INFORMATION
Below you will find information booklets on ophthalmological topics.
Hyperopia
Our eyes are dynamic. At rest, they can produce a clear image of objects at only one distance. It is a muscular effort, accommodation, that allows us to change the focal distance of our eyes. The ciliary muscle is a smooth muscle, similar to those in our intestines. Therefore, accommodation cannot be strengthened. During accommodation, we contract the ciliary muscle. This changes the shape of the lens to form a clear image, on the same principle as a camera.
Ciliary Muscle
Lens
Optically, hyperopia refers to an eye that is too short, as opposed to myopia where the eye is too long.
Optically ideal eye (emmetropic) - the image is focused on the retina
Hyperopic eye - the image is focused behind the retina
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Hyperopia is associated with contraction of the ciliary muscle and visual fatigue. The aim of optical correction is muscle relaxation, which is not instantaneous and usually requires continuous wearing of glasses.
A sensation of blurred distance vision is normal during the adaptation period to a new hyperopic correction. If it does not disappear after 6-8 weeks of continuous wear, we can offer alternatives to improve your comfort.
Hyperopia compensated by accommodative effort
Accommodation cannot compensate for myopia
A hyperopic eye should therefore see blurry. However, we can use our accommodation to bring the focal point back onto the retina. This allows the hyperopic eye to see clearly, but at the cost of constant muscular effort. This effort is greater when the object being viewed is close. Accommodative effort does not damage the eye. However, as accommodative ability decreases with age, it becomes increasingly difficult to compensate for hyperopia, which can become symptomatic. This results in visual fatigue, fluctuating vision, a desire to rest the eyes, headaches, etc. The goal of optical correction is not always to make vision "sharper," but to alleviate these symptoms. Since it is optically impossible to compensate for an overcorrection of hyperopia, the ideal correction will be the strongest that allows 100% vision. However, a ciliary muscle that is chronically forcing will often take several weeks to completely relax, creating an initial sensation of blur.
In case of doubt about a correction, the reference examination is cycloplegia. This procedure paralyzes the ciliary muscle and measures the objective correction of the eye at rest.
Cycloplegia
Our eye is dynamic. At rest, it is only possible to produce a clear image of objects at a single distance. It is a muscular effort, accommodation, which allows us to change the focal distance of our eye. During accommodation, we contract the ciliary muscle. This changes the shape of the lens in order to form a clear image, on the same principle as a camera.
Ciliary muscle
Crystalline
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After cycloplegia, near vision is generally disturbed for 6 to 8 hours, and the pupils may remain dilated for 24-48 hours. These durations may vary. As the effect of the drops may wear off more quickly in one eye than in the other, it is not abnormal to notice pupillary asymmetry during the effect of the drops. Accommodation therefore helps us to see up close, but also in certain cases, to compensate for an optical defect.
Hyperopia at rest - the image is blurry Hyperopia compensated by an accommodative effort
Since the ciliary muscle is responsible for accommodation and pupillary contraction, cycloplegia also causes dilation. Driving is therefore contraindicated. By resting the eye, cycloplegia makes it possible to measure its ideal correction without muscular contribution. It thus allows the diagnosis of hidden hyperopia, accommodative spasms or optical over-corrections.
The American Association of Optometrists recommends its systematic use during the first vision check for all children from the age of 1 month.
Since accommodation is a reflex, it is impossible for us to control it. The only way to evaluate the objective correction of the eye is therefore to relax the ciliary muscle with drops.
This test is called cycloplegia and makes it possible to evaluate vision at rest, without muscular effort. This is a frequent test which involves instilling 3 drops in each eye, 5 minutes apart, before measuring vision again after 30 minutes, when the drops are at their maximum effect.
5 min
5 min
30 mins
Amblyopia, commonly referred to as "lazy eye," occurs when the brain fails to generate a clear image despite having a healthy eye and/or the use of corrective lenses. This condition arises when one eye's vision is significantly weaker during the critical period of visual cortex development in the brain. As a result, the brain begins to disregard the blurred signals from the weaker eye. In the provided example, the brain ignores the visual input from the weaker right eye, yet binocular vision remains clear due to the stronger left eye.
