Eyes

Eyes

It''''s easy to take your vision for granted. After all, seeing is as simple as opening your eyes.

Or is it? In reality, just glancing at your watch involves your personal set of complex lens-adjusting, light-transmitting, image-focusing equipment--all within orbs that are about the size of a couple of golf balls.

Talk about Grand Central Station. These busy globes register 36,000 visual messages each hour--about 864,000 each day. With that kind of input, it''''s no surprise that a full 80 percent of what you learn in life comes through your eyes. In fact, you might say that the eyes aren''''t just windows on the world; they''''re your super sensors.

Seeing Is Receiving

The vision process starts with light, which enters the eye by passing through the cornea, the transparent membrane that curves around the front of the eyeball. Just behind the pupil--the black circle at the center of the iris--the eye muscles make minute adjustments in the shape of a tiny lens. With these adjustments a clear image is splashed like an upside-down movie on the retina inside the back of the eye. The pupil reacts to light intensity by expanding or contracting, adjusted by the iris that surrounds it.

The retina, which lies along the back wall inside your eyeball, is the big screen in this whole high-tech operation. It''''s a light-sensitive layer of membrane with two kinds of specialized nerve cells, rods and cones. Rods are sensitive to the dimmest light. The cones detect color and detail. Both the rods and cones convert light intensity, color and form into nerve impulses, which are conveyed back along the optic nerve--the cable hookup that leads to your brain.

Fast Frame

This whole process occurs at a speed that makes the blink of an eye seem like slow motion. When light hits the rods and cones, the visual impulse--in the form of nerve energy--zooms from the eye into the brain at a speed equivalent to 423 miles per hour. That impulse first reaches the back part of the brain, where the shapes of objects and spatial organization of a scene are interpreted. Other parts of the brain do some further visual processing--and voilà--what you see is what you get.

While all this nerve action is going on, the eyeballs are being tweaked, rolled and adjusted by a set of outside muscles that aim your orbs at whatever attracts your attention. The muscles are attached to the outer coat of each eye and to the cuplike bone that forms each eye socket. They''''re built to last, too: Each is 100 times as strong as it needs to be to move an eyeball. Coordination of these mighty orb rollers is entirely controlled by the brain.

When the Eyes Don''''t Have It

Some women never have problems with vision--staying eyeglass-free and contact lens­free into their forties or even later. For many of us, however, nearsightedness (myopia) and farsightedness (hyperopia) come calling at a fairly early age. These eye conditions are especially prevalent in the high-tech turies our eyes were used for hunting and scanning the horizon for enemies. Now, electricity makes it possible for people to work their eyes all day and then read all night. We''''re feeling the effects of the modern age."

Approximately 105 million Americans need to wear glasses or contact lenses for nearsightedness or farsightedness. The nearsighted crowd is slightly in the majority, and for unexplained reasons, more women than men are nearsighted.

There''''s a definite genetic link, says Eric Donnenfeld, M.D., associate professor of ophthalmology at North Shore University in Manhasset, New York, and co-chairman of external diseases at the Manhattan Eye, Ear and Throat Hospital. If both your parents were wearing glasses by their teens, you''''ll probably wear them, too. If you get through your twenties without donning corrective lenses, however, you''''re likely to be home free until later years.

Aging Eyes

Whether or not you start out with perfect vision, there is one sure enemy of crystal-clear vision: time. After all, the peak of your focusing ability is at about five years of age--which leaves a lot of decades for focusing efficiency to go downhill.

When you look at something up close, the lens in your eye gets thicker to bring the object into focus, says Mary Gilbert Lawrence, M.D., ophthalmologist at Yale University School of Medicine and instructor of ophthalmology at the Manhattan Eye, Ear and Throat Hospital. "As you get older, the ability of the lens to change shape diminishes. It doesn''''t get quite thick enough to focus up close." Therefore, near vision starts to blur.

