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Why do we Blink?

Karen Griffith

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Blinking cleans the ocular surface of debris and flushes fresh tears over the ocular surface. Each blink brings nutrients to the eye surface structures keeping them healthy.
Human are meant to blink. Not only are we meant to blink, but we are meant to blink in a particular way and at a particular frequency that ensures the renewal and revitalization of the front surface of the cornea and conjunctiva.
Blinking cleans the ocular surface of debris (dead cells, mucus and the junk that blow in the wind). It rinses fresh tears over the ocular surface. The fresh tears bring nutrients and other substances to the surface structures keeping them healthy. It helps prevent infection and clears and brightens the image received by our retina. Blinking wets the outer eye and in the case of a contact lens wearer, replenishes the tear layer upon which the contact lens floats.

Normally, a blink brings tears from the lacrimal gland which is located above the eyeball and under the brow bone, and sweeps them across the eye surface. Infrequent and incomplete blinks cause the surface of the eye to “dry” between refreshing tears. A few things will cause us to blink less often – staring at a computer for example. The blink rate slows down when reading or concentrating on a task. Paying attention to our blink rate can decrease dry eye and discomfort.

Lid structure and bad habits can prevent us from closing the eye completely with each blink.  After an incomplete blink the lower part of the eye is left exposed and without fresh tears. This is called “lagophthalmos.” Some people sleep with the eye partially open causing dessication (dryness) of the lower portion of the cornea. Not only is this uncomfortable, but can cause scarring. Nighttime lubricants and habit changes are often required to prevent complications from lagophthalmos.

Pay attention to how often you blink and how you blink. Make sure your eyelids meet with each blink and that you avoid starring when concentrating on a task.

 

Hyperopia

Karen Griffith 1 Comment

hyperopia

Hyperopia or farsightedness, is a type of refractive error in which the eye doesn’t have enough power. This is usually due to a short eye or small eye size. Other causes include a small curvature of the cornea or lens.
In a hyperopic eye the light rays converge to a point behind the eye. If you’re farsighted, distance objects are often easier to see than near objects. Hyperopia is often noticed while working on a computer or reading.
Hyperopia can be corrected with plus power contact lenses and glasses. The lenses shorten the converging light rays so images focus on the retina.

Grimy Contact Lens Cases

Karen Griffith 1 Comment

Dirty CL case NEI

Contact lens wear is quite safe as long as proper lens and storage case care are followed. Improper lens wear and care can put the lens wearer at risk for serious consequences. Sight-threatening microbial keratitis (corneal ulcer) is the most significant adverse event associated with contact lens wear and is largely preventable. The contact lens storage case is the most likely potential reservoir for contact lens related ocular infections. Contact lens storage cases should be replaced regularly, at least every 1-3 months. dirty cl case

BOOK REVIEW: The Mind’s Eye

Karen Griffith

The author of The Mind’s Eye., Oliver Sacks, is a neurologist who has written books on the various senses, brain function and dysfunction and perception. He makes challenging, vague Vintage-Minds-Eye-2011-194x300topics more obtainable to the layperson.
The Mind’s Eye is about different visual perception related conditions ranging from agnosia (inability to recognize and name objects), stereopsis, and peripheral vision.
Of the seven different topics/chapters my favorites were “Stereo Sue” and “Persistence of Vision.” Susan Barry is a neuroscientist who had been cross-eyed since infancy. Susan had strabismic surgery as a child to straighten her eyes but lacked fusion, the 2 eyes didn’t work together.She grew up viewing a flat world until she finally met an optometrist who created a vision training program for her. Due to her motivation and interest in perception she succeeded in obtaining stereo vision. Her two-dimensional world became three-dimensional. She has written a book about her journey into three dimensions – Fixing My Gaze. If you are interested in stereopsis, have a strabismic child or lack depth perception yourself I strongly recommend her book.

