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Conditions that have an effect on the way we see

Combating Digital Vision Syndrome

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Digital Vision Syndrome has been a popular topic in the last few years as more of our time is dedicated to viewing our many digital devices.  After long periods of use, many individuals, including myself, experience discomfort and visual problems.  

What kind of symptoms are we talking about? Eyestrain, headaches, and dry eyes to name a few of the major offenders.   The causes of Digital Vision Syndrome, however, are a little more difficult to pinpoint.  It is typically a combination of various factors such as: poor lighting, posture, blue light emitted, uncorrected visual problems.  

We take several steps to combat Digital Vision syndrome. Our first line of defense focuses on how we view our devices.  Basic ergonomics such as positioning yourself at a computer screen so that the screen is 20 to 28 inches away from your eyes and between 15 to 20 degrees below eye level. Additionally, proper room lighting is imperative.  Also make sure to take breaks by spending at least 20 seconds to look at something 20 feet away every 20 minutes of computer use.  This is called the 20-20-20 rule.  

The second line of defense focuses on blocking the harmful blue light emitted from these devices. Research has shown that certain blue light has been linked to sleep issues and has a possible link to certain eye diseases.  Special lens coatings can be added to your glasses to reduce this light. 

The third line of defense focuses on reducing the amount of eyestrain by reducing the amount of focusing work your eyes do when looking something near and the amount of tension on the eye muscles.  The newest technology in this category has been the Neurolens® released by eyeBrain Medical.  Using the Neurolens Measurement Device, eye alignment is accurately measured for all distances.  Any eye misalignment can cause the visual system to work harder which can lead individuals to experience the symptoms of Digital Vision Syndrome.  The Neurolens® is a special lens design that corrects eye misalignment. By reducing the demand on the visual system symptoms of Digital Vision Syndrome can be greatly reduced or eliminated.  

Blog contribution by Jonathan Kiriboon, Optometry Intern, College of Optometry, Western University of Health Sciences.

Sources:

Neurolenses

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Eye Motor Deficiencies:  Teaming, Focusing and Muscle Deficiencies

Clear vision is not the only important factor for comfortable vision. Equally important is when your eyes efficiently work together. This includes proper eye alignment and the ability to move the eyes smoothly together in all directions. Additionally, the tiny muscles located inside the eye must efficiently control our ”zoom” ability or near focus. Our brain, specifically our trigeminal nerve, senses when our eyes are out of alignment and compensates to help improve our focus. All of the compensation that we do can cause symptoms such as fatigue, headaches, neck pain, and discomfort in the eyes (asthenopia).

A variety of methods are used to help correct these vision-related issues. These include the standard methods of glasses or contact lenses but may also include Neurolens, prisms or over/under correcting lenses. Prisms can be prescribed in glasses that bend light and allow for comfortable vision when your eyes are not aligned normally. Over or under- correcting lenses serve to relieve or stimulate accommodation (focusing).

In the last few years we have improved our treatment of many eye misalignments. Using what is called a neurolens, we are able to better correct eye teaming issues. What is special about neurolens is its ability to correct distance ad near deviations in a single lens. This allows patients to be optimally corrected full-time. In fact, many patients respond so well that their symptoms are greatly reduced or eliminated after using the lenses for only a few weeks. If we are talking about a migraine or significant headache this can be life changing!

Vision Correction for High Prescriptions

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Implantable Collamer Lens (ICL)

What is ICL?

Implantable collamer lens implants help patients see better without glasses or contacts. Unlike traditional contact lenses that go on the surface of the eye, the ICL is positioned inside the eye between the iris and the crystalline lens. Once Implanted, the lens stays indefinitely in the eye. However, if your vision changes dramatically over time, the lens can be easily replaced or removed and hence this procedure is reversible!

Who is a good candidate?

• High Myopes

•Patients between the ages of 21-45

• Patients with little or no astigmatism

• Patients with average or thin corneal thickness who may not be Lasik or PRK candidates

• Stable refractions with less than 0.50 diopters of change in two years

• Dry eye patients

Procedure

The ICL procedure is a short 15-minute outpatient procedure. Prior to the implantation of the Visian ICL, you will receive topical anesthetic drops to minimize discomfort. The doctor then creates a micro opening to insert the lens. The lens is folded and loaded into a small cartridge and as the lens is injected, it gently unfolds in your eye.

