Ryan P. Hoekstra, OD

A properly working immune system identifies foreign substances in the body that might cause illness, such as bacteria and viruses. The immune system then creates antibodies which attack the foreign substances, neutralizing them and keeping the body safe. In people with autoimmune disorders, something goes wrong with this process. For reasons that are not fully understand, the immune system creates antibodies to attack the patient's own tissues.

Symptoms of an autoimmune disorder depend on which tissue is being attacked by the immune system, but common symptoms of autoimmune disease include fever, fatigue, and a general feeling of just not being well. Autoimmune disorders are more common in women than in men, and they may run in families. Autoimmune disorders can affect various parts of the body such as blood vessels, connective tissue, endocrine glands, joints, muscles, red blood cells, skin, and many others.

It is common to have more than one autoimmune disorder at a time. Most are chronic, or life-long illnesses, although they may come and go in flares. Treatment for autoimmune disorders depends on which part of the body is being attacked. For example:

• A type 1 diabetic whose pancreas has been damaged will need insulin.
• A person with Hashimoto's whose thyroid has been damaged will need replacement thyroid hormones.
• Someone with Sjogren's syndrome will need eye drops and mouth rinses to replace tears and saliva.

Many autoimmune disorders of all kinds are treated with immune-suppressing medications, such as corticosteroids (e.g. prednisone) to reduce the effect of the immune system.

Refractive disorders happen when the shape of the eye doesn't let allow someone focus very precisely. They might be myopic (nearsighted), hyperopic (farsighted), or have an astigmatism, which is a focus problem caused by the cornea. Refractive disorders can be corrected by glasses or contacts.

Glaucoma is the leading cause of blindness in the United States. It happens when fluid pressure builds up within the eye and damages the optic nerve. It is treated with medications and surgery.

Diabetic retinopathy is a common complication of diabetes. The retina is tissue at the back of the eye that is filled with numerous, tiny blood vessels. When diabetes damages these delicate blood vessels, they burst or leak, leading to blind spots and blurred vision. Diabetic retinopathy can be treated with laser therapy and surgery, but often vision cannot be restored.

Macular degeneration is common in older adults. The macula is the central part of the retina and is responsible for crisp center vision. Over time, the cells in the macula begin to die, making central vision blurry. An early symptom of macular degeneration is that straight lines appear wavy.

Cataracts happen when the clear lens in the front of the eye becomes cloudy, making things look blurry or faded. They are extremely common in older people. By age 80, more than half of all Americans will have had a cataract. In early stages, prescription glasses and magnifying lenses can help. As the cataracts get worse, surgery to replace the lens may be the best option.

More than just one of the five senses, the eyes are heavily relied upon to communicate, work, and get around every day. It's important to have regular eye exams for vision stays in good shape for years to come.