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All About Vision

Contacts & Glasses that Enhance Performance

Woman Contact LensEvery sports activity requires a different skill set for success, yet all sports share a critical need for good vision. Geraint Griffiths, a British optometrist, devised a study to determine the effects of visual acuity on sports performance. This study distributed special vision-blurring goggles to Wimbledon tennis players and UK national clay pigeon shooters. Their performance was studied while the goggles were worn. Even though the goggles only blurred their vision a bit, the marksmen and tennis players showed a 25% decrease in accomplishment. This study demonstrated clearly that vision and sports achievement are inextricably linked.

Visual clarity isn’t the only benefit provided by sports eyewear. There are a number of additional eyewear features that boost athletic performance and enhance eye safety.

Protect Your Eyes from Impact-Related Injuries

As reported by the American Academy of Ophthalmology, over 42,000 sports-related eye injuries occur in the United States each year. Approximately 43% of those injuries happen to children under the age of 15. The majority of these injuries can be prevented with protective eyewear, such as safety goggles with polycarbonate lenses.

Regular eyeglasses are designed for daily wear, and they aren’t resilient enough to handle the rough and tumble wear needed for sports. They also provide inadequate protection for your eyes. Contact lenses offer zero protection from sports-related eye injuries. In contrast, sports eyewear is constructed to be highly impact-resistant, thereby granting superior protection for your eyes and removing anxiety about potential eye injuries. Able to withstand the hit of a ball traveling at up to 90 miles per hour, polycarbonate lenses are about 10 times more impact-resistant than regular lenses.

Safety eyeglasses are advised for every activity that has the potential for injuries to the eye. Be aware that the following land sports run a higher risk to eyes: softball, baseball, hockey, football, basketball, handball, squash, racquetball, tennis, volleyball, soccer and lacrosse. In water, all swimming and pool sports require specialized eye gear. Paintball players should also make safety eyewear an essential part of their game.

A Barrier against UV Rays

Harmful ultraviolet (UV) radiation can be just as damaging to your eyes as other injuries. A number of eye diseases, such as ocular tumors, macular degeneration, and cataracts, have been associated with exposure to UV rays. Photokeratitis, which refers to sunburn on your eye, is another hazard. This painful condition can cause long-term corneal damage.

Dangerous UV rays are more potent at higher altitudes and also bounce off snow or outdoor water, which increases exposure. It is imperative for skiers and anyone who enjoys outdoor water sports to wear sports sunglasses or tinted goggles that block 100% of the sun’s UV rays.

Some types of contact lenses provide UV protection, yet they only cover the central part of your eye. For this reason, sunglasses that block UV rays should still be worn, preferably in a wraparound style that also covers the delicate tissues surrounding your eyes. Hats with a wide brim will upgrade your protection by further reducing facial exposure to UV rays.

Enhance Your Game with Colored Lenses

Special tinted eyewear may add a winning edge to your game. Depending upon the lighting conditions, it’s not always simple to “keep your eye on the ball”. Hunters favor shooting glasses with amber tinted lenses, which highlight the contrast of birds flying against an overcast, dim sky. Golfers tend to gain the largest benefit from green tinted lenses.

A wide range of specialized tints for specific indoor and outdoor sports are available. These lenses can improve visibility and contrast in a diversity of environments. Ask your eye doctor or optician for more information about which lenses can help raise your scores.

Don’t Let Light Get in the Way

Reflective surfaces, such as a flat body of water, a sandy beach or even light-colored pavement, can disturb your vision with glare. Polarized sunglasses are one effective way to resolve this problem.

Another glare reducer is to add and anti-glare (AG) component to your lenses. At night, sports eyewear with anti-glare will diminish lens reflections when playing under bright lights or spotlights. It’s a good idea to apply anti-glare to the back surface of sport sunglasses in order to decrease the glare that bounces into your eyesight when sunlight hits the back of your lenses.

You can control the light that enters your eye by wearing photochromic lenses. These clear lenses transition automatically into dark lenses upon exposure to UV rays. They also offer 100% UV protection, and return quickly to their former clear state when you go indoors.