It is a simple procedure with fast recovery and provides youwith a fast vision change. So, if you are tired of bulky eyeglasses and contacts, ICL implants may be an option for you.

Keep Your Eye On The Ball!

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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/

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.

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.

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.

 

Could going to the movies be an indicator to get your next eye exam?

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Could going to the movies be an indicator to get your next eye exam?

3da

In today’s world, 3D technology has become more popular and common in gaming systems, television, and especially movies. Most people are able to enjoy this thrilling experience through its realistic and close-up features. Nonetheless, there are some who find viewing 3D films gives them discomfort or makes them nauseated. According to the American Optometric Association (AOA), viewers who feel the 3 D’s of 3D viewing (Dizziness, Discomfort, or lack of perceived Depth perception) should get a comprehensive eye exam by an optometrists.

Studies indicate that the problem may arise from eye conditions known as amblyopia (a difference in visual strength between the two eyes) or strabismus (the misalignment of the eyes). However, one of the biggest problems with 3D is the inability to accommodate. When we look at something close, our eyes have a “near reflex”—accommodation, convergence, and miosis (pupils get smaller). Convergence occurs when an object is pointed towards your nose. The muscles that control your eyeballs work in sync by rotating them inwards. You can try this by placing your finger 6 inches away from your friends face—you’ll notice that your friend will now look cross-eyed. Accommodation occurs when you are focusing on near objects. These functions are all completely normal in the real world. In a 3D movie however, when we see objects coming towards us, we converge but don’t accommodate—thus only two of the three “near reflexes” are working normally. This inability to perform all three “near reflexes” may cause eye discomfort or headaches.

If these problems continue to persist, one of the solutions may be to get your eyes checked by an eye doctor. Not only can a strabismus or the inability to accommodate  prevent you from watching 3D movies, it can also cause difficulties in other aspects of your life.

Blog contribution by Jeffrey Dang, Optometry Intern, College of Optometry ,Western University of Health Sciences

Putting lazy eyes into the dark?

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An eye is considered lazy when vision is mildly to severely reduced. This can be due to a variety of reasons but the most common causes are high prescriptions and crossed eyes. Interestingly it is not the eye that is “lazy”, rather the brain’s vision center. In my practice I do not use the term lazy eye. Instead I use the more appropriate medical term “amblyopia” to describe the eye condition that is prevalent in 2% of the population.

Amblyopia begins early in childhood during critical developmental years. Neuron pathways are forming during this time and what our eyes see (or do not see) affects how good our vision develops. In fact the amazing thing about human neurological development is the ability of our brain to adapt and change according to environmental stimuli. Early in our lives our brain uses input from the environment to form patterns that allow it to be more efficient. Eventually, it loses plasticity and the ability to adjust to new patterns decreases significantly.  In the case of amblyopia, the brain learns to shut out input from an eye with an uncorrected prescription or crossed eye. Traditionally doctors have considered this to be a permanent reduction in vision when not corrected by age 8.

A new solution?

Researchers Kevin Duffy and Donald Mitchell of Dalhousie University recently conducted a study to return the brain back to its early development stages in an attempt to increase its flexibility. They believe this can serve to reset the brain. The study was conducted on kittens with induced amblyopia who were immersed in a pitch black room for ten days. After the ten days vision significantly improved in all subjects! The positive results of the experiments led researchers to believe the treatment may work on children and young adults with amblyopia. However, in order for this treatment to be effective subjects must be completely isolated from light for long periods of time.

The practicality of this treatment is questionable and I am not yet recommending patients to stay in a pitch dark room for an extended period of time.  I am optimistic about the possibility of a brain “reset” and look forward to further developments. I will still maintain that the key to an amblyopia treatment program is to start at an early age while the brain has great plasticity.

Written with Ian Gao, Optometry Intern, College of Optometry ,Western University of Health Sciences

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