Keep Your Eye On The Ball!

Does your son or daughter play soccer? Football? Baseball? Interestingly enough, optometrists can play an important role in their sports career! Especially if they want to continue on to the professional level, although it’s not always fun and games.

 

Former women’s U.S. soccer player, Cindy Parlow Cone’s career suddenly ended in 2006 due to a serious concussion. To this day, she still suffers from headaches, fatigue, visual and balance problems. Women’s soccer athletes are more likely to suffer from concussions and a new study seems to believe it’s due to this reason; having your eyes closed while heading the soccer ball! This study suggests that closing their eyes while going up for a header decreases the athlete’s visual awareness making the athlete more likely to collide with another athlete or having the ball hit awkwardly on his or her head.

 

On a more exciting note, optometrists can play an important role in the prevention, assessment and treatment of concussions; since they are sometimes unavoidable. When you think of vision training, you often think about athletes using it to enhance their skills. However, there could be another use for vision training and that is to protect athletes from serious head injuries. Joe Clark, a neurologist, ran a study over four years and saw a decrease of over 80 percent in concussions for the UC football team by simply putting them through regular vision training. Concussions are a major point of contention in many of today’s sports and with the help of starting vision training early, not only can optometrists help your child’s sports performance, it could help prevent serious injuries and keep them on the field!

Blog contribution by Alexis Romero, Optometry Intern, College of Optometry, Western University of Health Sciences.

Sources:

http://www.aoa.org/news/clinical-eye-care/vision-training-could-mitigate-soccer-related-concussions?sso=y

http://www.cnn.com/2015/11/12/health/cindy-parlow-cone-soccer-concussion/

http://healthnews.uc.edu/news/?/26057/

New Technology In Contacts

Who would have thought that a contact lens could be used for more than providing clear vision? In fact there are many researchers trying to take advantage of these lenses intimate relationship with the eye. One such project involves diabetes, a disease affecting almost 30 million people in the United States alone!

The current technology and procedure for monitoring diabetes is a rather invasive and primitive process. However, researchers from Oregon State University are working towards developing a bio-sensing contact lens that may advance the technique of medical care for diabetes. This lens will be able to utilize “ultra-thin transistor technology” and the biochemistry of glucose (sugar) to measure slight changes in glucose levels present in our tear film. When glucose shows up in the tears, chnages take place in the chemistry of our tears. This shift causes an electrical current to flow to a transistor in the contact lens, which can then be transmitted onto a personal device such as your iphone.

The prototype will allow diabetic patients to monitor their own blood glucose level with a simple contact lens rather than having to prick their finger every day! There is a lot of optimism and high hopes for this technology, despite the contact lens being in the very early prototype stages. Researchers want to expand the spectrum of diseases that the contact lens is able to detect to include glaucoma, renal failure, cancer and other debilitating ailments. As of right now, the researchers are hoping to be able to proceed to animal trials in the coming year.

 

http://www.diabetes.org/diabetes-basics/statistics/?loc=db-slabnav

https://futurism.com/new-bio-sensing-contact-lenses-will-utterly-transform-our-lives/

Blog contribution by Richard Nguyen Optometry Intern, College of Optometry, Western University of Health Sciences.

Yoga and Glaucoma (Say that 5 times fast)

Glaucoma is one of the leading causes of irreversible blindness because of damage to the optic nerve when fluid pressure increases in the eye. Doctors advise patients to live healthy and active lifestyles, but there are certain activities that should be avoided by glaucoma patients like pushups and lifting heavy weights due to elevated intraocular pressure (IOP). A new study has shown the potential risk associated with various yoga positions and exercises that involve inverted poses. In this research, both normal and glaucoma patients did four yoga positions. The greatest increase in pressure was found with the downward facing dog position where you place both feet and hands on the floor while looking at the ground. “The measurements were taken after the participants retuned to a seated position and again after waiting ten minutes, the pressure in most cases remained slightly elevated from the baseline.” In previous studies, participants in the headstand position showed almost two-fold rise in IOP. It is now advised to inform and educate glaucoma patients about the risks of physical exercises like yoga, so progression of glaucoma doesn’t get worse. Many times we consider a point or two of pressure increase to be a reason to prescribe additional eye drops or to recommend a glaucoma surgery. When patients go to yoga, patients should tell their instructors their disease to modify their yoga practice.

Mount Sinai Health System. (2016, January 7). Certain yoga positions may impact eye pressure in glaucoma patients. ScienceDaily. Retrieved January 20, 2016 from www.sciencedaily.com/releases/2016/01/160107105234.htm

Feeling Blue?

We all know how reliant we’ve become on our technology. We’re addicted to our cell phones, we can’t make a living without our computers, and we all want to have the most modern and up-to-date equipment. But how does this affect our health?

When I was busy playing Oregon Trail sometime in the 5th grade on my first computer, I never thought that something as seemingly harmless as the light from the screen could have such a ripple effect on our overall health. And yet according to the American Optometric Association it can not only affect our vision, but also our overall systemic health.

