Archive for year: 2015

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Biotrue Multifocal Contacts Are Revolutionary

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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!

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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

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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

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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

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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

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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.

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