Thursday, December 30, 2010

Blog title
Nintendo says that 3D gaming might be bad for kids eyes.

Monday, December 13, 2010

Computer Vision Syndrome

Friday, December 10, 2010

Give your lenses a good rub
Quality, Service and Price. Pick Two.

Tuesday, December 7, 2010

If you are a mouse this is good news. Gene tweaking appears to reverse macular degeneration in mice.

Monday, December 6, 2010

Those green lasers can cause flash blindness.

Saturday, December 4, 2010

Amblyopia can still be treated when you are older.

Friday, December 3, 2010

Putting Vodka in your eyeball is not a good eye-dea.

Thursday, December 2, 2010

Do you think people are more amenable to hearing loss or vision loss? Would you rather have dull ears or blurry vision?

Wednesday, December 1, 2010

Eye tracking can affect reading
Do you have a high deductible plan? Do you avoid the doctor because of it?

Tuesday, November 30, 2010

I guess vitamin C and E don't stop cataracts. Who wudda thunk.

Monday, November 29, 2010

Who people. Take a nap. It's not worth trying to use the side of the road to guide you in your sleep.

Saturday, November 27, 2010

Genentech can't seem to gain traction in convincing doctors to go with their expensive drug over Avastin.
Genentech can't seem to gain traction in convincing doctors to go with their expensive drug over Avastin.

Friday, November 26, 2010

Have you ever thought about when your child should get their first eye exam?

Thursday, November 25, 2010

Cheap reading glasses could be bad for your eyes. It is worth it to get prescription reading glasses.

Wednesday, November 24, 2010

Social networking may improve healthcare. What do you think?

Tuesday, November 23, 2010

Do you suffer from Smartphone Vision Syndrome?

Monday, November 22, 2010

Vitamin D may have a link to diabetic retinopathy.

Saturday, November 20, 2010

There is hope for those who's arms are getting shorter. Developments are being made with LASERs to correct presbyopia.

Friday, November 19, 2010

Itchy watery eyes
Premies should be screened and treated for retinopathy of prematurity.

Thursday, November 18, 2010

Anorexia can cause damage to the eye. It may be leading to progressive blindness.

Wednesday, November 17, 2010

Lucentis and Macugen might help diabetes in addition to macular degeneration.

Tuesday, November 16, 2010

Optometry uses advanced backwards technologically
New drug shows potential for helping patients with dry AMD. That's good news people.

Monday, November 15, 2010

The push-pull method has the potential to help out with amblyopia (lazy eye).
Good news. Early treatment of diabetes works.

Sunday, November 14, 2010

Haven't heard of "poppers" before but it appears they can cause eye damage. If you need a drug, stick with imagination

Saturday, November 13, 2010

Be careful. Don't buy your contacts on the street. A proper exam and fitting is cheaper than an eye infection.

Friday, November 12, 2010

YAG laser is awesome
Our pizza promotion has got some new fancy cards. If you need some referral cards come on in and get em. The offers good till end Nov.
What do you think about stem cells? They are now being injected into humans.

Thursday, November 11, 2010

OK, good news. New treatments for macular degeneration does not appear to increase risk of heart problems.

Wednesday, November 10, 2010

Do you buy glasses online?
Advances in treatments help people with eye disease. Look out blindness, here we come.

Tuesday, November 9, 2010

Infantsee does it's part to raise awareness about infant eye exams.
Deaf people gain super vision.

Monday, November 8, 2010

Check this out. An implantable lens fixed this guys farsightedness.
Check this out. An implantable lens fixed this guys farsightedness.

Sunday, November 7, 2010

Video game therapy may help with amblyopia in adults. My mom wasn't right about everything.

Saturday, November 6, 2010

What can 3D movies do for you? Give you a headache.

Friday, November 5, 2010

It costs a lot to be overweight.

Thursday, November 4, 2010

90% of consumers are aware that ultraviolet radiation (UVR) may damage our skin, but less than 10% know that it may damage our eyes

Wednesday, November 3, 2010

In dawn of 'universal' healthcare a record number of people are without health insurance.

Tuesday, November 2, 2010

News and Information
Does your doctor go to work when he is sick?

Monday, November 1, 2010

Do you use your insurance benefits?
Oral antivirals can help prevent recurrence of eye disease due to herpes simplex.

Friday, October 29, 2010

Kids see the world differently than adults.
Contact lenses are a medical device

Thursday, October 28, 2010

Stem cell research being conducted to investigate treatments for diabetic retinopathy.
Doesn't the world have enough diabetics already?

