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Understanding vision problems - treatment

How are vision problems identified?

Periodic  eye examinations are essential to monitor the health of your eyes and diagnose problems. Checking the position of each eye and its movements will reveal crossed eyes or other forms of strabismus. The examination may include these parts:

  • An eye chart uses letters of decreasing size to determine the sharpness of your vision at distance. 
  • The retinoscope projects a thin beam of light into the eye. When used with the rotating lens dial (called the phoropter) the optician measures any refractive error like short-sightedness, long-sightedness or astigmatism. 
  • A slit-lamp scope exam of the surface of each eye. The same device is used to inspect internal eye structures located in the front portion of the eye. This is how changes in the clear cornea and lens are identified. 
  • Pressure inside the eye is measured using one of several devices. 
  • Examinations with hand-held ophthalmoscope can reveal abnormalities of the retina, the macula and the optic nerve. 
  • Dilating eye drops may be given for a full examination.

What are the treatments for vision problems?

If routine testing indicates that you have a refractive error, conventional treatment calls for wearing corrective glasses or contact lenses, and, in rare cases having corrective surgery. Almost two-thirds of the population wear corrective lenses, and that number increases markedly after the age of 65.

Conventional treatment for disorders such as short-sightedness, long-sightedness and astigmatism typically relies on corrective prescription lenses. Disorders such as cataracts, glaucoma, macular degeneration and retinal detachment require advanced medical and surgical treatments. Enormous progress in eye surgery has been made over the past few decades. Many people with eye problems previously felt to be untreatable now enjoy improved eyesight and an improved quality of life. This applies to individuals of every age, from infants to pensioners!

To treat short-sightedness your optician will usually prescribe lenses to focus visual images correctly on the retina. Depending on the specifics of your eye examination, you may have a choice between wearing conventional spectacles and contact lenses.

As an alternative to corrective lenses, or in severe cases, surgery can be performed to treat short-sightedness. Radial keratotomy is a surgical procedure in which tiny, spoke-like incisions are made in the cornea, flattening the centre and focusing images correctly on the retina. The operation is performed on one eye at a time and the success rate is good. More than three-quarters of those who have had the surgery report being fully corrected or close to it. The procedure has potential complications, however, in that vision may fluctuate, the cornea may become infected and there is some risk of the corneal rupture.

Laser treatment offers results similar to or better than radial keratotomy. The laser beam removes microscopic amounts of tissue from the centre of the cornea. This effectively flattens the cornea so that light rays focus correctly on the retina.

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