Care Provided
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Age-Related Macular Degeneration
Personalized Support:
Taking Control of Your AMD Journey
What Is Age-Related Macular Degeneration?
Age-related macular degeneration (AMD) is a degenerative eye disease that affects central vision. AMD strikes at the macula, the central part of the retina that processes visual images. Think of the macula as the film or digital processor of a camera. Just as a damaged film or processor results in blurry pictures, a macula affected by AMD results in a blurred, dark spot or distorted area in the centre of the visual field.
This loss can significantly impact daily tasks like driving, reading, viewing screens, recognizing familiar faces, and hand-eye coordination, such as grasping objects. AMD is the leading cause of permanent vision loss as we age.
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Dry AMD: This form accounts for 85-90% of cases and occurs as the macula gets thinner with age and small deposits of lipids and proteins (called drusen) develop behind the retina. It usually progresses slowly over several years.
Wet AMD: This form, though less common, can cause more rapid declines in vision—from weeks to a few months. It happens when abnormal blood vessels grow beneath the retina. These vessels can leak fluid or blood and cause damage to the macula.
Dry AMD can transition into wet AMD, and if left untreated, wet AMD can lead to legal blindness.
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In most early AMD cases, daylight vision is unaffected; however, a change in night vision (the ability to see in low-light conditions) with the addition of impaired dark adaptation (your eye's ability to adjust from light to darkness), frequently blamed on other causes such as needing glasses or age, are indicators.
With late AMD, a person will notice blurriness, dark spots or distorted areas in their central vision.
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Diagnosing the earliest stages of AMD can be challenging because patients will often still have good vision and lack any symptoms.
However, research now shows that impaired dark adaptation is the earliest indicator of AMD*.This knowledge empowers eye care professionals to screen for and detect AMD in patients over age 50 before any damage has been done.* Once diagnosed, disease progression may be slowed through proactive and personalized treatment plans, giving you the power to take control of your vision health.
*Sources
Jackson GR, Scott IU, Kim IK, et al. Diagnostic Sensitivity and Specificity of Dark Adaptometry for Detection of Age-Related Macular Degeneration. Invest Ophthalmol Vis Sci. 2014 Mar. 10;55(3):1427-31. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/24550363
Gerson J, Corbin G, Ferucci S, et al. Practical Guidelines for the Treatment of AMD. In: Review of Optometry. October 2017. Newtown Square, PA: Jobson Medical Information.
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The treatment of late AMD is well understood, and once initiated, it can help to stop or slow further vision loss. However, treatment is limited in reversing the damage already done. This is why it is crucial to detect AMD early and take action before any vision loss occurs. Peterborough Optometric offers several testing options:
AdaptDx: The AdaptDx test screens for any sign of subclinical (the initial period of a disease when no symptoms or signs have yet manifested) AMD. Subclinical AMD is the earliest form of AMD. It occurs before the doctor may see any structural changes in the eye, or a patient may notice any changes in their vision. The AdaptDx can catch AMD three years sooner by measuring your dark adaptation. If any delay in dark adaptation is observed, your doctor will initiate preventative treatment to delay the onset of clinical AMD.
Genetic Testing: We offer in-office genetic testing using a non-invasive cheek swab to determine which vitamins are most helpful for treating AMD based on your unique genetic profile. One type of genetic testing can also estimate your risk of AMD progression over two, five, and ten years.
Contrast Sensitivity Test: This test qualitatively measures your ability to distinguish between finer and finer increments of light versus dark (contrast). Contrast sensitivity determines how a patient views details, essential for tasks such as driving at dusk or dawn. Contrast sensitivity results are also used to assess symptoms of age-related macular degeneration.
Red Light Therapy: Red light therapy is an emerging treatment for AMD. Early studies suggest that it may stabilize or improve the contrast sensitivity of patients with AMD. The therapy involves wearing glasses emitting red light for three minutes every other day. Your doctor will monitor your contrast sensitivity before starting red light therapy and during treatment to ensure it remains stable.
