Ho Optometrist

Your Local Optometrist from 怡保……Ipoh….. Perak, Malaysia

How Lazy is your eyes?

Lazy eye is also known as Amblyopia. Lazy eye is an early childhood condition where a child’s eyesight in one eye does not develop as it should. The problem is usually in just one eye, but can sometimes affect both of them.


lazy eye

When a patient has amblyopia the brain focuses on one eye more than the other, virtually ignoring the lazy eye. If that eye is not stimulated properly the visual brain cells do not mature normally. In the USA and UK amblyopia affects approximately 2% to 3% of all children. It is the most common cause of partial or total blindness in one eye (monocular blindness) in the USA.

The term lazy eye is inaccurate, because the eye is not lazy. In fact, it would probably be more accurate to say lazy brain, because it is a developmental problem in the brain, not an organic problem in the eye.

What are the symptoms of lazy eye?

A child with lazy eye will not be able to focus properly with one of their eyes. The other eye will make up for the problem, so much so that the affected eye suffers as a result. The eye with impaired vision (amblyopia) will not receive clear images; the brain won’t receive clear data, and will eventually start to ignore it.

In many cases the brain and the good eye make up for the shortfall so well that the child does not notice he/she has a problem. That is why lazy eye is often first detected after a routine eye test.

The signs and symptoms of a lazy eye may include:

  • Blurred vision
  • Double vision
  • Poor depth perception (of vision)
  • Eyes do not appear to work together
  • A squint (either upwards, downwards, outwards, or inwards)

It is important for a child to have a vision check. In most countries the first eye exam occurs at the age of 3 to 5 years. It is especially important to have an early eye check if there is a family history of crossed eyes, childhood cataracts or other eye conditions. Parents who see their child’s eye wandering after they are a few weeks old should tell their doctor.

What causes lazy eye?

Anything that causes a child’s eyes to cross or turn outward, or something that blurs their vision can provoke lazy eye. Below are examples of some possible causes:

    • An imbalance in the muscles that position the eye – strabismus – causing them to cross or turn out. The muscle imbalance undermines the two eyes’ ability to track objects together (move in harmony with each other, in a synchronized way, to be aligned). Strabismus may be inherited; it could be the result of long- or short-sightedness, a viral illness, or an injury.
    • Anisometropic amblyopia – a refractive error occurs due to myopia (short-sightedness), hypermetropia (long-sightedness), or astigmatism (the surface of the lens is uneven, causing blurred vision). A refractive error means light changes direction after going through the lens differently in each eye. A child with anisometropic amblyopia will be more long-sighted or short-sighted in one eye than the other, resulting in amblyopia developing in the eye that is affected more.
  • Stimulus deprivation amblyopia – this is the most uncommon form of amblyopia. One eye (or sometimes both) is prevented from seeing, and becomes lazy. This could be due to:
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Contact Lens Fungus Ate Her Eye….

‘Blinded by a contact lens’: Mother loses her sight after fungus eats away at her eyeball
Jacqui Stone, 42, had 22 operations on her eye but doctors couldn’t save it
Aggressive fungal infection ate away at three layers and 70 nerves
She noticed her vision going blurry the day after wearing the disposables
She was using the second most popular brand in Britain
The teaching assistant nearly died twice and now uses a prosthetic

By Keith Gladdis

PUBLISHED:17:32 GMT, 1 February 2013| UPDATED: 13:42 GMT, 2 February 2013

Read more: http://www.dailymail.co.uk/news/article-2272029/Dailies-contact-lenses-Jacqui-Stone-left-eye-removed-contracting-aggressive-infection.html#ixzz2JoAgmA5F
Follow us: @MailOnline on Twitter | DailyMail on Facebook

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10 Facts about Blindness

Fact 1

Worldwide, 285 million people are visually impaired due to various cases; 39 million of them are blind.

Fact 2

121 million are visually impaired because of uncorrected refractive errors (near-sightedness, far-sightedness or astigmatism). Almost all of them could have normal vision restored with eyeglasses, contact lenses or refractive surgery.

Fact 3

90% of visually impaired people live in low- and middle-income countries.

Fact 4

51% of all blindness is due to age-related cataract, the leading cause of blindness.

Fact 5

Cataract surgery and correction of refractive errors are among the most cost-effective health interventions.

Fact 6

Age-related causes of visual impairment and blindness are increasing, as is blindness due to uncontrolled diabetes.

Fact 7

Up to 80% of all blindness in adults is preventable or treatable. Among children, the major causes of avoidable blindness include cataract, retinopathy of prematurity (ROP), and Vitamin A deficiency.

Fact 8

Blindness caused by infectious diseases is decreasing globally due to public health action. Blinding trachoma affects 40 million people today, compared to 360 million in 1985.

