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Vision problems:Continued from i/59 Article 9 Alternative names: Vision Impairment; Impaired vision; Blurred vision Definition: There are many types of eye problems and visual disturbances. These include blurred vision, halos, blind spots, floaters, and other symptoms. Blurred vision is the loss of sharpness of vision and the inability to see small details. Blind spots (scotomas) are dark "holes" in the visual field in which nothing can be seen. For the most severe form of visual loss, see blindness. Considerations: Changes in vision, blurriness, blind spots, halos around lights, or dimness of vision should always be evaluated by a medical professional. Such changes may represent an eye disease, aging, eye injury, or a condition like diabetes that affects many organs in your body. Whatever the cause, vision changes should never be ignored. They can get worse and significantly impact the quality of your life. Professional help is always necessary. As you determine which professional to see, the following descriptions may help:
Common Causes: Vision changes and problems can be caused by many different conditions:
Other potential causes of vision problems include fatigue, overexposure to the outdoors (temporary and reversible blurring of vision), and many medications. Medications that can affect vision include antihistamines, anticholinergics, digitalis derivatives (temporary), some high blood pressure pills (guanethidine, reserpine, and thiazide diuretics), indomethacin, phenothiazines (like Compazine for nausea, Thorazine and Stelazine for schizophrenia), medications for malaria, ethambutol (for tuberculosis), and many others. Home Care: Safety measures may be necessary if you have any vision problems. For example, if you have trouble seeing at night, you should not drive after dusk. It may be helpful to increase the amount of light in a room or arrange a home to remove hazards. A specialist at a low-vision clinic may be able to help. Call 911 if:
Call your provider if you have:
What to expect at your health care provider's office: Your provider will check vision, eye movements, pupils, the back of your eye (called the retina), and eye pressure when needed. An overall medical evaluation will be done if necessary. Your provider will ask questions about your vision problems, such as:
· Do you have diabetes or is there a family history of diabetes? The following tests may be performed:
Treatments depend on the cause. Surgery will be recommended for some conditions (such as cataracts). Diabetics must control their blood-sugar level. Prevention: Regular eye checkups from an ophthalmologist or optometrist are important. They should be done once a year if you are over age 65. Your doctor will recommend earlier and more frequent exams if you have diabetes or you are already showing early signs of eye problems from diabetes, high blood pressure, or other causes. The pressure in your eyes will be measured at some visits to test for glaucoma. Periodically, your eyes will be dilated to examine the retina for any signs of problems from aging, high blood pressure, or diabetes. These important steps can prevent eye and vision problems:
References: US Preventive Services Task Force. Screening for glaucoma: Recommendation statement. Ann Fam Med. 2005; 3(2): 171-172. Spierer A. Presbyopia among normal individuals. Graefes Arch Clin Exp Ophthalmol. 2003; 241(2): 101-105. Update Date: 6/7/2004 Updated by: Jacqueline A. Hart, M.D., Department of Internal Medicine, Newton-Wellesley Hospital, Boston, Ma.
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