Wednesday, October 27, 2010

Variation in the Myopia gene.

Monday, October 25, 2010

Genes found for eye disease down under.

Saturday, October 23, 2010

Implantable telescope may help with macular degeneration.

Friday, October 22, 2010

When the newspaper gets blurry do you go to the dollar store or to your optometrist?
Success according to Steve Martin.

Wednesday, October 20, 2010

Be flexible in your spending.
Did you know you only have two eyes? It is less risky to neglect your annual finger exam than it is to neglect your yearly eye exam.

Tuesday, October 19, 2010

How can instantly improve vision NOT be at the top of your todo list? --Brian Regan
Use it or lose it

Monday, October 18, 2010

Is it OK for me to use your first name or do you still like Mr and Ms?
Welcome to the new blog
Optometrists can treat eye disease too.

Sunday, October 17, 2010

Fourth reason for an eye exam? Gettin with the times. Fashion changes rapidly and those 5 year old glasses aren't in fashion anymore.

Saturday, October 16, 2010

Third reason to get an eye exam? -- Vision Development. Your kids may have eye troubles and not know how to tell you.

Friday, October 15, 2010

Number two reason for an eye exam? -- You could have an eye disease and not know it.

Thursday, October 14, 2010

Scabble skills: FOVEA -- the central area of vision. This is an area to watch in senior years when risk of macular degeneration is higher.

Wednesday, October 13, 2010

Should you update your glasses prescription.
Number one reason for an eye exam? -- You can't see stuff.

Tuesday, October 12, 2010

Scrabble skills: ESOTROPIA -- When the eye is turned in. (crossed eyes)
Where do they come from?

Monday, October 11, 2010

How to over deliver

Sunday, October 10, 2010

We can do medical

My wife was talking to a friend today. She was talking about her eyes and some of the homeopathic things that can be done to help sight. I won't talk about the "don't wear sunglasses" mantra in this post. What has me riled up at the moment is that she said that she had to see an ophthalmologist because she has keratoconus. Since when?

Maybe a years ago an ophthalmologist was the best option for managing keratoconus but not today. I own a topographer and a system for creating custom computer designed contact lenses. They are the most well fit, versatile contacts around. I have a full education on keratoconus, its progression and management. No, you don't have to go to an ophthalmologist. I can provide the same treatment.

Now, there is a difference between an ophthalmologist and an optometrist. I don't do major surgery. The gap between the two professions was larger in the past but changes to education and law have made those differences much smaller.

So why wait in an ophthalmologists office for an hour, fill out a five page intake form, be worked up by a college student and see the doctor for five minutes when you can come to me? No waiting for your turn to go back, no paperwork to fill out, personal contact with the doctor and trained staff.

I love the ophthalmologists in town. They are all qualified surgeons and excellent physicians but don't think that they handle all medical issues, they don't. When you have eye problems call your optometrist first. Then, if specialty care is needed then we will send you to the appropriate specialist.

Tuesday, August 10, 2010

Monovision Ortho-K is OK.

I had a recent patient who underwent monovision ortho-k. That is, we corrected one eye for the distance and another for near. This was a good option for her because she is losing near vision and didn't want contacts. LASIK wasn't the best option either because monovision LASIK is permanent and she is in a transition phase (emerging presbyope). Monovision ortho-k allows her to see distance and near and because it is adjustable we can change the Rx as she loses more of her focusing ability.

From her experience she explained that the first few days were OK but the longer she had the lenses the more stable and clear her vision was. There was almost no adaptation period for dealing with monovision (using only one eye for a specific distance). It was a good experience and I'm looking forward to doing more of those in the future.

Wednesday, August 4, 2010

Sunglasses banned from campus.

My son is off to school for the first time. We are sending him to a charter school. That means a strict dress code. For the most part this is good exept for one clause. Sunglasses are banned from campus.

I can see what the administrators are trying to do: creat equity. However, they are missing a health issue by banning sunwear from campus. About 80% of a person's lifetime of exposure to the sun occurs in childhood. Ultraviolet exposure increases risk of cataracts and macular degeneration.

A better choice would be to Protect the student's health by allowing even mandating sunglasses for the students.
There are plenty of kids sunglasses to chose from.

Wednesday, July 28, 2010

Computers change the way we see.

Here is a short video on how we use computers and the effects that they can have on vision. For instance 11-18 year olds spend an average of 1.5  hours per day texting. Check out the video and learn more about our vision and computers. Eye strain from computers is something you don't have to fuss with. There are great solutions from Essilor and others that can help with eyestrain caused from extended computer use. They can be good considerations if you spend more than 2 hours per day in front of the computer.

