2020 Vision


Whatever New Year’s resolutions were made this year, chances are they have been allowed to slide off the radar by now. The year 2020 serves as a perfect backdrop to track and improve our eyesight or resolve any questions or recurring issues. The National Institute of Health believes 94% of Americans age 12 or older have good vision but that leaves a remaining 6%.  Of these 14 million, 83% can be corrected or alleviated.  Uncorrected visual health/impairment qualifies as a major public health issue according to Dr. Elias A. Zerhouni, former director of the NIH. Everyone is familiar with the term 20-20 vision and the belief that this denotes perfect vision.  20-20 is the term correctly used to describe normal visual clarity and sharpness measured at 20 feet. 20-100 means a person must be as close as 20 feet to see what a normal vision person sees at 100 feet.  In addition to sharpness and clarity, things like peripheral vision, eye coordination and depth perception, ability to focus and color vision all contribute to overall visual ability.

Other familiar terms are far-sightedness (hyperopia) or the ability to see things at a distance but unable to focus on things close and near-sightedness (myopia) which is the ability to see objects close but not at a distance. Some common eye conditions are as follows:


This happens when the cornea is shaped irregularly and prevents light from focusing properly on the retina. The retina is the light sensitive surface at the back of the eye. This condition results in blurry distance vision. Astigmatism occurs frequently in both near and far sightedness and causes headaches or general eye discomfort. It can be hereditary, present from birth and improve or worsen over time


Also known by the colorful term “Pink Eye.” This is caused by inflammation or swelling of the conjunctiva, the thin transparent tissue that lines the inner eyelid surface and the white portions of the eyeball. It can affect one or both eyes and is very common especially among children. It can be very contagious and sweep through a school or day care quickly. Conjunctivitis can be viral or bacterial or the result of an allergic reaction to irritants like pollen, air borne particles or pool chlorine.


Also known as Keratoconjunctivitis sicca (KCS). This occurs when insufficient tears are produced that lubricate, cleanse and nourish the eye. Dry Eye is common and chronic as we age. Gender (women), medications like antihistamines or for HTN or conditions like rheumatoid arthritis, diabetes, lupus, thyroid imbalances and LASIK surgery or screen time can all reduce tear production resulting in dry eye.


This is a cloudy opaque area in the lens which interferes with vision. The lens is inside the eye behind the iris (colored part). It sends light to the retina for focusing so the cloudiness causes the issue. Occurring mostly over age 55, it can appear occasionally in infants or young children. It happens in one or both eyes, but one is generally more affected. It often causes reduced night vision or problems with glare from oncoming headlights. Cataracts form due to changes in the protein and fibers that make up the lens and can be caused by diabetes, medications, UV light, smoking, alcohol use, injury, glaucoma surgery and nutritional deficiencies in vitamins C and E. Cataract surgery is the most common surgical procedure performed in the United States; approximately 2 million per year. Antioxidant studies are showing promising signs in decreasing cataract development. If cataract progression can be delayed by 10 years, the number of surgeries would reduce 45%.


This is a disease of the optic nerve and is the second leading cause of blindness worldwide. A certain amount of pressure is necessary in the eye to maintain its shape but too much can damage the optic nerve and affect peripheral vision. It’s not painful and often ignored until late in progression. Loss of peripheral vision, dark spots in the center of your vision or ‘floaters’ are other common clues. It is highly treatable with early screening and diagnosis but not curable.


This is the leading cause of severe vision loss for the over 50 population and characterized by loss of vision in the center of the eye. The Centers for Disease Control estimate 1.8 million cases with 7.3 million at risk. It is expected to triple by 2025. Caucasians and women are most at risk. It is caused by a depletion in the pigment in the macula, located in the retina which filters out harmful blue light wavelengths. There are two forms, wet (exudative) and dry (atrophic) with different causes and treatments.


Also known as “I can’t see that without my glasses” If you see someone holding a menu at arm’s length, this is what they are experiencing. It can occur suddenly, but most often is a natural part of the aging process. Changes in the shape of the crystalline lens result in a reduction in our ability to focus close up. It is not preventable but treatable, most commonly by wearing glasses.


This is a new umbrella term for eye, vision and physical problems associated with digital screen time. With 74% of Americans with a computer and 81% with a smart phone, the average adult spends 12 hours every day with a screen in front of their face. This amount of time results in blurred vision, headaches, dry eyes and neck/shoulder pain.


Characterized by blurred, distorted, wavy vision in the center field. Colors can appear faded and washed out. It can range from slightly blurry to a significant loss of vision. It is caused by a fluid build up in the macula from damaged blood vessels in the retina which causes it to swell and distort vision. Any disease that damages the retinal blood vessels like diabetes or hypertension can cause Macular edema however it can also be the result of eye surgeries for cataracts or glaucoma. It can be treated with anti-inflammatory drops, lasers or Intravitreal injections of medications like Avastin. Infrequently a vitrectomy is performed to remove the gel between the lens and retina to relieve the pressure and restore vision.


Comprehensive dilated eye exams by an optometrist are simple, painless but important aspects of an overall preventative eye health maintenance program. Even if you present no issues or problems, early detection can uncover potential eye and other health conditions which can benefit from early intervention. One of the most interesting developments is the link between beta-carotenes and antioxidants in healthy eye and vision care. This is more than ‘eat your carrots.’ Lutein and Zeaxanthin are carotenoids located in the eye and studies are showing a reduced need for cataract surgery by the addition of just 6 mg./day. Similar studies are being carried out using the antioxidants vitamin C (100mg/day) and E (9mg/day). Eating fruits and vegetables high in beta carotenes and antioxidants are proving good for you in more ways than not so it just goes to show you that Grandma was right. Eat your vegetables!

NHS Solutions offers a full range of benefits to our Interim Nurse Leaders. This includes an optional vision insurance plan. Contact us to discuss your next career move. Taking a short to mid-term Interim assignment doesn’t mean you don’t have the opportunity to enroll in health, dental, vision plans as well as invest in a robust 401k program.

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