Sunday, December 26, 2010

Do you worry about losing your vision ?



80 percent of Americans worry about losing their vision yet 86 percent of those who already have an eye disease do not get routine exams.

     A well known filmmaker, Joe Lovett was scared, really scared. Being able to see was critical to his work as a documentary filmmaker and, he thought, to his ability to live independently. But longstanding glaucoma threatened to rob him of this most important sense — the sense that more than 80 percent of Americans worry most about losing, according to a recent survey.

    Partly to assuage his fears, partly to learn how to cope if he becomes blind, and partly to alert Americans to the importance of regular eye care, Mr. Lovett, 65, decided to do what he does best. He produced a documentary called “Going Blind,” with the telling subtitle “Coming Out of the Dark About Vision Loss.”

    In addition to Mr. Lovett, the film features six people whose vision was destroyed or severely impaired by disease or injury:

Jessica Jones, an artist who lost her sight to diabetic retinopathy at age 32, but now teaches art to blind and disabled children. Emmet Teran, a schoolboy whose vision is limited by albinism, a condition he inherited from his father, and who uses comedy to help him cope with bullies.Peter D’Elia, an architect in his 80s who has continued working despite vision lost to age-related macular degeneration. Ray Korman, blinded at age 40 by an incurable eye disease called retinitis pigmentosa, whose life was turned around by a guide dog and who now promotes this aid to others. Patricia Williams, a fiercely independent woman legally blind because of glaucoma and a traumatic injury, who continues to work as a program support assistant for the Veterans Administration. Steve Baskis, a soldier blinded at age 22 by a roadside bomb in Iraq, who now lives independently and offers encouragement to others injured at war.

     Sadly, the nationwide survey (conducted Sept. 8 through 12 by Harris Interactive) showed that only a small minority of those most at risk get the yearly eye exams that could detect a vision problem and prevent, delay or even reverse its progression. Fully 86 percent of those who already have an eye disease do not get routine exams, the telephone survey of 1,004 adults revealed.

   The survey was commissioned by Lighthouse International, the world-renowned nonprofit organization in New York that seeks to prevent vision loss and treats those affected. In an interview, Lighthouse’s president, Mark G. Ackermann, emphasized that our rapidly aging population predicts a rising prevalence of sight-robbing diseases like age-related macular degeneration and diabetic retinopathy that will leave “some 61 million Americans at high risk of serious vision loss.”

                                                           The Benefits of a Checkup

   Low vision and blindness are costly problems in more ways than you might think. In addition to the occupational and social consequences of vision loss, there are serious medical costs, not the least of them from injuries due to falls. Poor vision accounts for 18 percent of broken hips.

  So, why don’t more of us get regular eye exams? For one thing, they may not be are covered by Medicare and many health insurers unless there is a eye disease found. But even those who have insurance or can pay out of pocket are often reluctant to go for regular eye exams. Fear and depression are common impediments for those at risk of vision loss, said Dr. Bruce Rosenthal, low-vision specialist at Lighthouse. Patients worry that they could become totally blind and unable to work, read or drive a car, he said.

  Yet many people fail to realize that early detection can result in vision-preserving therapy. Those at risk include people with diabetes, high blood pressure, high cholesterol or cardiovascular disease, as well as anyone who has been a smoker or has a family history of an eye disorder like macular degeneration, diabetic retinopathy or glaucoma.

   Smoking raises the risk of macular degeneration two to six times, Dr. Facchiano indicated. The eyes are truly a window to the body, and a proper eye exam can often alert physicians to a serious underlying disease like diabetes, multiple sclerosis or even a brain tumor.

                                                              Reasons Not to Wait

     Dr Facchiano OD FAAO along with the AOA recommends that all children have “a basic professional eye exam” before they start elementary school. “Being able to read the eye chart, which tests distance vision, is not enough, since most learning occurs close up,” he said. Studies indicate that “One in three  schoolchildren has a vision deficit. Learning and behavior problems can result if a child does not receive adequate vision correction.”

     Annual checkups are best done from age 20 on, and certainly by age 40, Dr. Facchiano OD FAAO said. Waiting until you have symptoms is hardly ideal. For example, glaucoma in its early stages is a silent thief of sight. It could take 10 years to cause a noticeable problem, by which time the changes are irreversible.

     For those who already have serious vision loss, the range of visual aids now available is extraordinary — and increasing almost daily. There are large-picture closed-circuit televisions, devices like the Kindle that can read books aloud, computers and readers that scan documents and read them out loud, Braille and large-print music, as well as the more familiar long canes and guide dogs.

     On Oct. 13, President Obama signed legislation requiring that every new technological advance be made accessible to people who are blind, visually impaired or deaf.

     Producing “Going Blind” helped to reassure Mr. Lovett that he will be able to cope, whatever the future holds. Meanwhile, the regular checkups and treatments he has received have slowed progression of his glaucoma, allowing him to continue his professional work and ride his bicycle along the many new bike paths in New York City.

