What is it? What causes it? When should you see an eye doctor? When should you begin to do some treatments on your own?
This is a very important topic. In fact, the majority of keynote searches on Google are related to blurred vision. If you wake up or close one eye and things are blurred, you’re frightened. You want to know what in the world is going on. You may not have access to a doctor or be able to schedule an appointment. I hope we’ll be able to discuss different aspects of blurred vision and key points on when you should see a doctor and when it’s serious.
When in doubt, you should definitely see your eye doctor. I’m not giving you medical advice.
When we talk about blurred vision, we have two main categories.
Painless blurred vision
Painful blurred vision.
PAINLESS CAUSES OF BLURRED VISION
Interestingly, it’s the painless blurred vision that typically is more serious. We’re going to talk about some of the serious causes of painless loss of vision.
A serious condition which can cause painless loss of vision is a retinal detachment. This needs immediate surgical care. If you ever discover that you’re losing vision in one eye, you can’t see anything, and it’s painless, that is one of the first times an eye doctor comes to mind. You need a careful dilated examination.
Typically when you develop a retinal detachment, there are some other symptoms associated with it such as flashes of light, waviness in your vision, or a curtain coming down or rising in your eye. These are common problems with retinal detachment.
A retinal detachment is typically a slowly progressing condition. If you are losing vision in one eye and seeing flashes of light, you need to see an eye doctor quickly. Don’t dilly-dally or think it’s going to go away. Immediately see an eye doctor.
There’s another type of detachment called a vitreous detachment. This is not a retinal detachment. The eye is filled with a liquid jelly called vitreous. It’s much like gelatin or Jell-O. As we get older, the Jell-O or gelatin begins to contract. Sometimes you’ll see a sudden shower of floaters or flashes of light. That’s a vitreous detachment.
Vitreous detachments are extremely common. When I was in ophthalmology training, we learned that the person’s age is the percent chance they will have a vitreous detachment. I am 66. That means I have a 66 percent chance of having a vitreous detachment. If I live to be 100, there’s a 100 percent chance I’m going to have a vitreous detachment.
Unfortunately, there are no good treatments for vitreous detachments. I believe it’s necessary to detoxify the body often. Vitreous detachment and floaters are associated with toxins in the body, like heavy metal poisoning, pesticides, and petropharmaceuticals. All those things contribute to vitreous detachment. Often an associated symptom is floaters.
Stroke to the eye
Retinal detachment is the big one with painless loss of vision. Another thing you have to consider is a stroke to the eye. You can have a painless stroke to the eye and a sudden loss of vision. If one of the small arterioles or venules is blocked, you can get a sudden loss of vision that is typically painless. You can have not only a stroke to your eye but a stroke to your body which can cause painless loss of vision. Both of these are rather serious conditions, and they are painless.
Another cause of painless loss of vision is glaucoma. Glaucoma is called the thief in the night. You typically slowly lose your peripheral vision. You get blurred vision, and there are low associated symptoms.
There’s another type of glaucoma called angle-closure. That type of glaucoma causes severe, excruciating pain. We’re going to talk about angle-closure glaucoma when we talk about painful causes of blurred vision.
You can have a migraine isolated to the eye. An ocular migraine typically has no pain associated with it, but you can lose vision. In fact, the vision can go completely black in one or both eyes due to an ocular migraine. An ocular migraine is typically short-lived. We know of the other type of migraines, but they cause severe pain. You can have an ocular migraine which is painless.
Need for Glasses
Refractive error or a need for glasses. I would say 80 percent of the population has some type of refractive error. That means you’re nearsighted or farsighted, or you have presbyopia. You have trouble reading. As we get older, the eye muscles are not functioning as well, and it is more likely we will develop blurred vision, especially when we’re working long hours and straining our eyes. You really need to consider this. In some cases, you need to get your spectacles corrected.
Diabetes can produce blurred vision in many different ways. One way is when you have an elevated blood sugar, it will blur your vision. The elevated blood sugar will change your refraction, the thickness of your glasses. If you have fluctuating prescriptions with your glasses and blurred vision at different times during the day, it could be due to your sugar. In diabetes, you can also get swelling in the back of the eye or leaking and bleeding. These things all cause painless loss of vision.
Cataracts are the leading cause of decreased vision over the age of 50. A cataract is a clotting or calcification of the lens. Once again, this is typically a painless condition.
Macular degeneration is where you get atrophy or aging changes in the macula, the central part of the retina where we have good, sharp vision. This is also painless. There’s a type of macular degeneration called wet macular degeneration. Once again, this is a painless cause of vision loss.
PAINFUL CAUSES OF BLURRED VISION
Now we’re going to talk about painful visual loss. Interestingly enough, the majority of painful conditions that cause blurred vision are not as bad as the painless. The number-one cause of painful visual loss is dry eye and blepharitis.
Dry eyes can be extremely painful. Those of you living in the Phoenix area with dry eyes will raise your hand and say, “Yes, Dr. Kondrot, I agree.” It is like rubbing sandpaper on your open eye. Dry eyes are very painful, and they do cause blurred vision.
Dry eyes are associated with a condition called blepharitis. Blepharitis is an inflammation of the eyelash. When you have dry eyes, you’re not making enough tears. Tears fight bacteria. If you’re not making enough tears, you have bacteria growing on your eyelids. This bacteria is producing toxins which make the dry eye condition a lot worse.
