For your eyes only: 20/20 solutions to keep your vision sharp

Men's Fitness, Dec, 2002 by Daniel Foster

Its a clear case of self-abuse: You've been subjecting your most sensitive organs to overstimulation, frenzied rubbing and The Anna Nicole Show.

Get your minds out of the gutter. We're talking about your eyes, guys. These miraculous orbs work like a camera to send images to the brain. Yet unlike your handy Handycam, the human lens comes in mostly imperfect models. Age plays its part, of course, but overlooking your oculi can mean a future filled with headaches, infections and vision loss.

"Many people are diligent about dental care, but often abandon their eyes" explains Jeffrey Weaver, O.D., clinical care director at the American Optometric Association. "Consider the value of your eyes in relation to the value of your teeth."

So chew on this: Regular eye exams are the first and most important sightline of defense against everything from eyestrain to glaucoma. An optometrist can easily spot most problems, though some may require subsequent treatment from an ophthalmologist, a specialist in eye disease. Meanwhile, "Sore Eyes and Eyesores" (page 88) can tell you how to recognize and respond to some common conditions on your own.

EYES PRIED OPEN--EVERY 12 MONTHS

Annual eye checkups for those with refractive errors such as nearsightedness, farsightedness and astigmatism are essential. (Guys under 40 blessed with 20/20 vision can take every other year off.) The optometrist will sometimes dilate each eye with painless drops, affording a roomier view of the retina, a type of light-reactive collection plate where rays get converted into nerve impulses before they travel to the brain.

"Some people just have thinner retinas than others," says Liviu Saimovici, M.D., medical and surgical director at Advanced Eye Care Associates in New York City. "They may have a genetic propensity to develop very small holes [called lattice degeneration] that require laser treatment. I've had patients in their 20s with great vision who have significant retinal problems." The condition affects about 10 percent of the population, often with no warning signs, although some experience flashing lights.

Peering deeper, a doctor will also check the optic nerve that channels data to the brain. "We examine the appearance of the tissue, its color and shape," Weaver says. "Glaucoma may be signaled by certain depressions."

Glaucoma can appear as early as age 35, especially for African Americans. A subset of the disease, pigmentary glaucoma, strikes mostly white males in their 30s and 40s. Pressure from excess fluid or improper drainage damages the optic nerve and can lead to tunnel vision, loss of peripheral vision, or blindness. The condition can also be detected by a "puff test," in which a bolt of air is shot at your eye, or a peripheral-vision test.

Glaucoma is a stealth disease, with no warning signs until peripheral vision begins to fray. Acute forms, however, may include headaches, blurred vision, halos that appear around lights, and nausea. Treatments include medicated drops to lower pressure or laser surgery to aid drainage. Recent studies at Washington University in St. Louis found that daily drops can halve the number of ocular hypertension cases that would otherwise progress into acute glaucoma.

TISSUE ISSUES

Not all the action is deep inside the eye. The cornea, the transparent tissue over the front of the eyeball, can thin and bulge, distorting your vision. This condition, called keratoconus, affects millions of teens and young adults. Although it's most likely activated by genes, many sufferers are habitual eye rubbers. Orthokeratology, a new procedure awaiting approval from the Federal Drug Administration, corrects the distorted vision with special contact lenses worn overnight that mold the cornea, with results lasting from eight to 20 hours. Advanced cases can require corneal transplants.

The veins and arteries that spider the whites of your eyes are also a diagnostic tool. "The eye is one of the few places where we can inspect blood vessels directly," says Weaver. "Their size and shape correlate to other vessels throughout the body."

Small arteries can be a sign of early hypertension. Arteries that nourish the retina can also harden, depriving the eye of oxygen and leading to macular degeneration, the leading cause of blindness in those over 50. Family history and farsightedness are also cofactors, so consult your doctor for tests and treatment. And start now to eliminate the disease's lifestyle links: smoking, high blood pressure and obesity.

Finally, presbyopia hits a significant number of adults in their 40s, because the eye's lens naturally loses elasticity with age, producing fuzzy near vision. (You'll know it by the arm extensions you start doing in order to read this magazine.) Over time, your vision will need to be corrected because the condition can be progressive.

Presbyopes can try an increasing array of eyeglasses and contact-lens options. And no, you don't have to spend $800 on a pair of Porsche specs; for some patients, any $8 pair of drugstore reading glasses will clarify tiny type. There's also a huge range of styles and options between the two extremes that can significantly alter not just how you see, but how you're seen. Keep your eyes open to the possibilities.