved vision almost immediately after cataract surgery, although complete healing may take a few weeks. You may still need reading glasses for close-up tasks. 6. Follow-Up Appointments: Your eye care professional will schedule follow-up appointments to monitor your healing progress and adjust your treatment as necessary. 7. Potential Complications: While cataract surgery is generally safe, there can be complications, such as infection, retinal detachment, and swelling. It's essential to follow your doctor's post-operative instructions carefully. Cataract surgery is fantastic for patients, but isn't without its risks. Tips for a Successful Cataract Surgery Recovery Recovery from cataract surgery is usually straightforward, but here are some tips to ensure a smooth and successful healing process: 1. Follow Surgeon's Instructions: Adhere to all post-operative instructions provided by your eye surgeon, including the use of prescribed eye drops and any restrictions on physical activities. 2. Protect Your Eyes: Wearing protective eyewear, like sunglasses, can help shield your eyes from bright sunlight and prevent debris from entering the eyes. 3. Avoid Rubbing Your Eyes: Touching or rubbing your eyes can increase the risk of infection or complications. Be gentle and avoid any direct contact with the eye. 4. Attend Follow-Up Appointments: Regularly attend your scheduled follow-up appointments to monitor your progress and address any concerns during the healing process. 5. Patience: It may take some time for your vision to stabilize and fully improve. Be patient and allow your eyes the time they need to heal properly. 6. Communicate: If you experience any unusual symptoms, discomfort, or changes in vision during your recovery, don't hesitate to contact your eye care professional. Living with IOLs After cataract surgery, you'll have an intraocular lens (IOL) in place of your natural lens. IOLs come in various types, including monofocal and multifocal, each offering specific advantages and weaknesses. Here's what you need to know about living with IOLs: 1. Monofocal IOLs: These IOLs are designed to provide clear vision at a single focal distance, typically for distance vision. Most people with monofocal IOLs will still need reading glasses for close-up tasks. These are the most common implants I use and have some of the highest patient satisfaction rates. They offer the best quality of vision overall. 2. Premium IOLs: This category of lenses provided added range to vision and come at an extra cost to the patient as they are not covered by insurance. They come in several variations, such as astigmatism correcting toric lenses, multifocal (or trifocal) lenses, and extended depth of field (EDOF) lenses. As we often say, there's no free lunch in optics, so none of these lenses will be as good as a healthy natural lens, but the technology continues to improve to offer greater range of vision options. Toric (astigmatism) IOLs: Corrects varying degrees of astigmatism to reduce the need for glasses prescription (refractive error) after surgery. These are specially positioned in the eye to treat variations in the curvature of the ocular surface (astigmatism). Multifocal IOLs: These are designed to provide clear vision at multiple distances, reducing the need for reading glasses. However, there are some trade-offs and weaknesses since light is being split into multiple focal points at far, intermediate, and near distances. Color contrast can be lost, rings or halos around lights are very common (especially at night), and vision can be poor in low light. These lenses also do not guarantee freedom from glasses, but reduce the dependence on them for some tasks. They are also highly sensitive to lens position within the eye and are not recommended if other eye conditions are present. Extended Range of Vision IOLs: Also called extended depth of field (EDOF) lenses, these create a blended or stretched focus to offer a range of vision. These tend to be most effective at far to intermediate distances and weaker at near. 3. Monovision: This is another method to reduce the need for reading glasses, where the surgeon will target the dominant eye at far distance, while the non-dominant eye will be targeted for a closer, intermediate or near range. This takes some neural adaptation by the brain and not all patients tolerate this well, however it works fantastically when tolerated. 4. Lifestyle Adjustments: Depending on the type of IOL you receive, you may need to make some lifestyle adjustments. Discuss your visual goals and lifestyle with your surgeon to determine the best IOL for your needs. 5. Regular Eye Exams: Even after successful cataract surgery, it's important to continue having regular eye exams to monitor your eye health and ensure your IOLs are functioning correctly. There's a great amount of nuance that can go into the planning and selection of IOLs for cataract surgery. Discuss this thoroughly with your ophthalmologist to ensure your goals for vision and hobbies are effectively accounted for in deciding the best selection for you. Consider booking a consultation if you'd like to discuss these options in greater depth for your needs. Preventing Cataracts While cataracts are often age-related and may be influenced by genetic factors, there are some steps you can take to reduce your risk or slow their progression: 1. Protect Your Eyes from UV Radiation: Wear sunglasses that block both UVA and UVB rays when you're outdoors, especially on bright, sunny days. 2. Quit Smoking: If you smoke, quitting can significantly reduce your risk of cataracts. 