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Visual Stress and Technology

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A study published by the New York Times in 2009 revealed adults are exposed to screens – TV, cell phones, computers, etc. – roughly eight and a half hours on any given day.

Even the smallest uncorrected prescription can cause problems at the computer. This is especially true if you happen to be far-sighted or have astigmatism, due to the excessive focusing required to maintain a clear image.
Dry eyes and poor tear quality can cause blur and eye discomfort. We tend to blink less often when viewing the computer allowing the tears to evaporate.

Some solutions to eyestrain at the computer or with other digital devices  include a correction specific for the task. For example, a pair of computer glasses designed with optimal correction at the distance to the digital display and including appropriate coatings and tints to reduce strain and improve efficiency.

Reducing glare from overhead lights and windows will minimize squinting. Simply adjusting the screen position, closing window blinds and decreasing the wattage of a desk lamp will reduce glare. To see an earlier post with more details click here.

Give your child every chance to see, learn and play

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Did your child pass the vision screening administered at school last year? Did he see the acuity chart tacked to the door at the pediatrician’s office? Although these tests are helpful in spotting a few basic eye problems, they don’t take the place of a comprehensive eye examination.

Very often screening tests simply measure how well your child can see at a distance. Other vision concerns, such as farsightedness, lazy eye, crossed eyes, poor eye coordination, or poor depth perception may go undetected. Often children do not recognize these problems themselves because they have “always seen it this way.”

Parents and teachers may be puzzled about a child’s slow progress in school. For example, if a child is farsighted, he or she will see distant objects clearly, but may have problems focusing the eyes for close work. The same child who can read the eye chart easily at a distance may have a difficult time seeing words close up in a textbook or on a math worksheet. As a result, reading problems may develop that can affect the student’s learning and achievement.

A comprehensive eye examination includes measurements of the vision at distances far away which is important for seeing the board and playing sports and closer distances which are important for reading, computers and desk work. The exam also includes evaluation of how the eyes work together and the ocular health.

Success during the first few years of school can significantly impact your child’s confidence and success. If a child can’t focus, track (follow words on a page) and otherwise see properly, reading and development will be delayed making school a frustrating experience.

When scheduling back-to school appointments, don’t forget to include the eye doctor.

Wearing Contact Lenses Overnight

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Have you ever wondered what would happen if you wore your contact lenses overnight? Unexpectedly stayed the night at a friends house and didn’t have anywhere to put your lenses? Enjoying a  late night and fall asleep with your contacts on?

It happens, contact lenses get worn too long and sometimes over night. Some contact lenses are better for this than others. I prescribe and fit people with the intention of overnight use. I also warn patients about the risks they are taking with their eyes.

Depending on the contact lens type and material, oxygen is reduced to the cornea. Movement of the contact with each blink aids the transmission of oxygen. When you are sleeping with the contact lens, the eye is closed and no oxygen gets to the cornea. There is no blinking either so the lens doesn’t move. The reduction in oxygen causes the cornea to swell, if the lens allows plenty of oxygen to get to the cornea during the day, the cornea will deswell and return to normal. However, if the cornea remains swollen, and you sleep in the lens consecutive nights, blood vessels will begin to grow into the cornea. Sometimes the eye responds by becoming inflamed, red and painful.

Another risk of leaving the lenses in overnight is infection. Typically when a lens is removed it is thrown away or placed in disinfecting solution. In the morning a new lens or a clean, disinfected lens is applied to the cornea. Microbials build up on a lens that is worn continually. If your cornea is compromised by a scratch or edema, the bacteria will infect the eye.

If you have been prescribed extended wear contact lenses, stay compliant to your wear schedule, once in awhile overnight or 6 consecutive nights. Clean and replace your lenses as prescribed. If you are wearing your daily wear contacts overnight, let’s talk about a safer option. This may include a higher oxygen material or even LASIK. Sometimes the prescription can be a limiting factor. If the prescription is higher,  farsighted or is toric and corrects astigmatism, the lenses will be thicker and reduce oxygen transmissability.

