What are some rare eye conditions that can affect vision. How do these unusual ocular disorders manifest and impact eyesight. What treatment options are available for uncommon eye problems.

Hematohidrosis: When Eyes Shed Tears of Blood

Hematohidrosis is a rare condition where blood seeps through intact skin or mucous membranes, including the eyes. While it may seem alarming, it’s important to understand that this phenomenon is not a disease itself but rather a symptom of underlying issues.

What causes hematohidrosis? Several factors can contribute to this unusual condition:

• Abnormal blood vessel growth
• Tumors in or around the eye
• Inflammation of ocular tissues
• Bacterial or viral infections

Interestingly, hematohidrosis is more prevalent in children and adolescents. The treatment approach varies depending on the root cause identified by medical professionals.

Polycoria: The Peculiarity of Multiple Pupils

Typically, the human eye has a single pupil that regulates the amount of light entering the eye by dilating or constricting. However, in rare cases, some individuals may have more than one functional pupil in a single eye, a condition known as polycoria.

The exact cause of polycoria remains unclear, but researchers have observed potential links to other ocular conditions such as glaucoma and cataracts. While not all cases of polycoria require intervention, surgical procedures can be performed to address impaired vision resulting from this condition.

Understanding Pupil Function

To fully grasp the implications of polycoria, it’s essential to understand the normal function of pupils:

1. Light regulation: Pupils dilate in low-light conditions and constrict in bright environments.
2. Focus assistance: Pupil size affects the eye’s depth of field and ability to focus on objects at different distances.
3. Visual acuity: Optimal pupil size contributes to sharp, clear vision.

In cases of polycoria, these functions may be compromised, potentially leading to visual disturbances.

Heterochromia: The Allure of Mismatched Eye Colors

Heterochromia is a fascinating condition characterized by differences in iris coloration. This can manifest in two primary forms:

• Complete heterochromia: Each eye has a distinctly different color.
• Partial heterochromia: One iris contains multiple colors or varying shades.

Is heterochromia a cause for concern? In most cases, when present from birth (congenital heterochromia), it’s a benign condition that doesn’t require treatment or cause additional symptoms. However, acquired heterochromia later in life may be indicative of underlying health issues or injuries.

Genetic factors play a significant role in congenital heterochromia, while acquired heterochromia can result from various causes, including eye injuries, certain medications, or systemic diseases affecting pigmentation.

Coloboma: The Feline-Like Eye Appearance

Coloboma is a congenital condition resulting in a gap or notch in various parts of the eye, most notably the iris or pupil. This distinctive appearance often resembles a cat’s eye, leading to its colloquial nickname “cat eye syndrome.”

What causes coloboma? The condition typically stems from genetic abnormalities that occur during fetal development. These genetic issues can affect not only the eyes but also other organs and body parts.

Managing coloboma often requires a multidisciplinary approach, involving various medical specialists to address the diverse symptoms associated with this condition. Treatment strategies may include:

• Corrective lenses to improve vision
• Surgical interventions for severe cases
• Regular monitoring to prevent complications
• Support for associated developmental issues

Optic Neuritis: When Inflammation Impacts Vision

Optic neuritis is an inflammatory condition affecting the optic nerve, which is responsible for transmitting visual information from the eye to the brain. This disorder typically manifests between the ages of 20 and 40 and can have significant implications for vision.

What are the symptoms of optic neuritis? Individuals with this condition may experience:

• Temporary vision loss lasting hours, days, or even months
• Partial loss of peripheral vision
• Eye pain, particularly during eye movement
• Blurred vision and difficulty focusing
• Perception of flashing lights
• Reduced color intensity, especially for reds

While optic neuritis often resolves on its own, medical intervention can help manage symptoms and reduce inflammation. Steroid treatments are commonly prescribed to alleviate pain and swelling.

The Link Between Optic Neuritis and Multiple Sclerosis

An important consideration with optic neuritis is its potential connection to multiple sclerosis (MS). Approximately half of the individuals diagnosed with optic neuritis may eventually develop MS, a degenerative neurological condition affecting the central nervous system.

This association underscores the importance of thorough evaluation and long-term monitoring for patients diagnosed with optic neuritis. Early detection and management of MS can significantly impact patient outcomes and quality of life.

Charles Bonnet Syndrome: Visual Hallucinations Without Mental Illness

Charles Bonnet Syndrome (CBS) is a fascinating neurological condition characterized by visual hallucinations in individuals with partial or severe vision loss. Unlike hallucinations associated with mental health disorders, CBS hallucinations are purely visual and not accompanied by auditory experiences.

What do CBS hallucinations look like? Individuals with this condition may see:

• Complex patterns or geometric shapes
• Vivid images of people, animals, or objects
• Static or moving hallucinations
• Hallucinations lasting from minutes to hours

The exact cause of Charles Bonnet Syndrome remains unclear, but researchers believe it may be the brain’s response to vision loss, particularly when it occurs suddenly. It’s crucial to understand that CBS is not indicative of mental illness or cognitive decline, such as dementia.