3. Limit Alcohol Consumption: Moderation is key when it comes to alcohol consumption, as excessive drinking may increase the risk of cataracts. 4. Manage Medical Conditions: If you have conditions like diabetes or hypertension, managing them effectively can reduce the likelihood of cataracts developing. Diabetes is the number one risk factor here. 5. Eat a Balanced Diet: A diet rich in antioxidants, vitamins, and minerals can support overall eye health. Foods like fruits, vegetables, and fish can be beneficial. 6. Regular Eye Exams: Schedule regular eye exams to monitor your eye health and catch cataracts in their early stages. This will help you and your ophthalmologist decide what timing may be best for your surgery. Conclusion Cataracts are a common eye condition that can impact anyone, regardless of age. While they can be a natural part of the aging process, cataracts should not be ignored. Recognizing the symptoms and knowing when to seek treatment are crucial for maintaining good eye health and quality of life. With advancements in cataract surgery and various treatment options available, restoring clear vision and improving your overall well-being is achievable. If you or a loved one is experiencing symptoms of cataracts, consult with an eye care professional to discuss the best course of action for your individual needs. By taking proactive steps, you can enjoy a life with clear vision and reduced risk of cataract-related complications. By Dr. Zachary Skurski Board Certified Ophthalmologist and Cataract, Cornea and Refractive Surgery Specialist

Cataract surgery is a big deal! Having eye surgery will affect you for the rest of your life, so it never hurst to go in well prepared. I enjoy when patients come in prepared with specific questions about their surgery or eye condition. It signals to me that they're interested and engaged, plus I enjoy teaching the concepts to patients. Overall it strengthens the relationship and help the patient understand what to expect and anticipate along the way. Here I'll include my recommendations of how to prepare and what to ask your Ophthalmologist when preparing for cataract or eye surgery. Tip #1 - Why do I need surgery? Sound simple, but it's vitally important you fully understand why surgery is recommended. Simply put: what is the problem you're faced with and how will surgery help to correct it? Understand what alternative treatments might be available. Tip #2 - Arrive to your appointment with questions written down. Think about any questions or concerns you have. Use this list to guide you. Write them down and bring them into your office visit to discuss with your surgeon. This will help to avoid leaving the appointment and having that burning question finally come to mind. Create a note in your phone to help keep the information accessible. "What should I expect during and after surgery?" Tip #3 - Take notes. There's a lot of new information you'll be introduced to while discussing your surgery. Take notes about your questions, instructions for medications, and post-operative recovery to help remind you and refer back to in the future. Tip #4 - How will surgery be performed? In cataract surgery there's the basic operation and intraocular lens implant (IOL) that is covered by insurance. However, there are often additional options that can be included for extra cost to you, the patient. This includes astigmatism correction, premium or multifocal lens implants, and laser assisted cataract surgery. Discuss with your surgeon which options are right for you and your goals. Tip #5 - What are the risks of surgery? These will vary to some degree depending on the type of surgery. It's important to understand what complications you are at risk for and how that could affect you if the were to happen. Ask your surgeon what their complication rates are. Ask if any medications you're taking may pose a risk. For example, in cataract surgery I want to know if a patient has ever taken Flomax (tamsulosin) for enlarged prostate as this can cause iris difficulties during surgery. Tip #6 - What about anesthesia? Understanding the type of anesthesia you'll receive will help manage your expectations for surgery and improve your comfort level during the procedure. Cataract surgery is frequently performed under topical anesthetic using numbing drops and/or gel for a pain free experience. Patients are also not usually put fully asleep under general anesthesia. Instead I.V. sedation, also known as monitored sedation, is more commonly given to help you feel comfortable and relaxed. There are other details, such as where you're having surgery than may