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Eye Exam and Vision Testing Basics – American Academy of Ophthalmology

November 18th, 2023 2:44 am

Getting an eye exam is an important part of staying healthy. But do you know when you and your family members should get eye exams?Do you know whata complete eye exam should cover?

Get the right exam at the right time and ensure your vision lasts a lifetime.

From birth through the teenage years, children's eyes are growing and changing quickly. The American Academy of Ophthalmology and the American Association for Pediatric Ophthalmology and Strabismus have developed specific childhood eye screening guidelines. Follow these guidelines to get your child screened at the right times. These screenings help identify when your child might need a complete eye exam.

If your eyes are healthy and vision is good, you should have a complete exam by your ophthalmologist once in your 20s and twice in your 30s.

There are some exceptions:

The American Academy of Ophthalmology recommends that adults get a complete eye examination at age 40. This is when early signs of disease or changes in vision may appear. It is important to find eye diseases early. Early treatment can help preserve your vision.

Some adults shouldn't wait until they are 40 to have a complete eye exam. See an ophthalmologist now if you have an eye disease or risk factors such as:

After an exam, your ophthalmologist can tell you how often you should have your eyes checked in the future. It's important to follow the schedule your ophthalmologist gives you, especially as you age. Your risk for eye disease increases as you get older.

If you are 65 or older, make sure you have your eyes checked every year or two. Your ophthalmologist will check for signs of age-related eye diseases such as:

Remember, always follow the schedule your ophthalmologist recommends for future eye exams.

A comprehensive eye exam is simple and comfortable. It shouldn't take more than 45 to 90 minutes. Your doctor may have a staff member do portions of this exam. Here is what the exam should include:

Your doctor will ask you about your vision and your general health.They will ask about:

This is the part of an eye exam people are most familiar with. You will read aneye chart to determine how well you see at various distances. You cover one eye while the other is being tested. This exam will determine whether you have20/20 vision or not.

Your doctor will ask you tolook at an eye chart through a device called a phoroptor. The phoroptor contains different lenses. It will help determine the best eyeglass or contact lens prescription for you.

Your doctor may check how yourpupils respond to light by shining a bright beam of light into your eye. Pupils usually respond by getting smaller. If your pupils widen or don't respond, this may reveal an underlying problem.

Loss of side vision (peripheral vision)may be a symptom of glaucoma. This test can find eye problems you aren't aware of because you can lose side vision without noticing.

A test called ocular motility evaluates the movement of your eyes. Your ophthalmologistlooks to see ifyour eyes are aligned.They also check that youreye muscles are working properly.

Eye pressure testing, called tonometry, measures the pressure within your eye (intraocular eye pressure, or IOP). Elevated IOP isonesign of glaucoma. The test may involve a quick puff of air onto the eye or gently applying a pressure-sensitive tip near or against your eye. Your ophthalmologist may use numbingeye drops for this test for your comfort.

Your ophthalmologist uses a slit-lamp microscope to light up the front part of the eye. This includes the eyelids, cornea,iris and lens. This test checks for cataracts or any scars or scratches on your cornea.

Your ophthalmologist will putdilating eye drops in your eye to dilate, or widen, your pupil. This will allowthemto examine yourretina andoptic nerve for signs of damage from disease. Your eyes might besensitive to light for a few hours after dilation.

Your ophthalmologist may suggest other tests to further examine your eye. This can include specialized imaging techniques such as:

These tests help your ophthalmologist detect problems in the back of the eye, on the eye's surface or inside the eye to diagnose diseases early.

Each part of the comprehensive eye exam provides important information about the health of your eyes. Make sure that you get a completeeye exam as part of yourcare for your overall health.

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Eye Exam and Vision Testing Basics - American Academy of Ophthalmology

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For Those With Diabetes On Medicare Part D, Insulin Is $35…If Its Covered – Forbes

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Eye care, vision impairment and blindness – World Health Organization (WHO)

October 27th, 2023 10:08 pm

Eye conditions that can be targeted effectively with preventive strategies include congenital and acquired eye conditions, myopia, ocular trauma, and ocular infections and inflammations. A good example of this is the practice of preventative lifestyle changes among children, including a combination of increased time spent outdoors and decreased near-work activities. This may delay the onset and slow the progression of myopia, which reduces the risk of high myopia and its complications later in life.