This is the condition called presbyopia, which is caused by the hardening of the lens. It''''s a natural part of aging. Whether or not you wore glasses earlier in your life, you''''re just as likely to become presbyopic later on, according to Dr. Donnenfeld.

As you ease gracefully into your forties, the chances are good that you''''ll need reading glasses--even if you had normal vision (20/20 vision)--your whole life up to then. The classic sign of presbyopia is when you start holding reading material farther and farther away from your eyes to be able to focus on it. "Patients come in and say, ''''Doctor, my arms aren''''t long enough anymore,'''' " says Dr. Lawrence.

If you find yourself squinting at the fine print more and more, here are a few tips.

Getting Framed If the eyes are the first thing you notice when you meet someone, their glasses are a close second. While shopping for specs, you should look long and hard for the pair that complements your face, says Jeffrey Anshel, O.D., an optometrist in Carlsbad, California, and author of Healthy Eyes, Better Vision. You may think that you have a good idea of your face shape, but here''''s a way to get a true outline. Pull back your hair, look in a mirror and then use some lipstick to outline your face on the mirror. You''''ll quickly find out whether your silhouette is oval, round, heart-shaped, rectangular, triangular, square or diamond-shaped. Use the illustrations on this page to determine what shape frames are best suited to your face shape. In addition Dr. Anshel recommends that you get glasses with a thick, darkly colored bridge that rests low on your nose if you want to de-emphasize wide-set eyes or a long nose. And if your eyes are close-set, choose glasses with a high, thin, lightly colored frame.			For a rectangular face, try on glasses with a strong top bar and round bottom lines.
			If your face is triangular, try heart-shaped frames, square frames, aviator frames with a straight top or wire frames that are rimless on the bottom.
			A square face is usually complemented with round or oval frames.
	If your face is oval, you can wear just about any well-proportioned frame.		For a diamond-shaped face, try a butterfly-shaped or square frame.
	For a round face, try on frames that have an angular shape or geometric angles.		If you have a heart-shaped face, try a frame with straight top lines and rounded sides.

Treat yourself to a spectacle. Try not to let fear of "looking old" keep you from buying a pair of reading glasses, says Jonathan Trobe, M.D., professor of ophthalmology at the University of Michigan Medical School in Ann Arbor and author of The Physician''''s Guide to Eye Care. "Everyone will need glasses by their mid-forties; it''''s very hard to escape."

Buy off the rack. You won''''t hurt your eyes one bit if a pair of off-the-rack magnifying glasses works for you--and you''''ll certainly save some money. Most drugstores carry magnifying glasses marked with different powers, measured in units of diopters. "Take in a newspaper, hold it at a comfortable distance and try on glasses until you get the right focus," suggests Dr. Lawrence. Most people need to increase the power of their reading glasses by a quarter diopter every five years.

Try the focals. If you wear glasses for nearsightedness and then develop presbyopia, your optometrist or ophthalmologist will probably recommend bifocals, which are glasses with two powers: one for distance viewing and one for very close work like reading, says Dr. Trobe.

There are other alternatives, including trifocals. With these lenses the upper part is for distance viewing, the lower for close-up viewing--with a middle area of the lens that eases the transition from near to far. Both bifocals and trifocals take some getting used to, and you''''ll need to have your vision checked every year or so as presbyopia advances.

Make some good contacts. If you''''re comfortable with contact lenses, you might want to stick with them as you enter the bifocal years, says Dr. Anshel. While bifocal contacts aren''''t 100 percent effective with everyone, the rigid types currently have a 70 percent chance of correcting your vision, while the soft ones are successful about 40 to 50 percent of the time.

Do eye-robics. Although some experts pooh-pooh the notion of eye exercises, others recommend the exercises as a way to improve vision. Dr. Anshel suggests the following exercise to maintain flexibility in the lens: Focus on something at a 16-inch reading distance, then shift your focus to something at least 20 feet away, and then back again. Do this several times a day to keep the lens muscle in working order.