influence this decision, which leads me to the next questions. Tip #7 - Where will surgery take place? Cataract surgery is an outpatient procedure and most frequently occurs in an Ambulatory Surgery Center (ASC). However, depending on your surgeon, you may have surgery in a hospital out patient facility or an office based setting. Tip #8 - What should I expect after surgery? This questions has two parts. It's good to be clear what your eye and vision will be like immediately after the procedure. After cataract surgery, expect vision to blur foggy and blurred. There's always some swelling and inflammation, as well as dilation drops and other medications that take a few days to clear. This then leads into what to expect for the overall recovery while you're at home over the next few weeks and what eye drops you'll be using and for how long. It's best to have a clear understanding of what to anticipate with recovery. Tip #9 - Ask about the surgeon's experience with the surgery. It's reasonable to ask your surgeon how regularly they perform this surgery and what their success and complication rates are. Also a plan for any additional questions or problems that you may have related to surgery. Set Yourself Up for Successful and Smooth Recovery Use the tips and questions as a starting point to help you get the most out of your surgical experience. While there are many other questions that might be specific to you, these will help to create a solid foundation to ensure that you understand your upcoming surgery and feel prepared with what to expect throughout the process. Read more about cataracts and get the full picture! -Dr. Zach Skurski

Understanding the age-related changes in vision is one of the major aspects of my Ophthalmology practice and educating patients. Here I'll describe 7 major changes that we commonly see with aging eyes and vision and give you a complete understanding of what can happen to our eyes with time. As we age, our bodies go through numerous transformations, and our vision is no exception. Age-related vision changes are a common and natural part of the aging process. While some changes are unavoidable, understanding these processes can help you prepare for them, manage your ocular health more effectively, and maintain your overall quality of life. In this comprehensive guide, we will explore the various vision changes associated with aging, their causes, and strategies for preserving eye health as we grow older. Whether you are experiencing these changes yourself or want to support a loved one and their eye health, this information will prove invaluable. Table of Contents The Basics of Vision 7 Major Age-Related Vision Changes Presbyopia (Reading Glasses) Cataracts Glaucoma Age-Related Macular Degeneration (AMD) Dry Eye Syndrome Flashes and Floaters (Vitreous Degeneration) Reduced Color Perception 10 Strategies for Maintaining Healthy Vision The Basics of Vision To better understand the aging process’s effect on vision, we need a brief overview of how the eye functions. Vision is a complex process that begins with light entering and passing through the eye and age can effect each part that light passes through along the way. The main components involved in vision include: Tear Film: The fluid and oils secreted from the ocular surface and eyelids that help to lubricate the eye and eyelids, as well as keep the surface smooth, clear, and comfortable. Cornea: The clear front surface of the eye that acts as a protective barrier and helps focus light. Basically the windshield of the eye. Pupil: The pupil is the black center of the eye, which is actually on opening in the iris, that regulates the amount of light entering into the eye. Iris: The colored part of the eye, this is a delicate muscle which controls the pupil size by expanding and contracting. Lens: A clear structure behind the iris that helps to further focus light onto the retina. When we’re born the lens is very flexible, which allows the focus of our vision to change from distance to near. This flexibility is eventually lost with age, requiring reading glasses (presbyopia). This is where cataracts form. Retina: The back of the eye and inner lining with light-sensitive nerve cells, called rods and cones, which convert light into electrical nerve signals for the brain. This is where macular degeneration occurs. Optic Nerve: The retina sends signals to this bundle of nerve fibers that then acts has a cable to transmit these signals to the brain for interpretation. Glaucoma causes damage to the optic nerve. Brain: The final destination of these signals, where they are processed into visual information. Now that we have a basic understanding of how vision works, let’s explore the changes that occur in each of these components as we age. 7 Major Age-Related Vision Changes Age-related vision changes can manifest in various ways, affecting different aspects of our visual function. These changes typically start around the age of 40 and progress over time. While not everyone will experience all of these changes, it’s essential to be aware of them and take proactive steps to maintain