Commonly Asked Eye Questions

April 7, 2020

Dr. Dean Glaros is a board-certified ophthalmologist and medical director of the Johns Hopkins Wilmer Eye Institute’s Columbia satellite office. He is also a member of CA’s Medical Advisory Board.

 As a comprehensive ophthalmologist in practice for over 25 years, I have fielded upwards of a million (gulp) questions from concerned patients. When I was approached by CA to write a brief article for this newsletter, it occurred to me that whittling down those many questions to the ones I have heard the most might be useful for our readers. Here goes: 

  1.   “What is the difference between an ophthalmologist and an optometrist?”

While both are addressed with the title of  “doctor,” ophthalmologists are physicians who attend medical schools (the same ones that other physicians do) but go on to perform a residency in ophthalmology. Optometrists attend schools of optometry but these are not considered medical schools. Both ophthalmologists and optometrists perform routine eye exams. There is some geographic variability and controversy regarding this next point but the vast majority of optometrists do not perform any eye surgery and have limited access to medicines used to treat eye disease. 

  1.   “Should I be seeing an ophthalmologist or an optometrist?”

It is not possible to answer this question without any bias, but I have always instructed patients that a good optometrist and a good ophthalmologist probably deliver equivalent eye care, especially for routine exams. The important thing is to have an eye doctor (ophthalmologist or optometrist) you trust and who will not hesitate to refer you for more specialized eye care if needed. 

  1.   “Can I hurt my eyes by using them too much?”

It is tempting to answer this with the one word “no,” but it’s not as simple as that. There is a world of difference between the terms “damage” and “fatigue.” It is probably safe to say that none of our usual visual activities (computer use, for example) can cause damage to our eyes.  In the same vein, our mothers were probably inaccurate when they told us that we would ruin our eyes if we sat too close to television or attempted to read our books in low light. However, all of us know that long periods of time spent reading or using a computer or driving at night can fatigue our eyes. Usually, all that this fatigue requires is visual rest or perhaps some artificial tear drops. Again, it is important not to confuse the temporary symptoms of eye fatigue with more serious eye damage. 

  1.   “But what about blue light?”

Blue light emitted by everyday electronic devices (e.g. your smartphone or the laptop I’m using now) does not damage your eyes. However, it is probably accurate to say that such blue light exposure in some people can lead to disturbances in sleep. Please do not waste your time worrying about blue light and certainly do not waste your money on glasses that block it. 

  1.   “What about sunglasses?”

Long-term exposure to sunlight can increase the risk of cataracts, growths and even cancers on the eye or eyelids. Think of sunglasses as sunscreen for your eyes and try to wear them at least during summer months when the sun’s rays are more powerful. Choose sunglasses that block at least 99% of both UVA and UVB radiation. It’s okay to make your fashion statement, but in general the bigger the better. The cost of the sunglasses isn’t important; it’s not unusual for very inexpensive sunglasses to block UV light just as well as expensive ones. Finally (and perhaps surprisingly), the actual color of the tint isn’t really important, but some eye doctors recommend black or gray to minimize impact on color perception while the sunglasses are being worn. 

  1.   “My eye feels like it’s twitching, should I be concerned?”

No. This is a common, benign (harmless) and temporary condition caused by many factors and none of them are serious (e.g. too much caffeine or eye fatigue/see above). 

  1.   “Am I farsighted or nearsighted?”

This question strikes fear into the hearts of any eye doctor because the terms themselves are so general that the answer requires a lengthy lesson in the science of optics. Suffice it to say that most people who require glasses for distance at a young age (the board in school in the third grade is classic) are nearsighted (“myopic”) while most people who do not need glasses until they are in their forties (first for reading and a few years later for distance also) are farsighted (“hyperopic”). It really comes down to the type of lens it takes to make someone see clearly (converging for hyperopia or diverging for myopia). Is that clear? Oh well… 

  1.   “Should I be taking special eye vitamins?”

Unless you have been diagnosed with macular degeneration of a specific stage, there is absolutely no need to take any special eye vitamins. This is true even if a parent or sibling was diagnosed with macular degeneration. While we’re at it though, smoking definitely increases your risk of developing macular degeneration. 

  1.   “What is the difference in cataracts and glaucoma?”

When the normally-clear lens of our eye (located deep inside the eye behind the colored iris) becomes clouded, the lens is called a cataract. Glaucoma is a disease in which the optic nerve becomes damaged by an abnormal condition in the eye; usually elevated eye pressure. Both conditions can be treated effectively by an ophthalmologist. 

  1. “Are floaters a sign of something serious going on with my eyes?”

Usually not, but new or worsening floaters should be checked by your eye doctor. 

  1. “Are my headaches or dizziness caused by a problem with my eyes?”

The answer is that neither one of these conditions is usually caused by an eye problem.  

  1. “My eyes are very precious to me. What can I do to keep from going blind?”

I saved this one for last because it’s probably the one I hear the most and the one that patients also tend to save for last. Over the years, I have come to understand that many patients who come to see me need nothing more than my reassurance that they’re not going blind. Therefore, no matter how busy I am, I try to answer this question with the respect and time that  it deserves:

  •       Healthy people tend to have healthy eyes. Do your best to maintain good health by making regular visits to your primary care physician. Columbia Association has an incredible array of programs and facilities to help you get healthy and stay there.
  •       Diabetes, hypertension and other chronic medical diseases are directly and indirectly associated with conditions that can cause blindness and should be controlled as meticulously as possible.
  •       Don’t smoke. Smoking increases the risk of macular degeneration and can worsen other eye conditions.
  •       Wear safety glasses when using power tools.
  •       Wear sunglasses when outdoors in bright sun; at least for prolonged periods in the summer months and/or at high altitudes. When in doubt, put on the shades.
  •       Above all, see your eye doctor for regular exams and immediately for new vision symptoms or eye pain.
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