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5 eye problems you shouldn't ignore, from floaters to pain

There are treatments for eye disorders hiding in plain sight, from seeing spots or lines to a change in pupil size.
/ Source: TODAY

Even though it’s a marvel of design, the human eye doesn’t get a lot of respect. Most of us wake up, see (often with help of glasses or contacts) and move on with our lives.

But about half of the estimated 93 million adults in the United States who are at high risk for serious vision loss haven’t visited an ophthalmologist in the past 12 months, according to the Centers for Disease Control and Prevention.

Eye exams not only gauge your vision, but can also provide vital information about your overall health.

"When we look inside someone's eyes, we're looking at these teeny blood vessels that are the same ones that feed your heart and your brain, so we'll often diagnose blood pressure issues, diabetes, a whole host of autoimmune issues, as well," Dr. Annie Negrin, ophthalmologist and medical director at Exhale MedSpa, told TODAY. "Even if you have good eyesight, it's super important to get checked regularly."

What's more, eye conditions often associated with aging, such as macular degeneration and glaucoma, are being diagnosed at younger ages, Negrin said.

"These diseases don't have any symptoms, so millions of people could be walking around with the beginnings of a sight-threatening disease, like glaucoma, and have no idea. Even in (your) 20s and 30s, it's not completely uncommon."

If you're yet convinced that you should finally make that appointment with your eye doctor, then at least stay on top of any changes in your eyesight and plan that checkup if you notice any.

“Anything that is new in terms of a change in your vision could be potentially worrisome,” Dr. Suber Huang, CEO of Retina Center of Ohio in Cleveland, told TODAY.

1. Flashes and floaters

Although most people have experienced floaters, those gnat-like or cobwebby squiggles that appear in your field of vision, a new onset of floaters, which may be accompanied by flashes of light (often described as a lightning streak in the peripheral vision), warrants a quick trip to an ophthalmologist.

You may be experiencing something benign called a posterior vitreous detachment (PVD.) Or you might be experiencing a retinal tear that could lead to a retinal detachment, which is potentially blinding if not fixed quickly.

A PVD is a process of aging (generally after age 50 for most of us and younger if you are near-sighted) in which the vitreous, a gel-like substance that fills your eye and is attached to the retina, begins to shrink and pull away from the retina.

It doesn’t hurt and some people may not even notice any symptoms, which can range from merely annoying to downright anxiety inducing, said Huang.

The bad news is that about 10% of people may experience a retinal tear if the vitreous gel separates from the retina with too much force. That tear, which needs to be taken care of ASAP, can generally be fixed right in your doctor’s office with a laser.

Although rare, some people may develop a full-blown retinal detachment, which is considered an emergency and requires surgery to avoid loss of sight. Retinal tears and detachments don’t hurt either.

If you are diagnosed with a PVD, your doctor will schedule a follow-up visit to make sure no tears have developed.

If floaters and flashes get worse, or if you lose your side vision, see a curtain moving across your field of vision or have a decrease in vision, your doctor will tell you not to wait for that follow-up appointment. Get in now. These are symptoms of tears and detachments.

The good news is the vast majority of people won’t have much trouble with a PVD, aside from learning how to live with floaters for a while. The brain will adapt and eventually, they will float out of your line of sight.

If you experienced a PVD in one eye, chances are good you’ll get one in your other eye, too.

2. Red, teary eyes

Red, teary eyes aren’t always due to a long night out, especially if you wear contacts. You might have keratitis, an infection of the cornea that causes redness, pain, inflammation, discharge and a host of other problems.

When caught early, it can be treated more easily. Wait too long and you could potentially lose your vision.

“I see this every day: People are happily wearing contact lenses, their eyes get irritated, and get more irritated, and by the time they come in, they can have some really bad infections,” said Dr. Randy J. Epstein, professor in the department of ophthalmology at Rush Medical College in Chicago.

If you are having problems such as weepy, painful, irritated, light-sensitive and red eyes, and you wear contacts, get in to see your doctor now.

Another tip: Don’t sleep in your contacts — ever. “Sleeping in contacts can make a person more prone to infection or scar the cornea, so it’s never a good a good idea to sleep in them even if they are labeled extended wear,” said Epstein.

3. Double vision

Although it can be caused by some benign conditions, “double vision is never good,” noted Dr. Rebecca Taylor, a board-certified ophthalmologist with Nashville Vision Associates.

People can experience double vision in one or both eyes. If you have double vision in one eye, it can be due to a corneal problem. If you have double vision in both eyes, which is more common, it means your eyes aren’t working together in the right way. That could be due to a neurological issue, an autoimmune problem or other potentially serious issues.

If you have pain, weakness, slurred speech, along with double vision (or any vision change), go to an emergency department. “If the double vision is new or sudden, you need to be evaluated,” Taylor explained.

4. Pupils don’t look the same size

Anisocoria is the technical name for unequal pupil size. Some people who are otherwise healthy may have unequal pupils.

Generally, if you’re an adult and one of your pupils — that black dot right in the middle of your eye — becomes larger or smaller, and you haven’t used eye drops, call your doctor.

Unequal pupil size can be a sign of serious problems. “It could be nothing or it could be an aneurysm, a tumor, a brain infection or a sign of a stroke,” said Taylor. “The point is to get in so we can figure it out.”

5. Eye pain

Your eyes should never hurt, so any pain should be taken seriously.

Although eye pain may have a very obvious cause, such as injury, it can also indicate other conditions that range from benign to potentially blinding, like optic neuropathy or angle-closure glaucoma.

How to prevent eye problems

Negrin stressed that taking care of your overall health will benefit your eyes, from managing your blood pressure and cholesterol to not smoking. You should also wear sunglasses all year long to prevent diseases like melanoma and macular degeneration, which are more likely with UV exposure.

For people who spend a lot of time looking at screens, which can create dry eyes, he also recommended following the 20-20-20 rule: Every 20 minutes, for 20 seconds, take a break by looking at something 20 feet away.

"It literally will have you go back to a normal blink rate, coat your cornea, you'll feel better, and it also relaxes those reading muscles that are overworking," she said.

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