Some common eye disorders will have no early symptoms. You may not experience any symptoms until the condition has become very advanced. Good eye health should involve no pain, redness, irritation, or discharge. While many of the disorders we’ll cover here are relatively harmless, certain conditions such as glaucoma can lead to vision loss and even blindness.
When Problems Develop
Many people will begin to develop eye issues in their mid-forties, however, symptoms may not appear until years down the road when the condition is harder to treat because it’s more advanced. Some people may not even know they have a disorder until a routine exam with their optometrist. During an exam, a specialist will check eye pressure, the optic nerve, and the retinas. An annual eye exam is very important to protect your eye health, unfortunately, many people fail to meet with their eye care specialist until they experience a problem with their vision.
Who Is At Risk?
As we grow older, our risk of developing an eye disorder will increase. However, there are other factors that can increase our risk of experiencing vision issues later down the line. A family history of glaucoma can significantly increase your risk of developing the disease. By detecting this type of disease early on, experts claim that nearly half of all blindness and vision loss is preventable.
There are some cases in which the symptoms of certain disorders can overlap with another condition. As an example, red eyes can be a sign of eye allergies, styes, or pink eye, whereas a new sensitivity to light combined with eye pain and headache can indicate a a person may simply need new glasses or that a serious migraine is headed their way. If you’re experiencing any new changes in your vision, accompanied by pain, contact your physician immediately.
Below I’ll go over some of the most common disorders, how they can impact your vision, and when to seek medical treatment.
Typically, the pupils in both eyes will constrict or dilate at the same time. When both eyes fail to do so, the pupils can appear to be different sizes. The medical term used is anisocoria, however, this is merely a symptom for other conditions and not a disorder itself.
If you wake up one morning and notice that your pupils are different sizes, seeking immediate medical attention is a must. While this change in pupil size doesn’t necessarily indicate that something serious is going on, this type of sudden change can also be an important red flag that you don’t want to ignore. It will be especially important to seek treatment if you’ve also recently suffered a head injury. While there are three different types of anisocoria, physiological anisocoria is the most common type. The other two types include mechanical and pathological.
Physiological anisocoria is diagnosed when the pupils are different sizes naturally. The difference in pupil size is usually no more than one millimeter. This condition may be permanent or temporary. Approximately twenty percent of the population has experienced this type of change in pupil size. Fortunately, this is not considered a serious eye health issue and often resolves on its own.
Mechanical is the second most common type and it’s a direct result of an eye injury.
Pathological is not as common and involves a change in pupil size that’s caused by a disease that affects the pupil or iris, or a disease that affects the information pathways that lead to the pupil.
This is a common condition that can significantly impact a person’s vision. With astigmatism, the surface of the cornea isn’t curved, which can lead to blurry vision. It can also be caused by a lens that is irregularly shaped. This condition can affect both adults and children. It’s typically present at birth, however, it can also develop after an injury or surgical procedure.
Because the cornea is curved abnormally, when light enters the eye it’s not focused correctly on the retina. This results in an unclear image. This condition can usually be easily diagnosed with a regular eye exam. Children affected by it may have a difficult time concentrating and reading. Because of this, regular eye exams are very important. Children should have a regular annual eye exam, while adults with healthy vision should have an eye test every two years.
Symptoms of astigmatism include distorted or blurred vision, headaches, constant squinting, and difficulty seeing at night.
