An ophthalmologist (Eye MD) went to medical school and has an MD degree. Following medical school, they complete a general medical internship and then a three year residency in ophthalmology. Following this, about half of ophthalmologists complete a one- or  two-year fellowship in a subspecialty area such as glaucoma, cornea, or retina. Optometrists complete a  four-year optometry degree after college and traditionally concentrate on prescribing glasses and  contacts. In some states, they can prescribe eye drops to treat some conditions. An optician is trained to  make and fit eyeglasses after receiving a prescription for the lens power from the ophthalmologist or optometrist.

Yes, glaucoma in most cases can be controlled with drops, laser, or surgery to lower the intraocular  pressure. By lowering the eye pressure, we can slow down the degeneration of the optic nerve which  carries the vision from the eye to the brain. Unfortunately, the vision loss from glaucoma that has already occurred cannot be reversed.

A cataract is a clouding of the natural lens of the eye that develops with aging. The lens sits right behind the pupil and focuses the light on the retina. With aging, the lens becomes yellowish and  hazy. It blurs the vision as if you were looking through a dirty window. 

Cataract surgery is necessary when the resulting blurred vision is affecting your activities of daily living.  Common reasons people require surgery are difficulty driving, trouble watching television, glare from  lights, and difficulty reading.

Blurred or distorted vision that cannot be corrected with glasses, pain, light sensitivity, flashing lights, or sudden onset of floating spots can be symptoms of serious eye disease. By covering one eye, you can detect disease occurring in only one eye.

OTC reading glasses are designed for people that have good distance vision without glasses. Over the age of 40, people need extra power to focus on near objects. Powers of these glasses generally range  from +1.00 to +3.00 diopters. At the age of 40, one would start with approximately a +1.25 and then gradually increased by +0.25 diopters every 2 to 4 years. Some people who are farsighted (hyperopic) can use a weaker pair to help  with their distance vision. The good news is that you cannot harm your eyes by wearing the wrong power lenses. Also, wearing eyeglasses does not weaken your eyes. This is a common myth that patients  bring up in exams. Also, you cannot “exercise” your eyes to lessen your dependence on glasses. If you think  about it, your eyes are constantly “exercising!”

Tearing is a very common problem that occurs more with aging. The lacrimal gland under the lateral  portion of the upper lid is constantly secreting tears to keep the eyes moist. The outer layers of the eye  must be moist to provide good vision. If they become dry, especially the cornea (the clear part over the  iris and the pupil), the eye becomes uncomfortable and feels sandy or scratchy. When the body senses  that the eye is dry, the tearing reflex is initiated. However, these tears are not the normal “basal” tears.  This reflex tearing is the most common cause of the tearing that patients notice under certain conditions  or throughout the day in more significant cases. This tearing can be treated with lubricant drops,  prescription drops, or small silicone plugs in the drainage openings (punctum) of the lower lids.  

The other less common cause of tearing is blockage of the nasolacrimal duct which drains the tears into the nasopharynx. This blockage causes constant tearing usually only in one eye. Surgery is necessary to re-establish the patency of the duct so tears can flow again from the eye to the back of the nose.

Bifocal and progressive eyeglasses are used in patients over 40 years old to provide corrected distance  and near vision in the same lens. With aging, the eye gradually loses its ability to change focus to see  near objects. Near-sighted (myopic) people will start to have problems reading while wearing their  single vision distance glasses, but they will generally read fine without glasses. Bifocal glasses have a line  representing a sharp demarcation between the distance and reading portion of the lens. Progressive  lenses are multifocal and have a gradual or progressive transition between the distance and near  portion. They also allow one to see the intermediate range for computer use or reading music. 

Yes, commonly used OTC drops include lubricant drops, or artificial tears, and allergy drops. One should  avoid using drops that promise to “get the red out.” These are vasoconstrictors and only mask the underlying problem. Lubricant drops, or artificial tears, can be safely used up to four times a day. If one  needs to use them more often, preservative-free drops, which come in individual vials, should be used  to prevent ocular irritation from the preservatives. Commonly used allergy drops include ketotifen  (Zaditor and Alaway) or olopatadine (Pataday).  

A stye or chalazion represents a blockage of an oil gland in the upper or lower eyelid. Each eyelid contains about 20 or 30 of these glands. They secrete oil onto the surface of the eye through orifices located posterior to the eye lashes. This oil layer keeps the tears from evaporating so quickly, thereby  helping to keep the eyes moist. Occasionally, the orifice becomes plugged, and the oil builds up in the  gland and extravasates into the eyelid. The body treats this as a foreign body which causes inflammation  and swelling. A painful nodule then forms. Treatment 3-4 times a day with hot compresses usually  resolves this condition over several weeks. Occasionally we prescribe topical or oral antibiotics.  Treatment with steroid injection or surgical excision is sometimes necessary. 

Wearing sunglasses helps protect your eyes by filtering out the ultraviolet rays which can lead to cataracts, macular degeneration, and certain types of eye cancer. A good diet with dark green, leafy vegetables (better than carrots) can protect the retina. Take care to make sure your eyelids are clean by using warm compresses or dilute Johnson’s baby shampoo to clean the eyelid margins. Wearing protective eyewear or safety goggles is also essential when performing  high risk activities such as sports, car repair, or construction. You cannot harm your eyes by reading, computer use, or wearing  the wrong power eyeglasses. Children should play outside for an hour a day to decrease the incidence or  severity of near-sightedness.  

Dilation of the pupils allows us to look at the back of the eye which can be considered “the engine of the  eye.” The front of the eye, the part we can see without dilation of the pupil, is designed to provide a  clear window to the back of the eye. The anterior segment also focuses the light on the retina. The posterior segment of the eye, which includes the retina and optic nerve, gathers and processes the light and sends it to the brain.  It is important to examine these structures to detect glaucoma, other optic nerve disorders and retinal diseases such as diabetic retinopathy, retinal tear, or retinal detachment.