Contacts Provide Comfortable and Convenient Vision

Many advantages come along with wearing contact lenses for sports, even if you normally wear eyeglasses on a daily basis:

  • Unobstructed peripheral vision
  • Natural-appearing vision, with no changes in image sizes
  • No fogging lenses
  • Non-slip when perspiring

The best contact lens choice for sports is soft one-day disposables. There’s no need to clean them and you can toss them in the garbage at the end of the day. The flexible, oxygen-permeable material of one-day soft lenses also requires very little adaptation. They can be inserted easily and worn comfortably for a full day of physical activity.

Although contact lenses offer high convenience and comfort, there are still a number of disadvantages with wearing contacts for sports. No protection against eye injury is provided and they don’t offer sufficient UV protection. For ultimate performance and safety, you need to wear quality protective eyewear or sunglasses over your lenses.

Styes

A stye (known by eye doctors as a hordeolum) is an infection of an oil gland which forms a pimple-like bump on the base of the eyelid or within the eyelid itself.  Sytes can be uncomfortable, causing swelling, pain, redness, discomfort, and sometimes excessive tearing. If the stye is large and it distorts the front surface of the eyes, it can cause blurred vision.

What causes a stye?

The oil glands on the eyelid sometimes become blocked with dirt, dead skin, or a buildup of oil.   When this occurs, bacteria can grow inside. Blockage is also commonly from eye cosmetics that block the orifices within the lid. This blockage causes the gland to become infected and inflamed, resulting in a stye.  A stye can form on the inside or the outside of the eyelid and can cause swelling around the eye, sometimes affecting the entire eyelid.

Treating a stye

Styes are treated with antibiotics, often in moderate and severe cases with a prescription for oral antibiotics to reduce the bacteria responsible for the infection. Treatment for a stye is recommended otherwise there is a likelihood of recurrence. Applying a hot compress to the eye for 10-15 minutes a few times throughout the day will bring some relief and speed up the healing process.

Similar to a pimple, the stye will likely rupture, drain and heal on its own. Occasionally a stye, especially one on the inside of the eyelid will not resolve itself and may require the assistance of an eye doctor for additional treatment. In such a case the stye is surgically opened and drained to reduce the swelling and cosmetic issues associated with the style.

You should never pop a stye! This can cause the bacteria to spread and worsen the infection.  The infection can then spread around the top and bottom eyelids and even reach the brain. If a stye is getting worse, painful, or irritated, contact your eye doctor for treatment.

In cases where styes occur frequently, your eye doctor may decide to prescribe topical antibiotic ointment or a cleansing regimen to prevent recurrence.

Chalazia: Another type of bump on the eyelid

Similar to a stye, a chalazion is a blocked oil gland on the eyelid that becomes enlarged. The main difference between a chalazion and stye isl TSO 1463 that the chalazion is usually non-infectious.  A chalazion in most occasions is an old hordeolum that did not resolve. Treatment involves lid hygiene, warm compresses, and lid massage.  In most cases, a chalazion requires surgical removal.

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Astigmatism

Many people have never heard of astigmatism, although it is an extremely common eye condition.

Astigmatism is one type of refractive error. Nearsightedness and farsightedness are other types of refractive error. Refractive errors are not eye diseases. Refractive error is a result of and imperfection of the size and shape of the eye, which results in blurry or double vision.

If left untreated, astigmatism may cause eyestrain, headaches, and blurry vision. If you have astigmatism you may not see objects in the distance or near without some form of distortion.

Symptoms of Astigmatism

Small amounts of astigmatism can go unnoticed, however, you may be suffering from eye fatigue, eyestrain, and headaches.

Astigmatism is a condition that usually can develops early in childhood. According to a study from The Ohio State University School of Optometry, 28% of school age children suffer from astigmatism.  Parents should be aware that their children might not notice that their vision is blurry, not understanding that this is not normal.  Nevertheless, astigmatism should be treated because vision problems can lead to learning problems and in extracurricular activities.  Make sure to have your child’s eyes examined at an eye doctor’s office at least once a year.