High-Tech Headaches

Sure, they''''re great time-savers, but computers can also be a big pain--literally. Nearly anyone who works in an office ends up staring into a bright computer screen for a good part of the day. The result: eyestrain, which can mean headaches, watery, red eyes and blurry vision at a distance or up close.

"I rarely have a service station attendant complaining of eyestrain on the job--it''''s not visually intensive," says Dr. Anshel. "But computers are very demanding on the eyes."

Luckily, there are enough ways to avoid eyestrain to fill a floppy disk. Here are some of the eye doctor''''s recommendations.

Dim the lights. Bright fluorescent light bounces off the computer screen in the form of glare, says Dr. Anshel. To see if the lighting in your office is too harsh, try this test: Shade your eyes with a hand as if looking over the horizon and look at your screen. Or, if you sit by a window, shade your eyes along the side of your face to block the light. If your eyes feel better being shielded, the light''''s too bright.

Remember that paperwork reflects light, so you need brighter illumination when doing that than computer work, which gives off light. Dr. Anshel recommends a task light on your desk for paperwork--that is, an ordinary desk lamp with an incandescent bulb.

Leave a couple of feet. The best distance from the screen to your eyes is between 20 and 28 inches, says James Sheedy, O.D., Ph.D, clinical professor of optometry at the University of California at Berkeley.

Peer down. "The eyes work most efficiently looking downward," notes Dr. Sheedy. The center of the screen should be four to nine inches below your eyes, so there''''s a 10- to 20-degree downward viewing angle when you''''re looking at the screen. "Anything higher than that is too high."

Take a quick vacation. Look away from the screen for a second or two every five or ten minutes, says Dr. Lawrence. She suggests hanging a picture of an outdoor scene on the wall of your office--ideally, a scene that shows a distant horizon or a body of water such as an ocean or lake. "Look at it every now and then. This helps relax your eyes when they''''re doing a lot of prolonged near-work."

Change colors. It''''s better to have black print on a white background than vice versa, notes Dr. Sheedy. "With white on black you''''re looking into a black hole that doesn''''t blend." Also, be sure to adjust the screen for brightness so that it matches the overall brightness of the room.

Be a blinker. Blinking is an act that normally helps keep the eyes moist and refreshed--but you may have to remind yourself to do it when you''''re working on a computer. You normally blink up to 22 times a minute, Dr. Anshel notes. When you''''re reading, your blink rate drops to 12 times a minute, and in front of a computer, you blink just 7 times a minute. "Blinking helps rest the eye even for a fraction of a second by rewetting it and cleaning its surface."

Sore Eyes

If you look in the mirror some morning and wonder, "Where''''d that pink-eyed Gila monster come from?," you may be staring at a case of conjunctivitis, or pinkeye. This problem is usually caused by viral or bacterial infections or allergies. If you have it, there will be redness, discharge and a gritty feeling in your eye. Bacterial conjunctivitis is treated with antibiotic eyedrops. Allergic conjunctivitis is treated with antihistamines and other anti-inflammatory eyedrops. If your eyes are pink and runny, see your doctor, and she''''ll prescribe the eyedrops if you need them.

Better yet, try these doctor-advised measures to avoid getting it in the first place.

Get all washed up. Conjunctivitis is spread by contact, notes Dr. Donnenfeld. If you touch the hands of a child who has pinkeye, for instance, you can easily pick up the infection, because children rub their eyes, and their hands carry the virus or bacteria. "Or they touch a doorknob and you touch it, then rub your eyes and give it to yourself."

To make sure you avoid carrying it to your own eyes, wash your hands with soap and water three times a day and after you''''re near someone with red eyes, Dr. Donnenfeld suggests. The average virus lasts about a week, so you should continue the washing routine up to a week after the last signs of infection have showed up.

Invest in new cosmetics. Get a new tube of mascara about every six to eight weeks, says Dr. Lawrence. "Your eyelashes are colonized with many bacteria. After you''''ve had conjunctivitis, throw away all your eye makeup--it may be contaminated with the virus."