What is an Epiretinal Membrane

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An Epiretinal Membrane (ERM) is also known as Cellophane Maculopathy or Macular Pucker. Sometimes it is simply referred to as a “wrinkle.” In most cases, a Posterior Vitreous Detachment (PVD) has occurred. This vitreous activity causes the macula to generate cells and create a scar-like membrane. This thin tissue layer can contract and cause a wrinkle.


In the above picture of the inside of an eye, the whitish irregularities on the left side is the membrane. The photo below shows a normal macula, note the the smooth and regular color on the left side. The dark spot to the left in each photo is the macula.

The macula provides sharp, central vision and allows us to see details. Any change in the surface, like a wrinkle, will cause distortion and blur. ERM usually occurs in one eye only. The initial onset of the blur and distortion can be very alarming, but most people get used to it depending on the extent. Sometimes it resolves on its own, but mostly it stays the same. If you are noticing this type of vision change it is very important to have an examination for a correct diagnosis. Blur and distortion can be symptoms of other conditions, such as a macular hole.

In cases where the vision is significantly impaired a surgical procedure can be done. A vitrectomy is performed to remove the vitreous, then very delicately the surgeon peels the membrane off of the macula. This often reduces distortion and improves the vision, but not completely. Retinal surgery is not without risks, the most common risk is the development of cataracts, but any damage to the macula during the procedure can cause permanent visual impairment.

ERM is not the same as Macular Degeneration.

Contact Lens Tip

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An easy way to make contact lenses more comfortable is to put a drop of artificial tears into the eye or onto the lens before putting on the contact lens. The scientific basis for this includes physical lubrication which enhances comfort by reducing dryness and protecting the cornea (surface of the eye). It also increases viscosity and lowers the tear film tension so the eye stays wetter.

In addition, the common ingredient in artificial tears is carboxymethylcellulose (CMC). The CMC is negatively charged so it binds to the preservatives in the multi-purpose disinfecting solutions to decrease irritation.

If your contact lenses are uncomfortable and you find yourself taking the lenses out earlier each day or not even putting them in, call Westside Optometry to schedule an appointment.

Firework Safety

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Fireworks

 

For most of us, celebrating the Fourth of July means barbeques and fireworks. Unfortunately, the fun can be cut short when fireworks are used inappropriately and cause serious injuries. One of the most common causes of firework injury is when a device explodes before expected. This often results in cuts, burns and bruises in and around the eye. Sparklers are not exempt, in fact they are responsible for a significant percentage of eye injury cases.

According to a study by the US Consumer Product Safety Commission, fireworks were the culprit for an estimated 8,800 injuries treated in US emergencies departments during 2009. Of these, 54 present were children and teens under the age of 20 years.

Below are tips to help protect and preserve eyesight during the Fourth of July holiday.

  • Discuss firework safety with children and teens prior to the Fourth of July holiday.
  • Do not allow kids to handle fireworks and never leave them unsupervised near fireworks.
  • Wear protective eyewear when lighting and handling fireworks of any kind.
  • Store fireworks, matches and lighters in a secure place where children won’t find them.
  • Refrain from purchasing sparklers. Heating up to 1,800 degrees, sparklers are the number one cause of fireworks injuries requiring trips to the emergency room.
  • Be aware of your surroundings and only light fireworks when family, friends and children are at a safe distance.

Have a happy and safe holiday!

Bifocal Contact Lenses

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I have attended 2 interactive evenings sponsored by 2 different contact lens manufacturers in the last 2 months. Both companies were promoting their soft multifocal contact lens products. Each lens type appears to offer something different.

I was able to gleen some tips that I think will improve patient success in the lenses. I am feeling more optimistic about soft multifocal contact lenses. A multifocal contact lens is designed to improve the close vision and make near tasks easier while wearing contact lenses. This is important for someone experiencing presbyopic changes and finding themselves pushing the newspaper farther away or reaching for reading glasses more frequently. The challenge with the lenses has been trying to achieve good near vision without decreasing the distance vision.

The other advantage of the newer multifocal contact lenses is they are available in the silicone hydrogel (sihy) material. The sihy material allows more oxygen to reach the cornea, less protein to deposit and better daily comfort.

