Give your child every chance to see, learn and play

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.

What is an Epiretinal Membrane

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.

Cool things patients teach me

I would like to say that I think of this stuff by myself but my brain is scientific and analytical (a good trait for a doctor). I can’t help but admire a creative mind. The other day I asked a patient for a list of medicines he was taking and he whipped out his iPhone. I thought he was going to call his wife to ask her, instead he went to his notes and read his list to me. Usually I get a piece of paper which I appreciate because I can xerox it and update my list later, but the phone list was legible, and up-to date. I was very impressed until about an hour later I asked a different patient if there were any changes in the medicine he was taking. The gentlemen whipped out his phone. PrescriptionNo way, this has never happened and twice in the same morning, did I miss a memo? Instead of a list, the patient showed me a picture. The picture was a pill bottle of his newest medication. Easier yet, includes dosage, correct spellings and even easier to maintain. Just take a picture of the bottle. Brilliant!

How do you use your smart phone to be smarter about your health and eyes? What about setting alerts when it is time to change your contact lenses?

Eating for your Eyes

Everyone knows that proper diet and nutrition have advantages for health, but did you know that it is beneficial to your eyes as well? A diet rich in beta carotene, lutein, zeaxanthin, zinc, omega-3 fatty acids and certain vitamins can also help protect against vision loss, particularly age related macular degeneration (AMD).

AMD diminishes central vision and currently affects the vision of more than 2 million Americans, ages 50 and older. AMD is a progressive disease that if left untreated, can result in severe vision loss and even blindness. The exact cause of AMD is unknown, but risk factors for the disease include age, race, smoking, family history and health conditions such as cardiovascular disease and hypertension.

eyes and nutrition

A wide variety of foods including lentils, grapes, carrots, bell peppers, broccoli, spinach, sweet potatoes, kale, certain kinds of fish, turkey and some kinds of nuts, have been shown to aid eye health. Although there are a variety of available over-the-counter supplements designed for vision and eye health, a doctor should always be consulted before use.

Foods that contain refined starches and are high in sugar can be damaging to vision. A study by Tufts University showed that high-glycemic foods cause a dramatic rise in blood sugar, which over time, may damage the retina and capillaries in the eye by promoting oxidative stress and inflammation. Soda and sugary drinks, candy, baked goods,  some cereals , white rice, foods made with white flour, such as white bread and pasta, should be avoided or limited.

Other healthy habits can lead to healthy vision. The risk of eye disease and vision loss can be lowered by:

  • Avoiding trans fats
  • Quitting smoking
  • Controlling blood pressure and cholesterol
  • Exercising regularly
  • Visiting your optometrist regularly

Save your Vision

Here we are closer to the end of March than the beginning and I have not talked about Save-Your-Vision month yet. March is Save-Your-Vision month. The American Optometric Association (AOA) selects a theme for Save-Your-Vision month and this year the theme is the importance of annual eye examinations. Having an eye exam every year can, ..well…, save your vision.

There are a number of eye conditions that do not have symptoms, like glaucoma, diabetic retinopathy and brain lesions. In most cases, early detection and the proper treatment can prevent blindness, disability or death. Some conditions do have symptoms, but they are still ignored. Blurred vision, eye strain and red eyes can be treated to make your life much more comfortable.

If you have not had a comprhensive eye examination in the last 12 months, make that call (707)762-8643, it can save your vision.

2012 New Years Resolutions

If you make your 2012 resolutions with the intention of achieving good health and well-being, you will be benefiting your eyes also. Here are recommendations from Westside Optometry to get you started:

1. QUIT SMOKING

Smoking contributes to cataract formation, macular degeneration and dry eyes.

2. EAT MORE FRUITS AND VEGETABLES

Anti-oxidants and other nutrients found in a variety of fruits and vegetables can prevent age-related ocular conditions such as cataracts and macular degeneration.

3. EXERCISE REGULARLY

Exercise can benefit you in many ways. It reduces stress, helps control weight and improves circulation all benefits for you and your eyes.

4. SCHEDULE EYE EXAMINATIONS FOR THE KIDS

It is never to early for children to have their eyes examined. The American Optometric Association recommends the first eye exam at 6 months of age. Early detection of vision problems can save your child much frustration when learning to read and play sports.