Wednesday, July 21, 2010

So, ortho-k or corneal molding

I think I have come to the conclusion that ortho-k or corneal molding would be two of the best names for orthokeratology. Ortho-k has some draw for me because of the exponential number of websites that use the term over corneal molding. A search for corneal molding yielded just over 7,000 results whereas a search for ortho-k brought back over 1.7 million. This is even more than a search for the full, classic term, orthokeratology. I suppose one might consider corneal molding to be a smaller ocean to put your water in and I might get higher results by going that way but there might be benefits too by going with the crowd. What do you think?

Tuesday, July 20, 2010

What to name orthokeratology?

I am debating about what to call orthokeratology. There are many names
I could give it. Most recently I have simply called it
orthokeratology. I figured it was the most universal reference to the
procedure and easiest to use while researching what it is and what it
can do.

Unfortunately, I think that the name is too much of a mouthful for
most people and it doesn't sound appealing. So, I want to make it more
chic, more attractive. (Instead of calling it International Business
Machines they went chick by calling themselves IBM.) So, what has
worked for you? Do you think using Corneal Refractive Therapy, as suggested by
Dr. Legerton in a recent Optometry News, or something else to make it
easy to understand and attractive?

Wednesday, July 14, 2010

Vision Training can help you in sports.

Vision Therapy, when known, is most often referred to in reference to children and problems in school. This video, from a crossfit conference, shows that vision therapy or vision training has application in sports and fitness. Training your eyes to focus better, to perceive better and increase your physical performance overall. Your eyes process a large portion of the overall input that you receive from the outside world and maximizing your visual fitness can aid you in responding to the world more effectively. Check out  this clip on how some crossfit trainees learned how vision training can help them.

Monday, July 12, 2010

More at risk for glaucoma

Dennis Thompson, a Healthday reporter,  indicated that the number of people at risk for Glaucoma is increasing. An increase in demographics such as elderly and Hispanics increases the risk for Glaucoma because of the higher propensity for these groups to develop Glaucoma. If  you have any of the risk factors such as age, Black or Hispanic, diabetic or hypertension be sure to get your eyes examined for Glaucoma every year. This disease is blinding and irreversible but can be well controlled if discovered early.

Saturday, July 10, 2010

We want to know.

I'm excited for a new initiative that we are working on. I want to know how you feel about Clear View and want to get detailed feedback. So, be prepared, if you get a call from us you have been selected for an important task. We want to know, in depth what your experience was like with Clear View Eye Care.

Did we take care of your needs? Did we listen to your vision complaints? Did we get you the glasses that you have always dreamed about? Did you leave with a smile on your face and a desire to share the experience with your friends?

For those who participate we will be offering $50 in store credit as a thank you for your time and feedback. Thank you to everyone who has come to our office for vision care. We hope that you have had the best experience and hope to continue to deliver. We also want to know what you think needs improved to make this the ideal place for all your vision needs.

Thursday, July 8, 2010

What is important for success?

I had another call with a consultant this morning. It was supposed to be a practice analysis including some advice on what we can do to make the practice better. After an hour and a half I was still curious what the most important key for success in an optometric practice. If I were to glean any tidbits from the phone call I would say it is caring.

When a patient comes into the office they want to be cared for. They trust us to give them the best in vision care. If I care for them and their eyes like they were part of my family then I think that is the gold standard in optometry. Some people may have concerns about money, potential disease or scratched glasses. If I am treating them like I would my own kin then they will get the very best. They get the best because I care.

Tuesday, July 6, 2010

Adding value to eye care

I have been racking my brain this weekend about adding value. I was contacted recently by a practice consulting group. One of their requests was to watch a video. On this video they outlined a simple concept: more outflow equals more inflow. In my interpretation this means adding value. When someone comes in for an eye exam, glasses, or corneal molding adding value means they get much more than the basic good or service. It doesn't have to cost money but it adds to the experience to the value of what the patient has come in the office for.

I've done a little brainstorming on what might add value when coming in to Clear View Eye Care. Have a look at the list. If you have some additional ideas let me know in the comments.