Causes of Astigmatism

Astigmatism is generally caused by a cornea with an irregular shape. The cornea is the front, clear layer of the eye.  With astigmatism, the cornea is not round and spherical and is instead irregular having two curves instead of one curve.  Astigmatism in some cases could also be caused by the lens located inside the eye that is irregular in shape.

Eyes with astigmatism distort the light that comes into the eyes because the cornea is irregularly shaped. This causes the light rays entering the eye to create two images in the back of the eye (because of the two curves), instead of one image. This is what causes the distortion in sight.

Treatments for Astigmatism

For most people, their astigmatism is fully corrected using prescription glasses or contact lenses. If you select contact lenses to correct your vision, soft contact lenses are the most common option. If for whatever reason soft contact lenses are not an option, rigid gas permeable (RGP or GP) are also a great choice.  Rigid gas permeable lenses usually give the clearest vision but the adaptation process will be significantly longer.  Another option are hybrid contact lenses. These contacts have a center made from a rigid gas permeable (RGP) lens and an outer ring made of soft contact lens material. This type of lens provides both excellent clarity and comfort.  LASIK could be another option to correct astigmatism.  LASIK usually only corrects low levels of astigmatism and some patients with higher levels of astigmatism might not be candidates.

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Eye Exams for Contact Lenses

Contact lenses are a great alternative to wearing eyeglasses. An often unknown fact is that not all patients wear contact lenses as their primary source of vision correction. Each patient is different, with some patients wearing contact lenses only on weekends, special occasions or just for sports. That is the beauty of contact lens wear, the flexibility it gives each individual patient and their lifestyle.

If you decide to opt for contact lens wear, it is very important that the lenses fit properly and comfortably and that you understand contact lens safety and hygiene. A contact lens exam will include both a comprehensive eye exam to check your overall eye health, your general vision prescription and then a contact lens consultation and measurement to determine the proper lens fit.

The Importance of a Comprehensive Eye Exam

Whether or not you have vision problems, it is important to have your eyes checked regularly to ensure they are healthy and that there are no signs of a developing eye condition. A comprehensive eye exam will check the general health of your eyes as well as the quality of your vision. During this exam the eye doctor will determine your prescription for eyeglasses, however this prescription alone is not sufficient for contact lenses. The doctor may also check for any eye health issues that could interfere with the comfort and success of contact lens wear.

The Contact Lens Consultation

The contact lens industry is always developing new innovations to make contacts more comfortable, convenient and accessible. Therefore, one of the initial steps in a contact lens consultation is to discuss with your eye doctor some lifestyle and health considerations that could impact the type of contacts that suit you best.

Some of the options to consider are whether you would prefer daily disposables or monthly disposable lenses, as well as soft versus rigid gas permeable (GP) lenses. If you have any particular eye conditions, such as astigmatism or dry eye syndrome, your eye doctor might have specific recommendations for the right type or brand for your optimal comfort and vision needs.

Now is the time to tell your eye doctor if you would like to consider colored contact lenses as well. If you are over 40 and experience problems seeing small print, for which you need bifocals to see close objects, your eye doctor may recommend multifocal lenses or a combination of multifocal and monovision lenses to correct your unique vision needs.

Contact Lens Fitting

One size does not fit all when it comes to contact lenses. Your eye doctor will need to take some measurements to properly fit your contact lenses. Contact lenses that do not fit properly could cause discomfort, blurry vision or even damage the eye. Here are some of the measurements your eye doctor will take for a contact lens fitting:

Corneal Curvature

In order to assure that the fitting curve of the lens properly fits the curve of your eye, your doctor will measure the curvature of the cornea or front surface of the eye. The curvature is measured with an instrument called a keratometer to determine the appropriate curve for your contact lenses. If you have astigmatism, the curvature of your cornea is not perfectly round and therefore a “toric” lens, which is designed specifically for an eye with astigmatism, would be fit to provide the best vision and lens fit. In certain cases your eye doctor may decide to measure your cornea in greater detail with a mapping of the corneal surface called corneal topography.

