Answers to the "Eye-Q" test:
1. Cataracts are growths that cover the eye and must be peeled off to restore clear vision.
Answer: False. A cataract is not a growth nor any additional structure in the eye. It is simply what we call the lens (of the eye) which has become cloudy... a "cataractous lens." When necessary, cataracts are taken OUT of the eye, an operation known as cataract extraction. Since they are not a growths or coverings, they cannot be "peeled off" the eye.
2. People who are nearsighted when they are young usually also become farsighted at the same time as they get to be over age 40.
Answer: False. The terms nearsighted and farsighted are often misunderstood. They refer to how the lens system of the eye focusses the light when the eye is fully relaxed, doing NO work and looking off into the distance. The nearsighted eye is too long (front-to-back length of the eye) causing the light rays to come to focus before they reach the retina. The farsighted eye is too short causing the light rays to reach the retina before they have a chance to be fully focussed. To say that a person is nearsighted and farsighted at the same time is like saying that a person is short and tall at the same time. The difficulty with reading when you get over the age of 40 relates to the loss of active focussing ability of the lens of the eye, a normal age-related change called presbyopia. This occurs in nearsightedness and farsightedness as well.
3. Most all babies are cross-eyed at birth but usually outgrow it on their own.
Answer: False. Most babies have truly straight eyes at birth, but because of the wide flat bridge of the nose, they seem to be cross eyed. This very common illusion of crossing, known as pseudoesotropia (esotropia is the technical term for crossed eyes), goes away when the nasal bridge fills out as the child gets older. Real crossing, however, is not outgrown.
4. Having astigmatism is usually normal.
Answer: True. Are you surprised? Astigmatism is the other of the 3 possible focussing errors that an eye can have (the other 2 being nearsighted and farsighted). It is nothing more than an out-of-roundness of the cornea (the front "window" of the eye) or the lens of the eye, or both. An football, for example, has an astigmatic surface...2 different curvatures at right angles to each other. Astigmatism, then, is a variation in the curvature of the surface of the eye. Although it is preferable not to have any, since it can cause blurry vision, it is,in fact, a variation of normal. The term comes from the Greek word stigma which means point. The prefix a means without. Therefore, astigmatism means "without a point." This refers to the idea that an astigmatic focussing surface, such as the cornea, causes a point source of light to be focussed not as a point image but more as a line. There are really two focal points from the astigmatic surface, and they do not fall at the same spot. Therefore, the image is alsways blurred. Except for a somewhat less common type of multiple curvature (so-called irregular) astigmatism which is usually the result of disease, ordinary astigmatism is normal.
5. Kids who have trouble reading don't usually improve by way of eye muscle exercises.
Answer: True. For many years it was felt that the act of reading represented a smooth following or tracking movement of the eyes. However, it has now been shown that reading is really a collection of movement clusters, known as saccades, which jump from one to another. Studies comparing these saccades in children with reading difficulties and those who are excellent readers have demonstrated absolutely no difference between the two groups. This, therefore, shows that the eye muscles, themselves, have no bearing on reading problems. Moreover, it has been known for years that children who have crossed eyes or children with a lazy eye may read every bit as well, or better than, those with "normal" eye findings. If you have a child with reading problems, you should know, then, that these so-called eye muscle exercises which often involve prolonged "tracking" techniques really will not help your child to read any better.
6. If your eye pressure is below 21, you don't have to worry about having glaucoma.
Answer: False. Glaucoma is a disease of the retinal nerve fiber layer and optic nerve. It is characterized by anatomic damage to these structures. Its cause is not known. While it is true that high pressure may cause damage, approximately one third of all patients who have this "glaucomatous" damage have never had a pressure above 21. By the same token, there are many eyes with pressures above 21 that have no disease at all. All of this means that having your eye pressure checked with nothing else examined in inadequate. Your ophthalmologist can evaluate your optic nerve and other ocular features to make the proper determination.