Clean your contacts. Some of the worst eye infections can come from contact lenses, notes Herbert Kaufmann, M.D., chief of Louisiana State University Eye Center in New Orleans. So make sure that you clean them with sterile solution, he notes. And remember: Although extended-wear lenses are comfortable and convenient, the risk of infections goes up when you wear them overnight. Contacts block the oxygen that reaches the surface of the eye. The closed eyelid rubs the lens against the eyeball, and infection can flourish in this sheltered under-the-lens environment.

How to Stymie Sties

Sties are painful, red, swollen bumps that sometimes pop up at the base of eyelash follicles. They usually go away by themselves after a while--but the faster, the better. So here are a few steps you can take to keep away these ugly bumps--or make them get lost.

Compress the issue. Because a sty is like a pimple--caused by a clogged-up oil gland--you should try to bring it to a head with a warm washcloth, notes Dr. Trobe. Hold a warm washcloth against the sty for a few minutes three times a day.

Sideline the eyeliner. Some women put eyeliner on the inside inner margin of the eyelashes--a practice that breeds sties and inflammation of the eyelids, notes Dr. Lawrence. The meibomian glands, or tiny black holes that produce the oily part of the tear film, open up on that part of the eyelid. "If you put eye makeup along that area, it may plug those glands." When you do use cosmetics in that general area, use an eye makeup remover to take off every bit of it. Then wash with baby soap.

General Orb Work

Sometimes the problem isn''''t what''''s going on behind your eye, it''''s what''''s in your eye. When rubbing against the nerve-covered corneas, something as trivial as a hair or a piece of lint can feel like a needle-sharp pain.

If you''''re pestered by eye debris, it''''s best to do the following:

Hose off. Using lukewarm water, you can rinse out the object by either getting in the shower or placing your face under the faucet and carefully pulling your eyelid away from your eye. Let the gentle flow of lukewarm water run directly in your eye. Or irrigate your eye with a clean eye syringe or a general-purpose bulb aspirator. Fill the syringe with lukewarm water. Pull your eyelid carefully away from your eye and apply the contents to the surface of your eyeball.

Refill the syringe and repeat several times. Just be sure you put in the drops gently, without squeezing the syringe, since a hard squirt can actually hurt the eyeball, says Thomas Gossel, R.Ph., Ph.D., professor of pharmacology and toxicology and dean of the College of Pharmacy at Ohio Northern University in Ada. It would be wise to purchase a syringe before you need it so you''''ll have it on hand.

Don''''t knuckle under. Remember, the cornea is extremely sensitive, says Dr. Gossel. So trying to rub your eyelid with your knuckle is just what you shouldn''''t do. "The cornea can scratch very easily."

Thieves of Sight

Going blind--it''''s a fear that most people rank higher than that of death and cancer. No one wants to hear her doctor say "glaucoma." Unfortunately, the eye disease glaucoma strikes 2 percent of the over-40 population.

People who have glaucoma often show no symptoms at all until significant vision has been lost. In fact, half of the three million Americans who have it don''''t know it.

The most common form of glaucoma is the chronic simple form, which usually hits after age 40 and tends to run in families. It''''s actually a case of clogged pipes. Inside the eye there''''s a fluid called aqueous humor that maintains a constant pressure, pumping up the eyeball to its natural shape. Over a period of years, the microscopic pores that carry the fluid may start to get blocked--and the resulting buildup of eye pressure eventually affects the optic nerve that transmits //images/library/books/femaleGuide/library/books/femaleGuide/ to the brain. The optic nerve, under pressure, can''''t interpret //images/library/books/femaleGuide/library/books/femaleGuide/ as it used to, and it goes on the fritz.