To add to the excitement, a new daily use multifocal has just hit the market. I think this will help include the patients who wear their lenses intermittently or who can only wear a lens once because of comfort issues.

Click here to read more about the rigid gas permeable  multifocal contact lens designs.

Burning Eyes

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Red rimmed eyes, burning eyes, watery eyes. These are symptoms of eyelid inflammation caused from Meibomian gland dysfunction (MGD), blepharitis or both. Another condition of the eyelid that causes discomfort and redness are styes; when one of the eyelid glands becomes infected. Styes are more localized and found on the edge if the eyelid.
The Meibomian glands are between the eyelashes. They can become plugged and inflamed causing problems with the tear quality. The compromised tears evaporate quickly causing the lacrimal gland to overcompensate and produce too many tears which spill over the eyelids. The inflammation produces a foamy discharge that sits on the lower eyelid margin causing irritation and burning.


Blepharitis in an infection or irritation of the eyelid. The typical sign of “bleph” is flakes and/or debris on the eyelashes. The flakes and debris end up in the eye causing irritation and redness.
At night when we sleep, the eye is closed and not blinking. Tear production is greatly reduced. Anything left on the eyelashes and eyelids will sit on the eye all night causing discomfort, grittiness and redness by morning. Treatment involves removing the potential irritants. This includes thorough removal of make-up and creams. A hot compress will soften the waxy plugs in the meibomian glands. Mild cleaning solution and a washcloth or cotton swab will remove debris from the eyelids and eyelashes. For a printable description of eyelid hygiene click here.

Good lid hygeine will improve contact lens comfort during the day, and reduce dry eye symptoms too.

What are the Advantages of Daily Use Contact Lenses?

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Soft daily use contact lenses have been available since 1995. The obvious advantage of replacing contact lenses daily is placing a clean, sterile, well-hydrated lens in your eye each morning. Even with the best cleaning and hygiene; lenses get dirty, lose their ability to stay wet and protein adheres to the surface. These factors reduce comfort, cause dryness and decrease lens clarity.

The other advantage is the elimination of contact lens solutions and the complications resulting from solutions. The contact lens solution industry changes as often as the lenses. Most contact lens complications result from sensitivity to the solution or poor compliance. Eliminating this component from the care of contact lenses, resolves multiple problems.

Probably the greatest advantages to patients is the convenience. No more contact lens solutions, no contact lens cases, just a clean, clear and comfortable lens each day.

For intermittent wearers, someone who uses lenses for sports, social events or infrequently, the daily lenses are easier to keep on hand, in a gym bag, briefcase or backpack. No more trying to remember how old a lens is, or opening the case to find dried up lenses.

One of the disadvantages is that not all prescriptions are available in daily disposable lenses. There are some toric lenses (astigmatism correction) in limited powers but not enough. Currently there is not a decent multifocal daily contact lens (although, this will be available in the future). The second disadvantage of daily replacement lenses is they are not designed for overnight use and must be removed before sleeping.

UV Damage and Your Eyes

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Most people (79%) know the importance of sun protection for the skin, but only 6% know how important it is for the eyes.
Studies from all over the world have shown that Ultraviolet (UV) damage due to chronic exposure to UV light is a factor in many diseases of the eye. Some of these conditions include pterygium ( a growth on the cornea), cataracts (clouding of the lens) and possible age-related macular degeneration (a condition causing decreased vision).

  •  No amount of UV exposure is healthy for the eyes.
  • The eye is the only place where internal tissues of the body are directly exposed to environmental UV.
  • UV damage is cumulative and often irreversible
  • Almost half of your UV exposure occurs when you are not in full sun and less likely to wear sunglasses or protection.

There are several things to consider when selecting sunglasses. The glasses should be comfortable and provide complete UV protection. More than one pair may be indicated; the sunglasses you wear running to the store, will be different than the pair you use for golf or boating. The style of frame and type of lens vary to the task.

The staff at Westside Optometry can help you make the best decisions to maximize your UV protection and maintain good eye health. They are very excited about a new lens that becomes polarized as it darkens.