Ask the Ophthalmologist

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By Nausheen Khuddus, M.D. | Photo courtesy of Nausheen Khuddus

Dr. Nausheen Khuddus is a fellowship trained pediatric ophthalmologist. She attended Chicago Medical School, then did her residency and fellowship at the University of Florida. She specializes in double vision and eye muscle disorders affecting children and adults. She has lived in Gainesville since 1997, and is married with four children. Her new office, Family Focus, opened in September 2017.

After spending all day at work looking at a computer, I come home with headaches and dry, tired eyes. What can I do to prevent this?

Eye strain or eye fatigue can be a frustrating problem. There are several things that can be done to help. First, make sure you are in the proper correction for the distance you are working. For example, reading glasses may be too strong for focusing on a computer screen. If glasses are too strong, they can make your eyes more tired. Second, when we are concentrating for long periods we often forget to blink regularly and this causes our eyes to dry out. This can be helped by taking breaks. Look across the room and focus on a distant object for a few seconds. This will help your eyes. You can also use artificial tears to help the eyes if they feel dry. In addition, anti-glare screen guards can help to minimize the amount of light that is reflected off your computer and can also reduce the amount of flickering you see. There are lenses for glasses that have blue- blocking filters in them that also minimize the amount of glare from the screen.

Why does it seem that there are specks floating around in my field vision? Is this a problem?

Most eye floaters are caused by age-related changes that occur as the jelly-like substance (vitreous) inside your eyes becomes more liquid. Microscopic fibers within the vitreous tend to clump and can cast tiny shadows on your retina, which appear to you as floaters or specks. We all have some physiologic floaters that are noted when we look at the sky, a white wall or a computer screen. Most floaters are just bothersome but not vision threatening. In some cases, floaters can be a sign of a retinal detachment if they are accompanied by lightening flashes, hundreds of floaters or the feeling a curtain is being pulled over the eye. The earlier a retinal problem is detected, the more options there are for treatment. There is no cure for floaters, but if it becomes a tear or detachment, timing is very important.

My friend suddenly started experiencing double vision. What can cause this and how can it be fixed?

This is actually my area of expertise. New onset double vision can occur for a multitude of reasons. It can occur as a deviation that has decompensated from a childhood problem, trauma or other medical problem. It is something that needs to be seen by an ophthalmologist urgently to determine the cause. Special testing such as an MRI or blood work may need to be done to find out the cause. In the office, there are some things we can do to help. We can add a temporary prism to the glasses to help with an acute problem and then eventually grind in the prism to help more permanently. In some cases, surgery is an option to help better align the eyes. Each case is evaluated in an individual basis to determine the best treatment plan. Double vision can be a very serious problem and it is crucial that it be taken care of as soon as possible.

Occasionally my eye will start twitching uncontrollably. Is this symptomatic of something bigger? And how can I stop the twitching?

Most eyelid twitching is due to increased stress, fatigue or caffeine. It typically lasts a few days to a week. However, some people can have a persistent eyelid twitch or facial twitch due to an overactive muscle. This is called blepharospasm. It can be treated with an injection called Botox to alleviate the ongoing twitch.

I have difficulty seeing at night, particularly when driving. How can I improve my night vision?

Driving at night can be more difficult as we get older. At night, we sometimes get more nearsighted because our pupils dilate and more light is let in. Problems at night can also be caused by changes to the lens of our eye, like cataracts, retinal issues or other medical problems. It is very important to have routine eye exams to check the health of the eye. We can get increased glare and star bursts from headlights of oncoming traffic. The first step in addressing the problem would be to make sure that you are wearing the proper correction. An anti-glare treatment to your glasses can also be added to reduce glare.

I’ve heard that sitting too close to the television and reading in dim light can damage my eyes. Is this true? Why?

Reading in dim light will not permanently damage your eyes but it will cause increased eye strain. The eye strain or fatigue can cause increased headaches and visual discomfort. In children, studies have shown that it causes increased nearsightedness as well. I recommend that reading be done with good lighting to prevent unnecessary eye strain.

Why are the whites of my eyes starting to take on a more yellow color?

As we get older the white of our eye, called the sclera, can subtly change. However if a sudden yellowish change occurs it would be advisable to see your primary care doctor to have some labs done to check for decreased liver function or other causes. The eyes are often referred to as the window to the soul and they tell a lot about the health of a person. It is important to get an annual check to make sure that your eyes and body are in good health.

Is there anything else you would like to add?

It is a very rewarding job to be able to help children and adults with their vision. It is amazing to see a child use both eyes together and see properly as well as help an adult see single vision after a lifetime of double vision. I am thankful every day that I get to be a part of this incredible process. I also run a nonprofit organization, Kidsight Foundation, that works with the Lion’s Club to screen preschool children for vision problems. I am a firm believer in early detection. The earlier a vision problem is detected the better chance we have of treat