eye health. Let’s delve into these age-related vision changes one by one. 1. Presbyopia Presbyopia is one of the most common age-related vision changes. It typically becomes noticeable in the early to mid-40s. This condition is characterized by gradual loss of the eye’s ability to focus on nearby objects. Individuals with presbyopia may find it challenging to read small print or perform tasks that require close-up vision without the aid of reading glasses or bifocal. Causes: The primary cause of presbyopia is the natural aging process. As we age, the lens of the eye becomes less flexible, making it difficult to change its shape for near vision. Management: Presbyopia can be managed effectively with reading glasses, progressive lenses, or multifocal contact lenses. Regular eye exams are essential to monitor changes in vision and adjust corrective lenses as needed. 2. Cataracts Cataracts are another common age related problem that causes problems with vision and a problem I see and treat on a daily basis in my practice. They involve clouding of the eye’s natural lens, which can lead to blurry vision, increased sensitivity to glare, and difficulty seeing in low-light conditions. Causes: Cataracts often develop due to aging, but they can also result from other factors like diabetes, genetics, smoking, excessive sun exposure, and certain medications like steroids. Management: The treatment for cataracts is surgical removal. Cataract surgery is highly successful and involves replacing the cloudy lens with a clear artificial one, called an intraocular lens (IOL). Early detection through regular eye exams is crucial to timely intervention. 3. Glaucoma Glaucoma is a group of eye conditions often characterized by increased pressure within the eye, which can damage the optic nerve and lead to vision loss. It’s often referred to as the “silent thief of sight” because it can progress without noticeable symptoms until significant damage has occurred, similar to high blood pressure (hypertension). Causes: The exact cause of glaucoma is not fully understood, but it is often associated with elevated intraocular pressure. Age is a significant risk factor for glaucoma, with the risk increasing as one gets older. Having a family history for glaucoma is also a major risk factor if parents or siblings also share this condition. Management: Glaucoma can be managed through medication, typically eye drops, laser therapy, or surgery to reduce intraocular pressure. Regular eye exams are vital for early detection and treatment to prevent vision loss. 4. Age-Related Macular Degeneration (AMD) A major cause of blindness and huge focus of ophthalmic research, age-related macular degeneration is a progressive eye condition that affects the macula, the central part of the retina responsible for sharp, detailed, central vision. AMD can lead to a loss of central vision making it difficult to read, drive, or recognize faces. Causes: The primary risk factor for AMD is aging, but genetics, smoking, and diet can also contribute to its development. Management: While there is no cure for AMD, treatments such as injections can slow its progression and help preserve vision. Early detection through regular eye exams and special imaging of the retina is crucial for timely intervention. Some patients benefit from ocular vitamins, known as the AREDS2 formulation. A screening tool known as an Amsler grid is often recommended to patients to monitor for symptoms at home. Any distortion in the grid where the straight lines become wavy or missing are signs to return to the Ophthalmologist quickly for evaluation. 5. Dry Eye Syndrome Dry eye syndrome occurs when thee eyes do not produce enough tears or when tears evaporate too quickly. It can lead to symptoms like itching, burning, redness, and blurred vision. Causes: Aging is a common cause of dry eye syndrome, as tear production tends to decrease with age. Other factors like medications, certain medical conditions, especially skin and autoimmune conditions, and environmental factors can also contribute. Management: Management of dry eye syndrome may involve artificial tears, prescription medications, lifestyle changes, or, in severe cases, procedures to block tear drainage. Proper hydration and avoiding dry environments can also help alleviate symptoms. 6. Flashes and Floaters Floaters are small, dark spots or lines that appear to float in your field of vision and a very common complaint in my clinic. They are caused by changes in the vitreous, a gel-like substance filling the inside of the eye and eventually these changes occur in all patients. While floaters are generally a harmless nuisance, the sudden appearance of flashes of light may indicate a more serious condition, such as a retinal tear or detachment. Causes: Floaters are often a natural part of aging as the vitreous undergoes changes and softens with age. Retinal issues that cause flashes can be related to aging or other factors like trauma or retinal disease and new symptoms should be evaluated with a dilated eye exam. Management: Floaters usually require no treatment and often become less noticeable over time. However, if you suddenly experience a significant increase in floaters or flashes, it’s essential to seek urgent medical attention with a dilated eye exam, as it could indicate a retinal tear or detachment. 