Achieving and Enjoying Healthy Sight Today

Refraction and Visual Acuity
The first step in providing Healthy Sight is the assessment of visual status. Since unrecognized and uncorrected refractive errors are a major cause of visual disability (153 million people worldwide) and functional blindness (8 million people worldwide), the best correctable visual acuity needs to be determined through an accurate and carefully performed refraction.
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Once this quantitative component of vision correction has been determined, attention should next be directed to quality of vision, an equally important component of vision correction. Glare and contrast sensitivity are the two major parameters of quality of vision that must be considered in most individuals in addressing their visual lifestyle needs.

Glare
Glare is an important consideration for everyone; even individuals with 20/20 vision, since it may impact adversely on visual safety, comfort, and convenience in the course of such everyday activities as driving, using the computer, watching television, or simply being outdoors. Glare may be a particularly important issue for individuals with already compromised vision or in others taking medications that can increase glare sensitivity or cause photophobia.
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Contrast Sensitivity
Contrast sensitivity is one of the most important arbiters of good everyday or real-world vision. It transforms a visual world of simple black and white into a more complex one made up of various shades of gray and color. Decreased contrast sensitivity is one of the most common problems affecting quality of vision. It is particularly important in diseased eyes with compromised vision, since impaired contrast worsens visual function in the face of quantitative visual impairment.
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Medications
Many topical and systemic medications in common everyday use can impair both quantity and quality of vision. This impairment can occur on an immediate or a long-term basis. Some medications can affect vision by causing acute fluctuations in the refractive state; an example is the myopia induced by some antibiotics, like tetracycline. Other medications can contribute to the development of chronic vision-threatening ocular diseases; the effect of steroidal agents in raising intraocular pressure (in so-called "steroid-responders") or promoting cataract formation is an example.

Possible acute and chronic qualitative effects of medications include photosensitization (where the potential for UVR-mediated ocular damage may be increased) and the induction of photophobia and impaired dark-light adaptation (secondary to miotic and mydriatic effects); these drug-related effects are usually temporary and readily reversible. More serious is the occurrence of night blindness due to retinal toxicity from certain agents, an example being plaquenil.
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Environmental Factors
Although individuals tend to have their own unique visual lifestyles, all are subject to environmental variations that can affect their visual needs and impact their quality of vision. These include changing seasons (and lighting conditions), alterations in climate (including temperature and humidity), air quality, and air-borne irritants and pollutants. The work environment is also important, particularly as concerns lighting conditions, computer use, and air quality and ventilation. In Healthy Sight Counseling, all of these diverse environmental factors are taken into account in assessing quality of vision and in selecting appropriate eyeglass lens enhancements to promote visual comfort and convenience.
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Eyestrain, Fatigue, and Headaches
While the eye itself is a remarkably compact and ingeniously designed organ whose primary purpose is to collect and integrate visual stimuli for the brain to make vision possible, there are muscular components to the visual process that can be susceptible to the same fatigue as muscles elsewhere in the body. The extra-ocular muscles move and align the eyes and the intraocular ciliary muscle changes the shape of the crystalline lens to focus or accommodate. When these ocular muscles are overworked or stressed, eye fatigue, eyestrain, and headaches may result.

Many individuals today are using their eyes more, spending longer hours in the office, with more time on the computer. Increased occupational or recreational use of the computer outside of the work place is accentuating this trend. Uncorrected or under-corrected refractive errors (especially incipient presbyopia), unrecognized ocular motility problems (eg, convergence insufficiency), and qualitative vision issues like computer-related glare and impaired contrast accentuate eyestrain and may lead to asthenopia and headaches.

Healthy Sight Counseling encourages a thorough investigation into complaints of eyestrain and "visual" headaches and calls for accurate refractive correction and the recommendation of selected eyeglass lens enhancements to specifically address problems of glare and impaired contrast. While Healthy Sight Counseling cannot eliminate troublesome eyestrain and its consequences, it can help to reduce it and promote visual comfort.
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Women’s Health
Women have long been second class citizens when it comes to healthcare, and vision and eye care are no exceptions to this trend. Attaining Healthy Sight presents some challenges that are unique to women. These hurdles include the hormonal changes related to both pregnancy and menopause, which have been linked to dry eye. In addition, eye make-up use can lead to ocular inflammation, both on an irritative and on an allergic basis. Women are more likely than men to wear contact lenses and to undergo cosmetic surgery in and around the eyes (eg, blepharoplasty, collagen, and Botox^® injections). Finally, women are becoming an increasingly larger segment of the population of smokers.
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The information presented here is intended as general health information and as an educational tool. It is not intended to be used in any other manner or for any other purpose. The information should not be used or provided to patients in place of a visit, call or consultation with a physician or other healthcare provider. Transitions Optical, Inc. ("Transitions") does not recommend the self-management of health or medical problems, nor does Transitions promote or recommend any particular form of medical or alternative treatment. People using information accessed through this Web site should also research original sources of authority. Information obtained by using this Web site is not exhaustive and does not cover all possible interactions among drugs. Should you have any healthcare related questions, please call or visit your physician or other healthcare provider. You should never disregard medical advice—or delay in seeking it—because of something you have read on this Web site. You should always seek prompt medical care for any specific health issue.