We are here to listen to you and provide you with the best answers. So, please, ask us!
Glaucoma
Preventing Vision Loss:
Taking Action Against Glaucoma
What is Glaucoma?
Glaucoma is a group of progressive eye disorders that damage the eye’s optic nerve. Often referred to as the silent thief of sight, it is one of the leading causes of blindness, affecting more than 450,000 Canadians.
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Primary Glaucomas: These glaucomas can occur without cause but are often related to high pressure in the eye when fluid cannot drain properly.
Secondary Glaucomas: Glaucomas caused by other medical conditions, such as diabetes, low or high blood pressure, and, less commonly, cataracts or tumours. Infections, injuries, and surgeries in or around the eye can also cause glaucoma.
Glaucoma most often occurs in adults over 40, with increased risk over 60, but it can affect people at any age. Family history and race can also play a part in developing the condition.
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Symptoms vary depending on the type and stage of glaucoma.
Open-angle Glaucoma
No early-stage symptoms
Difficulty with low-contrast situations and adjusting to extremely low or bright lighting conditions
Reduced peripheral vision, generally starting in the vision area closest to your nose and eventually resulting in tunnel vision.
Normal-tension Glaucoma: A type of open-angle glaucoma that happens in people with normal eye pressure.
Angle-closure Glaucoma (Chronic or Acute)
Intense eye pain
Severe headache
Nausea or vomiting
Blurred vision
Rainbow-coloured halos around lights
Eye redness
*If you experience rapid onset symptoms, you may have acute angle-closure glaucoma and will need treatment as soon as possible. Go to an emergency room or call our office immediately.
Congenital Glaucoma in Children and Infants
Larger and dull or cloudy cornea (infants)
Increased blinking/eyelid spasms (infants)
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Without telling symptoms, early detection of glaucoma by an optometrist or ophthalmologist is vital to preserving vision.
During an evaluation, eye pressure is measured and, using special equipment, the optometrist will also look for damage to the optic nerve and retinal layers. Other imaging and testing may be conducted to measure any functional vision loss and structural changes in the eye.
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There is no cure for glaucoma. Patients with glaucoma need ongoing treatment which aims to reduce pressure in the eye. Specific treatments vary depending on the type of glaucoma. For some patients, it is as simple as prescription eye drops taken daily, whereas for others, surgical treatment by an ophthalmologist is necessary to maintain vision.
Although glaucoma cannot be prevented, with early detection and treatment, blindness or significant vision loss can be prevented, so regular visits to your optometrist for glaucoma screening are essential.
Diabetes and Your Eyes
Your Guide to Optimal Eye Care
What is Diabetic Eye Disease?
Diabetic eye disease is a term for the group of eye conditions that can affect individuals with diabetes, leading to potential vision impairment and even blindness if left untreated. Four common types of diabetic eye disease include:
Diabetic Retinopathy
Diabetic Macular Edema (DME)
Cataracts
Glaucoma
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People with Type 1 diabetes (where the body's immune system attacks and destroys insulin-producing beta cells in the pancreas, leading to little or no insulin production) or Type 2 diabetes (where the body either resists the effects of insulin or doesn't produce enough insulin to maintain normal glucose levels) are at risk of developing a vision-threatening condition called diabetic retinopathy. The most common diabetic eye disease, this condition occurs when the blood sugar level is too high, causing damage to the blood vessels in the light-sensitive tissue at the back of the eye (the retina). These blood vessels can leak, causing swelling, abnormal blood vessel growth, and other changes that disrupt vision. There are two stages:
Non-proliferative Diabetic Retinopathy (NPDR): Early stage where blood vessels in the retina weaken and may leak fluid or tiny amounts of blood, causing retinal swelling and the formation of deposits.
Proliferative Diabetic Retinopathy (PDR): Advanced stage where new, abnormal blood vessels grow on the retina's surface, which can bleed into the vitreous (the gel-like substance inside the eye) and lead to scarring and retinal detachment.
