Common Vision Questions

How the Eye Works

The human eye is truly incredible. It provides us with a vast panoramic view of the world around us, a veritable kaleidoscope of color, and the ability to focus on objects from the tiny hairs on the backs of our hands to the stars in the sky – all without the need for batteries, cables or buttons. As a result, we can enjoy watching a spectacular sunrise over Mt. Hood while composing a text message to our friends or watching our children play on the beach while we read the latest best seller. To date, no camera or video system possesses the robust dynamic range, the incredible breadth of color rendering or the truly panoramic view afforded us by our eyes.

The eye is a marvelous organ that functions much like a sophisticated camera system. The cornea is the clear window located on the front of the eye. However, rather than just performing as a simple window it functions as a powerful lens, producing about 70% of the focusing power of the eye’s optical system. It is easily accessible and can have its focusing ability modified by Lasik or the KAMRA® corneal inlay. The iris is the colored part of the eye (blue, brown or hazel) and acts like an aperture or “f-stop” in a camera. It regulates the amount of light that can enter the eye and can also affect the eye’s range of focus. Located immediately behind the iris is the crystalline lens which further focuses light onto the retina. The retina functions like the film or image detecting microchip in a camera. It collects the light from the focused image, processes it and sends the partially processed data to the visual system in the brain via large specialized nerves. The brain then interprets the transmitted data in real time and creates what we call “vision”.

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Focusing Problems

Unfortunately, for some of us, our eyes come significantly out of focus. In earlier times these issues may have determined whether or not we became a scribe or cobbler versus a knight or warrior-hunter. In some cases, severe vision problems may have made us vulnerable to threats from wild animals or natural disasters. Of course all of that changed with the invention of glasses. In modern times, we can now treat many of these focusing problems with advanced laser vision correction procedures like Lasik.

LOSS OF NEAR VISION – UNDERSTANDING AGE RELATED NEAR VISION LOSS

I Can’t Read Anymore!

During our 40’s, most people begin to notice that they can no longer see well when performing near tasks. Simple everyday things that they used to enjoy like reading a magazine, viewing a computer monitor or reading or sending a simple text message become increasingly frustrating. Although this problem can be overcome by using reading glasses, in our modern fast paced world where text messages and emails arrive nearly continuously, the need to find a pair of readers to view these important communications is both limiting and annoying. Worse yet, many people associate the need for “readers” with “old age” and the need to dangle readers by a chain around their neck or to retrieve them from a shirt pocket or their purse each time their cell phone vibrates only serves to reminds them that they are getting older. As a group we are much more generally more active than our parents and old fashioned solutions like reading glasses don’t mesh well with our highly technological fast paced world.

This loss of reading ability is called presbyopia (prez-bee-oh-pee-yah) and is an inevitable part of aging. Ultimately, presbyopia affects 100% of the population – including those that had perfect vision before.

What Causes Presbyopia?

Our ability to focus from distance to far is created by the natural lens located inside the eye just behind the iris. When we are young, it acts like a zoom lens or autofocus mechanism on a camera to automatically adjust our focus on those objects we want to see. This focusing is performed using a complex feedback loop involving the brain and retina and is dependent upon impulses from the brain causing tiny muscles in the eye to change the shape of our natural lens. This natural lens is composed of complex crystalline proteins that are both elastic and clear.

As we age, just like other parts of the body that become less flexible, the proteins in the natural lens also age and become stiffer. At first the muscles in the eye involved in focusing work harder, which can offset the rigidity of the lens but this effort may can cause headaches and focus lag when rapidly looking from close to far. Moving the object further away or “getting longer arms” can also temporarily improve the focus as can increasing the ambient light to create more contrast. Eventually, despite these new behaviors, the ability to see objects in our normal working range is no longer possible.

Presbyopia worsens as we age as the lens continues to become more and more inflexible leading to the need for stronger and stronger reading glasses. As a result, the need for reading glasses can progress from only needing them for fine print or low light to needing them throughout the day for any task within arm’s length. If the lens proteins, in addition to becoming more rigid also begin to lose their clarity, the eye is said to have developed a “cataract”. In some sense, the onset of presbyopia is an early form of cataract.

With age the loss of elasticity and flexibility of the natural lens results in an improper focus for near objects and blurred near vision. This condition is called presbyopia.