8 Eye Problems Doctors Say You Should Never Ignore

Noticing a change in your vision can be alarming, but not every symptom means you need emergency care. One of the best ways to protect your sight is to get a comprehensive eye exam every one to two years so serious problems can be found and treated early.

"Many people really have no idea that the eye and the brain are so sophisticated that you can have 2020 vision, and still have very serious eye diseases lurking in the eye," says Stephanie Marioneaux, M.D., clinical spokesperson for the American Academy of Ophthalmology.

Below are eight common vision problems to watch for, along with their risk factors and possible treatments. Understanding them can help you catch vision loss before it progresses.

Refractive errors

What it is: Refractive errors are the most common vision impairment in adults ages 19 to 40. They include myopia (nearsightedness), hyperopia (farsightedness), astigmatism (distorted vision at all distances), and presbyopia (trouble focusing up close), according to Barbara Horn, O.D., president of the American Optometric Association. These problems occur when the eye cannot bend light properly.

The cause: Genetics, age, and sex all play a part. Spending long periods focusing on close-up tasks such as using a smartphone, reading, or quilting can also raise the risk of myopia, which is becoming more common.

What to do: Have your eyesight checked, then correct it with glasses, contact lenses, or laser surgery. The National Eye Institute says 11 million Americans are not adequately corrected and could see much better if they were.

Dry eyes

What it is: Tears protect the eye and help keep vision clear, but when there are not enough tears to properly lubricate the eyes, it becomes harder to flush out debris and prevent infection. Dry eyes can cause blurred vision, burning, or a gritty, scratchy, irritated feeling.

The cause: “This is an emerging problem,” says Dr. Marioneaux. “It’s based on the evaporation of tears from the surface of the eye, and this happens when you stare, which is what everybody’s doing day in and day out.” Frequent screen use on phones, tablets, televisions, and computers, or even long-distance driving without blinking, can trigger dry eyes. Some medicines, including antihistamines, blood pressure drugs, and antidepressants, plus environmental factors such as smoke, wind, or low humidity, eye surgery like LASIK, and conditions including Sjögren’s syndrome, rheumatoid arthritis, diabetes, and thyroid problems can also contribute.

What to do: Try the 20-20-20 rule to rest and rewet your eyes: every 20 minutes, look 20 feet away for 20 seconds. Also make sure your monitor is not positioned so high that your eyes have to stay wide open to see it. Exposing more of the eye to air speeds moisture loss. If dry eyes become chronic, see a doctor, who may recommend eye drops. “Dry eyes does not lead to blindness,” says Dr. Marioneaux, “but it can lead to compromised function.”

Eye infections

What it is: Bacteria in the eye can cause redness, itching, swelling, discharge, pain, and trouble seeing.

The cause: Germs can reach the eye in several ways. Wash your hands often and avoid touching your eyes. Old eye makeup can also carry bacteria. People who wear contact lenses are at higher risk because germs can be introduced while inserting the lenses.

What to do: Replace mascara every three months. Remove contact lenses at night, even if they are approved for extended wear, since sleeping in them greatly increases the risk by giving bacteria time to multiply. See an eye doctor right away, because prescription antibiotic drops may be needed.

Diabetic retinopathy

What it is: “Diabetic retinopathy occurs when your blood sugar is at such a high level that the glucose molecules damage the blood vessels in the eye, which then leach,” says Dr. Marioneaux. “So everything in your bloodstream, including lipids and proteins, spill into the eyes. Where the leakage of the blood vessels occurs will determine how much your vision is impacted.”

The cause: Poor blood sugar control is the main cause. Type 1, type 2, and gestational diabetes can all raise the risk. Because type 2 diabetes is so common in the U.S., research shows diabetic retinopathy is the leading cause of blindness in Americans ages 20 to 74. Symptoms can include spots or floaters, blurred vision, a dark or empty area in the center of vision, and difficulty seeing at night.