Managing Charles Bonnet Syndrome

While there is no definitive cure for CBS, several strategies can help individuals cope with the condition:

1. Adjusting lighting conditions in living spaces
2. Ensuring adequate rest and reducing stress
3. Engaging in activities that stimulate the mind
4. Seeking support from healthcare professionals and support groups

In severe cases where hallucinations significantly impact daily life, medications may be prescribed. However, due to potential side effects, these are typically reserved for the most challenging cases.

Albinism: When Lack of Pigment Affects Eye Health

Albinism is a genetic condition characterized by a lack of melanin, the pigment responsible for skin, hair, and eye color. This deficiency can have significant implications for eye health and vision.

How does albinism impact vision? The reduced pigmentation in the iris and retina can lead to various visual challenges:

• Blurred vision and difficulty focusing
• Strabismus (eyes that appear to look in different directions)
• Extreme sensitivity to light (photophobia)
• Impaired depth perception
• Nystagmus (involuntary eye movements)

While there is no cure for albinism, various interventions can help manage symptoms and improve quality of life for affected individuals. These may include:

1. Prescription eyewear (glasses or contact lenses)
2. Low vision aids and assistive technologies
3. Sun protection (sunglasses, hats, and sunscreen)
4. Vision therapy to improve eye coordination
5. Regular monitoring by eye care professionals

Traumatic Cataract: When Injury Clouds Vision

A traumatic cataract is a clouding of the eye’s natural lens that occurs as a result of injury or trauma to the eye. Unlike age-related cataracts, which develop gradually, traumatic cataracts can form relatively quickly following an injury.

What causes traumatic cataracts? Several types of eye injuries can lead to their formation:

• Blunt force trauma to the eye
• Penetrating injuries that pierce the lens
• Severe shaking or jolting of the head and eyes
• Exposure to certain types of radiation or chemicals

Traumatic cataracts often have a distinctive appearance, sometimes taking on a star-shaped or irregular pattern within the lens. Treatment approaches may vary depending on the severity of the injury and the extent of cataract formation.

Managing Traumatic Cataracts

The treatment of traumatic cataracts requires a delicate balance between addressing the immediate injury and managing long-term vision concerns. Common approaches include:

1. Initial treatment with corticosteroids to reduce inflammation and pain
2. Careful monitoring of cataract progression
3. Surgical removal of the cataract when appropriate
4. Implantation of an artificial intraocular lens
5. Post-operative care and vision rehabilitation

It’s important to note that while corticosteroids can be beneficial in the short term, prolonged use may exacerbate cataract formation in some cases. Close monitoring by an eye care professional is essential throughout the treatment process.

Ocular Myasthenia Gravis: When Eye Muscles Weaken

Ocular myasthenia gravis is a neuromuscular disorder that specifically affects the muscles controlling eye movement and eyelid function. This condition is part of the broader spectrum of myasthenia gravis, an autoimmune disease that causes muscle weakness throughout the body.

What are the symptoms of ocular myasthenia gravis? Individuals with this condition may experience:

• Ptosis (drooping of one or both eyelids)
• Diplopia (double vision)
• Difficulty maintaining eye position
• Fatigue of eye muscles, especially after prolonged use
• Weakness in other facial muscles, affecting expressions

Ocular myasthenia gravis typically onset between the ages of 18 and 40, although it can occur at any age. In some cases, the condition may progress to generalized myasthenia gravis, affecting muscles throughout the body.

Diagnosis and Treatment

Diagnosing ocular myasthenia gravis can be challenging, as its symptoms may mimic other neurological conditions. Diagnostic approaches may include:

1. Neurological examination
2. Blood tests to detect specific antibodies
3. Electromyography (EMG) to assess muscle function
4. Edrophonium test to evaluate muscle response

While there is no cure for ocular myasthenia gravis, several treatment options can help manage symptoms and improve quality of life:

• Acetylcholinesterase inhibitors to enhance muscle function
• Immunosuppressive medications to modulate the immune response
• Thymectomy (surgical removal of the thymus gland) in some cases
• Ocular surgeries to correct ptosis or strabismus
• Vision therapy and rehabilitation exercises

Anisocoria: The Mystery of Unequal Pupils

Anisocoria is a condition characterized by unequal pupil sizes. While a slight difference in pupil size is common and often benign, more significant discrepancies can indicate underlying health issues.

What causes anisocoria? The condition can result from various factors:

• Physiological anisocoria (a natural, harmless variation)
• Horner’s syndrome (a rare neurological disorder)
• Adie’s tonic pupil (a benign condition affecting pupil response)
• Certain medications or chemical exposures
• Underlying neurological conditions or brain injuries

It’s crucial to note that sudden onset of anisocoria, especially when accompanied by other symptoms like headache or vision changes, requires immediate medical attention as it could indicate a serious neurological event.

