Eye Health 101
Davina Kuhnline, OD
Northwest Eye Surgeons
Special Thanks
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Physicians and staff at Northwest Eye Surgeons
 Brett Bence, OD
Ross Koning – Professor of Biology at Eastern Connecticut State University
 Blind Spot Locator
 Bird optical illusions
Fact or Fiction
If I had an eye disease I would know right away because I would notice a change in
my vision or my eyes would hurt
Eye Anatomy
Eye Physiology
Vision is a complex process!
You have a blind spot in each of your eyes!
Vision disorders/diseases can affect any of the clear layers that light must pass
through, or the blood supply to those layers.
Vision changes can also occur when nerve pathway that carries the signal to the
brain or the brain itself is not functioning properly.
The brain is very good at filling in information so you might not notice changes in
your vision.
Fact or Fiction
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I know my eyes are healthy because I can see well without glasses
Farsightedness =Hyperopia
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Light focuses “behind” retina, distance and near objects are blurry without glasses
or contact lenses
Can often flex muscles inside eye to focus distant image on retina and flex even
more for near image
 This ability becomes more difficult after 40 years old
Nearsightedness =Myopia
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Distant light focuses in front of the retina
Near objects are clear, distant objects are blurry without glasses or contact lenses
 No amount of flexing/focusing will help this
Astigmatism = Two focal points
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Image can appear blurry, smeared, sometimes double
Light rays are focused at two different points
Fact or Fiction
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I know the health of my eyes is deteriorating because I have to wear glasses more
often
Presbyopia
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Loss of ability to focus up close
Lens grows and hardens throughout life
Arms seem shorter after about 40 years old
Dry Eye
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20 million people in US
Women > men
Hormones:
 Over age 50
 Post-menopausal women estrogen therapy (HRT)
Inflammation:
 Autoimmune diseases: Sjogren's, rheumatoid arthritis, lupus
 Contact lens wearers
 Post-surgical eye patients
 Environmental influence – air-born allergens, irritants, or toxins
 Diet low in omega-3 essential fatty acids
Drug induced: antidepressants, antiallergy, diuretics
Vitamin A deficiency
Dry Eye
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Burning, itching, tearing, gritty/gravely, dry, red, intermittent blur
Can be caused from not blinking enough, tears drying too quickly, or not producing
enough tears
 Usually a combination
Dry Eye Treatment
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Take frequent breaks when doing near tasks - blink
Artificial tears
Warm compresses
Increase dietary omega-3 fatty acids
 Walnuts, salmon, tuna, mackerel, sardines, anchovies; pasture raised meats,
eggs, and dairy; chia seeds, flax seeds, hemp seeds, wild rice, kidney beans
Punctal plugs
Reduce inflammation
 Steroid and/or antibiotic eye drops
 Restasis
 Oral antibiotic
Subconjunctival Hemorrhage
Broken blood vessel over white of eye under clear covering called conjunctiva
Similar to bruise, usually takes a couple of weeks to resolve without treatment
Causes: trauma, rubbing eye, coughing, sneezing, vomiting, straining, certain eye
infections
Risk factors: high blood pressure, diabetes, blood thinning medications, blood-clotting
disorders
Call if any change in vision noted, if recurring, if bleeding elsewhere, or if associated
with tearing or discharge
Floaters
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Clumps in vitreous (gel that fills the eye) cast shadow on retina
Mostly annoying
Can be symptom of retinal tear or detachment
 Call if sudden increase in floaters, the appearance of flashing lights, or
decreased side vision
Floaters
Most of the time there is no treatment necessary for floaters
If the floaters are due to a retinal tear or detachment, then surgical repair is
necessary
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If floaters are not associated with a tear or detachment, but cause significant blur,
then surgery can be done to remove the vitreous gel
Cataract
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42-51% of World Blindness
 Congenital
 Trauma
 Diabetes, other systemic diseases
 Medications - steroids
 Inflammation
 UV light
 Radiation
 Tobacco
 Alcohol
 Ageing ~ 50% of those over 65 years old have cataracts affecting vision
Cataract
Clear crystalline lens
Cataract = hazy lens
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Blur, glare from headlights
Cataract Surgery
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Your hazy lens is removed and is replaced by a clear artificial lens implant
 This improves vision and reduces glare as long as the rest of your visual
system is healthy.