  Dr Facchiano recommends that you start the new year out by scheduling an eye exam.

            A version of this article appeared in print on December 21, 2010, on page D2 of the New York edition.

Wednesday, December 15, 2010

What Eye Exams Detect

Most people think of eye exams as something done to detect a need for eye glasses, prescription sun glasses or contact lenses. That is one of the results of an eye exam, but that isn't what they are "for." The reason for eye exams is to check the total health of the eye. Sometimes, problems with seeing things clearly might be from eye diseases or other health issues that affect vision. Optometrists are trained at looking for health problems and will be able to detect a variety of diseases from the instruments used during an eye exam.

Here are the most common diseases caught by optometrists who practice full scope primary eye care:

Glaucoma

Macular Degeneration

Cataracts

Diabetes

High Blood Pressure

Cancer

When the doctors do a full examination, they'll be able to use all the tools available to them to make determinations if there are any underlying issues with reported vision problems. Sometimes, there won't be any reported vision problems and the diseases will be caught in an early stage that makes managing them much easier. So don't think that the only thing eye exams detect is a need for corrective lenses, they do so much more than that.

Tuesday, December 14, 2010

HD Optics

There is a marketing buzz word going around right now for contact lenses that you might be hearing about more next year and it is called "HD Optics." If you are like me and wear corrective lenses like glasses or contacts, you might notice "halo" effects or glare from lights or other bright objects. Glasses already have an option to reduce  these sometimes bothersome effects with anti-reflective coating that helps with eye strain as well. Contacts haven't been as fortunate, until now. To put it in simple terms, "HD Optics" for contact lenses is essentially like the anti-reflective option for glasses. For people who don't wear glasses or contact lenses, trying to explain how light "looks" different with a pair of corrective lenses is actually pretty tough. That is probably why the term "HD Optics" was born, to simplify things.

One of the first contact lenses to go all out with an "HD" option is Bausch + Lomb's PureVision 2 monthly disposable lens. With this heir to the original PureVision line, Bausch + Lomb is  starting to incorporate the latest technology to sharpen up images as much as possible. I pulled an image from the B+L website that does its best to simulate what it means in terms of "HD."

The face of Big Ben doesn't have any sort of funky lighting effect, which is supposed to emulate what the PureVision 2 HD will do for patients. If you want to read up more on the lens, you can check out the official webpage or talk to your optometrist.

So that is the fuss about "HD Optics." It is a way of telling people that contacts are making progress in reducing halo and glare and now, more than ever, there will be an option for everyone if they choose to wear contact lenses.

Monday, December 13, 2010

How Multifocal Contacts Work

I've said it about a thousand times, but there is a contact lens out there for everybody. When people hit the age of 40, the eyes start doing all kinds of weird things and that is around the time patients start noticing the need for bifocals and rush to their eye doctor to get it corrected. For contact lens wearers, that shift in the need for a more specialized correction meant they had to go back to glasses. Now, there are many options available that incorporate different prescription powers so that those in need of multifocal contacts have options.

How do these multifocal contact lenses work? Most people are familiar with glasses and the no-line transitions but how multifocal contacts work is slightly different. Kinda.

There are actually a few ways that multifocal contacts correct for mutliple distances. One common method used by contact lens makers is to put concentric circles in the lens that correct for different distances. The following crudely drawn diagram I found through an image search actually does a good job at showing what I am talking about



This is just one way of correcting for multiple points of focus. There are also a few other ways to correct with multifocal contact lenses that are closer in proximity to how no-line progressive lenses glasses work, just on a much smaller scale.

Now the question becomes, how does the contact move to the right area of correction. The trick is that the the eye is the one that "moves" to focus on the right part of the contact. It is such a slight focus adjustment that people will not be able to tell the eyes have "moved." That, in a nut shell, is how multifocal contacts work. Remember, your optometrist will have more information when you go in for your next contact lens fitting if you are really looking to get the fine details on how the mutlifocal contacts work.

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Tuesday, December 7, 2010

Digital Retinal Photos Are a Great Tool for Optometrists

There are many parts to an eye exam that assess the overall health of the eyes. One of the most helpful parts is the digital retinal photography. It is essentially a digital camera that has been developed to take a clear image of the back of the eye. The pictures are so detailed that not only can optometrists diagnose eye diseases such as Glaucoma, Cataracts and Macular Degeneration but they can spot signs of diabetes, high blood pressure and eye cancers. Since the resulting image is digital, it can act as a "snapshot in time" of your eye health. Each year, the optometrist will be able to look for any small changes to the health of the eye and catch any potential abnormalities at early stages.



The photos are defiantly something you don't see everyday. I've even had a few patients during the eye exam prescreening half-jokingly ask if they could have the photo as their Facebook profile picture. Kidding aside, these photos are incredibly helpful when it comes to catching eye diseases as it gives optometrists time to successfully manage and control those problems. The digital retinal photos are just one of the many aspects we look at during our eye exams, but one that is vitally important.

