Basic Eye Care
Where do I go for eye care?
You go to your eye doctor! Now it could be an ophthalmologist, who's a specialist in medical diseases of the eye, or it could be an optometrist, a specialist in glasses, contacts, and primary eye care. An optician is somebody who specializes in fitting glasses to your eyes- making lenses, fitting the frames, adjusting the nose pieces. Opticians can also be involved in dispensing contact lenses, but they don't prescribe glasses or contacts, and they don't measure or examine your eyes. It depends what kind of eye care you need.
What is the difference between a Optician, Optometrist and an Ophthalmologist?
Opticians are people who make your eyeglasses, fit them to your face, adjust the nose pads; they're the people you walk into and talk to in the mall when you walk into the eyeglass store. Optometrists are people who specialize in measuring the eyes. They prescribe glasses and contact lenses, and they also do primary eye care. They'll examine your eyes, find out if you have eye diseases and, in fact, treat many of the relatively basic eye diseases. Optometrists cannot do surgery. Ophthalmologists do medical and surgical diagnoses and treatment of eye diseases and they also provide primary eye care. So, generally, if you need surgery on your eye, you're seeing an ophthalmologist.
How will I know which type of eye doctor I need?
In terms of eye doctors, you have a choice of an optometrist or an ophthalmologist. Both can provide primary eye care and both are good entries into the system if you're having an eye problem or if you need your eyes checked. What you should do is find out who the best doctor around is, and don't worry too much about exactly which degree they have.
How do I find an eye doctor in my area?
The best way to find an eye doctor in your area is by referral. Get referrals from friends of yours who are happy with their eyecare. Even better, get referrals from other doctors. Ask your internist, your gynecologist, your ENT doctor. Whoever's taking care of you medically is going to have a good idea of who the good local eye doctors are.
What is "ophthalmology"?
Ophthalmology is the scientific study of the eye, its diseases, and its treatments, including surgery.
How should I pick an eye doctor?
When picking an eye doctor, look for someone who's referred by friends or other doctors, and check out their credentials. Make sure that they're a member of their local societies, that they're in good standing with the local medical or optometry board. Go to see the eye doctor. See what kind of an exam they do. Is it thorough, is it careful? Or are they rushed and not paying attention? Judge the quality of your interaction with the person. Generally, if you feel good about them, if you connect well with them, they're probably a good eye doctor for you.
What if I get glasses or contacts and they're uncomfortable?
If you get a new pair of glasses or contacts and they don't seem right, go back to the doctor. It doesn't mean they made a mistake; glasses and contacts are tricky, and sometimes they have to be changed or adjusted. Go back, give the doctor another chance - even the best doctors need to occasionally remake the glasses. But, if this happens over and over, it's probably worth getting a second opinion. Again, the doctor didn't necessarily make a mistake, but sometimes another doctor can have more success. Of course, if your glasses are just a little uncomfortable, a minor adjustment of the nose pads or ear-pieces is likely to solve the problem.
What is an eye exam and who should get one?
An eye exam is a comprehensive look at the health of your eyes and your vision. Everyone should have an eye exam probably every couple of years, and children should probably get their first eye exam by the age of two years old, preferably perhaps even earlier. As you get to be over the age of 4, you ought to have an eye exam every year to detect potentially blinding eye diseases like cataracts, glaucoma and macular degeneration.
What is "near-sightedness"?
Near-sightedness means you can see things up close without your glasses, but you can't see things that are far away. Generally if you're near-sighted it means that the curvature of the front part of your eye, what we call the cornea, that's that part right there, is too curved for the size of your eye. So to correct that, you either make your eye smaller, there's no way to do that, you reshape the cornea, that's what we call LASIK or laser surgery, or you wear glasses or contacts. There's about 60,000,000. Americans who are near-sighted, based on studies that are now probably 10 to 15 years old. My suspicion is there's considerably more than that, because there's a higher incidence of near-sightedness in young people today than ever before.
What is "far-sightedness"?
In contrast far-sightedness means your distance vision is not very good and things up close are really blurry. You're far-sighted if the curvature of the front part of your eye, what we call the cornea, the part you can touch, you touch right there. If curvature of the cornea is too little for the size of your eye. We correct that with either glasses or contacts, or by making the cornea more curved: that's what laser surgery does. Far-sightedness is very common. Perhaps ninety million people in America are far-sighted. People typically find out they're far-sighted in their mid thirties, because they start having trouble reading. They find themselves holding the book material further away. They may be getting headaches, their eyes feel fatigued, sometimes their eyes will cross. These can all be signs of far-sightedness which tends to become more symptomatic as you get older.
What is meant by the term, "20/20 vision"?
20/20 vision is used colloquially to mean your vision's perfect. What it means technically, though, is you can see a particular letter of a certain size 2 feet away. That size was defined historically by what people thought normal vision was. In practice, 20/20 vision means your vision's really good. But it turns out that many people, especially after laser surgery or with a very well-fitted pair of glasses or contacts, see better than 20/20. What we call 20/15, or super vision. If your vision's worse than 2/2 -- say it's 2/4 -- what that means is that you can see at 2 feet what someone with normal vision could see at 4 feet. So you have to get closer. Or if you're 2/1, it means that you can see at 2 feet what somebody else could see 1 feet away. And so their vision is in a way five times better than yours. It's just a way to think about it intuitively.
What are the parts of my eye?
There are two eyelids in each eye, the lower eyelid and the upper eyelid. The eyelids are critically important because every time you blink it smears a layer of pure tears over your eyes, which keeps your eye comfortable, healthy, and seeing well. The cornea is the clear dome that covers the colored part of your eye. In fact, if you touch the center of your eye, you're actually touching the cornea. The cornea's critical because it's the main focusing lens of the eye. The cornea does more focusing of light than any other part of your eye. The conjunctiva is essentially the white part of the eye all around the colored part. That's important because it produces some of the tears in your eyes, and it's what gets red and inflamed when you get pink eye. The iris is the colored part of your eye. And it's important because in the middle of it is your pupil, which is the window through which all the light passes from the outside world going into your eye. It's like a keyhole through which your eye does all its seeing. Your eye is a hollow ball and it's filled with a material that we call vitreous. It's like a jellylike material, and it's what gives your eye its structure and shape when you're young. It's important because as we age that degenerates, and that degeneration can lead to retinal detachments in some people. The optic nerve is the nerve that connects the eye to the brain. It carries all the images of the outside world back to your brain so you can make sense of them. The crystalline lens, we just call it the lens for short, is a lens inside your eye that allows the focus of your eye to change so you can see far away, intermediate, up close. It helps focus light from all different distances so you have clear vision.
Where do tears come from?
Tears in your eyes are produced by glands. They're actually modified sweat glands. The main gland is up here, called the lacrimal gland, and that produces the tears which drain down through the tear duct and keeps your eye nice and moist. Then there's something called the colloquium, we call them the tear drainage ducts. We call it the lacrimal system. It drains tears from your eyes into your nose. That's why your eye doesn't overflow with tears. They just have to go somewhere. They go out the drain. In fact, the reason your nose runs when you cry is because as you cry those tears run down into your nose and make your nose run.