Importantly, the prevention and management of systemic diseases, such as diabetes and hypertension, can also be effective in reducing the risk of ocular diseases. In addition, interventions to prevent vitamin A deficiency, measles and rubella, through vitamin A supplementation and immunization, are highly effective in reducing the risk of corneal opacities that can occur secondary to these conditions.

Another example is the prevention of workplace ocular injuries through promoting the use of protective eye equipment (e.g., masks, protective goggles, visors etc.) during high-risk activities and industries (e.g., certain sports, agricultural activities, construction workers, welders etc.).

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Eye care, vision impairment and blindness - World Health Organization (WHO)

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Oliver Douglas Schein, M.D., M.P.H. – Johns Hopkins Medicine

October 16th, 2023 8:24 pm

Oliver Schein, M.D., M.P.H., is the Burton E. Grossman Professor of Ophthalmology at the Wilmer Eye Institute and carries a joint appointment in the Department of Epidemiology at the Johns Hopkins University Bloomberg School of Public Health. Dr. Schein's clinical expertise is in medical and surgical conditions of the anterior segment of the eye including cataract and complications of cataract surgery, corneal scarring and corneal surgery. He is a past author of the American Academy of Ophthalmology's "Preferred Practice Pattern" on Cataract. Research activities are directed toward the epidemiology of major ocular diseases, ophthalmic technology assessment and outcomes research in ophthalmology.

Dr. Schein received his M.D. and M.P.H. degrees from Johns Hopkins University and completed his ophthalmology residency and cornea and external eye disease fellowship at Harvard University's Massachusetts Eye and Ear Infirmary. He joined the Wilmer faculty in 1988.

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Oliver Douglas Schein, M.D., M.P.H. - Johns Hopkins Medicine

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Michael Xavier Repka, M.D., M.B.A. – Johns Hopkins Medicine

October 16th, 2023 8:24 pm

Michael X. Repka, M.D., M.B.A., is the David L. Guyton, M.D., and Feduniak Family Professor of Ophthalmology at the Wilmer Eye Institute.He specializes in pediatric ophthalmology, strabismus, retinopathy of prematurity and pediatric neuro-ophthalmology. His clinical practice includes an interest in the management of strabismus and amblyopia. In these areas, he has a special interest in using alternatives to patching for the management of amblyopia and using strabismus surgery, botulinum toxin and adjustable sutures to treat strabismus. He also performs cataract surgery and intraocular lens implantation on children with cataracts and has a special interest in pediatric neuro-ophthalmology involving normal and abnormal visual development and the effect of injury and tumor on the visual system of the child.

Dr. Repka received his M.D. degree from Thomas Jefferson University and completed his ophthalmology residency at Wills Eye Hospital. He completed fellowships in neuro-ophthalmology andpediatric ophthalmologyat the Wilmer Eye Institute and joined the faculty in 1985. In addition to his clinical responsibilities, Dr. Repka is the vice chair for clinical practice at Wilmer.

Dr. Repka is the past chairman of the Pediatric Eye Disease Investigator Group and past president of the Maryland Society of Eye Physicians and Surgeons. He is medical director of Government Affairs of the American Academy of Ophthalmology.

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Michael Xavier Repka, M.D., M.B.A. - Johns Hopkins Medicine

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Esen Karamursel Akpek, M.D. – Johns Hopkins Medicine

October 16th, 2023 8:24 pm

Esen K. Akpek, M.D., is an internationally renowned leader in the fields of corneal transplantation and surface reconstruction. She is an expert in all forms of cataract surgeries, as well as combined cataract and cornea surgery procedures. She currently sees patients in the Wilmer Eye Institute's locations at The Johns Hopkins Hospital and Johns Hopkins Bayview Medical Center.

The Bendann Professor of Ophthalmology at the Johns Hopkins University School of Medicine, Dr. Akpek has been on the surgical faculty of the Wilmer Eye Institute since 1999.

Dr. Akpeks clinical and research expertise centers on the inflammatory diseases of the ocular surface. She currently serves as the director of the Ocular Surface Disease and Dry Eye Clinic at Wilmer and the associate director of the Jerome L. Greene Sjgrens Center at Johns Hopkins Bayview Medical Center. She has been involved in major dry eye initiatives including TFOS DEWS II in 2017 and the International Meibomian Gland Dysfunction Workshop in 2011. She is a member of the Clinical Trials Consortium-Sjgrens Syndrome Foundation, OMERACT (Outcomes Measures in Rheumatology) initiative for Sjgrens syndrome, member of the Medical & Scientific Advisory Board of the Tear Film and Ocular Surface Society (TFOS). She has led many clinical trials funded by industry as well as the Department of Defense and the National Eye Institute evaluating advanced treatments and diagnostic options for patients with dry eye disease.