Pupil or Iris Size

Your eye doctor may measure the size of your pupil or your iris (the colored area of your eye) with an instrument called a biomicroscope or slit lamp or manually with a ruler or card. This measurement is especially important if you are considering specialized lenses such as Gas Permeable (GP) contacts.

Tear Film Evaluation

One of the most common problems affecting contact lens wear is dry eyes. If the lenses are not kept adequately hydrated and moist, they will become uncomfortable and your eyes will feel dry, irritated and itchy. Particularly if you have dry eye syndrome, your doctor will want to make sure that you have a sufficient tear film to keep the lenses moist and comfortable, otherwise, contact lenses may not be a suitable vision option.

A tear film evaluation is performed by the doctor by putting a drop of liquid dye on your eye and then viewing your tears with a slit lamp or by placing a special strip of paper under the lid to absorb the tears to see how much moisture is produced. If your tear film is weak, your eye doctor may recommend certain types of contact lenses that are more successful in maintaining moisture.

Contact Lens Trial and Prescription

After deciding which pair of lenses could work best with your eyes, the eye doctor may have you try on a pair of lenses to confirm the fit and comfort before finalizing and ordering your lenses. The doctor or assistant would insert the lenses and keep them in for 15-20 minutes before the doctor exams the fit, movement and tearing in your eye. If after the fitting, the lenses appear to be a good fit, your eye doctor will order the lenses for you. Your eye doctor will also provide care and hygiene instructions including how to insert and remove your lenses, how long to wear them and how to store them if relevant.

Follow-up

Your eye doctor may request that you schedule a follow-up appointment to check that your contact lenses are fitting properly and that your eyes are adjusting properly. If you are experiencing discomfort or dryness in your eyes you should visit your eye doctor as soon as possible. Your eye doctor may decide to try a different lens, a different contact lens disinfecting solution or to try an adjustment in your wearing schedule.

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Signs & Symptoms

Cataracts don’t suddenly develop overnight. They generally start off small and only begin to noticeably affect your vision as they grow.  The first symptom is usually that your vision becomes blurred, hazy or cloudy.  Additionally, you may become sensitive to light, making sunlight, oncoming headlights or indoor lighting appear exceptionally glaring or bright. Colors may seem dim and you may notice halos around lights or double vision.

The symptoms people experience from cataracts may vary. Some individuals even report a temporary improvement in near vision when a cataract first develops, a phenomenon known as “second sight”.

Here is a list of possible signs and symptoms of developing cataracts:

  • Blurry or cloudy vision (that can’t be corrected with a change in eyeglass prescription)
  • Glare from lamps, sunlight, oncoming traffic when driving at night or indoor lighting
  • Colors appear dim and less vibrant
  • Halos around lights
  • Double vision
  • Poor night vision
  • Sudden improvement in near vision

If you experience any change in your vision, visit your eye doctor immediately.

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Shooting Glasses and Hunting Eyewear

Firearms can be dangerous, and all have some recoil. In addition most shooting occurs outside, where elements such as dust, wind, sun, trees and vegetation can potentially harm eyes. Therefore it’s very important to use eye protection at all times when engaged in shooting activities, indoors and outside.

Generally, sports goggles that you can buy without prescription usually protect your eyes if you wear contacts or don’t need glasses. These goggles usually wrap around your eyes to form a shield against the elements. Make sure to buy goggles with lenses made of polycarbonate, which is the best and strongest lens material available.

Features of Shooting Glasses

Glasses for shooters are specially designed and have several important features. These glasses have more features that the general aviator- shaped frames that are popular. The most important feature is that the frame has a safety rating. Don’t buy any shooting glasses that don’t have such a rating. All of these models have a strong rim which holds the lenses in place. Some glasses have a “sweat bar” that goes along the width of the frame which creates stability for the frame to stay on the face. Other models use padding on the frame around the eyes, which cushions the frame on your face. This protects your face from gun recoil. Additionally, it adds to the protection against the elements.