Also referred to as facial palsy, Bell’s palsy involves severe weakness or paralysis of the facial muscles located on one side of the face. The weakness and paralysis is caused by the swelling of the nerve that controls facial muscles. The facial nerve is what controls the majority of the muscles in parts of the ear and face. The nerve runs through a very narrow path of bone from the face to the brain. If the nerve becomes inflamed it can become pinched in the narrow pathway or press against the cheekbone. This often results in damage caused to the nerve’s protective covering. If the covering becomes damaged the signals that go from the muscles in the face to the brain will not be able to transmit properly. This will lead to paralyzed or weakened facial muscles. The exact cause of this condition is not known. Some research has shown that the herpes virus is to blame. However, there are other viruses that have been linked to this condition, such as:
- Cold sores
- Epstein-Barr virus
- Influenza B
- Mumps virus
- Influenza B
- Hand, foot, and mouth disease
A disruption in nerve function or nerve damage can occur since the facial nerve is so complex and has so many functions. Symptoms of this disorder tend to vary from person to person and can be mild or severe. These symptoms can include:
- Paralysis on one side of the face
- Paralysis on both sides of the face
- Muscle twitching
- Drooping of the corner of the mouth and eyelid
- Dryness of the mouth and eye
- Impairment of taste
- Excessive tearing in one or both eyes
Symptoms for this condition typically reach their peak within forty-eight hours. Other serious symptoms can include pain in the face and around the jawline, impaired speech, loss of speech, lightheadedness, trouble speaking, and difficulty drinking and eating.
In terms of treatment, a steroid called prednisolone can help to speed up the recovery process. This steroid can help to reduce inflammation, which can accelerate recovery time. It works by preventing the release of certain inflammatory substances in the body such as leukotrienes and prostaglandins.
Blurred vision isn’t a condition, but more of a symptom that points towards an underlying condition. Blurred vision can occur for a number of reason, such as an eye infection, allergies, contact dermatitis, or general irritation. Blurred vision is one of the most common eye issues and often, it’s not an indication that something serious is going on. It can merely be a sign that you need to have your prescription updated for your contacts or glasses. However, there are times when this type of vision change can indicate something more serious is going on. A fast onset of blurred vision that does not resolve itself in one to two days can be a cause for concern. Make an appointment with your primary care physician or optometrist if your vision doesn’t improve after two days.
The main cause of vision loss in people over the age of forty is cataracts. These are cloudy areas the form in the lens of the eyes. A cataract can cause the lens to become cloudy or opaque, preventing light from easily passing through and leading to blurry or foggy vision. The cloudier the lens is, the worse a person’s vision will be affected. Cataracts that are age-related will appear later in life. In most cases, a doctor will recommend surgery if the person affected has problems leaving the house due to severe vision impairment, or the patient is unable to drive at certain times of day, especially night, due to cloudy vision. Before surgery, the physician will assess the eyes, measuring each of the eyes in order to prepare a replacement artificial lens.
Before the procedure, eye drops will be administered to widen and dilate the pupils. General anesthesia will be injected into the tissue surrounding the eyes. Once the anesthesia takes effect, the procedure will begin. Different replacement lenses may be needed. Monofocal lenses are used to improve one level of vision. These lenses will have two or strengths and can improve both near and distance vision. The accommodating lens is very similar to the natural human lens of the eye and allows the eyes to easily focus on distant and near objects. Cataract surgical procedures will involve removing the cloudy lens, replacing it with a clear, artificial, plastic lens. This is called an intraocular lens.
These days, cataract surgery is considered minimally invasive, allowing the patient to return home the same day. After the procedure, a person will notice that their vision has improved immediately. However, it can take time for the eyes to adjust completely.
Conjunctivitis (Pink Eye)
Conjunctivitis, which is also referred to as pink eye, occurs with the conjunctiva becomes irritated and reddened by allergies or an infection. The eyes will become swollen, red, tender, and discharge is often present. This condition can affect one or both eyes. Some forms of conjunctivitis are highly contagious. There are three types:
The most common type is viral conjunctivitis. This form is highly contagious and usually spreads like wildfire in daycares, schools, and other types of crowded public places.
Allergic pink eye is a form that occurs when a person has an allergic reaction to something. Fortunately, this type of pink eye is not contagious. However, it presents with many of the same symptoms that bacterial and viral conjunctivitis do.
Bacterial pink eye causes the eye to produce sticky discharge. This form of pink eye is highly contagious. Viral conjunctivitis is also very contagious and can occur when a person becomes sick with the flu, common cold, or an upper respiratory infection.
