Dr. William Joseph Reynders, MD

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.

Each family member can be affected by an issue in an individual and unique way, typically depending on age, maturity, and involvement. This means that family issues are often inequitable, with one or more family members bearing a disproportionate weight of the problem. A frequent example is parental divorce. While both parents may appreciate the immediate relief, divorce can rapidly threaten a developing child's sense of stability and self-confidence. Similarly, a mother who is subject to domestic abuse may conceal the issue in order to shield her children from her distress. In some cases, family issues are generational; a father may cause residual guilt or disagreements from his childhood to carry forward to his own son. While each family's experience is unique, common family issues can include:

• Financial disputes
• Divorce and separation
• Abuse and violence
• Narcissistic caretaker(s)
• Death
• Infidelity and relationship issues
• Sibling rivalry
• Religious and cultural conflicts
• Lifestyle disagreements
• Severe physical illness
• Mental health issues
• Neglect
• Retirement and older adulthood
• Unsafe or unstable household environment

Some family issues are inevitable – such as retirement and minor lifestyle disagreements – while others can be unexpected and dramatic. Unsafe household environments, abuse, and neglect can lead to severe trauma and intervention by social services or law enforcement.

Most common family issues can be addressed through therapy with one or more family members. Family therapy involves sessions led by a licensed mental health therapist. These sessions often include family discussion, resolution strategies, and other activities to promote family harmony. Another form of treatment for family issues is couples counseling, in which a couples counselor can help spouses communicate and employ problem-solving techniques to improve the strength of their relationship. For children, specialized child therapy can help children and adolescents manage and overcome family issues with age-appropriate methods.

Some people find individual therapy or counseling beneficial in resolving family issues, especially for those who are unable to attend family therapy with other family members. Therapists may encourage the creation of family boundaries. At an extreme, therapy may cause an adult to come to the conclusion that communication with a narcissistic parent must stop in order to preserve mental health and wellbeing.