What to do: People with diabetes can help prevent this complication with strict glucose control, but taking diabetes medicine does not mean you are fully protected. “Patients who keep their blood sugar over 100 and their hemoglobin A1C around 7, 100% of them will develop diabetic retinopathy within 20 years,” says Dr. Marioneaux. “Well, 7 is okay for the heart, brain, and circulation, but it is disastrous for the eye so ophthalmologists say to keep your hemoglobin A1C under 6.5 and blood sugar between 80 and 100.” If you have diabetes, eat well, exercise, take prescribed medications, monitor blood sugar regularly, and get a yearly dilated retinal exam. Lasers, injections, and surgery can help, but only before vision is lost, which makes early diagnosis essential.

Macular degeneration

What it is: The macula is a small part of the retina in the back of the eye that helps you see what is directly ahead. With age-related macular degeneration (AMD), the leading cause of severe vision loss and blindness in adults over 65, some people may notice a gray or black spot in the center of vision while still retaining some peripheral sight.

The cause: Over time, deposits can build up in the macula, leading to early, or “dry,” AMD, the most common form. The “wet” form happens when abnormal blood vessels form and leak into the macula. Age and genetics are the biggest factors, but smoking and UV exposure also raise the risk.

What to do: “Most people with macular degeneration have the dry form, for which there is no known treatment,” says Horn. “The less common wet form may respond to laser procedures and medication injections, if diagnosed and treated early.” Once you reach your mid-to-late 40s, you should have an eye exam every two years, or every year if there is a family history of AMD. Your doctor will dilate your pupils to examine the back of the eye. If early or intermediate AMD is found, you may be advised to take special vitamins containing C, E, zinc, lutein, and other nutrients to help slow the damage.

Glaucoma

What it is: Pressure inside the eye can gradually damage the optic nerve. Side vision is usually affected first, but total blindness can eventually occur. “Primary open-angle glaucoma often develops slowly and painlessly, with no early warning signs,” says Horn. “It can gradually destroy your vision without you knowing it.” More than 3 million Americans are estimated to have glaucoma, and the number may rise as the population ages.

The cause: “The exact cause is unknown, but for some reason, the passages that normally allow fluid within your eye to drain become clogged or blocked,” says Horn. “The fluid in your eye then builds up and increases pressure on the optic nerve.” Anyone can develop it, though age and genetics increase the odds.

What to do: See an eye doctor for a checkup, since about half of people with glaucoma do not know they have it. “Essentially, if you begin to lose vision from the side—your peripheral vision—your brain is so smart that you just move your head and you don’t even notice that your vision is shrinking,” says Dr. Marioneaux. “Plus, if it’s only happening in one eye, your brain will use the better image from your other eye.” Although a puff-of-air test can be used for screening, a formal diagnosis requires a dilated exam to inspect the optic nerve and other tests. Medicine, lasers, and surgery can help prevent the disease from worsening. “The goal of the treatment is to prevent vision loss by lowering the fluid pressure in the eye,” says Horn. “Unfortunately, any vision lost already from glaucoma usually cannot be restored.”

Cataract

What it is: Proteins in the lens can clump together and form cloudy areas that blur vision. Cataracts may start as a small blurry spot or become a large opaque area. They can also make colors harder to perceive, create halos around lights, and cause trouble seeing at night.

The cause: As people age, cataracts become extremely common. They are sometimes found in younger people, including newborns, says Horn. Spending a lot of time in the sun, taking steroids, having diabetes, smoking, or drinking heavily can increase the risk.

What to do: A cataract can be detected during a dilated eye exam, though symptoms often appear first. If it is small, magnifying glasses and brighter lighting at home or work may help. If it grows larger, outpatient surgery is an option. “Most patients are excellent candidates for cataract surgery and we have very excellent results,” says Dr. Marioneaux. “We are able to remove that cloudy lens which focuses the light in your eye and we replace it with an artificial lens.”

Floaters

What it is: Dots, circles, lines, and specks that seem to drift across your field of view may look like they are floating on top of the eye, but the disturbance is actually inside the eye.

The cause: The clear gel behind the eye clumps together, making it visible.

What to do: These gel clumps are usually harmless, but if floaters appear suddenly or come with flashes of light or shadows, see a doctor to rule out a retinal tear. Otherwise, leave them alone. Over time, the eye and brain typically adjust, and you stop noticing the floater. Eye drops will not make floaters go away.