We spend increasingly more time glued to some sort of blue light producing technology. In fact, more than half of us in the modern world are spending more than 5 hours a day staring at a screen. With that comes an increase in eye strain. It also allows more of the free radicals associated with retinal injury to enter the eye (think about what tanning beds do to the skin). This can age our eye more quickly and may account for many of the age-related vision problems in younger patient groups. Blue light has also been associated with issues sleeping, from decreased sleep to less affective rest while sleeping. And while blue light might not have direct systemic influence, the dysfunctional sleep cycle can be linked to other issues, such as diabetes and some forms of cancer.

As health care professionals, it is important for us to be aware of the things that can not only affect the health of our patient’s eyes, but also their health overall. With that, it is important for us to do what we can to alleviate the issues as necessary, such as provide the various lenses and filters available to filter out blue light. The iPhone will even allow you set times where it will reduce the amount of blue light coming from the screen before you go to bed!

Blog contribution by Amy Pham, Optometry Intern, College of Optometry, Western University of Health Sciences.

Biotrue Multifocal Contacts Are Revolutionary

btod

For years we have had bi-focal or multi-focal soft contact lenses.  These lenses, aimed at providing both near and far vision without the use of reading glasses, often fall short of useful vision.  Problems include glare, haloing, and loss of stereo vision.  Fortunately a newly designed lens is available with 3 zone optics that place these obstacles in the past. Introducing the Bausch and Lomb Biotrue for Presbyopia contact lens. Never before have I achieved such great patient satisfaction. Last week, after being fit with the lens, a patient left saying “I cannot believe an eye examination could be so great”.

So what is the difference? There are two contributory factors. For one, the lens material is the same as the Biotrue Daily. A lens made of 80% water, it’s like placing a bag of water on the eye.  Literally you cannot even feel the lens on eye.  And this is extremely important. The feeling of a contact lens on the eye relates to how dry the surface of the lens becomes throughout the day. A dry eye will inhibit good optics through the lens and lead to blurred vision and tired eyes.  Biotrue contacts are designed to prevent loss of water.  Second, the fresh multi-focal design assures clean optics at 3 distinct zones.  In the past, contacts were focused mainly on 2 areas.  Now, distance, computer and reading vision are satisfied with Biotrue for Presbyopia’s optics.

These lenses are certainly a valuable part of my lens library.  I will say that they are lenses that require a careful examination. I study a patient’s visual demand by discussing occupation, daily routine and hobbies in detail.  Special time is set aside for each multi-focal contact lens evaluation. Additionally, these lenses require an adaptation period.  As with other advanced prescribing, I talk to patients about letting these lenses settle for the first 1 week or so.

Feel free to comment or send me your thought on using multi-focal contacts.

Makeup, Keep it Clean!

A light application of makeup can often help you to look and feel your best. Without proper care, however, it may impair your capacity to see your best.  Whether you are going for a natural look or something more dramatic, it is important to use discretion when applying around your eyes.

Keep it clean:                                   

Make sure your hands are washed before you begin.  Use only your own makeup and brushes.  It may seem fine to borrow a swipe of mascara, but even your BFF may have germs that are harmful to you.  Infections from poor hygiene or contamination may lead to itchy, swollen eyes and light sensitivity.

Do not disturb:                                   

Only apply eye makeup in a setting where you can be relaxed and focused.  Putting on makeup in a vehicle risks injury at every stop and bump during your commute.  Take your time and don’t rush; not only will you get better results, but you’ll do better to avoid poking yourself in the eye or scratching your cornea.

Contact lens wearers:                 

It is better to put in your soft contact lenses before your makeup routine.  When choosing a mascara, avoid mascara with lengthening fibers, which can scratch, and waterproof mascara, which may stain your lenses.  At the end of the day, remove your contacts, clean them, and place in fresh solution before you wash off your makeup.

It can be rewarding to use cosmetics, but safety should always be top priority.  If your makeup causes you to experience irritation or injury, discontinue use and contact your optometrist.

 

Blog contribution by Kaitlyn Sanchez, Optometry Intern, College of Optometry, Western University of Health Sciences.

 

http://www.aoa.org/patients-and-public/eye-and-vision-problems/glossary-of-eye-and-vision-conditions/conjunctivitis?sso=y

http://www.aoa.org/patients-and-public/caring-for-your-vision/contact-lenses/contact-lenses-and-cosmetics?sso=y

http://www.fda.gov/Cosmetics/ProductsIngredients/Products/ucm137241.htm

Overnight Vision Correction

Wouldn’t it be great if you could correct your eyesight and reduce your dependence on glasses or contact lenses — without having to undergo eye surgery? Orthokeratology (ortho-k) is the fitting of specially designed gas permeable (GP) contact lenses that you wear overnight. While you are asleep, the lenses gently reshape the front surface of your eye (cornea) so you can see clearly the following day after you remove the lenses when you wake up. GP contact lenses are not the same as the soft contact lenses that you may already wear; instead they are made of a firm, durable plastic that transmits oxygen.

How does an Ortho-K lens work?