Horner’s Syndrome: A Notable Cause of Anisocoria

Horner’s syndrome is a rare neurological condition that can cause anisocoria. Its characteristic symptoms include:

1. A noticeably smaller pupil on one side
2. Partial ptosis (drooping of the upper eyelid)
3. Apparent sinking of the eyeball into the socket (enophthalmos)
4. Reduced or absent sweating on one side of the face

Horner’s syndrome results from disruption of the sympathetic nerve supply to the eye and surrounding structures. Identifying and addressing the underlying cause is crucial in managing this condition.

Retinoblastoma: A Rare Childhood Eye Cancer

Retinoblastoma is a rare form of eye cancer that primarily affects young children. It originates in the retina, the light-sensitive tissue at the back of the eye responsible for processing visual information.

What are the signs of retinoblastoma? Parents and caregivers should be aware of these potential indicators:

• A white or glowing pupil when light shines into the eye (leukocoria)
• Misaligned eyes or a “lazy eye” appearance
• Redness or swelling of the eye
• Poor vision or changes in visual behavior
• An enlarged pupil or change in iris color

Early detection and treatment of retinoblastoma are crucial for preserving vision and preventing the spread of cancer. Regular pediatric check-ups and parental vigilance play vital roles in identifying this condition in its early stages.

Treatment Approaches for Retinoblastoma

The management of retinoblastoma has evolved significantly in recent years, with a focus on preserving vision whenever possible. Treatment options may include:

1. Chemotherapy (systemic or localized)
2. Radiation therapy (external beam or brachytherapy)
3. Laser therapy or cryotherapy for smaller tumors
4. Surgical removal of the eye (enucleation) in advanced cases
5. Stem cell transplantation for high-risk cases

The choice of treatment depends on factors such as the size and location of the tumor, whether one or both eyes are affected, and the overall health of the child. A multidisciplinary team of specialists typically collaborates to develop the most effective treatment plan.

Retinitis Pigmentosa: A Progressive Genetic Eye Disorder

Retinitis pigmentosa (RP) is a group of inherited genetic disorders that progressively damage the retina’s light-sensitive cells. This condition leads to a gradual loss of vision, typically beginning with night blindness and peripheral vision loss.

What are the characteristics of retinitis pigmentosa? Individuals with RP may experience:

Pictures of Unusual Eye Conditions

Medically Reviewed by Whitney Seltman, OD on January 21, 2022

Yes, you really can cry tears of blood. But it isn’t so much a disease as a symptom. Causes include:

• Blood vessels that don’t grow the right way
• Tumors
• Inflamed tissues
• Bacterial or viral infections

It’s more common in children and teens. Treatment depends on the cause. 

Your pupil is a round hole that gets bigger as light fades and smaller as light brightens. It’s rare, but some people have more than one working pupil in a single eye. It isn’t clear what causes polycoria, but there may be a link to conditions like glaucoma and cataracts. Not everyone needs treatment, but surgery can restore dimmed vision.

Your irises are the colored part of each eye. Sometimes they’re a different color from one another. Or one iris might contain different colors.  If you’re born with it, you probably won’t have other symptoms or need treatment. Sometimes it’s a sign of a rare condition you get from your parents at birth. An injury or disease can cause it later in life.

This disease can cause a notch or gap in parts of your eyes. Your doctor will call it a coloboma. When it affects your iris or pupil, your eye might look like a cat’s. You can also get colobomas in other organs and body parts. Most of the time they come from a problem in your genes that resut in changes during development and show up when you’re born. You may need a team of doctors to manage the different symptoms.

It can strike anywhere between ages 20 and 40. About half the people who have it will get multiple sclerosis, a disease that attacks brain cells. It usually affects one eye. You could lose vision for a few hours or days or even months or lose a portion of yoir peripheral vision. You may have pain, blurry vision, and see flashing lights. Colors, especially red, might be less bright. Though it usually goes away on its own, the doctor can give you steroids to ease the inflammation and pain. Your eyesight should be back to normal within a year, but the condition can return.   

People with this condition see (but don’t hear) patterns or images that others can’t. These hallucinations can last from minutes to hours. They might be still or move. The cause isn’t clear, but it’s likely your brain’s response to a loss of vision, especially if it’s sudden. It isn’t a sign of mental breakdown or a brain disease like dementia. There’s no cure, but it can help to change lighting and get plenty of rest. There are medications, but they have serious side effects and are reserved for severe cases.

Your iris absorbs light. Your retina, at the back of your eye, processes it. If you don’t have enough of the pigment that gives them their color, the nerves that help you see could get damaged. That can lead to: 

• Blurry vision
• Eyes that look in different directions
• Light sensitivity
• Trouble judging distance  

There’s no cure, but your doctor can help you manage your symptoms.

