Eyestrain

Eyestrain

Definition:

Eyestrain occurs when your eyes get tired from intense use, such as driving a car for extended periods, reading or working at a computer.

Although eyestrain can be annoying, it usually isn't serious and goes away once you rest your eyes. In some cases, signs and symptoms of eyestrain can indicate an underlying eye condition that needs treatment. Although you may not be able to change the nature of your job or all the factors that can cause eyestrain, you can take steps to reduce eyestrain.

Symptoms:

Eyestrain signs and symptoms include:

• Sore, tired, burning or itching eyes
• Watery eyes
• Dry eyes
• Blurred or double vision
• Headache
• Sore neck
• Sore back
• Shoulder pain
• Increased sensitivity to light
• Difficulty focusing

Computer use or the use of other digital electronic devices can cause many of these symptoms.

When to see a doctor
If home treatments don't work to relieve your eyestrain symptoms, see your eye doctor. See your doctor if you have ongoing symptoms that may include:

• Eye discomfort
• A noticeable change in vision
• Double vision
• Headache

Causes:

Common causes of eyestrain include:

• Extended use of a computer or digital electronic devices
• Reading for extended periods
• Other activities involving extended periods of intense focus and concentration, such as driving a vehicle
• Exposure to bright light or glare
• Straining to see in very dim light

Using a computer for long periods is one of the most common causes of eyestrain. This type of eyestrain is called computer vision syndrome. In some cases, an underlying eye problem such as eye muscle imbalance or uncorrected vision can cause or worsen computer eyestrain.


Complications:

 Eyestrain doesn't have serious or long-term consequences, but it can be disruptive and unpleasant. It can make you tired and reduce your ability to concentrate. In some cases, it may take days for all eyestrain symptoms to go away after you've taken steps to change your activities or environment or treated any underlying cause.


Treatments and drugs:

Generally, treatment for eyestrain consists of making changes in your work habits or your environment.

• In some cases, eyestrain may improve if you get treatment for another underlying eye condition.
• For some people, wearing glasses that are prescribed for specific activities, such as using a computer or reading, may help reduce eyestrain.
• Your doctor may suggest that you do regular eye exercises to help your eyes focus at different distances.

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Eye melanoma

Eye melanoma

Definition:

Melanoma is a type of cancer that develops in the cells that produce melanin — the pigment that gives your skin its color. Your eyes also have melanin-producing cells and can develop melanoma. Eye melanoma is also called ocular melanoma.

Most eye melanomas form in the part of the eye you can't see when looking in a mirror. This makes eye melanoma difficult to detect. In addition, eye melanoma typically doesn't cause early signs or symptoms.

Treatment is available for eye melanomas. Treatments for some small eye melanomas may not interfere with your vision. However, treatment for large eye melanomas typically causes some vision loss.

Symptoms:

Eye melanoma may not cause signs and symptoms. When they do occur, signs and symptoms of eye melanoma can include:

• A growing dark spot on the iris
• A sensation of flashing lights
• A change in the shape of the dark circle (pupil) at the center of your eye
• Poor or blurry vision in one eye
• Loss of peripheral vision
• Sensation of flashes and specs of dust in your vision (floaters)

When to see a doctor
Make an appointment with your doctor if you have any signs or symptoms that worry you. Sudden changes in your vision signal an emergency, so seek immediate care in those situations.


Causes:

It's not clear what causes eye melanoma, also called ocular melanoma. Doctors know that eye melanoma occurs when errors develop in the DNA of healthy eye cells. The DNA errors tell the cells to grow and multiply out of control, so the mutated cells go on living when they would normally die. The mutated cells accumulate in the eye and form an eye melanoma.

Where eye melanoma occurs
Eye melanoma most commonly develops in the cells of the uvea, the vascular layer of your eye sandwiched between the retina, the thin layer of tissue that lines the back inner wall of your eyeball, and the white of your eye (sclera). Eye melanoma can occur in the front part of the uvea (iris and ciliary body) or in the back part of the uvea (choroid layer).

Eye melanoma can also occur on the most outer layer on the front of the eye (conjunctiva), in the socket that surrounds the eyeball and on the eyelid, though these types of eye melanoma are very rare.


Complications:

Complications of eye melanoma may include:

• Increasing pressure within the eye (glaucoma). A growing eye melanoma may cause glaucoma. Signs and symptoms of glaucoma may include eye pain and redness, as well as blurry vision.
  
• Vision loss. Large eye melanomas often cause vision loss in the affected eye and can cause complications, such as retinal detachment, that also cause vision loss. Small eye melanomas can cause some vision loss if they occur in critical parts of the eye. You may have difficulty seeing in the center of your vision or on the side. Very advanced eye melanomas can cause complete vision loss.
  
• Eye melanoma that spreads beyond the eye. Eye melanoma can spread outside of the eye and to distant areas of the body, including the liver, lungs and bones. 

Treatments and drugs:

Your eye melanoma treatment options will depend on the location and size of the eye melanoma, as well as your overall health and your preferences.

Waiting to treat small eye melanomas
A small eye melanoma may not require immediate treatment. If the melanoma is small and isn't growing, you and your doctor may choose to wait and watch for signs of growth. If the melanoma grows or causes complications, you may choose to undergo treatment at that time.

