Retinal detachment - A curtain coming down on your vision

Have you ever heard of a condition called retinal detachment?

We hope so, but if you're like most people you probably haven't. Even if you have heard of it, do you know what the symptoms are? Most people don't know but much like a heart attack, retinal detachments are considered medical emergencies and require immediate treatment to prevent permanent vision loss so let's make sure you know what to watch for!

"... a retinal detachment happens when a part of the retina pulls away from the underlying tissue. It can happen to anyone"

Let's start by understanding what a retinal detachment really is. Essentially, a retinal detachment happens when a part of the retina pulls away from the underlying tissue. Fairly quickly, that tissue dies since it is unable to get the oxygen and other nutrients it needs to survive. If left untreated it will usually spread and the entire retina will detach. Since we need our retina to see, if it fully detaches we lose the ability to see with that eye and unfortunately can't get it back. Caught early, it can be treated and stop the vision loss in its tracks

Who is at risk for a retinal detachment? Unfortunately, everyone. Some people have a higher risk, such as people with high nearsighted prescriptions or people with a family history of retinal detachment, but anyone with eyes can have their retina detach. Your retina may detach after an eye injury or accident but that's not required for a retinal detachment to occur.

This is what a detached retina looks like when your doctor looks inside your eye. It's not something we want to see!

So how do you catch and stop a retinal detachment? Well, the main thing is to have regular, dilated eye examinations. That helps your doctor of optometry check your peripheral retina for any problems like thin areas or retinal holes. Sometimes though your retina will look perfect and you still end up with a retinal detachment! So what then?

"Retinal detachments cause flashing lights, floating spots, curtains waving in your vision or a combination of all three!"

Most retinal detachments are highly symptomatic. People experience flashing lights, floating spots, a curtain waving in their vision or a combination of all three! There are many eye disorders that have similar symptoms including things that are relatively harmless like posterior vitreous detachment and ocular migraines but because a retinal detachment is so serious (meaning you can go totally blind)  it's important to have your doctor confirm the diagnosis. Don't try to make that judgment yourself. It's not worth the risk

If you have questions about retinal detachments or anything else feel free to contact us on Twitter, Facebook, Google +, via our website or phone us at (403) 474-6744.

Primary Open Angle Glaucoma - the most common type of glaucoma

You may recall from our first blog on glaucoma that this eye problem isn't really just one disease but a whole bunch of different diseases lumped together that have a similar effect on your eyes and vision. That makes it relatively difficult to explain in a non specific way (though I tried in my introduction to glaucoma blog)! To really understand it we have to talk about each type of glaucoma separately. Let's start with one of the most common types of glaucoma: primary open angle glaucoma.

So who gets this type of glaucoma? The short answer is anyone can get open angle glaucoma. Typically your risk is higher if you're of African descent, if you have a high nearsighted prescription or if you have a family member who has glaucoma. Our risk goes up with age too. The thing to take away here is that these factors increase your risk of the disease but you can't say "Gosh, I don't have any of those, I'll never get glaucoma". One person may have a lower risk than another but we all have some risk of developing glaucoma.

Alright, here's a really quick anatomy lesson (with pictures) that is absolutely required to know what's going on in glaucoma. Basically fluid is produced by the ciliary body which you can see in the picture below. That fluid flows up through your pupil and then drains out through the little corner formed between the cornea (front clear part of your eye) and your iris.

This is how an eye without glaucoma produces and drains fluid (known as 'aqueous humour') in the eye.

If you have open angle glaucoma fluid is still produced by the ciliary body and flows up through your pupil but when it goes to drain it doesn't drain as quickly or as well and so the fluid stays in the eye longer. The more fluid that remains in the eye and the slower it drains the higher the pressure in the eye becomes and the greater the chance for damage to the optic nerve and your vision.

If someone develops open angle glaucoma the fluid produced can't drain as quickly and stays in the eye longer increasing the eye pressure which can lead to damage and permanent vision loss.

So why doesn't the fluid drain as well? Good question. If you figure it out let me know and we can alert the Nobel Prize committee together. There are some types of glaucoma where the drainage gets clogged but those are secondary glaucomas (meaning they are caused by another problem like debris or physical damage preventing good fluid drainage) as opposed to primary glaucoma (the fluid isn't draining but there aren't any other diseases happening to blame it on). There are some great theories out there including some that suggest that the very tiny blood vessels that this fluid drains into may collapse or partially collapse leading to a decreased ability to drain fluid away but so far we don't know for sure why primary glaucoma happens.

Regardless of what causes it, glaucoma is treatable. Usually all that is required is one drop of medication once a day to control the pressure. In order to treat the disease and prevent vision loss though you have to know you have glaucoma! The MOST important take away is that primary open angle glaucoma has absolutely no symptoms until it's end stage and vision loss is severe. The only way to diagnose glaucoma and prevent severe vision loss is to have regular eye exams with your optometrist.

If you want to read more feel free to check out the following links or as always you can contact us on Twitter, Facebook, Google +, via our website or phone us at (403) 474-6744.

The CNIB (Canadian National Institute for the Blind) - Glaucoma

The Canadian Association of Optometrists - Glaucoma

The Alberta Association of Optometrists - Glaucoma

The American Optometric Association - Glaucoma

Introduction to Glaucoma

You may have heard of glaucoma, or maybe not.  However, you should know that while this disease affects over 250,000 people in Canada - only half of them know it! This is important because glaucoma is the second most common cause of vision loss in people over the age of 65. Glaucoma has no symptoms and the only way that glaucoma can be detected is through regular eye exams.