7. Your ophthalmologist can always tell if you have diabetes just from the eye exam.
Answer: False. Many diabetics, even those with poor control of their blood sugar level, do not show evidence of diabetes in their eyes (diabetic retinopathy). If you have the disease (and have had it for a number of years) AND it happens to be present in your retina, then your ophthalmologist can tell you that you have diabetes (although you probably already know it). If nothing shows up in the eye exam, you still may have diabetes, however.
8. The ultimate goal in treating glaucoma with eye drops is to lower the pressure in the eyes.
Answer: False. The ULTIMATE goal in treating glaucoma is preservation of vision. Reducing the pressure with eye drops is a means to an end, not the end in itself. (If you answered this one as true, go ahead and count it as a correct answer... I am being a bit philosophic here).
9. Conjunctivitis is usually contagious.
Answer: False. The term conjunctivitis is a general term that means inflammation of the conjunctiva (which is the outer lining of the eyeball and the internal lining of the eyelid. Ther term inflammation does not necessarily imply infection. For example, if you come out of a swimming pool with chlorinated water, and your eyes are red, that it conjunctivitis...chemical conjunctivitis. The itchy red watery eyes you get in association with hay fever is also conjunctivitis... allergic conjunctivitis. Getting hit in the eye can produce a red irrited eye, also conjunctivitis.... traumatic conjunctivitis. None of these are contagious. Infectious conjuctivitis, whether viral, bacterial, fungal or otherwise, may be contagious, however.
10. Sleeping with soft contact lenses in the eyes can result in serious eye problems.
Answer: True. Very true! The likelihood of developing an ulceration of the cornea when sleeping with soft lenses (even approved extended wear lenses) is substantially higher than when taking them out each day. In spite of the fact that many lenses are "officially" approved for wear continuously (extended wear), we recommend against it. It is far safer for the eye to remove and disinfect the contact lens each night. Give your corneas a rest, and you'll have fewer problems. And you should NEVER sleep with a hard or gas-permeable hard lens in your eye.
11. A person who experiences a sensation of light flashes in his or her vision should have the eyes examined to make sure there is no retinal problem.
Answer: True. While many, if not most, light flashes that one may experience (where there actually is no real light flashing) are normal, flashes may represent a tear in the retina. This kind of problem should be noted because untreated retinal tears and holes might lead to retinal detachment.
12. Glaucoma usually is never associated with eye pain.
Answer: True. Most glaucoma has no pain with it. Only in a case of so-called angle closure glaucoma in which the pressure inside the eye can rise to extremely high levels (sometimes 60-70) within a few hours is there usually pain.
13. Surgical correction of nearsightedness (refractive surgery) is an option available to virtually anyone who wants to have it done.
Answer: False. While it is true that refractive surgery is wonderful option available to a great many people, there are some important limitations. Only those whose eyeglass prescription is within certain limits and have been stable over the prior few years can be candidates. This usually eliminates teenagers and some younger adults who continue to experience progression of their myopia. Absence of some specific eye diseases and systemic illnesses are requirements as well. Because of these medical implications, if you are considering refractive surgery, see an ophthalmologist, an "Eye M.D." You should not leave this important decision making to a non-physician.
14. Having a child's eyes examined before the child can read an eye chart is not very practical.
Answer: False. It is not necessary for a child to be able to read letters or an eye chart for us to determine if the eyes are healthy and if glasses are needed. This can all be done "silently." Similarly, the same idea applies to adults who cannot read or understand. A child should have a thorough medical eye examination by an ophthalmologist well before starting school. This is the time for us to detect a lazy eye problem and treat it before the vision is permanently impaired.
15. Teenagers who are nearsighted can ruin their eyes if they don't wear their glasses when they are supposed to.
Answer: False. As much as the expression "ruining the eyes" is used, it actually has no meaning whatsoever. There is no such thing as ruining the eyes. The only time in which there may be a permanent detrimental effect on the vision of a child is when the child is under about age 5 and needs glasses to avoid or treat an existing lazy eye (amblyopia) problem. Only a physical injury can damage the eyes. Even though your teenager might squint and strain to see without glasses, no permanent harm or damage will occur. Usually the most common reason that children do not wear their glasses "when they are supposed to" is that the glasses do not provide any real benefit that the child can appreciate from his or her perspective.
