They’re more common with age, particularly between the ages of 50 and 70, due to the natural shrinkage and liquefaction of the vitreous.

Signs and Symptoms of Vitreous Floaters Floaters typically appear in many shapes and movements:

• Grey or black dots
• Squiggly lines or wispy strands
• Transparent rings or cobwebs
• Threadlike floaters that shift when you move your eyes

These often become more noticeable in bright lighting or when staring at blank backgrounds. In many cases, they become less distracting as they “settle” below your line of sight.

When to Worry: Retinal Warning Signs While floaters are usually harmless, sudden or severe symptoms may indicate a more serious issue such as a retinal tear or detachment. These include:

• Sudden appearance of new floaters
• Flashes of light (photopsias)
• A curtain-like shadow moving across your vision
• Rapid vision loss or distortion

These symptoms require immediate medical attention to prevent permanent vision damage.

Causes and Risk Factors Floaters are primarily caused by natural age-related changes, but other contributing factors include:

• Posterior vitreous detachment (PVD)
• Nearsightedness (myopia)
• Previous eye trauma or surgery
• Inflammation within the eye (uveitis)

These changes cause the gel inside the eye to clump or shrink, casting shadows perceived as floaters.

Treatment Options Most floaters require no treatment. However, if they become dense and affect vision significantly, options may include:

Vitrectomy – A surgical procedure to remove the vitreous gel and replace it with saline. It is effective but carries risks such as retinal detachment, bleeding, and cataracts.

Laser Therapy – Used in rare cases to break up floaters, though not widely adopted.

If a retinal tear is found early, non-invasive laser therapy or cryopexy (cold treatment) can be used to prevent retinal detachment. More severe cases may require:

• Pneumatic retinopexy
• Scleral buckling
• Vitrectomy for reattachment

In Summary Floaters are typically a natural part of ageing and are mostly benign. But sudden changes or accompanying flashes should never be ignored. Regular check-ups with your optometrist can ensure early detection and help preserve your long-term vision.

A mature cataract occurs when the natural lens of the eye becomes completely clouded, obstructing light from passing through effectively. Unlike early cataracts—where glasses may still offer some visual improvement—mature cataracts no longer respond to stronger spectacle lenses. Instead, patients often report feeling like their glasses are always dirty, constantly trying to wipe them clean to no effect.

At this stage, a referral to an ophthalmologist is typically recommended to discuss cataract surgery, which remains the most effective way to restore vision.

How Do Mature Cataracts Affect Vision?

As the cataract progresses, it significantly impairs your ability to see clearly:

• Vision becomes cloudy, blurry, or filmy
• Glare sensitivity worsens, particularly when driving at night
• Colours appear faded or dull
• You may notice halos around lights or double vision in one eye
• Reading, recognising faces, or enjoying hobbies becomes difficult

Cataracts may affect one or both eyes, often progressing at different rates. Even activities like crocheting, playing cards, or watching TV can become challenging.

Signs and Symptoms of a Mature Cataract

If you’re experiencing any of the following, it may be time to consult with your eye care provider:

• Persistent blurry or cloudy vision
• Colours seem muted or yellowed
• Halos or glare from headlights or lamps
• Frequent changes in glasses prescriptions with no improvement
• Poor night vision
• Double vision in one eye
• Feeling like your glasses are always smudged

While these symptoms may be mistaken for other eye conditions, a full eye exam will confirm whether cataracts are the cause.

Causes and Risk Factors

Cataracts form when the proteins in the eye’s lens begin to clump, creating cloudiness and preventing light from focusing clearly on the retina. Though age is the most common factor, several others contribute:

• UV exposure
• Smoking and alcohol consumption
• Diabetes and hypertension
• Obesity
• Use of corticosteroids or statins
• Previous eye injury or surgery
• Family history of cataracts
• Hormonal changes or HRT use

Over time, the cataract thickens and hardens, eventually becoming mature and unresponsive to optical correction.

Treatment: When to Consider Surgery

If mature cataracts significantly impair daily life—making it hard to read, drive, or enjoy hobbies—it may be time to consider cataract surgery.

During the procedure, the cloudy lens is removed and replaced with a clear, artificial intraocular lens (IOL). This restores the eye’s ability to focus light and improves vision dramatically.

Key points about cataract surgery:

• It is safe and routine, with over 3 million procedures performed annually in the U.S. alone
• Surgeries on each eye are done several weeks apart to prevent complications
• Most patients achieve 20/20 to 20/40 vision post-surgery

Your optometrist will assist you before and after the procedure. At Davida van der Merwe Optometrist, temporary reading glasses are offered during your healing period, followed by a complete eye exam and personalised prescription once your eyes have stabilised.