  1. A phone call after dispensing glasses to see how they are making out.
  2. Birthday emails.
  3. A Happy Thanksgiving card.
  4. A lens cloth and case to go with your glasses.
  5. Warranty on frames and lenses.
  6. A contact lens case and solution at six months after exam just to say thanks.
  7. A blog, like this, to keep patients informed and make comments.
  8. A Facebook page that makes me easily accessible for questions and comments.
  9. Rewards for patient referrals.
  10. Discounts for your family and friends when you bring them into the office.
  11. A smile and handshake when you come into the office.
  12. Discounts for other business just for coming in.
What do you think? Are there other ways to add value when coming in to the eye doctor? What is of value to you when you come in to visit. Let me know in the comments.

Monday, June 28, 2010

Does new equipment impress you?

There are so many pieces of equipment these days in the eye care field. The Vision West Expo rents out hundred of booths to vendors. Many of these vendors are touting diagnostic equipment. The question I have is this: Does it impress you? I'm not talking about the doctors, any doctor who has purchased a piece of diagnostic equipment has felt impressed by what it can do. In some cases we get outright giddy over being able to see the retina with super detail or analyze a visual field in ninety seconds but I am sure that you, the patient just wants to know what it means to you and your vision.

But does it impress you? When you see a giant white machine that sounds like an aircraft carrier taking off does it make you think, "Wow, I this thing is so neat! My doctor has the greatest diagnostic equipment in the world. He can take care of my eyes because he took this picture of my eye?"

My thought is that in some cases the answer is yes. In other cases it depends on the doctor and how the instrument is explained. If it is done in your language, "What does this mean to me and my vision?" rather than too much focus on spectral domain and the nerve fiber layer then it can give a good impression.

So, let me know what you think. Does the equipment impress you or does it make us look like we are compensating for something else?

Tuesday, June 15, 2010

Sunglasses that are responsive.

I came across an interesting new product today, responsive sunglasses. This is a little different than Transitions. They are in fact branded by Transitions but it ads a twist. Instead of going clear inside they remain tinted. Thus, these glasses are intended to be used as an outdoor pair. However, unlike a regular sunglass, which is the same in all light conditions, these will adjust to the brightness of the light.

This makes the sunglasses far more functional. They now give enough light to work well in cloudy conditions and get dark enough to cut out the glare in bright conditions. I was amazed to learn about this and think it is a great idea. If that doesn't make it good enough, the lenses are polarized too.

They have a great website that you can check out. It includes demos and shows applications of the SolFX lens. Transitions

Thursday, June 3, 2010

When a deductible is evil.

I had a patient come into the office recently who is at risk for glaucoma. She has a grandmother with glaucoma and when I look at her eyes she has signs on her optic nerve that indicate risk for glaucoma. So, when I finish the exam I take some time to explain to her the need for a GDx, a laser scan that will help determine if there are changes to her nerve fiber layer. The response I get is that she doesn't want to do anything that costs money because she hasn't met her deductible.

The risks involved are explained and the need for close follow up outlined. Glaucoma causes blindness, there are often no symptoms involved and any vision damage is reversible. Her response was that she would come in if she got sick and met her $2500 deductible. Glaucoma is sickness.

Why would someone take the risk. There are some medical decisions that a person can take that are reversible but damage from glaucoma is not. The best approach to glaucoma is to catch it early and watch it close to prevent vision loss. As one of the leading causes of blindness it should not be taken lightly, especially if the reason for observing glaucoma is a high deductible.

I hope for those listening that you will consider the advice of your doctor. If you can't afford custom rims on your new car, fine you can put off something like that. If your doctor tells you to get a test cause you could go blind don't be a penny pincher.

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Saturday, May 29, 2010

Is social media overhyped?

I was talking to a marketing consultant today and asked him what he though of social media marketing. He said that it had its place but he thought that it was over hyped. I wasn't sure what to think of this statement. In some ways I agree with him. It takes time and effort to be a part of social media. It's as simple as setting up a Facebook page and becoming famous online.

Social media takes time and interaction. Just like face to face marketing, social media marketing requires interaction. Attending the local chamber of commerce is OK but to get the most out of your membership you must interact with others. Social media is much the same it is a networking group, in a sense. Simply having a presence is only part of the equation. Interaction with others is what makes social media work.

Online networking has the advantage over "brick and mortar" networking in that time and space are less of an issue. You can meet and interact with people at any time of the day, anywhere. You can meet people that you would not have the opportunity for otherwise.

So, is social media marketing over hyped? Maybe, if you think that it is a passive marketing strategy then yes. If you look at it like a new portal to other people and ideas and are willing to interact then I think it can be a valuable tool.