Your lens helps focus light and images onto your retina. It may take a while, but if it gets hit or pierced, or jostled around, a cataract can form. It will look cloudy and may be star-shaped. The doctor may give you corticosteroids, which help with swelling and pain from the injury but can sometimes make the cataract worse over time  

You can inherit genes that cause the muscles in and around your eye to get weak or stop working. It could start anywhere from age 18 to 40. It can affect one or both eyes. You may find it hard to swallow or you might feel that muscles all over your body are weak, especially after you exercise. There’s no cure, but surgery can correct droopy eyelids and other symptoms. 

Your pupils could be different sizes. About 1 in 5 people who have this don’t have any other health conditions along with it. Sometimes it signals a rare nerve problem. Horner’s syndrome is marked by one much smaller pupil, a droopy upper lid, an eyeball sunken into its socket, and a lack of facial sweat on just one side of the face. If a change in your pupil size happens suddenly, call your doctor immediately or go to the emergency room. In Adie syndrome, which usually doesn’t require treatment, one pupil is always open and barely responds to light. Some drugs like scopolamine patches for sea sickness can also cause one pupil to dilate if the medicine gets in the eye. 

This cancer affects your retina. It’s the most common form of eye cancer in children, but rare for adults. You might notice a white color in the pupil of your child’s eye when light shines on it. Their eyes may be red, swollen, and seem to look in different directions. Treatments include radiation and surgery.

This group of rare genetic diseases damages special light-sensitive cells in your retina, the tissue that lines the back of your eye. It narrows your field of vision and makes it harder to see at night. There’s no cure, and it will get worse over time. But doctors and therapists can show you how to use special devices and tactics to make the most of the vision you have.

Your child’s eyes could be abnormally small or completely missing (anophthalmia) at birth. Scientists think genes cause this disorder. Exposure to certain chemicals or viruses may raise the risk, but more research is needed to be sure. There isn’t much help for vision loss from this disease, but doctors can place a full or partial artificial eye in your baby’s eye socket. As they grow, it’ll look more normal.

This inherited disease causes yellow or white crystals to form in your retina. Over time your vision will get less sharp and you’ll have trouble seeing at night. You might lose your side vision or have trouble seeing colors. Your eyes could worsen at different rates. The trouble starts in your teens or 20s. By your 40s or 50s you may have to turn your head to see to the side. That makes you legally blind. It doesn’t mean you can’t see, just that you have low vision that can’t be corrected with glasses or contacts.

This inherited condition causes a fatty buildup on your retina. It can damage your central vision. It happens slowly and doesn’t lead to total blindness. It mostly affects children and teens, but you may not notice it until you’re an adult. There’s no treatment.

IMAGES PROVIDED BY:

1) Thinkstock

2) Medical Images

3) Science Source

4) Science Source

5) Thinkstock

6) Thinkstock

7) Science Source

8) Science Source

9) Science Source

10) Thinkstock

11) Science Source

12) Thinkstock

13) CDC

14) Retina Image Bank® / Robert T. Wendel, MD / American Society of Retina Specialists

15) Thinkstock

SOURCES:

Investigative Ophthalmology & Visual Science: “Haemolacria: A Unique Diagnostic And Treatment Approach.”

National Eye Institute: “Facts About Anophthalmia and Microphthalmia,” Facts About Retinitis Pigmentosa,” “Facts About Stargardt Disease,” Healthy Eyes Facts.”

Acta Ophthalmologica: “True polycoria or pseudo-polycoria?”

Arquivos Brasileiros de Oftalmologia: “Pupilloplasty in a patient with true polycoria: a case report. ”

American Academy of Ophthalmology: “Anisocoria,” “Heterochromia,” “Management of Traumatic Cataract,” “Ocular Trauma: Acute Evaluation, Cataract, Glaucoma.”

NIH Genetic and Rare Diseases Information Center: “Chronic progressive external ophthalmoplegia,” “Heterochromia Iridis.”

National Organization for Rare Disorders: “Adie Syndrome,”
“Cat Eye Syndrome,” “Horner’s Syndrome.”

Mayo Clinic: “Optic Neuritis: Diagnosis & Treatment,” “Optic Neuritis: Symptoms & Causes,” “Retinoblastoma: Diagnosis & treatment,” “Retinoblastoma: Symptoms & causes.”

NHS Choices: “Charles Bonnet syndrome.”

U.S. National Library of Medicine Genetics Home Reference: “Ocular albinism.”

National Organization for Albinism and Hypopigmentation: “Information Bulletin – What is Albinism?”

VisionAware: “Eye Health: Anatomy of the Eye.”

Genetics Home Reference: “Bietti Crystalline Dystrophy,” “Stargardt macular degeneration.”

American Foundation for the Blind: “Low Vision and Legal Blindness Terms and Descriptions. ”

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What Eye Problems Look Like

Blurry vision, spots, glare at night, flashing lights — these are common eye complaints. Each could be a harmless annoyance or an early sign of disease. It isn’t always easy to tell the difference. Visit your eye doctor promptly if you notice any changes in your vision.

Which number do you see on the far left? If it’s “3,” you probably have normal color vision. If it’s a “5,” you may be color blind. The center panel shows a mild lack of color vision. Complete color blindness, which is rare, appears at right. No number is visible. Tinted glasses may help you see better.