I love ozonated eye drops. Some of you may think, “Isn’t ozone a toxic gas? Isn’t that dangerous?” Ozone is a very powerful treatment for rejuvenating and reducing inflammation. We are making ozonated eye drops to help dry eyes. If you’re interested, go to YouTube and search “Kondrot and ozone.” You’ll come up with my YouTube video all about making ozonated eye drops.
You can use over-the-counter eye drops. I don’t like them because they have preservatives. They have thimerosal, which contains mercury. Sometimes, long-term use of these eye drops can cause more problems. Certainly don’t take steroid eye drops or Restasis. If anybody out there is taking Restasis eye drops for dry eyes, listen up. Stop right now. Do something else.
One of the best things you can do is change your diet. You need more essential oils. I like plant-based oils, not fish oils. The plant-based omega oils include primrose, borage, and flaxseed oils. You need a lot of the omega oils which will help lubricate your eye. Also drink a lot more water. If you’re living in the desert, you’re going to be dehydrated. Begin drinking a lot more water.
The next most common thing is eye strain. We’re all suffering from eye strain. I’m going to give you a couple of key pointers on how you can reduce eye strain.
First, increase the light intensity. That may be counterintuitive. You may say, “Isn’t the bright light going to cause more strain?” No. The brighter you can make your computer screen, the less strain you will have. Why? Bright lights will cause the pupil to constrict. When the pupil is constricted, you have a greater focal distance just like a camera.
Have proper working distance. If you need reading glasses or intermediate glasses when you’re working, put them on. You want those eye muscles to relax.
Take breaks. Look away from the computer.
Infection and inflammation
The next area is infection and inflammation. Typically, infections are mild and don’t cause permanent visual loss. It could be viral conjunctivitis or blepharitis on your eye. They should have some type of appropriate intervention by an eye doctor. If you have an infection, discharge, or burning in your eye, you should definitely see your eye doctor.
Temporal Arteritis- a very serious condition
There’s a more serious condition called temporal arteritis. This is inflammation of the temporal artery, which can cause a lot of pain and loss of vision. This is a medical emergency. If you have severe pain around the eye and loss of vision, you need to be tested for temporal arteritis. You need appropriate treatment. Otherwise, it could lead to total blindness.
Inflammation can be a serious problem. It usually causes blurred vision, irritation, light sensitivity, and photophobia. If you have blurred vision or subtle irritations to your eye, you do need an evaluation.
Acute or narrow angle glaucoma
Earlier I talked about glaucoma. Most causes of glaucoma do not cause any pain, but there is a condition called angle-closure glaucoma. This is a unique type of glaucoma where the pressure goes up suddenly and quickly. A factor that precipitates or triggers this is going into a dark room. If you have these painful states at night, you have to consider angle-closure glaucoma, and you need to be evaluated.
In some cases, angle-closure glaucoma can cause severe pain associated with nausea and vomiting. The classic story with angle-closure glaucoma is that someone goes into a movie theater where it’s dark. They watch the movie, and then they develop a splitting headache and a lot of pain in the eye. It’s the dark conditions that will trigger this angle-closure attack.
I was going to tell you about Night Shift. I’ve been using my iPhone for at least five years. To be honest with you, I don’t know when they put Night Shift on the phone. I was investigating Night Shift, and it decreases the intensity and shifts the light to a warmer spectrum, a reddish tone. This is brilliant.
One of the biggest problems I feel is related to eye strain is interference with our circadian rhythm, the light and dark cycles we need. We need light during the day and darkness at night. Unfortunately, blue light at night is hazardous to our eyes. We need blue light during the day. That’s why God made the sky and the ocean blue. We need a lot of blue light.
At night when you are using a bright computer screen or compact florescent lights, which give off that cold, blue light, it can be hazardous to our eye. I thought it was ingenious of Apple to have Night Shift. You can program it on your iPhone. It will shift the spectrum more toward a reddish tone, a softer tone that is more beneficial to your eye and will reduce eye strain. That’s another way you can reduce eye strain. Use Night Shift.
What if you don’t have an iPhone and it’s not on your computer? You can get blue blockers. I believe computer stores now sell a blue-blocker. It’s like amber colored shooter glasses. The amber color blocks the blue spectrum of light. You can put that on your computer screen at night, which will change the spectrum, or you can wear shooter glasses when you’re working at night. One of the keys to reduce eye strain is avoiding blue light at night.
I’d like to review eye strain. Make sure you have a very intense light during the day on your computer. The brighter light will reduce eye strain. I’m not talking about blinding light, but turn up the intensity. It will reduce eye strain.
Have a proper working distance. Work at a comfortable distance. Closer is not better. The greater the distance away, the more comfort you will have. Why is this? The closer you get to your computer, the more your eyes have to accommodate. The muscles in your eyes are working.
Another problem is not taking frequent breaks. When you are working on the computer or reading, take a break. Look away from the computer screen. When you look at a far distance, when you look at infinity, that relaxes your eye muscles so you’re able to work on the computer for a much longer time.
Those are some simple ways to reduce eye strain. In my book, I have a chapter on Dr. Bates, a turn-of-the-century ophthalmologist who developed some wonderful eye exercises to reduce strain. The one I love is called palming. This is simply rubbing your hands together and placing the cup of your hand, the palm, over your closed eye. This is a type of meditation technique where you close your eyes and breathe deeply. It helps relax the eye muscles. That is another wonderful technique.