Friday, May 21, 2010

Introducing online optical

Clear View Eye Care is proud to introduce our very own online optical. We had a start in selling sunglasses with shopify and now have expanded that to a full service, huge selection optical. This website features thousands of glasses, sunglasses and contacts to choose from. It also features a virtual try on system to see if you like the way they look on your own face. We will continue to have our brick and mortar store to offer you personalized service, hands on fittings and expert advice. But, if you want to shop for glasses in your pajamas then our online optical is a great place to go.

Friday, May 7, 2010

You get what you pay for

There are a number of ads I've seen on TV. It is for ultra low prices glasses and exams. This seems very inviting. Glasses can be a significant investment and for people looking to save money in a rocky economy are pulled by these offers. I want to address these ads and clarify what you are getting.

The adage goes that you get what you pay for and the same holds true in this case. Yes, you get glasses and free eye exam for $100 but that is all you are getting. You aren't told in these advertisements what you will not get.

First, these deals include standard plastic CR-39. This is a very cheap plastic that is good for a small range of prescriptions. The lens does not block UV and is subject to shattering. They are a very fragile lens and you run the risk of injury if the lenses shatter.

Second, it does not include premium treatments that can greatly enhance your vision and the functionality of the lenses. Crizal Avance with Scotchguard costs money but it makes the lenses super scratch resistant, easy to clean and reduces the glare that causes eye strain at the computer and while driving at night. Further, it improves the appearance of the glasses by allowing people to see your eyes instead of a reflection of the lens.

Third, the deal only include a very small range of prescriptions. If you have a moderate or high prescription you are not able to capitalize on this deal. Kids are another group that shouldn't be in CR-39 plastic for safety reasons.

Finally, I can't confirm this but have heard that staff is trained to up sell you. You come in expecting to spend $100 at your visit and end up spending much more by the time you leave. Surveys show that retail chains do not cost less than a private optometrist. The difference is only in perception, average retail price of equal lenses and technologies are on par with each other.

So, next time you see one of these commercials remember that you get what you pay for.

Thursday, May 6, 2010

What is myopia?

Myopia or nearsightedness is a condition where light comes into focus before it hits the back of the eye. This causes images to be blurry.
In order for you to see a clear image, light must come into focus and land on the retina while in focus. The cornea and lens refract or bends light


Myopia affects about to about 1/3 of people in the USA. In fact a recent study found that the percentage of nearsighted people has increased over the last 30 years. Nearsightedness affects men and women equally.

Signs and Symptoms

Myopia primarily affects distance vision. This can cause headaches and eye strain. Nearsighted people will often squint to see objects and signs. 


Nearsightedness has a genetic component and can run in families. Typically, myopia arises from the length of the eyeball outstretching the focusing elements in the eye. The change in myopia, or myopic creep, will slow and stop at maturity when a person is fully grown.


The most common forms of treatment for myopia is glasses or contacts. 
Other treatments include LASIK surgery, intacts or orthokeratology. These forms can offer a higher degree of freedom than glasses or contacts. There are some caveats in that these procedures cannot be done on everyone who is myopic. If you are interested in one of these, consult with us and we can tell you if you a good candidate or not.


A comprehensive eye exam including a refraction can help diagnose nearsightedness. Frequently, an optometrist will perform an objective measure of refraction using retinoscopy or an auto-refraction instrument. The actual prescription is then refined through subjective refraction.
A nearsighted prescription will appear on the prescription pad with a minus sign in front of the numbers. A larger number indicates a higher level of nearsightedness.


Early diagnosis and treatment is essential. Children suffering from nearsightedness can have problems participating in sports or reading the board in school. Further, measures to slow the progression of nearsightedness using orthokeratology are better utilized in the early stages.

Monday, May 3, 2010

A time not to treat

There are certain occasions when strabismus is not something that you treat. For instance a child with a large eye turn may be corrected with surgery. Now that the surgeon has corrected the cosmetic aspect the question should be asked concerning vision therapy. Vision therapy can be used to reduce suppression and improve alignment. However, in some cases if alignment is still too far off the patient may experience double vision that is hard to correct.

Many factors need to be taken into account when someone with an eye turn wants to improve their vision. It may not be in their best interest to have vision therapy treatment. Consult with your eye doctor or a vision therapist to discuss the best treatment plan.

Wednesday, April 28, 2010

Frames Gallery

Frames Gallery

A new video of some of our frames.

