The Whites Of Your Eyes: Understanding Ocular Albinism

Albinism is a genetic condition that is extremely rare. It affects normal pigmentation in the skin, hair, and eyes. However, it can be more difficult to spot an albino than you might think. For many people, albinism only affects the eyes, leaving the skin and hair with normal levels of pigment. In this case, it is referred to as ocular albinism. Discover more here.

How does ocular albinism affect vision?

Without proper pigmentation in the iris and the retina, people with albinism may struggle with some unique vision problems. Normally, the deep pigmentation in the iris and retina help to absorb ultraviolet light, allowing images to fully register within the eye. However, when light within the eye is not absorbed as well due to lack of pigment, people may:

  • become sensitive to light. People who have pale eyes (usually blue in color), including albinos, have trouble seeing clearly or experience pain in bright light.
  • have lowered visual acuity. Because the retina is not properly pigmented, the macula is underdeveloped. This means that some images will be blurry. 
  • have involuntary eye movements. This condition is called congenital nystagmus, or "dancing eyes". The eyes will flit up and down or side to side very quickly. However, people with nystagmus will not notice a change in their worldview; the world does not seem to shake, nor do they notice the eye moving. This condition can often worsen problems with visual acuity.
  • have lowered depth perception. Because the macula is not fully developed, one eye may be more dominant over the other. This dominance is more prominent in albinos because the underdeveloped muscles in the eyes will cause the weaker eye travel in or out while the other eye remains steady, resulting in eye misalignment. Misalignment of the eyes, or strabismus, is what weakens depth perception.

What treatments are available for ocular albinism?

It's important to realize that ocular albinism is not a disease. It's a genetic issue, but it does not get worse over time and is not life threatening. There are many ways to manage the vision problems that come as a result. These include:

1. Special glasses. Some albinos will benefit from wearing glasses, especially because astigmatism is more common for those with albinism. Because every person's eyes are different, glasses will be given out on a case-by-case basis, as some albinos find that even though they have a need for vision correction, glasses do not help because of the involuntary movement of the eyes that many albinos experience; the eye does not look through the center of the glasses lens.

Most albinos will need to attach a distance vision tool onto their glasses in order to participate in daily activities like schoolwork or driving. Normal glasses lenses can correct nearsightedness, but they still don't provide the acuteness of vision that albinos lack. Therefore, when choosing glasses, albinos often include the attachment of bioptic telescopes to the frames, which magnify objects enough to provide a clear focus. 

2. Sunglasses. Lack of pigment in the eyes means that those who have albinism are at greater risk for eye damage as a result of UV light. If they wear glasses regularly, it's best to get outfitted with transition lenses that will protect the eye both inside and outside as the light changes.

3. Contacts. Most albinos do best with contact lenses because contacts stay adhered to the eye, moving with the pupil as it flits back and forth. Contacts can also provide vision correction for each eye, even if the eyes do not always look in the same direction, as with strabismus. Depending on the severity of vision impairment, contact lenses can help to improve vision clarity partially, reducing the need to use bioptic vision aids.