Optical correction alone can sometimes restore clear vision, but in other cases, the brain continues to perceive a blurred image despite correction. A major concern with amblyopia is that the visual cortex gradually loses its plasticity between the ages of 2 and 8 years. After this period, the visual deficit becomes irreversible. Additionally, an amblyopic eye can hinder the development of binocular or stereoscopic (3D) vision.
Early and prompt intervention is crucial for a good visual prognosis. Continuous use of corrective lenses and regular follow-ups are essential to optimize long-term visual potential. Amblyotherapy requires close monitoring, such as every five weeks for a five-year-old child. Once 100% visual acuity is achieved, a consolidation phase ensures that good vision is maintained long-term.
The primary treatment for amblyopia involves the complete optical correction of any refractive error with continuous wear. This correction should be performed under cycloplegia to place the eye and brain in the best condition for optimal development. Continuous follow-up is necessary to ensure rapid visual improvement while the visual cortex is still developing. Often, the treatment also includes increased visual stimulation using eye patches. These patches, worn under glasses from waking until sleeping, force the brain to use the weaker eye, following a customized schedule.
When amblyopia is accompanied by strabismus or another ophthalmological condition, specific management strategies will be proposed. Early detection and intervention are key to preventing irreversible visual impairment, making regular eye check-ups essential for young children.
Myopic Overcorrection
Our eye is dynamic. At rest, it can only produce a clear image of objects at one distance. It is a muscular effort, accommodation, that allows us to change the focal distance of our eye. The ciliary muscle is a smooth muscle, similar to those in our intestines. Therefore, accommodation cannot be strengthened. During accommodation, we contract the ciliary muscle. This changes the shape of the lens to form a clear image, operating on the same principle as a camera.
Ciliary muscle
Lens
Optically, myopia refers to an eye that is too long, unlike hyperopia where the eye is too short.
Optically ideal eye (emmetropic) - the image is focused on the retina
Myopic eye - the image is focused in front of the retina
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Overcorrection is associated with muscle contraction and visual fatigue. Optimizing the correction allows for muscle relaxation, but the benefit is not instantaneous. A sensation of blurred distance vision is normal during the initial period after reducing an overcorrection. If it does not disappear after 6-8 weeks of continuous wear, we can offer you alternatives to improve your comfort.
Myopic overcorrection compensated by accommodative effort
A myopic eye sees distant objects as blurry. The goal of optical correction is to move the focal point backward, onto the retina. An overcorrection pushes the focal point too far back, behind the retina. Therefore, a myopic overcorrection should result in a blurry image. However, we can use our accommodation to bring the focal point forward, onto the retina. This allows the overcorrected myopic eye to see clearly but at the cost of constant muscular effort. This effort is greater when the object being viewed is close. Accommodative effort does not damage the eye. However, as accommodative capacity decreases with age, it becomes increasingly difficult to compensate for the overcorrection, and it can become symptomatic. This results in visual fatigue, fluctuating vision, difficulties with near vision, headaches, etc. The goal of optimizing the correction is then not always to make the vision "sharper" but to alleviate these symptoms.
As it is optically impossible to compensate for myopic undercorrection, the ideal correction will be the weakest one allowing for 100% vision. However, a chronically strained muscle will often take several weeks to fully relax, creating an initial sensation of blurriness.
Myopic undercorrection cannot be compensated by accommodation
In case of doubt about a correction, the reference examination is cycloplegia. It paralyzes the ciliary muscle and measures the objective correction of the eye at rest.
Chalazion
The edge of our eyelids contains about fifty glands: the meibomian glands. These glands are about half a centimeter thick in the eyelid and secrete the oily part of our tears.
Mucinous phase
Aqueous phase
Oily phase
Like all glands, they can become blocked. When this happens, they swell and produce a sort of bump in the eyelid: a chalazion. This is completely benign. It is deeper than a stye, in which another gland, more superficial at the base of the eyelashes, is blocked. Any factor causing eyelid inflammation can promote the occurrence of chalazions.
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The treatment of chalazion
It mainly consists of opening the pores of the blocked gland to drain its contents. To do this, three steps can be repeated ideally three times a day until symptoms disappear:
Warm compresses
For at least 2 minutes, in the shower, with a clean towel, or with a compress soaked in hot water. They aim to dilate the pores of the glands and to liquefy their secretions.
Eyelid massages
In the direction of the gland, that is, towards the eye, applying pressure on the chalazion gradually helps to drain its contents.