In general treatment for conjunctivitis will depend on the type you have. Viral pink eye is usually not treated since the body can fight the virus on its own. Allergic conjunctivitis can require special drops that can help to ease symptoms and counteract the histamines that are causing the irritation.
Bacterial pink eye will require antibiotic eye drops, in addition to eye drops that can help to ease the symptoms. To learn more, click here to read my guide on the best eye drops.
The medical term used for dilated pupils is mydriasis. A person’s eyes will normally dilate when the light is dim, in order to allow more light to enter the eyes. Mydriasis is a term used to describe a condition in which the pupils have dilated in an unusual way, without any changes in lighting. This condition can be caused by psychological factors, an injury, or when a person takes certain medications. Blown pupil is another term used to refer to more pronounced eye dilation when the pupils are dilated and fixed. This condition is usually a symptom of a brain injury caused by a stroke or physical trauma. Miosis is the opposite of mydriasis and involves the constriction of the iris. Mydriasis can affect one or both pupils. Several types of medications can cause this condition, such as:
- Muscle relaxers
- Medication used to treat Parkinson’s disease
- Recreational drugs
If you notice that your pupils have dilated without a known cause, make an appoint with an eye specialist. If this condition develops after an injury to the head or eyes, you should seek medical attention immediately.
There are many underlying causes of mydriasis. Some causes are temporary and may wear off within a matter of hours. In more serious cases, a person may require surgery in order to correct the underlying cause.
This condition occurs as a result of damage to the retina, which is caused by complications of diabetes. If left untreated, this condition can lead to severe or total loss of vision. Regular exams and effectively managing diabetes is often enough to prevent this condition. The term diabetic retinopathy describes damage to the blood vessel in the retina. Symptoms can include total loss of vision, floaters, trouble distinguishing colors, and blurred vision. If you’ve been diagnosed with diabetes, annual exams can help prevent DR from developing.
A minor form of DR, called non-proliferative DR, usually presents no symptoms. Proliferative DR is the most advanced stage of DR and refers to the development of new abnormal blood vessels found in the retina.
During the early stages, DR does not present any symptoms. Only later, once the condition is considered advanced, will a person experience noticeable symptoms. The only way to prevent this condition is to have the eyes examined once or twice a year.
It’s possible to have this condition for several months or even years without experiencing any symptoms. Noticeable symptoms can include:
- Trouble reading
- Double vision
- Blurred vision
- Floaters in your vision
- Eye pressure
- Eye pain
- Shadows in your field of vision
Diabetes is obviously the primary cause of this condition. When the damaged blood vessels in the eyes leak fluid into the retina, it can result in diabetic macular edema, which will cause severe swelling in the center of the eye that can negatively impact your vision. Without treatment, prolonged damage to the small blood vessels can lead to poor circulation in the macula and retina, which can promote the growth of abnormal blood vessels. It can also result in scar tissue on the retina’s surface.
These new blood vessels can cause severe scarring which can pull on the retina, causing it to detach. It can also lead to severe pain and pressure in the eye if the vessels develop on the iris. This will cause a clog in the eye’s drainage system and can cause vision loss.
With proper, ongoing treatment, DR can easily be detected before vision loss occurs. If your doctor detects any signs of this disorder, they can determine how often you’ll need to be seen in order to effectively manage this condition.
There are five different types of glaucoma:
- Normal tension
This is a disease of the eye that damages the optic nerve. The optic nerve is what supplies the brain with visual information. Typically this condition is a result of dangerously high pressure in the eyes. Over a period of time, this type of increased pressure damages and essentially erodes the nerve, which leads to severe vision loss or total blindness. If treated early on, additional vision loss may be prevented.
Open-angle glaucoma is the most common type. Unfortunately, the only symptom is gradual vision loss, which can make it hard to detect without a proper exam.