Thursday, April 22, 2010

Deadly sunglasses

Sunglasses without protection from the harmful UVA and UVB rays can be harmful to the eyes. Cheap sunglasses often do not block out the ultraviolet light that can cause damage to the retina. Cheap shades reduce the amount of visible light entering your eye, allowing you look without squinting. Furthermore, the pupil dilates to compensate for the decrease in ambient light. This can be very harmful for your eyes because you have opened up the window for UV light to enter the eye. In fact, being outside without sunglasses, causing your pupil to constrict and forcing you to squint is better for your eye health than wearing cheap sunglasses.
Be careful where you buy sunglasses, be sure that they block UVA and UVB. Also be wary of claims that they block UV light as there are not FDA regulations concerning UV blocking claims. Some sunglasses may have a sticker on them touting UV blockage but it is only partial UV protection. Cheap can be OK  but be careful, you only have one set of eyes and damage from the sun is permanent.

Friday, April 9, 2010

Orthokeratology is great for kids

One of the largest potential groups for orthokeratology (ortho-k, crt, corneal molding, vision reshaping treatment etc) is for kids. They are very active and growing. The growing part is one reason that Lasik is contraindicated in children. Their eyes, and prescription, change regularly. This can be a wasteful thing for a family who has invested $3K into their child to see good and only need glasses again the next year. Glasses or contacts can work but true functionality comes from ortho-k.

Ortho-k for children has at least two big advantages. One, they are free from glasses and contacts during the day. No glasses to lose, break or get in the way of sports. Two, it can slow the progression of myopia or nearsightedness. That way, when your child becomes an adult they have semi-functional vision without glasses instead of being legally blind without correction. Further, when and if Lasik is chosen later on there is much less treatment required because ortho-k has slowed the progression of myopia.

So, the next time you are into the eye doctor, ask about ortho-k for your child. Imagine the freedom you can achieve and the benefits that are reaped from this cool treatment.

Tuesday, April 6, 2010

Demand for Lasik decreasing

A recent report indicates that the demand for Lasik is on the decline. The economy could be one reason, or perhaps the increased popularity of orthokeratology is another reason for the low numbers.

Monday, April 5, 2010

Accommodation and Vergence

One of the troubles with 3D movies is that vergence and accommodation are linked together. This means that when you focus on something close it causes your eye to cross and vice-versa. So, when you are watching a 3D movie and you see something "close" and cross your eyes too look at it your eyes automatically focus. The problem is that the image is still projected in the distance so you are trying to focus up close on an object that is still in the distance. For a full discourse on the subject click here.

Thursday, April 1, 2010

E-readers may cause eye strain

With the advent of the i-pad and the coming of age of the Kindle e-reader the question is posed, "Which of these is easiest on the eyes." The technologies work differently. One uses a liquid crystal display with a back light, the other uses electrically charged inks to display in gray scale without the need for a back light. The kindle type are easier to see in brighter conditions much like paper. However, as the light dims, LCD's are easier to read due to the backlight.

The Wall Street Journal reports, "So far, there's little scientific evidence about which screens are better for the eyes. Ophthalmologists say there isn't really much of a difference between how the eye works with either e-paper or back-lit screens. Neither could damage the eye and neither flicker like old-fashioned TVs."

The bottom line is that either would work well for you and the choice should be made according to your lifestyle. For me, I like to read in bed at night. A laptop is a great place for me to read. I can turn the lights out and read for long periods with little difficulty.

Tuesday, March 30, 2010

Does fish oil come from snakes?

Snake oil is a term born from peddlers who announced amazing cures from stuff that didn't work. In a society where the FDA will only approve a drug that can prove, with double blind studies, that it works and doesn't harm  one would think that our days of snake oil salesman would be over.

However, the FDA does not regulate 'natural' ingredients. Herbs and fruits are not under the same scrutiny that pharmaceuticals are. Hence the rise of the neutraceutical generation. Gogi juice, noni juice, xango juice, vitamins, and minerals sold as cures and 'prevention to cures' for anything from cancer to diabetes. New antioxidant indexes have arose.

Fish oil is among these nutritional supplements that have been advocated as a beneficial part of a regular diet. Regular doses of fish oil are good for dry eye. Unlike other neutraceuticals, fish oil is the subject of numerous studies to quantify the benefits of fish oil. One such study suggested that fish oil was as effective as doxycyline for pre and post-op Lasik.

When deciding to add a supplement to your diet take into account the snake oil effect. Be wary of anecdotal evidence. Though testimonials may be true they also may not. It is difficult to measure cause and effect on one person or a small group of people. For a cool graphic outlining popular nutritional supplements and the amount of evidence available to support its claims.