Happy New Year

Back to School in 3D

If  your child has not been enjoying the 3D summer movies, he or she may have a vision problem.

The 3Ds of Stereoscopic 3D viewing

  • Discomfort: Since 3D viewing is based on the eyes converging in front of or beyond the screen, viewing 3D images can potentially create eyestrain and headaches.
  • Dizziness: 3D technology can exaggerate visual motion hypersensitivity, which can cause motion sickness, and vergence-accommodation conflict, causing viewers to feel dizzy or nauseous during or after watching 3D movies.
  • Lack of Depth: A viewer lacking binocular vision, simply won’t see 3D. While this doesn’t pose any problem viewing the screen, it serves as a “vision screening” that something is abnormal with the viewer’s binocular vision.

Symptoms indicating a potential problem viewing images in 3D can vary. Some common symptoms include headaches, blurred vision, nausea and dizziness. If you or your child have had an uncomfortable experience watching a movie in 3D, call Westside Optometry for an eye examination.

Diabetic Retinopathy

In the previous blog post I wrote about the reasons I dilate patient’s eyes. If you have diabetes, I will dilate your eyes at least once a year. Diabetes can affect many organs of the body, in the eyes it causes blindness.
Many problems develop in the retina due to diabetes. There is abnormal blood vessel growth, hemorrhages and lipid leakage. If these problems are allowed to continue without treatment they will cause scarring which leads to detachment of the retina. Another complication is the leakage of fluid under the macula which will severely reduce vision.
Not all these conditions will have symptoms. Only when the bleeding or fluids reach a certain size will you notice blur or dark spots. The earlier changes in the retina are detected, the better treatment results will be.

The picture above shows some of the changes diabetes causes in the retina. There is bleeding and some areas where blood isn’t flowing properly (ischemia). This patient did not notice any changes in his vision.

Why do I Dilate the Eyes?

I dilate most everybody’s eyes during an eye examination. If you have any health conditions such as diabetes, are taking certain medication, or have  cataracts I will dilate your eyes more often.
Through a dilated pupil I can see more eye structures.  I will use diagnostic lights and lenses that provide a 3 dimensional view of the inside of the eye. If there is a retinal hole, a lesion or fluid, it is much easier to detect through a dilated pupil. If I look through a keyhole, I can see part of the room, if I open the door, I can see everything.
Dilation requires drops in the eye. The effect usually lasts 3-4 hours. Most people notice an increased sensitivity to lights because the pupil is larger. I recommend bringing sunglasses to your appointment. If you think driving may be a problem, arrange for a driver. The drops can also cause a cycloplegic effect, which means focusing on objects up close will be difficult. Try to plan your schedule accordingly. Don’t plan on doing computer work or other close tasks immediately after being dilated.

This is the view of a normal retina looking through a dilated pupil. The optic nerve is the whitish circle on the left, it provides an entrance point to the eye for the blood vessels and an exit pathway for the nerve fibers carrying input to the brain. The 130 million photoreceptors (rods and cones) covering the retina, which appears as an orange background, receive all visual images and send these signals to the brain where the vision process occurs. When you have your eyes dilated at Westside Optometry we will take a similar picture of your eye. Don’t let me forget to show it to you.

Save Your Vision Month

March is Save your Vision Month

It is important to be proactive and protect your eyesight and vision for the future. 

For adults in their 20s and 30s, the eyes are generally healthy as are the other organs in the body. Start protecting your vision now.

 Eat right! Include lots of fruits and vegetables in your diet
 Quit smoking
 Wear sunglasses to protect against harmful ultraviolet radiation.

For adults in their 40s and 50s, you are probably noticing some significant changes in vision, especially close-up. Menopause can increase dry eye symptoms for women.

 Ask family members about eye diseases. Many conditions run in the family
 Invest in accurate and quality reading glasses
 Your general health can have profound effects on your eyes. Be prepared to discuss medications and health conditions with your optometrist

After 60 it is crucial to maintain regular eye examinations. The incidence of many eye diseases increases. Many of these conditions like glaucoma, have no symptoms.

 Schedule annual exams or as recommended.
 Report all changes in general health to the eye doctor. Don’t accept declining vision as just a part of aging.