Note: Avoid using off-the-shelf readers long-term. They may be unbalanced, leading to unnecessary eye strain or fatigue.

Feel like your glasses are never clean? Vision increasingly foggy or frustrating?

Book an assessment with Davida van der Merwe Optometrist for expert advice on managing mature cataracts and referrals for safe, life-changing cataract surgery.

A cataract is the gradual clouding of the eye’s natural lens, leading to reduced vision over time. In the early stages, cataracts often go unnoticed—but subtle symptoms like blurred vision, increased glare, and frequent prescription changes may begin to appear.

Contrary to popular belief, not all cataracts require immediate surgery. In fact, many people with early cataracts experience excellent improvement with updated spectacles, anti-glare coatings, or lifestyle adjustments.

How Cataracts Affect Vision

The lens in your eye must remain clear to focus light sharply onto the retina. When protein fibres within the lens begin to clump and cloud, light is scattered, and vision becomes foggy or distorted. This is particularly noticeable when:

• Driving at night
• Reading small print
• Recognising faces or colours
• Working in bright lighting conditions

One telltale sign of early cataracts? You feel like your glasses are constantly dirty, even after cleaning them.

Signs and Symptoms of Early Cataracts

As cataracts form and progress, you may notice:

• Cloudy, blurry, or hazy vision
• Colours appear faded or yellowed
• Increased sensitivity to glare, especially at night
• Halos around lights
• Poor night vision
• Double vision or ghosting in one eye
• Frequent changes in your glasses prescription
• Contact lenses or spectacles no longer feel effective

These symptoms can also mimic other eye conditions, which is why routine eye exams are essential.

What Causes Cataracts?

The lens is made primarily of water and proteins, which must remain transparent. Over time, protein clumping and oxidation lead to the clouding of the lens.

Common risk factors include:

• Ageing (most common cause)
• Long-term UV exposure (sunlight or tanning beds)
• Diabetes and hypertension
• Smoking and excessive alcohol consumption
• Long-term use of steroids or statins
• Obesity and poor nutrition
• Family history of cataracts
• Eye injuries or prior surgeries

Managing Early Cataracts

Cataracts do not need to be removed immediately. In many cases, non-surgical solutions provide noticeable improvement in vision:

Early-Stage Management Options:

• Updated prescription lenses
• Anti-reflective coatings and UV-blocking sunglasses
• Improved indoor lighting
• Bifocals, magnifiers, or reading aids

Routine check-ups allow your optometrist to monitor progression and recommend when—or if—referral to an ophthalmologist is appropriate.

When Should Surgery Be Considered?

Cataract surgery becomes an option when:

• Vision significantly affects daily activities (e.g. driving, reading, recognising faces)
• Night driving becomes dangerous
• There’s frequent lens prescription changes with minimal improvement
• Vision loss impacts work or independence

Surgery is not urgent and can be postponed until you’re ready. Your optometrist will guide you, helping you make a well-informed decision without pressure.

Noticing blurry or foggy vision that glasses can’t fix?

Schedule an eye exam with Davida van der Merwe Optometrist to assess for early cataracts, explore non-surgical solutions, and make informed choices about your eye health.

Keratoconus is a progressive eye condition where the cornea (the clear, dome-shaped front surface of the eye) gradually becomes thinner and bulges outward into a cone-like shape. This irregularity distorts how light enters the eye, causing blurred or distorted vision that cannot be corrected by glasses alone.

Often confused with standard astigmatism in its early stages, keratoconus requires professional diagnosis and management. The condition can affect one or both eyes (often asymmetrically) and typically develops during the teenage years or early adulthood.

How It Affects Vision

As the cornea thins and begins to bulge:

• Vision becomes increasingly distorted
• Light entering the eye is scattered, resulting in ghosting, halos, and multiple images (monocular polyopia)
• Night vision deteriorates, with glare from headlights and streetlamps becoming overwhelming
• Spectacle prescriptions change frequently, often with minimal improvement in clarity

Patients may report a sensation like looking through wavy or distorted glass, with worsening of symptoms in low-light environments.

Signs and Symptoms of Keratoconus

Symptoms may develop slowly and vary in severity. Common signs include:

• Blurred or distorted vision at all distances
• Frequent changes in eyeglass prescriptions
• Sensitivity to light (photophobia)
• Halos or ghosting around lights
• Eye strain and irritation
• Difficulty driving at night
• Increased eye rubbing

In the early stages, symptoms may resemble normal refractive errors. However, as the condition progresses, regular lenses no longer offer visual clarity.