Dr. Akpek is the former director of the fellowship program in cornea and external disease and former co-director of Ophthalmology Clerkship at Wilmer and has trained numerous ophthalmologists who have become leaders in the field. She has lectured extensively nationally and abroad, is involved in the organization of multiple online and in-person educational activities including Sonoma Eye, International Ocular Inflammation Society, the Foster Ocular Inflammation Society, and Wilmer Dry Eye Meeting. She has published over 180 articles in peer-reviewed journals, many book chapters, editorials, and review articles. Currently, Dr. Akpek is the president of the Foster Ocular Immunology Society. She serves on the editorial board of 11 scientific journals.

Her previous appointments include serving as member of the Board of Directors for the Cornea Society, medical director of KeraLink International and CorneaGen. She currently serves on the Preferred Practice Patterns Committee for the American Academy of Ophthalmology, where she received its Senior Honor Award. She also received many other awards including the Cora Verhagen Immunology Prize, and a scholarship from the Research to Prevent Blindness.

Dr. Akpek received her medical degree from Hacettepe University in Ankara, Turkey. Following her internship and residency training in Ankara Numune Hospital, she completed a subspecialty training in Ocular Immunology and Uveitis at the Massachusetts Eye and Ear Infirmary, Harvard University Medical School. She then completed a second fellowship program in cornea, cataract and external diseases at the Wilmer Eye Institute.

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Esen Karamursel Akpek, M.D. - Johns Hopkins Medicine

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Thomas Vincent Johnson III, M.D., Ph.D. – Johns Hopkins Medicine

October 16th, 2023 8:24 pm

Lab

Lab Website: Johnson Laboratory

View all on PubMed

Johnson TV, Martin KR. Development and characterization of an adult retinal explant organotypic tissue culture system as an in vitro intraocular stem cell transplantation model. Invest Ophthalmol Vis Sci. 2008 Aug;49(8):3503-12. doi: 10.1167/iovs.07-1601. Epub 2008 Apr 11. PubMed PMID: 18408186.

Johnson TV, Oglesby EN, Steinhart MR, Cone-Kimball E, Jefferys J, Quigley HA. Time-Lapse Retinal Ganglion Cell Dendritic Field Degeneration Imaged in Organotypic Retinal Explant Culture. Invest Ophthalmol Vis Sci. 2016 Jan 1;57(1):253-64. doi: 10.1167/iovs.15-17769. PubMed PMID: 26811145; PubMed Central PMCID: PMC4736988.

Johnson TV, DeKorver NW, Levasseur VA, Osborne A, Tassoni A, Lorber B, Heller JP, Villasmil R, Bull ND, Martin KR, Tomarev SI. Identification of retinal ganglion cell neuroprotection conferred by platelet-derived growth factor through analysis of the mesenchymal stem cell secretome. Brain. 2014 Feb;137(Pt 2):503-19. doi: 10.1093/brain/awt292. Epub 2013 Oct 30. PubMed PMID: 24176979; PubMed Central PMCID: PMC3914467.

Johnson TV, Bull ND, Hunt DP, Marina N, Tomarev SI, Martin KR. Neuroprotective effects of intravitreal mesenchymal stem cell transplantation in experimental glaucoma. Invest Ophthalmol Vis Sci. 2010 Apr;51(4):2051-9. doi: 10.1167/iovs.09-4509. Epub 2009 Nov 20. PubMed PMID: 19933193; PubMed Central PMCID: PMC2868400.

Johnson TV, Bull ND, Martin KR. Identification of barriers to retinal engraftment of transplanted stem cells.Invest Ophthalmol Vis Sci. 2010 Feb;51(2):960-70. doi: 10.1167/iovs.09-3884. Epub 2009 Oct 22. PubMed PMID: 19850833; PubMed Central PMCID: PMC2868445.