Glasses for shooting often have temples with spring hinges. This type of hinge allows the frame to move without breaking. Many glasses often include temples that wrap around your ear which helps keep the frame in the correct position on your face. Features that make the frames more comfortable often include soft silicon pads around the nose, which also help to keep the frame in place. Frames may be made out of several different types of materials, including various metals and titanium, plastic and polycarbonate.

Lenses for Shooting Glasses

Shooters have chosen polycarbonate lenses with UV protection and a scratch-resistant coating as their lens of choice for years. Polycarbonate lenses are extremely resistant to impact, and also give a lot of “bounce back” and “blow back” protection. However, there are newer materials for lenses that have been developed recently that are also excellent choices for shooters.

Non-prescription shooting glasses often come with interchangeable lenses. These lenses are used when facing varied conditions of light. If you need prescription lenses, you can order your lenses in various colors of your choice. Shooters often enjoy using orange or yellow colored lenses. These colors of lenses block blue light as well as haze. They also provide a more vivid hue of orange, which is often the color of the target. Bright yellow lenses are good for using in low light, or foggy weather conditions.

A light purple lens is particularly good for seeing an orange target when the background is green trees. Purple lenses are made from a mixture of vermillion and gray. Some shooters like vermilion, because this color helps see where there is a natural outdoor background, and helps the target to stand out. If you prefer a neutral or natural color, gray is the color of choice. A gray lens allows you to see all colors naturally, and are good for using in strong sunshine.

Polarized lenses are available in most colors. Polarized lenses are good for use in the outdoors, as they reduce glare. This is particularly helpful when shooting near water.

Retinitis Pigmentosa

Retinitis pigmentosa (RP) is an eye disease that is inherited, and very rare. About one in four thousand Americans are affected by this disease. The retina, which is the light-sensitive portion of the eye, degenerates progressively over time. The result of this degeneration is the loss of peripheral vision, loss of central vision, night blindness, and sometimes blindness.

Retinitis Pigmentosa Symptoms

Childhood is when the first symptoms of retinitis pigmentosa generally appear. Usually both eyes are implicated in the disease. Sometimes RP doesn’t appear until older age, at age 30 or even older.

The main symptom of  RP in the beginning stages is night blindness. Tunnel vision may develop in the later stages of the disease, where central vision is affected, and only a small portion of sight is available.

One study of patients suffering from RP revealed that, in patients 45 years and older, 52% had at least 20/40 central vision in one eye, 25% had 20/200 vision or below, and 0.5% were completely blind.

Causes of Retinitis Pigmentosa

Very little is known about the causes behind RP, beyond that it is an inherited disease. Scientists believe that defective molecules in our genes cause RP. This explains why the disease affects patients so differently.

If one parent carries the defective gene, it’s possible to get RP, even if your parents do not have the disease. Approximately one percent of the population are carriers of the RP recessive gene. Sometimes this recessive gene is passed on to the child, who will then develop retinitis pigmentosa.

RP affects the retina in the eye. The disease causes the light-sensitive cells that are located in the retina to die gradually. Most often, the cells that are used for night and peripheral vision, called rod cells, are affected. Sometimes the cells that are used to see color and for central vision, called cones, are also affected.

Diagnosis and Treatment

The main diagnostic tool employed is visual field testing. This test determines how much peripheral vision loss has occurred. Other diagnostic tools may be used to test night vision and color vision.

Few treatments exist for RP. What is available helps conditions associated with RP, not the disease itself. For patients older than 25, there is a prosthesis system that was recently approved. This system captures images via glasses, and transmits the signal captures to an implanted device located on the retina.

Most treatments center around helping the patient learn to deal with their vision loss. Psychological counseling, and occupational therapy, may be recommended. Technological instruments that help with low vision, such as illuminated magnifiers, can help patients with RP see as well as possible with their limited vision. Some doctors recommend vitamin A supplements as there is some evidence that vitamin A might help delay the progression of the disease.