Causes and Risk Factors

The exact cause of keratoconus remains unknown, but contributing factors include:

• Genetic predisposition (family history)
• Chronic eye rubbing, often linked to allergies
• Underlying atopic conditions like eczema, asthma, and hay fever
• Oxidative stress and a reduced ability of the cornea to repair itself
• Deficiencies in collagen and anchoring fibrils that maintain corneal structure
• Hormonal fluctuations, especially during puberty

Keratoconus is not caused by infection and is not contagious, but it can significantly impact quality of life if untreated.

Diagnosis

Keratoconus is typically diagnosed through:

• Corneal topography (maps the shape of the cornea)
• Slit-lamp examination
• Pachymetry (measuring corneal thickness)
• Keratometry (measuring curvature of the cornea)

Early diagnosis is crucial to managing the condition effectively and preventing irreversible visual impairment.

Treatment Options for Keratoconus

Treatment depends on the severity and stage of the condition. Options include:

Non-Surgical Management

1. Spectacles or custom soft contact lenses – useful in early stages
2. Rigid Gas Permeable (RGP) lenses – provide a smooth surface for light to enter
3. Piggybacking lenses – soft lenses beneath rigid lenses for improved comfort
4. Hybrid contact lenses – rigid centre with soft outer ring for comfort and clarity
5. Scleral and semi-scleral lenses – ideal for advanced cases, offering better fit and comfort
6. Collagen Cross-Linking (CXL) – a clinical procedure that strengthens corneal tissue to halt progression

Surgical Options

7. Intacs – tiny ring segments implanted into the cornea to flatten its shape
8. Corneal transplant (keratoplasty) – for severe cases where lenses no longer provide usable vision

Blurry vision, frequent prescription changes, or ghosting around lights?

Book a comprehensive corneal assessment with Davida van der Merwe Optometrist to detect keratoconus early and protect your vision with expert care.

Dry Eye Disease, also known as Keratoconjunctivitis Sicca, is a common and often chronic condition that occurs when your eyes don’t produce enough quality tears to stay lubricated. This can cause irritation, blurred vision, and a persistent gritty or burning sensation.

Tears are composed of three layers: a lipid (oil) layer, an aqueous (water) layer, and a mucin (mucus) layer. When any one of these becomes deficient—due to environmental factors, medications, systemic health issues, or aging—dry eye symptoms can develop or worsen.

What Causes Dry Eye?

DED can result from a wide range of issues, including:

• Prolonged screen use (reduced blinking)
• Air conditioning or windy environments
• Hormonal changes, especially in menopausal women
• Certain medications such as antihistamines or antidepressants
• Autoimmune diseases like Sjögren’s syndrome, lupus, or rheumatoid arthritis
• Contact lens wear or post-LASIK surgery
• Vitamin imbalances or poor nutrition
• Skin conditions and eyelid inflammation

Signs and Symptoms of Dry Eye

While the symptoms can vary in intensity, the most common include:

• Burning or stinging sensation
• Grittiness, as if sand is in your eyes
• Redness and occasional eye pain
• Watery eyes (reflex tearing)
• Stringy discharge
• Blurred vision, especially after reading or screen use
• Eye fatigue and heavy eyelids
• Contact lens discomfort
• Difficulty with prolonged focus tasks

Sometimes, the eye produces excess tears as a response to dryness, but these tears are often watery and lack the protective quality of a full tear film.

Who Is at Risk?

You’re more likely to develop DED if you:

• Are over the age of 50
• Are female, especially postmenopausal
• Spend long hours on computers or smartphones
• Live in dry or windy climates
• Have chronic allergies
• Use medications that affect tear production
• Wear contact lenses regularly
• Have had cosmetic or refractive eye surgery

Treatment Options for Dry Eye

Dry Eye Disease is manageable, especially when diagnosed early. Your optometrist can help tailor a treatment plan to suit your needs.

Lifestyle and Home Adjustments:

• Blink more frequently, especially during screen use
• Take regular breaks while reading or working
• Remove eye makeup thoroughly
• Use high-quality sunglasses outdoors
• Maintain proper eyelid hygiene

Medical Treatments:

• Artificial tears or ointments – daily use maintains moisture
• Steroid eye drops – short-term relief of inflammation
• Punctal plugs – tiny devices placed in tear ducts to prevent tear drainage
• Omega-3 supplements – promote tear quality and reduce inflammation
• Warm compresses and lid massage – unblock Meibomian glands
• Topical immunosuppressants or anti-inflammatories (prescribed)
• Surgical intervention (in rare, extreme cases)

Struggling with tired, burning, or gritty eyes—especially after a long day on screens?

Book a dry eye assessment at Davida van der Merwe Optometrist for expert diagnosis, tailored treatment, and real relief.