Central Vision: What is it ?

Central Vision: What is it ?

Central Vision is the straight-ahead vision you use to see fine detail in order to read, drive and recognize faces. You rely on your Central Vision to complete everyday tasks, watch a movie, or scan your smartphone.

When people say they have “good vision”, this is the vision they mean. It is quantified with numbers like normal 20/20 acuity, the clarity of objects at 6 meters away. When it needs improvement, you can get corrective lenses, such as eyeglasses or contact lenses, or have certain kinds of surgery like refractive surgery or cataract lens replacement.

Central Vision Loss

Central Vision Loss is the loss of detail vision, resulting in having only side vision remaining.

Central Vision Loss, may be associated with many conditions and the most common of them include the following:

• Age-Related Macular Degeneration (AMD)

Age-related Macular Degeneration (AMD) is an eye disease that can blur your central vision. It happens when aging causes damage to the macula — the part of the eye that controls sharp, straight-ahead vision. The macula is part of the retina (the light-sensitive tissue at the back of the eye).

• Central Serous Chorioretinopathy

Central Serous Chorioretinopathy (CSCR) is the fourth most common retinopathy after age-related macular degeneration, diabetic retinopathy and branch retinal vein occlusion. CSCR typically occurs in males in their 20s to 50s who exhibit acute or sub-acute central vision loss or distortion.

• Diabetic Retinopathy

Diabetic Retinopathy is a diabetes complication that affects eyes. It’s caused by damage to the blood vessels of the light-sensitive tissue at the back of the eye (retina). At first, diabetic retinopathy might cause no symptoms or only mild vision problems.

• Idiopathic Intracranial Hypertension

Idiopathic Intracranial Hypertension (IIH) is a disorder related to high pressure in the brain. It causes signs and symptoms of a brain tumor. It is also sometimes called pseudotumor cerebri or benign intracranial hypertension. The fluid that surrounds the spinal cord and brain is called cerebrospinal fluid or CSF.

• Ischemic Optic Neuropathy

Ischemic Optic Neuropathy is a damage of the optic nerve caused by a blockage of its blood supply. Blockage can occur with inflammation of the arteries (called arteritic, typically as part of a disorder called giant cell arteritis) or without inflammation of the arteries (called nonarteritic).

• Retinal Artery Occlusion

A symptomatic retinal artery occlusion is an ophthalmic emergency that requires immediate evaluation and transfer to a stroke center. It is an obstruction of retinal blood flow that may be due to an embolus causing occlusion or thrombus formation, vasculitis causing retinal vasculature inflammation, traumatic vessel wall damage, or spasm. The lack of oxygen delivery to the retina during the blockage often results in severe vision loss in the area of ischemic retina. Patients often have concurrent silent ischemic stroke. There are no evidence based treatments that have been demonstrated to have visual benefit, and a 2015 meta-analysis of fibrinolysis suggests that many interventions may be harmful or even fatal.

• Stargardt Disease

Stargardt Disease is a rare genetic eye disease that happens when fatty material builds up on the macula — the small part of the retina needed for sharp, central vision. Vision loss usually starts in childhood — but some people with Stargardt Disease don’t start to lose their vision until they’re adults.

AMSLER EYE TEST FOR CENTRAL VISION

An Amsler grid is a useful tool for monitoring your central visual field. It is an important way to detect early and sometimes subtle visual changes in a variety of macular diseases such as age-related macular degeneration and diabetic macular edema. It is also helpful in monitoring changes in vision once they have been detected. With the Amsler grid, each eye is tested separately by you. This helps you to recognize visual symptoms which are in one eye only. Amsler grids can be obtained from your eye specialist.

Instructions for using the Amsler grid

• Test your vision with adequate lighting
• Wear your reading glasses or look through the reading portion of your bifocals (if you normally read with spectacles)
• Hold the Amsler grid at normal reading distance (about 36 cm)
• Cover one eye at a time with the palm of your hand
• Stare at the centre dot of the chart at all times
• Do not let your eye drift from the centre dot

Ask yourself the following questions as you check each eye separately:

• Are any of the lines crooked or bent?
• Are any of the boxes different in size or shape from the others?
• Are any of the lines wavy, missing, blurry, or discoloured?

If the answer to any of these questions is “yes” (and this is a new finding for you), you should contact your ophthalmologist immediately for an examination. Sometimes these changes may mean that there is leakage or bleeding in the back of the eye causing swelling of the retina.

Amsler grid test in Age Related Macular Degeneration

• Here is what an Amsler grid normally looks like

• This is how an Amsler grid might look to someone with AMD

Low Vision, what Is it ?

Low Vision refers to vision loss that cannot be corrected by medical or surgical treatments or conventional eyeglasses. A person with low vision must learn to adjust to it.

The good news: There are many ways to help so that people with low vision can continue to do things that are important to them. Losing vision does not mean giving up activities, but it may mean learning new ways to do them.

Vision rehabilitation helps patients to learn new strategies and find devices that can assist them.

Vision Loss, the experience and  the impact  

It’s important to acknowledge the anger and frustration you may feel if you learn that your vision loss is irreversible. Getting help to work through these feelings and learn about the strategies of vision rehabilitation will help you stay active and avoid depression.

You can live well with low vision but you cannot live well with depression. Counseling and a good support group can help you recognize that your value does not depend on your vision. You are worth the effort it takes to learn how to make the most of the vision you have. 

Low Vision, don’t let it stop you !

Don’t isolate yourself. Keep your social group, job or outside activities. You might need large print, a magnifier, someone to drive you to events or additional help to participate in sports. Ask for the help you need. Staying home to avoid asking for help is not independence. Friends are honored to be asked.

Low Vision and Medical Acupuncture

Medical Acupuncture is performed at “Orasis Acupuncture Institute”. It acts complementary to established ophthalmological treatments with functional restoration of retinal cells and optic nerve fibers.  Additionally, it increases tissue oxygenation and improves the patients’ quality of life for hard-to-treat low vision conditions.