For the future, scientists are hopeful that there will be additional treatments for RP, including new drug treatments and retinal implants.

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Amblyopia (Lazy Eye)

Amblyopia, which is also called “lazy eye”, is a disorder that affects the visual development in children. Amblyopia is difficult to correct just with the use of contact lenses, or eyeglasses. Ambylopia can cause vision loss if it is not treated early and properly. This vision disorder affects 2-3% of the population.

What are the symptoms of Amblyopia?

Usually children that are born with amblyopia, the symptoms start in early childhood. Some signs of amblyopia in children are squinting, closing one eye in order to see better, poor general vision, headaches, and eyestrain. Usually caretakers such as parents, caregivers, doctors, or nurses notice these symptoms and recommend the child for treatment.

What are the causes of Amblyopia?

Strabismus is usually the cause of amblyopia. Strabismus is the eyes aligning incorrectly. Amblyopia can also be caused when there is a large difference between the eyes in refractive errors (prescription much higher in one eye than the other). For example, one eye is nearsighted, while the other is farsighted. If amblyopia is not treated, the brain will learn to disregard the vision in the eye with amblyopia. The eye that is disregarded does not grow with clear image and vision loss can be permanent.  This is why it is very important to get early treatment and take your child to see your eye doctor if any signs are apparent.

How is Amblyopia treated?

There are several treatments for amblyopia, depending on the cause. Often children are treated using vision therapy, which usually includes a patch on the better eye. Other treatments are atropine eye drops, correct prescription eyeglasses, or surgery.

Vision Therapy

Vision therapy consists of eye exercises, which aim to teach the eyes to work together. In cases of amblyopia, the exercises require the brain to recognize the affected eye, which restores vision in that eye. Some doctors place a patch over the more functional eye, which forces the less functional eye to work harder and become stronger. The patch is generally worn for a few hours a day.  Depending on the severity of the condition, treatment can last for weeks or months. Some children refuse to wear a patch, in those cases, a prosthetic contact lens is available. These contact lenses look like the regular eye, and are designed to block vision in that eye.

Atropine drops

Some doctors use atropine eye drops to treat amblyopia. These drops blur vision in the child’s better eye, forcing the weaker eye to work harder and get stronger. In the morning, one drop is instilled under eye doctor’s instructions. The advantage to this method of treatment is that the patch is avoided.

Prescription eyeglasses

If your child has developed amblyopia because of uncorrected vision, sometimes all that is needed is a pair of eyeglasses. When there is strong uncorrected prescription, or when there is a large difference in prescription between the two eyes, sometimes amblyopia can result. Your eye doctor may recommend eye patch therapy in addition to corrective lenses.

Surgery

Strabismus surgery is usually required if the amblyopia is due to a large eye turn. This type of surgery aligns the eyes and corrects the problem within the eye muscles. After the surgery the eyes will able to focus better.  Additional vision therapy may be required after strabismus surgery.

Amblyopia must be treated as early as possible as there is no chance that it will resolve by itself. Untreated amblyopia can lead to permanent vision loss in that eye and reduced depth perception. Amblyopia needs to be treated promptly so that your child can have the best vision possible in childhood and later in life. When amblyopia is diagnosed and treated before age 9, the weaker eye can often develop significantly better vision.  The most critical time to treat amblyopia is from 3 to 6 years of age.  If you or anyone sees any signs of amblyopia, go to your eye doctor to find the best treatment for your child.

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Your Comprehensive Eye Exam

Your eyes are one of the most complex organs in your body. A comprehensive eye exam to assess your visual system and eye health involves a number of different of tests. Unlike a simple vision screening, which only assesses your vision, a comprehensive eye exam includes a battery of tests in order to do a complete evaluation of the health of your eyes and your vision.