So I hear what you’re thinking. I’m not 65. Why do I care? Well, just because glaucoma is the second most common cause of blindness in people over 65 doesn’t mean it only strikes people in that age range! One in two hundred people under the age of 50 are also affected.

Glaucoma doesn’t have symptoms, at least not until the disease is end stage. So what does it do? Glaucoma causes a slow, symptomless, painless loss of your peripheral vision. Peripheral vision, or the sight you have all around what you’re looking at directly, helps you know your surroundings. It helps you detect the cars around you when you drive, it helps prevent you from hitting your head on objects above you. Basically it helps you maneuver in your world.

This is what tunnel vision looks like. Since the vision changes happen slowly most people with glaucoma have no idea they're losing vision.

So where does glaucoma come from? What causes it? Those are very complicated questions for later blogs! The short answer is we really don’t understand exactly where glaucoma comes from. We know that if someone in your family had glaucoma your risk goes up. Certain groups of people, those with certain types of vision prescriptions, age and gender all can play a role. One of the problems with really nailing down a definition is that there are many types of Glaucoma. There really isn’t any one thing in common across all the different types of glaucoma except that there is damage to the optic nerve causing loss of your peripheral vision.

The best prevention is seeing your Optometrist for regular eye exams.  Get checked, and ask them about your risk for glaucoma.  

If you have any questions about this or anything else feel free to contact us on Twitter, Facebook, Google +, via our website or phone us at (403) 474-6744. To learn more about glaucoma check out the links below.

The CNIB (Canadian National Institute for the Blind) - Glaucoma

The Canadian Association of Optometrists - Glaucoma

The Alberta Association of Optometrists -Glaucoma

The American Optometric Association - Glaucoma

Psychedelic, surreal, multi-coloured shapes in my vision!

Alberta is a land of ups and downs when it comes to weather (you may have noticed this recently with our ‘spring’ weather). +20C in December? -10C in July? -40C on Tuesday and +20C on Wednesday? These are just normal weather patterns here and as anyone who gets migraines can tell you it’s not fun. The wild temperature swings wreak havoc on our systems and can cause some funny things to happen.

You’re busy doing your thing when suddenly your vision goes a little funny. You may notice shapes or colours or motion in your vision, not right in the middle but just off to the side. The effect may get larger or smaller. It may move faster or slower or not at all. Sections of your vision may simply vanish and go dark or you may still be able to ‘see’ but things you know should be there just aren’t visible to you anymore (like whatever is supposed to be there pulled a chameleon on you and has become invisible). You may have never had this happen but if these symptoms sound familiar you’re not alone. If you had this happen and didn’t panic at least a little I’m impressed. I’m an optometrist and when this happened to me even though I fully recognized my symptoms and knew what was happening my heart rate bumped up a few notches. This event is known as an ocular migraine.

I know what you're thinking... what the heck did I eat? No, you aren't having a psychedelic trip, this is an example of an ocular migraine. Everyone experiences them differently though so if yours doesn't look exactly like this don't panic.

The term ocular migraine implies that you should get a headache afterwards. That’s not always the case. Some people do have migraine headaches after seeing these images in their vision but not everyone. You may have heard of people getting an aura that tells them they’re about to get a migraine. That’s essentially what this is. Auras or 'ocular migraines' usually last about 20 minutes and are followed by a return to normal vision and depending on the person a headache, a migraine, or absolutely no pain.

So, what the heck is going on? It’s not certain but what is believed to happen is that for some reason the blood vessels in the visual cortex (the very back of your brain… about as far from your eyes as you can get and still be in your head) shrink way down and not as much blood is getting through as before. This lack of blood flow means your brain can’t function the way it would like and you start to experience really bizarre things in your vision. It takes your brain, usually, about 20 minutes to figure out this isn’t normal at which point the blood vessels do one of two things. They either return to their normal size, blood flow returns to normal levels and you stop feeling like you ate a brownie you shouldn’t have OR the blood vessels expand to their maximum size stretching themselves to be as big as they can. It’s that extreme stretch that causes the horrible pain people experience with migraines. In some cases the vision changes can last longer than 20 minutes. This usually occurs if someone completely panics causing an adrenaline surge. The resulting stress levels can cause the visual changes to linger for about an hour.

Here’s the real kicker. There’s not much you can do about this. We think that all those blood vessel antics are caused by the same things that cause migraines… so, almost anything (certain smells or foods, weather patterns, stress, lack of sleep. The list goes on and on). Migraine medication can be helpful if a person is getting ocular migraines all the time and it’s seriously interfering with their life but otherwise we just recommend that a person sit back and enjoy the show for 20 minutes.  If you’re driving it is strongly recommended to pull over and wait it out. These vision changes are temporary and do not cause any damage to your eyes or your brain.

So rest assured that if you have been properly diagnosed with an ocular migraine your eyes are safe and sound. I would love to leave it at that but there is one more thing. Not all flashes in your eyes are harmless. Retinal holes, tears and detachments can cause symptoms including flashing lights in your vision, floaters and a curtain moving in and out of your vision. These flashes do not go away in 20 minutes and generally are noticed at the very edge of your vision. Retinal detachments are extremely serious and cause permanent loss of vision. If you experience flashing lights in your vision of any kind it is best to have it properly checked by an optometrist.  These visits are considered medically necessary and are fully covered by Alberta Health Care. I would advise against taking a risk. If you see flashing let an optometrist have a look at your retina to confirm everything is normal.

For more information feel free to contact us on Twitter, Facebook, Google +, via our website, phone us at (403) 474-6744 or come in anytime. You can also read more at the links below.

All About Vision - Ocular Migraine

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