16. Cataracts should be ripe before they are removed.
Answer: False. It is easier and safer to remove a cataract before it becomes fully ripe. To get to be ripe, it must have been in the eye for a very long time, and this would cause needless poor vision for much longer than necessary. It is far preferable to have the cataract removed before it becomes fully ripe.
17. Intraocular lens implants are generally better than cataract eyeglasses for vision correction after a cataract is removed.
Answer: True. Intraocular lens implants (IOL's) provide much more natural vision than the old fashioned cataract glasses and do not have the extreme distortion that those glasses have. Virtually all cataract surgery now is done with IOL implants.
18. Lasers remove cataracts safer and more quickly than regular surgery does.
Answer: False. Lasers do NOT remove cataracts. Surgery, usually with a very small incision is still needed.
19. Since eye drops only go into the eyes, they can almost always be used safely even if other diseases are present elsewhere in the body.
Answer: False. All eye drops can get absorbed into the body through the lining tissue of the eye and by being swallowed as they drain from the eyelid into the tear duct system and then into the back of the throat. Eye drops can cause high or low blood pressure, asthma, fainting, stomach upset and, in some cases, severe systemic allergic problems.
20. Medications such as Plaquenil® for treating arthritis can harm the eye.
Answer: True. Just as eye drops can be harmful to the rest of the body, medications taken by mouth can sometimes harm the eye. Plaquenil®, for example, a quinine derivative, can cause a toxic reaction in the retina. Proper and timely monitoring by your ophthalmologist is a must if you take this medication. Furthermore, there are many systemically-taken medications that can affect your eyes and your vision. It is always helpful if you know what medications you are taking when you have your eyes examined.
21. Disposable contact lenses that are kept for only 2 weeks at a time don't need to be disinfected each night during the 2 week period.
Answer: False. All soft contacts can become contaminated in a time period far less than 2 weeks. You should always disinfect your lenses every night when you remove them, even if you throw them away every two weeks. Sleeping in the is not recommended at all.
22. Most headaches come from eye problems.
Answer: False. Most headaches do not come from eye problems. Rather, they may cause the eyes to hurt or the vision to blur. Since headaches, by definition, occur in the brain area which is adjacent to the eyes, it is common to assume that the eyes cause the problem. In many cases, however, even though the eyes may not actually cause the headaches, your ophthalmologist, a Doctor of Medicine, may be able to help determine the cause by way of the examination of the central nervous system as it can be "seen" through the eye exam. Many neurological problems begin with vision complaints, and a comprehensive eye exam may locate the source of the problem.
23. Spending lots of time in front of a computer is perfectly safe for the eyes.
Answer: True. There is no doubt that many people suffer from "eyestrain" and headaches as a result of spending hours in front of a computer terminal. However, fortunately there has never been any evidence to show or suggest that any type of physical harm occurs.
24. Macular degeneration can usually be improved by taking high doses of vitamins.
Answer: False. Most macular degeneration does not get better with any known medical treatment although there are some new investigational surgical procedures underway. However, a major study that was published recently has shown that a specific combination of vitamins with supplemental zinc and copper may retard the progression of macular degeneration in some individuals who have specific physical findings or others who may be at high risk. Unfortunately, this supplement will not make the basic condition better. Most of the commercially available multivitamin/mineral supplements, however, have not been proven to be effective. Only your ophthalmologist can determine if your eye condition might benefit from taking supplements.
25. Making bifocals or reading glasses stronger will almost always improve a person's ability to read for longer periods of time.
Answer: False. The most common cause of easy fatigability when reading is age-related decrease in circulation. Stronger reading glasses, while providing a larger image, usually don't prolong the time a person can read without becoming tired unless, of course, the glasses are significantly too weak under ordinary circumstances in the first place.
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