When you’re nearsighted, things in the distance look blurry. Doctors call it myopia. You’re more likely to have it if: 

• One or both of your parents have it
• You do lots of close-up reading

Nearsightedness can make it harder to drive, play sports, or see a blackboard or TV. Symptoms include blurred vision, squinting, and fatigue. To correct it, you can wear glasses, contacts, or get surgery in some cases.

Most people are born with mild farsightedness and outgrow it in childhood. When it persists, you may see distant objects well, but books, knitting, and other close objects are a blur. This problem runs in families. Symptoms include trouble with reading, blurry vision at night, eyestrain, and headaches. To treat it, you may wear glasses or contacts. Some people get surgery for it.

Trouble reading fine print is a sign of aging. It’s called presbyopia, which means “old eye” in Greek. Most people start to notice it in their 40s. The eyes’ lenses become less flexible and can’t change shape to focus on objects at reading distance. The solution: Wear reading glasses or bifocals, which correct both near and distance vision. If you wear contacts, ask your eye doctor about contacts made for people with presbyopia.

The cause is usually an eyeball that is too long. Or it can result from an oddly-shaped cornea or lens. Light rays focus just in front of the retina, instead of directly on it. This sensitive membrane lines the back of the eye (seen in yellow) and sends signals to the brain through the optic nerve. Nearsightedness often develops in school-age children and teens, so they may need to change glasses or contacts frequently as they grow. Multifocal contact lens or glasses and eye drops such as atropine can help slow the progression. The prevalence of myopia has been rising at an alarming rate, much of it being attributed to increased use of handheld devices and computers.

This problem results from an eyeball that is too short or an oddly-shaped lens or cornea. Light rays focus behind your retina and close objects look blurry. Your distance vision might be fuzzy, too. Severely farsighted children often have crossed eyes (strabismus) or lazy eye (amblyopia) and may have trouble reading. That’s one reason eye doctors recommend vision exams for young children.

If you have astigmatism in one or both eyes, your vision may be out of focus at any distance. It happens when the cornea, the clear “window” that covers the front of the eye, isn’t shaped right. Light rays can’t focus on a single point on your retina. Instead they scatter to many places. Glasses or contact lenses correct it. Surgery may be an option. Symptoms include blurred vision, headaches, fatigue, and eye strain.

Do you dream of seeing clearly without glasses? Surgery to reshape your cornea can correct nearsightedness, farsightedness, or astigmatism with a success rate of better than 90%. Surgery may not be right for you if you have severe dry eye, thin or oddly shaped corneas, or severe vision problems. Side effects include glare or sensitivity to light.

You can’t feel it, but this disease damages your optic nerve. You may not have any symptoms until you lose your central vision. Your side vision will go first. That’s why you need regular eye exams every 1 to 2 years, especially after you turn 40. Doctors can treat glaucoma with medications or surgery.

Your eye is filled with fluid. Sometimes too much of it builds up and raises pressure inside your eye. This can damage your optic nerve, a bundle of nerve fibers that carries information to your brain. Without treatment, glaucoma can cause total blindness.

The bright yellow circle shows an optic nerve head damaged by glaucoma. The dark central area is the macula, which controls your finely-detailed central vision.

Age-related macular degeneration (AMD) damages and then destroys your central vision, making it hard to read or drive. Symptoms can include a central blurry spot or straight lines that appear wavy. You’re more likely to have it if you are older than 60, smoke, have high blood pressure, are obese, are female, or have a family history of the condition. See your eye doctor regularly to check for AMD. Prompt treatment can help slow vision loss. 

AMD affects the central part of your retina, called the macula. There are two types:

• Dry: Doctors often see yellow deposits called drusen in the macula. As it worsens, the macular tissue breaks down. That causes changes or loss of your central vision over time.
• Wet: Abnormal blood vessels grow in your eye. They leak blood and fluid (shown here), which causes scars and further damages the macula.

Both types leave you with a central blind spot.

Cover one eye and stare at the center dot in this Amsler grid from a distance of 12 to 15 inches. (You can wear your reading glasses.) Do you see wavy, broken, or blurry lines? Are any areas warped or just plain gone? Repeat for your other eye. Although no self-test can take the place of an eye exam, this grid is used to help spot early symptoms of AMD.

Next:  See how this grid looks with AMD.

As seen here, the Amsler grid can look quite distorted to if you have severe macular degeneration. It may include a central dark spot. Straight lines that appear wavy are also cause for concern, as they can be an early symptom of wet AMD, the more serious, fast-moving type. See your eye doctor right away for a thorough exam.

Type 1 and type 2 diabetes can cause partial vision loss (an example is shown here) and lead to blindness. The damage involves tiny blood vessels in your retina. It can often be treated, but don’t wait for symptoms. By the time you have them — blurry vision, spots, shadows, or pain — the disease may be severe. If you have diabetes, get an annual eye exam. The best prevention is to keep your blood sugar in check.