“Persistence of Vision”  is a journal of Oliver Sacks’ own experience slowly losing vision  in one eye due to a tumor. He scolds himself for missing his annual eye exams which would have detected the tumor earlier. Losing his vision in one eye caused the loss of stereovision and peripheral vision. As a neurologist, Sacks analyzes not only the loss of peripheral vision but the loss of awareness in the visual field. He had to learn to deal with moving around without awareness of objects to his right, this resulted in a lot of bruises on the right side of his body.

In the first pages of the book, Sacks describes the human variation in visual imagery, peoples ability to visualize something without actually seeing it. At the end of the book he gives examples of individuals who have profound enhancement of the remaining senses when one is lost and other individuals who don’t gain sensitivity. The one consistent factor of the brain and human perception is that it isn’t consistent.

My one complaint of the book is the footnotes on nearly every page. By the end of the book I was annoyed to the point where I had to ignore the footnotes to finish reading the text.

How does Diabetes Damage the Eyes?

Karen Griffith

Vision Loss

Over time uncontrolled blood sugar and poor circulation can harm the internal structures of the eye.
Blurry or Double Vision
Fluctuating blood sugar and fluctuating vision are connected. A change in glucose levels affects the eye’s ability to maintain sharp focus. It may take several months after your blood sugar is well controlled for your vision to stabilize.
Diabetic Retinopathy
The leading cause of diabetes-related vision loss is diabetic retinopathy. Diabetic retinopathy can damages the network of blood vessels supplying the retina or cause the growth of  abnormal  blood vessels on the retina. When these fragile blood vessels leak, the fluid and blood damage the retina and can cause permanent vision loss.
Cataracts
People with diabetes have a much greater risk for developing cataracts and at an earlier age. A cataract is clouding of the eye’s natural lens and results in the inability to focus light, glare and compromised vision,
Glaucoma
Diabetes also increases your risk of developing glaucoma. Glaucoma causes irreversible damage to the retina and optic nerve. If untreated, this damage leads to vision loss.

Scheduling regular eye exams can help detect diabetes-related eye diseases before they cause irreversible damage.
Exercise, a healthy diet and keeping glucose levels and blood pressure controlled can also help control eye problems.

Improved Dry Eye Care

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Dr Staton and I spent attended the UC Berkeley School of Optometry lecture and workshop on “Dry Eye Disease: the Latest Trends in Clinical Care and Scientific Research.” Many eye conditions cause feelings of dryness, plugged meibomian glandsdiscomfort, burning, foreign body sensation or blurred vision. “Dry Eye” is a general term that is more a symptom of ocular surface disease than a cause. Many people stop wearing contact lenses because of poor tear quality. The majority of dry eye disease is caused from obstruction of the meibomian glands. The meibomian glands are located in the eyelids and secrete meibum, a substance important to the tear quality and health of the front surface of the eye. The accurate diagnosis and management of dry eye requires special evaluation that extends beyond a standard eye exam.
We have been experimenting and testing different eye drops, eyelid cleaning solutions and heat compresses to find the most cost effective and best results. Some dry eye treatments require prescription eye drops, oral medications, and/or punctual occlusion.
Dry eye can cause significant discomfort and poor vision for the person suffering from it. We are planning to aggressively treat and control dry eye causes and symptoms. Don’t be surprised if either one of us asks you to schedule a dry eye assessment. Or you can be proactive and schedule yourself.
We are starting the dry eye clinic on Thursdays and will expand as demand requires.

Make-up and Contact Lenses

Karen Griffith

Many contact lens users wear eye make-up. Recent studies at the University of Waterloo Centre for Contact Lens Research has shown that hand creams, mascara and make-up removers can alter the contact lens shape and optics. These changes in the contact lenssoft CL will interfere with lens comfort and performance.
Cleaning lenses with a hydrogen peroxide system such as Clearcare removes some of the cosmetic product from the lens, but not completely. Waterproof mascare was associated with the greatest amount of surface depostition. Clearcare only partially removed these deposits.
Make-up removers induced the greatest changes to the lens diameter or size.
If you wear contact lenses and make-up you can avoid complications from cosmetic deposits and build-up on your lenses by following these rules:

  • Daily use contact lenses are a simple solution to the build-up of cosmetic residues. Unfortunately, this isn’t an option for everyone.
  • Washing your hands before handling your contacts removes lotions and debris from your hands.
  • Insert your contact lenses before applying any lotions or make-up.
  • Remove your contact lenses before removing your make-up. And remove your make-up every night.
  • Replace your contact lenses as prescribed

If you are experiencing contact lens discomfort, poor vision or red eyes, try the above recommendations. If you are still having problems, call the office for an appointment.

Aging Eyes

Karen Griffith

 

It’s a fact of life that vision can change over time, resulting in a number of noticeable differences in how aging adults see the world around them.
Common age-related vision problems include difficulty seeing things up close or far away, problems seeing in low light or at night, and sensitivity to light and glare. Some symptoms that may seem like minor vision problems may actually be signs of serious eye diseases that could lead to permanent vision loss, including:

  • Age-Related Macular Degeneration (AMD). An eye disease affecting the macula, the center of the light sensitive retina at the back of the eye. AMD can cause loss of central vision.
  • Cataracts. A clouding of the lens of the eye that usually develops slowly over time and can interfere with vision. Cataracts can cause a decrease in visual contrast between objects and their background, a dulling of colors and an increased sensitivity to glare.
  • Diabetic Retinopathy. A condition occurring in people with diabetes, which causes progressive damage to the tiny blood vessels that nourish the retina. The longer a person has diabetes, the more likely they are to develop the condition, which can lead to blindness.
  • Glaucoma. An eye disease leading to progressive damage to the optic nerve due to rising internal fluid pressure in the eye. Glaucoma is one of the leading causes of blindness.
  • Dry Eyes. Dry Eye occurs when there is insufficient tears to nourish the eyes. This can be caused by medications, hormones and environmental factors. Poor tear quality can cause dry eye symptoms too.

Many eye diseases have no early symptoms and may develop painlessly; therefore adults may not notice changes in vision until the condition is quite advanced. Healthy lifestyle choices can help ward off eye diseases and maintain existing eyesight. Eating a low-fat diet rich in green, leafy vegetables and fish, not smoking, monitoring blood pressure levels, exercising regularly and wearing proper sunglasses to protect eyes from Ultraviolet (UV) rays can all play a role in preserving eyesight and eye health. Early diagnosis, treatment of serious eye diseases and disorders is critical and can often prevent a total loss of vision, improve adults’ independence and quality of life.

The best way to prevent eye disease and continue leading an active productive live is to maintain yearly eye exams or follow the doctor’s recommendations.

Choosing the Best Lens for your Glasses

Karen Griffith

The lenses you choose for your eyeglasses – even more than the frames – often will determine how happy you are with your eyewear.
When buying eyeglasses, the frame you choose is important to both your appearance and your comfort when wearing glasses. But the eyeglass lenses you choose influence four factors: appearance, comfort, vision and safety.
A common mistake people make when buying eyeglasses is not spending enough time considering their choices of lens materials , designs and coatings.

 

Lens Materials

Eyeglass lens thickness is determined in part by the size and style of the frame you choose. For thinner lenses, choose smaller, round or oval frames; plastic frames hide edge thickness better.
Glass Lenses. Originally, all the eyeglass lenses were made of glass. Although glass lenses offer exceptional optics, they are heavy and can break, potentially causing serious harm to the eye or even loss of an eye. For these reasons, glass lenses are not used for eyeglasses very often.

Plastic Lenses. The first plastic eyeglass lenses were made of a plastic polymer called CR-39. Because it is half the weight of glass, has good optics and is inexpensive, it remains a popular choice for lens material.

Polycarbonate Lenses were introduced in the 1970s for safety glasses. Originally developed for helmet visors for the Air Force it offers a lighter and significantly more impact-resistant option. It is preferred for children’s eyewear, safety glasses and sports eyewear.