Monday, December 6, 2010

Medication Apps

One of the most important questions asked before any type of exam is what medications are currently being used. At that point, there are two types of patients, those who cannot remember what types of medicine they take and those that produce a tattered piece of paper from their wallet or purse listing, in impressive detail, the medications they take.

The one thing these two types of people have in common is a cell phone, often times a smart phone. There are applications to download on the phone that not only list medications taken, but also remind people when it is time to take them.

The New York Times recently did an article about a few of these applications. They test MedsLog, Medsy, MotionPHR Health Record Manager and Dosecast and give their recommendations about what apps are worth the time. Since a phone is something that a lot of people carry, the information is always accessible and easy to read.

I couldn't end this post without highlighting one app that is specifically for eye care. The Eye Chart Pro is a portable Snellen eye chart that you can show to all your friends.

Friday, December 3, 2010

Going Blind: Coming Out of the Dark About Vision Loss

If you were told that you were going blind, what would you do? One film maker, when faced with that question, decided to document the entire experience.

The director, Joseph Lovett, has worked on many TV and films in his career but now he is the subject in a documentary about helping people understand vision loss. Lovett isn't the only person highlighted, there are people suffering from eye disease, complications from diabetes and an Iraq War veteran who lost his sight during his service. These personal accounts are extremely touching as each person has dealt with the issue of losing vision in different ways that show the power of human determination.

On the official movie website, there are tons of images and video clips from the documentary that show people talking about their conditions and what vision means to them.

Find more information on the Going Blind Twitter account at @GoingBlindMovie

Thursday, December 2, 2010

5 Things to Consider Before LASIK

Laser-Assisted In Situ Keratomileusis, or LASIK for short, is the medical procedure that changes the shape of the eye so that corrective lenses aren't needed as much, or at all. Many people ask me during the pre-screening for eye exams  if they are good candidates for the operation. When I hear that, I encourage a patient to talk with our optometrists and find out if LASIK is right for them. There are a lot of factors to consider that need to be weighed and balanced before going forward with the LASIK surgery.

There are people and groups who don't need LASIK

If someone has a slight prescription, or is really young, LASIK really isn't recommended or needed in a lot of cases. Take a look at your lifestyle, age and dependence on contacts or glasses and deeply consider if it will improve your day-to-day life or if would be just "nice" to have. There are risks with undergoing LASIK and certain people might lose more than they gain.

Are there problems with the eye beyond "not seeing well?"

If you have Glaucoma, past eye traumas, eye conditions like dry eyes or a host of other problems or complications related to the eye, there are complications that could result in diminished vision or vision loss. Always go in for an eye exam and make sure that everything checks out. It is now a requirement that vision remains stable for an entire year before proceeding with LASIK.

Researching and finding the best surgeon

Is the doctor experienced with the best knowledge and latest FDA approved equipment? That is the question everyone should ask, however, many people only consider price when shopping around for LASIK, but that should only be one of the many considerations when selecting a doctor to preform the operation. Doing a little legwork and getting all the facts on LASIK centers in imperative before getting the procedure done. Your primary eye care doctor will also be able to make recommendations.

Commitment

LASIK isn't just a one time surgery that makes the need for glasses or contacts disappear. There many steps along the road to the operation and many steps that follow. People who get the LASIK done might even need to go back for touch-ups a few years down the road.

Won't solve all problems

A lot of times, people will still have to wear reading glasses after a LASIK operation. People looking to be totally free of glasses or contacts need to be aware that there still might be need for corrective lenses following the operation for things like close-up vision.

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If you want to know more information about LASIK, the FDA has a great website that covers all the bases about what to expect, what to do/not do and other bits of information that is useful for people considering the surgery.

Wednesday, December 1, 2010

Airsoft Guns and Vision Do Not Mix Well



There are quite a few ways to injure the eyes. They are such a delicate part of the body that even something seemingly minor can end up causing a lot of trouble. Then, there are some activities that beg for trouble if the proper precautions aren't taken. Like AirSoft.

AirSoft is like paintball in the sense that enthusiasts play games of tag with realistic guns, however, the ammo is plastic pellets not unlike BBs. The AirSoft guns are relatively inexpensive for basic models so it wasn't too long for a dedicated following to emerge. Without proper precautions, AirSoft can be a dangerous game of how fast can you shoot an eye out. That means that people concerned about eye care sprout new grey hairs.

Just like a Dentist would caution against eating candy and brushing your teeth after each sweet treat, Optometrists and Ophthalmologist will caution against playing this sport/hobby all together. If you do, make sure to get all the proper equipment that will have the greatest chance of keeping your eyes safe and healthy. Anything that seems to cut corners like Mesh Masks can still get debris through to the eyes and put your vision at risk.

Thanks to Dr. Ryo's Blog for the idea on covering AirSoft