High blood sugar levels damage the tiny blood vessels that support your retina. They can swell, break, and leak fluid. Sometimes dozens of new, abnormal blood vessels grow. This is called proliferative retinopathy. They’re fragile and break open easily. Over time all this can damage the retina and cause blurred vision, blind spots, or blindness. 

By age 80, more than half of us will have had a cataract, or cloudy lens. Your vision slowly gets foggy and it gets hard to read, drive, and see at night. Diabetes, smoking, or too much time in the sun raise your chances. Surgery that replaces the clouded lens with a man-made one works well.

A healthy lens focuses light into a single spot on your retina. It captures the image like film in a camera. As you age, protein builds up in the lens. It gets cloudy and sends scattered rays of light to your retina. Instead of one sharp clear image you get blurred vision, changes in color vision, and glare, especially at night. Advanced cataracts are easy to see. It’s the muddy-colored circle at the center of this picture.

You can inherit this disorder from your parents. It often begins with night vision problems. Next comes a slow loss of side vision. That becomes tunnel vision and finally, in some cases, blindness. It’s uncertain whether vitamin A and/or fish oil supplements help improve this condition. More research is needed. 

The light-sensitive tissue of the retina slowly breaks down over many years. As that happens, it no longer sends signals to your brain, and you lose some vision. Eye exams show abnormal dark spots (pigments) sprinkled around the retina. Early cataracts can also happen, along with a swelling of the retina called macular edema (the central orange mass shown here).

Do you see blurry spots or specks that move? They’re probably floaters — debris in your eye’s vitreous gel. They don’t block vision and are easier to see in bright light. Floaters are common and usually harmless. See a doctor right away if:

• They show up or multiply suddenly.
• You also see flashes of light.
• You see white or black spots all the time. 
• You notice a sudden shadow or loss of side vision.

When you’re a child, if one eye doesn’t see well, your brain may favor the other. This condition, called amblyopia, can happen if your eyes aren’t aligned right (strabismus or crossed eyes) or one eye just doesn’t work as well. The doctor will prescribe a patch or drops that blur vision in the “good” eye. This prompts your brain to use the other eye. If amblyopia isn’t treated during childhood, it can cause permanent vision loss.

Because so many nerve endings lie just beneath the surface or your cornea, even a tiny speck can be painful. Don’t rub your eye, or you could cause serious damage. Wash it with non preserved sterile saline solution — do not use regular tap water. If the object doesn’t move, call a doctor. They can remove it and give you antibiotic drops to prevent an infection.

Tears keep your eyes moist. Sometimes you don’t have enough, either from dry air, aging, or other health conditions. Your eyes can get painful and irritated. Eye drops labeled artificial tears may do the trick for a mild case. If it’s a bigger problem, you may benefit from other treatments, medications or nutritional supplements

This inflammation results from a virus, bacteria, irritant, or an allergic reaction. Your eye will get red and itch or burn. You’ll also notice a gunky discharge. If your eye itches an allergy is probably to blame. The type you catch from other people is usually viral,  so you won’t need antibiotics. If your pinkeye is caused by bacteria, the doctor will give you antibiotic eye drops. Pinkeye can be very contagious, so wash your hands often while you wait for it to clear up.

This painful red bump looks like a pimple on or near the edge of your eyelid. It’s a type of infection of the eyelids (the doctor will call it blepharitis). Styes usually heal in a week. You can speed things up by putting a warm, wet compress on it 3 to 6 times a day. Don’t wear contacts or eye makeup until it heals.

They can cause itchy, watery eyes. Pollen, grass, dust, weeds, and pet dander are common triggers. An allergy doctor can tell you what’s to blame for yours. Keep your windows shut at home and in your car. You can get special pillow and mattress covers to keep allergens out. Clean your house thoroughly and use allergen filters in your furnace and air conditioner. Allergy eye drops, artificial tears, and antihistamines may help.

You need regular checkups all through your life, especially if eye problems run in your family or if you have other risk factors. An eye exam can also find other problems, like diabetes and high blood pressure, or even a stroke or brain tumor. Bulging eyes can signal thyroid disease. A yellow tint in the whites of your eyes might be a sign of liver problems.

UV rays can harm your eyes. Exposure can cause you to get cataracts 8-10 years earlier than normal. Just one long session in the sun can cause very painful irritation of your corneas. So wear a hat and sunglasses that block UV rays. You can add a clear, protective UV-blocking film to your car’s side windows, too. If you have light-colored eyes you may be more sensitive to light. If it suddenly starts to bother you more than usual, call your eye doctor.

Grease splatters from a pan, yard debris flies up from the lawn mower, cleaning solution splashes in a bucket. Some of the greatest eye hazards are in the home. Eye doctors suggest  everyone keep a pair of protective eyewear at home. Look for one approved by the American National Standards Institute. Even if an eye injury seems minor, go to the emergency room or your eye doctor right away to get it checked out.