Trivex is a newer lightweight eyeglass material with similar impact-resistant properties as polycarbonate. It has better clarity than the polycarbonate, but isn’t quite as thin.

High-Index Plastic Lenses are indicated for thinner, lighter eyeglasses. High-index materials also provide UV protection.

Lens Treatments

For more comfortable and better looking glasses, the following lens treatments are available.

Anti-Reflective Coating (ARC) makes all eyeglass lenses look and perform better.  AR vs no ARARC eliminates reflections in lenses that reduce contrast and clarity, especially at night. The coating makes the lenses look invisible and increase the transmission of light. This is especially important in high index lenses, because of the higher index of refraction that causes more light to be reflected.

Adaptive Lenses or Transitions change color depending on the ambient ultraviolet light levels.

Digital Lenses reduce aberrations and improve clarity. This is most important in higher prescriptions and progressive lenses.

The next time you are selecting glasses, take advantage of the Westside Optometry team to design the optimum pair for you.

Vision Expo West

Karen Griffith

Riding Vespa at Vision Expo

It wasn’t all fun and games in Las Vegas this past weekend. Before Peg and I rode the Vespa under the Arc de Triomphe, we checked out the newest progressive lenses and learned some new measurement techniques.

Between Peg and I we attended 12 hours of education ranging from frame manufacturing to oral medications to nutrition. Here are the highlights of each course we want to share with you:

  • Global Frame Manufacturing. Italy was once the primary country for eyeglass frame manufacturing, but as with other industries, the factories have relocated in China for economic reasons. The next trend is a shift to India.  It takes time to train the workers and get the factories up to standard. The speaker emphasized that the quality of the product isn’t dependent of the country of production, but the individual factory of production. Some frame companies demand the highest standards of skill, environmental impact and human treatment.
  • Corneal Cross-Linking. Corneal X-linking is a treatment to stabilize a diseased corneal. Keratoconus is the primary condition that benefits from this procedure, and the earlier in the disease process it is performed the better the outcome and quality of life for the patient. Unfortunately, the US is the only non-third world country that doesn’t have approval. The FDA has delayed approval because corneal X-linking requires Riboflavin, a drug, and UVA radiation, a device. Apparently the FDA drug department and the FDA device department can’t work together. Until it is approved there are test sites in the US or patients have to leave the country for treatment.
  • Shades of Grey. Peg went to this course aimed at women and their maturing eyes and the tissue around the eye. Topics such as the risks and benefits of permanent make-up, Botox and Fillers were discussed. Common conditions like dry eye, the causes  and treatments were highlighted.
  • Eyefoods. This course was presented by Laurie Capogna, O.D., one of the authors of the book Eyefoods that I reviewed. She talked about preventative eyecare through nutrition and lifestyle. 2 take home points are Eyefoods do not Replace Supplements and Supplements do not Replace Eyefoods.
  • Strong and Unusual Lenses. The gist of this lecture was predicting the thickness and weight of lenses in various prescriptions. Utilizing different materials and lens treatments can improve the appearance and clarity of a high powered lens.
  • Oral Medications. This class included antibiotics, antivirals, steroids and supplements. The ocular complications of systemic medications  was also covered. For example Prozac can cause dry eye, light sensitivity and red eyes. Tamoxifen can cause changes to the macula.
  • Trouble-Shooting Eyewear Problems. The most important point in this class was to start with a good fitting frame. Not all frame designs work with all prescriptions and not all styles fit all faces.

Besides classes, we spent a lot of time in the exhibition hall which was divided into 3 areas: Eyewear & Accessories, Lenses & Processing Technology and Medical and Scientific. I purchased a new piece of testing equipment that I will talk more about when it arrives. We also visited vendors of dry eye treatments whose products Dr. Staton and I will be evaluating so we can better address  our patient’s dry eye issues. Lastly, Peg visited many frame companies. She has a short list of new products that we will transition into our dispensary as we update our frames.