An ophthalmologist, an optician, an orthoptist or an optometrist? Who are those specialists? And how will their combined efforts help you see better? We usually classify four essential vision disorders that can affect your sight, all of them can be corrected by wearing special glasses: These sight disorders are: Myopia, Astigmatism, Hypermetropia and Presbyopia.

The ophthalmologist: he is a physician specialized in sight and ocular treatments. He normally proceeds to a complete eye exam, can prescribe corrective glasses and realize eye surgery. He also intervenes in case of chronicle pathologies that can affect the eyes, such as diabetes and arterial hypertension.

The optician:he intervenes as a complement to the ophthalmologist. He’s in charge of realizing the optical equipment according to the medial prescription and counsels the patient in matters of eye glasses and frames.

The orthoptist’ orthoptist’s mission is to reeducate all sight anomalies (amblyopic, low vision, strabismus, insufficient convergence…)

The optometrist insures you a complete ocular and visual service, including the detection of ocular diseases, refraction, and provision of optical equipments and rehabilitation of the visual system. This profession, acknowledged in all Anglo-Saxon countries, is not yet recognized in France.

Your close vision is perfect, but you cannot see well from a distance. This vision disorder is usually hereditary. It appears or amplifies in the adolescence period and often stabilizes when you become an adult.

Myopia signs: You usually blink your eyes when watching something from a long distance. This visual defect can be corrected by a divergent glass that is thicker on the sides and thinner in the middle (concave glass)

Seeing things up close tires you and demands a lot of concentration. This vision disorder is usually hereditary. You usually cannot detect hypermetropia until the age of 35/40, because it used to be compensated by an accommodation effort.

Hypermetropia signs:The efforts you have to make in order to see things up close give you a headache and tire your sight. This visual defect can be corrected by a convergent glass that is thinner on the sides and thicker in the middle (convex glass).

Certain lines appear fuzzy. Your vision is imprecise up close and from a further distance. Heredity also plays a certain role in the appearance of astigmatism. It often stays stable all along your lifetime. The subject finds it hard to discern the contrasts between horizontal, vertical or oblique lines.

Astigmatism’s signs: You mix Hs, Ms and Ns or sometimes 8s and 0s. This visual defect can appear isolated or combined with myopia or astigmatism. It can be corrected by a cylindrical glass that combines different rays of curvature (ring glass).

You seem unable to see closes things but have no trouble seeing from a distance. Presbyopia is the normal process of eye aging: It concerns all the population. With time, your eye loses its faculties to discern close elements.

Presbyopia signs: Starting the age of 45, you start stretching your arms in order to read a book; you stay close to the sources of light. Presbyopia is added to other visual defects you might already have: (myopia, astigmatism or hypermetropia)

The bottom of eye: The bottom of eye is a complete exam of the vascularisation (blood vessels) of the retina and optical nerve. Using an ophthalmoscope (a device issuing a light beam into the patient’s eye) the ophthalmologist can visualize the retina with a multiplying factor of about 14.

Conduct of the examination: It is not necessary for a routine eye bottom to dilate the ward in order to examine the central part of the retina. For a more in depth exam, a dilatation of the ward must be practiced, especially in order to follow up the myopic.

This exam takes place in the dark, provoking a physiologic mydriasis (dilatation of the ward), which is necessary in order to observe the largest part of the retina. The physician applies the viewfinder of his ophthalmoscope to his own eye and moves closer to about 15 cm of the patient. He then directs the beam to the eye and approaches gently, as close as possible, without however touching the eye.
This exam is performed in an ophthalmologist’s clinic and takes less than a minute. It doesn’t need any preparation.
The result is instant. The physician will evaluate immediately the state of the retina’s centre, of the retinal vessels and the initial point of the optical nerve.

Main indications: This exam is meant to detect all possible lesions that might affect the central zone of the retina, particularly in case of :
vascular retinopathies. A vascular retinopathy can be caused by an arterial hypertension that was not treated properly or by an advanced case of diabetes (diabetic retinopathy) that might affect the retinal blood vessels.
Vascular retinopathies are also generally linked to MDA (Macular degeneration associated with age): a major cause of visual deficit for older people,
or to congenital anomalies (i.e.: retinitis pigmentosa)

Contraindications: There are none, since the physician does not use mydriatic products to dilate the ward.