Narrow angle glaucoma, also known as acute angle closure glaucoma is considered a medical emergency. If you experience any of the following symptoms, seek medical attention right away:
- Pain in the eyes
- Red eyes
- Blurred vision
- Sudden changes in vision
Progression of the Disease
In the back of the eyes, aqueous humor, a type of clear fluid, is produced around the clock. When this fluid is made it fills up the front portion of the eyes. It leaves the eyes via channels in both the iris and the cornea. However, if one or both of these channels become partially obstructed or blocked, then the pressure in the eyes can increase. There is always a certain level of pressure in the eyes, which is referred to as intraocular pressure. As this ocular pressure increases the optic nerve can become damaged. As the damage continues to progress, the affected person will lose sight in their eye. The root cause of this increase in pressure isn’t always easy to identify. However, some eye specialists believe one of the following factors is to blame:
- Elevated blood pressure
- Restricted or damaged drainage in the eyes
- Reduced blood flow to the optic nerves
- Certain medications
Glaucoma is currently the second leading cause of blindness in the world.
At some point, we’ve all experienced that random eye twitching that seems to come and go rather quickly, with no apparent cause. However, in some cases, people may experience this type of unusual twitching more often than they’d like.
Myokymia, or eye twitching, is a type of involuntary, repetitive spasms of the eyelid muscles. This type of twitch takes place in the upper lid, however, it can also occur in both the lower and upper eyelids. These spasms tend to be relatively mild and can be best described as a slight tug on the eyelid or lids. However, some people may experience stronger spasms that will force both the upper and lower lids to completely close. This condition is different and is called blepharospasm. These spasms usually occur every two or three seconds and can last as long as one to three minutes. These short episodes are usually unpredictable and can occur randomly, on and off for one day or a period of several days.
These twitches are not painful and are considered harmless, however, they can be very bothersome and embarrassing to the person affected. Most muscle spasms will resolve on their own without requiring treatment.
What are Eye Muscle Spasms?
In very rare cases, these spasms can be an early red flag for a chronic disorder. This is especially true if they’re accompanied by other types of facial twitching.
So, what’s the root causes of muscle spasms? In many cases, these spasms occur without an identifiable cause. Because they aren’t often considered a major sign of a serious medical issue, most people don’t bother with investigating the cause.
Regardless, twitching can be made worse or caused by:
- Lack of sleep
- General eye irritation
- Eye strain
- Physical exertion
- Increased stress
- Use of caffeine, tobacco, or alcohol
Should these spasms become more frequent, you may be diagnosed with benign essential blepharospasm. This is the name for uncontrollable, chronic blinking. This condition will usually affect both of the eyes. While the exact underlying cause is not known, the following disorders can make these spasms more severe and frequent:
- Dry eyes
- Pink eye
- Too much caffeine
- Too much alcohol
- Environmental irritants
- Sensitivity to light
- Tobacco use
People who are farsighted will have trouble focusing on close objects. Severe cases of hyperopia can also cause issues with seeing objects that are in the distance clearly, such as road signs. However, this is a pretty common disorder and one that affects around twenty-five percent of the population. Farsightedness will increase with age, affecting fifty percent of people over the age of sixty. This sight issue usually runs in the family and is usually present at birth. Fortunately, many children tend to outgrow it with proper eye care such as glasses.
Farsightedness will occur when the light that enters the eye is under-focused onto the retina. If the front of the eye is too flat or the back of the eye is too short, then the light will not be able to focus fast enough to form the right image onto the retina. With this condition, the eye’s optics are too weak. This will force a person to concentrate on using their internal eye muscles in order to clearly see.
The symptoms of farsightedness include:
- Eye strain
- Trouble reading street signs
- Difficulty concentrating on nearby objects
If you have experienced any of these symptoms and have never worn contacts or glasses, then you may be farsighted.