The tests that you will undergo in a comprehensive eye examination may vary from eye doctor to eye doctor but here are are some common exams that you may encounter:

Patient Background and History

One of the most important parts in a comprehensive eye exam is your patient health history. This information will alert your doctor to any conditions that should be monitored closely, such as an allergy to any medications, current or family history of systemic or eye pathology or environmental conditions that could be affecting your vision or eye health. This will also help your doctor to determine any preventative eye care measures that are relevant to keep your eyes healthy for years to come.

Visual Acuity

Visual acuity is a measurement of your vision using an eye chart, the Snellen Eye Chart. In this test the patient is seated at a standard distance and is asked to read letters or symbols of various sizes, which get smaller as you move down the chart. The results are the familiar ratio of 20/20, 20/40 etc. which is a comparison of your vision compared to the average person with good vision, which is typically 20/20. For example, a patient that has 20/40 vision, can only see at 20 feet what the normal person can see from a distance of 40 feet. This test is a preliminary test of how clearly you are seeing in each eye but it does not give you a prescription for corrective lenses.

Refraction

Those who don’t have 20/20 vision have what is referred to in most cases as a “Refractive Error.” The patient may have nearsightedness, farsightedness, astigmatism or other eye conditions that prevent the patient from seeing 20/20. A refraction will tell the doctor which prescription lenses will correct your eyesight to achieve 20/20 vision or whichever amount your vision is correctable to.

A refraction may include a couple of steps.

Retinoscopy

Retinoscopy is a test that allows the doctor to obtain an approximate prescription for eyeglasses. In this test the doctor uses a hand-held instrument called a retinoscope that shines a light into the patient’s eye. The doctor then analyzes the reflex of the light from the patient’s eye to determine the patient’s prescription for glasses.

An instrument called a phoropter is something most patients associate with an eye exam. This space age appearing instrument, positioned in front of the patient’s face during the eye exam, gives the doctor the ability to determine the patient’s focusing ability as well as their eye alignment. The phoropter also determines which, out of the hundreds and hundreds of potential eyeglass prescriptions, will help the patient see as clear as possible. Using the phoropter, the doctor will ask the patient which series of lenses makes their vision the clearest.

While retinoscopy is quite effective for children and nonverbal patients, there are now a number of computerized or automated instruments available today to help doctors accurately determine a patient’s eyeglass prescription.

Autorefractors and Aberrometers

Autorefractors and aberrometers are computerized machines that are able to measure your refractive error to determine your prescription for glasses or contact lenses. These instruments are usually used in addition to testing described earlier:

- An autorefractor is similar to retinoscopy, which electronically analyses the light reflex from the patient’s eye.

- An aberrometer measures distortions or aberrations in the cornea and lens of the eye that disrupt proper focus of light on the retina. Using wavefront technology, the instrument measures the rays of light as they pass through your eye to look for imperfections which may indicate a refractive error.

Eye Focusing and Eye Teaming Tests

During the comprehensive eye exam, your eye doctor will also want to test how your eyes function individually and together from a mechanical perspective. In order to see clearly and comfortably, your eyes need to work together as a team.

Eye Health

The final and most important aspect of a comprehensive eye exam is a check of your overall eye health. These tests (below) are done to identify any eye conditions or diseases, both inside the eye as well as the external parts of the eye, that could affect your vision and general health.

Slit Lamp Test

The slit lamp or biomicroscope is an instrument that allows the doctor to examine the internal and external parts of the eye in detail, such as the conjunctiva, iris, lens, cornea, retina and the optic nerve. The patient rests their forehead and chin on a headrest to stabilize the head, while the doctor looks into the eye with the slit lamp microscope, which is magnified with a high-intensity light. A slit lamp test enables the doctor to evaluate the eyes for signs of normal aging and eye pathology, such as conjunctivitis, cataracts, macular degeneration or retinal detachment. Early diagnosis and treatment of eye diseases are essential for preventing vision loss.

Tonometry

Tonometry is a test to detect glaucoma by measuring the pressure inside your eye or IOP (intraocular pressure). Glaucoma can cause vision loss and even blindness if the IOP in the eye is too high and damages the optic nerve.