Anti-inflammatory ointment
Its application as close as possible to the meibomian glands, in the lower eyelid, helps to reduce tissue swelling and gradually improves the effectiveness of the compresses and massages.
Anti-inflammatories are generally prescribed for a maximum of 2 weeks. Always consult your doctor before extending the treatment.
Like many bumps, chalazions can sometimes get larger before they drain and disappear. Continuing the treatment is therefore encouraged. Surgical treatment is possible but is only indicated if functional or aesthetic discomfort persists despite optimal medical treatment.
Although rare, a skin infection can sometimes occur: cellulitis. Always consult your doctor if you develop a fever, visual disturbances, or skin redness.
Dry Eye Syndrome
Dry eye syndrome is a common condition, affecting an estimated 30% of the population. Although it is rarely severe, its symptoms can occasionally become painful or debilitating in daily life. The tear film serves several essential functions, including:
• Optical function: It is the first layer light passes through when entering the eye, contributing to visual clarity. Its instability leads to the dispersion of light rays and generates optical aberrations.
• Protective function: It protects the cornea, which, without it, can develop superficial erosions and damage to its nerve endings, potentially causing acute or chronic pain.
For these reasons, it is not uncommon for dry eye syndrome to cause a multitude of symptoms, including:
• Pain: Sensations of irritation, stinging, burning, or a "gritty" feeling in the eye. • Functional discomfort: Excessive tearing, eye redness, secretions at the corner of the eye, especially in the morning. • Visual disturbances: Fluctuating vision, particularly when reading and varying with blinking, and light sensitivity.
Dry eye syndrome is not always caused by a lack of tears. Often, it results from an imbalance in their composition. The tears lose their cohesive nature and break up quickly between blinks. This explains the frequent coexistence of dryness and excessive tearing.
Tear Film
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The lacrimal gland produces the aqueous phase of tears, while the lipid phase is produced by the meibum glands located in the eyelids.
Treatment of Dry Eye Syndrome
Depending on the causes, the following measures may be indicated:
Eyelid massages help expel oil and mucus from the glands with gentle pressure on the upper and lower eyelids.
Certain medications, procedures, or diseases can exacerbate dry eye syndrome. This includes antihistamines, refractive surgery, blepharitis, and rosacea.
Artificial tears replace the missing elements in tears to stabilize the tear film. They can be used regularly or as needed depending on the situation.
Warm compresses improve the function of the meibum glands. Apply for 2 to 5 minutes, either in the shower or with a compress soaked in hot water.
Cleaning the eyelid margins helps minimize eyelid inflammation and unclog the glands. Treatments for the eyelids show effects after 1 to 2 months.
Pharmaceutical treatments such as antibiotics or anti-inflammatories may be necessary in some cases before considering more specialized, autologous, or interventional treatments.
Saline solution is not an artificial tear. Its regular use increases tear evaporation and can worsen dry eye syndrome.
Each case is different, and there are many possible treatments. The approach must be personalized and adapted to each case through a gradual approach.
Visual concentration (reading, computer work, driving, etc.) reduces the frequency of blinking and worsens dryness. It is advised to take regular breaks, for 20 seconds every 20 minutes, to rest the eyes and blink.
Atropine cycloplegia
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Cycloplegia is a common ophthalmological examination to assess vision at rest, without muscular effort, and thus to measure the ideal correction of the eye. Atropine is the drop of choice for this test. Although these drops are often replaced by eye drops with shorter effects, atropine is still favored in many cases, particularly in people with very dark irises, those with an epileptic condition, or when other drops have not had any effect. little effect. In order to perform this exam, we need your participation to put the drops at home in preparation for your next appointment.
The protocol is as follows:
One drop in both eyes 3 times a day (morning, noon and evening), starting 3 days before your appointment, and instilling a final drop the morning of your appointment. This is a total of 10 drops in each eye. To help you, you can use the table below:
D-3: 3 drops
D-2: 3 drops
D-1: 3 drops
Day of appointment: 1 drop
Atropine eye drops sometimes need to be ordered from the pharmacy, so plan to get them in advance.
It is essential to follow the protocol carefully in order to obtain reliable measurements. Do not exceed prescribed doses. Do not drink the drops. Blurred near vision and pupil dilation are normal with cycloplegia. They usually fade within 1 to 2 weeks. Report any other side reactions to your doctor immediately.
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