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Megan Elizabeth Collins, M.D., M.P.H. – Johns Hopkins Medicine

October 16th, 2023 8:24 pm

Megan Collins, M.D., the Allan and Claire Jensen Professor of Ophthalmology, is a pediatric ophthalmologist who provides comprehensive clinical and surgical care to pediatric patients and adults with strabismus in Baltimore, Maryland. An assistant professor of ophthalmology, Dr. Collins specializes in the diagnosis and treatment of retinopathy of prematurity, pediatric craniofacial malformations and adult strabismus. She is also an associate faculty member at the Johns Hopkins Berman Institute of Bioethics.

In addition to her clinical practice, she directs the Wilmer pediatric ophthalmology fellowship program and is course director for the Wilmer residency ethics and professionalism curriculum.

Dr. Collins received her medical degree from the University of Chicago, where she also completed a fellowship in clinical medical ethics at the MacLean Center for Clinical Ethics. After an internship in internal medicine at the University of Maryland, she returned to the University of Chicago for her residency in ophthalmology, followed by a fellowship in pediatric ophthalmology and adult strabismus at the University of Torontos Hospital for Sick Children. She later received her Masters in Public Health from the Johns Hopkins University Bloomberg School of Public Health.

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Megan Elizabeth Collins, M.D., M.P.H. - Johns Hopkins Medicine

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Tin Yan Alvin Liu, M.D. – Johns Hopkins Medicine

October 16th, 2023 8:24 pm

T. Y. Alvin Liu, M.D. is an assistant professor of ophthalmology and the founding director of the Wilmer Precision Ophthalmology Center of Excellence. He is originally from Hong Kong, and speaks fluent Cantonese and Mandarin. He attended Phillips Exeter Academy in Exeter, New Hampshire, and graduated from Cornell University with a dual major in biology and economics. He received his M.D. from Columbia University in 2012, and completed his residency (2016) and fellowship (surgical and medical retina- 2018) at Johns Hopkins.

He is subspecialty-trained in the medical and surgical treatment of vitreoretinal diseases, including age-related macular degeneration, diabetic retinopathy, diabetic macular edema, retinal vascular occlusion, retinal detachment, vitreous hemorrhage, epiretinal membrane and macular hole.

Dr. Liu's research interests center on the application of artificial intelligence in the screening, diagnosis, prognostication and treatment of ophthalmic diseases, with a specific focus on vitreoretinal diseases such as age-related macular degeneration and diabetic retinopathy.

In addition, he is involved in research on the pathogenesis of and treatment for pathologic myopia and the management of severe ocular trauma.

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Tin Yan Alvin Liu, M.D. - Johns Hopkins Medicine

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Neuropathy | Duke Health

October 16th, 2023 8:22 pm

Neuropathy treatments vary widely based on type, cause, and symptoms. Treating contributing conditions is crucial to reducing neuropathy symptoms and possibly reversing nerve damage. Duke offers the full range of therapies, from traditional treatments to breakthrough options.

Pain ManagementOur neurologists are experienced in treating neuropathic pain and partner with pain medicine specialists to reduce or eliminate debilitating pain caused by neuropathy. From medications to transcutaneous electrical nerve stimulation (TENS) therapy, we have an array of options so we can find what works best for you.

Peripheral Nerve Stimulators and Spinal Cord StimulatorsNew surgically placed devices like peripheral nerve stimulators and spinal cord stimulators use electricity to relieve certain types of chronic pain. Spinal cord stimulators are FDA approved to treat diabetic neuropathy symptoms. Research shows they can help reduce pain and improve function.

SteroidsOral or intravenous steroids treat neuropathies caused or worsened by inflammation.

Intravenous Immunoglobulin (IVIG)This IV medication can reverse nerve damage caused by autoimmune neuropathies like GBS and CIDP.

Amyloid-Reducing MedicationsThese medicines can stall or reverse symptoms of amyloidosis neuropathy by slowing down the production of defective proteins called amyloid that can cause neuropathy.

Antibody TherapyThis infusion medication is administered every four to six months to help stabilize or reverse neuropathic nerve damage caused by vasculitis or inflammation.

Plasma Exchange TherapyAlso called PLEX or plasmapheresis, this can treat neuropathies caused by inflammation and autoimmune disorders. Through a central line in your upper chest or an IV in your arm, a special machine withdraws your blood, removes cells that cause inflammation and destructive antibodies, and then returns the blood along with extra fluid. Duke is one of only a handful of centers in North Carolina that offers plasma exchange therapy.

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