Tuesday, March 16, 2010

Keratoconus and cross-linking

Keratoconus is a degenerative disease that tends to get worse over time. It is often seen in young males and those with Down's syndrome. Treatment for keratoconus usually starts with glasses then rigid contacts and eventually penetrating keratoplasty (PKP or cornea transplant). A new procedure is showing promise for use as a treatment for keratoconus.

Cornea cross-linking has been shown outside of the USA to help stabilize the keratoconus. In keratoconus the cornea (front-clear part of the eye) begins to weaken and bulge. What cross-linking does is increase the number of anchors that keep the cornea from bulging. The process is currently in FDA trials in the US but has been shown to be effective and safe in European studies.

Cross-linking may slow the progression of keratoconus (the bulging) and help reduce the number of cornea transplants that are required for this group of patients. This is a promising prospect as PKP is invasive, unpredictable and often the implant develops keratoconus also requiring additional transplant procedures every five to ten years.

Wednesday, March 10, 2010

Smoking increases the risk of macular degeneration

If you don't have enough reason's to stop smoking here is one more. It increases your risk of severe macular degeneration. Current smokers are four times as likely to develop the more serious form of the disease. Macular degeneration is one of the leading causes of blindness in the United States. The risk decreases a little for former smokers but still the risk remains. Further, a recent study indicates that the risk for former smokers may even be underestimated.

There are at least 13 studies that link smoking as a modifiable risk factor in developing macular degeneration. Quitting smoking does lower the risk of developing macular degeneration but only marginally and most of the effect is over the first few years. Also, of the vitamins that are shown to help decrease the risk of development, beta carotene cannot be taken by smokers due to increased risk of lung cancer.

If you are a smoker or thinking about taking it up I hope this gives you one more reason to save some money and lower your risk of a blinding disease.

Friday, February 26, 2010

A call for tender loving (vision) care

I want to share with you an experience. I was working for another company. They only had me there one day per week but wanted to get the most out of me. I was scheduled to see patients every half hour. That's not too bad if the doctor has support staff but I was doing all of the examination myself. Furthermore, if I had consented, they would have squeezed patients in tighter than that.

There's the facts now here's my beef. When a patient exam is rushed it becomes a lose-lose encounter. The patient loses quality of care. A fast exam loses quality: whether it is from cutting out exam elements or doing them so quickly that subtleties are easily missed. The patient also is left with little understanding of diagnosis and treatment because there is no time to properly explain. The practice then loses because rushed exams lead to a higher rate of prescription redos and missed opportunities for care; which is what the patient has hired us to do in the first place.

My philosophy? Slow down, do it right. Taking time means seeing fewer patients in a block of time but just like a good watch, quality pays for itself. A good quality exam leads to greater patient satisfaction leading to loyalty. Greater loyalty means less patient erosion and fewer redos. Clear View Eye Care strives hard to give each patient the best in vision care. This means taking time to get to know you, your needs and then examining carefully to be sure we have done our best to ensure healthy vision.

Tuesday, February 16, 2010

Don't wait till it's too late.

An ounce of prevention is worth a pound of cure. Is there an optometry analogy? Nothing catchy comes to mind but a good story does. I had a young patient come into my office who needed contacts. This man was a new adult and off to college. His mother asked me to stress healthy habits as he had a history of abusing his contact lenses. We discussed the need to replace his contacts according to the recommended schedule as, "Buying contact lenses is cheaper than dealing with an eye infection."

Three months passed and I get a from this young man needing my immediate attention. Severe conjunctivitis (pink eye) plagued him, a result of contact lens over wear. We managed to treat the eye infection but the treatment cost him double that of a year's supply of contacts.

The lesson? An ounce of prevention (buying your contacts) is worth a pound of cure (treating an eye infection). This practice is applicable to many aspects of eye care. Macular degeneration, Glaucoma, Diabetic Retinopathy and others are far easier to treat and prevent than they are to cure. A regular, vision exam on a yearly basis is your best line of defense.

Thursday, February 11, 2010

People who have strabismus (an eye turn) often manifest suppression. This means that the weaker eye will "turn off" or be ignored by the brain. It is a coping mechanism for when the turned eye would otherwise cause double vision. Now, the problem with this is when a surgeon or vision therapist corrects the positioning of the eyes there is no visual benefit if one eye is suppressed.

So what can be done? There are a number of techniques that can be implemented to correct suppression. First off, passive therapy can be used to stimulate the use of the weaker eye. The strong eye is patched, forcing the suppressing eye to work. In addition to passive therapy, active therapy, guided by an eye doctor can help treat suppression. Peripheral fusion is usually treated first working toward central vision as therapy continues.