Carrots really are good for your eyes. So are spinach, nuts, oranges, beef, fish, whole grains, many other things that make up a healthy diet. Look for foods with antioxidants like omega-3 fatty acids; vitamins C, E, and beta-carotene; as well as zinc, lutein, and zeaxanthin.

How flash photography can indicate vision problems: a reminder for parents

From May 10 to 16, Retinoblastoma Awareness Week, the most common eye tumor in children under 5, was held around the world. What parents need to know about this disease and how a flash photo can save a child’s life, says ophthalmologist Oksana Ageenkova, head of the ophthalmology department at the GMS clinic.

“Retinoblastoma is a malignant tumor of the retina of the eye that mainly occurs in childhood. As a rule, this is a congenital disease. Most often, it is diagnosed in children aged 12–18 months, but it can be detected both in the first year of life and up to the age of 5 years. It happens that retinoblastoma is found in adults. For example, in my practice there was a case of retinoblastoma in a 32-year-old man, and a year later the disease was detected in his 4-year-old son,” says Oksana Ageenkova.

Why the disease occurs

The cause of the tumor is a genetic mutation, which can be either hereditary or spontaneous. Therefore, there is no prevention of this disease, except for knowledge of the family history. Retinoblastoma is a hereditary, genetically determined disease. If there were cases in the family, that is, grandparents, uncles and other relatives, then parents should be alert about the occurrence of a malignant process in their children, ”explains our expert.

Retinoblastoma. Photo: Wikimedia Commons

What is important to know about the diagnosis

According to Dr. Ageenkova, regular visits to the ophthalmologist according to the recommendations play an important role. “To begin with, the recommendations of the Russian Ministry of Health require an examination of a child by an ophthalmologist at the age of one and twelve months. Eleven months between examinations, the child is under the control of parents, environment, pediatricians and other specialists whom he visits. It is important for parents to know that at the age of one month, an eye examination should take place at an ophthalmologist’s appointment. At the same time, the ophthalmologist must necessarily drip drops to expand the pupil, as well as in each subsequent appointment (at least once a year). So the doctor can examine not only the central part of the fundus, that is, the retina, but also its peripheral parts,” says Oksana.

At the same time, examination of the fundus is important not only for the diagnosis of retinoblastoma: such an examination can help to identify other equally serious diseases. “I always urge all the parents of my patients to contact an ophthalmologist at 1 month of age of the child, so that the doctor evaluates the structural features of the fundus and the organ of vision of the child. Of course, mom and dad, as well as a competent pediatrician, after looking at the child and assessing the condition of his outer eye in the absence of strabismus, incorrect position of the eyeball, any additional changes in the eyelids, conclude that everything is fine. But one small detail remains – this is an examination of the fundus. It can only be performed by an ophthalmologist.

Very often, during such an examination, we detect not only hereditary diseases (such as a malignant tumor of the retina), but also other types of hereditary problems, when the child does not yet have manifestations, but there are features that are quite characteristic of various processes.

It is equally important to show the child to an ophthalmologist at the age of one year. I always advise my patients not to skimp on this technique, but still try to see a doctor, even when you think that everything is fine and the child has no problems, ”Oksana emphasizes.

What parents should pay attention to

The peculiarity of retinoblastoma is that the tumor is located in the back of the inner part of the eye (retina), behind the pupil. Although, of course, only a qualified ophthalmologist can conduct an examination of the fundus and see the tumor, parents and relatives of children may notice alarming symptoms.

“In the everyday sense, parents should pay attention to such an alarming symptom as leukocoria. Leukocoria, translated into non-medical language, is a white pupil.

When we try to take a photo of someone with the flash with “no red-eye” turned off, there is always a fundus reflex. The pupil at the same time should look red, crimson or purple – but never white or yellow. If, while filming your child, you see that one pupil is red, and the second one glows with a different shade (yellow or whitish), this is a reason to be wary,” says Oksana. – Such a symptom is alarming, and ideally, in such a situation, you should immediately contact an ophthalmologist.

Leukocoria. Photo: EyeRounds.org / The University of Iowa / CC BY-NC-ND 3.0

If this is not possible or if a relative who viewed these photos noticed a feature, you need to take another shot and compare. The symptom of leukocoria, when there is a noticeable difference in the color of the pupils, is best seen in a photograph with a flash (I emphasize when the “no red-eye” mode is turned off), and ideally the photo should be in portrait mode, when the child’s face is seen close enough.

Important to know about family history

“A word of advice to parents about retinoblastoma: try asking your grandparents, aunts, uncles about your family history of the disease. In my practice, very often parents, when asked about heredity, have little knowledge of family history, says Oksana. “Even in our age of modern technology, patients do not talk much about diseases with relatives: perhaps because of modesty or tact. However, this way you can learn a lot of useful things for yourself and the health of children in the future.

All vision problems can be important: visually impaired, blind, blind relatives, all cases of hereditary diseases that ophthalmologists work with – retinal dystrophies, retinoblastoma, various genetic diseases, glaucoma, astigmatism. Preventing such diseases in a child involves knowing about them and about their existence in your family and your environment, as well as in the family of the other parent of your child.