Fact 9

Around 1.4 million children under age 15 are blind. Yet approximately half of all childhood blindness can be avoided by treating diseases early and by correcting abnormalities at birth such as cataract and glaucoma.

Fact 10

For decades, WHO has been working with global partners to eliminate the main causes of avoidable blindness, strengthening country-level efforts by providing technical assistance, monitoring and coordination.

Source: http://www.who.int/features/factfiles/blindness/en/index.html

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Top Ten Tips for your Children’s Eye Health

1. It is never too soon to take your child for an eye examination, as optometrists can examine children’s eyes even if they are unable to read letters. You should aim to take children for their first eye examination at least by the time they are three years old, especially if there is a family history of wearing glasses.

2. Children should have eye examinations at least once every two years, and more often, as advised by their optometrist, if they have an existing eye condition. Eye tests for children under 16 are free. It is important to know that the eye screening children receive in schools is not as detailed as the eye examination carried out by an optometrist.

3. Always make sure there is plenty of light when your child is doing their homework so they do not strain their eyes to see. An Anglepoise lamp is very useful.

4. Children of any age who are underachieving at school should have an eye examination. Poor vision is very likely to cause problems with reading and writing.

5. If you suspect that your child has a colour vision problem or if there is a family history of colour vision problems then arrange an eye examination with your local optometrist. There is no cure for colour vision deficiency but at least teachers can be made aware of this problem and avoid using certain colours in their teaching.

6. Always protect your child’s sight in the sun. There is increasing evidence to suggest that over-exposure to the sun’s ultraviolet rays (UV) can contribute to the development of cataracts, age-related macular degeneration and ocular melanoma (eye cancer). On average, people receive 50% of their lifetime sun exposure before they are 18 years old.

7. Make sure they eat their greens! Eating certain fruit and vegetables which contain substances called lutein and zeaxanthin could help protect against some eye conditions, in particular cataracts and age-related macular degeneration, the leading cause of blindness in this country. In particular ensure they eat plenty of broccoli, oranges, peas, kiwi fruits, mangoes, sweetcorn, grapes, and of course spinach!

8. If your child is computer crazy or a bookworm ensure they take regular breaks from such close work. Although there is no conclusive evidence to suggest either activity causes visual problems they can certainly lead to tired, red and sore eyes.

9. Children who rub their eyes a lot or who complain of tired eyes and frequent headaches should have an eye examination. Poor vision is a common cause of sore eyes and headaches.

10. When your child is playing certain sports, such as badminton or squash, get them to wear protective goggles so they don’t risk a dangerous eye injury. These can be obtained from your optometrist and can even have a prescription built-in.

Source: http://www.healthyeyes.org.uk/index.php?id=103

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Did you Know?

Did you Know?

Benjamin Franklin invented bifocals.  The first corrective lens was used by Nero in the 1st century.  The first Spectacles,(eye glasses), were made by Salvino D’Armate in Italy in 1284.


In this later life, Benjamin Franklin developed presbyopia. As he was also myopic, he got tired of constantly having to interchange two paris of glasses. So he decided to figure out a way to make his glasses let him see both near and far. He had two pairs of spectacles cut in half and put half of each lens in a single frame to make a bifocal.


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Did you Know?

Leonardo Da Vinci (15 April 1452 – 2 May 1519) was an Italian Renaissance genius. He was good at many things, but was most famous as a painter. He was also a scientist, a mathematician, an engineer, an inventor, an anatomist, a sculptor, an architect, a botanist, a musician and writer. Leonardo was curious about everything in nature. He wanted to know how everything worked. He was very good at studying, designing and making all sorts of interesting things.

Leonardo Da Vinci is frequently credited with introducing the idea of contact lenses in his 1508 Codex of the eye, Manual D, where he described a method of directly altering corneal power by submerging the eye in a bowl of water. Leonardo, however, did not suggest his idea be used for correcting vision—he was more interested in learning about the mechanisms of accommodation of the eye

Did you Know?

Leonardo da Vinci could write with the one hand and draw with the other simultaneously.

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Did you Know?

Did you know?

Our Eyes are the most complex organs you possess except for your brain.

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Glaucoma… Steals your Vision…. No Warning


Glaucoma is an eye disorder in which the optic nerve suffers damage, permanently damaging vision in the affected eye(s) and progressing to complete blindness if untreated. Optic nerve is the part of the eye that carries images we see from the eye to the brain. The optic nerve is made up of many nerve fibres (like an electric cable containing numerous wires).