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Diabetic retinopathy may look like:
Blurred vision
Dark or empty areas in the field of vision
Floaters (dark spots or strings floating in the field of vision)
Flashes of light in the field of vision
Fluctuating or double vision
Loss of vision
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Early stages may not present noticeable symptoms or only mild vision problems. Unchecked and untreated diabetic retinopathy can lead to irreversible vision loss, making regular eye examinations crucial for individuals with diabetes.
The Canadian Association of Optometrists advises individuals with diabetes to undergo annual eye examinations to monitor any changes in their ocular health.
A Vision & Eye Health Evaluation at Peterborough Optometric can lead to early detection of diabetes and diabetic retinopathy. We can reduce the risk of vision loss and minimize the risk of other life-threatening complications of diabetes.
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The prevention and management of diabetic eye disease involve controlling blood sugar levels, blood pressure, and cholesterol, regular Vision & Eye Health Evaluations, and timely medical intervention when necessary.
There are various ways to treat diabetic eye damage, depending on the severity of the damage, including medications, laser therapy, vitrectomy (a surgical procedure), or anti-VEGF injections to reduce abnormal blood vessel growth and fluid leakage. However, the best course of action is preventative care. Taking care of your health now by monitoring your blood sugar, cholesterol, and blood pressure, as well as regular diet and exercise, are the best ways to help protect your eyes against diabetic eye damage.
Cataracts
What You Need to Know About this Common Eye Condition
What are Cataracts?
Cataracts are a common eye condition characterized by the usually clear lens inside the eye becoming cloudy and opaque. The lens is made up of water and proteins arranged in a precise way to keep it clear and allow light to pass through it without obstruction. Cataracts form due to the clumping of the proteins and changes in the lens fibres, obstructing the passage of light and causing blurred or dim vision. If left untreated, cataracts can lead to blindness.
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Blurred or cloudy vision that changes in prescription for glasses or contact lenses cannot correct
The sensation of a persistent film over the eyes that remains despite blinking
A temporary alteration in distance and/or near vision
Sensitivity to light and glare, especially at night
Seeing halos around lights
Colours appearing faded or yellowed
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Early detection of cataracts is crucial for effective management and treatment. Ageing is the most common cause of cataracts, typically occurring gradually over time and developing without pain or redness, so regular comprehensive Vision & Eye Health Evaluations are essential, especially for individuals over 60 or those with risk factors such as diabetes, smoking, prolonged exposure to sunlight, or a family history of cataracts.
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In the early stages, vision can often be enhanced with new glasses, progressive addition lenses, or magnifying lenses. Additionally, anti-glare sunglasses and improved lighting can help alleviate symptoms.
Cataracts themselves cannot be reversed or cured through medication or lifestyle changes. If they start interfering with daily activities, such as driving, and non-surgical management cannot improve vision, we will refer you to an ophthalmologist (eye surgeon) who may recommend surgical removal.
Timely intervention and appropriate treatment can significantly enhance the quality of life for individuals with cataracts, restoring clear vision and independence.
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Cataracts may arise from a range of contributing factors, including ageing; family history; certain diseases and health conditions, such as diabetes; injury to the eye; sun exposure; smoking and excessive alcohol consumption; long-term use of certain medications; exposure to radiation, such as radiation therapy for cancer; poor nutrition, particularly a lack of antioxidants like vitamins C and E, previous eye surgeries, leading to secondary cataracts; and congenital factors,often due to genetic factors or infections contracted during pregnancy, such as rubella.
While cataracts cannot be entirely prevented, specific measures can reduce the risk or delay their progression:
Wearing sunglasses that block UV rays
Quitting smoking
Managing health conditions like diabetes
Eating a healthy diet rich in antioxidants
Regular Vision & Eye Health Evaluations to monitor eye health
Advanced Dry Eye
You Don't Have to Suffer.
We can help.
