Question: The doctor is concerned about my grand-daughter’s squint. What is a squint, and is it serious?
A squint (or strabismus, to give it its correct medical name), occurs when the two eyes do not align equally when looking at a distant object. One eye appears to be looking in one direction, while the other is looking in a different direction. This is quite normal when looking at something very close, as both eyes turn in to look at it.
If a child does have a significant squint, the brain will gradually suppress the sight in one eye, to avoid double vision. The affected eye may never learn to see again, resulting in the child becoming blind in that eye. The correction of a squint at an early age is therefore vital. Treatment usually involves prescribing special spectacles to correct the problem. If the squint is more severe, the good eye will be covered for a period every day, as well as using the glasses. This strengthens the vision in the poor eye and prevents blindness in that eye. In marked degrees of squint, it is necessary to operate on the tiny muscles that control eye movement to shorten those that are not pulling the eye around far enough.

Question: I get flashes of black or clear spots or shapes in my eyes. My vision is still perfect. Any suggestions?
I have several suggestions as to the cause, but they will all end the same way— you must see a doctor!
The most likely cause is that you have a floater in your eye. This is a clump of cells floating in the fluid inside the eye. They can be quite annoying, and can be destroyed by laser treatment. The problem is what has caused the floater? The cells may have broken away for no serious reason, but it is possible that they are the first sign of significant eye problems. For this reason floaters must always be checked by an ophthalmologist (eye specialist).
Spots in your vision may also be due to migraines (and these are not always accompanied by a headache), a damaged retina (the light-sensitive layer of cells at the back of the eyeball), a cataract (cloudiness or damage to the lens in the eye), a deteriorating blood supply to the eye (for example after a stroke) or due to a tumor in or around the eye or the brain.
It is because there are so many possible nasty causes that it is essential to have an accurate diagnosis.

Question: Can glare damage your eyes?
Yes. Glare will cause chronic inflammation to the narrow segment of the white of the eyes that is exposed to the reflected sun’s rays when squinting. Over a period of several years this can lead to the build-up of scar and fat tissue in this area. This is known as a pinguecula. They cause no harm to the eye, but are unsightly and may become inflamed and itchy. Cataracts may also be aggravated by glare, including the glare reflected from water onto the eyes.
The problem is prevented by wearing high-quality sun glasses.

Question: Can you give me information on what causes vitreous floaters in the eye. How long do they last?
Floaters are abnormal clumps of cells in the center of the eyeball that cast a shadow on the light-sensitive retina at the back of the eye, and the brain perceives this shadow as an object (spot) in front of the eye.
The ‘floater’ can occur at any point in the field of vision, but the closer it is to the center (i.e. when looking straight ahead), the more annoying it becomes. The cells can form in the center of the eye because of bleeding into the eye, a detached retina, infection or no apparent cause may be found. Diseases such as diabetes, leukemia, high blood pressure, and a number of rarer conditions may cause bleeding into the eye. A detached retina can be repaired by laser therapy in the early stages, but if left, may result in permanent blindness. Because there may be a serious disease causing the problem, all patients with floaters must be appropriately investigated to exclude these problems.
The condition is only treated if it is causing significant trouble, as most floaters dissipate with time.

Question: I have floaters in the inside of the eye. Could you tell me if there is any treatment for this?
Patients with floaters can ’see’ one or more fine, dark spots or lines that appear to ‘float’ across their field of vision. Floaters are actually extremely small particles that are formed from clumps of cells, and drift in the fluid that fills the eye. This fluid has the consistency of half-set jelly. These cell clumps break away from the inside lining of the eye, or are caused by bleeding from or damage to the lining of the eye ball. Most of them are not an indication of any serious disease, but because some floaters are caused by diseases such as diabetes, leukemia, high blood pressure and other rarer but more serious conditions, every patient with floaters must be carefully examined by a doctor.
The only treatment necessary in the majority of cases is reassurance, but where a particular disease is found to cause the problem, this must be treated. Persistent, annoying floaters are treated by eye specialists using lasers.

Question: My mother has been diagnosed as having mild glaucoma, but all the doctor has done is give her some eye drops. How is glaucoma treated?
Your sight is one of your most valued possessions. Any disease that can reduce your vision, or worse still, make you blind, is of great concern. One such disease is glaucoma.
Glaucoma is an increase in the pressure of the fluid inside the eye. If this pressure becomes too high, the eye can be permanently damaged. It is diagnosed by measuring the pressure inside the eyeball. There are two methods of measuring the eyeball pressure. In the older method, special drops to numb the eye are used, and then an instrument is rested on the eye for a few seconds. A more sophisticated method is to use a machine that puffs air onto the eye for a fraction of a second and measures the amount of air pressure reflected from the eye. Both can give very accurate measurements of the eye pressure. Looking at the outside of the eye at different angles, and examining the back of the eyeball with a magnifying instrument also help make the diagnosis. There are more than 20 different types of glaucoma, with different causes and therefore different treatments. It is a complex area, that once suspected or diagnosed, is best dealt with by an ophthalmologist (specialist eye doctor).
Treatment involves the use of one or more eye drops on a regular basis, every day, usually for the rest of the patient’s life. Some types of glaucoma may also require the taking of tablets. Occasionally the disease settles spontaneously in old age. Glaucoma cannot be prevented, but it can be controlled successfully in nearly all patients, and sometimes it can be cured by surgery. The surgery increases the rate of drainage of fluid from the eye, and may involve the use of lasers to burn microscopic drain holes in the corner of the eye. With modern treatment techniques, the outcome for patients with glaucoma is normally very good, but continued follow-up by a doctor is essential.

Question: I have just been diagnosed as having glaucoma. My mother had it too. What causes this disease?
Your eyeball contains a transparent liquid that has the consistency of half-set jelly. This liquid is produced by special cells that sit just behind the iris (the colored part of the eye). There is a slow circulation of this fluid around the eyeball and out through the pupil to the area in front of the iris. Here the fluid is absorbed back into the bloodstream.
The fluid in the eyeball is under pressure to maintain the shape of the eye and prevent distortion of the light waves entering the eye. If the pressure of the fluid increases, the light-sensitive cells inside the eye will be damaged and vision will decrease possibly to the point of blindness. Glaucoma is the disease caused by an increase in the pressure of the fluid in the eye. The most common type of glaucoma has a slow onset over many months or years. The patient may not be aware that there is anything wrong unless a routine test by a doctor detects it.
Unfortunately, the first symptom is often deteriorating vision, and by then it may be impossible to reverse the existing damage, but any further damage can be prevented by the correct treatment. There is an hereditary tendency to this type of glaucoma, and anyone who has parents with glaucoma should have their eyes checked every couple of years after the age of 35.

Question: What is color blindness?
The normal form of color blindness is an inability to differentiate between the colors red and green. In some men, other colors may be involved, but only rarely is all color vision lost with the person seeing in black and white. Color blindness is hereditary, and occurs nearly always in men.
Special cards covered in colored dots, with numbers hidden amongst the dots, are used by doctors to diagnose the condition. There is no treatment available, but most patients can live quite happily with the problem, and may have adapted so completely to the problem, that they are not aware of its existence. Those planning a to work as an electrician or commercial pilot, or in some other areas where color differentiation is vital, may not be allowed to undertake these careers.