Is this exam painful? : , it is completely painless.

Remarks :You should report all personal or family history of glaucoma, diabetes or arterial hypertension. A detailed bottom of eye must be performed regularly on myopic subjects, or subjects with history of retinal pathologies.

The glasses offered by your optician can have different natures according to your levels of optical correction and your visual needs. These glasses can also receive specific treatments in order to fit your comfort. Nowadays, even in the case of a strong visual correction, you have the possibility to obtain thin glasses, allowing you to have harmonious spectacles.

The mineral glass: A silica based glass, it is breakable, heavy and resistant to scratching.

The hardened treatment : This treatment is used for organic and polycarbonate glasses. It helps prevent scratches and makes the glass more resistant to chocks. This treatment is often applied to children’s eyeglasses.

Lenses are small disks of thin plastic. They are curved and designed to fit the shape of the eye. The contact lenses follow the same principle as the eyeglasses. They are a safe and efficient way to correct the vision if used with the appropriate control and care. There is no age limitation: Even small children can wear contacts if they can manipulate them properly or they can be supervised by their parents. On the other hand a good tears secretion is necessary in order to tolerate contact lenses.

Rigid and oxygen permeable lenses : They were created more than 25 years ago. They have a small diameter and offer several possibilities of corrections, especially when it comes to strong corrections, astigmatism or cases of insufficient tearing. Their replacement frequency can vary from 1 to 4 years. Hard lenses are prescribed in 15% of the cases.

Hydrophilic soft lenses : They were invented in the seventies. Of a larger diameter, thin and comfortable, they offer you immediate tolerance and comfort and can correct all your visual defaults. Their replacement frequency varies from one day to 18 months. Soft lenses are prescribed in 85% of the cases.There are disposable and non disposable soft lenses:

Non disposable lenses: They can be rigid or soft hydrophilic lenses. They are changed on average every two years and need constant maintenance.

Disposable lenses:

• Daily disposable lenses: without special maintenance.
• Weekly disposable lenses: They are worn day and night but have to be discarded and changed within a week.
• Monthly disposable lenses; they are worn for a month but have to be removed every night in order to preserve and entertain them.

How to choose your contact lenses : Wearing contact lenses requires a proper adaptation performed by a competent health professional. In all cases, a visit to the ophthalmologist is highly recommended.
During the adaptation exam, the professional will determine the power, the curve, the diameter and the geometry of the lens according to your eyes. The adaptation period will also determine, according to your eye and visual needs, the material, type and wearing frequency of the lens (daily or permanent) which is adaptable according to everyone’s life rhythm.

How to maintain your contact lenses? : Hygiene is a key element in avoiding the accumulation of deposits and fixation of germs, due to tears on your lenses. Hygiene guaranties their transparency and their optical quality.

It is indispensible to wash your hands thoroughly with a neutral soap before manipulating your lenses. Remove each lens at a time and put it into its specific case respecting the indication: left eye and right eye. This way you will avoid inversions.

Nowadays,” multifunction” products exist. They clean, decontaminate, and rinse efficiently and very simply your lenses. In all cases, never change your product without a professional advice since you may be exposing yourself to intolerance

Some last recommendations:

• Never wear your contacts while sleeping except if they are designed for permanent wear.
• If you practice swimming in a pool, wear an appropriate corrective swimming glass.
• . You should remove your lenses before swimming in a river or any other source of sweet non-chlorinated water.
• For all other sports, except violent activities of course, you might wear your lenses without any problem
• If you are driving while wearing your lenses, you are bound by the law to keep your glasses in the car.
• You should always respect the expiration period and the regular control visits to your specialist
• if you ever feel a case of red eye or an irritation remove your lenses immediately and consult with your physician.

Main contraindications::

• Frequent ocular infection, Repetitive keratitis
• Serious allergies
• Ocular dryness (except particular cases)
• Very dirty workplace (extremely dusty or dry : air conditioning…)
• Incapacity of manipulating or entertaining properly the lenses
• You should always respect the expiration period and the regular control visits to your specialist
• if you ever feel a case of red eye or an irritation remove your lenses immediately and consult with your physician.