People who are nearsighted will have trouble seeing objects in the distance. However, they will be able to see close objects clearly. This condition affects a high percentage of the world’s population, however, it can easily be corrected with surgery, contact lenses, or glasses. In people diagnosed with nearsightedness, the cornea has too much curve to it or the eyeball is too long. Because of this, when light enters the eye it’s not correctly focused. Instead, images will focus in front of the retina instead of directly on the retina.
People who are nearsighted have what is called a refractive error. In people with myopia, the eyeball is too long or the cornea has too much curvature, so the light entering the eye is not focused correctly., resulting in blurred vision. This condition Is genetic and Often first appears in early childhood. This condition tends to worsen with age but will typically level off in adulthood. People with nearsightedness will usually complain of frequent squinting, eye strain, headaches, and fatigue when reading or driving. Treatment can be as simple as an eye exam. In most cases, glasses or contact lenses will be prescribed.
Herpes simplex is a virus that affects many people. It can cause cold sores, which can also appear on the eyes. Once it affects a person’s ability to see, it’s diagnosed as herpetic eye disease or ocular herpes. Herpetic eye disease can be a major concern since it’s very uncomfortable. In some cases, the sores can affect the deep layers of the eyes.
There are two types of herpes viruses that exist. The first is type one and it’s the most common. It usually affects the face and is responsible for cold sores around the mouth and nose. Type two is sexually transmitted and affects the genitals. This virus is transmitted by skin to skin contact with an infected person. The virus can lay dormant in the nerve cells, traveling along the nerves to the eye when it’s active. Most people have been infected with this virus at one point in their life, however, not everyone will show symptoms. When a person is infected with herpetic eye disease they can experience several symptoms. While it can affect both eyes, typically one eye is more affected than the other. Some of the common symptoms include:
- Sensitivity to light
- Red eyes
Feeling as if a foreign object is in trapped in the eye
Some people will also experience sores on top of the lids. These sores can resemble a blistering rash. These blisters will form a thick crust and will typically heal in five to seven days. If the virus affects the cornea or the retina, the person’s vision will be affected. This condition doesn’t usually cause pain, however, it can look very painful. There are certain triggers that can cause a dormant herpes virus to become active and start causing eye irritation. These triggers can include:
Unfortunately, this virus is highly contagious. A physician can usually diagnose this condition simply by examining the sores. If the deep layers of the eyes are affected, the doctor will need to use a special instrument that measures eye pressure.
Treatment will usually involve medication that can cause the virus to become dormant, eye drops to alleviate general irritation, redness, and swelling, and antibiotics in the event the sores have become infected.
This term refers to any type of situation in which the pressure inside the eye is higher than normal. The pressure in the eye is measured in millimeters of mercury. A normal range is ten to twelve mm hg. To be diagnosed with this condition, the pressure must be greater than twenty-one.
The balance between fluid drainage and fluid production in the eye is what can impact eye pressure. By itself, ocular hypertension isn’t considered a disease. It’s just a term that’s used to describe people who must be closely monitored for the onset of certain eye conditions such as glaucoma.
Higher than average pressure in the eyes is a concern because it’s one of the main risk factors for more serious eye conditions. This type of elevated pressure can be caused by the imbalance in the drainage and production of eye fluid known as aqueous humor. The channels that are responsible for draining the fluid in the eyes are unable to properly function. When the fluid cannot be drained there will be an increased amount inside the eye, which is what can raise the level of pressure. Most people with this condition will not experience any symptoms. Because of this, regular eye exams with a specialist are important in order to rule out damage to the optic nerve due to the increase in pressure.
Ocular Migraines (Ophthalmic Migraines)
This type of migraine is characterized by several visual disturbances such as the appearance of zig-zag lines, blind spots, and vision loss. Unlike other types of migraine headaches, this type of migraine can occur without any head pain. In some cases, a patient will simply experience a variety of visual symptoms.
There are a couple of major types of ocular migraines that I’ll discuss below.