Today, retinoblastoma is treated quite successfully. “Early detection of retinoblastoma leads to a very positive prognosis: 95% of patients undergo treatment successfully and save their eyes, eyesight, life, Oksana emphasizes. “One small procedure — a visit to an ophthalmologist — can save your health and your family.”

Cover photo: Shutterstock / Gabriela Insuratelu

Remove red-eye from photos

By Aimee Rodrigues; reviewed by Gary Heiting, OD

Are you tired of seeing ruined photos that make your eyes look bright red?

This article provides answers to frequently asked questions about red-eye and how to avoid it.

Why are there red eyes in the photos?

Eyes appear red in photographs when the camera detects light reflecting off the subject’s retina when the flash is used at night or in dim light.

Light rays pass through the cornea and pupil of the eye to focus on the retina, the layer of light-sensitive cells at the back of the eye.

When the camera’s flash fires, the subject’s eyes do not have time to contract to reduce the amount of light entering the eyes. Thus, a large burst of light reaches the retina and is reflected on the film.

The eyes have a red sheen due to an abundant blood supply to the choroid, the layer of connective tissue at the back of the eye that nourishes the retina and gives it its normal red color.

The greater the distance between the lens and the flash, the less likely red-eye is to appear in photographs.

Does turning off the flash correct red-eye?

Yes, as long as there is enough light to take pictures without using a flash, red-eye will not appear in the pictures.

Are there other ways to prevent red-eye in photos?

In addition to turning off the flash, red-eye can be prevented in photographs by the following methods:

Do not look directly at the camera. Ask the people you are shooting to look slightly away from the lens so that their eyes do not catch the flash at a right angle. This will reduce the chance of red-eye appearing in photos.

Light up the room. The darker the environment, the wider the pupils of the person being photographed become, which increases the likelihood of red-eye in photographs. Increasing the light level will help eliminate red eyes.

Turn on the red-eye protection on the camera. Most modern cameras have this feature: before taking a picture, the camera makes short flashes of light in quick succession. In response to these flashes of light, the pupils of the person being photographed constrict, reducing the amount of light reflected from the retina.

Use an external flash. This method is not suitable for cameras with built-in flashes, but if you have a camera that supports the use of an external flash, moving the flash away from the lens will prevent light reflections into the lens and red-eye.

Do not film drunk people! Too much alcohol slows down a person’s reaction time. Did you know that it also affects pupil reaction time? Red eyes are more common in photos of drunk people because their pupils don’t constrict fast enough to reduce the amount of light reflected off the retina.

Removing red eyes from photos

If you have photos in which someone has red eyes, there are several ways to remove red eyes:

Digital photos. If you are using a digital camera, you can download the photos to your computer and then correct the annoying red eyes with the “Red Eye Removal Tool” in the image editing program. Some apps have a “drag and drop” feature whereby you can “take” a color from the iris and place it over the parts of the eyes that look red; other programs automatically correct red eyes.

Photos from smartphones. Apps are available for all kinds of smartphones to fix red eyes in photos. The general principle is this: if a red eye is detected in a photo, then you can use the automatic correction tool to eliminate the red color and give the eyes a more natural color. In addition, most image editing applications have a tool that allows you to manually fix red eyes in photos.

Printed photographs. If you have developed the film and notice red eyes, this effect can be removed using a special marker to remove red eyes. You can also scan a photo to a computer and use a photo editing program to remove red-eye.

Why does only some people show red-eye in a group photo?

This is due to a number of factors. The most likely cause is that people without red-eye were not looking directly into the lens or were not in line with the camera’s built-in flash.

What does it mean when only one eye is red in a photo?

When only one eye is red in a photograph, it usually means that only one eye of the person being photographed (the red eye) was looking directly at the camera lens, and the other eye was located at a slightly different angle.

In rare cases, a red eye effect in only one eye may indicate an eye disease such as a tumor or cataract. This is also possible with strabismus, that is, inconsistency of the eyes.

If you or someone close to you has only one eye consistently red in photographs, consult an ophthalmologist.

A family photo revealed this little boy’s eye disease. (Image: Megan Webber)

I always have red eyes in photos! Is there something wrong with me?

The most likely reason you always have red eyes in photographs is that when you are posing for photographs, you usually look directly into the lens, and therefore light is reflected from the retina directly back to the camera.

When taking a photo in the future, slightly change the direction of your gaze to the left or right of the camera to prevent red-eye.

Your pupils may be large. If you have large pupils, then your eyes are more likely to be red in photographs. But in this case, try not to look directly into the lens to reduce the chance that your eyes will be red in the photos.

What if one eye is red and the other looks bright yellow or white?

A white or yellowish glow (leukocoria) in one eye may be indicative of serious eye disease or disease, including cataracts, Coats’ disease, eye infection, and retinal detachment.