Commonly asked questions about vision.

Q My eye doctor says I have severe astigmatism. What does that mean? Can I still wear contact lenses?

A Astigmatism is a vision condition that occurs when surfaces of the eye, such as the cornea, are oval-shaped like an egg. This prevents light from focusing properly on the back of the eye, called the retina. It's a common vision problem affecting millions of Americans. In fact, about eight out of 10 people have it. It's often found in conjunction with nearsightedness, or myopia, but also can be found in people who are farsighted. It is not related to either condition.

If you have astigmatism, you can most certainly wear contact lenses. Major advances in contact lenses over the past 20 years mean that even people with significant astigmatism can be fitted for lenses. You can even get tinted, disposable and bifocal lenses if you have astigmatism. (32)

When you're being fitted for contacts, make sure your eye health professional provides you with a pair of trial lenses before ordering the final pair. This way, you can make sure the lenses work for you before investing in them.

--Jeffrey Anshel, OO

Optometrist 

Carlsbad, CA

President, Corporate Vision Consulting

Encinitas, CA

Q What does a complete glaucoma test consist of?

A Glaucoma is an eye condition that can be caused by high pressure in the eye. Like high blood pressure, it is a silent disease, and without regular eye exams, you may not know you have it until your optic nerve is destroyed and your sight lost. That's why regular eye exams with a qualified ophthalmologist or optometrist are so important. This is particularly important if you are African American or have a family member with glaucoma.

During the exam, your eye care professional should conduct complete testing for glaucoma. This includes a visual acuity test, i.e., an eye chart test to evaluate your distance vision; a tonometer test, in which a special instrument is used to measure the pressure inside your eye; and a visual field test to measure your side, or peripheral, vision (loss of peripheral vision is a sign of glaucoma).

Additionally, you should receive a dilated eye exam. Drops widen the pupils of your eyes, and the eye care professional uses a magnifying lens to examine your retina and optic nerve for problems. And, finally, you should undergo pachymetry, in which your eye is numbed with drops, and an ultrasonic wave instrument is used to measure the thickness of your cornea. A thin cornea is a risk factor for the development of glaucoma.

--Cynthia Grosskreutz, MD

Ophthalmologist

Massachusetts Eye and Ear Infirmary 

Harvard Medical School 

Boston, MA

I am constantly amazed by the links between how we live and every aspect of our health. While it's no surprise that your diet and levels of exercise can affect the health of your heart, it probably comes as a shock to learn those factors can also affect the health of your eyes.

In fact, many of the same things that lead to common chronic conditions like diabetes, atherosclerosis and even dementia also play a role in the health of your eyes.

That's why I've come up with the 10-point Eye Health Plan. I'm no eye care expert, but I am a healthy lifestyle expert. Here's what I recommend for protecting your eyes:

1. Quit smoking. If you smoke, you're much more likely to develop age-related macular degeneration, or AMD, than nonsmokers. AMD is the most common cause of blindness in those over 65. And while there are some ways to slow its progression, there is no cure.

2. Wear sunglasses and a wide-brimmed hat when you're in the sun. These two simple steps can reduce your exposure to eye-damaging UV rays up to 18-fold! (34) And, if you wear contacts, ask your eye care specialist about contact lenses with UV protection.

3. Watch your weight. What's weight got to do with your eyes? A lot. Being overweight is a major risk factor for developing Type 2 diabetes. And diabetic retinopathy is the leading cause of blindness in those under 65. Not only that, but the Nurses' Health Study from Harvard Medical School found women with a body mass index of 30 or more (considered obese) were 36 percent more likely to develop cataracts, possibly because of some relation to high blood glucose levels. (35)

4. Take fish oil supplements daily, or eat fish two or three times a week. There's some evidence that the omega-3 fatty acids found in fish and other foods may reduce your risk of AMD. Conversely, limit the amount of vegetable oil in your diet; there's some evidence it can increase your risk. (36), (37)

5. Eat three or more servings of fruit a day. In one study, women who did this reduced their risk of AMD by 36 percent compared to those who ate less than 1.5 servings. (38)

6. Eat your spinach. What Popeye didn't know was that spinach is a rich source of lutein and zeaxanthin, powerful antioxidants that can reduce the risk of certain eye diseases, like AMD. (39) Other good sources include any kind of leafy green vegetable such as collards and kale, as well as eggs and orange-colored fruits.

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7. See your eye care professional for a full vision examination at least once every two years. Go more often if you have diabetes or any other eye-related condition.

8. Get a 30-minute walk in every day. There's some evidence that regular exercise can reduce the intraocular pressure in people with glaucoma. In one study, glaucoma patients who walked briskly four times per week for 40 minutes lowered the pressure within their eyes enough so they could stop taking their glaucoma medication.

9. Change your eye makeup every three to six months. That means new mascara, liner and powder. The makeup becomes contaminated with bacteria from your lashes and lids and can infect your eye.

10. Don't fall asleep in your daily-wear contact lenses. In fact, don't ever wear them longer than they're designed to be worn. If you want contacts that you can wear overnight, talk to your eye care professional about whether they are appropriate for you.

To learn more about vision health, visit www.healthywomen.org.

References

(32) Russell CH, Slonim CB. The correction of astigmatism with soft contact lenses. Ophthalmol Clin North Am. Sep 2003; 16(3):353-358, vi.

References

(34) Rosenthal FS, West SK, Munoz B, Emmett EA, Strickland PT, Taylor HR. Ocular and facial skin exposure to ultraviolet radiation in sunlight: a personal exposure model with application to a worker population. Health Phys. Jul 1991;61(1):77-86.

(35) Weintraub JM, Willett WC, Rosner B, Colditz GA, Seddon JM, Hankinson SE. A prospective study of the relationship between body mass index and cataract extraction among US women and men. Int J Obes Relat Metab Disord. Dec 2002; 26(12):1588-1595.

(36) SanGiovanni JP, Chew EY. The role of omega-3 long-chain polyunsaturated fatty acids in health and disease of the retina. Prog Retin Eye Res. Jan 2005;24(1):87-138.

(37) Seddon JM, Rosner B, Sperduto RD, et al. Dietary fat and risk for advanced age-related macular degeneration. Arch Ophthalmol. Aug 2001;119(8):1191-1199.

(38) Cho E, Seddon JM, Rosner B, Willett WC, Hankinson SE. Prospective study of intake of fruits, vegetables, vitamins, and carotenoids and risk of age-related maculopathy. Arch Ophthalmol. Jun 2004;122(6):883-892.

(39) Mares-Perlman JA, Fisher Al, Klein R, et al. Lutein and zeaxanthin in the diet and serum and their relation to age-related maculopathy in the third national health and nutrition examination survey. Am J Epidemiol. Mar 1 2001;153(5):424-432.

By Pamela Peeke, MD, MPH NWHRC Medical Advisor

Dr. Peeke is a Pew Foundation Scholar in Nutrition and Metabolism, and Assistant Clinical Professor of Medicine at the University of Maryland in Baltimore. She writes about health and lifestyle issues important to all women.