Migraine with an Aura
Migraines that are accompanied by an aura can significantly affect a person’s vision and can include symptoms such as flashes of light, or blind spots. Visual disruptions are often the most noticeable symptoms however, the aura can also affect other senses including motor skills and speech. A migraine aura can be accompanied by a headache, which is usually short in duration. When the aura is accompanied by head pain, the pain will usually occur between the beginning and peak phase of the migraine. These headaches can last one hour or several.
This type of migraine is believed to be a result of abnormal electrical activity that affects certain regions of the brain. This type of activity spreads across the brain at a very slow rate. This spread is what’s responsible for the movement and growth of the visual disturbance. Retinal migraines can be caused by the same type of disturbance, however, it will occur in the back of the eye. These visual disturbances can also be caused by a lack of blood flow to the retina.
A retinal migraine is the second most common type of migraine that will impact your vision. The term retinal migraine refers to the visual symptoms that will occur in a single eye right before or during the headache phase of a migraine. The symptoms of a retinal migraine are said to be much more invasive than the aura symptoms and often include impaired vision, temporary blindness, and flashes of lights. For some people, it can be difficult to distinguish between retinal and aura migraines. Because of this, it’s very important that you meet with your physician for a proper diagnosis and treatment.
Like other types of migraine, harsh lights and electronic screens can be triggers. Straining your eyes by staring at a screen for long periods of time, spending time in fluorescent or other types of harsh lighting, driving long distances and other taxing visual activities can increase your risk for attacks. Talk to your eye doctor about how to avoid attacks.
For some attacks, a medication that focuses on treating the symptoms can be very effective. These medications can include anti-nausea medication or NSAIDs. There are also some types of preventative therapies that can help including tricyclic or calcium channel blocker medications. Other options can include avoiding harsh lighting conditions or resting the eyes often. Like with all types of migraine headaches, avoiding triggers such as low blood sugar levels or stress can help to minimize the frequency of these attacks.
The term uveitis refers to a wide range of conditions that can cause inflammation in the tissue surrounding the eye, or in the middle layer of the eye. This type of inflammation can be uncomfortable, and painful. Cloudy vision and redness are both common symptoms. There are some underlying conditions that can cause uveitis. Additionally, it can also be a result of a bacterial infection, viral infection, or an injury. This condition is the fifth leading cause of vision loss in America And it will primarily affect the iris, the ciliary body, and the choroid of the eye. Inflammation of the iris is the most common type.
Common symptoms include:
- General vision problems
- Cloudy vision
- Blurred vision
- Small pupil
These symptoms can occur rapidly or over time.
Unfortunately, the exact cause of this condition is not clear. However, some factors can increase a person’s risk.
These risk factors include:
- Juvenile arthritis
- Autoimmune disorders
- Inflammatory disorders
If you have a bacterial or eye infection, then this condition can also occur as a normal immune response.
In order to diagnose this condition, an eye specialist will look at all of your symptoms and try to determine the underlying cause. If there does appear to be an underlying condition the eye specialist may need to refer you to another doctor in order to ensure that you receive proper treatment.
Diagnosis and Complications
During an exam, if the iris appears inflamed, the patient may feel severe pain when the pupil contracts as the light hits it. Protein and white blood cells will be visible if uveitis is present.
If an infection is responsible for the inflammation, antibiotics will be prescribed. In some cases, corticosteroids will be prescribed in the form of eye drops.
Fortunately, with proper treatment, the chances of complications are reduced significantly. However, if complications do occur, it can include:
- Scar tissue
- Macular edema
- Vision loss
- Retinal detachment
More research is needed to determine who is at risk of developing this condition, more effective ways to treat it, and the possible causes.
As you can see, not all of these common eye disorders are serious. However, in the beginning, treatment can be essential to prevent complications. Certain conditions such as diabetic retinopathy, glaucoma, and ocular herpes will require ongoing treatment and monitoring in order to properly manage them with the use of prescribed medications and therapies. If you’ve experienced any type of change in your vision or symptoms such as irritation, discharge, chronic redness, and eye strain, make an appointment with an eye care specialist for an assessment.