The central portion of the lens fits closer to the eye than a standard contact lens exerting a gentle pressure. The outer part of the lens surrounds the central visual zone and is farther away from the cornea, allowing room for the cornea to change shape:

orthokeratology

 

Ortho-K lenses are custom made for each individual, but not everyone qualifies for this corneal refractive therapy. Two important factors that determine the candidacy for orthokeratology includes the curvature of the eye and the prescription. Your eye care practitioner will measure the exact shape of your cornea and prescribe lenses with the curvature, size, and corrective power that suit your eyes. Ortho-k is recommended for low to mild nearsightedness (-5 diopters or less).

When you begin to wear ortho-k lenses, you will likely have mild awareness of the lenses on your eyes until you fall asleep. Because the corneal reshaping effect is temporary, little risk is involved, and you can discontinue wearing the lenses at any time.

In summary:  no glasses, no daytime contacts, no surgery, 20/20 vision…no kidding!

 

Blog contribution by Eric Saidi, Optometry Intern, College of Optometry, Western University of Health Sciences.

Healing the Eye

Our eyes are exposed to a wide variety of environmental conditions such as extreme weather, work environment and wearing contact lenses.  Sometimes these conditions may be so harsh that they stress the cornea, the outermost eye structure. Occasionally a patient will present in my office with an extremely compromised cornea. Such cases sometimes need a form of an eye band-aide to properly heal.

Enter the Amniotic Membrane

Such a bandage is an amniotic membrane which is derived from the placenta of an elective c-section. Human amniotic membrane is a unique collagenous membrane derived from the innermost submucosa of the placenta. Harvested under sterile conditions from the placenta of elective C-section after a full term pregnancy in medically cleared donors. This type of tissue has been used widely in the treatment of surface ocular diseases as it aids epitheliazation, reduces inflammation and fibrosis, prevents structural damage, and is also known to have some antimicrobial properties. It is used for a wide variety of ocular surface disorders such as: corneal ulcers, chemical or thermal burns of the cornea, and persistent epithelial defects.

An example used in our office is the ProKera Ring. It is a cryopreserved, sutureless amniotic membrane clipped to a plastic ring. ProKera is placed on the eye in a similar fashion as a large contact lens. ProKera does not require an operating room and can be performed in the office. Most importantly, it is reasonably well tolerated by patients.

Blog contribution by Lilia Babakhan, Optometry Intern, College of Optometry, Western University of Health Sciences.

 

Addressing the Dress

The Dress Debate of 2015 has divided people around the world into two teams: Blue and Black versus White and Gold. However, this debate can be resolved with the knowledge that color is a visual perception, and is open to interpretation to all people. In our retinas, we have different color-sensing receptors that identify various levels of blue, red, and green. All of these different color sensors are stimulated in different amounts by light entering our eyes, and therefore, our brains interpret particular colors. However, it gets more complex, with the integration of the visual cues around The Dress that make us perceive two different color patterns. For example, if we take a color swatch from bright lighting conditions, and bring it into a shadow, our brain will perceive that color swatch as a darker color. Side-by-side, an identical color swatch can be perceived as two different colors! This is known as color constancy—a phenomenon that is responsible for causing the perceived color change based on surrounding colors and shadows. This further proves that we see the world with our brain, where the eyes are an eminent relay station, and that the brain itself is influenced by our experiences and assumptions.

Blog contribution by Anna Parfenova, Optometry Intern, College of Optometry, Western University of Health Sciences.

 

SOAP, Beyond Clean! Part 2

After attaining a good patient history, it is important for me to assess the patient’s condition objectively. This is the second part of the S.O.A.P note; subjective, objective, assessment, plan. Something that is subjective is influenced by personal feelings, tastes, and opinions. To be objective, something must be rooted out independent of these personal feelings and opinions. The patient will report the subjective details about the reason for their visit then it is my duty to further investigate. Objective signs are used to support the patient’s symptoms and ultimately, my final diagnosis. It is critical that I be able to objectively come to a conclusion without relying on the patient’s self-reported symptoms. This allows me to verify the patient’s diagnosis based on facts and clinically traceable signs.

Let’s look at the example from SOAP Part I again. The patient presented with a complaint of “my eyes are often red.” Once I ask a series of problem focused questions, I have a thorough medical history which helps me narrow down my potential diagnosis. For this example, the diagnoses are infection, allergy, and dryness. The objective signs I expect to see are different for each of these diagnoses. In the case of infection, the main difference I may expect to find is discharge. For allergy, I would expect to find swelling of various parts of the eye, papillae behind the eyelids and no pre-auricular node hardness. Finally, dryness would show decreased tear break-up time and corneal defects would be evident with staining.

As you can see, the patient can come in with subjective symptoms which are shared by multiple conditions. The objective signs however, are more unique for each condition. To make an accurate diagnosis, objective evidence is needed to clearly and accurately come to the correct diagnosis. Stay tuned for the next part of the series SOAP, Beyond Clean to learn about the assessment of the diagnosis, the “A” in SOAP.

Blog contribution by Jennifer Aslam, Optometry Intern, College of Optometry, Western University of Health Sciences.