Surgery
Operations used to treat eye melanoma include procedures to remove part of the eye or a procedure to remove the entire eye. Options may include:

• Surgery to remove the melanoma and a small area of healthy tissue. Surgery to remove the melanoma and a band of healthy tissue that surrounds it may be an option for treating small melanomas. What procedure you'll undergo depends on the size and location of your eye melanoma. For instance, surgery to remove a small melanoma affecting the iris is called iridectomy. Surgery to remove a melanoma in the choroid is called choroidectomy.
  
• Surgery to remove the entire eye (enucleation). Enucleation is often used for large eye tumors. It may also be used if the tumor is causing eye pain. After the eye with melanoma is removed, an implant is inserted into the same position, and the muscles controlling movement of the eye are attached to the implant, which allows the implant to move. After you've had some time to heal, an artificial eye (prosthesis) is made. The front surface of your new eye will be custom painted to match your existing eye.

Radiation therapy
Radiation therapy uses high-powered energy beams, such as protons or gamma rays, to kill cancer cells. Radiation therapy is typically used for small to medium-sized eye melanomas.

The radiation is usually delivered to the tumor by placing a radioactive plaque on your eye, directly over the tumor in a procedure called brachytherapy. The plaque is held in place with temporary stitches. The plaque looks similar to a bottle cap and contains several radioactive seeds. The plaque remains in place for four to five days before it's removed.

The radiation can also come from a machine that directs radiation, such as proton beams, to your eye (external beam radiation or teletherapy). This type of radiation therapy is often administered over several days.

Laser treatment
Treatment that uses a laser to kill the melanoma cells may be an option in certain situations. One type of laser treatment, called thermotherapy, uses an infrared laser and is sometimes used in combination with radiation therapy.

Cold treatments
Extreme cold (cryotherapy) may be used to destroy melanoma cells in some small eye melanomas, but this treatment isn't commonly used.

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Eye floaters

Eye floaters

Definition:

Eye floaters are spots in your vision. Eye floaters may look like black or gray specks, strings or cobwebs that drift about when you move your eyes.

Most eye floaters are caused by age-related changes that occur as the jelly-like substance (vitreous) inside your eyes becomes more liquid. When this happens, microscopic fibers within the vitreous tend to clump together and can cast tiny shadows on your retina, which you may see as eye floaters.

If you notice a sudden increase in the number of eye floaters, contact an eye specialist immediately — especially if you also see flashes of light or lose your peripheral vision. These can be symptoms of an emergency that requires prompt attention


Symptoms:

Symptoms of eye floaters may include:

• Spots in your vision that may look like dark specks or knobby, transparent strings of floating material
• Spots that move when you move your eyes, so when you try to look at them, they move quickly out of your visual field
• Spots that are most noticeable when you look at a plain bright background, such as a blue sky or a white wall
• Spots that eventually settle down and drift out of the line of vision

When to see a doctor
Contact an eye specialist promptly if you notice:

• Many more eye floaters than usual
• A sudden onset of new floaters
• Flashes of light
• Darkness on the sides of your vision (peripheral vision loss)

These painless symptoms could be caused by a retinal tear, with or without a retinal detachment — a sight-threatening condition that requires immediate attention.


Causes:

Eye floaters may be caused by:

• Age-related eye changes. Eye floaters most commonly occur as a result of age-related changes in the vitreous, the jelly-like substance that fills your eyeballs and helps maintain their round shape. Over time, the vitreous changes in consistency and partially liquefies — a process that causes it to shrink and pull away from the interior surface of the eyeball. As the vitreous shrinks and sags, it clumps up and gets stringy. Bits of this debris block some of the light passing through the eye, casting tiny shadows on your retina.
  
• Inflammation in the back of the eye. Posterior uveitis is inflammation in the layers of the uvea in the back of the eye. Posterior uveitis, which can cause eye floaters, may be caused by infection or inflammatory diseases, among other causes.
  
• Bleeding in the eye. Vitreous hemorrhage is bleeding into the eye's jelly-like vitreous. Bleeding in the eye can have many causes, including injury and blood vessel problems.
  
• Torn retina. Retinal tears can occur when a sagging vitreous tugs on the retina with enough force to tear it. A retinal tear may cause new floaters to appear in your vision. Without treatment, retinal tear may lead to retinal detachment — an accumulation of fluid behind the retina that causes it to separate from the back of your eye. Untreated retinal detachment can cause permanent vision loss.

Treatments and drugs:


Most eye floaters don't require treatment
In most cases, eye floaters don't require treatment. Learning to cope with your floaters may take time. Living with eye floaters may be frustrating. With time, you may find you can ignore the floaters more easily and that you notice the floaters less often.

Treatments for floaters that impair your vision
In rare cases, your eye floaters may impair your vision. Rarely, floaters may be so large or so numerous that it's difficult to go about your daily tasks. In these situations, you and your eye doctor may consider treatment for your eye floaters.
Options may include:

• Using a laser to dissolve floaters. During laser therapy, an ophthalmologist aims a special laser at the floaters in the vitreous. The laser may break up the floaters and make them less noticeable. Some people who undergo laser therapy for their floaters report improved vision, while others notice little or no difference. Risks of laser therapy include damage to your retina that can occur if the laser is pointed incorrectly. Laser surgery to treat floaters is considered experimental and isn't widely used.
•  
• Using surgery to remove the vitreous. During a vitrectomy procedure, an ophthalmologist makes a small incision in your eye and removes the gel-like vitreous. A solution is placed in the eye to help it maintain its shape. Eventually, your body makes and fills your eye with fluid that will replace the solution. Vitrectomy may not remove all the floaters in your vision, and new floaters can develop after surgery. Risks of vitrectomy include bleeding and retinal tears.

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