Because this sly buildup of pressure rarely causes dramatic symptoms at first, it''''s usually detected only through a routine eye exam. The doctor will check your eye pressure, and if it''''s high, she''''ll probably recommend regular, continuous treatment with eyedrops to bring the pressure down. Once the treatment is prescribed, you have to keep it up to control the glaucoma condition.

In addition to treatment, there are some simple tips that you can follow to help prevent glaucoma''''s progression.

Dry up. Drinking lots of fluids in a short period of time can increase pressure in an already fluid-filled eye, notes Jay Cohen, M.D., associate professor at the State University of New York College of Optometry in New York City. "Don''''t drink more than eight ounces in one hour," he cautions. Drink liquids at various times throughout the day--not all at once.

Drain it with a vitamin. Vitamin C has been shown to pull some of the moisture from the eyes, says Dr. Cohen. "One thousand to 2,000 milligrams a day can help lower pressure in the eye by one or two millimeters." Since this is far higher than the Daily Value of 60 milligrams--and vitamin C can be toxic in some people if they take more than 1,200 milligrams a day--you should consult a doctor before going on a large dose to relieve eye pressure.

Break a sweat. Regular aerobic exercise such as walking or running--which allows muscles to work at a steady rate with a constant supply of oxygen-carrying blood--can help reduce eye pressure in people with glaucoma, says Dr. Cohen. "There are prolonged drops in pressure from it. Even after you stop, the effects last a few weeks." He recommends 40 minutes of brisk walking five times a week.

Get a checkup. Regular eye exams after age 40 are a must--especially if you have a family history of glaucoma and if you''''re in a high-risk group. Among those who have a higher-than-average risk of glaucoma are African-Americans and people who have diabetes, says Ivan Schwab, M.D., professor of ophthalmology at the University of California, Davis.

According to experts, if you aren''''t experiencing vision problems, you should see your eye doctor every three to five years if you''''re age 20 to 39. Women ages 40 to 64 need an exam every two to four years. If you''''re 65 or older, get an exam every one or two years. If you are having vision problems, see your eye doctor right away.

Not Every Cloud Has a Silver Lining

Another potential sight stealer is the cataract, which is a partial or complete clouding of the lens of the eye. Between the ages of 65 and 74, about 23 percent of the population will develop one. After the age of 75, nearly half of us will have cataracts.

Fortunately, cataract removal has come a long way. In addition to standard surgery, there is the option of phacoemulsification surgery, in which the nucleus of the cloudy lens is broken up and liquefied by ultrasound.

In most cases people can live with cataracts for a while, but at a certain point, it makes sense to have them removed. Doctors say that when vision is reduced to levels of 20/70 or 20/100--where you can''''t drive a car or easily read a newspaper--it''''s a good idea to go ahead with surgery. If both eyes are affected, surgery is usually performed on the worse eye.

There is also plenty that you can do when you''''re younger to help prevent them or at least slow their development.

Don''''t smoke. The pernicious weed that''''s behind so many other health problems also contributes to cataract development, notes William Christen, Sc.D., instructor at Harvard Medical School and Brigham and Women''''s Hospital in Boston. "It''''s not clear exactly why, but one possibility is that cigarettes decrease blood levels of nutrients that help maintain lens transparency."

Dr. Christen points to the results of a 1992 study that involved over 17,000 participants in the Physicians Health Study. The study showed that people who smoked 20 or more cigarettes per day had about twice the risk of cataracts as people who had never smoked.

Wear shades. Because years of unprotected exposure to ultraviolet (UV) light has been linked to the development of cataracts, it''''s a good idea to wear sunglasses outside, says Dr. Lawrence. "All you need are lenses that will protect you from UV light. You can buy the $8 bargains--as long as it says ''''blocks UV'''' somewhere on the glasses." Gray is the least color-distorting lens, she notes.

The Art of Plucking Well-plucked brows help to flatter your eyes--and eyebrow plucking can be quick and painless, if you follow the rules of the game. Here are some suggestions from a New York City theatrical makeup expert, Joseph Anthony.