Dry eye disease (DED) is also known as dry eye, dry eye syndrome, keratoconjunctivitis sicca, or keratitis sicca.
Dry eye disease is a common condition resulting from an imbalance in tear production or composition. It causes the eyes to become dry, irritated, and uncomfortable. Quality tears are essential for maintaining eye health, providing lubrication, reducing the risk of infection, and keeping the eyes' surface clear and smooth.
Tear Production. Not producing enough tears or tears evaporate too quickly.
Tear Composition. Tears are made up of 3 layers, each with its essential job:
1/ The outer lipid (oily) layer keeps the tear surface smooth and prevents tears from evaporating too quickly.
2/ The middle aqueous (water) layer keeps our eyes clean and nourishes the front surface of our eyes (cornea).
3/ The inner mucin (mucus) layer supports spreading the water layer over the eye's surface, keeping it moist and stable.
Dry eye symptoms may develop if tears evaporate too quickly or fail to spread evenly over the cornea due to issues with any of these layers.
Dry eye can be short-lived but is often a chronic condition. It can make you uncomfortable and affect daily activities and quality of life. If severe dry eye is left untreated, it can damage the eye's surface.
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Diabetic retinopathy may look like:
Blurred vision
Dark or empty areas in the field of vision
Floaters (dark spots or strings floating in the field of vision)
Flashes of light in the field of vision
Fluctuating or double vision
Loss of vision
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Dry eye disease can be caused by varying factors, including:
Ageing (you are age 50 or older)
Gender (women, especially those who are pregnant, on birth control, or experiencing menopause, have a higher risk due to hormonal changes)
Certain Diseases:
Sjögren's syndrome
Rheumatoid arthritis
Lupus
Diabetes
Thyroid disorders
Certain Medications:
Diuretics
Beta-blockers
Antihistamines
Decongestants
Antidepressants
Heartburn medicines
Birth control pills
Medical Conditions:
Meibomian gland dysfunction
Blepharitis (inflammation of the eyelids)
Entropion (eyelids turn in); ectropion (eyelids turn outward)
Allergic conjunctivitis
Eye Surgeries:
LASIK or other refractive surgeries
Cataract surgery
Environmental Influences:
Wind
Smoke
Dry climates
Air Conditioning
Prolonged screen use
Reading and other activities that reduce blinking
Wearing Contact Lenses
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Diagnosing dry eye disease begins with a comprehensive Vision & Eye Health Evaluation by an optometrist. Your optometrist will review your medical history, discuss symptoms, and conduct various tests to evaluate the quantity and quality of tears produced and to highlight any damage to the eye's surface. They will then recommend a suitable treatment plan.
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Treatment for dry eye disease aims to restore and maintain a normal amount of tears in the eye to minimize dryness and discomfort. Options include:
Adding Tears: over-the-counter eye drops (artificial tears)
Saving Tears:
blocking tear ducts with punctal plugs to prevent tear drainage
surgery to fix loose lower eyelids (not very common)
For Discomfort:
lubricating eye drops and ointments
self-care with warm compresses and eye massage
lifestyle changes, such as taking regular breaks from screens and using humidifiers
In-Office Treatments:
There are amazing new advances in technology that can improve tear quality, reduce inflammation and preserve health. Such advances include in-office deep eyelid cleaning, Radio Frequency treatment for Meibomian Gland Dysfunction and Intense Pulse Light therapy for Rosacea.
Our eyes need quality tears to stay healthy and comfortable and to have good vision. If you feel you are experiencing the symptoms of Dry eye disease, call us. We are here to help you understand your condition and provide the best possible care. Your comfort and eye health are our top priorities.
Dry Eye Prevention Tips & Strategies
• Avoid environments that contribute to dryness.
• Hair dryers are underestimated culprits
• Keep rooms temperate and add moisture with a humidifier
• Take regular breaks during activities that strain the eyes (every 20
minutes, take a 20-second break and focus your eyes on something
at least 20 feet away).
• Stay hydrated.