The power of the lens implant is calculated from measurements of your eye taken
before surgery
 Often times this allows you to be less dependent on glasses after the surgery at
either distance or near, but not both with a traditional lens implant
 The artificial lens implant is not flexible so it cannot change focus like your
natural lens can prior to 40 years of age
 There are new lens designs on the market that will help you to be less
dependent on glasses at distance and near
Glaucoma
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About 3 million people in the United States have glaucoma
Half of them do not know it
 Vision loss is gradual and usually not symptomatic until advanced
 Damage is not reversible
Annual glaucoma blindness: 5,000 people in US
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Risk doubles every decade starting in the 40s
Risk Factors:
 Over age 60
 African descent and over age 40
 Diabetes mellitus
 Family history
 Vascular factors (anemia, low BP, blood loss, sickle cell)
 Sleep apnea
Glaucoma
Glaucoma Treatment
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Eye drops to lower eye pressure
Surgery to lower eye pressure
Monitor for changes as recommended by your eye care provider
Macular Degeneration
Normal Macula
Dry Macular Degeneration
Severe Macular Degeneration
Severe Dry AMD
Wet Macular Degeneration
Treatment for Macular Degeneration
Dry Macular Degeneration
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Quit smoking
Wear UV protection
Add more leafy green vegetables to diet (caution if on warfarin)
Control high blood pressure
If you have moderate changes taking an AREDs or AREDs 2** vitamin can slow
progression to severe by 25%
**AREDs 2 is safer for smokers
Wet Macular Degeneration
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Same as dry macular degeneration plus:
Injection of anti-VEGF medication into eye
For Both: monitor every 6 weeks to 12 months as recommended by your eye care
provider
Fact or Fiction
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Systemic disorders or diseases like high blood pressure and diabetes cause
changes in the body that can be seen in the eyes
Diabetic Retinopathy
Healthy Retina
Diabetic Retinopathy
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Risk factors: length of time with diabetes, poor blood sugar control
Management
Manage blood sugar control with family physician or endocrinologist
 Follow diabetic diet and exercise daily
Monitor with yearly eye exams or sooner as recommended by your eye care
provider
 Mild to moderate changes are monitored
 Severe changes require laser treatment and/or an injection in the eye
Hypertensive Retinopathy
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Risk factors: high blood pressure, length of time with uncontrolled high blood
pressure
Management
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Work with family physician to control blood pressure
 Quit smoking
 Exercise regularly
 DASH diet:
 Eat more fruits, vegetables, and low-fat dairy foods
 Cut back on foods that are high in saturated fat, cholesterol, and trans fats
 Eat more whole grain products, fish, poultry, and nuts
 Eat less red meat (especially processed meats) and sweets
 Eat foods that are rich in magnesium, potassium, and calcium
 Eat 1,500mg (2/3tsp.) or less sodium (salt) daily
Monitor with yearly eye exams or sooner as recommended by your eye care
provider
Frequently Asked Questions
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Are carrots good for your eyes?
Can reading in dim lighting be bad for your eyes?
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Does using your eyes too much wear them out?
Can wearing someone else’s glasses damage your eyes?
If you cross your eyes, can they get stuck?
Can sitting too close to the TV/computer ruin your vision?
Will you go blind if you look directly at the sun?
Do babies see colors?
Can your eyeball pop out?
True or False
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A comprehensive eye exam is included during my annual physical with my family
physician
How Often Should I have an Eye Exam?
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Every 6 months
Every year
Every 2 years
Every 5 years
Only when my eyes feel uncomfortable or I notice a change in my vision
See Your Local Optometrist
List of Providers in Our Area
Sequim
John Picard, OD
Costco Vision Center
955 W. Washington St.
Sequim, WA 98382
360-406-2036
Diana Young, OD
Neil Cays, OD
Sequim Vision Clinic
128 E. Washington St.
Sequim, WA 98382
360-683-3389
Alan Copeland, OD
Wal-Mart Vision Center
1284 W. Washington St.
Sequim, WA 98382
360-683-1590
William Wickline, OD
360-681-3937
680 E. Washington St., Ste. E-102
Sequim, WA 98382
Port Hadlock/Port Townsend
David Shores, OD
360-385-1093
Port Hadlock Vision Clinic
150 Chimacum Creek Dr.
Port Hadlock, WA 98339
Greg Hare, OD
360-379-6477
Olympic Optical
2500 W. Sims Way, Ste. 203
Port Townsend, WA 98368
Port Angeles
Thomas Reis, OD
Kirk Thompson, OD
Eric VanOrman, OD
Angeles Vision Clinic
811 E. Georgiana St.
Port Angeles, WA 98362
360-417-2020
360-452-7661
360-452-2100
Larry Nivala, OD
360-452-2361
The Contact Lens & Eye Clinic
114 E. 1st St.
Port Angeles, WA 98362
Cynthia Bidegary, OD
John Huard, OD
Downtown Eye Care
228 W. 1st. St., Ste. V.
Port Angeles, WA 98362
360-452-2020
Thomas McCurdy, OD
360-457-1032
Olympic Eye Care Center
504 E. 8th St., Ste. A
Port Angeles, WA 98362
Scott Braun, OD
Thomas Hainstock, OD
Optometry Associates
901 S. Lincoln St.
Port Angeles, WA 98362
360-452-4056
360-452-9007
George Symonds, OD
360-457-1161
Peninsula Contact Lens & Vision Care Clinic
1122 E. Front St.
Port Angeles, WA 98362
Margot Williams, OD
Walmart Vision Center
3411 E. Kolonels Way
Port Angeles, WA 98362
360-452-7625
Thank You!!