The applanation tonometer, typically attached to a slit lamp, is one of the most common instruments used to measure the pressure in the eye. Prior to doing this test the doctor will numb the patient’s eyes using an anesthetic, before gently applanating (putting pressure on) the patient’s cornea to measure the pressure in the eye.

Pupil Dilation

During your comprehensive eye exam, your doctor may decide to do a dilated eye exam. In this test, your doctor will instill dilating drops in each eye, which would enlarge your pupils to give the doctor a better view of certain parts of the back of the eye. Dilation is done at the discretion of the doctor, with some patients dilated every year and others at specified intervals; the frequency of dilation will vary for each patient.

Typically the drops take around 20 to 30 minutes to take effect and may last up to several hours following the exam; each patient is different. Since more light enters your eyes when your pupils are dilated, you will be more sensitive to bright light, especially sunlight. Although your doctor may provide disposable sunglasses, you may want to bring a pair of sunglasses to wear after the exam to make it more comfortable until the drops wear off.

A comprehensive eye exam is an important part of your overall general health maintenance and should be scheduled on a regular basis. The findings from your comprehensive eye exam can give your doctor important information about your overall health, particularly diabetes and high blood pressure.

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Computer Vision Syndrome Q & A

According to recent studies, 60% of people spend as much as 6 hours a day in front of a digital device whether it is a computer, tablet, smartphone or other gadget. All of these devices emit blue light or high-energy visible (HEV) light, which is a known cause of computer vision syndrome, sleep disruptions and possibly other potential dangers to the eyes. Blue light radiation is also emitted from television screens, electronic devices. fluorescent and LED lighting and yes, even the sun.

What is Blue Light?

Emitted from the sun, blue light is naturally occurring in the world around us. On the spectrum of visible light (light that humans can see), blue light has the highest energy and the shortest wavelength. It is also sometimes known as blue-violet or violet light, which is where ultraviolet (UV) light rays that are just beyond our perception get their name. Much like ultraviolet light, blue light has both dangers and benefits to our health, particularly to our eyes.

What are the Potential Dangers of Blue Light?

Research is still being done to determine the long-term effects of blue light or high-energy visible (HEV) light emission, however it is known is that blue light is a cause of computer vision syndrome (CVS) and sleep disruptions.

Eye Strain

The high energy and shorter wavelengths of blue or HEV light emit a less consistent flow of light, creating a glare or flickering that can cause eye strain. Because sharpness and visual contrast are affected by this, the eyes have to work harder to see clearly. After extended periods of time this can result in headaches, blurred vision, dry eyes, and mental and physical fatigue.

Sleep Disruptions

Natural blue light in the atmosphere is known to help regulate the body’s circadian rhythm (which controls your sleep cycles), to boost your mood and level of alertness and to improve memory and cognitive function. However, prolonged exposure to artificial sources of blue light has been shown to reverse these positive effects, causing disruptions in the circadian rhythm which affects sleep, as well as an increased risk of depression. Studies show that using a digital device before bedtime can negatively impact ther amount and quality of your sleep.

Macular Degeneration

Researchers at Harvard University have shown that over time, prolonged exposure to blue light can cause damage to the retina at the back of your eye, which may lead to age-related macular degeneration (AMD) and possibly other serious health and vision problems. AMD is a leading cause of vision loss and low vision.

How Can You Protect Yourself from Blue Light Emissions?

As the dangers of blue light from digital devices emerge, more and more options are becoming available to protect your eyes. The eyes have very limited natural ability to block out blue light radiation so we need to be aware of blue light exposure and how to minimize it.

Computer glasses with blue-blocking lenses, coatings and filters are a good solution for those working on a computer for long periods of time each day. You can also add anti-glare coatings with blue light protection to your regular eyeglass and sunglass lenses. Additionally, there are filters available for devices such as computers, smartphones and tablets, to reduce the amount of blue light radiation that can reach your eyes.

The easiest way to reduce blue light exposure is to take frequent breaks when working on a computer and to reduce screen time overall.