7. Reduced Color Perception Some individuals may experience a decline in color perception as they age, particularly difficulty distinguishing between shades of blue and green. This change can affect the perception of color in everyday life. Causes: The exact cause of reduced color perception in older adults is not well understood, but it may be related to changes in the eye’s lens or the way the brain processes color information. Management: While there is no specific treatment for reduced color perception, regular eye exams can help detect and address any underlying eye conditions that may contribute to the issue. 10 Strategies for Maintaining Healthy Vision While age–related vision changes are a natural part of growing older, there are several strategies to adopt to promote and maintain healthy vision throughout our lives. Here are some practical tips: 1. Regular Eye Exams One of the most critical steps in maintaining eye health is scheduling regular eye exams. These exams can help detect changes at early stages when they are most treatable. The American Academy of Ophthalmology recommends the following schedule: Adults under 40: Every 5 to 10 years Adults 40 to 54: Every 2 to 4 years Adults 55 to 64: Every 1 to 3 years Adults 65 and older: Every 1 to 2 years However, individuals with certain risk factors or pre-existing eye conditions may need more frequent exams. 2. Maintain a Healthy Lifestyle A balanced diet rich in antioxidants, vitamins, and minerals can support eye health. Eye vitamins can be a major component of managing macular degeneration. Foods such as leafy greens, carrots, citrus fruits, and fatty fish, like salmon, are known to benefit the eyes. Keeping hydrated and avoiding excessive alcohol consumption can help maintain eye moisture. This can help reduce the discomfort associated with dry eye syndrome. 3. Protect Your Eyes from UV Ray Prolonged exposure to ultraviolet (UV) rays from the sun can increase the risk of cataracts and other eye conditions like pterygium and ocular cancer. Wearing sunglasses that block 100% of UVA and UVB rays when outdoors can help protect your eyes. 4. Quit Smoking Smoking is a significant risk factor for numerous eye conditions, including cataracts, macular degeneration, and thyroid eye disease. Quitting smoking can reduce the risk of these conditions and improve overall eye health. 5. Manage Chronic Health Conditions Conditions such as diabetes and hypertension can greatly impact eye health. Managing these conditions through medication, lifestyle changes, and regular medical checkups can help reduce the risk of associated eye problems. Uncontrolled diabetes is a major problem that often affects the eyes early and can lead to severe vision problems (diabetic retinopathy) if left untreated. 6. Stay Active and Maintain a Healthy Weight Regular physical activity and maintaining a healthy weight can help reduce the risk of developing diabetes and other conditions that can affect the eyes. 7. Follow Computer and Screen Usage Guidelines Computer vision syndrome is increasingly common. To prevent digital eye strain, take regular breaks when using computers or digital devices for extended periods. Follow the 20-20-20 rule: every 20 minutes, take a 20-second break, and focus on something distant, at least 20 feet away. This will help relax your eye muscles and reduce eye strain. 8. Use Proper Lighting Ensure that your workspace and home have adequate lighting to reduce eye strain when reading or performing close-up tasks. 9. Eye Protection In addition to wearing UV blocking sunglasses, it’s important to wear protective glasses or goggles while performing activities that could pose a risk. Protective lenses are recommended while utilizing power tools and construction projects, doing yard work, and mechanical tasks, and other activities that could result in eye trauma. Eye protection (commonly shortened to EyePro in the military) is a major factor in preventing severe ocular trauma which can be vision threatening. 10. Get Quality Sleep Adequate sleep is crucial for overall health, including eye health. Aim for 7-9 hours of quality sleep per night to help your eyes rest and recover. Conclusion Understanding age-related vision changes is essential for maintaining eye health as we grow older. While these changes are a natural part of aging, proactive measures can help minimize their impact and preserve our quality of life. Regular eye exams, a healthy lifestyle, and protective measures against UV rays, trauma, and environmental factors are key components of maintaining healthy vision throughout your lifetime. At Vision 101, we’ll keep you informed and help inform you to take the steps needed to care for your eyes so you can enjoy clear and comfortable vision as you age gracefully. By Dr. Zachary Skurski Board Certified Ophthalmologist and Cataract, Cornea and Refractive Surgery Specialist