When treating strabismus eliminating suppression is a first step to achieving healthy binocular vision. (Photo courtesy Mattox)

Thursday, January 28, 2010

Strabismus: Signs and Symptoms

When someone discovers strabismus it occurs in one of three ways:
(1) a person starts to have double vision
(2) no apparent double vision or eye turn but the patient experiences asthenopia (eye strain)
(3) poor vision which may or may not be associated with strabismus

Young children rarely complain of double vision. Rather parents can look for telltale behaviors that may be due to strabismus. Some of the signs that parents might see is their child turning their head, tilting or tipping it, or winking one eye excessively. Older children are more likely to complain of double vision.

Strabismus is treatable. Surgery can often help the eyes align but often vision therapy is needed to help both eyes work together in an efficient fashion.

Wednesday, January 27, 2010

Strabismus comes in various shapes and sizes

Strabismus or eye turn affects about 4% of children under 6. It can have cosmetic consequences and be the source of vision problems such as double vision and amblyopia (reduced vision). It typically caused by a muscle imbalance. It can come in a few varieties. It can be constant or intermittent, turned in or turned out.

The best treatment for strabismus depends on they type and degree of strabismus. Large, constant strabismus can be treated initially with surgery. Surgery can do a good job of repairing the cosmetic appearance but it may not completely solve the problems associated with it. Often, vision therapy is a necessary compliment to strabismus surgery.

Vision therapy can often address issues of double vision and stereopsis. It can train the eye muscles to align better and with better range.

Thursday, January 21, 2010

Technorati code

I'm adding this code so I can be listed on the technorati website. YG9HWUJUJR5W

Sunday, January 17, 2010

Diabetes is bad news for the eyes

On the front page of its Science Times section, the New York Times (6/16, D1, Rabin) reports, "Study after study suggests that alcohol in moderation may promote heart health and even ward off diabetes and dementia." In fact, the "evidence is so plentiful that some experts consider moderate drinking...a central component of a healthy lifestyle." But skepticism abounds because apparently no one has "ever proved a causal relationship between moderate drinking and lower risk of death -- only that the two often go together. It may be that moderate drinking is just something healthy people tend to do, not something that makes people healthy." There are also concerns about "the financial relationships that have sprung up between the alcoholic beverage industry and many academic centers, which have accepted industry money to pay for research, train students, and promote their findings." In light of these things, some are calling for "a large, long-term randomized controlled clinical trial, like the ones for new drugs." (courtesy AOA)

Friday, January 15, 2010

Ever had a 3D headache?

Watching 3D movies is an expanding market. Movies like Avatar are designed to take full advantage of our stereopsis (our ability to sense depth by the difference in image angle between the two eyes). There have, however, been some reports of side effects. Enter the 3D headache.

Slight muscle imbalances such as phorias can cause eye strain when watching a 3D movie. These muscle imbalances make it harder for the brain to process the stereo images. The images are calibrated differently in the real world and in 3D movies making it harder for people who's eyes are balanced differently.

People with amblyopia (an eye that cannot see 20/20) or strabismus (eye turn). May not be able to see 3D at all. Fortunately, in the real world there are many cues to depth that goes beyond stereopsis. These clues include overlap like one arm crossed over the other, atmospheric clues, our familiarity with the normal size of objects and others. These people may not be able to experience fish jumping out of the screen but they can still drive safely because of the many other cues to depth that exist.

Now, if you do get a headache watching 3D movies what can you do? Vision therapy is an option. Eye exercises designed to help your eyes work better together. Check out our website to learn more about vision therapy and happy movie watching.

Tuesday, January 12, 2010

Slowing myopia with bifocals

A recent study indicates that fitting myopic children with bifocals may slow the progression of the myopia. The National Eye Institute reported recently that the incidence of myopia is increasing. They found that in certain demographics that myopia increased 66%.

The study followed 135 children who had progressive myopia. The children were assigned to single vision, bifocals or bifocals with prism. What they found after two years was that the prismatic bifocal group were the slowest to progress.

This is a new promising development to the issue of progressive myopia. High myopia is related to increased risk of retinal detachment, glaucoma and cataracts. This not to mention the problem associated with being legally blind without correction.

The article does not mention the option of orthokeratology in treating myopic progression. There are numerous studies and increased evidence that ortho-k can slow myopic progression. The advantage of ortho-k over bifocals is the cosmetic advantage of  no correction during the day.

These developments are significant. Early treatment through ortho-k can prevent myopic progression to the point of severe dependence on correction.