It is often, but not always, associated with increased pressure of the fluid in the eye (aqueous humour). The term ‘ocular hypertension’ is used for cases having constantly raised intraocular pressure (IOP) without any associated optic nerve damage. Conversely, the term ‘normal’ or ‘low tension glaucoma’ is suggested for the typical visual field defects when associated with a normal or low IOP.Glaucoma damages nerve fibres, which can cause blind spots in our vision and vision loss will develop.

The nerve damage involves loss of retinal ganglion cells in a characteristic pattern. There are many different subtypes of glaucoma, but they can all be considered a type of optic neuropathy. Raised intraocular pressure is a significant risk factor for developing glaucoma (above 21 mmHg or 2.8 kPa). One person may develop nerve damage at a relatively low pressure, while another person may have high eye pressure for years and yet never develop damage. Untreated glaucoma leads to permanent damage of the optic nerve and resultant visual field loss, which can progress to blindness.

Glaucoma can be divided roughly into two main categories,”open angle” and “closed angle” glaucoma. Closed angle glaucoma can appear suddenly and is often painful; visual loss can progress quickly, but the discomfort often leads patients to seek medical attention before permanent damage occurs. Open angle, chronic glaucoma tends to progress at a slower rate and patients may not notice they have lost vision until the disease has progressed significantly.

Signs and tests

A test called Tonometry is done to check eye pressure. However, eye pressure always changes. Eye pressure can be normal in some people with glaucoma. This is called normal-tension glaucoma. Your doctor will need to run other tests to confirm glaucoma.

Some of the tests your Opthalmologist may perform can include:

  • Using a special lens to look at the eye (gonioscopy)
  • Photographs or laser scanning images of the inside of the eye (optic nerve imaging)
  • Examination of the retina in the back of the eye
  • Slit lamp examination
  • Visual acuity
  • Visual field measurement


The goal of treatment is to reduce eye pressure. Treatment depends on the type of glaucoma that you have.

If you have open-angle glaucoma, you will probably be given eye drops. You may need more than one type. Most people can be treated successfully with eye drops. Most of the eye drops used today have fewer side effects than those used in the past. You may also be given pills to lower pressure in the eye.

Other treatments may involve:

  • Laser therapy called an iridotomy
  • Eye surgery if other treatments do not work

Acute angle-closure attack is a medical emergency. Blindness will occur in a few days if it is not treated. If you have angle-closure glaucoma, you will receive:

  • Eye drops
  • Medicines to lower eye pressure, given by mouth and through a vein (by IV)

Some people also need an emergency operation, called an iridotomy. This procedure uses a laser to open a new pathway in the colored part of the eye. This relieves pressure and prevents another attack.

Congenital glaucoma is almost always treated with surgery. This is done using general anesthesia. This means the patient is asleep and feels no pain.

If you have secondary glaucoma, treatment of the underlying disease may help your symptoms go away. Other treatments may be needed.


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Red itchy tearing eye… Conjunctivitis

Conjunctivitis is an inflammation of the conjunctiva (kon-junk-TY-va), which is the thin membrane that lines the inside of the eyelids and covers the sclera, or white surface of the eye. Conjunctivitis is often called pinkeye.

Conjunctivitis, or pinkeye, is an inflammation of the membrane covering the inside of your eyelids and the outer part of your eye. It is generally not serious but can be highly contagious.

Conjunctivitis often feels like you have something in your eye that you can’ t get rid of. There are many causes of conjunctivitis. Viruses are the most common cause. Other causes include:

  • Allergies (allergic conjunctivitis)
  • Bacteria
  • Certain diseases
  • Chemical exposure
  • Chlamydia
  • Fungi
  • Parasites (rarely)
  • Use of contact lenses (especially extended-wear lenses)

“Pink eye” refers to a viral infection of the conjunctiva. These infections are especially contagious among children.

Newborns can be infected by bacteria in the birth canal. This condition is called ophthalmia neonatorum, and it must be treated immediately to preserve eyesight.

Conjunctivitis is generally not a serious problem and often will go away by itself. You should still, however, see your doctor. Chronic conjunctivitis, if left untreated, can cause permanent eye damage.


Treatment varies depending on what is causing the inflammation. Bacterial conjunctivitis is generally treated with antibiotic eyedrops or ointment. Viral conjunctivitis does not respond to antibiotics, but antihistamines and anti-inflammatory medications may help relieve your symptoms. Warm or cool compresses may help reduce itching and swelling.

Drug Therapies

Viral conjunctivitis: Generally, your doctor will let the virus run its course. Your doctor may prescribe antiviral eyedrops, such as acyclovir (Zovirax) or trifluridine (Viroptic). Treatment is supportive and may include ocular decongestants, and artificial tears. Cold compresses applied 3 times daily for 1 – 3 weeks may relieve discomfort.

