Ask Dr. Etingin: Causes of blurry vision; Insomnia and coronary heart disease
What causes blurry vision?
Blurry vision can be caused by what ophthalmologists call a “refractive error,” which occurs when the shape of the eye prevents light from focusing directly on the retina. Common refractive errors include nearsightedness, farsightedness, and astigmatism. Another common cause of blurry vision is presbyopia, an age-related vision condition that makes it difficult to read at close distances.
Blurry vision may be caused by a number of eye diseases, such as cataracts, age-related macular degeneration, and glaucoma. Also, blurry vision may be a symptom of diabetic retinopathy (an eye disease caused by diabetes), psoriatic arthritis, a condition called vein occlusion that is caused by high blood pressure, or multiple sclerosis.
Blurry or limited vision that occurs suddenly may be a sign of stroke, especially if it’s accompanied by sudden numbness or weakness on one side of your body, difficulty speaking, confusion, loss of balance, or severe headache—if you have any of these symptoms, call 911 and get to the nearest hospital immediately.
Don’t ignore your blurry vision—make an appointment with an ophthalmologist who can check your vision and conduct a thorough examination of your eye. Even if you don’t notice any changes in your vision, it’s important to get regular eye exams; many eye diseases don’t cause any symptoms in the early stages, but they can be detected during an eye exam. If you do have an eye disease, the sooner it is diagnosed, the sooner you can get treatment that may save your vision or delay the progression of vision loss.
And if you suddenly notice an increase in floaters—small shapes or specks that look like spots, thread-like strands, or squiggly lines floating around in your field of vision—see your eye doctor as soon as possible. More numerous and/or more prominent floaters are sometimes a sign of retinal detachment, which can result in permanent vision loss if it’s not diagnosed and treated.
Before I was diagnosed with coronary artery disease, I started having frequent insomnia. Could this be related to my heart disease?
There is evidence that insomnia (defined as difficulty falling asleep and/or staying asleep) is associated with an increased risk for cardiovascular disease, which includes heart disease and artery disease. Insomnia also has been linked with hypertension and elevated resting heart rate—two conditions that increase the risk of cardiovascular disease. In addition, insomnia has been linked with a higher risk of diabetes and other chronic diseases, as well as mental health conditions such as depression and anxiety.
Women are more likely to have insomnia than men, especially if they are age 60 or older. Insomnia is sometimes linked to a coexisting medical issue, such as chronic pain, gastroesophageal reflux disease, lung disease, or polyuria (the need to urinate frequently). In some conditions, such as depression and anxiety, it is difficult to determine whether insomnia is the cause or the effect, but studies show there is a definite link.
There are many strategies that can help with insomnia, including sticking to a set sleep schedule even on weekends, avoiding a heavy meal, caffeine, alcohol, and exercise for at least three hours before bed, limiting daytime naps to no more than 30 minutes, and getting daily exercise. Also ask your doctor or pharmacist to review any medications you are taking to see if your insomnia could be a side effect.
If your insomnia continues, you may want to talk with your doctor about the possibility of seeing a sleep disorder specialist. He or she can do a thorough evaluation aimed at identifying the cause of your insomnia and suggest strategies or treatments that may help you sleep
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