Allergic conjunctivitis: Your doctor may recommend allergy shots over several months, to reduce your sensitivity to the allergen. Antihistamine eyedrops, such as over-the-counter antazoline phosphate (Vasocon-A) or prescription olopatadine ophthalmic (Patanol), may reduce swelling or itching. An oral antihistamine can help relieve itching. A cool compress may help relieve symptoms, too.

Bacterial conjunctivitis: is treated with antibiotic eyedrops, such as sodium sulfacetamide (Cetamide, Bleph-10), or azithromycin, or ointment such as erythomycin (E-Mycin), bacitracin, or neomycin.

Table 1

Causes of conjunctivitis, and who is primarily affected
Cause of conjunctivitis Newborn babies Children Adults
Viral infection Uncommon Usually affects both eyes Usually affects both eyes
Bacterial infection May be severe and sight threatening May affect one or both eyes. May be severe and sight threatening May affect one or both eyes. May be severe and sight threatening
Chlamydia Can cause conjunctivitis of the newborn Causes trachoma, which usually affects both eyes Usually affects both eyes
Allergy Uncommon Usually affects both eyes Uncommon
Chemical irritants/traditional eye remedies Uncommon Can affect one or both eyes Can affect one or both eyes
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Something in the Eye…. Pterygium

What is a Pterygium?

A pterygium (pronounced ter-idge-ee-um, plural: pterygia) is a triangular-shaped lump of tissue with blood vessels that grows from the conjunctiva (the thin membrane that covers the white of the eye) on to the cornea (the clear central part of the eye).

Pterygia frequently occur in both eyes, usually on the side of the eye closer to the nose. A pterygium is not a cancer. People sometimes confuse pterygia with cataracts. A cataract is a clouding of the lens inside the eye and cannot be seen easily with the naked eye.

What causes pterygia?

” The development of pterygia is strongly associated with exposure to ultraviolet radiation and hot, dry environments.”

In Malaysia, people who live in rural environments are approximately 5 times more likely to develop pterygia that those who live in urban areas. Pterygia are thus more common among people such as farmers and surfers who spend a lot of time outdoors, but anyone can develop a pterygium.

Are pterygia dangerous?

Pterygia are not dangerous, but they can be a problem cosmetically and can cause irritation and redness. Pterygia may also interfere with vision as their growth can cause corneal distortion.

” If the pterygium grows on to the central part of the cornea it can begin to block light from entering the eye.

Although a pterygium is not dangerous, it should be checked to make sure that it is not something more serious. If you have any area of tissue on or around the eyes that changes rapidly or that you have not had checked previously you should make an appointment with an optometrist or eye surgeon (ophthalmologist).

How can pterygia be treated?

In cases where the pterygium is not actively growing on to the cornea, protecting the eyes from ultraviolet light will often stabilise its growth. In many cases, provided it is not threatening vision and it remains stable, this may be all that is required.

If a pterygium causes discomfort, eye drops and ointments may be useful. Your optometrist can advise you on the use of decongestant eye drops to assist in making the eye less red, or artificial tears to make the eye more comfortable.

In cases where a pterygium is actively growing on to the cornea and threatening to distort the vision, the only effective treatment is surgical removal. This surgery is usually performed under a local anaesthetic. It is best to have surgery before the pterygium progresses to the point where it interferes with vision. Your optometrist can assess the pterygium and refer you to an eye surgeon if the pterygium requires removal.

Can I wear contact lenses if I have a pterygium?

Your optometrist will be able to advise you regarding the most suitable contact lens for your situation and will require you to attend for regular contact lens aftercare visits so that they can monitor changes in corneal shape that may indicate progression of the
pterygium and check the ongoing suitability of the fit of the contact lens.

How can pterygia be prevented?

The best way to reduce your risk of developing a pterygium, or to slow the progression of an existing pterygium, is to protect your eyes from ultraviolet light. UV radiation can also cause cataracts and other eye diseases, as well as skin cancers, so reducing exposure
is a wise move. The best ways of doing this are to:

  • Avoid the sun: UV radiation is strongest between between 10 am and 3 pm. Staying out of the sun between those times will significantly reduce your UV
  • Wear a hat: a broad-brimmed hat will not only protect your head from sunburn, but will reduce by at least half the amount of UV radiation reaching your eyes.
  • Wear sunglasses: a good pair of sunglasses will reduce the amount of UV
    reaching your eyes and cut the amount of glare. Wrap-around sunglasses are
    best as they block UV radiation that can slip around the sides of
    conventional sunglasses.

Parents should ensure that they protect the eyes of babies and children from ultraviolet light through the use of hats and children’s sunglasses that meet the safety standards.

Can pterygia grow back after they have been removed?

It is not uncommon for pterygia to grow back after they have been surgically removed so it is important to follow the recommendations above for the prevention of pterygia.

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